Keyword: risk factors
9000 (1)
Pressure Ulcers Among Newly Admitted Nursing Home Residents: Measuring the Impact of Transferring From Hospital. Doupe, M., B., Day, S., McGregor, M., J., John, P., S., Chateau, D., Puchniak, J., Dik, N., & Sarkar, J. Medical care, 9000.
![Pressure Ulcers Among Newly Admitted Nursing Home Residents: Measuring the Impact of Transferring From Hospital [link]](https://bibbase.org/img/filetypes/link.svg "link")
Website abstract bibtex
Website abstract bibtex Objectives: Pressure ulcers (PUs) are reported more often among newly admitted nursing home (NH) residents who transfer from hospital versus community. We examine for whom this increased risk is greatest, further defining hospitalized patients most in need of better PU preventive care. Research Design: Retrospective observational cohort study. Subjects: All NH residents (N=5617) newly admitted between April 1, 2008 and March 31, 2012 in Winnipeg, MB, Canada. Measures: RAI-MDS 2.0 data were linked to administrative health care use files capturing each person's NH admission date, their presence of a PU at this time, whether they transferred into NH from hospital or community, and their PU susceptibility (eg, amount of help needed to maneuver in bed or to transfer from one surface to another, frequency of incontinence, presence of diabetes, amount of food consistently left uneaten). Log-binomial regression with interaction terms was used to analyze data. Results: 67.6% of our cohort transferred into a NH directly from hospital; 9.2% of these residents were reported to have a stage 1+ PU on NH admission versus 2.6% of those who transferred from community. From regression models, transferring from hospital versus community was associated with increased PU risk equally across various subgroups of less and more susceptible residents. Conclusions: Transferring from hospital versus community places both more and less susceptible newly admitted NH residents at increased PU risk. Using evidence-based preventive care practices is thus needed for all subgroups of hospital patients before NH use, to help reduce PU risk. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
@article{
title = {Pressure Ulcers Among Newly Admitted Nursing Home Residents: Measuring the Impact of Transferring From Hospital},
type = {article},
year = {9000},
identifiers = {[object Object]},
keywords = {hospitals,nursing homes,pressure ulcers,risk factors,transitions},
volume = {Publish Ah},
websites = {http://journals.lww.com/lww-medicalcare/Fulltext/publishahead/Pressure_Ulcers_Among_Newly_Admitted_Nursing_Home.98939.aspx},
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notes = {ID: 00005650-900000000-98939},
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private_publication = {false},
abstract = {Objectives: Pressure ulcers (PUs) are reported more often among newly admitted nursing home (NH) residents who transfer from hospital versus community. We examine for whom this increased risk is greatest, further defining hospitalized patients most in need of better PU preventive care. Research Design: Retrospective observational cohort study. Subjects: All NH residents (N=5617) newly admitted between April 1, 2008 and March 31, 2012 in Winnipeg, MB, Canada. Measures: RAI-MDS 2.0 data were linked to administrative health care use files capturing each person's NH admission date, their presence of a PU at this time, whether they transferred into NH from hospital or community, and their PU susceptibility (eg, amount of help needed to maneuver in bed or to transfer from one surface to another, frequency of incontinence, presence of diabetes, amount of food consistently left uneaten). Log-binomial regression with interaction terms was used to analyze data. Results: 67.6% of our cohort transferred into a NH directly from hospital; 9.2% of these residents were reported to have a stage 1+ PU on NH admission versus 2.6% of those who transferred from community. From regression models, transferring from hospital versus community was associated with increased PU risk equally across various subgroups of less and more susceptible residents. Conclusions: Transferring from hospital versus community places both more and less susceptible newly admitted NH residents at increased PU risk. Using evidence-based preventive care practices is thus needed for all subgroups of hospital patients before NH use, to help reduce PU risk. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.},
bibtype = {article},
author = {Doupe, Malcolm B and Day, Suzanne and McGregor, Margaret J and John, Philip St and Chateau, Dan and Puchniak, Joe and Dik, Natalia and Sarkar, Joykrishna},
journal = {Medical care}
}2018 (1)
Suicide on the Railways in Belgium: A Typology of Locations and Potential for Prevention. Strale, M., Krysinska, K., Van Overmeiren, G., & Andriessen, K. International Journal of Environmental Research and Public Health, 2018.
doi abstract bibtex
doi abstract bibtex
Suicide on railway networks comprises a serious public health problem. However, the geographical distribution and the environmental risk factors remain unclear. This study analyzed the geographic distribution of railway suicides in Belgium from 2008⁻2013 at the level of a railway section (average length of 3.5 km). Principal component analysis (PCA) identified three groups of correlations that helped explain the variance of railway suicide. The three groups are related to characteristics of urban spaces, psychiatric facilities, and railway traffic density. Based on the PCA results, the study found four types of railway sections. The density of railway suicide was average and low in the urban and rural/industrial sections, respectively. However, it was high in the suburban sections and the sections close to psychiatric facilities. As the geographical proximity of a psychiatric facility comprises a specific risk factor for suicide on railways, preventative measures should target these sections and establish collaborations with psychiatric facilities. The typology of locations found in this study constitutes crucial information for national and local suicide prevention on the Belgian railway network.
@article{strale_suicide_2018,
title = {Suicide on the {Railways} in {Belgium}: {A} {Typology} of {Locations} and {Potential} for {Prevention}},
volume = {15},
issn = {1660-4601},
shorttitle = {Suicide on the {Railways} in {Belgium}},
doi = {10.3390/ijerph15102074},
abstract = {Suicide on railway networks comprises a serious public health problem. However, the geographical distribution and the environmental risk factors remain unclear. This study analyzed the geographic distribution of railway suicides in Belgium from 2008⁻2013 at the level of a railway section (average length of 3.5 km). Principal component analysis (PCA) identified three groups of correlations that helped explain the variance of railway suicide. The three groups are related to characteristics of urban spaces, psychiatric facilities, and railway traffic density. Based on the PCA results, the study found four types of railway sections. The density of railway suicide was average and low in the urban and rural/industrial sections, respectively. However, it was high in the suburban sections and the sections close to psychiatric facilities. As the geographical proximity of a psychiatric facility comprises a specific risk factor for suicide on railways, preventative measures should target these sections and establish collaborations with psychiatric facilities. The typology of locations found in this study constitutes crucial information for national and local suicide prevention on the Belgian railway network.},
language = {eng},
number = {10},
journal = {International Journal of Environmental Research and Public Health},
author = {Strale, Mathieu and Krysinska, Karolina and Van Overmeiren, Gaëtan and Andriessen, Karl},
year = {2018},
pmid = {30248897},
pmcid = {PMC6209948},
keywords = {Belgium, Environment Design, Hospitals, Psychiatric, Humans, Principal Component Analysis, Railroads, Risk Factors, Rural Health, Suicide, Urban Health, geographical distribution, prevention, principal component analysis, psychiatric hospitals, railway, suicide}
}2017 (1)
Renal cell carcinoma. Hsieh, J. J., Purdue, M. P., Signoretti, S., Swanton, C., Albiges, L., Schmidinger, M., Heng, D. Y., Larkin, J., & Ficarra, V. Nature Reviews. Disease Primers, 3:17009, March, 2017.
doi abstract bibtex
doi abstract bibtex
Renal cell carcinoma (RCC) denotes cancer originated from the renal epithelium and accounts for \textgreater90% of cancers in the kidney. The disease encompasses \textgreater10 histological and molecular subtypes, of which clear cell RCC (ccRCC) is most common and accounts for most cancer-related deaths. Although somatic VHL mutations have been described for some time, more-recent cancer genomic studies have identified mutations in epigenetic regulatory genes and demonstrated marked intra-tumour heterogeneity, which could have prognostic, predictive and therapeutic relevance. Localized RCC can be successfully managed with surgery, whereas metastatic RCC is refractory to conventional chemotherapy. However, over the past decade, marked advances in the treatment of metastatic RCC have been made, with targeted agents including sorafenib, sunitinib, bevacizumab, pazopanib and axitinib, which inhibit vascular endothelial growth factor (VEGF) and its receptor (VEGFR), and everolimus and temsirolimus, which inhibit mechanistic target of rapamycin complex 1 (mTORC1), being approved. Since 2015, agents with additional targets aside from VEGFR have been approved, such as cabozantinib and lenvatinib; immunotherapies, such as nivolumab, have also been added to the armamentarium for metastatic RCC. Here, we provide an overview of the biology of RCC, with a focus on ccRCC, as well as updates to complement the current clinical guidelines and an outline of potential future directions for RCC research and therapy.
@article{hsieh_renal_2017,
title = {Renal cell carcinoma},
volume = {3},
issn = {2056-676X},
doi = {10.1038/nrdp.2017.9},
abstract = {Renal cell carcinoma (RCC) denotes cancer originated from the renal epithelium and accounts for {\textgreater}90\% of cancers in the kidney. The disease encompasses {\textgreater}10 histological and molecular subtypes, of which clear cell RCC (ccRCC) is most common and accounts for most cancer-related deaths. Although somatic VHL mutations have been described for some time, more-recent cancer genomic studies have identified mutations in epigenetic regulatory genes and demonstrated marked intra-tumour heterogeneity, which could have prognostic, predictive and therapeutic relevance. Localized RCC can be successfully managed with surgery, whereas metastatic RCC is refractory to conventional chemotherapy. However, over the past decade, marked advances in the treatment of metastatic RCC have been made, with targeted agents including sorafenib, sunitinib, bevacizumab, pazopanib and axitinib, which inhibit vascular endothelial growth factor (VEGF) and its receptor (VEGFR), and everolimus and temsirolimus, which inhibit mechanistic target of rapamycin complex 1 (mTORC1), being approved. Since 2015, agents with additional targets aside from VEGFR have been approved, such as cabozantinib and lenvatinib; immunotherapies, such as nivolumab, have also been added to the armamentarium for metastatic RCC. Here, we provide an overview of the biology of RCC, with a focus on ccRCC, as well as updates to complement the current clinical guidelines and an outline of potential future directions for RCC research and therapy.},
language = {eng},
journal = {Nature Reviews. Disease Primers},
author = {Hsieh, James J. and Purdue, Mark P. and Signoretti, Sabina and Swanton, Charles and Albiges, Laurence and Schmidinger, Manuela and Heng, Daniel Y. and Larkin, James and Ficarra, Vincenzo},
month = mar,
year = {2017},
pmid = {28276433},
pmcid = {PMC5936048},
keywords = {Bevacizumab, Carcinoma, Renal Cell, Humans, Imidazoles, Indazoles, Indoles, Kidney, Kidney Diseases, Niacinamide, Phenylurea Compounds, Pyrimidines, Pyrroles, Quality of Life, Risk Factors, Sulfonamides, Vascular Endothelial Growth Factor A},
pages = {17009},
}2016 (4)
Bloodstream infections caused by Escherichia coli producing AmpC β-lactamases: epidemiology and clinical features. Pascual, V., Alonso, N., Simó, M., Ortiz, G., Garcia, M. C., Xercavins, M., Rivera, A., Morera, M. A., Miró, E., Espejo, E., Navarro, F., Gurguí, M., Pérez, J., Rodríguez-Carballeira, M., Garau, J., & Calbo, E. European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of Clinical Microbiology, 35(12):1997–2003, 2016.
doi abstract bibtex
doi abstract bibtex
The aim of the study was to investigate the epidemiology and clinical features of bloodstream infections due to Escherichia coli producing AmpC β-lactamases (AmpC-Ec-BSI). In a multi-centre case-control study, all third-generation-cephalosporin-resistant Escherichia coli BSI (3GC-Ec-BSI) isolates were analysed. Acquired bla AmpC (bla ac-AmpC) detection was done by polymerase chain reaction (PCR) and sequencing. Chromosomal bla AmpC (bla c-AmpC) expression was quantified by real-time PCR. Cases were patients with AmpC-Ec-BSI. Controls were patients with cephalosporin-susceptible E. coli BSI, matched 1:1 by sex and age. Demographics, comorbidities, intrinsic and extrinsic risk factors for antimicrobial resistance, clinical presentation and outcomes were investigated. Among 841 E. coli BSI, 17 were caused by AmpC-Ec (2 %). Eleven isolates (58.8 %) had bla ac-AmpC and six were bla c-AmpC overproducers. The mean age of cases was 66.2 years and 71 % were men. Cases were more frequently healthcare-related (82 vs. 52 % controls, p \textless 0.05) and presented more intrinsic and extrinsic risk factors. At least one risk factor was present in 94.1 % of cases vs. 41.7 % of controls (p = 0.002). Severity and length of stay (LOS) were higher among cases (mean Pitt Score 2.6 vs. 0.38 in controls, p = 0.03; LOS 17.5 days vs. 6 in controls, p = 0.02). Inappropriate empirical therapy (IET) was administered to 70.6 % of cases and 23.5 % of controls (p \textless 0.003). No differences were found in terms of cure rate at the 14th day and mortality. Bloodstream infections due to AmpC-Ec (mostly plasmid-mediated) are infrequent in our area. AmpC-Ec-BSI affects mainly patients with intrinsic risk factors and those with previous antibiotic exposure. A high proportion received IET.
@article{pascual_bloodstream_2016,
title = {Bloodstream infections caused by {Escherichia} coli producing {AmpC} β-lactamases: epidemiology and clinical features},
volume = {35},
issn = {1435-4373},
shorttitle = {Bloodstream infections caused by {Escherichia} coli producing {AmpC} β-lactamases},
doi = {10.1007/s10096-016-2752-3},
abstract = {The aim of the study was to investigate the epidemiology and clinical features of bloodstream infections due to Escherichia coli producing AmpC β-lactamases (AmpC-Ec-BSI). In a multi-centre case-control study, all third-generation-cephalosporin-resistant Escherichia coli BSI (3GC-Ec-BSI) isolates were analysed. Acquired bla AmpC (bla ac-AmpC) detection was done by polymerase chain reaction (PCR) and sequencing. Chromosomal bla AmpC (bla c-AmpC) expression was quantified by real-time PCR. Cases were patients with AmpC-Ec-BSI. Controls were patients with cephalosporin-susceptible E. coli BSI, matched 1:1 by sex and age. Demographics, comorbidities, intrinsic and extrinsic risk factors for antimicrobial resistance, clinical presentation and outcomes were investigated. Among 841 E. coli BSI, 17 were caused by AmpC-Ec (2 \%). Eleven isolates (58.8 \%) had bla ac-AmpC and six were bla c-AmpC overproducers. The mean age of cases was 66.2 years and 71 \% were men. Cases were more frequently healthcare-related (82 vs. 52 \% controls, p {\textless} 0.05) and presented more intrinsic and extrinsic risk factors. At least one risk factor was present in 94.1 \% of cases vs. 41.7 \% of controls (p = 0.002). Severity and length of stay (LOS) were higher among cases (mean Pitt Score 2.6 vs. 0.38 in controls, p = 0.03; LOS 17.5 days vs. 6 in controls, p = 0.02). Inappropriate empirical therapy (IET) was administered to 70.6 \% of cases and 23.5 \% of controls (p {\textless} 0.003). No differences were found in terms of cure rate at the 14th day and mortality. Bloodstream infections due to AmpC-Ec (mostly plasmid-mediated) are infrequent in our area. AmpC-Ec-BSI affects mainly patients with intrinsic risk factors and those with previous antibiotic exposure. A high proportion received IET.},
language = {eng},
number = {12},
journal = {European Journal of Clinical Microbiology \& Infectious Diseases: Official Publication of the European Society of Clinical Microbiology},
author = {Pascual, V. and Alonso, N. and Simó, M. and Ortiz, G. and Garcia, M. C. and Xercavins, M. and Rivera, A. and Morera, M. A. and Miró, E. and Espejo, E. and Navarro, F. and Gurguí, M. and Pérez, J. and Rodríguez-Carballeira, M. and Garau, J. and Calbo, E.},
year = {2016},
pmid = {27549108},
keywords = {Adult, Age Distribution, Aged, Aged, 80 and over, Anti-Bacterial Agents, Bacteremia, Bacterial Proteins, Case-Control Studies, DNA, Bacterial, Escherichia coli, Escherichia coli Infections, Female, Humans, Length of Stay, Male, Middle Aged, Polymerase Chain Reaction, Risk Factors, Sequence Analysis, DNA, Severity of Illness Index, Treatment Outcome, beta-Lactamases},
pages = {1997--2003},
}Physical Activity Benefits the Skeleton of Children Genetically Predisposed to Lower Bone Density in Adulthood. Mitchell, J. A., Chesi, A., Elci, O., McCormack, S. E., Roy, S. M., Kalkwarf, H. J., Lappe, J. M., Gilsanz, V., Oberfield, S. E., Shepherd, J. A., Kelly, A., Grant, S. F., & Zemel, B. S. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 31(8):1504–1512, 2016.
doi abstract bibtex
doi abstract bibtex
Both genetics and physical activity (PA) contribute to bone mineral density (BMD), but it is unknown if the benefits of physical activity on childhood bone accretion depend on genetic risk. We, therefore, aimed to determine if PA influenced the effect of bone fragility genetic variants on BMD in childhood. Our sample comprised US children of European ancestry enrolled in the Bone Mineral Density in Childhood Study (N = 918, aged 5 to 19 years, and 52.4% female). We used a questionnaire to estimate hours per day spent in total, high-, and low-impact PA. We calculated a BMD genetic score (% BMD lowering alleles) using adult genome-wide association study (GWAS)-implicated BMD variants. We used dual-energy X-ray absorptiometry to estimate femoral neck, total hip, and spine areal-BMD and total body less head (TBLH) bone mineral content (BMC) Z-scores. The BMD genetic score was negatively associated with each bone Z-score (eg, TBLH-BMC: estimate = -0.03, p = 1.3 × 10(-6) ). Total PA was positively associated with bone Z-scores; these associations were driven by time spent in high-impact PA (eg, TBLH-BMC: estimate = 0.05, p = 4.0 × 10(-10) ) and were observed even for children with lower than average bone Z-scores. We found no evidence of PA-adult genetic score interactions (p interaction \textgreater 0.05) at any skeletal site, and there was no evidence of PA-genetic score-Tanner stage interactions at any skeletal site (p interaction \textgreater 0.05). However, exploratory analyses at the individual variant level revealed that PA statistically interacted with rs2887571 (ERC1/WNT5B) to influence TBLH-BMC in males (p interaction = 7.1 × 10(-5) ), where PA was associated with higher TBLH-BMC Z-score among the BMD-lowering allele carriers (rs2887571 AA homozygotes: estimate = 0.08 [95% CI 0.06, 0.11], p = 2.7 × 10(-9) ). In conclusion, the beneficial effect of PA on bone, especially high-impact PA, applies to the average child and those genetically predisposed to lower adult BMD (based on GWAS-implicated BMD variants). Independent replication of our exploratory individual variant findings is warranted. © 2016 American Society for Bone and Mineral Research.
@article{mitchell_physical_2016,
title = {Physical {Activity} {Benefits} the {Skeleton} of {Children} {Genetically} {Predisposed} to {Lower} {Bone} {Density} in {Adulthood}},
volume = {31},
issn = {1523-4681},
doi = {10.1002/jbmr.2872},
abstract = {Both genetics and physical activity (PA) contribute to bone mineral density (BMD), but it is unknown if the benefits of physical activity on childhood bone accretion depend on genetic risk. We, therefore, aimed to determine if PA influenced the effect of bone fragility genetic variants on BMD in childhood. Our sample comprised US children of European ancestry enrolled in the Bone Mineral Density in Childhood Study (N = 918, aged 5 to 19 years, and 52.4\% female). We used a questionnaire to estimate hours per day spent in total, high-, and low-impact PA. We calculated a BMD genetic score (\% BMD lowering alleles) using adult genome-wide association study (GWAS)-implicated BMD variants. We used dual-energy X-ray absorptiometry to estimate femoral neck, total hip, and spine areal-BMD and total body less head (TBLH) bone mineral content (BMC) Z-scores. The BMD genetic score was negatively associated with each bone Z-score (eg, TBLH-BMC: estimate = -0.03, p = 1.3 × 10(-6) ). Total PA was positively associated with bone Z-scores; these associations were driven by time spent in high-impact PA (eg, TBLH-BMC: estimate = 0.05, p = 4.0 × 10(-10) ) and were observed even for children with lower than average bone Z-scores. We found no evidence of PA-adult genetic score interactions (p interaction {\textgreater} 0.05) at any skeletal site, and there was no evidence of PA-genetic score-Tanner stage interactions at any skeletal site (p interaction {\textgreater} 0.05). However, exploratory analyses at the individual variant level revealed that PA statistically interacted with rs2887571 (ERC1/WNT5B) to influence TBLH-BMC in males (p interaction = 7.1 × 10(-5) ), where PA was associated with higher TBLH-BMC Z-score among the BMD-lowering allele carriers (rs2887571 AA homozygotes: estimate = 0.08 [95\% CI 0.06, 0.11], p = 2.7 × 10(-9) ). In conclusion, the beneficial effect of PA on bone, especially high-impact PA, applies to the average child and those genetically predisposed to lower adult BMD (based on GWAS-implicated BMD variants). Independent replication of our exploratory individual variant findings is warranted. © 2016 American Society for Bone and Mineral Research.},
language = {eng},
number = {8},
journal = {Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research},
author = {Mitchell, Jonathan A. and Chesi, Alessandra and Elci, Okan and McCormack, Shana E. and Roy, Sani M. and Kalkwarf, Heidi J. and Lappe, Joan M. and Gilsanz, Vicente and Oberfield, Sharon E. and Shepherd, John A. and Kelly, Andrea and Grant, Struan Fa and Zemel, Babette S.},
year = {2016},
pmid = {27172274},
pmcid = {PMC4970901},
keywords = {Adolescent, Adult, BONE MINERAL DENSITY, Bone Density, Bone and Bones, CHILDREN, Child, Cohort Studies, EXERCISE, Exercise, Female, GENETIC, Genetic Loci, Genetic Predisposition to Disease, Humans, Male, PHYSICAL ACTIVITY, Polymorphism, Single Nucleotide, Risk Factors},
pages = {1504--1512}
}Impact of healthcare reform on LGBT elders. Harley, D. A. In Harley, D. A. & Teaster, P. B., editors, Handbook of LGBT elders: An interdisciplinary approach to principles, practices, and policies, pages 375--389, Chapter xviii, 691 Pages. Springer Science + Business Media, New York, NY, 2016. DOI: 10.1007/978-3-319-03623-6_19
Paper abstract bibtex
Paper abstract bibtex The purpose of this chapter was to examine the impact of healthcare reform in the USA on LGBT elders, especially the Affordable Care Act (ACA). Attention is given to health disparities and coming out risk factors for LGBT elders, health systems challenges for LGBT elders, advantages and disadvantages of healthcare reform on LGBT elders, and future directions of healthcare reform in the USA. Where appropriate, discussion from an international perspective is included, especially Canada and the UK. It is not the intent of this chapter to endorse any point of view over the other or to be advisory about healthcare issues. The intent is to present multiple perspectives concerning the benefits and debates of healthcare reform on seniors, especially LGBT elders. (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: chapter)
@incollection{harley_impact_2016,
title = {Impact of healthcare reform on {LGBT} elders},
url = {http://uml.idm.oclc.org/login?url=https://search.proquest.com/docview/1862755097?accountid=14569},
abstract = {The purpose of this chapter was to examine the impact of healthcare reform in the USA on LGBT elders, especially the Affordable Care Act (ACA). Attention is given to health disparities and coming out risk factors for LGBT elders, health systems challenges for LGBT elders, advantages and disadvantages of healthcare reform on LGBT elders, and future directions of healthcare reform in the USA. Where appropriate, discussion from an international perspective is included, especially Canada and the UK. It is not the intent of this chapter to endorse any point of view over the other or to be advisory about healthcare issues. The intent is to present multiple perspectives concerning the benefits and debates of healthcare reform on seniors, especially LGBT elders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
(Source: chapter)},
language = {English},
booktitle = {Handbook of {LGBT} elders: {An} interdisciplinary approach to principles, practices, and policies},
publisher = {Springer Science + Business Media, New York, NY},
author = {Harley, Debra A.},
editor = {Harley, Debra A. and Teaster, Pamela B.},
year = {2016},
note = {DOI: 10.1007/978-3-319-03623-6\_19},
keywords = {3370:Health \& Mental Health Services, Adulthood (18 yrs \& older), Aged (65 yrs \& older), Aging, Cross Cultural Differences, Empirical Study, Female, Health Care Reform, Health Disparities, Healthcare reform, Human, LGBT elders' health, LGBT health disparities, Longitudinal Study, Male, Psychology: Professional \& Research, Quantitative Study, Retrospective Study, Risk Factors, Transgender, bookitem},
pages = {375--389, Chapter xviii, 691 Pages}
}Infections due to Carbapenem Resistant Enterobacteriaceae among Saudi Arabian Hospitalized Patients: A Matched Case-Control Study. Garbati, M A, Sakkijha, H, & Abushaheen, A BioMed research international, 2016(101600173):3961684, 2016. Garbati, M A. Section of Infectious Diseases, Medical Specialties Department, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia. Sakkijha, H. Pulmonary and Critical Care Medicine Department, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia. Abushaheen, A. Scientific Research and Publication Center, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia.
abstract bibtex
abstract bibtex
Background. We conducted this case-control study to determine the risk factors and treatment outcome of infections due to carbapenem resistant Enterobacteriaceae in our institution. Methods. This is a matched case-control study of patients with infection due to carbapenem resistant Enterobacteriaceae (CRE) and carbapenem susceptible Enterobacteriaceae (CSE), from Riyadh, Saudi Arabia, between March 2012 and December 2013. Results. During this period, 29 cases and 58 controls were studied. The mean ages of the cases (55.4 years) and controls (54.7 years) were similar (p = 0.065). Cases had higher mean Charlson comorbidity index (CCI) (3.1) than controls (1.9), p = 0.026. Several factors contributed to infection among the studied population. Prior uses of piperacillin-tazobactam, a carbapenem, a quinolone, and metronidazole were significantly associated with CRE infections. Nine of the cases died compared with 7 of the controls, p = 0.031. Mortality was associated with advanced age, the presence of comorbidities, ICU stay, and receipt of invasive procedures. Conclusions. Infections due to CRE resulted in a significantly increased mortality. Combination antibiotic therapy was associated with reduced mortality. Properly designed randomized controlled studies are required to better characterize these findings.
@article{garbati_infections_2016,
title = {Infections due to {Carbapenem} {Resistant} {Enterobacteriaceae} among {Saudi} {Arabian} {Hospitalized} {Patients}: {A} {Matched} {Case}-{Control} {Study}.},
volume = {2016},
issn = {2314-6141},
abstract = {Background. We conducted this case-control study to determine the risk factors and treatment outcome of infections due to carbapenem resistant Enterobacteriaceae in our institution. Methods. This is a matched case-control study of patients with infection due to carbapenem resistant Enterobacteriaceae (CRE) and carbapenem susceptible Enterobacteriaceae (CSE), from Riyadh, Saudi Arabia, between March 2012 and December 2013. Results. During this period, 29 cases and 58 controls were studied. The mean ages of the cases (55.4 years) and controls (54.7 years) were similar (p = 0.065). Cases had higher mean Charlson comorbidity index (CCI) (3.1) than controls (1.9), p = 0.026. Several factors contributed to infection among the studied population. Prior uses of piperacillin-tazobactam, a carbapenem, a quinolone, and metronidazole were significantly associated with CRE infections. Nine of the cases died compared with 7 of the controls, p = 0.031. Mortality was associated with advanced age, the presence of comorbidities, ICU stay, and receipt of invasive procedures. Conclusions. Infections due to CRE resulted in a significantly increased mortality. Combination antibiotic therapy was associated with reduced mortality. Properly designed randomized controlled studies are required to better characterize these findings.},
number = {101600173},
journal = {BioMed research international},
author = {Garbati, M A and Sakkijha, H and Abushaheen, A},
year = {2016},
note = {Garbati, M A. Section of Infectious Diseases, Medical Specialties Department, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia.
Sakkijha, H. Pulmonary and Critical Care Medicine Department, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia.
Abushaheen, A. Scientific Research and Publication Center, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia.},
keywords = {*Carbapenems/tu [Therapeutic Use], *Cross Infection/dt [Drug Therapy], *Cross Infection/mo [Mortality], *Drug Resistance, Bacterial, *Enterobacteriaceae Infections/dt [Drug Therapy], *Enterobacteriaceae Infections/mo [Mortality], Aged, 80 and over, Case-Control Studies, Cross Infection/mi [Microbiology], Enterobacteriaceae Infections/mi [Microbiology], Enterobacteriaceae/cl [Classification], Enterobacteriaceae/de [Drug Effects], Enterobacteriaceae/ip [Isolation \& Purification], Hospitalization/sn [Statistics \& Numerical Data], Humans, Risk Factors, Saudi Arabia/ep [Epidemiology], adolescent, adult, aged, female, incidence, male, middle aged, survival rate, treatment outcome, young adult},
pages = {3961684}
}2015 (8)
Comparing Humoral and Cellular Immune Response Against HBV Vaccine in Kidney Transplant Patients. Friedrich, P., Sattler, A., Muller, K., Nienen, M., Reinke, P., & Babel, N. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 15(12):3157--3165, December, 2015.
doi abstract bibtex
doi abstract bibtex
Host protection upon vaccination usually results from the complex interplay of humoral and cellular components of the immune system. Exploring hepatitis B surface antigen (HBsAg)-specific T cell responses and their correlation with humoral responses under immunosuppression, we analyzed 51 renal transplant recipients, differing in HBV vaccine-specific antibody titers (non [NRs]-, low [LRs]-, and high responders [HRs]) and in 22 healthy controls (HCs) in a cross-sectional study. HBsAg-specific T cells were analyzed by flow cytometry according to expression of activation markers CD40L and/or CD69, and the cytokines IFNgamma, IL-2, TNFalpha, and IL-17. No significant differences in responder rate and magnitude of HBsAg-specific T cell responses were found between HCs and HRs. Interestingly, HBsAg-specific Th-cells were also observed in 50% of humoral NRs. Frequencies of HBsAg-specific CD40L+ Th-cells were significantly higher in HRs compared to LRs (p = 0.009) and in LRs in comparison to NRs (p = 0.043). All but NRs showed a predominance of multi-potent HBsAg-specific TNFalpha+IL-2+ Th-cells. As expected, HBsAg-specific CD8(+) T cells were rarely found. In conclusion, mounting of hepatitis B vaccine-specific T cell responses is possible in kidney transplant recipients despite immunosuppression. Detection of HBV-specific Th-cells in a significant proportion of humoral NRs contributes to the current discussion on conferring immune protection by cellular memory in such patients.
@article{friedrich_comparing_2015,
title = {Comparing {Humoral} and {Cellular} {Immune} {Response} {Against} {HBV} {Vaccine} in {Kidney} {Transplant} {Patients}.},
volume = {15},
copyright = {(c) Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.},
issn = {1600-6143 1600-6135},
doi = {10.1111/ajt.13380},
abstract = {Host protection upon vaccination usually results from the complex interplay of humoral and cellular components of the immune system. Exploring hepatitis B surface antigen (HBsAg)-specific T cell responses and their correlation with humoral responses under immunosuppression, we analyzed 51 renal transplant recipients, differing in HBV vaccine-specific antibody titers (non [NRs]-, low [LRs]-, and high responders [HRs]) and in 22 healthy controls (HCs) in a cross-sectional study. HBsAg-specific T cells were analyzed by flow cytometry according to expression of activation markers CD40L and/or CD69, and the cytokines IFNgamma, IL-2, TNFalpha, and IL-17. No significant differences in responder rate and magnitude of HBsAg-specific T cell responses were found between HCs and HRs. Interestingly, HBsAg-specific Th-cells were also observed in 50\% of humoral NRs. Frequencies of HBsAg-specific CD40L+ Th-cells were significantly higher in HRs compared to LRs (p = 0.009) and in LRs in comparison to NRs (p = 0.043). All but NRs showed a predominance of multi-potent HBsAg-specific TNFalpha+IL-2+ Th-cells. As expected, HBsAg-specific CD8(+) T cells were rarely found. In conclusion, mounting of hepatitis B vaccine-specific T cell responses is possible in kidney transplant recipients despite immunosuppression. Detection of HBV-specific Th-cells in a significant proportion of humoral NRs contributes to the current discussion on conferring immune protection by cellular memory in such patients.},
language = {eng},
number = {12},
journal = {American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons},
author = {Friedrich, P. and Sattler, A. and Muller, K. and Nienen, M. and Reinke, P. and Babel, N.},
month = dec,
year = {2015},
pmid = {26137874},
keywords = {*Kidney Transplantation, B-Lymphocytes/immunology, Basic (laboratory) research/science, Case-Control Studies, Female, Flow Cytometry, Follow-Up Studies, Glomerular Filtration Rate, Graft Survival, Hepatitis B Surface Antigens/immunology, Hepatitis B Vaccines/*therapeutic use, Hepatitis B virus/*immunology, Hepatitis B/*immunology, Humans, Immunity, Cellular/*immunology, Immunity, Humoral/*immunology, Kidney Failure, Chronic/*immunology/surgery, Kidney Function Tests, Male, Middle Aged, Prognosis, Risk Factors, T cell biology, T-Lymphocytes, Regulatory/immunology, Th1 Cells/immunology, flow cytometry, immunobiology, immunosuppressant, infection and infectious agents, kidney transplantation/nephrology, vaccine, viral: hepatitis B},
pages = {3157--3165}
}Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments. Schnitker, L., M., Martin-Khan, M., Burkett, E., Brand, C., A., Beattie, E., R., Jones, R., N., Gray, L., C., & Panel, R., C., f., Q., C., o., O., P., E., C. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 22(3):273-284, by the Society for Academic Emergency Medicine, 3, 2015.
abstract bibtex
abstract bibtex
OBJECTIVES: The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs). METHODS: A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs; 3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set; and 4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria. RESULTS: At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed: 1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care; 2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care; 3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment; 4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors; and 5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment. CONCLUSIONS: This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.
@article{
title = {Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments},
type = {article},
year = {2015},
identifiers = {[object Object]},
keywords = {Aged,Caregivers,Cognition Disorders/therapy,Delirium/diagnosis,Emergency Service, Hospital/organization & adminis,Humans,Policy,Quality Indicators, Health Care,Quality of Health Care/organization & administrati,Risk Factors},
pages = {273-284},
volume = {22},
month = {3},
publisher = {by the Society for Academic Emergency Medicine},
city = {The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia.},
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notes = {CI: (c) 2015; JID: 9418450; CIN: Acad Emerg Med. 2015 Mar;22(3):362-4. PMID: 25716708; 2014/05/18 [received]; 2014/08/25 [revised]; 2014/10/09 [revised]; 2014/10/15 [accepted]; ppublish},
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abstract = {OBJECTIVES: The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs). METHODS: A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs; 3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set; and 4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria. RESULTS: At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed: 1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care; 2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care; 3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment; 4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors; and 5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment. CONCLUSIONS: This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.},
bibtype = {article},
author = {Schnitker, L M and Martin-Khan, M and Burkett, E and Brand, C A and Beattie, E R and Jones, R N and Gray, L C and Panel, Research Collaboration for Quality Care of Older Persons: Emergency Care},
journal = {Academic emergency medicine : official journal of the Society for Academic Emergency Medicine},
number = {3}
}Eosinophilic Laryngitis in Children with Aerodigestive Dysfunction. Yawn, R., Acra, S, Goudy, S., Flores, R, & Wootten, C. Otolaryngol Head Neck Surg, 153(1):124–129, July, 2015.
Paper doi abstract bibtex
Paper doi abstract bibtex OBJECTIVE: To describe the presence of laryngeal eosinophils and associated symptomatology in patients with aerodigestive dysfunction. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary pediatric referral center. SUBJECTS: Eighty-one consecutive pediatric patients referred to a multidisciplinary aerodigestive clinic with upper airway concerns. METHODS: Microlaryngoscopy and posterior arytenoid biopsy, flexible bronchoscopy, esophagogastroduodenoscopy and esophageal biopsy, and impedance probe testing were performed as indicated by clinical symptoms. Positive versus negative posterior arytenoid biopsy for eosinophils and the presence or absence of concomitant histopathological laryngitis and/or esophagitis were measured. RESULTS: Nine of 81 (11%) patients had positive laryngeal biopsy for eosinophils (range, 1-29 eosinophils/high-powered field [HPF]). Three of these 9 patients also had concurrent biopsy-proven eosinophilic esophagitis, while 8 of 81 total patients had biopsy-proven eosinophilic esophagitis. The frequency of biopsy-proven eosinophilic esophagitis was higher in patients with posterior arytenoid eosinophils versus patients without laryngeal eosinophils (33% versus 6.9%, P = .0408). CONCLUSIONS: Eosinophilic inflammation in the larynx has not been described in children with complex aerodigestive complaints. Posterior arytenoid eosinophils may serve as a marker of chronic laryngeal inflammation in children with aerodigestive dysfunction, although their exact role in this inflammation remains unclear. In our population, \textgreater15 eosinophils/HPF within posterior arytenoid biopsies was associated with concomitant eosinophilic esophagitis.
@article{yawn_eosinophilic_2015,
title = {Eosinophilic {Laryngitis} in {Children} with {Aerodigestive} {Dysfunction}.},
volume = {153},
url = {https://www.ncbi.nlm.nih.gov/pubmed/25820587},
doi = {10.1177/0194599815577568},
abstract = {OBJECTIVE: To describe the presence of laryngeal eosinophils and associated symptomatology in patients with aerodigestive dysfunction. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary pediatric referral center. SUBJECTS: Eighty-one consecutive pediatric patients referred to a multidisciplinary aerodigestive clinic with upper airway concerns. METHODS: Microlaryngoscopy and posterior arytenoid biopsy, flexible bronchoscopy, esophagogastroduodenoscopy and esophageal biopsy, and impedance probe testing were performed as indicated by clinical symptoms. Positive versus negative posterior arytenoid biopsy for eosinophils and the presence or absence of concomitant histopathological laryngitis and/or esophagitis were measured. RESULTS: Nine of 81 (11\%) patients had positive laryngeal biopsy for eosinophils (range, 1-29 eosinophils/high-powered field [HPF]). Three of these 9 patients also had concurrent biopsy-proven eosinophilic esophagitis, while 8 of 81 total patients had biopsy-proven eosinophilic esophagitis. The frequency of biopsy-proven eosinophilic esophagitis was higher in patients with posterior arytenoid eosinophils versus patients without laryngeal eosinophils (33\% versus 6.9\%, P = .0408). CONCLUSIONS: Eosinophilic inflammation in the larynx has not been described in children with complex aerodigestive complaints. Posterior arytenoid eosinophils may serve as a marker of chronic laryngeal inflammation in children with aerodigestive dysfunction, although their exact role in this inflammation remains unclear. In our population, {\textgreater}15 eosinophils/HPF within posterior arytenoid biopsies was associated with concomitant eosinophilic esophagitis.},
language = {eng},
number = {1},
journal = {Otolaryngol Head Neck Surg},
author = {Yawn, RJ and Acra, S and Goudy, SL and Flores, R and Wootten, CT},
month = jul,
year = {2015},
keywords = {Risk Factors},
pages = {124--129}
}Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011. Mezuk, B., Lohman, M., Leslie, M., & Powell, V. American Journal of Public Health, 105(7):1495-1502, 7, 2015.
abstract bibtex
abstract bibtex
OBJECTIVES: We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. METHODS: Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. RESULTS: Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. CONCLUSIONS: LTC may be an important point of engagement in suicide prevention.
@article{
title = {Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011},
type = {article},
year = {2015},
identifiers = {[object Object]},
keywords = {Aged,Assisted Living Facilities/statistics & numerical,Female,Humans,Logistic Models,Long-Term Care/psychology/statistics & numerical d,Male,Middle Aged,Nursing Homes/statistics & numerical data,Risk Factors,Suicide/psychology/statistics & numerical data,Virginia/epidemiology},
pages = {1495-1502},
volume = {105},
month = {7},
city = {At the time of the study, Briana Mezuk and Matthew Lohman were with the Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond. Briana Mezuk is also with the Institute for Social Research,},
id = {7c70a992-e923-387b-a4fe-d1dc15aa907d},
created = {2016-08-20T16:52:23.000Z},
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read = {false},
starred = {false},
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confirmed = {true},
hidden = {false},
source_type = {JOUR},
notes = {LR: 20150701; GR: F31 AG044974/AG/NIA NIH HHS/United States; GR: F31-AG044974/AG/NIA NIH HHS/United States; GR: K01 MH093642/MH/NIMH NIH HHS/United States; GR: K01-MH093642/MH/NIMH NIH HHS/United States; GR: U17/CCU322391/PHS HHS/United States; GR: U17/CE001315/CE/NCIPC CDC HHS/United States; JID: 1254074; NIHMS698999; OID: NLM: NIHMS698999; OID: NLM: PMC4463392; 2015/05/14 [aheadofprint]; ppublish},
folder_uuids = {cdbb2de4-6c81-48cd-8385-a5b97ccb22f4},
private_publication = {false},
abstract = {OBJECTIVES: We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. METHODS: Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. RESULTS: Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. CONCLUSIONS: LTC may be an important point of engagement in suicide prevention.},
bibtype = {article},
author = {Mezuk, B and Lohman, M and Leslie, M and Powell, V},
journal = {American Journal of Public Health},
number = {7}
}Linking smoking, coffee, urate, and Parkinson's disease-a role for gut microbiota?. Scheperjans, F., Pekkonen, E., Kaakkola, S., & Auvinen, P. Journal of Parkinson's Disease, 5(2):255-262, 2015.
![Linking smoking, coffee, urate, and Parkinson's disease-a role for gut microbiota? [pdf]](https://bibbase.org/img/filetypes/pdf.svg "pdf")
Paper abstract bibtex
Paper abstract bibtex While the etiology and pathogenesis of Parkinson's disease (PD) is still obscure, there is evidence for lifestyle factors influencing disease risk. Best established are the inverse associations with smoking and coffee consumption. In other contexts there is evidence that health effects of lifestyle factors may depend on gut microbiome composition. Considering the gastrointestinal involvement in PD, it was recently speculated, that the associations between smoking, coffee, and PD risk could be mediated by gut microbiota. Here we review such a possible mediatory role of gut microbiota taking into account recent findings on microbiome composition in PD and extending the scope also to urate.
@article{
title = {Linking smoking, coffee, urate, and Parkinson's disease-a role for gut microbiota?},
type = {article},
year = {2015},
identifiers = {[object Object]},
keywords = {Gut-brain axis,caffeine,constipation,dietary fiber,gut motility,gut permeability,inflammation,nicotine,non-motor symptoms,risk factors},
pages = {255-262},
volume = {5},
id = {cc440533-14b4-3420-9dea-51394018e969},
created = {2017-03-10T13:56:13.000Z},
file_attached = {true},
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authored = {false},
confirmed = {true},
hidden = {false},
folder_uuids = {828769d4-4165-4191-b8d1-200c6367a61f},
abstract = {While the etiology and pathogenesis of Parkinson's disease (PD) is still obscure, there is evidence for lifestyle factors influencing disease risk. Best established are the inverse associations with smoking and coffee consumption. In other contexts there is evidence that health effects of lifestyle factors may depend on gut microbiome composition. Considering the gastrointestinal involvement in PD, it was recently speculated, that the associations between smoking, coffee, and PD risk could be mediated by gut microbiota. Here we review such a possible mediatory role of gut microbiota taking into account recent findings on microbiome composition in PD and extending the scope also to urate.},
bibtype = {article},
author = {Scheperjans, Filip and Pekkonen, Eero and Kaakkola, Seppo and Auvinen, Petri},
journal = {Journal of Parkinson's Disease},
number = {2}
}Different risk factor profiles distinguish early-onset from late-onset. Schachtner, T., Babel, N., & Reinke, P. Transplant international : official journal of the European Society for Organ Transplantation, 28(9):1081--1091, September, 2015.
doi abstract bibtex
doi abstract bibtex
Two of three reactivations of latent BKV-infection occur within the first 6 months after renal transplantation. However, a clear differentiation between early-onset and late-onset BKV-replication is lacking. Here, we studied all kidney transplant recipients (KTRs) at our single transplant center between 2004 and 2012. A total of 103 of 862 KTRs were diagnosed with BK viremia (11.9%), among which 24 KTRs (2.8%) showed progression to BKV-associated nephropathy (BKVN). Sixty-seven KTRs with early-onset BKV-replication (65%) and 36 KTRs with late-onset BKV-replication (35%) were identified. A control group of 598 KTRs without BKV-replication was used for comparison. Lymphocyte-depleting induction,
@article{schachtner_different_2015,
title = {Different risk factor profiles distinguish early-onset from late-onset},
volume = {28},
copyright = {(c) 2015 Steunstichting ESOT.},
issn = {1432-2277 0934-0874},
doi = {10.1111/tri.12601},
abstract = {Two of three reactivations of latent BKV-infection occur within the first 6 months after renal transplantation. However, a clear differentiation between early-onset and late-onset BKV-replication is lacking. Here, we studied all kidney transplant recipients (KTRs) at our single transplant center between 2004 and 2012. A total of 103 of 862 KTRs were diagnosed with BK viremia (11.9\%), among which 24 KTRs (2.8\%) showed progression to BKV-associated nephropathy (BKVN). Sixty-seven KTRs with early-onset BKV-replication (65\%) and 36 KTRs with late-onset BKV-replication (35\%) were identified. A control group of 598 KTRs without BKV-replication was used for comparison. Lymphocyte-depleting induction,},
language = {eng},
number = {9},
journal = {Transplant international : official journal of the European Society for Organ Transplantation},
author = {Schachtner, Thomas and Babel, Nina and Reinke, Petra},
month = sep,
year = {2015},
pmid = {25959355},
keywords = {Adolescent, Adult, Aged, BK Virus, BK polyomavirus, CMV, Creatinine/blood, Disease Progression, Female, Graft Rejection, Humans, Immunosuppression, Immunosuppressive Agents/therapeutic use, Inflammation, Kidney Transplantation/*adverse effects, Male, Middle Aged, Polymerase Chain Reaction, Polyomavirus Infections/etiology, Renal Insufficiency/complications/*surgery, Retrospective Studies, Risk Factors, Treatment Outcome, Virus Replication, Young Adult, renal transplantation},
pages = {1081--1091}
}Patient characteristics and predictors of mortality associated with pericardial decompression syndrome: a comprehensive analysis of published cases. Pradhan, R., Okabe, T., Yoshida, K., Angouras, D. C., DeCaro, M. V., & Marhefka, G. D. European Heart Journal. Acute Cardiovascular Care, 4(2):113--120, April, 2015.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Pericardial decompression syndrome (PDS) is a rare and potentially fatal complication of pericardial drainage, either by needle pericardiocentesis or surgical pericardiostomy. It manifests with paradoxical hemodynamic deterioration and/or pulmonary edema, commonly associated with ventricular dysfunction. We sought to elucidate factors associated with mortality in PDS. METHODS: MEDLINE was systematically searched for PDS case reports and case series published between 1983 and 2013. For this analysis, clinical variables, echocardiographic and hemodynamic variables, details of drainage procedure and clinical outcomes were collected for each case. RESULTS: A total of 35 cases (12 male, 23 female) were identified. PDS developed after pericardiocentesis, pericardiostomy, or both, in 18, 16, and one patients, respectively. Cardiac tamponade was the indication in 33 cases (94%). The mean age was 47 ± 17 years. The mean amount of effusion drained was 888 mL. The minimum amount of effusion drained was 450 mL. The onset of PDS after the procedure varied widely, ranging from 'immediate' to 48 hours. Presentations included 10 (29%) with cardiogenic pulmonary edema without shock, 14 (40%) with left ventricular failure, three (9%) with right ventricular failure, seven (20%) with biventricular failure, and one (3%) with non-cardiogenic pulmonary edema. Ten patients (29%) died of PDS. Mortality was associated only with surgical drainage (p\textless0.001). Severe LV dysfunction normalized in PDS survivors. CONCLUSIONS: PDS is a rare complication of pericardial drainage with a high mortality rate. Surgical pericardiostomy was associated with mortality in PDS.
@article{pradhan_patient_2015,
title = {Patient characteristics and predictors of mortality associated with pericardial decompression syndrome: a comprehensive analysis of published cases},
volume = {4},
issn = {2048-8734},
shorttitle = {Patient characteristics and predictors of mortality associated with pericardial decompression syndrome},
doi = {10.1177/2048872614547975},
abstract = {BACKGROUND: Pericardial decompression syndrome (PDS) is a rare and potentially fatal complication of pericardial drainage, either by needle pericardiocentesis or surgical pericardiostomy. It manifests with paradoxical hemodynamic deterioration and/or pulmonary edema, commonly associated with ventricular dysfunction. We sought to elucidate factors associated with mortality in PDS.
METHODS: MEDLINE was systematically searched for PDS case reports and case series published between 1983 and 2013. For this analysis, clinical variables, echocardiographic and hemodynamic variables, details of drainage procedure and clinical outcomes were collected for each case.
RESULTS: A total of 35 cases (12 male, 23 female) were identified. PDS developed after pericardiocentesis, pericardiostomy, or both, in 18, 16, and one patients, respectively. Cardiac tamponade was the indication in 33 cases (94\%). The mean age was 47 ± 17 years. The mean amount of effusion drained was 888 mL. The minimum amount of effusion drained was 450 mL. The onset of PDS after the procedure varied widely, ranging from 'immediate' to 48 hours. Presentations included 10 (29\%) with cardiogenic pulmonary edema without shock, 14 (40\%) with left ventricular failure, three (9\%) with right ventricular failure, seven (20\%) with biventricular failure, and one (3\%) with non-cardiogenic pulmonary edema. Ten patients (29\%) died of PDS. Mortality was associated only with surgical drainage (p{\textless}0.001). Severe LV dysfunction normalized in PDS survivors.
CONCLUSIONS: PDS is a rare complication of pericardial drainage with a high mortality rate. Surgical pericardiostomy was associated with mortality in PDS.},
language = {eng},
number = {2},
journal = {European Heart Journal. Acute Cardiovascular Care},
author = {Pradhan, Rajesh and Okabe, Toshimasa and Yoshida, Kazuki and Angouras, Dimitrios C. and DeCaro, Matthew V. and Marhefka, Gregary D.},
month = apr,
year = {2015},
pmid = {25178691},
keywords = {Cardiac Tamponade, Echocardiography, Transesophageal, Evidence-Based Medicine, Humans, Leukemia, Myeloid, Acute, Pericardial Effusion, Pericardial Window Techniques, Pericardiocentesis, Predictive Value of Tests, Risk Factors, Sensitivity and Specificity, Syndrome, Treatment Outcome, Ultrasonography, Interventional, pericardial decompression syndrome, pericardiostomy},
pages = {113--120}
}The effect of change in body mass index on volumetric measures of mammographic density. Hart, V., Reeves, K. W., Sturgeon, S. R., Reich, N. G., Sievert, L. L., Kerlikowske, K., Ma, L., Shepherd, J., Tice, J. A., Mahmoudzadeh, A. P., Malkov, S., & Sprague, B. L. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 24(11):1724–1730, November, 2015.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Understanding how changes in body mass index (BMI) relate to changes in mammographic density is necessary to evaluate adjustment for BMI gain/loss in studies of change in density and breast cancer risk. Increase in BMI has been associated with a decrease in percent density, but the effect on change in absolute dense area or volume is unclear. METHODS: We examined the association between change in BMI and change in volumetric breast density among 24,556 women in the San Francisco Mammography Registry from 2007 to 2013. Height and weight were self-reported at the time of mammography. Breast density was assessed using single x-ray absorptiometry measurements. Cross-sectional and longitudinal associations between BMI and dense volume (DV), non-dense volume (NDV), and percent dense volume (PDV) were assessed using multivariable linear regression models, adjusted for demographics, risk factors, and reproductive history. RESULTS: In cross-sectional analysis, BMI was positively associated with DV [β, 2.95 cm(3); 95% confidence interval (CI), 2.69-3.21] and inversely associated with PDV (β, -2.03%; 95% CI, -2.09, -1.98). In contrast, increasing BMI was longitudinally associated with a decrease in both DV (β, -1.01 cm(3); 95% CI, -1.59, -0.42) and PDV (β, -1.17%; 95% CI, -1.31, -1.04). These findings were consistent for both pre- and postmenopausal women. CONCLUSION: Our findings support an inverse association between change in BMI and change in PDV. The association between increasing BMI and decreasing DV requires confirmation. IMPACT: Longitudinal studies of PDV and breast cancer risk, or those using PDV as an indicator of breast cancer risk, should evaluate adjustment for change in BMI.
@article{hart_effect_2015,
title = {The effect of change in body mass index on volumetric measures of mammographic density},
volume = {24},
issn = {1538-7755},
doi = {10.1158/1055-9965.EPI-15-0330},
abstract = {BACKGROUND: Understanding how changes in body mass index (BMI) relate to changes in mammographic density is necessary to evaluate adjustment for BMI gain/loss in studies of change in density and breast cancer risk. Increase in BMI has been associated with a decrease in percent density, but the effect on change in absolute dense area or volume is unclear.
METHODS: We examined the association between change in BMI and change in volumetric breast density among 24,556 women in the San Francisco Mammography Registry from 2007 to 2013. Height and weight were self-reported at the time of mammography. Breast density was assessed using single x-ray absorptiometry measurements. Cross-sectional and longitudinal associations between BMI and dense volume (DV), non-dense volume (NDV), and percent dense volume (PDV) were assessed using multivariable linear regression models, adjusted for demographics, risk factors, and reproductive history.
RESULTS: In cross-sectional analysis, BMI was positively associated with DV [β, 2.95 cm(3); 95\% confidence interval (CI), 2.69-3.21] and inversely associated with PDV (β, -2.03\%; 95\% CI, -2.09, -1.98). In contrast, increasing BMI was longitudinally associated with a decrease in both DV (β, -1.01 cm(3); 95\% CI, -1.59, -0.42) and PDV (β, -1.17\%; 95\% CI, -1.31, -1.04). These findings were consistent for both pre- and postmenopausal women.
CONCLUSION: Our findings support an inverse association between change in BMI and change in PDV. The association between increasing BMI and decreasing DV requires confirmation.
IMPACT: Longitudinal studies of PDV and breast cancer risk, or those using PDV as an indicator of breast cancer risk, should evaluate adjustment for change in BMI.},
language = {eng},
number = {11},
journal = {Cancer Epidemiology, Biomarkers \& Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology},
author = {Hart, Vicki and Reeves, Katherine W. and Sturgeon, Susan R. and Reich, Nicholas G. and Sievert, Lynnette Leidy and Kerlikowske, Karla and Ma, Lin and Shepherd, John and Tice, Jeffrey A. and Mahmoudzadeh, Amir Pasha and Malkov, Serghei and Sprague, Brian L.},
month = nov,
year = {2015},
pmid = {26315554},
pmcid = {PMC4633314},
keywords = {Body Mass Index, Breast, Breast Density, Breast Neoplasms, Cross-Sectional Studies, Female, Humans, Linear Models, Longitudinal Studies, Mammary Glands, Human, Mammography, Middle Aged, Risk Factors},
pages = {1724--1730}
}2014 (4)
Inflammatory activation and recovering BKV-specific immunity correlate with self-limited BKV replication after renal transplantation. Schachtner, T., Stein, M., Sefrin, A., Babel, N., & Reinke, P. Transplant International, 27(3):290--301, March, 2014.
Paper doi bibtex
Paper doi bibtex @article{schachtner_inflammatory_2014,
title = {Inflammatory activation and recovering {BKV}-specific immunity correlate with self-limited {BKV} replication after renal transplantation},
volume = {27},
issn = {09340874},
url = {http://doi.wiley.com/10.1111/tri.12251},
doi = {10.1111/tri.12251},
language = {en},
number = {3},
urldate = {2017-02-01TZ},
journal = {Transplant International},
author = {Schachtner, Thomas and Stein, Maik and Sefrin, Anett and Babel, Nina and Reinke, Petra},
month = mar,
year = {2014},
keywords = {Adult, Aged, Antibodies, Viral/blood, Antigens, Viral, BK Virus/immunology/*pathogenicity/physiology, BKV replication, Chemokine CXCL10/blood, ELISPOT, Female, Humans, IP-10, Intercellular Adhesion Molecule-1/blood, Interferon-gamma/biosynthesis, Kidney Transplantation/*adverse effects, Male, Middle Aged, Nephritis/etiology/immunology, Polyomavirus Infections/etiology/immunology, Prospective Studies, Renal transplantation, Risk Factors, T cells, T-Lymphocytes/immunology, Transplantation Immunology, Tumor Virus Infections/etiology/immunology, Vascular Cell Adhesion Molecule-1/blood, Virus Activation/immunology, Virus Replication/immunology},
pages = {290--301}
}Birthweight and the risk of atopic diseases: the ISAAC Phase III study. Mitchell, E., A., Clayton, T., García-Marcos, L., Pearce, N., Foliaki, S., & Wong, G. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 25(3):264-270, 2014.
Paper abstract bibtex
Paper abstract bibtex BACKGROUND: The association between birthweight and asthma, eczema and rhinoconjunctivitisis conflicting. AIMS: To examine the association between birthweight and symptoms of asthma, eczema and rhinoconjunctivitis. METHODS: Parents or guardians of children aged 6–7 yr completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including birthweight. RESULTS: There were 162,324 children from 60 centres in 26 countries. Low birthweight(<2.5 kg) was associated with an increased risk of symptoms of asthma (current wheeze odds ratio = 1.20; 95% confidence interval = 1.12–1.30). Low birthweight was associated with a lower risk of eczema ever. Low birthweight was not associated with rhinoconjunctivitis. Large babies (birthweight ≥4.5 kg) were not associated with any of these outcomes. CONCLUSIONS: This study has confirmed that low birthweight is a risk factor for symptoms of asthma, but not for rhinoconjunctivitis. The findings for eczema are equivocal.
@article{
title = {Birthweight and the risk of atopic diseases: the ISAAC Phase III study},
type = {article},
year = {2014},
identifiers = {[object Object]},
keywords = {asthma,eczema,isaac,low birthweight,rhinoconjunctivitis,risk factors},
pages = {264-270},
volume = {25},
id = {7256ddc4-fce3-33d5-9d19-cc5d2a9a7a17},
created = {2017-12-18T01:47:09.310Z},
file_attached = {true},
profile_id = {6c9edcaf-81dc-3357-bb56-dee7616baa0c},
group_id = {ac4e17e4-c387-3e1e-aa52-1ae5d129a0ef},
last_modified = {2018-01-14T20:35:42.609Z},
read = {true},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
private_publication = {false},
abstract = {BACKGROUND: The association between birthweight and asthma, eczema and rhinoconjunctivitisis conflicting. AIMS: To examine the association between birthweight and symptoms of asthma, eczema and rhinoconjunctivitis. METHODS: Parents or guardians of children aged 6–7 yr completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including birthweight. RESULTS: There were 162,324 children from 60 centres in 26 countries. Low birthweight(<2.5 kg) was associated with an increased risk of symptoms of asthma (current wheeze odds ratio = 1.20; 95% confidence interval = 1.12–1.30). Low birthweight was associated with a lower risk of eczema ever. Low birthweight was not associated with rhinoconjunctivitis. Large babies (birthweight ≥4.5 kg) were not associated with any of these outcomes. CONCLUSIONS: This study has confirmed that low birthweight is a risk factor for symptoms of asthma, but not for rhinoconjunctivitis. The findings for eczema are equivocal.},
bibtype = {article},
author = {Mitchell, Edwin A. and Clayton, Tadd and García-Marcos, Luis and Pearce, Neil and Foliaki, Sunia and Wong, Gary},
journal = {Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology},
number = {3}
}Influenza and coronary artery disease: exploring a clinical association with myocardial infarction and analyzing the utility of vaccination in prevention of myocardial infarction. Hebsur, S., Vakil, E., Oetgen, W. J., Kumar, P. N., & Lazarous, D. F. Reviews in Cardiovascular Medicine, 15(2):168--175, 2014.
abstract bibtex
abstract bibtex
Both coronary artery disease and influenza outbreaks contribute significantly to worldwide morbidity and mortality. An increasing number of epidemiologic studies have concluded that a temporal association exists between acute viral illnesses and myocardial infarction. Viral illnesses such as influenza can cause or exacerbate coronary atherosclerosis by activating inflammatory pathways. Data from a large case-controlled trial and two randomized controlled trials suggest that influenza vaccination in patients with coronary artery disease may lead to a decrease in incidence, morbidity, and mortality from acute myocardial infarction. A meta-analysis of the two randomized controlled trials for cardiovascular death demonstrated a pooled relative risk of 0.39 (95% confidence interval, 0.20-0.77) for patients who received the influenza vaccine compared with placebo.
@article{ hebsur_influenza_2014,
title = {Influenza and coronary artery disease: exploring a clinical association with myocardial infarction and analyzing the utility of vaccination in prevention of myocardial infarction},
volume = {15},
issn = {1530-6550},
shorttitle = {Influenza and coronary artery disease},
abstract = {Both coronary artery disease and influenza outbreaks contribute significantly to worldwide morbidity and mortality. An increasing number of epidemiologic studies have concluded that a temporal association exists between acute viral illnesses and myocardial infarction. Viral illnesses such as influenza can cause or exacerbate coronary atherosclerosis by activating inflammatory pathways. Data from a large case-controlled trial and two randomized controlled trials suggest that influenza vaccination in patients with coronary artery disease may lead to a decrease in incidence, morbidity, and mortality from acute myocardial infarction. A meta-analysis of the two randomized controlled trials for cardiovascular death demonstrated a pooled relative risk of 0.39 (95% confidence interval, 0.20-0.77) for patients who received the influenza vaccine compared with placebo.},
language = {eng},
number = {2},
journal = {Reviews in Cardiovascular Medicine},
author = {Hebsur, Shrinivas and Vakil, Erik and Oetgen, William J. and Kumar, Princy N. and Lazarous, Daisy F.},
year = {2014},
pmid = {25051134},
keywords = {Humans, Inflammation, Influenza Vaccines, Influenza, Human, Myocardial Infarction, Prognosis, Risk Factors, Vaccination},
pages = {168--175}
}Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery: analyses of a National US Hospital Discharge Database. Kozhimannil, K. B., Arcaya, M. C., & Subramanian, S. V. PLoS medicine, 11(10):e1001745, October, 2014.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. METHODS AND FINDINGS: Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project–a 20% sample of US hospitals–we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. CONCLUSIONS: Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight the need for more comprehensive or linked data including parity and gestational age as well as examination of other factors-such as hospital policies, practices, and culture–in determining cesarean section use. Please see later in the article for the Editors' Summary.
@article{kozhimannil_maternal_2014,
title = {Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery: analyses of a {National} {US} {Hospital} {Discharge} {Database}},
volume = {11},
issn = {1549-1676},
shorttitle = {Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery},
doi = {10.1371/journal.pmed.1001745},
abstract = {BACKGROUND: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses.
METHODS AND FINDINGS: Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project--a 20\% sample of US hospitals--we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0\% (95\% confidence interval 22.0\% to 22.1\%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95\% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95\% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age.
CONCLUSIONS: Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight the need for more comprehensive or linked data including parity and gestational age as well as examination of other factors-such as hospital policies, practices, and culture--in determining cesarean section use. Please see later in the article for the Editors' Summary.},
language = {ENG},
number = {10},
journal = {PLoS medicine},
author = {Kozhimannil, Katy B. and Arcaya, Mariana C. and Subramanian, S. V.},
month = oct,
year = {2014},
keywords = {Cesarean Section, Databases, Factual, Delivery, Obstetric, Female, Hospitals, Humans, Obstetric Labor Complications, Pregnancy, Risk Factors},
pages = {e1001745}
}2013 (7)
Epidemiological features and risk factors of Salmonella gastroenteritis in children resident in Ho Chi Minh City, Vietnam. Thompson, C. N., Phan, V. T. M., Le, T. P. T., Pham, T. N. T., Hoang, L. P., Ha, V., Nguyen, V. M. H., Pham, V. M., Nguyen, T. V., Cao, T. T., Tran, T. T. N., Nguyen, T. T. H., Dao, M. T., Campbell, J. I., Nguyen, T. C., Tang, C. T., Ha, M. T., Farrar, J., & Baker, S. Epidemiology and infection, 141(8):1604–1613, August, 2013.
doi abstract bibtex
doi abstract bibtex
Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged \textless5 years in Ho Chi Minh City to define the epidemiology and examine risk factors associated with Salmonella diarrhoeal infections. From 1419 diarrhoea cases and 571 controls enrolled between 2009 and 2010, 77 (54%) diarrhoea cases were stool culture-positive for non-typhoidal Salmonella. Salmonella patients were more likely to be younger than controls (median age 10 and 12 months, respectively) [odds ratio (OR) 097; 95% confidence interval (CI) 094-099], to report a recent diarrhoeal contact (81% cases, 18% controls; OR 598, 95% CI 18-204) and to live in a household with \textgreater2 children (cases 208%, controls 102%; OR 232, 95% CI 12-47). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home.
@article{thompson_epidemiological_2013,
title = {Epidemiological features and risk factors of {Salmonella} gastroenteritis in children resident in {Ho} {Chi} {Minh} {City}, {Vietnam}.},
volume = {141},
issn = {1469-4409 0950-2688},
doi = {10.1017/S0950268812002014},
abstract = {Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged {\textless}5 years in Ho Chi Minh City to define the epidemiology and examine risk factors associated with Salmonella diarrhoeal infections. From 1419 diarrhoea cases and 571 controls enrolled between 2009 and 2010, 77 (54\%) diarrhoea cases were stool culture-positive for non-typhoidal Salmonella. Salmonella patients were more likely to be younger than controls (median age 10 and 12 months, respectively) [odds ratio (OR) 097; 95\% confidence interval (CI) 094-099], to report a recent diarrhoeal contact (81\% cases, 18\% controls; OR 598, 95\% CI 18-204) and to live in a household with {\textgreater}2 children (cases 208\%, controls 102\%; OR 232, 95\% CI 12-47). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home.},
language = {eng},
number = {8},
journal = {Epidemiology and infection},
author = {Thompson, C. N. and Phan, V. T. M. and Le, T. P. T. and Pham, T. N. T. and Hoang, L. P. and Ha, V. and Nguyen, V. M. H. and Pham, V. M. and Nguyen, T. V. and Cao, T. T. and Tran, T. T. N. and Nguyen, T. T. H. and Dao, M. T. and Campbell, J. I. and Nguyen, T. C. and Tang, C. T. and Ha, M. T. and Farrar, J. and Baker, S.},
month = aug,
year = {2013},
pmid = {23010148},
pmcid = {PMC3733064},
keywords = {*Developing Countries, Bacterial Typing Techniques, Case-Control Studies, Child, Preschool, Diarrhea/*epidemiology/microbiology, Feces/microbiology, Female, Gastroenteritis/*epidemiology/microbiology, Humans, Infant, Male, Prevalence, Risk Factors, Salmonella Infections/*epidemiology/microbiology/transmission, Salmonella/*isolation \& purification, Surveys and Questionnaires, Urban Population, Vietnam/epidemiology},
pages = {1604--1613},
}Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in UK primary care - a retrospective database study. Jameson, K., Amber, V., D'Oca, K., Mills, D., Giles, A., & Ambegaonkar, B. International Journal of Clinical Practice, 67(12):1228--1237, December, 2013.
doi abstract bibtex
doi abstract bibtex
AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice. METHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines. RESULTS: At the index date, 98% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2% (sub-group range: 11.0-22.9%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8% to 68.9%, and from 99.2% to 68.7%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0% to 26.9%, whereas that of low HDL-C levels increased, from 16.6% to 18.0%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels. CONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.
@article{jameson_impact_2013,
title = {Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in {UK} primary care - a retrospective database study},
volume = {67},
issn = {1742-1241},
doi = {10.1111/ijcp.12238},
abstract = {AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice.
METHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20\%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines.
RESULTS: At the index date, 98\% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2\% (sub-group range: 11.0-22.9\%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8\% to 68.9\%, and from 99.2\% to 68.7\%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0\% to 26.9\%, whereas that of low HDL-C levels increased, from 16.6\% to 18.0\%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels.
CONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.},
language = {eng},
number = {12},
journal = {International Journal of Clinical Practice},
author = {Jameson, K. and Amber, V. and D'Oca, K. and Mills, D. and Giles, A. and Ambegaonkar, B.},
month = dec,
year = {2013},
pmid = {23944233},
pmcid = {PMC4232237},
keywords = {Adult, Aged, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Dyslipidemias, Female, Great Britain, Humans, Hypolipidemic Agents, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors},
pages = {1228--1237}
}Role of seminal shedding of herpesviruses in HIV Type 1 Transmission. Gianella, S., Morris, S. R., Vargas, M. V., Young, J. A., Callahan, B., Richman, D. D., Little, S. J., & Smith, D. M. The Journal of Infectious Diseases, 207(2):257–261, January, 2013.
doi abstract bibtex
doi abstract bibtex
To investigate the role of genital shedding of herpesviruses in human immunodeficiency virus type 1 (HIV) transmission, we compared 20 HIV-infected men who did and 26 who did not transmit HIV to their sex partners. As described previously, HIV transmission was associated with the potential source partner having higher levels of HIV RNA in blood and semen, having lower CD4(+) T cell counts, having bacterial coinfections in the genital tract, and not using antiretroviral therapy. This study extended these findings by observing significant associations between HIV transmission and the following characteristics, especially among therapy-naive potential source partners: seminal cytomegalovirus (CMV) shedding, seminal Epstein-Barr virus shedding, and levels of anti CMV immunoglobulin in blood plasma.
@article{gianella_role_2013,
title = {Role of seminal shedding of herpesviruses in {HIV} {Type} 1 {Transmission}},
volume = {207},
issn = {1537-6613},
doi = {10.1093/infdis/jis683},
abstract = {To investigate the role of genital shedding of herpesviruses in human immunodeficiency virus type 1 (HIV) transmission, we compared 20 HIV-infected men who did and 26 who did not transmit HIV to their sex partners. As described previously, HIV transmission was associated with the potential source partner having higher levels of HIV RNA in blood and semen, having lower CD4(+) T cell counts, having bacterial coinfections in the genital tract, and not using antiretroviral therapy. This study extended these findings by observing significant associations between HIV transmission and the following characteristics, especially among therapy-naive potential source partners: seminal cytomegalovirus (CMV) shedding, seminal Epstein-Barr virus shedding, and levels of anti CMV immunoglobulin in blood plasma.},
language = {eng},
number = {2},
journal = {The Journal of Infectious Diseases},
author = {Gianella, Sara and Morris, Sheldon R. and Vargas, Milenka V. and Young, Jason A. and Callahan, Bryan and Richman, Douglas D. and Little, Susan J. and Smith, Davey M.},
month = jan,
year = {2013},
pmid = {23148284},
pmcid = {PMC3532824},
keywords = {Adult, Coinfection, Cytomegalovirus, HIV Infections, HIV-1, Herpesviridae, Herpesvirus 4, Human, Homosexuality, Male, Humans, Male, Middle Aged, RNA, Viral, Risk Factors, Semen, Virus Shedding},
pages = {257--261},
}Ratio of trunk to leg volume as a new body shape metric for diabetes and mortality. Wilson, J. P., Kanaya, A. M., Fan, B., & Shepherd, J. A. PloS One, 8(7):e68716, 2013.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Body shape is a known risk factor for diabetes and mortality, but the methods estimating body shape, BMI and waist circumference are crude. We determined whether a novel body shape measure, trunk to leg volume ratio, was independently associated with diabetes and mortality. METHODS: Data from the National Health and Nutritional Examination Survey 1999-2004, a study representative of the US population, were used to generate dual-energy X-ray absorptiometry-derived trunk to leg volume ratio and determine its associations to diabetes, metabolic covariates, and mortality by BMI category, gender, and race/ethnicity group. RESULTS: The prevalence of pre-diabetes and diabetes increased with age, BMI, triglycerides, blood pressure, and decreased HDL level. After adjusting for covariates, the corresponding fourth to first quartile trunk to leg volume ratio odds ratios (OR) were 6.8 (95% confidence interval [CI], 4.9-9.6) for diabetes, 3.9 (95% CI, 3.0-5.2) for high triglycerides, 1.8 (95% CI, 1.6-2.1) for high blood pressure, 3.0 (95% CI, 2.4-3.8) for low HDL, 3.6 (95% CI, 2.8-4.7) for metabolic syndrome, and 1.76 (95% CI, 1.20-2.60) for mortality. Additionally, trunk to leg volume ratio was the strongest independent measure associated with diabetes (P\textless0.001), even after adjusting for BMI and waist circumference. Even among those with normal BMI, those in the highest quartile of trunk to leg volume ratio had a higher likelihood of death (5.5%) than those in the lowest quartile (0.2%). Overall, trunk to leg volume ratio is driven by competing mechanisms of changing adiposity and lean mass. CONCLUSIONS: A high ratio of trunk to leg volume showed a strong association to diabetes and mortality that was independent of total and regional fat distributions. This novel body shape measure provides additional information regarding central adiposity and appendicular wasting to better stratify individuals at risk for diabetes and mortality, even among those with normal BMI.
@article{wilson_ratio_2013,
title = {Ratio of trunk to leg volume as a new body shape metric for diabetes and mortality},
volume = {8},
issn = {1932-6203},
doi = {10.1371/journal.pone.0068716},
abstract = {BACKGROUND: Body shape is a known risk factor for diabetes and mortality, but the methods estimating body shape, BMI and waist circumference are crude. We determined whether a novel body shape measure, trunk to leg volume ratio, was independently associated with diabetes and mortality.
METHODS: Data from the National Health and Nutritional Examination Survey 1999-2004, a study representative of the US population, were used to generate dual-energy X-ray absorptiometry-derived trunk to leg volume ratio and determine its associations to diabetes, metabolic covariates, and mortality by BMI category, gender, and race/ethnicity group.
RESULTS: The prevalence of pre-diabetes and diabetes increased with age, BMI, triglycerides, blood pressure, and decreased HDL level. After adjusting for covariates, the corresponding fourth to first quartile trunk to leg volume ratio odds ratios (OR) were 6.8 (95\% confidence interval [CI], 4.9-9.6) for diabetes, 3.9 (95\% CI, 3.0-5.2) for high triglycerides, 1.8 (95\% CI, 1.6-2.1) for high blood pressure, 3.0 (95\% CI, 2.4-3.8) for low HDL, 3.6 (95\% CI, 2.8-4.7) for metabolic syndrome, and 1.76 (95\% CI, 1.20-2.60) for mortality. Additionally, trunk to leg volume ratio was the strongest independent measure associated with diabetes (P{\textless}0.001), even after adjusting for BMI and waist circumference. Even among those with normal BMI, those in the highest quartile of trunk to leg volume ratio had a higher likelihood of death (5.5\%) than those in the lowest quartile (0.2\%). Overall, trunk to leg volume ratio is driven by competing mechanisms of changing adiposity and lean mass.
CONCLUSIONS: A high ratio of trunk to leg volume showed a strong association to diabetes and mortality that was independent of total and regional fat distributions. This novel body shape measure provides additional information regarding central adiposity and appendicular wasting to better stratify individuals at risk for diabetes and mortality, even among those with normal BMI.},
language = {eng},
number = {7},
journal = {PloS One},
author = {Wilson, Joseph P. and Kanaya, Alka M. and Fan, Bo and Shepherd, John A.},
year = {2013},
pmid = {23874736},
pmcid = {PMC3707853},
keywords = {Adult, Aged, Body Size, Body Weights and Measures, Diabetes Mellitus, Female, Humans, Leg, Male, Middle Aged, Mortality, Nutrition Surveys, Organ Size, Prevalence, Risk Factors, Somatotypes, Thorax, Young Adult},
pages = {e68716}
}Case-control analysis on metformin and cancer of the esophagus. Becker, C., Meier, C. R., Jick, S. S., & Bodmer, M. Cancer causes & control: CCC, 24(10):1763--1770, October, 2013.
doi abstract bibtex
doi abstract bibtex
PURPOSE: Metformin use has been associated with decreased cancer risks, though data on esophageal cancer are scarce. We explored the relation between use of metformin or other anti-diabetic drugs and the risk of esophageal cancer. METHODS: We conducted a case-control analysis in the UK-based general practice research database (GPRD, now clinical practice research datalink, CPRD). Cases were individuals with an incident diagnosis of esophageal cancer between 1994 and 2010 at age 40-89 years. Ten controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the GPRD prior to the index date. Various potential confounders including diabetes mellitus, gastro-esophageal reflux, and use of proton-pump inhibitors were evaluated in univariate models, and the final results were adjusted for BMI and smoking. Results are presented as odds ratios (ORs) with 95 % confidence intervals (CI). RESULTS: Long-term use (≥30 prescriptions) of metformin was not associated with a materially altered risk of esophageal cancer (adj. OR 1.23, 95 % CI 0.92-1.65), nor was long-term use of sulfonylureas (adj. OR 0.93, 95 % CI 0.70-1.23), insulin (adj. OR 0.87, 95 % CI 0.60-1.25), or of thiazolidinediones (adj. OR 0.71, 95 % CI 0.37-1.36). CONCLUSION: In our population-based study, use of metformin was not associated with an altered risk of esophageal cancer.
@article{becker_case-control_2013,
title = {Case-control analysis on metformin and cancer of the esophagus},
volume = {24},
issn = {1573-7225},
doi = {10.1007/s10552-013-0253-6},
abstract = {PURPOSE: Metformin use has been associated with decreased cancer risks, though data on esophageal cancer are scarce. We explored the relation between use of metformin or other anti-diabetic drugs and the risk of esophageal cancer.
METHODS: We conducted a case-control analysis in the UK-based general practice research database (GPRD, now clinical practice research datalink, CPRD). Cases were individuals with an incident diagnosis of esophageal cancer between 1994 and 2010 at age 40-89 years. Ten controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the GPRD prior to the index date. Various potential confounders including diabetes mellitus, gastro-esophageal reflux, and use of proton-pump inhibitors were evaluated in univariate models, and the final results were adjusted for BMI and smoking. Results are presented as odds ratios (ORs) with 95 \% confidence intervals (CI).
RESULTS: Long-term use (≥30 prescriptions) of metformin was not associated with a materially altered risk of esophageal cancer (adj. OR 1.23, 95 \% CI 0.92-1.65), nor was long-term use of sulfonylureas (adj. OR 0.93, 95 \% CI 0.70-1.23), insulin (adj. OR 0.87, 95 \% CI 0.60-1.25), or of thiazolidinediones (adj. OR 0.71, 95 \% CI 0.37-1.36).
CONCLUSION: In our population-based study, use of metformin was not associated with an altered risk of esophageal cancer.},
language = {eng},
number = {10},
journal = {Cancer causes \& control: CCC},
author = {Becker, Claudia and Meier, Christoph R. and Jick, Susan S. and Bodmer, Michael},
month = oct,
year = {2013},
pmid = {23820930},
keywords = {Adult, Aged, Aged, 80 and over, Case-Control Studies, Esophageal Neoplasms, Great Britain, Humans, Hypoglycemic Agents, Logistic Models, Metformin, Middle Aged, Risk Factors},
pages = {1763--1770}
}Identifying associations in Escherichia coli antimicrobial resistance patterns using additive Bayesian networks. Ludwig, A., Berthiaume, P., Boerlin, P., Gow, S., Léger, D., & Lewis, F., I. Preventive veterinary medicine, 110(1):64-75, 5, 2013.
Website doi abstract bibtex
Website doi abstract bibtex While the genesis of antimicrobial resistance (AMR) in animal production is a high profile topic in the media and the scientific community, it is still not well understood. The epidemiology of AMR is complex. This complexity is demonstrated by extensive biological and evolutionary mechanisms which are potentially impacted by farm management and husbandry practices - the risk factors. Many parts of this system have yet to be fully described. Notably, the occurrence of multiple resistance patterns is the rule rather than exception - the multivariate problem. A first essential step in the development of any comprehensive risk factor analysis - whose goal is the prevention or reduction of AMR - is to describe those associations between different patterns of resistance which are systematic. That is, have sufficient statistical support for these patterns to be considered robust features of the underlying epidemiological system, and whose presence must therefore be incorporated into any risk factor analysis of AMR for it to be meaningful with respect to the farm environment. Presented here is a case study that seeks to identify systematic associations between patterns of resistance to 13 different antimicrobials in Escherichia coli isolates obtained from composite finisher (>80 kg) pig faecal samples obtained from Canada's five major pork producing provinces. The use of a Bayesian network analysis approach allowed us to identify many systematic associations between individual antimicrobial resistances. Sixteen of these resistances are corroborated with existing literature. These associations are distributed between several important classes of antimicrobials including the β-lactams, folate biosynthesis inhibitors, tetracyclines, aminoglycosides and quinolones. This study presents an exciting first step towards the larger and far more ambitious goal of developing generic and holistic risk factor analyses for on-farm occurrence of AMR. Analyses of this nature would combine multivariate response variables (joint patterns of resistance) with multi-factorial causal factors from within the livestock production environment thereby permitting a more complete understanding of the epidemiology of antimicrobial resistance.
@article{
title = {Identifying associations in Escherichia coli antimicrobial resistance patterns using additive Bayesian networks.},
type = {article},
year = {2013},
keywords = {Animals,Anti-Bacterial Agents,Anti-Bacterial Agents: pharmacology,Bayes Theorem,Canada,Drug Resistance, Multiple, Bacterial,Escherichia coli,Escherichia coli Infections,Escherichia coli Infections: epidemiology,Escherichia coli Infections: microbiology,Escherichia coli Infections: veterinary,Escherichia coli: drug effects,Feces,Feces: microbiology,Multivariate Analysis,Risk Factors,Seasons,Swine,Swine Diseases,Swine Diseases: epidemiology,Swine Diseases: microbiology},
pages = {64-75},
volume = {110},
websites = {http://www.sciencedirect.com/science/article/pii/S0167587713000366},
month = {5},
day = {15},
id = {20390ed2-fc37-3869-b04a-af71a1eff1a1},
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confirmed = {true},
hidden = {false},
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abstract = {While the genesis of antimicrobial resistance (AMR) in animal production is a high profile topic in the media and the scientific community, it is still not well understood. The epidemiology of AMR is complex. This complexity is demonstrated by extensive biological and evolutionary mechanisms which are potentially impacted by farm management and husbandry practices - the risk factors. Many parts of this system have yet to be fully described. Notably, the occurrence of multiple resistance patterns is the rule rather than exception - the multivariate problem. A first essential step in the development of any comprehensive risk factor analysis - whose goal is the prevention or reduction of AMR - is to describe those associations between different patterns of resistance which are systematic. That is, have sufficient statistical support for these patterns to be considered robust features of the underlying epidemiological system, and whose presence must therefore be incorporated into any risk factor analysis of AMR for it to be meaningful with respect to the farm environment. Presented here is a case study that seeks to identify systematic associations between patterns of resistance to 13 different antimicrobials in Escherichia coli isolates obtained from composite finisher (>80 kg) pig faecal samples obtained from Canada's five major pork producing provinces. The use of a Bayesian network analysis approach allowed us to identify many systematic associations between individual antimicrobial resistances. Sixteen of these resistances are corroborated with existing literature. These associations are distributed between several important classes of antimicrobials including the β-lactams, folate biosynthesis inhibitors, tetracyclines, aminoglycosides and quinolones. This study presents an exciting first step towards the larger and far more ambitious goal of developing generic and holistic risk factor analyses for on-farm occurrence of AMR. Analyses of this nature would combine multivariate response variables (joint patterns of resistance) with multi-factorial causal factors from within the livestock production environment thereby permitting a more complete understanding of the epidemiology of antimicrobial resistance.},
bibtype = {article},
author = {Ludwig, Antoinette and Berthiaume, Philippe and Boerlin, Patrick and Gow, Sheryl and Léger, David and Lewis, Fraser I},
doi = {10.1016/j.prevetmed.2013.02.005},
journal = {Preventive veterinary medicine},
number = {1}
}Cancer diagnosed by emergency admission in England: an observational study using the general practice research database. Tsang, C., Bottle, A., Majeed, A., & Aylin, P. BMC health services research, 13:308, 2013.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Patients diagnosed with cancer by the emergency route often have more advanced diseases and poorer outcomes. Rates of cancer diagnosed through unplanned admissions vary within and between countries, suggesting potential inconsistencies in the quality of care. To reduce diagnoses by this route and improve patient outcomes, high risk patient groups must be identified. This cross-sectional observational study determined the incidence of first-ever diagnoses of cancer by emergency (unplanned) admission and identified patient-level risk factors for these diagnoses in England. METHODS: Data for 74,763 randomly selected patients at 457 general practices between 1999 and 2008 were obtained from the General Practice Research Database (GPRD), including integrated Hospital Episode Statistics (HES) data and Office for National Statistics (ONS) mortality data. The proportion of first-ever diagnoses by emergency admission out of all recorded first cancer diagnoses by any route was analysed by patient characteristics. RESULTS: Diagnosis by emergency admission was recorded in 13.9% of patients diagnosed with cancer for the first time (n = 817/5870). The incidence of first cases by the emergency route was 2.51 patients per 10,000 person years. In adjusted regression analyses, patients of older age (p \textless 0.0001), living in the most deprived areas (RR 1.93, 95% CI 1.51 to 2.47; p \textless 0.0001) or who had a total Charlson score of 1 compared to 0 (RR 1.34, 95% CI 1.06 to 1.69; p = 0.014) were most at risk of diagnosis by emergency admission. Patients with more prior (all-cause) emergency admissions were less at risk of subsequent diagnosis by the emergency route (RR 0.31 per prior emergency admission, 95% CI 0.20 to 0.46; p \textless 0.0001). CONCLUSIONS: A much lower incidence of first-ever cancer diagnoses by emergency admission was found compared with previous studies. Identified high risk groups may benefit from interventions to reduce delayed diagnosis. Further studies should include screening and cancer staging data to improve understanding of delayed or untimely diagnosis and patient care pathways.
@article{tsang_cancer_2013,
title = {Cancer diagnosed by emergency admission in {England}: an observational study using the general practice research database},
volume = {13},
issn = {1472-6963},
shorttitle = {Cancer diagnosed by emergency admission in {England}},
doi = {10.1186/1472-6963-13-308},
abstract = {BACKGROUND: Patients diagnosed with cancer by the emergency route often have more advanced diseases and poorer outcomes. Rates of cancer diagnosed through unplanned admissions vary within and between countries, suggesting potential inconsistencies in the quality of care. To reduce diagnoses by this route and improve patient outcomes, high risk patient groups must be identified. This cross-sectional observational study determined the incidence of first-ever diagnoses of cancer by emergency (unplanned) admission and identified patient-level risk factors for these diagnoses in England.
METHODS: Data for 74,763 randomly selected patients at 457 general practices between 1999 and 2008 were obtained from the General Practice Research Database (GPRD), including integrated Hospital Episode Statistics (HES) data and Office for National Statistics (ONS) mortality data. The proportion of first-ever diagnoses by emergency admission out of all recorded first cancer diagnoses by any route was analysed by patient characteristics.
RESULTS: Diagnosis by emergency admission was recorded in 13.9\% of patients diagnosed with cancer for the first time (n = 817/5870). The incidence of first cases by the emergency route was 2.51 patients per 10,000 person years. In adjusted regression analyses, patients of older age (p {\textless} 0.0001), living in the most deprived areas (RR 1.93, 95\% CI 1.51 to 2.47; p {\textless} 0.0001) or who had a total Charlson score of 1 compared to 0 (RR 1.34, 95\% CI 1.06 to 1.69; p = 0.014) were most at risk of diagnosis by emergency admission. Patients with more prior (all-cause) emergency admissions were less at risk of subsequent diagnosis by the emergency route (RR 0.31 per prior emergency admission, 95\% CI 0.20 to 0.46; p {\textless} 0.0001).
CONCLUSIONS: A much lower incidence of first-ever cancer diagnoses by emergency admission was found compared with previous studies. Identified high risk groups may benefit from interventions to reduce delayed diagnosis. Further studies should include screening and cancer staging data to improve understanding of delayed or untimely diagnosis and patient care pathways.},
language = {eng},
journal = {BMC health services research},
author = {Tsang, Carmen and Bottle, Alex and Majeed, Azeem and Aylin, Paul},
year = {2013},
pmid = {23941140},
pmcid = {PMC3751722},
keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Confidence Intervals, Cross-Sectional Studies, Databases, Factual, Emergency Service, Hospital, England, Female, General Practice, Humans, Infant, Male, Medical Audit, Middle Aged, Neoplasms, Patient Admission, Poisson Distribution, Qualitative Research, Risk Factors, Young Adult},
pages = {308}
}2012 (7)
ICU admission characteristics and mortality rates among elderly and very elderly patients. Fuchs, L., Chronaki, C. E., Park, S., Novack, V., Baumfeld, Y., Scott, D., McLennan, S., Talmor, D., & Celi, L. Intensive Care Medicine, 38(10):1654--1661, October, 2012.
doi abstract bibtex
doi abstract bibtex
PURPOSE: The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear. METHODS: Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analyzed. Patients were divided into three age groups: 65-74, 75-84, and 85 and above. The primary endpoints were 28-day and 1-year mortality. RESULTS: The analysis focused on 7,265 patients above the age of 65, representing 45.7 % of the total ICU population. From the first to third age group there was increased prevalence of heart failure (25.9-40.3 %), cardiac arrhythmia (24.6-43.5 %), and valvular heart disease (7.5-15.8 %). There was reduced prevalence of diabetes complications (7.5-2.4 %), alcohol abuse (4.1-0.6 %), chronic obstructive pulmonary disease (COPD) (24.4-17.4 %), and liver failure (5.0-1.0 %). Logistic regression analysis adjusted for gender, sequential organ failure assessment, do not resuscitate, and Elixhauser score found that patients from the second and third age group had odds ratios of 1.38 [95 % confidence interval (CI) 1.19-1.59] and 1.53 (95 % CI 1.29-1.81) for 28-day mortality as compared with the first age group. Cox regression analysis for 1-year mortality in all populations and in 28-day survivors showed the same trend. CONCLUSIONS: The proportion of elderly patients from the total ICU population is high. With advancing age, the proportion of various preexisting comorbidities and the primary reason for ICU admission change. Advanced age should be regarded as a significant independent risk factor for mortality, especially for ICU patients older than 75.
@article{fuchs_icu_2012,
title = {{ICU} admission characteristics and mortality rates among elderly and very elderly patients},
volume = {38},
issn = {1432-1238},
doi = {10.1007/s00134-012-2629-6},
abstract = {PURPOSE: The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear.
METHODS: Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analyzed. Patients were divided into three age groups: 65-74, 75-84, and 85 and above. The primary endpoints were 28-day and 1-year mortality.
RESULTS: The analysis focused on 7,265 patients above the age of 65, representing 45.7 \% of the total ICU population. From the first to third age group there was increased prevalence of heart failure (25.9-40.3 \%), cardiac arrhythmia (24.6-43.5 \%), and valvular heart disease (7.5-15.8 \%). There was reduced prevalence of diabetes complications (7.5-2.4 \%), alcohol abuse (4.1-0.6 \%), chronic obstructive pulmonary disease (COPD) (24.4-17.4 \%), and liver failure (5.0-1.0 \%). Logistic regression analysis adjusted for gender, sequential organ failure assessment, do not resuscitate, and Elixhauser score found that patients from the second and third age group had odds ratios of 1.38 [95 \% confidence interval (CI) 1.19-1.59] and 1.53 (95 \% CI 1.29-1.81) for 28-day mortality as compared with the first age group. Cox regression analysis for 1-year mortality in all populations and in 28-day survivors showed the same trend.
CONCLUSIONS: The proportion of elderly patients from the total ICU population is high. With advancing age, the proportion of various preexisting comorbidities and the primary reason for ICU admission change. Advanced age should be regarded as a significant independent risk factor for mortality, especially for ICU patients older than 75.},
language = {eng},
number = {10},
journal = {Intensive Care Medicine},
author = {Fuchs, Lior and Chronaki, Catherine E. and Park, Shinhyuk and Novack, Victor and Baumfeld, Yael and Scott, Daniel and McLennan, Stuart and Talmor, Daniel and Celi, Leo},
month = oct,
year = {2012},
pmid = {22797350},
pmcid = {PMC5718912},
keywords = {Acute Disease, Aged, Aged, 80 and over, Chronic Disease, Comorbidity, Critical Care, Demography, Female, Hospital Mortality, Hospitalization, Humans, Intensive Care Units, Male, Outcome Assessment (Health Care), Patient Admission, Risk Factors, Survival Analysis},
pages = {1654--1661}
}Prolongation of QTc and risk of stroke: The REGARDS (REasons for Geographic and Racial Differences in Stroke) study. Soliman, E. Z, Howard, G., Cushman, M., Kissela, B., Kleindorfer, D., Le, A., Judd, S., McClure, L. A, & Howard, V. J Journal of the American College of Cardiology, 59(16):1460–1467, April, 2012.
doi abstract bibtex
doi abstract bibtex
OBJECTIVES: The purpose of this study was to examine the association between prolongation of QT interval corrected for heart rate (QTc) with incident stroke. BACKGROUND: Unlike cardiovascular morbidity and mortality, little is known about the relationship between QTc and risk of stroke. METHODS: A total of 27,411 participants age 45 years and older without previous stroke from the REGARDS (REasons for Geographic and Racial Differences in Stroke) study were included in this analysis. QTc was calculated using Framingham formula (QTc(Fram)). Stroke cases were identified and adjudicated during up to 8.2 years of follow-up (median, 5.1 years). RESULTS: The risk of incident stroke in study participants with prolonged QTc(Fram) was almost 3 times the risk in those with normal QTc(Fram) (hazard ratio [HR] [95% confidence interval (CI)]: 2.88 [2.12 to 3.92], p \textless 0.0001). After adjustment for demographics (age, race, and sex), traditional stroke risk factors (antihypertensive medication use, systolic blood pressure, current smoking, diabetes, left ventricular hypertrophy, atrial fibrillation, and previous cardiovascular disease), warfarin use, aspirin use, QRS duration and use of QTc-prolonging drugs, the risk of stroke remained significantly high (HR [95% CI]: 1.67 [1.16 to 2.41], p = 0.0061) and was consistent across several subgroups of REGARDS study participants. Similar results were obtained when the risk of stroke was estimated per 1-SD increase in QTc(Fram), (HR [95% CI]: 1.12 [1.03 to 1.21], p = 0.0053 in multivariable-adjusted model) and when other QTc correction formulas including those of Hodge, Bazett, and Fridericia were used. CONCLUSIONS: QTc prolongation is associated with a significantly increased risk of incident stroke independent of traditional stroke risk factors. Examining the risk of stroke associated with QTc-prolonging drugs may be warranted.
@article{soliman_prolongation_2012,
title = {Prolongation of {QTc} and risk of stroke: {The} {REGARDS} ({REasons} for {Geographic} and {Racial} {Differences} in {Stroke}) study},
volume = {59},
issn = {1558-3597},
shorttitle = {Prolongation of {QTc} and risk of stroke},
doi = {10.1016/j.jacc.2012.01.025},
abstract = {OBJECTIVES: The purpose of this study was to examine the association between prolongation of QT interval corrected for heart rate (QTc) with incident stroke.
BACKGROUND: Unlike cardiovascular morbidity and mortality, little is known about the relationship between QTc and risk of stroke.
METHODS: A total of 27,411 participants age 45 years and older without previous stroke from the REGARDS (REasons for Geographic and Racial Differences in Stroke) study were included in this analysis. QTc was calculated using Framingham formula (QTc(Fram)). Stroke cases were identified and adjudicated during up to 8.2 years of follow-up (median, 5.1 years).
RESULTS: The risk of incident stroke in study participants with prolonged QTc(Fram) was almost 3 times the risk in those with normal QTc(Fram) (hazard ratio [HR] [95\% confidence interval (CI)]: 2.88 [2.12 to 3.92], p {\textless} 0.0001). After adjustment for demographics (age, race, and sex), traditional stroke risk factors (antihypertensive medication use, systolic blood pressure, current smoking, diabetes, left ventricular hypertrophy, atrial fibrillation, and previous cardiovascular disease), warfarin use, aspirin use, QRS duration and use of QTc-prolonging drugs, the risk of stroke remained significantly high (HR [95\% CI]: 1.67 [1.16 to 2.41], p = 0.0061) and was consistent across several subgroups of REGARDS study participants. Similar results were obtained when the risk of stroke was estimated per 1-SD increase in QTc(Fram), (HR [95\% CI]: 1.12 [1.03 to 1.21], p = 0.0053 in multivariable-adjusted model) and when other QTc correction formulas including those of Hodge, Bazett, and Fridericia were used.
CONCLUSIONS: QTc prolongation is associated with a significantly increased risk of incident stroke independent of traditional stroke risk factors. Examining the risk of stroke associated with QTc-prolonging drugs may be warranted.},
language = {eng},
number = {16},
journal = {Journal of the American College of Cardiology},
author = {Soliman, Elsayed Z and Howard, George and Cushman, Mary and Kissela, Brett and Kleindorfer, Dawn and Le, Anh and Judd, Suzanne and McClure, Leslie A and Howard, Virginia J},
month = apr,
year = {2012},
pmid = {22497826},
keywords = {Aged, Continental Population Groups, Electrocardiography, Female, Follow-Up Studies, Heart Rate, Humans, Incidence, Long QT Syndrome, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Stroke, Survival Rate, United States},
pages = {1460--1467}
}HIV incidence among non-pregnant women living in selected rural, semi-rural and Urban areas in Kwazulu-Natal, South Africa. Ramjee, G., Wand, H., Whitaker, C., McCormack, S., Padian, N., Kelly, C., & Nunn, A. AIDS and Behavior, 2012.
abstract bibtex
abstract bibtex
The province of KwaZulu-Natal has the highest prevalence of HIV in South Africa, particularly among young women. In order to more closely examine the HIV prevalence and incidence in non-pregnant women from rural, semi-rural and urban areas, data from 5,753 women screened for enrolment into three HIV prevention studies were combined and analysed. The prevalence of HIV infection was 43% at screening. HIV incidence among the 2,523 enrolled HIV-negative women was determined every quarter, and sexual behaviour and socio-demographic data were collected as per respective protocols. During followup, 211 women seroconverted (6.6/100 women years). Multivariate analysis found that seroconversion rates were highest among women who were ≤24 years old, single and not cohabiting, and who had incident sexually transmitted infections. The epidemic in KwaZulu-Natal calls for targeted HIV prevention interventions among those at highest risk of acquiring or transmitting infection. © Springer Science+Business Media, LLC 2011.
@article{
title = {HIV incidence among non-pregnant women living in selected rural, semi-rural and Urban areas in Kwazulu-Natal, South Africa},
type = {article},
year = {2012},
identifiers = {[object Object]},
keywords = {Cohabitation,HIV,Risk factors,South Africa,Women},
volume = {16},
id = {d1a105a8-f01a-3593-aa31-d6628fd9becf},
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confirmed = {false},
hidden = {false},
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abstract = {The province of KwaZulu-Natal has the highest prevalence of HIV in South Africa, particularly among young women. In order to more closely examine the HIV prevalence and incidence in non-pregnant women from rural, semi-rural and urban areas, data from 5,753 women screened for enrolment into three HIV prevention studies were combined and analysed. The prevalence of HIV infection was 43% at screening. HIV incidence among the 2,523 enrolled HIV-negative women was determined every quarter, and sexual behaviour and socio-demographic data were collected as per respective protocols. During followup, 211 women seroconverted (6.6/100 women years). Multivariate analysis found that seroconversion rates were highest among women who were ≤24 years old, single and not cohabiting, and who had incident sexually transmitted infections. The epidemic in KwaZulu-Natal calls for targeted HIV prevention interventions among those at highest risk of acquiring or transmitting infection. © Springer Science+Business Media, LLC 2011.},
bibtype = {article},
author = {Ramjee, G. and Wand, H. and Whitaker, C. and McCormack, S. and Padian, N. and Kelly, C. and Nunn, A.},
journal = {AIDS and Behavior},
number = {7}
}Health service use in families where children enter public care: a nested case control study using the General Practice Research Database. Simkiss, D. E., Spencer, N. J., Stallard, N., & Thorogood, M. BMC health services research, 12:65, 2012.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: At least 3% of children spend some of their childhood in public care and, as a group, have poor outcomes across a range of education, employment, health and social care outcomes. Research, using social care or government datasets, has identified a number of risk factors associated with children entering public care but the utility of risk factors in clinical practice is not established. This paper uses routine primary health care data to see if risk factors for children entering public care can be identified in clinical practice. METHODS: A nested case control methodology using routine primary care data from the United Kingdom. Health service use data were extracted for the 12 months before the case child entered public care and compared with 12 months of data for four control mother child pairs per case pair, matched on the age and sex of the child and the general practice. Exposures of interest were developed from a systematic review of the literature on risk factors associated with children entering public care. RESULTS: Conditional logistic regression was used to investigate the combined effect of more than one exposure of interest. Maternal mental illness (OR 2.51, 95% CI 1.55-4.05), maternal age at birth of the child, socio-economic status (5(th) quintile vs. 1(st) quintile OR 7.14, 95% CI 2.92-17.4), maternal drug use (OR 28.8, 95% CI 2.29-363), non attendance at appointments (OR 2.42, 95% CI 1.42-4.14), child mental illness (OR 2.65, 95% CI 1.42-4.96) and child admission to hospital (OR 3.31, 95% CI 1.21-9.02) were all significantly associated with children entering public care. Maternal use of primary care contraception services was negatively associated with children entering public care (OR 0.52, 95% CI 0.31-0.87). CONCLUSIONS: Differences in health service use can be identified from routine primary care data in mother child pairs where children enter public care after controlling for maternal age and socio-economic status. The interaction between different risk factors needs testing in a cumulative risk model using longitudinal datasets.
@article{simkiss_health_2012,
title = {Health service use in families where children enter public care: a nested case control study using the {General} {Practice} {Research} {Database}},
volume = {12},
issn = {1472-6963},
shorttitle = {Health service use in families where children enter public care},
doi = {10.1186/1472-6963-12-65},
abstract = {BACKGROUND: At least 3\% of children spend some of their childhood in public care and, as a group, have poor outcomes across a range of education, employment, health and social care outcomes. Research, using social care or government datasets, has identified a number of risk factors associated with children entering public care but the utility of risk factors in clinical practice is not established. This paper uses routine primary health care data to see if risk factors for children entering public care can be identified in clinical practice.
METHODS: A nested case control methodology using routine primary care data from the United Kingdom. Health service use data were extracted for the 12 months before the case child entered public care and compared with 12 months of data for four control mother child pairs per case pair, matched on the age and sex of the child and the general practice. Exposures of interest were developed from a systematic review of the literature on risk factors associated with children entering public care.
RESULTS: Conditional logistic regression was used to investigate the combined effect of more than one exposure of interest. Maternal mental illness (OR 2.51, 95\% CI 1.55-4.05), maternal age at birth of the child, socio-economic status (5(th) quintile vs. 1(st) quintile OR 7.14, 95\% CI 2.92-17.4), maternal drug use (OR 28.8, 95\% CI 2.29-363), non attendance at appointments (OR 2.42, 95\% CI 1.42-4.14), child mental illness (OR 2.65, 95\% CI 1.42-4.96) and child admission to hospital (OR 3.31, 95\% CI 1.21-9.02) were all significantly associated with children entering public care. Maternal use of primary care contraception services was negatively associated with children entering public care (OR 0.52, 95\% CI 0.31-0.87).
CONCLUSIONS: Differences in health service use can be identified from routine primary care data in mother child pairs where children enter public care after controlling for maternal age and socio-economic status. The interaction between different risk factors needs testing in a cumulative risk model using longitudinal datasets.},
language = {eng},
journal = {BMC health services research},
author = {Simkiss, Douglas E. and Spencer, Nicholas J. and Stallard, Nigel and Thorogood, Margaret},
year = {2012},
pmid = {22424404},
pmcid = {PMC3361673},
keywords = {Adolescent, Adult, Case-Control Studies, Child, Child, Preschool, Databases, Factual, Family Health, Female, General Practice, Great Britain, Health Services Research, Hospitalization, Humans, Infant, Logistic Models, Male, Maternal Age, Maternal-Child Health Centers, Mental Disorders, Middle Aged, Mothers, Primary Health Care, Public Sector, Questionnaires, Risk Factors, Social Class, Young Adult},
pages = {65}
}Bisphosphonates and risk of upper gastrointestinal cancer--a case control study using the General Practice Research Database (GPRD). Wright, E., Schofield, P. T., Seed, P., & Molokhia, M. PloS One, 7(10):e47616, 2012.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Concerns have been raised as to the safety of bisphosphonates; in particular a possible link between bisphosphonate use and upper gastrointestinal (GI) cancer. Two published studies using different study populations but drawn from earlier versions of the same national UK database, reached differing conclusions: one finding no evidence for an increase in the risk of gastric or oesophageal cancer in bisphosphonate users and one finding a small but significantly increased risk of oesophageal cancer linked to duration of bisphosphonate use. METHODOLOGY/ PRINCIPAL FINDINGS: Design-A case control study comparing bisphosphonate prescribing in cases of upper GI cancer from 1995 to 2007 using UK primary care electronic health records (GPRD). Main Outcome Measure-Relative Risk (approximated to Odds Ratio for rare events) for oesophageal and gastric cancer development in bisphosphonate users compared to non-users. The odds of being a case of oesophageal cancer, adjusted for smoking status, were significantly increased in women who had had one or more bisphosphonate prescriptions, odds ratio 1.54 (95% CI 1.27-1.88) compared to non-users. There was no significant effect on gastric cancer in women, odds ratio adjusted for smoking status, 1.06 (95% CI 0.83-1.37) and also no apparent risk in men for either oesophageal or gastric cancer, odds ratio adjusted for smoking status 0.78 (95%CI 0.56-1.09) and 0.87 (95% CI 0.55-1.36) respectively. CONCLUSIONS/ SIGNIFICANCE: Our results support a small but significant increased risk of oesophageal cancer in women prescribed bisphosphonates and is based on the largest number of exposed cases to date in the UK.
@article{wright_bisphosphonates_2012,
title = {Bisphosphonates and risk of upper gastrointestinal cancer--a case control study using the {General} {Practice} {Research} {Database} ({GPRD})},
volume = {7},
issn = {1932-6203},
doi = {10.1371/journal.pone.0047616},
abstract = {BACKGROUND: Concerns have been raised as to the safety of bisphosphonates; in particular a possible link between bisphosphonate use and upper gastrointestinal (GI) cancer. Two published studies using different study populations but drawn from earlier versions of the same national UK database, reached differing conclusions: one finding no evidence for an increase in the risk of gastric or oesophageal cancer in bisphosphonate users and one finding a small but significantly increased risk of oesophageal cancer linked to duration of bisphosphonate use.
METHODOLOGY/ PRINCIPAL FINDINGS: Design-A case control study comparing bisphosphonate prescribing in cases of upper GI cancer from 1995 to 2007 using UK primary care electronic health records (GPRD). Main Outcome Measure-Relative Risk (approximated to Odds Ratio for rare events) for oesophageal and gastric cancer development in bisphosphonate users compared to non-users. The odds of being a case of oesophageal cancer, adjusted for smoking status, were significantly increased in women who had had one or more bisphosphonate prescriptions, odds ratio 1.54 (95\% CI 1.27-1.88) compared to non-users. There was no significant effect on gastric cancer in women, odds ratio adjusted for smoking status, 1.06 (95\% CI 0.83-1.37) and also no apparent risk in men for either oesophageal or gastric cancer, odds ratio adjusted for smoking status 0.78 (95\%CI 0.56-1.09) and 0.87 (95\% CI 0.55-1.36) respectively.
CONCLUSIONS/ SIGNIFICANCE: Our results support a small but significant increased risk of oesophageal cancer in women prescribed bisphosphonates and is based on the largest number of exposed cases to date in the UK.},
language = {eng},
number = {10},
journal = {PloS One},
author = {Wright, Ellen and Schofield, Peter T. and Seed, Paul and Molokhia, Mariam},
year = {2012},
pmid = {23112825},
pmcid = {PMC3480418},
keywords = {Aged, Alendronate, Bone Density Conservation Agents, Case-Control Studies, Databases, Factual, Diphosphonates, Esophageal Neoplasms, Esophagus, Female, Gastrointestinal Neoplasms, Humans, Intestines, Male, Middle Aged, Risk Factors, Stomach},
pages = {e47616}
}Angiotensin receptor blockers and risk of cancer: cohort study among people receiving antihypertensive drugs in UK General Practice Research Database. Bhaskaran, K., Douglas, I., Evans, S., van Staa, T., & Smeeth, L. BMJ (Clinical research ed.), 344:e2697, 2012.
abstract bibtex
abstract bibtex
OBJECTIVES: To investigate whether there is an association between use of angiotensin receptor blockers and risk of cancer. DESIGN: Cohort study of risk of cancer in people treated with angiotensin receptor blockers compared with angiotensin converting enzyme (ACE) inhibitors. Effects were explored with time updated covariates in Cox models adjusted for age, sex, body mass index (BMI), diabetes and metformin/insulin use, hypertension, heart failure, statin use, socioeconomic status, alcohol, smoking, and calendar year. Absolute changes in risk were predicted from a Poisson model incorporating the strongest determinants of risk from the main analysis. SETTING: UK primary care practices contributing to the General Practice Research Database. PARTICIPANTS: 377,649 new users of angiotensin receptor blockers or ACE inhibitors with at least one year of initial treatment. MAIN OUTCOME MEASURES: Adjusted hazard ratios for all cancer and major site specific cancers (breast, lung, colon, prostate) by exposure to angiotensin receptor blockers and by cumulative duration of use. RESULTS: Follow-up ended a median of 4.6 years after the start of treatment; 20,203 cancers were observed. There was no evidence of any increase in overall risk of cancer among those ever exposed to angiotensin receptor blockers (adjusted hazard ratio 1.03, 95% confidence interval 0.99 to 1.06, P = 0.10). For specific cancers, there was some evidence of an increased risk of breast and prostate cancer (1.11, 1.01 to 1.21, P = 0.02; and 1.10, 1.00 to 1.20, P = 0.04; respectively), which in absolute terms corresponded to an estimated 0.5 and 1.1 extra cases, respectively, per 1000 person years of follow-up among those with the highest baseline risk. Longer duration of treatment did not seem to be associated with higher risk (P\textgreater0.15 in each case). There was a decreased risk of lung cancer (0.84, 0.75 to 0.94), but no effect on colon cancer (1.02, 0.91 to 1.16). CONCLUSIONS: Use of angiotensin receptor blockers was not associated with an increased risk of cancer overall. Observed increased risks for breast and prostate cancer were small in absolute terms, and the lack of association with duration of treatment meant that non-causal explanations could not be excluded.
@article{bhaskaran_angiotensin_2012,
title = {Angiotensin receptor blockers and risk of cancer: cohort study among people receiving antihypertensive drugs in {UK} {General} {Practice} {Research} {Database}},
volume = {344},
issn = {1756-1833},
shorttitle = {Angiotensin receptor blockers and risk of cancer},
abstract = {OBJECTIVES: To investigate whether there is an association between use of angiotensin receptor blockers and risk of cancer.
DESIGN: Cohort study of risk of cancer in people treated with angiotensin receptor blockers compared with angiotensin converting enzyme (ACE) inhibitors. Effects were explored with time updated covariates in Cox models adjusted for age, sex, body mass index (BMI), diabetes and metformin/insulin use, hypertension, heart failure, statin use, socioeconomic status, alcohol, smoking, and calendar year. Absolute changes in risk were predicted from a Poisson model incorporating the strongest determinants of risk from the main analysis.
SETTING: UK primary care practices contributing to the General Practice Research Database.
PARTICIPANTS: 377,649 new users of angiotensin receptor blockers or ACE inhibitors with at least one year of initial treatment.
MAIN OUTCOME MEASURES: Adjusted hazard ratios for all cancer and major site specific cancers (breast, lung, colon, prostate) by exposure to angiotensin receptor blockers and by cumulative duration of use.
RESULTS: Follow-up ended a median of 4.6 years after the start of treatment; 20,203 cancers were observed. There was no evidence of any increase in overall risk of cancer among those ever exposed to angiotensin receptor blockers (adjusted hazard ratio 1.03, 95\% confidence interval 0.99 to 1.06, P = 0.10). For specific cancers, there was some evidence of an increased risk of breast and prostate cancer (1.11, 1.01 to 1.21, P = 0.02; and 1.10, 1.00 to 1.20, P = 0.04; respectively), which in absolute terms corresponded to an estimated 0.5 and 1.1 extra cases, respectively, per 1000 person years of follow-up among those with the highest baseline risk. Longer duration of treatment did not seem to be associated with higher risk (P{\textgreater}0.15 in each case). There was a decreased risk of lung cancer (0.84, 0.75 to 0.94), but no effect on colon cancer (1.02, 0.91 to 1.16).
CONCLUSIONS: Use of angiotensin receptor blockers was not associated with an increased risk of cancer overall. Observed increased risks for breast and prostate cancer were small in absolute terms, and the lack of association with duration of treatment meant that non-causal explanations could not be excluded.},
language = {eng},
journal = {BMJ (Clinical research ed.)},
author = {Bhaskaran, Krishnan and Douglas, Ian and Evans, Stephen and van Staa, Tjeerd and Smeeth, Liam},
year = {2012},
pmid = {22531797},
pmcid = {PMC3339864},
keywords = {Adolescent, Adult, Aged, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Breast Neoplasms, Causality, Cohort Studies, Data Interpretation, Statistical, Family Practice, Female, Great Britain, Humans, Hypertension, Male, Medical Records Systems, Computerized, Middle Aged, Neoplasms, Proportional Hazards Models, Prostatic Neoplasms, Risk Factors, Young Adult},
pages = {e2697}
}Derivation and validation of updated QFracture algorithm to predict risk of osteoporotic fracture in primary care in the United Kingdom: prospective open cohort study. Hippisley-Cox, J. & Coupland, C. BMJ (Clinical research ed.), 344:e3427, 2012.
abstract bibtex
abstract bibtex
OBJECTIVE: To develop and validate an updated version of the QFracture algorithm for estimating the risk of a patient sustaining an osteoporotic fracture or hip fracture in a primary care population. DESIGN: Prospective open cohort study using routinely collected data from 420 general practices in the United Kingdom to develop updated QFracture scores and 207 practices to validate scores. Cox's proportional hazards model was used in the derivation cohort to derive risk equations using several explanatory variables. We calculated measures of calibration and discrimination using the validation cohort. PARTICIPANTS: 3,142,673 patients in derivation cohort and 1,583,373 in validation cohort, aged 30-100 years, who contributed 23,608,337 and 11,732,106 person years of observation, respectively. We identified 59,772 incident diagnoses of osteoporotic fracture in the derivation cohort and 28,685 in the validation cohort. OUTCOMES: Incident diagnosis of osteoporotic fracture (vertebral, distal radius, proximal humerus, or hip) and incident hip fracture recorded in general practice records or linked cause of death records. RESULTS: We found significant independent associations with overall fracture risk in women for age, body mass index, ethnic origin, alcohol intake, smoking status, chronic obstructive pulmonary disease or asthma, any cancer, cardiovascular disease, dementia, diagnosis or treatment for epilepsy, history of falls, chronic liver disease, Parkinson's disease, rheumatoid arthritis or systemic lupus erythematosus, chronic renal disease, type 1 diabetes, type 2 diabetes, previous fracture, endocrine disorders, gastrointestinal malabsorption, any antidepressants, corticosteroids, unopposed hormone replacement therapy, and parental history of osteoporosis. Risk factors for hip fracture in women were similar except for gastrointestinal malabsorption and parental history of hip fracture. Risk factors for men were largely the same as those for women but also included care home residence. The updated hip fracture algorithm explained 71.7% (95% confidence interval 71.1% to 72.3%) of the variation in women and 70.4% (69.3% to 71.5%) in men. D statistic values for hip fracture were high for women (3.26, 3.21 to 3.31) and men (3.15, 3.06 to 3.24), and higher than for osteoporotic fracture. Values for the area under the receiver operating characteristics curves for hip fracture were 0.89 for women and 0.88 for men, compared with 0.79 and 0.71 for osteoporotic fracture, respectively. The updated algorithms performed better than the 2009 algorithms. CONCLUSIONS: Two QFracture algorithms were updated to predict risk of osteoporotic and hip fracture in primary care populations to include ethnic origin, all classes of antidepressants, chronic obstructive pulmonary disease, epilepsy, dementia, Parkinson's disease, cancer, systemic lupus erythematosus, chronic renal disease, type 1 diabetes, previous fragility fracture, and care home residence. These updated algorithms showed improved performance compared with previous QFracture algorithms reported in 2009.
@article{hippisley-cox_derivation_2012,
title = {Derivation and validation of updated {QFracture} algorithm to predict risk of osteoporotic fracture in primary care in the {United} {Kingdom}: prospective open cohort study},
volume = {344},
issn = {1756-1833},
shorttitle = {Derivation and validation of updated {QFracture} algorithm to predict risk of osteoporotic fracture in primary care in the {United} {Kingdom}},
abstract = {OBJECTIVE: To develop and validate an updated version of the QFracture algorithm for estimating the risk of a patient sustaining an osteoporotic fracture or hip fracture in a primary care population.
DESIGN: Prospective open cohort study using routinely collected data from 420 general practices in the United Kingdom to develop updated QFracture scores and 207 practices to validate scores. Cox's proportional hazards model was used in the derivation cohort to derive risk equations using several explanatory variables. We calculated measures of calibration and discrimination using the validation cohort.
PARTICIPANTS: 3,142,673 patients in derivation cohort and 1,583,373 in validation cohort, aged 30-100 years, who contributed 23,608,337 and 11,732,106 person years of observation, respectively. We identified 59,772 incident diagnoses of osteoporotic fracture in the derivation cohort and 28,685 in the validation cohort.
OUTCOMES: Incident diagnosis of osteoporotic fracture (vertebral, distal radius, proximal humerus, or hip) and incident hip fracture recorded in general practice records or linked cause of death records.
RESULTS: We found significant independent associations with overall fracture risk in women for age, body mass index, ethnic origin, alcohol intake, smoking status, chronic obstructive pulmonary disease or asthma, any cancer, cardiovascular disease, dementia, diagnosis or treatment for epilepsy, history of falls, chronic liver disease, Parkinson's disease, rheumatoid arthritis or systemic lupus erythematosus, chronic renal disease, type 1 diabetes, type 2 diabetes, previous fracture, endocrine disorders, gastrointestinal malabsorption, any antidepressants, corticosteroids, unopposed hormone replacement therapy, and parental history of osteoporosis. Risk factors for hip fracture in women were similar except for gastrointestinal malabsorption and parental history of hip fracture. Risk factors for men were largely the same as those for women but also included care home residence. The updated hip fracture algorithm explained 71.7\% (95\% confidence interval 71.1\% to 72.3\%) of the variation in women and 70.4\% (69.3\% to 71.5\%) in men. D statistic values for hip fracture were high for women (3.26, 3.21 to 3.31) and men (3.15, 3.06 to 3.24), and higher than for osteoporotic fracture. Values for the area under the receiver operating characteristics curves for hip fracture were 0.89 for women and 0.88 for men, compared with 0.79 and 0.71 for osteoporotic fracture, respectively. The updated algorithms performed better than the 2009 algorithms.
CONCLUSIONS: Two QFracture algorithms were updated to predict risk of osteoporotic and hip fracture in primary care populations to include ethnic origin, all classes of antidepressants, chronic obstructive pulmonary disease, epilepsy, dementia, Parkinson's disease, cancer, systemic lupus erythematosus, chronic renal disease, type 1 diabetes, previous fragility fracture, and care home residence. These updated algorithms showed improved performance compared with previous QFracture algorithms reported in 2009.},
language = {eng},
journal = {BMJ (Clinical research ed.)},
author = {Hippisley-Cox, Julia and Coupland, Carol},
year = {2012},
pmid = {22619194},
keywords = {Adult, Aged, Aged, 80 and over, Algorithms, Cohort Studies, Female, Great Britain, Hip Fractures, Humans, Male, Middle Aged, Osteoporotic Fractures, Predictive Value of Tests, Primary Health Care, Proportional Hazards Models, Reproducibility of Results, Risk Assessment, Risk Factors},
pages = {e3427}
}2011 (6)
Exposure to cyclooxygenase-2 inhibitors and risk of cancer: nested case-control studies. Vinogradova, Y., Coupland, C., & Hippisley-Cox, J. British Journal of Cancer, 105(3):452--459, July, 2011.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Selective cyclooxygenase-2 (COX2) inhibitors are widely used as analgesics and it is unclear whether its long-term use affects cancer risk. METHODS: A series of nested case-control studies using the QResearch primary care database. Associations of COX2 inhibitor use with risk of all cancers and 10 common site-specific cancers were estimated using conditional logistic regression adjusted for comorbidities, smoking status, socioeconomic status, and use of non-steroidal anti-inflammatory drugs, aspirin and statins. RESULTS: A total of 88,125 cancers, diagnosed between 1998 and 2008, matched with up to five controls, were analysed. Use of COX2 inhibitors for more than a year was associated with a significantly increased risk of breast cancer (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.08-1.42) and haematological malignancies (OR 1.38, 95% CI 1.12-1.69) and a decreased risk of colorectal cancer (OR 0.76, 95% CI 0.63-0.92). There were no other significant associations. CONCLUSION: Prolonged use of COX2 inhibitors was associated with an increased risk of breast and haematological cancers and decreased risk of colorectal cancer. These findings need to be confirmed using other data sources.
@article{vinogradova_exposure_2011,
title = {Exposure to cyclooxygenase-2 inhibitors and risk of cancer: nested case-control studies},
volume = {105},
issn = {1532-1827},
shorttitle = {Exposure to cyclooxygenase-2 inhibitors and risk of cancer},
doi = {10.1038/bjc.2011.252},
abstract = {BACKGROUND: Selective cyclooxygenase-2 (COX2) inhibitors are widely used as analgesics and it is unclear whether its long-term use affects cancer risk.
METHODS: A series of nested case-control studies using the QResearch primary care database. Associations of COX2 inhibitor use with risk of all cancers and 10 common site-specific cancers were estimated using conditional logistic regression adjusted for comorbidities, smoking status, socioeconomic status, and use of non-steroidal anti-inflammatory drugs, aspirin and statins.
RESULTS: A total of 88,125 cancers, diagnosed between 1998 and 2008, matched with up to five controls, were analysed. Use of COX2 inhibitors for more than a year was associated with a significantly increased risk of breast cancer (odds ratio (OR) 1.24, 95\% confidence interval (CI) 1.08-1.42) and haematological malignancies (OR 1.38, 95\% CI 1.12-1.69) and a decreased risk of colorectal cancer (OR 0.76, 95\% CI 0.63-0.92). There were no other significant associations.
CONCLUSION: Prolonged use of COX2 inhibitors was associated with an increased risk of breast and haematological cancers and decreased risk of colorectal cancer. These findings need to be confirmed using other data sources.},
language = {eng},
number = {3},
journal = {British Journal of Cancer},
author = {Vinogradova, Y. and Coupland, C. and Hippisley-Cox, J.},
month = jul,
year = {2011},
pmid = {21750557},
pmcid = {PMC3172909},
keywords = {Adult, Aged, Aged, 80 and over, Breast Neoplasms, Case-Control Studies, Colorectal Neoplasms, Cyclooxygenase 2 Inhibitors, Drug Administration Schedule, Female, Hematologic Neoplasms, Humans, Male, Middle Aged, Neoplasms, Risk Factors},
pages = {452--459}
}Comparison of the results of Cox proportional hazards model and parametric models in the study of length of stay in a tertiary teaching hospital in Tehran, Iran. Ravangard, R., Arab, M., Rashidian, A., Akbarisari, A., Zare, A., & Zeraati, H. Acta medica Iranica, 49(10):650–658, 2011.
abstract bibtex
abstract bibtex
Survival analysis is a set of methods used for analysis of the data which exist until the occurrence of an event. This study aimed to compare the results of the use of the semi-parametric Cox model with parametric models to determine the factors influencing the length of stay of patients in the inpatient units of Women Hospital in Tehran, Iran. In this historical cohort study all 3421 charts of the patients admitted to Obstetrics, Surgery and Oncology units in 2008 were reviewed and the required patient data such as medical insurance coverage types, admission months, days and times, inpatient units, final diagnoses, the number of diagnostic tests, admission types were collected. The patient length of stay in hospital 'leading to recovery' was considered as a survival variable. To compare the semi-parametric Cox model and parametric (including exponential, Weibull, Gompertz, log-normal, log-logistic and gamma) models and find the best model fitted to studied data, Akaike's Information Criterion (AIC) and Cox-Snell residual were used. P\textless0.05 was considered as statistically significant. AIC and Cox-Snell residual graph showed that the gamma model had the lowest AIC (4288.598) and the closest graph to the bisector. The results of the gamma model showed that factors affecting the patient length of stay were admission day, inpatient unit, related physician specialty, emergent admission, final diagnosis and the number of laboratory tests, radiographies and sonographies (P\textless0.05). The results showed that the gamma model provided a better fit to the studied data than the Cox proportional hazards model. Therefore, it is better for researchers of healthcare field to consider this model in their researches about the patient length of stay (LOS) if the assumption of proportional hazards is not fulfilled.
@article{ravangard_comparison_2011,
title = {Comparison of the results of {Cox} proportional hazards model and parametric models in the study of length of stay in a tertiary teaching hospital in {Tehran}, {Iran}},
volume = {49},
issn = {1735-9694},
abstract = {Survival analysis is a set of methods used for analysis of the data which exist until the occurrence of an event. This study aimed to compare the results of the use of the semi-parametric Cox model with parametric models to determine the factors influencing the length of stay of patients in the inpatient units of Women Hospital in Tehran, Iran. In this historical cohort study all 3421 charts of the patients admitted to Obstetrics, Surgery and Oncology units in 2008 were reviewed and the required patient data such as medical insurance coverage types, admission months, days and times, inpatient units, final diagnoses, the number of diagnostic tests, admission types were collected. The patient length of stay in hospital 'leading to recovery' was considered as a survival variable. To compare the semi-parametric Cox model and parametric (including exponential, Weibull, Gompertz, log-normal, log-logistic and gamma) models and find the best model fitted to studied data, Akaike's Information Criterion (AIC) and Cox-Snell residual were used. P{\textless}0.05 was considered as statistically significant. AIC and Cox-Snell residual graph showed that the gamma model had the lowest AIC (4288.598) and the closest graph to the bisector. The results of the gamma model showed that factors affecting the patient length of stay were admission day, inpatient unit, related physician specialty, emergent admission, final diagnosis and the number of laboratory tests, radiographies and sonographies (P{\textless}0.05). The results showed that the gamma model provided a better fit to the studied data than the Cox proportional hazards model. Therefore, it is better for researchers of healthcare field to consider this model in their researches about the patient length of stay (LOS) if the assumption of proportional hazards is not fulfilled.},
language = {eng},
number = {10},
journal = {Acta medica Iranica},
author = {Ravangard, Ramin and Arab, Mohamad and Rashidian, Arash and Akbarisari, Ali and Zare, Ali and Zeraati, Hojjat},
year = {2011},
pmid = {22071639},
keywords = {Data Interpretation, Statistical, Female, Health Services Research, Hospitals, Teaching, Humans, Iran, Length of Stay, Proportional Hazards Models, Risk Assessment, Risk Factors, Survival Analysis, Survival Rate, Time Factors, Women's Health Services},
pages = {650--658}
}Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients. Gallagher, A. M., Setakis, E., Plumb, J. M., Clemens, A., & van Staa, T. Thrombosis and Haemostasis, 106(5):968--977, November, 2011.
doi abstract bibtex
doi abstract bibtex
Atrial fibrillation (AF) carries an increased risk of ischaemic stroke, and oral anticoagulation with warfarin can reduce this risk. The objective of this study was to evaluate the association between time in therapeutic International Normalised Ratio (INR) range when receiving warfarin and the risk of stroke and mortality. The study cohort included AF patients aged 40 years and older included in the UK General Practice Research Database. For patients treated with warfarin we computed the percentage of follow-up time spent within therapeutic range. Cox regression was used to assess the association between INR and outcomes while controlling for patient demographics, health status and concomitant medication. The study population included 27,458 warfarin-treated (with at least 3 INR measurements) and 10,449 patients not treated with antithrombotic therapy. Overall the warfarin users spent 63% of their time within therapeutic range (TTR). This percentage did not vary substantially by age, sex and CHA2DS2-VASc score. Patients who spent at least 70% of time within therapeutic range had a 79% reduced risk of stroke compared to patients with ≤30% of time in range (adjusted relative rate of 0.21; 95% confidence interval 0.18-0.25). Mortality rates were also significantly lower with at least 70% of time spent within therapeutic range. In conclusion, good anticoagulation control was associated with a reduction in the risk of stroke.
@article{gallagher_risks_2011,
title = {Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients},
volume = {106},
issn = {0340-6245},
doi = {10.1160/TH11-05-0353},
abstract = {Atrial fibrillation (AF) carries an increased risk of ischaemic stroke, and oral anticoagulation with warfarin can reduce this risk. The objective of this study was to evaluate the association between time in therapeutic International Normalised Ratio (INR) range when receiving warfarin and the risk of stroke and mortality. The study cohort included AF patients aged 40 years and older included in the UK General Practice Research Database. For patients treated with warfarin we computed the percentage of follow-up time spent within therapeutic range. Cox regression was used to assess the association between INR and outcomes while controlling for patient demographics, health status and concomitant medication. The study population included 27,458 warfarin-treated (with at least 3 INR measurements) and 10,449 patients not treated with antithrombotic therapy. Overall the warfarin users spent 63\% of their time within therapeutic range (TTR). This percentage did not vary substantially by age, sex and CHA2DS2-VASc score. Patients who spent at least 70\% of time within therapeutic range had a 79\% reduced risk of stroke compared to patients with ≤30\% of time in range (adjusted relative rate of 0.21; 95\% confidence interval 0.18-0.25). Mortality rates were also significantly lower with at least 70\% of time spent within therapeutic range. In conclusion, good anticoagulation control was associated with a reduction in the risk of stroke.},
language = {eng},
number = {5},
journal = {Thrombosis and Haemostasis},
author = {Gallagher, A. M. and Setakis, E. and Plumb, J. M. and Clemens, A. and van Staa, T.-P.},
month = nov,
year = {2011},
pmid = {21901239},
keywords = {Adult, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Blood Coagulation, Drug Monitoring, Female, General Practice, Great Britain, Humans, International Normalized Ratio, Kaplan-Meier Estimate, Male, Middle Aged, Odds Ratio, Proportional Hazards Models, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Warfarin, databases as topic, stroke},
pages = {968--977}
}Long-term use of fluticasone propionate/salmeterol fixed-dose combination and incidence of cataracts and glaucoma among chronic obstructive pulmonary disease patients in the UK General Practice Research Database. Miller, D. P., Watkins, S. E., Sampson, T., & Davis, K. J. International Journal of Chronic Obstructive Pulmonary Disease, 6:467--476, 2011.
doi abstract bibtex
doi abstract bibtex
OBJECTIVES: Some large population-based studies have reported a dose-related increased risk of cataracts and glaucoma associated with use of inhaled corticosteroids (ICS) in patients with asthma or chronic obstructive pulmonary disease (COPD). We evaluated the association between use of ICS-containing products, specifically fluticasone propionate/salmeterol fixed-dose combination (FSC), and incidence of cataracts and glaucoma among patients with COPD in a large electronic medical record database in the United Kingdom. METHODS: We identified a cohort of patients aged 45 years and over with COPD in the General Practice Research Database (GPRD) between 2003 and 2006. Cases of incident cataracts or glaucoma were defined based on diagnosis and procedure codes and matched to controls from the risk set to estimate odds ratios (OR) and 95% confidence intervals (CI). The association with FSC or ICS exposure was modeled using conditional logistic regression. Medication exposure was assessed with respect to recency, duration, and number of prescriptions prior to the index date. Average daily dose was defined as none, low (1-250 mcg), medium (251-500 mcg), high (501-1000 mcg), or very high (1001+ mcg) using fluticasone propionate (FP) equivalents. RESULTS: We identified 2941 incident cataract cases and 327 incident glaucoma cases in the COPD cohort (n = 53,191). FSC or ICS prescriptions were not associated with risk of incident cataracts or glaucoma for any exposure category, after adjusting for confounders. We observed a lack of a dose response in all analyses, where low dose was the reference group. The odds of cataracts associated with FSC dose were medium OR: 1.1 (95% CI: 0.9-1.4); high OR: 1.2 (95% CI: 0.9-1.5); and very high OR: 1.2 (95% CI: 0.9-1.7). The odds of glaucoma associated with FSC dose: medium OR: 1.0 (95% CI: 0.5-2.1); high OR: 1.0 (95% CI: 0.5-2.0); and very high OR: 1.0 (95% CI: 0.4-2.8). CONCLUSIONS: FSC or other ICS exposure was not associated with an increased odds of cataracts or glaucoma, nor was a dose-response relationship observed in this population-based nested case-control study of COPD patients in the United Kingdom.
@article{miller_long-term_2011,
title = {Long-term use of fluticasone propionate/salmeterol fixed-dose combination and incidence of cataracts and glaucoma among chronic obstructive pulmonary disease patients in the {UK} {General} {Practice} {Research} {Database}},
volume = {6},
issn = {1178-2005},
doi = {10.2147/COPD.S14247},
abstract = {OBJECTIVES: Some large population-based studies have reported a dose-related increased risk of cataracts and glaucoma associated with use of inhaled corticosteroids (ICS) in patients with asthma or chronic obstructive pulmonary disease (COPD). We evaluated the association between use of ICS-containing products, specifically fluticasone propionate/salmeterol fixed-dose combination (FSC), and incidence of cataracts and glaucoma among patients with COPD in a large electronic medical record database in the United Kingdom.
METHODS: We identified a cohort of patients aged 45 years and over with COPD in the General Practice Research Database (GPRD) between 2003 and 2006. Cases of incident cataracts or glaucoma were defined based on diagnosis and procedure codes and matched to controls from the risk set to estimate odds ratios (OR) and 95\% confidence intervals (CI). The association with FSC or ICS exposure was modeled using conditional logistic regression. Medication exposure was assessed with respect to recency, duration, and number of prescriptions prior to the index date. Average daily dose was defined as none, low (1-250 mcg), medium (251-500 mcg), high (501-1000 mcg), or very high (1001+ mcg) using fluticasone propionate (FP) equivalents.
RESULTS: We identified 2941 incident cataract cases and 327 incident glaucoma cases in the COPD cohort (n = 53,191). FSC or ICS prescriptions were not associated with risk of incident cataracts or glaucoma for any exposure category, after adjusting for confounders. We observed a lack of a dose response in all analyses, where low dose was the reference group. The odds of cataracts associated with FSC dose were medium OR: 1.1 (95\% CI: 0.9-1.4); high OR: 1.2 (95\% CI: 0.9-1.5); and very high OR: 1.2 (95\% CI: 0.9-1.7). The odds of glaucoma associated with FSC dose: medium OR: 1.0 (95\% CI: 0.5-2.1); high OR: 1.0 (95\% CI: 0.5-2.0); and very high OR: 1.0 (95\% CI: 0.4-2.8).
CONCLUSIONS: FSC or other ICS exposure was not associated with an increased odds of cataracts or glaucoma, nor was a dose-response relationship observed in this population-based nested case-control study of COPD patients in the United Kingdom.},
language = {eng},
journal = {International Journal of Chronic Obstructive Pulmonary Disease},
author = {Miller, David P. and Watkins, Stephanie E. and Sampson, Tim and Davis, Kourtney J.},
year = {2011},
pmid = {22003292},
pmcid = {PMC3186745},
keywords = {Adrenergic beta-2 Receptor Agonists, Aged, Aged, 80 and over, Albuterol, Androstadienes, Bronchodilator Agents, Case-Control Studies, Cataract, Databases, Factual, Drug Administration Schedule, Drug Combinations, Female, General Practice, Glaucoma, Great Britain, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Pulmonary Disease, Chronic Obstructive, Risk, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, cataracts, fluticasone propionate/salmeterol, incidence, inhaled corticosteroids},
pages = {467--476}
}Traumatic brain injuries in illustrated literature: experience from a series of over 700 head injuries in the Asterix comic books. Kamp, M., a., Slotty, P., Sarikaya-Seiwert, S., Steiger, H., & Hänggi, D. Acta neurochirurgica, 153(6):1351-5; discussion 1355, 6, 2011.
Paper Website abstract bibtex
Paper Website abstract bibtex The goal of the present study was to analyze the epidemiology and specific risk factors of traumatic brain injury (TBI) in the Asterix illustrated comic books. Among the illustrated literature, TBI is a predominating injury pattern.
@article{
title = {Traumatic brain injuries in illustrated literature: experience from a series of over 700 head injuries in the Asterix comic books.},
type = {article},
year = {2011},
identifiers = {[object Object]},
keywords = {Adult,Books, Illustrated,Brain Injuries,Brain Injuries: diagnosis,Brain Injuries: epidemiology,Brain Injuries: etiology,Cross-Sectional Studies,Disability Evaluation,Female,Humans,Literature, Modern,Male,Medicine in Literature,Neurologic Examination,Retrospective Studies,Risk Factors,Roman World,Skull Base,Skull Base: injuries,Skull Fractures,Skull Fractures: diagnosis,Skull Fractures: epidemiology,Skull Fractures: etiology},
pages = {1351-5; discussion 1355},
volume = {153},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/21472486},
month = {6},
id = {bd582003-2ab7-3b09-a80f-31bfa92600d8},
created = {2017-06-01T08:24:01.728Z},
accessed = {2012-03-13},
file_attached = {true},
profile_id = {b6efe121-8b29-3abc-9df5-2353a8d30e77},
group_id = {32ad6c38-dd7d-39b9-9a71-86890e245b76},
last_modified = {2017-06-01T08:24:01.893Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
abstract = {The goal of the present study was to analyze the epidemiology and specific risk factors of traumatic brain injury (TBI) in the Asterix illustrated comic books. Among the illustrated literature, TBI is a predominating injury pattern.},
bibtype = {article},
author = {Kamp, Marcel a and Slotty, Philipp and Sarikaya-Seiwert, Sevgi and Steiger, Hans-Jakob and Hänggi, Daniel},
journal = {Acta neurochirurgica},
number = {6}
}Volume of mammographic density and risk of breast cancer. Shepherd, J. A., Kerlikowske, K., Ma, L., Duewer, F., Fan, B., Wang, J., Malkov, S., Vittinghoff, E., & Cummings, S. R. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 20(7):1473–1482, July, 2011.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Assessing the volume of mammographic density might more accurately reflect the amount of breast volume at risk of malignant transformation and provide a stronger indication of risk of breast cancer than methods based on qualitative scores or dense breast area. METHODS: We prospectively collected mammograms for women undergoing screening mammography. We determined the diagnosis of subsequent invasive or ductal carcinoma in situ for 275 cases, selected 825 controls matched for age, ethnicity, and mammography system, and assessed three measures of breast density: percent dense area, fibroglandular volume, and percent fibroglandular volume. RESULTS: After adjustment for familial breast cancer history, body mass index, history of breast biopsy, and age at first live birth, the ORs for breast cancer risk in the highest versus lowest measurement quintiles were 2.5 (95% CI: 1.5-4.3) for percent dense area, 2.9 (95% CI: 1.7-4.9) for fibroglandular volume, and 4.1 (95% CI: 2.3-7.2) for percent fibroglandular volume. Net reclassification indexes for density measures plus risk factors versus risk factors alone were 9.6% (P = 0.07) for percent dense area, 21.1% (P = 0.0001) for fibroglandular volume, and 14.8% (P = 0.004) for percent fibroglandular volume. Fibroglandular volume improved the categorical risk classification of 1 in 5 women for both women with and without breast cancer. CONCLUSION: Volumetric measures of breast density are more accurate predictors of breast cancer risk than risk factors alone and than percent dense area. IMPACT: Risk models including dense fibroglandular volume may more accurately predict breast cancer risk than current risk models.
@article{shepherd_volume_2011,
title = {Volume of mammographic density and risk of breast cancer},
volume = {20},
issn = {1538-7755},
doi = {10.1158/1055-9965.EPI-10-1150},
abstract = {BACKGROUND: Assessing the volume of mammographic density might more accurately reflect the amount of breast volume at risk of malignant transformation and provide a stronger indication of risk of breast cancer than methods based on qualitative scores or dense breast area.
METHODS: We prospectively collected mammograms for women undergoing screening mammography. We determined the diagnosis of subsequent invasive or ductal carcinoma in situ for 275 cases, selected 825 controls matched for age, ethnicity, and mammography system, and assessed three measures of breast density: percent dense area, fibroglandular volume, and percent fibroglandular volume.
RESULTS: After adjustment for familial breast cancer history, body mass index, history of breast biopsy, and age at first live birth, the ORs for breast cancer risk in the highest versus lowest measurement quintiles were 2.5 (95\% CI: 1.5-4.3) for percent dense area, 2.9 (95\% CI: 1.7-4.9) for fibroglandular volume, and 4.1 (95\% CI: 2.3-7.2) for percent fibroglandular volume. Net reclassification indexes for density measures plus risk factors versus risk factors alone were 9.6\% (P = 0.07) for percent dense area, 21.1\% (P = 0.0001) for fibroglandular volume, and 14.8\% (P = 0.004) for percent fibroglandular volume. Fibroglandular volume improved the categorical risk classification of 1 in 5 women for both women with and without breast cancer.
CONCLUSION: Volumetric measures of breast density are more accurate predictors of breast cancer risk than risk factors alone and than percent dense area.
IMPACT: Risk models including dense fibroglandular volume may more accurately predict breast cancer risk than current risk models.},
language = {eng},
number = {7},
journal = {Cancer Epidemiology, Biomarkers \& Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology},
author = {Shepherd, John A. and Kerlikowske, Karla and Ma, Lin and Duewer, Frederick and Fan, Bo and Wang, Jeff and Malkov, Serghei and Vittinghoff, Eric and Cummings, Steven R.},
month = jul,
year = {2011},
pmid = {21610220},
pmcid = {PMC3132306},
keywords = {Breast, Breast Neoplasms, Carcinoma, Ductal, Breast, Female, Humans, Mammography, Risk Factors, Surveys and Questionnaires},
pages = {1473--1482}
}2010 (6)
Estimating risk factors for farm-level transmission of disease: foot and mouth disease during the 2001 epidemic in Great Britain. Bessell, P. R., Shaw, D. J., Savill, N. J., & Woolhouse, M. E. J. Epidemics, 2(3):109--115, September, 2010.
doi abstract bibtex
doi abstract bibtex
Controlling an epidemic would be aided by establishing whether particular individuals in infected populations are more likely to transmit infection. However, few analyses have characterised such individuals. Such analyses require both data on who infected whom and on the likely determinants of transmission; data that are available at the farm level for the 2001 Foot and Mouth Disease epidemic in Great Britain. Using these data a putative number of daughter infected premises (IPs) resulting from each IP was calculated where these daughters were within 3km of the IP. A set of possible epidemiological, demographic, spatial and temporal risk factors were analysed, with the final multivariate generalised linear model (Poisson error term) having 6 statistically significant (p\textless0.05) main effects including geographic area, local cattle and sheep densities, and the number of non-IP culls. This model demonstrates that farms are heterogeneous in their propensity to transmit infection to other farms and, importantly, that it may be possible to identify holdings that are at high risk of spreading disease a priori. Such information could be used to help prioritise the response to an epidemic.
@article{bessell_estimating_2010,
title = {Estimating risk factors for farm-level transmission of disease: foot and mouth disease during the 2001 epidemic in {Great} {Britain}.},
volume = {2},
copyright = {Copyright (c) 2010 Elsevier B.V. All rights reserved.},
issn = {1878-0067 1878-0067},
doi = {10.1016/j.epidem.2010.06.002},
abstract = {Controlling an epidemic would be aided by establishing whether particular individuals in infected populations are more likely to transmit infection. However, few analyses have characterised such individuals. Such analyses require both data on who infected whom and on the likely determinants of transmission; data that are available at the farm level for the 2001 Foot and Mouth Disease epidemic in Great Britain. Using these data a putative number of daughter infected premises (IPs) resulting from each IP was calculated where these daughters were within 3km of the IP. A set of possible epidemiological, demographic, spatial and temporal risk factors were analysed, with the final multivariate generalised linear model (Poisson error term) having 6 statistically significant (p{\textless}0.05) main effects including geographic area, local cattle and sheep densities, and the number of non-IP culls. This model demonstrates that farms are heterogeneous in their propensity to transmit infection to other farms and, importantly, that it may be possible to identify holdings that are at high risk of spreading disease a priori. Such information could be used to help prioritise the response to an epidemic.},
language = {eng},
number = {3},
journal = {Epidemics},
author = {Bessell, Paul R. and Shaw, Darren J. and Savill, Nicholas J. and Woolhouse, Mark E. J.},
month = sep,
year = {2010},
pmid = {21352781},
keywords = {Animal Husbandry, Animals, Cattle, Epidemics/prevention \& control/statistics \& numerical data/*veterinary, Foot-and-Mouth Disease Virus/physiology, Foot-and-Mouth Disease/epidemiology/*transmission, Models, Biological, Multivariate Analysis, Poisson Distribution, Risk Factors, Sheep, United Kingdom/epidemiology},
pages = {109--115}
}Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the General Practice Research Database. Mehta, N. N., Azfar, R. S., Shin, D. B., Neimann, A. L., Troxel, A. B., & Gelfand, J. M. European Heart Journal, 31(8):1000--1006, April, 2010.
doi abstract bibtex
doi abstract bibtex
AIMS: Psoriasis is a common chronic inflammatory T-helper cell-1/17 mediated skin disease. Recent studies suggest that psoriasis, particularly if severe, may be an independent risk factor for atherosclerosis, myocardial infarction (MI), and stroke. We conducted a cohort study using the General Practice Research Database to determine if severe psoriasis patients have an increased risk of cardiovascular (CV) mortality. METHODS AND RESULTS: Severe psoriasis was defined as patients who received a psoriasis diagnosis and systemic therapy consistent with severe psoriasis (n = 3603). Up to four unexposed patients without psoriasis were selected from the same practices and start dates for each psoriasis patient (n = 14 330). For every death, the cause was determined by review of the electronic medical record. Severe psoriasis was an independent risk factor for CV mortality (HR 1.57; 95% CI 1.26, 1.96) when adjusting for age, sex, smoking, diabetes, hypertension, and hyperlipidaemia. Overall, severe psoriasis patients experienced one extra CV death per 283 patients per year, even when adjusting for major CV risk factors. The relative risk of CV mortality was modified by age. For example, the RR of CV death for a 40-year-old and 60-year-old with severe psoriasis was 2.69 (1.45, 4.99) and 1.92 (1.41, 2.62), respectively. The findings were robust to multiple sensitivity analyses. CONCLUSION: Patients with severe psoriasis have an increased risk of CV mortality that is independent of traditional CV risk factors. Additional studies are needed to determine the mechanism of this association and the impact that control of psoriasis has on CV risk.
@article{mehta_patients_2010,
title = {Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the {General} {Practice} {Research} {Database}},
volume = {31},
issn = {1522-9645},
shorttitle = {Patients with severe psoriasis are at increased risk of cardiovascular mortality},
doi = {10.1093/eurheartj/ehp567},
abstract = {AIMS: Psoriasis is a common chronic inflammatory T-helper cell-1/17 mediated skin disease. Recent studies suggest that psoriasis, particularly if severe, may be an independent risk factor for atherosclerosis, myocardial infarction (MI), and stroke. We conducted a cohort study using the General Practice Research Database to determine if severe psoriasis patients have an increased risk of cardiovascular (CV) mortality.
METHODS AND RESULTS: Severe psoriasis was defined as patients who received a psoriasis diagnosis and systemic therapy consistent with severe psoriasis (n = 3603). Up to four unexposed patients without psoriasis were selected from the same practices and start dates for each psoriasis patient (n = 14 330). For every death, the cause was determined by review of the electronic medical record. Severe psoriasis was an independent risk factor for CV mortality (HR 1.57; 95\% CI 1.26, 1.96) when adjusting for age, sex, smoking, diabetes, hypertension, and hyperlipidaemia. Overall, severe psoriasis patients experienced one extra CV death per 283 patients per year, even when adjusting for major CV risk factors. The relative risk of CV mortality was modified by age. For example, the RR of CV death for a 40-year-old and 60-year-old with severe psoriasis was 2.69 (1.45, 4.99) and 1.92 (1.41, 2.62), respectively. The findings were robust to multiple sensitivity analyses.
CONCLUSION: Patients with severe psoriasis have an increased risk of CV mortality that is independent of traditional CV risk factors. Additional studies are needed to determine the mechanism of this association and the impact that control of psoriasis has on CV risk.},
language = {eng},
number = {8},
journal = {European Heart Journal},
author = {Mehta, Nehal N. and Azfar, Rahat S. and Shin, Daniel B. and Neimann, Andrea L. and Troxel, Andrea B. and Gelfand, Joel M.},
month = apr,
year = {2010},
pmid = {20037179},
pmcid = {PMC2894736},
keywords = {Adult, Aged, Cardiovascular Diseases, Dermatologic Agents, Female, Great Britain, Humans, Male, Middle Aged, Psoriasis, Risk Factors, incidence},
pages = {1000--1006}
}Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management: population-based cohort study. Gulliford, M. C., Charlton, J., Rudd, A., Wolfe, C. D., & Toschke, A. M. Journal of Neurology, Neurosurgery, and Psychiatry, 81(4):416--422, April, 2010.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: The authors estimated trends in 1-year case-fatality of stroke in relation to changes in vascular risk management from 1997 to 2005. METHODS: A cohort study was implemented using data for 407 family practices in the UK General Practice Research Database, including subjects with first acute strokes between 1997 and 2005. One-year case-fatality was estimated by year and sex. Rate ratios were estimated using Poisson regression. RESULTS: There were 19 143 women and 16 552 men who had first acute strokes between 1997 and 2005. In women, the 1-year case-fatality declined from 41.2% in 1997 to 29.2% in 2005. In men, the decline was from 29.2% in 1997 to 22.2% in 2005. The proportion of general practices that prescribed antihypertensive drugs to two-thirds or more of new patients with stroke increased from 6% in 1997 to 48% in 2005, for statins from 1% to 39% and for antiplatelet drugs from 11% to 39%. The rate ratio for 1-year mortality in 2005, compared with 1997-1998, adjusted for age group, sex, prevalent coronary heart disease, prevalent hypertension and deprivation quintile was 0.79 (0.74 to 0.86, p\textless0.001). After adjustment for antihypertensive, statin and antiplatelet prescribing, the rate ratio was 1.29 (1.17 to 1.42). CONCLUSIONS: Reducing 1-year case-fatality after acute stroke may be partly explained by increased prescribing of antihypertensive, statin and antiplatelet drugs to patients with recent strokes. However, these analyses did not include measures of possible changes over time in stroke severity or acute stroke management.
@article{gulliford_declining_2010,
title = {Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management: population-based cohort study},
volume = {81},
issn = {1468-330X},
shorttitle = {Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management},
doi = {10.1136/jnnp.2009.193136},
abstract = {BACKGROUND: The authors estimated trends in 1-year case-fatality of stroke in relation to changes in vascular risk management from 1997 to 2005.
METHODS: A cohort study was implemented using data for 407 family practices in the UK General Practice Research Database, including subjects with first acute strokes between 1997 and 2005. One-year case-fatality was estimated by year and sex. Rate ratios were estimated using Poisson regression.
RESULTS: There were 19 143 women and 16 552 men who had first acute strokes between 1997 and 2005. In women, the 1-year case-fatality declined from 41.2\% in 1997 to 29.2\% in 2005. In men, the decline was from 29.2\% in 1997 to 22.2\% in 2005. The proportion of general practices that prescribed antihypertensive drugs to two-thirds or more of new patients with stroke increased from 6\% in 1997 to 48\% in 2005, for statins from 1\% to 39\% and for antiplatelet drugs from 11\% to 39\%. The rate ratio for 1-year mortality in 2005, compared with 1997-1998, adjusted for age group, sex, prevalent coronary heart disease, prevalent hypertension and deprivation quintile was 0.79 (0.74 to 0.86, p{\textless}0.001). After adjustment for antihypertensive, statin and antiplatelet prescribing, the rate ratio was 1.29 (1.17 to 1.42).
CONCLUSIONS: Reducing 1-year case-fatality after acute stroke may be partly explained by increased prescribing of antihypertensive, statin and antiplatelet drugs to patients with recent strokes. However, these analyses did not include measures of possible changes over time in stroke severity or acute stroke management.},
language = {eng},
number = {4},
journal = {Journal of Neurology, Neurosurgery, and Psychiatry},
author = {Gulliford, Martin C. and Charlton, Judith and Rudd, Anthony and Wolfe, Charles D. and Toschke, André Michael},
month = apr,
year = {2010},
pmid = {20176596},
pmcid = {PMC2921278},
keywords = {Antihypertensive Agents, Cerebrovascular Disorders, Cohort Studies, Drug Prescriptions, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hypertension, Male, Platelet Aggregation Inhibitors, Population Surveillance, Risk Factors, Risk Reduction Behavior, Survival Rate, stroke},
pages = {416--422}
}Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database. Cornish, R., Macleod, J., Strang, J., Vickerman, P., & Hickman, M. BMJ (Clinical research ed.), 341:c5475, 2010.
abstract bibtex
abstract bibtex
OBJECTIVE: To investigate the effect of opiate substitution treatment at the beginning and end of treatment and according to duration of treatment. DESIGN: Prospective cohort study. Setting UK General Practice Research Database. PARTICIPANTS: Primary care patients with a diagnosis of substance misuse prescribed methadone or buprenorphine during 1990-2005. 5577 patients with 267 003 prescriptions for opiate substitution treatment followed-up (17 732 years) until one year after the expiry of their last prescription, the date of death before this time had elapsed, or the date of transfer away from the practice. MAIN OUTCOME MEASURES: Mortality rates and rate ratios comparing periods in and out of treatment adjusted for sex, age, calendar year, and comorbidity; standardised mortality ratios comparing opiate users' mortality with general population mortality rates. RESULTS: Crude mortality rates were 0.7 per 100 person years on opiate substitution treatment and 1.3 per 100 person years off treatment; standardised mortality ratios were 5.3 (95% confidence interval 4.0 to 6.8) on treatment and 10.9 (9.0 to 13.1) off treatment. Men using opiates had approximately twice the risk of death of women (morality rate ratio 2.0, 1.4 to 2.9). In the first two weeks of opiate substitution treatment the crude mortality rate was 1.7 per 100 person years: 3.1 (1.5 to 6.6) times higher (after adjustment for sex, age group, calendar period, and comorbidity) than the rate during the rest of time on treatment. The crude mortality rate was 4.8 per 100 person years in weeks 1-2 after treatment stopped, 4.3 in weeks 3-4, and 0.95 during the rest of time off treatment: 9 (5.4 to 14.9), 8 (4.7 to 13.7), and 1.9 (1.3 to 2.8) times higher than the baseline risk of mortality during treatment. Opiate substitution treatment has a greater than 85% chance of reducing overall mortality among opiate users if the average duration approaches or exceeds 12 months. CONCLUSIONS: Clinicians and patients should be aware of the increased mortality risk at the start of opiate substitution treatment and immediately after stopping treatment. Further research is needed to investigate the effect of average duration of opiate substitution treatment on drug related mortality.
@article{cornish_risk_2010,
title = {Risk of death during and after opiate substitution treatment in primary care: prospective observational study in {UK} {General} {Practice} {Research} {Database}},
volume = {341},
issn = {1756-1833},
shorttitle = {Risk of death during and after opiate substitution treatment in primary care},
abstract = {OBJECTIVE: To investigate the effect of opiate substitution treatment at the beginning and end of treatment and according to duration of treatment.
DESIGN: Prospective cohort study. Setting UK General Practice Research Database.
PARTICIPANTS: Primary care patients with a diagnosis of substance misuse prescribed methadone or buprenorphine during 1990-2005. 5577 patients with 267 003 prescriptions for opiate substitution treatment followed-up (17 732 years) until one year after the expiry of their last prescription, the date of death before this time had elapsed, or the date of transfer away from the practice.
MAIN OUTCOME MEASURES: Mortality rates and rate ratios comparing periods in and out of treatment adjusted for sex, age, calendar year, and comorbidity; standardised mortality ratios comparing opiate users' mortality with general population mortality rates.
RESULTS: Crude mortality rates were 0.7 per 100 person years on opiate substitution treatment and 1.3 per 100 person years off treatment; standardised mortality ratios were 5.3 (95\% confidence interval 4.0 to 6.8) on treatment and 10.9 (9.0 to 13.1) off treatment. Men using opiates had approximately twice the risk of death of women (morality rate ratio 2.0, 1.4 to 2.9). In the first two weeks of opiate substitution treatment the crude mortality rate was 1.7 per 100 person years: 3.1 (1.5 to 6.6) times higher (after adjustment for sex, age group, calendar period, and comorbidity) than the rate during the rest of time on treatment. The crude mortality rate was 4.8 per 100 person years in weeks 1-2 after treatment stopped, 4.3 in weeks 3-4, and 0.95 during the rest of time off treatment: 9 (5.4 to 14.9), 8 (4.7 to 13.7), and 1.9 (1.3 to 2.8) times higher than the baseline risk of mortality during treatment. Opiate substitution treatment has a greater than 85\% chance of reducing overall mortality among opiate users if the average duration approaches or exceeds 12 months.
CONCLUSIONS: Clinicians and patients should be aware of the increased mortality risk at the start of opiate substitution treatment and immediately after stopping treatment. Further research is needed to investigate the effect of average duration of opiate substitution treatment on drug related mortality.},
language = {eng},
journal = {BMJ (Clinical research ed.)},
author = {Cornish, Rosie and Macleod, John and Strang, John and Vickerman, Peter and Hickman, Matt},
year = {2010},
pmid = {20978062},
pmcid = {PMC2965139},
keywords = {Adolescent, Adult, Buprenorphine, Female, Great Britain, Humans, Male, Methadone, Middle Aged, Narcotics, Opioid-Related Disorders, Prospective Studies, Risk Factors, Time Factors, Young Adult},
pages = {c5475}
}Age-related hyperkyphosis: its causes, consequences, and management. Katzman, W. B., Wanek, L., Shepherd, J. A., & Sellmeyer, D. E. The Journal of Orthopaedic and Sports Physical Therapy, 40(6):352–360, June, 2010.
doi abstract bibtex
doi abstract bibtex
SYNOPSIS: Age-related hyperkyphosis is an exaggerated anterior curvature in the thoracic spine that occurs commonly with advanced age. This condition is associated with low bone mass, vertebral compression fractures, and degenerative disc disease, and contributes to difficulty performing activities of daily living and decline in physical performance. While there are effective treatments, currently there are no public health approaches to prevent hyperkyphosis among older adults. Our objective is to review the prevalence and natural history of hyperkyphosis, associated health implications, measurement tools, and treatments to prevent this debilitating condition. LEVEL OF EVIDENCE: Diagnosis/prognosis/therapy, level 5.J Orthop Sports Phys Ther 2010;40(6):352-360, Epub 15 April 2010. doi:10.2519/jospt.2010.3099.
@article{katzman_age-related_2010,
title = {Age-related hyperkyphosis: its causes, consequences, and management},
volume = {40},
issn = {0190-6011},
shorttitle = {Age-related hyperkyphosis},
doi = {10.2519/jospt.2010.3099},
abstract = {SYNOPSIS: Age-related hyperkyphosis is an exaggerated anterior curvature in the thoracic spine that occurs commonly with advanced age. This condition is associated with low bone mass, vertebral compression fractures, and degenerative disc disease, and contributes to difficulty performing activities of daily living and decline in physical performance. While there are effective treatments, currently there are no public health approaches to prevent hyperkyphosis among older adults. Our objective is to review the prevalence and natural history of hyperkyphosis, associated health implications, measurement tools, and treatments to prevent this debilitating condition.
LEVEL OF EVIDENCE: Diagnosis/prognosis/therapy, level 5.J Orthop Sports Phys Ther 2010;40(6):352-360, Epub 15 April 2010. doi:10.2519/jospt.2010.3099.},
language = {eng},
number = {6},
journal = {The Journal of Orthopaedic and Sports Physical Therapy},
author = {Katzman, Wendy B. and Wanek, Linda and Shepherd, John A. and Sellmeyer, Deborah E.},
month = jun,
year = {2010},
pmid = {20511692},
pmcid = {PMC2907357},
keywords = {Activities of Daily Living, Aged, Aging, Braces, Exercise, Humans, Kyphosis, Mobility Limitation, Muscle Weakness, Muscle, Skeletal, Musculoskeletal Manipulations, Orthopedic Equipment, Orthopedic Procedures, Physical Examination, Proprioception, Quality of Life, Radiography, Risk Factors, Spinal Cord Diseases, Spine, Surgical Tape},
pages = {352--360}
}Assessing the quality of surgical care in vascular surgery; moving from outcome towards structural and process measures. Ploeg, A. J., Flu, H. C., Lardenoye, J. H. P., Hamming, J. F., & Breslau, P. J. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 40(6):696–707, December, 2010.
doi abstract bibtex
doi abstract bibtex
OBJECTIVES: This study presents a review of studies reporting on quality of care in vascular surgery. The aim of this study was to provide insight in quality improvement initiatives in vascular surgery. DESIGN: Original data were collected from MEDLINE and EMBASE databases. Inclusion criteria were: description of one of the three factors of quality of care, e.g. process, outcome or structure and prospectively described. All articles identified were ascribed to a domain of quality of care. RESULTS: 57 prospective articles were included, drawn from 859 eligible reports. Structure as an indicator of quality of care was described in 19 reports, process in 7 reports and outcome in 31 reports. Most studies based on structural measures considered the introduction of a clinical pathway or a registration system. Reports based on process measures showed promising results. Outcome as clinical indicator mainly focussed on identifying risk factors for morbidity, mortality or failure of treatment. CONCLUSIONS: Structure and process indicators are evaluated scarcely in vascular surgery. Many studies in vascular surgery have been focussed on outcomes as indicator of quality of care, but a shift towards process measures should be considered as focus of attention in the future.
@article{ploeg_assessing_2010,
title = {Assessing the quality of surgical care in vascular surgery; moving from outcome towards structural and process measures},
volume = {40},
issn = {1532-2165},
doi = {10.1016/j.ejvs.2010.05.010},
abstract = {OBJECTIVES: This study presents a review of studies reporting on quality of care in vascular surgery. The aim of this study was to provide insight in quality improvement initiatives in vascular surgery.
DESIGN: Original data were collected from MEDLINE and EMBASE databases. Inclusion criteria were: description of one of the three factors of quality of care, e.g. process, outcome or structure and prospectively described. All articles identified were ascribed to a domain of quality of care.
RESULTS: 57 prospective articles were included, drawn from 859 eligible reports. Structure as an indicator of quality of care was described in 19 reports, process in 7 reports and outcome in 31 reports. Most studies based on structural measures considered the introduction of a clinical pathway or a registration system. Reports based on process measures showed promising results. Outcome as clinical indicator mainly focussed on identifying risk factors for morbidity, mortality or failure of treatment.
CONCLUSIONS: Structure and process indicators are evaluated scarcely in vascular surgery. Many studies in vascular surgery have been focussed on outcomes as indicator of quality of care, but a shift towards process measures should be considered as focus of attention in the future.},
language = {eng},
number = {6},
journal = {European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery},
author = {Ploeg, A. J. and Flu, H. C. and Lardenoye, J. H. P. and Hamming, J. F. and Breslau, P. J.},
month = dec,
year = {2010},
pmid = {20889355},
keywords = {Critical Pathways, Health Services Research, Humans, Outcome and Process Assessment (Health Care), Prospective Studies, Quality Indicators, Health Care, Research Design, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Vascular Surgical Procedures},
pages = {696--707}
}2009 (6)
Renal vulnerability to drug toxicity. Perazella, M. A. Clinical journal of the American Society of Nephrology: CJASN, 4(7):1275–1283, July, 2009.
doi abstract bibtex
doi abstract bibtex
Drug-induced kidney disease occurs primarily in patients with underlying risk factors. A number of factors enhance the vulnerability of the kidney to the nephrotoxic effects of drugs and toxins. They are broadly categorized as patient-specific, kidney-related, and drug-related factors. One, two, or all three of the factor categories can act to promote various forms of renal injury. Importantly, all compartments of the kidney can be affected and result in one or more classic clinical renal syndromes. These include acute kidney injury, various tubulopathies, proteinuric renal disease, and chronic kidney disease. Recognizing risk factors that increase renal vulnerability to drug-induced kidney disease is the first step in reducing the renal complications of drugs and toxins.
@article{perazella_renal_2009,
title = {Renal vulnerability to drug toxicity},
volume = {4},
issn = {1555-905X},
doi = {10.2215/CJN.02050309},
abstract = {Drug-induced kidney disease occurs primarily in patients with underlying risk factors. A number of factors enhance the vulnerability of the kidney to the nephrotoxic effects of drugs and toxins. They are broadly categorized as patient-specific, kidney-related, and drug-related factors. One, two, or all three of the factor categories can act to promote various forms of renal injury. Importantly, all compartments of the kidney can be affected and result in one or more classic clinical renal syndromes. These include acute kidney injury, various tubulopathies, proteinuric renal disease, and chronic kidney disease. Recognizing risk factors that increase renal vulnerability to drug-induced kidney disease is the first step in reducing the renal complications of drugs and toxins.},
language = {eng},
number = {7},
journal = {Clinical journal of the American Society of Nephrology: CJASN},
author = {Perazella, Mark A.},
month = jul,
year = {2009},
pmid = {19520747},
keywords = {Drug-Related Side Effects and Adverse Reactions, Humans, Kidney Diseases, Risk Factors},
pages = {1275--1283}
}Prevention of breast cancer in postmenopausal women: approaches to estimating and reducing risk. Cummings, S. R., Tice, J. A., Bauer, S., Browner, W. S., Cuzick, J., Ziv, E., Vogel, V., Shepherd, J., Vachon, C., Smith-Bindman, R., & Kerlikowske, K. Journal of the National Cancer Institute, 101(6):384–398, March, 2009.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: It is uncertain whether evidence supports routinely estimating a postmenopausal woman's risk of breast cancer and intervening to reduce risk. METHODS: We systematically reviewed prospective studies about models and sex hormone levels to assess breast cancer risk and used meta-analysis with random effects models to summarize the predictive accuracy of breast density. We also reviewed prospective studies of the effects of exercise, weight management, healthy diet, moderate alcohol consumption, and fruit and vegetable intake on breast cancer risk, and used random effects models for a meta-analyses of tamoxifen and raloxifene for primary prevention of breast cancer. All studies reviewed were published before June 2008, and all statistical tests were two-sided. RESULTS: Risk models that are based on demographic characteristics and medical history had modest discriminatory accuracy for estimating breast cancer risk (c-statistics range = 0.58-0.63). Breast density was strongly associated with breast cancer (relative risk [RR] = 4.03, 95% confidence interval [CI] = 3.10 to 5.26, for Breast Imaging Reporting and Data System category IV vs category I; RR = 4.20, 95% CI = 3.61 to 4.89, for \textgreater75% vs \textless5% of dense area), and adding breast density to models improved discriminatory accuracy (c-statistics range = 0.63-0.66). Estradiol was also associated with breast cancer (RR range = 2.0-2.9, comparing the highest vs lowest quintile of estradiol, P \textless .01). Most studies found that exercise, weight reduction, low-fat diet, and reduced alcohol intake were associated with a decreased risk of breast cancer. Tamoxifen and raloxifene reduced the risk of estrogen receptor-positive invasive breast cancer and invasive breast cancer overall. CONCLUSIONS: Evidence from this study supports screening for breast cancer risk in all postmenopausal women by use of risk factors and breast density and considering chemoprevention for those found to be at high risk. Several lifestyle changes with the potential to prevent breast cancer should be recommended regardless of risk.
@article{cummings_prevention_2009,
title = {Prevention of breast cancer in postmenopausal women: approaches to estimating and reducing risk},
volume = {101},
issn = {1460-2105},
shorttitle = {Prevention of breast cancer in postmenopausal women},
doi = {10.1093/jnci/djp018},
abstract = {BACKGROUND: It is uncertain whether evidence supports routinely estimating a postmenopausal woman's risk of breast cancer and intervening to reduce risk.
METHODS: We systematically reviewed prospective studies about models and sex hormone levels to assess breast cancer risk and used meta-analysis with random effects models to summarize the predictive accuracy of breast density. We also reviewed prospective studies of the effects of exercise, weight management, healthy diet, moderate alcohol consumption, and fruit and vegetable intake on breast cancer risk, and used random effects models for a meta-analyses of tamoxifen and raloxifene for primary prevention of breast cancer. All studies reviewed were published before June 2008, and all statistical tests were two-sided.
RESULTS: Risk models that are based on demographic characteristics and medical history had modest discriminatory accuracy for estimating breast cancer risk (c-statistics range = 0.58-0.63). Breast density was strongly associated with breast cancer (relative risk [RR] = 4.03, 95\% confidence interval [CI] = 3.10 to 5.26, for Breast Imaging Reporting and Data System category IV vs category I; RR = 4.20, 95\% CI = 3.61 to 4.89, for {\textgreater}75\% vs {\textless}5\% of dense area), and adding breast density to models improved discriminatory accuracy (c-statistics range = 0.63-0.66). Estradiol was also associated with breast cancer (RR range = 2.0-2.9, comparing the highest vs lowest quintile of estradiol, P {\textless} .01). Most studies found that exercise, weight reduction, low-fat diet, and reduced alcohol intake were associated with a decreased risk of breast cancer. Tamoxifen and raloxifene reduced the risk of estrogen receptor-positive invasive breast cancer and invasive breast cancer overall.
CONCLUSIONS: Evidence from this study supports screening for breast cancer risk in all postmenopausal women by use of risk factors and breast density and considering chemoprevention for those found to be at high risk. Several lifestyle changes with the potential to prevent breast cancer should be recommended regardless of risk.},
language = {eng},
number = {6},
journal = {Journal of the National Cancer Institute},
author = {Cummings, Steven R. and Tice, Jeffrey A. and Bauer, Scott and Browner, Warren S. and Cuzick, Jack and Ziv, Elad and Vogel, Victor and Shepherd, John and Vachon, Celine and Smith-Bindman, Rebecca and Kerlikowske, Karla},
month = mar,
year = {2009},
pmid = {19276457},
pmcid = {PMC2720698},
keywords = {Aged, Antineoplastic Agents, Hormonal, Biomarkers, Tumor, Breast, Breast Neoplasms, Case-Control Studies, Confidence Intervals, Confounding Factors (Epidemiology), Estrogen Receptor Modulators, Female, Gonadal Steroid Hormones, Humans, Life Style, Middle Aged, Models, Statistical, Odds Ratio, Postmenopause, Predictive Value of Tests, Prospective Studies, Raloxifene Hydrochloride, Randomized Controlled Trials as Topic, Research Design, Risk Assessment, Risk Factors, Risk Reduction Behavior, Tamoxifen},
pages = {384--398}
}Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Andersohn, F., Schade, R., Suissa, S., & Garbe, E. The American Journal of Psychiatry, 166(5):591--598, May, 2009.
doi abstract bibtex
doi abstract bibtex
OBJECTIVE: Use of antidepressants has been reported to cause considerable weight gain. The aim of this study was to assess the risk of diabetes mellitus associated with antidepressant treatment and to examine whether the risk is influenced by treatment duration or daily dose. METHOD: This was a nested case-control study in a cohort of 165,958 patients with depression who received at least one new prescription for an antidepressant between January 1, 1990, and June 30, 2005. Data were from from the U.K. General Practice Research Database. Patients were at least 30 years of age and without diabetes at cohort entry. RESULTS: A total of 2,243 cases of incident diabetes mellitus and 8,963 matched comparison subjects were identified. Compared with no use of antidepressants during the past 2 years, recent long-term use (\textgreater24 months) of antidepressants in moderate to high daily doses was associated with an increased risk of diabetes (incidence rate ratio=1.84, 95% CI=1.35-2.52). The magnitude of the risk was similar for long-term use of moderate to high daily doses of tricyclic antidepressants (incidence rate ratio=1.77, 95% CI=1.21-2.59) and selective serotonin reuptake inhibitors (incidence rate ratio=2.06, 95% CI=1.20-3.52). Treatment for shorter periods or with lower daily doses was not associated with an increased risk. CONCLUSIONS: Long-term use of antidepressants in at least moderate daily doses was associated with an increased risk of diabetes. This association was observed for both tricyclic antidepressants and selective serotonin reuptake inhibitors.
@article{andersohn_long-term_2009,
title = {Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus},
volume = {166},
issn = {1535-7228},
doi = {10.1176/appi.ajp.2008.08071065},
abstract = {OBJECTIVE: Use of antidepressants has been reported to cause considerable weight gain. The aim of this study was to assess the risk of diabetes mellitus associated with antidepressant treatment and to examine whether the risk is influenced by treatment duration or daily dose.
METHOD: This was a nested case-control study in a cohort of 165,958 patients with depression who received at least one new prescription for an antidepressant between January 1, 1990, and June 30, 2005. Data were from from the U.K. General Practice Research Database. Patients were at least 30 years of age and without diabetes at cohort entry.
RESULTS: A total of 2,243 cases of incident diabetes mellitus and 8,963 matched comparison subjects were identified. Compared with no use of antidepressants during the past 2 years, recent long-term use ({\textgreater}24 months) of antidepressants in moderate to high daily doses was associated with an increased risk of diabetes (incidence rate ratio=1.84, 95\% CI=1.35-2.52). The magnitude of the risk was similar for long-term use of moderate to high daily doses of tricyclic antidepressants (incidence rate ratio=1.77, 95\% CI=1.21-2.59) and selective serotonin reuptake inhibitors (incidence rate ratio=2.06, 95\% CI=1.20-3.52). Treatment for shorter periods or with lower daily doses was not associated with an increased risk.
CONCLUSIONS: Long-term use of antidepressants in at least moderate daily doses was associated with an increased risk of diabetes. This association was observed for both tricyclic antidepressants and selective serotonin reuptake inhibitors.},
language = {eng},
number = {5},
journal = {The American Journal of Psychiatry},
author = {Andersohn, Frank and Schade, René and Suissa, Samy and Garbe, Edeltraut},
month = may,
year = {2009},
pmid = {19339356},
keywords = {Amitriptyline, Antidepressive Agents, Tricyclic, Body Mass Index, Case-Control Studies, Cyclohexanols, Depressive Disorder, Female, Fluvoxamine, Great Britain, Humans, Male, Middle Aged, Paroxetine, Risk Factors, Serotonin Uptake Inhibitors, Time Factors, diabetes mellitus, incidence},
pages = {591--598}
}Sleep apnoea and sleep breathing disorders. O Reilly, J. British journal of hospital medicine (London, England : 2005), 70(6):320-6, 6, 2009.
Paper abstract bibtex
Paper abstract bibtex Sleep apnoea and related sleep breathing disorders are a major cause of medical, social and occupational disability. Excessive sleepiness may be associated with respiratory failure, obesity, hypertension and insulin resistance in the cardiometabolic syndrome. This article reviews practical assessment and management.
@article{
id = {47698e21-3e15-3700-a5dc-aa0503c09f51},
title = {Sleep apnoea and sleep breathing disorders.},
type = {article},
year = {2009},
identifiers = {[object Object]},
keywords = {Continuous Positive Airway Pressure,Continuous Positive Airway Pressure: methods,Female,Humans,Male,Middle Aged,Oximetry,Quality of Life,Risk Factors,Sleep Apnea Syndromes,Sleep Apnea Syndromes: diagnosis,Sleep Apnea Syndromes: etiology,Sleep Apnea Syndromes: therapy,Snoring,Snoring: diagnosis,Snoring: etiology,Snoring: therapy},
created = {2010-08-14T01:09:57.000Z},
pages = {320-6},
volume = {70},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/19516207},
month = {6},
file_attached = {true},
profile_id = {fe7067eb-58b8-34c6-b8cd-6717fdf7605c},
group_id = {ba0deb47-e19a-3151-83cc-b6262d5edb6e},
last_modified = {2014-07-19T19:17:36.000Z},
read = {true},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
citation_key = {OReilly2009},
client_data = {"desktop_id":"d213605e-6754-4e1d-9dd5-4886055b4438"},
abstract = {Sleep apnoea and related sleep breathing disorders are a major cause of medical, social and occupational disability. Excessive sleepiness may be associated with respiratory failure, obesity, hypertension and insulin resistance in the cardiometabolic syndrome. This article reviews practical assessment and management.},
bibtype = {article},
author = {O Reilly, John},
journal = {British journal of hospital medicine (London, England : 2005)},
number = {6}
}Mortality associated with attention-deficit hyperactivity disorder (ADHD) drug treatment: a retrospective cohort study of children, adolescents and young adults using the general practice research database. McCarthy, S., Cranswick, N., Potts, L., Taylor, E., & Wong, I. C. K. Drug Safety, 32(11):1089--1096, 2009.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Following reports of sudden death in patients taking medication to treat attention-deficit hyperactivity disorder (ADHD), this study aimed to identify cases of death in patients prescribed stimulants and atomoxetine and to determine any association between these and sudden death. METHOD: The UK General Practice Research Database (GPRD) was used to identify patients aged 2-21 years from 1 January 1993 to 30 June 2006 with a prescription for methylphenidate, dexamfetamine or atomoxetine. Patients were followed from the date of first prescription until whichever came first: date of death, transferred-out date, age \textgreater21 years or end of the study period. RESULTS: From a cohort of 18 637 patient-years, seven patients died. Cause of death was obtained for six of the patients. None were deemed to be cases of sudden death. Compared with a general population rate of sudden death in the literature, the worst-case scenario of one case of sudden death gave an incident rate ratio of 1.63 (95% CI 0.04, 9.71). Although it was not the primary outcome of the study, following reports of suicide in the cohort the standardized mortality ratio (SMR) of suicide was calculated. Due to differences in the definition of suicide used for children and adults, patients were categorized into two age groups: 11-14 years and 15-21 years. The SMR for suicide for patients aged 11-14 years was 161.91 (95% CI 19.61, 584.88). The SMR for suicide for patients aged 15-21 years was 1.84 (95% CI 0.05, 10.25). CONCLUSION: This study demonstrated no increase in the risk of sudden death associated with stimulants or atomoxetine. However, an increased risk of suicide was seen. Although we cannot exclude that the medications may contribute to the increased risk of suicide, there are other factors such as depression and antisocial behaviour that frequently co-exist with ADHD, which can also predispose to teenage suicide. Clinicians should identify patients at increased risk of cardiovascular events and identify those patients at increased risk of suicide, particularly males with co-morbid conditions, and monitor them appropriately.
@article{mccarthy_mortality_2009,
title = {Mortality associated with attention-deficit hyperactivity disorder ({ADHD}) drug treatment: a retrospective cohort study of children, adolescents and young adults using the general practice research database},
volume = {32},
issn = {0114-5916},
shorttitle = {Mortality associated with attention-deficit hyperactivity disorder ({ADHD}) drug treatment},
doi = {10.2165/11317630-000000000-00000},
abstract = {BACKGROUND: Following reports of sudden death in patients taking medication to treat attention-deficit hyperactivity disorder (ADHD), this study aimed to identify cases of death in patients prescribed stimulants and atomoxetine and to determine any association between these and sudden death.
METHOD: The UK General Practice Research Database (GPRD) was used to identify patients aged 2-21 years from 1 January 1993 to 30 June 2006 with a prescription for methylphenidate, dexamfetamine or atomoxetine. Patients were followed from the date of first prescription until whichever came first: date of death, transferred-out date, age {\textgreater}21 years or end of the study period.
RESULTS: From a cohort of 18 637 patient-years, seven patients died. Cause of death was obtained for six of the patients. None were deemed to be cases of sudden death. Compared with a general population rate of sudden death in the literature, the worst-case scenario of one case of sudden death gave an incident rate ratio of 1.63 (95\% CI 0.04, 9.71). Although it was not the primary outcome of the study, following reports of suicide in the cohort the standardized mortality ratio (SMR) of suicide was calculated. Due to differences in the definition of suicide used for children and adults, patients were categorized into two age groups: 11-14 years and 15-21 years. The SMR for suicide for patients aged 11-14 years was 161.91 (95\% CI 19.61, 584.88). The SMR for suicide for patients aged 15-21 years was 1.84 (95\% CI 0.05, 10.25).
CONCLUSION: This study demonstrated no increase in the risk of sudden death associated with stimulants or atomoxetine. However, an increased risk of suicide was seen. Although we cannot exclude that the medications may contribute to the increased risk of suicide, there are other factors such as depression and antisocial behaviour that frequently co-exist with ADHD, which can also predispose to teenage suicide. Clinicians should identify patients at increased risk of cardiovascular events and identify those patients at increased risk of suicide, particularly males with co-morbid conditions, and monitor them appropriately.},
language = {eng},
number = {11},
journal = {Drug Safety},
author = {McCarthy, Suzanne and Cranswick, Noel and Potts, Laura and Taylor, Eric and Wong, Ian C. K.},
year = {2009},
pmid = {19810780},
keywords = {Adolescent, Adrenergic Uptake Inhibitors, Attention Deficit Disorder with Hyperactivity, Cause of Death, Central Nervous System Stimulants, Child, Child, Preschool, Cohort Studies, Databases, Factual, Death, Sudden, Dextroamphetamine, Female, Great Britain, Humans, Male, Methylphenidate, Propylamines, Retrospective Studies, Risk Factors, Suicide, Young Adult},
pages = {1089--1096}
}Management of hirsutism. Alsantali, A & Shapiro, J Skin therapy letter, 14(7):1--3, September, 2009.
abstract bibtex
abstract bibtex
Hirsutism is a relatively common condition affecting about 5%-O10% of women of childbearing age. Herein, we present an overview of hirsutism with emphasis on its etiology and therapeutic options.
@article{alsantali_management_2009,
title = {Management of hirsutism},
volume = {14},
issn = {1201-5989},
abstract = {Hirsutism is a relatively common condition affecting about 5\%-O10\% of women of childbearing age. Herein, we present an overview of hirsutism with emphasis on its etiology and therapeutic options.},
language = {eng},
number = {7},
journal = {Skin therapy letter},
author = {Alsantali, A and Shapiro, J},
month = sep,
year = {2009},
pmid = {20039595},
keywords = {Androgen Antagonists, Contraceptives, Oral, Female, Glucocorticoids, Gonadotropin-Releasing Hormone, Hair Removal, Hirsutism, Humans, Polycystic Ovary Syndrome, Risk Factors},
pages = {1--3}
}2008 (5)
Changes in the characteristics of patients prescribed selective cyclooxygenase 2 inhibitors after the 2004 withdrawal of rofecoxib. Setakis, E., Leufkens, H. G. M., & van Staa, T. P. Arthritis and Rheumatism, 59(8):1105--1111, August, 2008.
doi abstract bibtex
doi abstract bibtex
OBJECTIVE: To evaluate the impact of rofecoxib withdrawal on the characteristics of patients prescribed selective cyclooxygenase 2 (COX-2) inhibitors. METHODS: The General Practice Research Database was used to identify patients age \textgreater or =18 years who were prescribed a selective COX-2 inhibitor. Various patient characteristics were noted at the start of therapy: age, sex, nonsteroidal antiinflammatory drug-related risk factors for upper gastrointestinal (GI) events, and the Framingham risk score for cardiovascular disease. Logistic regression was used to compare patients using selective COX-2 inhibitors before and after September 2004. RESULT: The study population included 171,645 patients receiving selective COX-2 inhibitors. The number of users substantially increased over time until September 2004 and sharply declined thereafter. Approximately 80% stopped selective COX-2 inhibitor therapy within 6 months. Patients receiving selective COX-2 inhibitors after September 2004 were younger and included more men compared with those receiving therapy before September 2004. There was no change before and after September 2004 in the proportion of patients with GI risk factors or high Framingham risk scores, after adjustment for age and sex. A correlation was found between presence of GI risk factors and high Framingham risk scores. Only 20% of patients receiving selective COX-2 inhibitors had GI risk factors but low Framingham risk score, which did not change after September 2004. CONCLUSION: There was no channeling in the usage of selective COX-2 inhibitors toward patients with a high risk of GI and low risk of cardiovascular disease following the withdrawal of rofecoxib.
@article{setakis_changes_2008,
title = {Changes in the characteristics of patients prescribed selective cyclooxygenase 2 inhibitors after the 2004 withdrawal of rofecoxib},
volume = {59},
issn = {0004-3591},
doi = {10.1002/art.23925},
abstract = {OBJECTIVE: To evaluate the impact of rofecoxib withdrawal on the characteristics of patients prescribed selective cyclooxygenase 2 (COX-2) inhibitors.
METHODS: The General Practice Research Database was used to identify patients age {\textgreater} or =18 years who were prescribed a selective COX-2 inhibitor. Various patient characteristics were noted at the start of therapy: age, sex, nonsteroidal antiinflammatory drug-related risk factors for upper gastrointestinal (GI) events, and the Framingham risk score for cardiovascular disease. Logistic regression was used to compare patients using selective COX-2 inhibitors before and after September 2004.
RESULT: The study population included 171,645 patients receiving selective COX-2 inhibitors. The number of users substantially increased over time until September 2004 and sharply declined thereafter. Approximately 80\% stopped selective COX-2 inhibitor therapy within 6 months. Patients receiving selective COX-2 inhibitors after September 2004 were younger and included more men compared with those receiving therapy before September 2004. There was no change before and after September 2004 in the proportion of patients with GI risk factors or high Framingham risk scores, after adjustment for age and sex. A correlation was found between presence of GI risk factors and high Framingham risk scores. Only 20\% of patients receiving selective COX-2 inhibitors had GI risk factors but low Framingham risk score, which did not change after September 2004.
CONCLUSION: There was no channeling in the usage of selective COX-2 inhibitors toward patients with a high risk of GI and low risk of cardiovascular disease following the withdrawal of rofecoxib.},
language = {eng},
number = {8},
journal = {Arthritis and Rheumatism},
author = {Setakis, E. and Leufkens, H. G. M. and van Staa, T. P.},
month = aug,
year = {2008},
pmid = {18668614},
keywords = {Adolescent, Adult, Aged, Cardiovascular Diseases, Cyclooxygenase 2 Inhibitors, Databases, Factual, Drug Prescriptions, Drug Utilization Review, Female, Gastrointestinal Diseases, Great Britain, Humans, Lactones, Logistic Models, Male, Middle Aged, Rheumatic Diseases, Risk Factors, Sulfones, incidence},
pages = {1105--1111}
}Proton pump inhibitor use and risk of hip fractures in patients without major risk factors. Kaye, J. A. & Jick, H. Pharmacotherapy, 28(8):951--959, August, 2008.
doi abstract bibtex
doi abstract bibtex
STUDY OBJECTIVE: To estimate the relative risk of hip fracture associated with proton pump inhibitor (PPI) use in a population without major risk factors. DESIGN: A two-phase, matched, nested case-control study. DATA SOURCE: United Kingdom General Practice Research Database (GPRD). PATIENTS: Phase 1 identified 4414 case patients (aged 50-79 yrs) with an incident hip fracture between 1995 and 2005 who had at least 2 years of recorded history in the GPRD; each case was matched by age, sex, and index date (date of first-time hip fracture for cases, same date for matched controls) to up to 10 controls who did not have hip fracture. Phase 2 included the 1098 case patients identified as having no major medical risk factors for hip fracture (as assessed in phase 1) and a new set of 10,923 controls without major risk factors for hip fracture matched by sex, age, index date, and duration of history in the GPRD. MEASUREMENTS AND MAIN RESULTS: In phase 1, we identified major medical risk factors for hip fracture. In phase 2, we restricted the study to case patients with none of these risk factors and matched them to new controls, who also had none of the risk factors. Data on use of PPIs were collected and compared between the groups. The relative risk (RR) for hip fracture among patients who received any PPI prescription was 0.9 (95% confidence interval 0.7-1.1) compared with those with no PPI prescription. We found no evidence of an increased risk of hip fracture with increased PPI use. The RR estimates were similar in both sexes and in all age subgroups. No specific PPI was associated with an increased risk of hip fracture. CONCLUSION: Use of PPIs does not increase the risk of hip fracture in patients without major risk factors. The difference in results between our study and that of another, which indicated that PPI use increases the risk of hip fracture, may be due to residual confounding or effect modification in the latter study.
@article{kaye_proton_2008,
title = {Proton pump inhibitor use and risk of hip fractures in patients without major risk factors},
volume = {28},
issn = {0277-0008},
doi = {10.1592/phco.28.8.951},
abstract = {STUDY OBJECTIVE: To estimate the relative risk of hip fracture associated with proton pump inhibitor (PPI) use in a population without major risk factors.
DESIGN: A two-phase, matched, nested case-control study.
DATA SOURCE: United Kingdom General Practice Research Database (GPRD).
PATIENTS: Phase 1 identified 4414 case patients (aged 50-79 yrs) with an incident hip fracture between 1995 and 2005 who had at least 2 years of recorded history in the GPRD; each case was matched by age, sex, and index date (date of first-time hip fracture for cases, same date for matched controls) to up to 10 controls who did not have hip fracture. Phase 2 included the 1098 case patients identified as having no major medical risk factors for hip fracture (as assessed in phase 1) and a new set of 10,923 controls without major risk factors for hip fracture matched by sex, age, index date, and duration of history in the GPRD.
MEASUREMENTS AND MAIN RESULTS: In phase 1, we identified major medical risk factors for hip fracture. In phase 2, we restricted the study to case patients with none of these risk factors and matched them to new controls, who also had none of the risk factors. Data on use of PPIs were collected and compared between the groups. The relative risk (RR) for hip fracture among patients who received any PPI prescription was 0.9 (95\% confidence interval 0.7-1.1) compared with those with no PPI prescription. We found no evidence of an increased risk of hip fracture with increased PPI use. The RR estimates were similar in both sexes and in all age subgroups. No specific PPI was associated with an increased risk of hip fracture.
CONCLUSION: Use of PPIs does not increase the risk of hip fracture in patients without major risk factors. The difference in results between our study and that of another, which indicated that PPI use increases the risk of hip fracture, may be due to residual confounding or effect modification in the latter study.},
language = {eng},
number = {8},
journal = {Pharmacotherapy},
author = {Kaye, James A. and Jick, Hershel},
month = aug,
year = {2008},
pmid = {18657011},
keywords = {Aged, Case-Control Studies, Female, Hip Fractures, Humans, Male, Middle Aged, Proton Pump Inhibitors, Risk Factors},
pages = {951--959}
}Risk factors for a first-time drink-driving conviction among young men: A birth cohort study of all men born in Denmark in 1966. Christoffersen, M., N., Soothill, K., & Francis, B. Journal of Substance Abuse Treatment, 34(4):415-425, 6, 2008.
abstract bibtex
abstract bibtex
Using a complete birth cohort of all young men born in 1966 in Denmark (N = 43,403), the prevalence of a first-time drink-driving conviction among young men is estimated. More than 7% of the total male birth cohort was so convicted before the age of 27 years. In an examination of risk factors for a first-time drink-driving conviction, young adults coming from potentially vulnerable groups have an increased risk. Earlier criminal convictions of various types were also significant predictors of drink driving. Situational pressures also play a part and are controlled for, with the risk of a drink-driving conviction increased substantially in rural areas compared to metropolitan areas. The study concludes that disadvantages during adolescence, including parental substance abuse, having a teenage mother, and domestic violence, are associated with a first-time drink-driving conviction. ?? 2008.
@article{
title = {Risk factors for a first-time drink-driving conviction among young men: A birth cohort study of all men born in Denmark in 1966},
type = {article},
year = {2008},
identifiers = {[object Object]},
keywords = {Childhood factors,Conviction,Drink driving,Driving under the influence,Life course,Risk factors},
pages = {415-425},
volume = {34},
month = {6},
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last_modified = {2016-09-13T05:55:56.000Z},
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abstract = {Using a complete birth cohort of all young men born in 1966 in Denmark (N = 43,403), the prevalence of a first-time drink-driving conviction among young men is estimated. More than 7% of the total male birth cohort was so convicted before the age of 27 years. In an examination of risk factors for a first-time drink-driving conviction, young adults coming from potentially vulnerable groups have an increased risk. Earlier criminal convictions of various types were also significant predictors of drink driving. Situational pressures also play a part and are controlled for, with the risk of a drink-driving conviction increased substantially in rural areas compared to metropolitan areas. The study concludes that disadvantages during adolescence, including parental substance abuse, having a teenage mother, and domestic violence, are associated with a first-time drink-driving conviction. ?? 2008.},
bibtype = {article},
author = {Christoffersen, Mogens Nygaard and Soothill, Keith and Francis, Brian},
journal = {Journal of Substance Abuse Treatment},
number = {4}
}Geographic and topographic determinants of local FMD transmission applied to the 2001 UK FMD epidemic. Bessell, P. R., Shaw, D. J., Savill, N. J., & Woolhouse, M. E. J. BMC veterinary research, 4:40, October, 2008.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Models of Foot and Mouth Disease (FMD) transmission have assumed a homogeneous landscape across which Euclidean distance is a suitable measure of the spatial dependency of transmission. This paper investigated features of the landscape and their impact on transmission during the period of predominantly local spread which followed the implementation of the national movement ban during the 2001 UK FMD epidemic. In this study 113 farms diagnosed with FMD which had a known source of infection within 3 km (cases) were matched to 188 control farms which were either uninfected or infected at a later timepoint. Cases were matched to controls by Euclidean distance to the source of infection and farm size. Intervening geographical features and connectivity between the source of infection and case and controls were compared. RESULTS: Road distance between holdings, access to holdings, presence of forest, elevation change between holdings and the presence of intervening roads had no impact on the risk of local FMD transmission (p \textgreater 0.2). However the presence of linear features in the form of rivers and railways acted as barriers to FMD transmission (odds ratio = 0.507, 95% CIs = 0.297,0.887, p = 0.018). CONCLUSION: This paper demonstrated that although FMD spread can generally be modelled using Euclidean distance and numbers of animals on susceptible holdings, the presence of rivers and railways has an additional protective effect reducing the probability of transmission between holdings.
@article{bessell_geographic_2008,
title = {Geographic and topographic determinants of local {FMD} transmission applied to the 2001 {UK} {FMD} epidemic.},
volume = {4},
issn = {1746-6148 1746-6148},
doi = {10.1186/1746-6148-4-40},
abstract = {BACKGROUND: Models of Foot and Mouth Disease (FMD) transmission have assumed a homogeneous landscape across which Euclidean distance is a suitable measure of the spatial dependency of transmission. This paper investigated features of the landscape and their impact on transmission during the period of predominantly local spread which followed the implementation of the national movement ban during the 2001 UK FMD epidemic. In this study 113 farms diagnosed with FMD which had a known source of infection within 3 km (cases) were matched to 188 control farms which were either uninfected or infected at a later timepoint. Cases were matched to controls by Euclidean distance to the source of infection and farm size. Intervening geographical features and connectivity between the source of infection and case and controls were compared. RESULTS: Road distance between holdings, access to holdings, presence of forest, elevation change between holdings and the presence of intervening roads had no impact on the risk of local FMD transmission (p {\textgreater} 0.2). However the presence of linear features in the form of rivers and railways acted as barriers to FMD transmission (odds ratio = 0.507, 95\% CIs = 0.297,0.887, p = 0.018). CONCLUSION: This paper demonstrated that although FMD spread can generally be modelled using Euclidean distance and numbers of animals on susceptible holdings, the presence of rivers and railways has an additional protective effect reducing the probability of transmission between holdings.},
language = {eng},
journal = {BMC veterinary research},
author = {Bessell, Paul R. and Shaw, Darren J. and Savill, Nicholas J. and Woolhouse, Mark E. J.},
month = oct,
year = {2008},
pmid = {18834510},
pmcid = {PMC2573875},
keywords = {Animals, Case-Control Studies, Cattle, Cattle Diseases/*epidemiology/*transmission, Disease Outbreaks/*veterinary, Foot-and-Mouth Disease/*epidemiology/*transmission, Geography, Linear Models, Population Density, Railroads, Risk Factors, Rivers, Sheep, Sheep Diseases/*epidemiology/*transmission, United Kingdom/epidemiology},
pages = {40}
}Elucidating the role of chest wall irradiation in 'intermediate-risk' breast cancer: the MRC/EORTC SUPREMO trial. Kunkler, I H, Canney, P, van Tienhoven, G, Russell, N S, & MRC/EORTC (BIG 2-04) SUPREMO Trial Management Group Clinical oncology (Royal College of Radiologists (Great Britain)), 20(1):31--34, February, 2008.
bibtex
bibtex
@article{kunkler_elucidating_2008,
title = {Elucidating the role of chest wall irradiation in 'intermediate-risk' breast cancer: the {MRC}/{EORTC} {SUPREMO} trial},
volume = {20},
issn = {0936-6555},
shorttitle = {Elucidating the role of chest wall irradiation in 'intermediate-risk' breast cancer},
language = {eng},
number = {1},
journal = {Clinical oncology (Royal College of Radiologists (Great Britain))},
author = {Kunkler, I H and Canney, P and van Tienhoven, G and Russell, N S and {MRC/EORTC (BIG 2-04) SUPREMO Trial Management Group}},
month = feb,
year = {2008},
pmid = {18345543},
keywords = {Breast Neoplasms, Combined Modality Therapy, Female, Heart, Humans, Lymphatic Metastasis, mastectomy, Neoplasm Recurrence, Local, Radiation Dosage, Radiotherapy, Adjuvant, Risk Factors, Thoracic Wall},
pages = {31--34},
file = {1-s2.0-S0936655507008357-main.pdf:files/46501/1-s2.0-S0936655507008357-main.pdf:application/pdf}
}2007 (2)
Risk of malignancy in patients with schizophrenia or bipolar disorder: nested case-control study. Hippisley-Cox, J., Vinogradova, Y., Coupland, C., & Parker, C. Archives of General Psychiatry, 64(12):1368--1376, December, 2007.
doi abstract bibtex
doi abstract bibtex
CONTEXT: There is conflicting evidence on whether people with schizophrenia have a different risk of cancer from that of the general population. OBJECTIVE: To determine the risk of 6 common cancers in patients with schizophrenia or bipolar disorder. DESIGN: Population-based, nested, case-control study. SETTING: A total of 454 practices contributing to the QRESEARCH general practice database. PARTICIPANTS: We analyzed 40,441 incident cases of 6 cancers (breast, colon, rectal, gastroesophageal, prostate, and respiratory) and up to 5 controls per case matched by single year of age, sex, general practice, and calendar time. MAIN OUTCOME MEASURES: Odds ratios (ORs) for cancer risk associated with schizophrenia and bipolar disorder, adjusting for smoking, body mass index, socioeconomic status, comorbidities, and prescribed medications, including antipsychotics. RESULTS: For breast cancer, we identified 10,535/50,074 cases/controls; colon cancer, 5108/24,458; rectal cancer, 3248/15,552; gastroesophageal cancer, 3854/18,477; prostate cancer, 10,190/48,748; and respiratory cancer, 7506/35,981. After adjustment, patients with schizophrenia had a 190% increased colon cancer risk (adjusted OR, 2.90; 95% confidence interval [CI], 1.85-4.57), a marginal increased breast cancer risk (adjusted OR, 1.52; 95% CI, 1.10-2.11), and a 47% decreased respiratory cancer risk (adjusted OR, 0.53, 95% CI, 0.34-0.85). Patients with schizophrenia taking antipsychotics had a 308% increased colon cancer risk (adjusted OR, 4.08; 95% CI, 2.43-6.84). Patients with bipolar disorder had cancer risks similar to patients with neither condition after adjustment. CONCLUSIONS: Patients with schizophrenia have a significantly higher risk of colon cancer and a lower risk of respiratory cancer compared with patients without schizophrenia after adjustment for confounders. In contrast, the risks of cancer in patients with and without bipolar disorder are similar, suggesting that residual confounding is unlikely to explain the findings. The increased risk of colon cancer is particularly marked in patients with schizophrenia who take antipsychotic medications.
@article{hippisley-cox_risk_2007,
title = {Risk of malignancy in patients with schizophrenia or bipolar disorder: nested case-control study},
volume = {64},
issn = {1538-3636},
shorttitle = {Risk of malignancy in patients with schizophrenia or bipolar disorder},
doi = {10.1001/archpsyc.64.12.1368},
abstract = {CONTEXT: There is conflicting evidence on whether people with schizophrenia have a different risk of cancer from that of the general population.
OBJECTIVE: To determine the risk of 6 common cancers in patients with schizophrenia or bipolar disorder.
DESIGN: Population-based, nested, case-control study.
SETTING: A total of 454 practices contributing to the QRESEARCH general practice database.
PARTICIPANTS: We analyzed 40,441 incident cases of 6 cancers (breast, colon, rectal, gastroesophageal, prostate, and respiratory) and up to 5 controls per case matched by single year of age, sex, general practice, and calendar time.
MAIN OUTCOME MEASURES: Odds ratios (ORs) for cancer risk associated with schizophrenia and bipolar disorder, adjusting for smoking, body mass index, socioeconomic status, comorbidities, and prescribed medications, including antipsychotics.
RESULTS: For breast cancer, we identified 10,535/50,074 cases/controls; colon cancer, 5108/24,458; rectal cancer, 3248/15,552; gastroesophageal cancer, 3854/18,477; prostate cancer, 10,190/48,748; and respiratory cancer, 7506/35,981. After adjustment, patients with schizophrenia had a 190\% increased colon cancer risk (adjusted OR, 2.90; 95\% confidence interval [CI], 1.85-4.57), a marginal increased breast cancer risk (adjusted OR, 1.52; 95\% CI, 1.10-2.11), and a 47\% decreased respiratory cancer risk (adjusted OR, 0.53, 95\% CI, 0.34-0.85). Patients with schizophrenia taking antipsychotics had a 308\% increased colon cancer risk (adjusted OR, 4.08; 95\% CI, 2.43-6.84). Patients with bipolar disorder had cancer risks similar to patients with neither condition after adjustment.
CONCLUSIONS: Patients with schizophrenia have a significantly higher risk of colon cancer and a lower risk of respiratory cancer compared with patients without schizophrenia after adjustment for confounders. In contrast, the risks of cancer in patients with and without bipolar disorder are similar, suggesting that residual confounding is unlikely to explain the findings. The increased risk of colon cancer is particularly marked in patients with schizophrenia who take antipsychotic medications.},
language = {eng},
number = {12},
journal = {Archives of General Psychiatry},
author = {Hippisley-Cox, Julia and Vinogradova, Yana and Coupland, Carol and Parker, Chris},
month = dec,
year = {2007},
pmid = {18056544},
keywords = {Aged, Antipsychotic Agents, Bipolar Disorder, Breast Neoplasms, Colonic Neoplasms, Demography, Drug Therapy, Esophageal Neoplasms, Female, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasms, Prevalence, Prostatic Neoplasms, Rectal Neoplasms, Risk Factors, Schizophrenia, incidence},
pages = {1368--1376}
}Statins and the risk of pneumonia: a population-based, nested case-control study. Schlienger, R. G., Fedson, D. S., Jick, S. S., Jick, H., & Meier, C. R. Pharmacotherapy, 27(3):325--332, March, 2007.
doi abstract bibtex
doi abstract bibtex
STUDY OBJECTIVE: To determine if the use of statins affects pneumonia-related outpatient visits, hospitalizations with survival, and deaths. DESIGN: Population-based, retrospective, nested case-control analysis. DATA SOURCE: United Kingdom-based General Practice Research Database. PARTICIPANTS: The study population (134,262 patients aged \textgreater or = 30 yrs) consisted of 55,118 patients who took statins and/or fibrates, 29,144 patients with hyperlipidemia not taking lipid-lowering agents, and 50,000 randomly selected patients without hyperlipidemia and without lipid-lowering treatment. MEASUREMENTS AND MAIN RESULTS: We identified 1253 patients with pneumonia and matched them with 4838 control subjects based on age, sex, general practice, and index date. After adjusting for comorbidity and frequency of visits to general practitioners, we calculated the risks (odds ratios with 95% confidence intervals) of uncomplicated pneumonia, hospitalization for pneumonia with survival, and fatal pneumonia in participants who used statins compared with those who did not. Current statin users had a significantly reduced risk of fatal pneumonia (adjusted odds ratio 0.47, 95% confidence interval 0.25-0.88) and slightly but not significantly reduced risks of uncomplicated pneumonia and pneumonia hospitalization with survival. Recent or past statin use and fibrate use at any time were not associated with a reduced risk of pneumonia. CONCLUSION: Current use of statins was associated with a reduced risk of pneumonia. The risk reduction was particularly strong in the subgroup of patients with fatal pneumonias.
@article{schlienger_statins_2007,
title = {Statins and the risk of pneumonia: a population-based, nested case-control study},
volume = {27},
issn = {0277-0008},
shorttitle = {Statins and the risk of pneumonia},
doi = {10.1592/phco.27.3.325},
abstract = {STUDY OBJECTIVE: To determine if the use of statins affects pneumonia-related outpatient visits, hospitalizations with survival, and deaths.
DESIGN: Population-based, retrospective, nested case-control analysis.
DATA SOURCE: United Kingdom-based General Practice Research Database.
PARTICIPANTS: The study population (134,262 patients aged {\textgreater} or = 30 yrs) consisted of 55,118 patients who took statins and/or fibrates, 29,144 patients with hyperlipidemia not taking lipid-lowering agents, and 50,000 randomly selected patients without hyperlipidemia and without lipid-lowering treatment.
MEASUREMENTS AND MAIN RESULTS: We identified 1253 patients with pneumonia and matched them with 4838 control subjects based on age, sex, general practice, and index date. After adjusting for comorbidity and frequency of visits to general practitioners, we calculated the risks (odds ratios with 95\% confidence intervals) of uncomplicated pneumonia, hospitalization for pneumonia with survival, and fatal pneumonia in participants who used statins compared with those who did not. Current statin users had a significantly reduced risk of fatal pneumonia (adjusted odds ratio 0.47, 95\% confidence interval 0.25-0.88) and slightly but not significantly reduced risks of uncomplicated pneumonia and pneumonia hospitalization with survival. Recent or past statin use and fibrate use at any time were not associated with a reduced risk of pneumonia.
CONCLUSION: Current use of statins was associated with a reduced risk of pneumonia. The risk reduction was particularly strong in the subgroup of patients with fatal pneumonias.},
language = {eng},
number = {3},
journal = {Pharmacotherapy},
author = {Schlienger, Raymond G. and Fedson, David S. and Jick, Susan S. and Jick, Hershel and Meier, Christoph R.},
month = mar,
year = {2007},
pmid = {17316144},
keywords = {Adult, Aged, Anticholesteremic Agents, Case-Control Studies, Clofibric Acid, Family Practice, Female, Great Britain, Hospitalization, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hyperlipidemias, Male, Middle Aged, Pneumonia, Retrospective Studies, Risk Factors, Survival Analysis, databases as topic},
pages = {325--332}
}2006 (6)
QFLU: new influenza monitoring in UK primary care to support pandemic influenza planning. Hippisley-Cox, J., Smith, S., Smith, G., Porter, A., Heaps, M., Holland, R., Fenty, J., Harcourt, S., George, R., Charlett, A., Pebody, R. G., & Painter, M. Euro Surveillance: Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 11(6):E060622.4, 2006.
bibtex
bibtex
@article{hippisley-cox_qflu:_2006,
title = {{QFLU}: new influenza monitoring in {UK} primary care to support pandemic influenza planning},
volume = {11},
issn = {1560-7917},
shorttitle = {{QFLU}},
language = {eng},
number = {6},
journal = {Euro Surveillance: Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin},
author = {Hippisley-Cox, J. and Smith, S. and Smith, G. and Porter, A. and Heaps, M. and Holland, R. and Fenty, J. and Harcourt, S. and George, R. and Charlett, A. and Pebody, R. G. and Painter, M.},
year = {2006},
pmid = {16819130},
keywords = {Communicable Disease Control, Disease Notification, Disease Outbreaks, Family Practice, Great Britain, Health Planning, Humans, Influenza, Human, Population Surveillance, Primary Health Care, Risk Assessment, Risk Factors, incidence},
pages = {E060622.4}
}Transgenic crops expressing Bacillus thuringiensis toxins and biological control. Romeis, J., Meissle, M., & Bigler, F. Nature biotechnology, 24(1):63-71, Nature Publishing Group, 2006.
Paper abstract bibtex
Paper abstract bibtex The area devoted to growing transgenic plants expressing insecticidal Cry proteins derived from Bacillus thuringiensis (Bt) is increasing worldwide. A major concern with the adoption of Bt crops is their potential impact on nontarget organisms including biological control organisms. Regulatory frameworks should advocate a step-wise (tiered) approach to assess possible nontarget effects of Bt crops. Laboratory and glasshouse studies have revealed effects on natural enemies only when Bt-susceptible, sublethally damaged herbivores were used as prey or host, with no indication of direct toxic effects. Field studies have confirmed that the abundance and activity of parasitoids and predators are similar in Bt and non-Bt crops. In contrast, applications of conventional insecticides have usually resulted in negative impacts on biological control organisms. Because Bt-transgenic varieties can lead to substantial reductions in insecticide use in some crops, they can contribute to integrated pest management systems with a strong biological control component.
@article{
title = {Transgenic crops expressing Bacillus thuringiensis toxins and biological control.},
type = {article},
year = {2006},
identifiers = {[object Object]},
keywords = {bacillus thuringiensis,bacillus thuringiensis genetics,bacillus thuringiensis metabolism,bacterial proteins,bacterial proteins adverse effects,bacterial proteins genetics,bacterial proteins metabolism,biological,biological methods,consumer product safety,genetically modified,genetically modified adverse effects,genetically modified genetics,genetically modified metabolism,insecticide resistance,insecticide resistance physiology,pest control,plants,risk assessment,risk assessment methods,risk factors},
pages = {63-71},
volume = {24},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/16404399},
publisher = {Nature Publishing Group},
institution = {Agroscope FAL Reckenholz, Swiss Federal Research Station for Agroecology and Agriculture, Reckenholzstr. 191, 8046 Zurich, Switzerland. Joerg.Romeis@fal.admin.ch},
id = {b03218f2-e35f-3344-8134-ebbd542350e8},
created = {2015-07-21T19:14:16.000Z},
file_attached = {true},
profile_id = {1a467167-0a41-3583-a6a3-034c31031332},
group_id = {0e532975-1a47-38a4-ace8-4fe5968bcd72},
last_modified = {2015-07-23T20:45:14.000Z},
read = {false},
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authored = {false},
confirmed = {true},
hidden = {false},
citation_key = {Romeis2006},
abstract = {The area devoted to growing transgenic plants expressing insecticidal Cry proteins derived from Bacillus thuringiensis (Bt) is increasing worldwide. A major concern with the adoption of Bt crops is their potential impact on nontarget organisms including biological control organisms. Regulatory frameworks should advocate a step-wise (tiered) approach to assess possible nontarget effects of Bt crops. Laboratory and glasshouse studies have revealed effects on natural enemies only when Bt-susceptible, sublethally damaged herbivores were used as prey or host, with no indication of direct toxic effects. Field studies have confirmed that the abundance and activity of parasitoids and predators are similar in Bt and non-Bt crops. In contrast, applications of conventional insecticides have usually resulted in negative impacts on biological control organisms. Because Bt-transgenic varieties can lead to substantial reductions in insecticide use in some crops, they can contribute to integrated pest management systems with a strong biological control component.},
bibtype = {article},
author = {Romeis, Jörg and Meissle, Michael and Bigler, Franz},
journal = {Nature biotechnology},
number = {1}
}Fracture risk in people with primary biliary cirrhosis: a population-based cohort study. Solaymani-Dodaran, M., Card, T. R., Aithal, G. P., & West, J. Gastroenterology, 131(6):1752--1757, December, 2006.
doi abstract bibtex
doi abstract bibtex
BACKGROUND & AIMS: Controversy exists as to whether people with primary biliary cirrhosis (PBC) have an increased risk of developing osteoporosis and the extent to which this may translate into an increased risk of fracture. We have performed a cohort study using the General Practice Research Database to quantify the excess fracture risk in people with PBC. METHODS: We identified 930 people with PBC and 9202 age- and sex-matched control subjects. We used Cox regression to estimate the hazard ratios for any fracture, hip fracture, and ulna/radius fracture in the PBC cohort compared with the general population. RESULTS: There were approximately 2-fold relative increases in the risk of any fracture, hip fracture, and ulna/radius fracture for the PBC cohort compared with the general population (hazard ratio [HR], 2.03; 95% confidence interval [CI]: 1.70-2.44; HR 2.14 (95% CI: 1.40-3.28), and HR, 1.96; 95% CI: 1.42-2.71, respectively). The absolute excess in fracture rates were for any fracture, 12.5 per 1000 person-years (95% CI: 8.1-16.9); for hip fracture, 1.9 per 1000 person-years (95% CI: 0.3-3.5); and for ulna/radius fracture, 3.4 per 1000 person-years (95% CI: 1.2-5.7). In those people with more severe disease, the relative risks of fracture were similar (any fracture HR, 2.24; hip fracture HR, 1.25; ulna/radius fracture HR, 1.28). CONCLUSIONS: There are modest increases in both the absolute and relative fracture risks in people with PBC compared with the general population, with the excess risks similar in those with more severe disease.
@article{solaymani-dodaran_fracture_2006,
title = {Fracture risk in people with primary biliary cirrhosis: a population-based cohort study},
volume = {131},
issn = {0016-5085},
shorttitle = {Fracture risk in people with primary biliary cirrhosis},
doi = {10.1053/j.gastro.2006.09.012},
abstract = {BACKGROUND \& AIMS: Controversy exists as to whether people with primary biliary cirrhosis (PBC) have an increased risk of developing osteoporosis and the extent to which this may translate into an increased risk of fracture. We have performed a cohort study using the General Practice Research Database to quantify the excess fracture risk in people with PBC.
METHODS: We identified 930 people with PBC and 9202 age- and sex-matched control subjects. We used Cox regression to estimate the hazard ratios for any fracture, hip fracture, and ulna/radius fracture in the PBC cohort compared with the general population.
RESULTS: There were approximately 2-fold relative increases in the risk of any fracture, hip fracture, and ulna/radius fracture for the PBC cohort compared with the general population (hazard ratio [HR], 2.03; 95\% confidence interval [CI]: 1.70-2.44; HR 2.14 (95\% CI: 1.40-3.28), and HR, 1.96; 95\% CI: 1.42-2.71, respectively). The absolute excess in fracture rates were for any fracture, 12.5 per 1000 person-years (95\% CI: 8.1-16.9); for hip fracture, 1.9 per 1000 person-years (95\% CI: 0.3-3.5); and for ulna/radius fracture, 3.4 per 1000 person-years (95\% CI: 1.2-5.7). In those people with more severe disease, the relative risks of fracture were similar (any fracture HR, 2.24; hip fracture HR, 1.25; ulna/radius fracture HR, 1.28).
CONCLUSIONS: There are modest increases in both the absolute and relative fracture risks in people with PBC compared with the general population, with the excess risks similar in those with more severe disease.},
language = {eng},
number = {6},
journal = {Gastroenterology},
author = {Solaymani-Dodaran, Masoud and Card, Tim R. and Aithal, Guruprasad P. and West, Joe},
month = dec,
year = {2006},
pmid = {17087953},
keywords = {Adult, Aged, Aged, 80 and over, Calcium, Cohort Studies, Female, Fractures, Bone, Hip Fractures, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Osteoporosis, Proportional Hazards Models, Radius Fractures, Risk Factors, Vitamin D},
pages = {1752--1757}
}Esophageal stricture: incidence, treatment patterns, and recurrence rate. Ruigómez, A., García Rodríguez, L. A., Wallander, M., Johansson, S., & Eklund, S. The American Journal of Gastroenterology, 101(12):2685--2692, December, 2006.
doi abstract bibtex
doi abstract bibtex
OBJECTIVES: We aimed to determine the incidence, natural history, and recurrence rate of esophageal stricture diagnosed in primary care. METHODS: From the U.K. General Practice Research Database, we identified patients with a stricture diagnosis recorded between 1994 and 2000. Diagnoses were confirmed by general practitioner-completed questionnaires. Patients with stricture were compared to an age- and sex-matched sample of controls from the original source population. We estimated the incidence of stricture, potential risk factors, and comorbidities, and relative risk (RR) for subsequent stricture recurrence and mortality. RESULTS: The incidence of esophageal stricture was 1.1 per 10,000 person-years and increased markedly with age. Incidence of stricture decreased from 1994 to 2000, concomitant with a substantial increase in proton pump inhibitor (PPI) use. The majority of stricture cases (68%) were peptic. Prior dysphagia, gastroesophageal reflux disease (GERD), hiatus hernia, peptic ulcer disease, and heavy alcohol use were associated with an increased risk of stricture. The rate of stricture recurrence was 11.1 per 100 person-years. Risk of recurrence associated with long-term PPI use adjusting for other factors was 0.6 (95% CI 0.3-1.1). Mortality in patients with peptic stricture was similar to that in the control population. CONCLUSIONS: Esophageal stricture is a rare event, and most cases in primary care are peptic strictures. Prior GERD, hiatus hernia, and peptic ulcer are associated with an increased risk of peptic stricture. Incidence of stricture decreased from 1994 to 2000.
@article{ruigomez_esophageal_2006,
title = {Esophageal stricture: incidence, treatment patterns, and recurrence rate},
volume = {101},
issn = {0002-9270},
shorttitle = {Esophageal stricture},
doi = {10.1111/j.1572-0241.2006.00828.x},
abstract = {OBJECTIVES: We aimed to determine the incidence, natural history, and recurrence rate of esophageal stricture diagnosed in primary care.
METHODS: From the U.K. General Practice Research Database, we identified patients with a stricture diagnosis recorded between 1994 and 2000. Diagnoses were confirmed by general practitioner-completed questionnaires. Patients with stricture were compared to an age- and sex-matched sample of controls from the original source population. We estimated the incidence of stricture, potential risk factors, and comorbidities, and relative risk (RR) for subsequent stricture recurrence and mortality.
RESULTS: The incidence of esophageal stricture was 1.1 per 10,000 person-years and increased markedly with age. Incidence of stricture decreased from 1994 to 2000, concomitant with a substantial increase in proton pump inhibitor (PPI) use. The majority of stricture cases (68\%) were peptic. Prior dysphagia, gastroesophageal reflux disease (GERD), hiatus hernia, peptic ulcer disease, and heavy alcohol use were associated with an increased risk of stricture. The rate of stricture recurrence was 11.1 per 100 person-years. Risk of recurrence associated with long-term PPI use adjusting for other factors was 0.6 (95\% CI 0.3-1.1). Mortality in patients with peptic stricture was similar to that in the control population.
CONCLUSIONS: Esophageal stricture is a rare event, and most cases in primary care are peptic strictures. Prior GERD, hiatus hernia, and peptic ulcer are associated with an increased risk of peptic stricture. Incidence of stricture decreased from 1994 to 2000.},
language = {eng},
number = {12},
journal = {The American Journal of Gastroenterology},
author = {Ruigómez, Ana and García Rodríguez, Luis Alberto and Wallander, Mari-Ann and Johansson, Saga and Eklund, Stefan},
month = dec,
year = {2006},
pmid = {17227515},
keywords = {Adult, Aged, Anti-Ulcer Agents, Cohort Studies, Esophageal Stenosis, Female, Great Britain, Humans, Male, Middle Aged, Primary Health Care, Proton Pump Inhibitors, Recurrence, Risk Factors, incidence},
pages = {2685--2692}
}Promoter variation in the DC-SIGN-encoding gene CD209 is associated with tuberculosis. Barreiro, L. B., Neyrolles, O., Babb, C. L., Tailleux, L., Quach, H., McElreavey, K., Helden, P. D. v., Hoal, E. G., Gicquel, B., & Quintana-Murci, L. PLoS medicine, 3(2):e20, February, 2006. 00192
doi abstract bibtex
doi abstract bibtex
BACKGROUND: Tuberculosis, which is caused by Mycobacterium tuberculosis, remains one of the leading causes of mortality worldwide. The C-type lectin DC-SIGN is known to be the major M. tuberculosis receptor on human dendritic cells. We reasoned that if DC-SIGN interacts with M. tuberculosis, as well as with other pathogens, variation in this gene might have a broad range of influence in the pathogenesis of a number of infectious diseases, including tuberculosis. METHODS AND FINDINGS: We tested whether polymorphisms in CD209, the gene encoding DC-SIGN, are associated with susceptibility to tuberculosis through sequencing and genotyping analyses in a South African cohort. After exclusion of significant population stratification in our cohort, we observed an association between two CD209 promoter variants (-871G and -336A) and decreased risk of developing tuberculosis. By looking at the geographical distribution of these variants, we observed that their allelic combination is mainly confined to Eurasian populations. CONCLUSIONS: Our observations suggest that the two -871G and -336A variants confer protection against tuberculosis. In addition, the geographic distribution of these two alleles, together with their phylogenetic status, suggest that they may have increased in frequency in non-African populations as a result of host genetic adaptation to a longer history of exposure to tuberculosis. Further characterization of the biological consequences of DC-SIGN variation in tuberculosis will be crucial to better appreciate the role of this lectin in interactions between the host immune system and the tubercle bacillus as well as other pathogens.
@article{barreiro_promoter_2006,
title = {Promoter variation in the {DC}-{SIGN}-encoding gene {CD209} is associated with tuberculosis},
volume = {3},
issn = {1549-1676},
doi = {10.1371/journal.pmed.0030020},
abstract = {BACKGROUND: Tuberculosis, which is caused by Mycobacterium tuberculosis, remains one of the leading causes of mortality worldwide. The C-type lectin DC-SIGN is known to be the major M. tuberculosis receptor on human dendritic cells. We reasoned that if DC-SIGN interacts with M. tuberculosis, as well as with other pathogens, variation in this gene might have a broad range of influence in the pathogenesis of a number of infectious diseases, including tuberculosis.
METHODS AND FINDINGS: We tested whether polymorphisms in CD209, the gene encoding DC-SIGN, are associated with susceptibility to tuberculosis through sequencing and genotyping analyses in a South African cohort. After exclusion of significant population stratification in our cohort, we observed an association between two CD209 promoter variants (-871G and -336A) and decreased risk of developing tuberculosis. By looking at the geographical distribution of these variants, we observed that their allelic combination is mainly confined to Eurasian populations.
CONCLUSIONS: Our observations suggest that the two -871G and -336A variants confer protection against tuberculosis. In addition, the geographic distribution of these two alleles, together with their phylogenetic status, suggest that they may have increased in frequency in non-African populations as a result of host genetic adaptation to a longer history of exposure to tuberculosis. Further characterization of the biological consequences of DC-SIGN variation in tuberculosis will be crucial to better appreciate the role of this lectin in interactions between the host immune system and the tubercle bacillus as well as other pathogens.},
language = {eng},
number = {2},
journal = {PLoS medicine},
author = {Barreiro, Luis B. and Neyrolles, Olivier and Babb, Chantal L. and Tailleux, Ludovic and Quach, Hélène and McElreavey, Ken and Helden, Paul D. van and Hoal, Eileen G. and Gicquel, Brigitte and Quintana-Murci, Lluis},
month = feb,
year = {2006},
pmid = {16379498},
pmcid = {PMC1324949},
note = {00192 },
keywords = {Adult, African Continental Ancestry Group, Case-Control Studies, Cell Adhesion Molecules, Dendritic Cells, Female, Genetic Predisposition to Disease, Humans, Lectins, C-Type, Male, Middle Aged, Mycobacterium tuberculosis, Phylogeny, Polymorphism, Single Nucleotide, Promoter Regions, Genetic, Receptors, Cell Surface, Risk Factors, South Africa, Tuberculosis, Pulmonary},
pages = {e20},
}Non-steroidal anti-inflammatory drugs and risk of first hospital admission for heart failure in the general population. Huerta, C., Varas-Lorenzo, C., Castellsague, J., & García Rodríguez, L. A. Heart (British Cardiac Society), 92(11):1610--1615, November, 2006.
doi abstract bibtex
doi abstract bibtex
OBJECTIVES: To estimate the risk of a first hospital admission for heart failure (HF) associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: Cohort study with a nested case-control analysis based on the UK General Practice Research Database. Overall, 1396 cases of first hospital admission for non-fatal HF were identified (January 1997 to December 2000) and compared with a random sample of 5000 controls. RESULTS: The incidence rate was 2.7/1000 person years. Prior clinical diagnosis of HF was the main independent risk factor triggering a first HF hospitalisation (relative risk 7.3, 95% confidence interval (CI) 6.1 to 8.8). The risk of a first hospital admission for HF associated with current use of NSAIDs was 1.3 (95% CI 1.1 to 1.6) after controlling for major confounding factors. No effects of dose and duration were found. The relative risk in current users of NSAIDs with prior HF was 8.6 (95% CI 5.3 to 13.8) compared with patients who did not use NSAIDs and without prior clinical diagnosis of HF. CONCLUSION: Use of NSAIDs was associated with a small increase in risk of a first hospitalisation for HF. In patients with prior clinical diagnosis of HF, the use of NSAIDs may lead to worsening of pre-existing HF that triggers their hospital admission. This increased risk, although small, may result in considerable public health impact, particularly among the elderly.
@article{huerta_non-steroidal_2006,
title = {Non-steroidal anti-inflammatory drugs and risk of first hospital admission for heart failure in the general population},
volume = {92},
issn = {1468-201X},
doi = {10.1136/hrt.2005.082388},
abstract = {OBJECTIVES: To estimate the risk of a first hospital admission for heart failure (HF) associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs).
METHODS: Cohort study with a nested case-control analysis based on the UK General Practice Research Database. Overall, 1396 cases of first hospital admission for non-fatal HF were identified (January 1997 to December 2000) and compared with a random sample of 5000 controls.
RESULTS: The incidence rate was 2.7/1000 person years. Prior clinical diagnosis of HF was the main independent risk factor triggering a first HF hospitalisation (relative risk 7.3, 95\% confidence interval (CI) 6.1 to 8.8). The risk of a first hospital admission for HF associated with current use of NSAIDs was 1.3 (95\% CI 1.1 to 1.6) after controlling for major confounding factors. No effects of dose and duration were found. The relative risk in current users of NSAIDs with prior HF was 8.6 (95\% CI 5.3 to 13.8) compared with patients who did not use NSAIDs and without prior clinical diagnosis of HF.
CONCLUSION: Use of NSAIDs was associated with a small increase in risk of a first hospitalisation for HF. In patients with prior clinical diagnosis of HF, the use of NSAIDs may lead to worsening of pre-existing HF that triggers their hospital admission. This increased risk, although small, may result in considerable public health impact, particularly among the elderly.},
language = {eng},
number = {11},
journal = {Heart (British Cardiac Society)},
author = {Huerta, C. and Varas-Lorenzo, C. and Castellsague, J. and García Rodríguez, L. A.},
month = nov,
year = {2006},
pmid = {16717069},
pmcid = {PMC1861219},
keywords = {Aged, Anti-Inflammatory Agents, Non-Steroidal, Case-Control Studies, Cohort Studies, Female, Great Britain, Heart Failure, Hospitalization, Humans, Male, Risk Factors},
pages = {1610--1615}
}2005 (3)
Polymorphisms of the DNA mismatch repair gene HMSH2 in breast cancer occurence and progression. Poplawski, T., Zadrozny, M., Kolacinska, A., Rykala, J., Morawiec, Z., & Blasiak, J. Breast Cancer Research and Treatment, 94(3):199–204, December, 2005.
doi abstract bibtex
doi abstract bibtex
The response of the cell to DNA damage and its ability to maintain genomic stability by DNA repair are crucial in preventing cancer initiation and progression. Therefore, polymorphism of DNA repair genes may affect the process of carcinogenesis. The importance of genetic variability of the components of mismatch repair (MMR) genes is well documented in colorectal cancer, but little is known about its role in breast cancer. hMSH2 is one of the crucial proteins of MMR. We performed a case-control study to test the association between two polymorphisms in the hMSH2 gene: an A –\textgreater G transition at 127 position producing an Asn –\textgreater Ser substitution at codon 127 (the Asn127Ser polymorphism) and a G –\textgreater A transition at 1032 position resulting in a Gly –\textgreater Asp change at codon 322 (the Gly322Asp polymorphism) and breast cancer risk and cancer progression. Genotypes were determined in DNA from peripheral blood lymphocytes of 150 breast cancer patients and 150 age-matched women (controls) by restriction fragment length polymorphism and allele-specific PCR. We did not observe any correlation between studied polymorphisms and breast cancer progression evaluated by node-metastasis, tumor size and Bloom-Richardson grading. A strong association between breast cancer occurrence and the Gly/Gly phenotype of the Gly322Asp polymorphism (odds ratio 8.39; 95% confidence interval 1.44-48.8) was found. Therefore, MMR may play a role in the breast carcinogenesis and the Gly322Asp polymorphism of the hMSH2 gene may be considered as a potential marker in breast cancer.
@article{poplawski_polymorphisms_2005,
title = {Polymorphisms of the {DNA} mismatch repair gene {HMSH2} in breast cancer occurence and progression},
volume = {94},
issn = {0167-6806},
doi = {10.1007/s10549-005-4793-7},
abstract = {The response of the cell to DNA damage and its ability to maintain genomic stability by DNA repair are crucial in preventing cancer initiation and progression. Therefore, polymorphism of DNA repair genes may affect the process of carcinogenesis. The importance of genetic variability of the components of mismatch repair (MMR) genes is well documented in colorectal cancer, but little is known about its role in breast cancer. hMSH2 is one of the crucial proteins of MMR. We performed a case-control study to test the association between two polymorphisms in the hMSH2 gene: an A --{\textgreater} G transition at 127 position producing an Asn --{\textgreater} Ser substitution at codon 127 (the Asn127Ser polymorphism) and a G --{\textgreater} A transition at 1032 position resulting in a Gly --{\textgreater} Asp change at codon 322 (the Gly322Asp polymorphism) and breast cancer risk and cancer progression. Genotypes were determined in DNA from peripheral blood lymphocytes of 150 breast cancer patients and 150 age-matched women (controls) by restriction fragment length polymorphism and allele-specific PCR. We did not observe any correlation between studied polymorphisms and breast cancer progression evaluated by node-metastasis, tumor size and Bloom-Richardson grading. A strong association between breast cancer occurrence and the Gly/Gly phenotype of the Gly322Asp polymorphism (odds ratio 8.39; 95\% confidence interval 1.44-48.8) was found. Therefore, MMR may play a role in the breast carcinogenesis and the Gly322Asp polymorphism of the hMSH2 gene may be considered as a potential marker in breast cancer.},
language = {eng},
number = {3},
journal = {Breast Cancer Research and Treatment},
author = {Poplawski, Tomasz and Zadrozny, Marek and Kolacinska, Agnieszka and Rykala, Jan and Morawiec, Zbigniew and Blasiak, Janusz},
month = dec,
year = {2005},
pmid = {16252083},
keywords = {Biomarkers, Tumor, Breast Neoplasms, Case-Control Studies, Cell Transformation, Neoplastic, DNA Damage, DNA Repair, Female, Genotype, Humans, Lymphocytes, Middle Aged, MutS Homolog 2 Protein, Phenotype, Point Mutation, Polymorphism, Genetic, Risk Factors, Tumor Markers, Biological},
pages = {199--204},
}The impact of workplace violence on nurses in South Taiwan. Lin, Y. & Liu, H. International journal of nursing studies, 42(7):773--778, September, 2005.
doi abstract bibtex
doi abstract bibtex
The purpose of this study was to explore the prevalence of workplace violence (WPV) committed by patients and their family members against healthcare workers in south Taiwan. WPV incident questionnaires were completed by 205 nurses from a medical facility in south Taiwan. Sixty-two percent of the nurses reported experiencing WPV. The majority of the cases consisted of verbal abuse including threats of violence or threatening words from patients or families. The verbal expressions of violence were mainly due to misunderstanding and drunkenness on the part of patients and their families, and personal problems in the nurses' relationships with doctors and co-workers. The cases of physical WPV reported by the nurses were perpetrated by patients who were mentally unstable. The findings of this study may help hospitals and nurses in avoiding, reducing, and controlling incidents of WPV.
@article{lin_impact_2005,
title = {The impact of workplace violence on nurses in {South} {Taiwan}},
volume = {42},
issn = {0020-7489},
doi = {10.1016/j.ijnurstu.2004.11.010},
abstract = {The purpose of this study was to explore the prevalence of workplace violence (WPV) committed by patients and their family members against healthcare workers in south Taiwan. WPV incident questionnaires were completed by 205 nurses from a medical facility in south Taiwan. Sixty-two percent of the nurses reported experiencing WPV. The majority of the cases consisted of verbal abuse including threats of violence or threatening words from patients or families. The verbal expressions of violence were mainly due to misunderstanding and drunkenness on the part of patients and their families, and personal problems in the nurses' relationships with doctors and co-workers. The cases of physical WPV reported by the nurses were perpetrated by patients who were mentally unstable. The findings of this study may help hospitals and nurses in avoiding, reducing, and controlling incidents of WPV.},
language = {eng},
number = {7},
journal = {International journal of nursing studies},
author = {Lin, Yu-Hua and Liu, Hsueh-Erh},
month = sep,
year = {2005},
pmid = {15964004},
keywords = {Adult, Female, Humans, Nursing Staff, Hospital, Occupational Exposure, Risk Factors, Social Behavior, Taiwan, Violence},
pages = {773--778}
}Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Grundy, S., M., Cleeman, J., I., Daniels, S., R., Donato, K., A., Eckel, R., H., Franklin, B., A., Gordon, D., J., Krauss, R., M., Savage, P., J., Smith, S., C., Spertus, J., A., & Costa, F. Circulation, 2005.
bibtex
bibtex
@article{
title = {Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement.},
type = {article},
year = {2005},
identifiers = {[object Object]},
keywords = {Diabetes Mellitus, Type 2,Diabetes Mellitus, Type 2: epidemiology,Diabetes Mellitus, Type 2: prevention & control,Humans,Lipoproteins,Lipoproteins: blood,Metabolic Syndrome X,Metabolic Syndrome X: complications,Metabolic Syndrome X: diagnosis,Metabolic Syndrome X: epidemiology,Metabolic Syndrome X: therapy,National Institutes of Health (U.S.),Risk Factors,Societies, Medical,United States,United States: epidemiology},
id = {7598f17e-f498-39c9-86e7-e47f32399b06},
created = {2015-10-06T16:39:30.000Z},
file_attached = {false},
profile_id = {9119439d-54eb-3aeb-9ae6-8bf806ce7a35},
group_id = {d83c42cd-843c-302b-9a7f-a839f548dcf7},
last_modified = {2015-10-06T16:39:30.000Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {false},
hidden = {false},
bibtype = {article},
author = {Grundy, Scott M and Cleeman, James I and Daniels, Stephen R and Donato, Karen A and Eckel, Robert H and Franklin, Barry A and Gordon, David J and Krauss, Ronald M and Savage, Peter J and Smith, Sidney C and Spertus, John A and Costa, Fernando},
journal = {Circulation}
}2004 (5)
Application of a propensity score to adjust for channelling bias with NSAIDs. Morant, S. V., Pettitt, D., MacDonald, T. M., Burke, T. A., & Goldstein, J. L. Pharmacoepidemiology and Drug Safety, 13(6):345--353, June, 2004.
doi abstract bibtex
doi abstract bibtex
PURPOSE: To compare the relative risks of upper GI haemorrhage (UGIH) in users of Newer versus Older, non-specific NSAIDs when adjusted for channelling bias by regression on individual covariates, a propensity score and both. METHODS: Cohort study of patients prescribed NSAIDs between June 1987 and January 2000. Exposure to Newer and Older non-specific NSAIDs was identified, and risk factors evaluated for each patient. Results of multiple covariate analyses and the propensity scoring technique to assess potential channelling bias in comparisons between Newer and Older non-specific NSAIDs were compared. RESULTS: This study included 7.1 thousand patient years (tpy) exposure to meloxicam, 1.6 tpy exposure to coxibs, and 628 tpy exposure to Older non-specific NSAIDs. Patients receiving Newer NSAIDs were older, more likely to have a history of GI symptoms, and at higher risk for GI complications. Adjusting for these risk factors reduced the relative risks of UGIH on meloxicam and coxibs versus Older non-specific NSAIDs to 0.84 (95%CI 0.60, 1.17) and 0.36 (0.14, 0.97) respectively. CONCLUSIONS: Channelling towards high GI risk patients occurred in the prescribing of Newer NSAIDs. Propensity scores highlighted the markedly different risk profiles of users of Newer and Older non-specific NSAID. Correcting for channelling bias, coxib exposure, but not meloxicam exposure, was associated with less UGIH than Older non-specific NSAID exposure. In the present study, corrections made by regression on a propensity score and on individual covariates were similar.
@article{morant_application_2004,
title = {Application of a propensity score to adjust for channelling bias with {NSAIDs}},
volume = {13},
issn = {1053-8569},
doi = {10.1002/pds.946},
abstract = {PURPOSE: To compare the relative risks of upper GI haemorrhage (UGIH) in users of Newer versus Older, non-specific NSAIDs when adjusted for channelling bias by regression on individual covariates, a propensity score and both.
METHODS: Cohort study of patients prescribed NSAIDs between June 1987 and January 2000. Exposure to Newer and Older non-specific NSAIDs was identified, and risk factors evaluated for each patient. Results of multiple covariate analyses and the propensity scoring technique to assess potential channelling bias in comparisons between Newer and Older non-specific NSAIDs were compared.
RESULTS: This study included 7.1 thousand patient years (tpy) exposure to meloxicam, 1.6 tpy exposure to coxibs, and 628 tpy exposure to Older non-specific NSAIDs. Patients receiving Newer NSAIDs were older, more likely to have a history of GI symptoms, and at higher risk for GI complications. Adjusting for these risk factors reduced the relative risks of UGIH on meloxicam and coxibs versus Older non-specific NSAIDs to 0.84 (95\%CI 0.60, 1.17) and 0.36 (0.14, 0.97) respectively.
CONCLUSIONS: Channelling towards high GI risk patients occurred in the prescribing of Newer NSAIDs. Propensity scores highlighted the markedly different risk profiles of users of Newer and Older non-specific NSAID. Correcting for channelling bias, coxib exposure, but not meloxicam exposure, was associated with less UGIH than Older non-specific NSAID exposure. In the present study, corrections made by regression on a propensity score and on individual covariates were similar.},
language = {eng},
number = {6},
journal = {Pharmacoepidemiology and Drug Safety},
author = {Morant, S. V. and Pettitt, D. and MacDonald, T. M. and Burke, T. A. and Goldstein, J. L.},
month = jun,
year = {2004},
pmid = {15170763},
keywords = {Adult, Age Factors, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal, Cohort Studies, Cyclooxygenase Inhibitors, Databases, Factual, Drug Utilization Review, Family Practice, Female, Gastrointestinal Hemorrhage, Great Britain, Humans, Male, Middle Aged, Osteoarthritis, Regression Analysis, Risk Factors, Sex Factors, Thiazines, Thiazoles, pharmacoepidemiology},
pages = {345--353}
}Risk of extra-oesophageal malignancies and colorectal cancer in Barrett's oesophagus and gastro-oesophageal reflux. Solaymani-Dodaran, M., Logan, R. F. A., West, J., Card, T., & Coupland, C. Scandinavian Journal of Gastroenterology, 39(7):680--685, July, 2004.
doi abstract bibtex
doi abstract bibtex
BACKGROUND: The relationship between Barrett's oesophagus and colorectal cancer and other extra-oesophageal malignancies (EOM) has been a matter of controversy. These relationships have therefore been examined in a prospective study design in the General Practice Research Database. METHODS: Cohorts of patients having Barrett's oesophagus (n=1677), oesophagitis (n=6392), and simple reflux (n=6328), and a standard reference cohort representing the general population in the UK (n=13,416) were selected. The last three cohorts were matched to the Barrett's cohort by general practice, age and sex. Incident outcomes occurring beyond the first year of the follow-up were used for analyses. Hazard ratios and 95% confidence intervals were calculated using Cox's proportional hazards regression. The associations with cataract and oesophageal cancer were explored for comparison. RESULTS: Incident cases of 567 EOM (including 74 colorectal cancers), 448 cataract and 43 oesophageal cancers were used in the final analysis. The relative risks for colorectal cancer compared to the standard reference cohort were 1.16 (0.42-3.21) in the Barrett's cohort, 1.39 (0.76-2.54) in the oesophagitis cohort, and 0.93 (0.45-1.90) in the simple reflux cohort. The corresponding relative risks in the Barrett's cohort were 1.29 (0.90-1.85), 1.60 (1.10-2.32), and 10.56 (5.07-21.99) for EOM, cataract and oesophageal cancer, respectively. CONCLUSIONS: The risk of colorectal cancer was not higher in any of the Barrett's oesophagus, oesophagitis, or reflux cohorts compared to the general population. The explanations for the modest increase in the risk of EOM and cataract in the above cohorts are unclear but they may be mediated by ascertainment bias or shared risk factors.
@article{solaymani-dodaran_risk_2004,
title = {Risk of extra-oesophageal malignancies and colorectal cancer in {Barrett}'s oesophagus and gastro-oesophageal reflux},
volume = {39},
issn = {0036-5521},
doi = {10.1080/00365520410004802},
abstract = {BACKGROUND: The relationship between Barrett's oesophagus and colorectal cancer and other extra-oesophageal malignancies (EOM) has been a matter of controversy. These relationships have therefore been examined in a prospective study design in the General Practice Research Database.
METHODS: Cohorts of patients having Barrett's oesophagus (n=1677), oesophagitis (n=6392), and simple reflux (n=6328), and a standard reference cohort representing the general population in the UK (n=13,416) were selected. The last three cohorts were matched to the Barrett's cohort by general practice, age and sex. Incident outcomes occurring beyond the first year of the follow-up were used for analyses. Hazard ratios and 95\% confidence intervals were calculated using Cox's proportional hazards regression. The associations with cataract and oesophageal cancer were explored for comparison.
RESULTS: Incident cases of 567 EOM (including 74 colorectal cancers), 448 cataract and 43 oesophageal cancers were used in the final analysis. The relative risks for colorectal cancer compared to the standard reference cohort were 1.16 (0.42-3.21) in the Barrett's cohort, 1.39 (0.76-2.54) in the oesophagitis cohort, and 0.93 (0.45-1.90) in the simple reflux cohort. The corresponding relative risks in the Barrett's cohort were 1.29 (0.90-1.85), 1.60 (1.10-2.32), and 10.56 (5.07-21.99) for EOM, cataract and oesophageal cancer, respectively.
CONCLUSIONS: The risk of colorectal cancer was not higher in any of the Barrett's oesophagus, oesophagitis, or reflux cohorts compared to the general population. The explanations for the modest increase in the risk of EOM and cataract in the above cohorts are unclear but they may be mediated by ascertainment bias or shared risk factors.},
language = {eng},
number = {7},
journal = {Scandinavian Journal of Gastroenterology},
author = {Solaymani-Dodaran, M. and Logan, R. F. A. and West, J. and Card, T. and Coupland, C.},
month = jul,
year = {2004},
pmid = {15370691},
keywords = {Aged, Barrett Esophagus, Colorectal Neoplasms, Esophageal Neoplasms, Esophagitis, Female, Follow-Up Studies, Gastroesophageal Reflux, Great Britain, Humans, Male, Middle Aged, Prospective Studies, Risk Factors},
pages = {680--685}
}Lymphedema Secondary to Postmastectomy Radiation: Incidence and Risk Factors. Md, C. S. H., Mpa, N. L. W., Md, H. R., William Giese MD, J. D., Md, T. H., Kathleen A. Fassl PT, B. S., & Md, S. B. E. Annals of Surgical Oncology, 11(6):573--580, June, 2004.
Paper doi abstract bibtex
Paper doi abstract bibtex Background Postmastectomy radiotherapy (PMRT) has proven benefits for certain patients with breast cancer; however, one of its complications is lymphedema. This study examines the incidence of and risk factors associated with lymphedema secondary to PMRT. Methods The charts of patients treated with mastectomy at Roswell Park Cancer Institute between January 1, 1995, and April 20, 2001, who received PMRT were reviewed. Univariate analysis of patient, disease, and treatment variables was conducted. Multivariate analysis was performed on variables found to be significant in univariate analysis. Results One hundred five patients received PMRT. The incidence of lymphedema was 27%. Patient age, body mass index, disease stage, positive lymph nodes, nodes resected, postoperative infection, duration of drainage, chemotherapy, and hormonal therapy were not associated with lymphedema. Total dose (P = .032), posterior axillary boost (P = .047), overlap technique (P = .037), radiotherapy before 1999 (P = .028), and radiotherapy at Roswell Park Cancer Institute (P = .028) were significantly associated with lymphedema. Increased lymphedema was noted with supraclavicular, internal mammary, mastectomy scar boost, and chest wall tangential photon beam radiation, but the associations were not statistically significant. Conclusions The high incidence and debilitating effects of lymphedema must be weighed against the benefits of PMRT. Efforts to prevent lymphedema should be emphasized.
@article{md_lymphedema_2004,
title = {Lymphedema {Secondary} to {Postmastectomy} {Radiation}: {Incidence} and {Risk} {Factors}},
volume = {11},
issn = {1068-9265, 1534-4681},
shorttitle = {Lymphedema {Secondary} to {Postmastectomy} {Radiation}},
url = {http://link.springer.com/article/10.1245/ASO.2004.04.017},
doi = {10.1245/ASO.2004.04.017},
abstract = {Background Postmastectomy radiotherapy (PMRT) has proven benefits for certain patients with breast cancer; however, one of its complications is lymphedema. This study examines the incidence of and risk factors associated with lymphedema secondary to PMRT. Methods The charts of patients treated with mastectomy at Roswell Park Cancer Institute between January 1, 1995, and April 20, 2001, who received PMRT were reviewed. Univariate analysis of patient, disease, and treatment variables was conducted. Multivariate analysis was performed on variables found to be significant in univariate analysis. Results One hundred five patients received PMRT. The incidence of lymphedema was 27\%. Patient age, body mass index, disease stage, positive lymph nodes, nodes resected, postoperative infection, duration of drainage, chemotherapy, and hormonal therapy were not associated with lymphedema. Total dose (P = .032), posterior axillary boost (P = .047), overlap technique (P = .037), radiotherapy before 1999 (P = .028), and radiotherapy at Roswell Park Cancer Institute (P = .028) were significantly associated with lymphedema. Increased lymphedema was noted with supraclavicular, internal mammary, mastectomy scar boost, and chest wall tangential photon beam radiation, but the associations were not statistically significant. Conclusions The high incidence and debilitating effects of lymphedema must be weighed against the benefits of PMRT. Efforts to prevent lymphedema should be emphasized.},
language = {en},
number = {6},
urldate = {2013-06-30},
journal = {Annals of Surgical Oncology},
author = {Md, Christian S. Hinrichs and Mpa, Nancy L. Watroba and Md, Hamed Rezaishiraz and William Giese MD, J. D. and Md, Thelma Hurd and Kathleen A. Fassl PT, B. S. and Md, Stephen B. Edge},
month = jun,
year = {2004},
keywords = {Breast Neoplasms, Complications, Female, Humans, Incidence, Lymphedema, Middle Aged, Multivariate Analysis, New York, Oncology, Postmastectomy radiation, Radiotherapy, Adjuvant, Retrospective Studies, Risk Factors, Surgery, Surgical Oncology},
pages = {573--580},
file = {10.1245_ASO.2004.04.017.pdf:files/46619/10.1245_ASO.2004.04.017.pdf:application/pdf;10.1245_ASO.2004.04.017.pdf:files/46700/10.1245_ASO.2004.04.017.pdf:application/pdf}
}Medical conditions associated with venous leg ulcers. Margolis, D. J., Knauss, J., & Bilker, W. The British Journal of Dermatology, 150(2):267--273, February, 2004.
abstract bibtex
abstract bibtex
BACKGROUND: In patients who have a venous leg ulcer, very little is known about the frequency of their concomitant medical conditions. OBJECTIVES: To evaluate the frequency that other medical conditions are associated with a new venous leg ulcer. METHODS: We studied a 10% random sample of elderly patients registered in the General Practice Research Database between 1988 and 1996. We describe the frequency of medical conditions using simple percentages. In order to assess the associations between medical conditions and the onset of a venous leg ulcer, we used logistic regression models. RESULTS: Several medical conditions occur commonly in patients who develop venous leg ulcers, including anaemia, angina, asthma, cellulitis of the lower extremity, depression, diabetes, limb oedema, hypertension, osteoarthritis, pneumonia and urinary tract infection. After statistical adjustment many medical conditions were significantly associated with those who had recent onset of a venous leg ulcer, including asthma, cellulitis of the lower extremity, congestive heart failure, diabetes, deep venous thrombosis, lower limb oedema, osteoarthritis, peripheral vascular arterial disease of the lower extremity, rheumatoid arthritis, history of hip surgery, and history of venous surgery/ligation. Unexpectedly, some illnesses were inversely associated with those that had recent onset of a venous leg ulcer, including angina, cerebral vascular accident, depression, malignancy, myocardial infarction, pneumonia and urinary tract infection. CONCLUSIONS: Physicians caring for individuals with venous leg ulcers need to be aware that it is likely that these individuals may have one of the comorbid illnesses listed above.
@article{margolis_medical_2004,
title = {Medical conditions associated with venous leg ulcers},
volume = {150},
issn = {0007-0963},
abstract = {BACKGROUND: In patients who have a venous leg ulcer, very little is known about the frequency of their concomitant medical conditions.
OBJECTIVES: To evaluate the frequency that other medical conditions are associated with a new venous leg ulcer.
METHODS: We studied a 10\% random sample of elderly patients registered in the General Practice Research Database between 1988 and 1996. We describe the frequency of medical conditions using simple percentages. In order to assess the associations between medical conditions and the onset of a venous leg ulcer, we used logistic regression models.
RESULTS: Several medical conditions occur commonly in patients who develop venous leg ulcers, including anaemia, angina, asthma, cellulitis of the lower extremity, depression, diabetes, limb oedema, hypertension, osteoarthritis, pneumonia and urinary tract infection. After statistical adjustment many medical conditions were significantly associated with those who had recent onset of a venous leg ulcer, including asthma, cellulitis of the lower extremity, congestive heart failure, diabetes, deep venous thrombosis, lower limb oedema, osteoarthritis, peripheral vascular arterial disease of the lower extremity, rheumatoid arthritis, history of hip surgery, and history of venous surgery/ligation. Unexpectedly, some illnesses were inversely associated with those that had recent onset of a venous leg ulcer, including angina, cerebral vascular accident, depression, malignancy, myocardial infarction, pneumonia and urinary tract infection.
CONCLUSIONS: Physicians caring for individuals with venous leg ulcers need to be aware that it is likely that these individuals may have one of the comorbid illnesses listed above.},
language = {eng},
number = {2},
journal = {The British Journal of Dermatology},
author = {Margolis, D. J. and Knauss, J. and Bilker, W.},
month = feb,
year = {2004},
pmid = {14996097},
keywords = {Aged, Aged, 80 and over, Comorbidity, Female, Great Britain, Humans, Male, Regression Analysis, Retrospective Studies, Risk Factors, leg ulcer},
pages = {267--273}
}Acute and clinically relevant drug-induced liver injury: a population based case-control study. de Abajo, F. J., Montero, D., Madurga, M., & García Rodríguez, L. A. British Journal of Clinical Pharmacology, 58(1):71--80, July, 2004.
doi abstract bibtex
doi abstract bibtex
AIMS: To provide quantitative information about the absolute and relative risks of acute and clinically relevant drug-induced liver injury. METHODS: We performed a population-based case-control study using the UK-based General Practice Research Database as the source of information. A total of 1,636,792 persons subjects aged 5-75 years old registered in the database from 1 January, 1994 to 31 December, 1999 were followed-up for a total of 5,404,705 person-years. Cases were identified by an exhaustive computer search, then reviewed manually and finally validated against the clinical records. Only idiopathic cases serious enough to be referred to hospital or a consultant were selected. A total of 5000 controls were randomly sampled from the person-time of study cohort. Current users were defined if a prescription ended within 15 days of the index date, and nonusers if there was no prescription before the index date. RESULTS: One hundred and twenty-eight patients were considered as valid cases, being the crude incidence rate of 2.4 (95% confidence interval: 2.0, 2.8) per 100 000 person-years. The strongest associations were found with chlorpromazine (adjusted odds ratio (AOR); 95% CI = 416; 45, 3840), amoxicillin/clavulanic acid (AOR = 94.8; 27.8, 323), flucloxacillin (AOR = 17.7; 4.4, 71.0), macrolides (AOR = 6.9; 2.3, 21.0), tetracyclines (AOR = 6.2; 2.4, 15.8); metoclopramide (AOR = 6.2; 1.8, 21.3); chlorpheniramine (AOR = 9.6; 1.9, 49.7); betahistine (AOR = 15.3; 2.9, 80.7); sulphasalazine (AOR = 25.5; 6.0, 109); azathioprine (AOR = 10.5; 1.4, 76.4), diclofenac (AOR = 4.1; 1.9, 8.8) and antiepileptics (AOR = 5.1; 1.9, 13.7). A dose-effect was apparent for diclofenac, amoxicillin/clavulanic acid and flucloxacillin. The combination of two or more hepatotoxic drugs increased the risk by a factor of 6. The highest crude incidence rates were found for chlorpromazine, azathioprine, and sulfasalazine (about 1 per 1000 users). CONCLUSIONS: Idiopathic, acute and clinically relevant liver injury, which has the use of drugs as the most probable aetiology, is a rare event in the general population. The relative risks of 40 drugs/therapeutic classes are provided, along with the crude incidence rates for 15 of them where a statistical association was found.
@article{de_abajo_acute_2004,
title = {Acute and clinically relevant drug-induced liver injury: a population based case-control study},
volume = {58},
issn = {0306-5251},
shorttitle = {Acute and clinically relevant drug-induced liver injury},
doi = {10.1111/j.1365-2125.2004.02133.x},
abstract = {AIMS: To provide quantitative information about the absolute and relative risks of acute and clinically relevant drug-induced liver injury.
METHODS: We performed a population-based case-control study using the UK-based General Practice Research Database as the source of information. A total of 1,636,792 persons subjects aged 5-75 years old registered in the database from 1 January, 1994 to 31 December, 1999 were followed-up for a total of 5,404,705 person-years. Cases were identified by an exhaustive computer search, then reviewed manually and finally validated against the clinical records. Only idiopathic cases serious enough to be referred to hospital or a consultant were selected. A total of 5000 controls were randomly sampled from the person-time of study cohort. Current users were defined if a prescription ended within 15 days of the index date, and nonusers if there was no prescription before the index date.
RESULTS: One hundred and twenty-eight patients were considered as valid cases, being the crude incidence rate of 2.4 (95\% confidence interval: 2.0, 2.8) per 100 000 person-years. The strongest associations were found with chlorpromazine (adjusted odds ratio (AOR); 95\% CI = 416; 45, 3840), amoxicillin/clavulanic acid (AOR = 94.8; 27.8, 323), flucloxacillin (AOR = 17.7; 4.4, 71.0), macrolides (AOR = 6.9; 2.3, 21.0), tetracyclines (AOR = 6.2; 2.4, 15.8); metoclopramide (AOR = 6.2; 1.8, 21.3); chlorpheniramine (AOR = 9.6; 1.9, 49.7); betahistine (AOR = 15.3; 2.9, 80.7); sulphasalazine (AOR = 25.5; 6.0, 109); azathioprine (AOR = 10.5; 1.4, 76.4), diclofenac (AOR = 4.1; 1.9, 8.8) and antiepileptics (AOR = 5.1; 1.9, 13.7). A dose-effect was apparent for diclofenac, amoxicillin/clavulanic acid and flucloxacillin. The combination of two or more hepatotoxic drugs increased the risk by a factor of 6. The highest crude incidence rates were found for chlorpromazine, azathioprine, and sulfasalazine (about 1 per 1000 users).
CONCLUSIONS: Idiopathic, acute and clinically relevant liver injury, which has the use of drugs as the most probable aetiology, is a rare event in the general population. The relative risks of 40 drugs/therapeutic classes are provided, along with the crude incidence rates for 15 of them where a statistical association was found.},
language = {eng},
number = {1},
journal = {British Journal of Clinical Pharmacology},
author = {de Abajo, Francisco J. and Montero, Dolores and Madurga, Mariano and García Rodríguez, Luis A.},
month = jul,
year = {2004},
pmid = {15206996},
pmcid = {PMC1884531},
keywords = {Acute Disease, Adolescent, Adult, Age Factors, Aged, Case-Control Studies, Child, Child, Preschool, Drug-Induced Liver Injury, Female, Humans, Male, Middle Aged, Risk Factors},
pages = {71--80}
}2003 (4)
Adverse drug events associated with hospital admission. Peyriere, H., Cassan, S., Floutard, E., Riviere, S., Blayac, J., Hillaire-Buys, D., Le Quellec, A., & Hansel, S. The Annals of Pharmacotherapy, 37(1):5–11, January, 2003.
abstract bibtex
abstract bibtex
OBJECTIVE: To increase the knowledge base on the frequency, causality, and avoidability of adverse drug events (ADEs) as a cause for admission in internal medicine or when occurring during hospitalization. METHODS: A prospective study was performed for 6 periods of 8 days each. Epidemiologic data (e.g., age, gender, medical history), drug utilization, and adverse drug reactions on patients hospitalized during these periods were collected by a pharmacy student. RESULTS: A total of 156 patients (70 men and 86 women) were included in the study. The patients' mean age +/- SD was 66.5 +/- 18.1 years and mean length of stay was 13.2 +/- 9 days. Renal and hepatic insufficiency and previous history of drug intolerance were observed in 17.9%, 10.2%, and 2% of the hospitalized patients, respectively. Thirty-eight ADEs occurred in 32 patients; in 15 cases, ADEs were identified as the reason for admission, 10 cases occurred during hospitalization, and 13 cases were present at admission, but were not the cause of admission. The most frequent ADEs involved the neurologic (23.6%), renal (15.7%), and hematologic (13.1%) systems. Among these 38 ADEs, 22 were considered avoidable (57.9%); 20 of these were associated with therapeutic errors (inappropriate administration, drug-drug interactions, dosage error, drug not stopped despite the onset of ADEs). Patients with ADEs stayed longer in the hospital and took more drugs both before and during their hospital stay (p \textless 0.05). CONCLUSIONS: Most of the ADEs observed in this study were avoidable. The risk/benefit ratio of administered drugs could be improved with better knowledge of the patients' medical history and the risk factors of ADEs.
@article{peyriere_adverse_2003,
title = {Adverse drug events associated with hospital admission},
volume = {37},
issn = {1060-0280},
abstract = {OBJECTIVE: To increase the knowledge base on the frequency, causality, and avoidability of adverse drug events (ADEs) as a cause for admission in internal medicine or when occurring during hospitalization.
METHODS: A prospective study was performed for 6 periods of 8 days each. Epidemiologic data (e.g., age, gender, medical history), drug utilization, and adverse drug reactions on patients hospitalized during these periods were collected by a pharmacy student.
RESULTS: A total of 156 patients (70 men and 86 women) were included in the study. The patients' mean age +/- SD was 66.5 +/- 18.1 years and mean length of stay was 13.2 +/- 9 days. Renal and hepatic insufficiency and previous history of drug intolerance were observed in 17.9\%, 10.2\%, and 2\% of the hospitalized patients, respectively. Thirty-eight ADEs occurred in 32 patients; in 15 cases, ADEs were identified as the reason for admission, 10 cases occurred during hospitalization, and 13 cases were present at admission, but were not the cause of admission. The most frequent ADEs involved the neurologic (23.6\%), renal (15.7\%), and hematologic (13.1\%) systems. Among these 38 ADEs, 22 were considered avoidable (57.9\%); 20 of these were associated with therapeutic errors (inappropriate administration, drug-drug interactions, dosage error, drug not stopped despite the onset of ADEs). Patients with ADEs stayed longer in the hospital and took more drugs both before and during their hospital stay (p {\textless} 0.05).
CONCLUSIONS: Most of the ADEs observed in this study were avoidable. The risk/benefit ratio of administered drugs could be improved with better knowledge of the patients' medical history and the risk factors of ADEs.},
language = {eng},
number = {1},
journal = {The Annals of Pharmacotherapy},
author = {Peyriere, Hélène and Cassan, Stéphanie and Floutard, Edith and Riviere, Sophie and Blayac, Jean-Pierre and Hillaire-Buys, Dominique and Le Quellec, Alain and Hansel, Sylvie},
month = jan,
year = {2003},
pmid = {12503925},
keywords = {Adult, Adverse Drug Reaction Reporting Systems, Aged, Aged, 80 and over, Drug Hypersensitivity, Drug-Related Side Effects and Adverse Reactions, Female, Hospitalization, Humans, Length of Stay, Male, Medication Errors, Middle Aged, Pharmacy Service, Hospital, Prospective Studies, Risk Factors},
pages = {5--11}
}The incidence of sterilisation in the UK. Rowlands, S. & Hannaford, P. BJOG: an international journal of obstetrics and gynaecology, 110(9):819--824, September, 2003.
abstract bibtex
abstract bibtex
OBJECTIVE: To estimate incidence rates for tubal occlusion and vasectomy, and to examine how these vary with age, geographical area and time. DESIGN: Search of patient files for operation codes in the years 1992-1999 and calculation of person time. POPULATION AND SETTING: General Practice Research Database. METHODS: Patient files of women aged 20-54 years and men aged 20-64 years were searched for sterilisation operation codes. Annual incidence rates in five year aged bands were calculated for sterilisation operations for both sexes. Figures were examined according to National Health Service Region and population density category of the general practices. The relationship between year of operation and mean age at operation was also examined. MAIN OUTCOME MEASURES: Incidence rates by year, age group and geographical area. RESULTS: The average annual incidence of sterilisation in the eight year period was 4.75 per 1000 person years at risk for women aged 20-54 and 4.48 per 1000 person years at risk for men aged 20-64. For women, there was a statistically significant 30% decrease in incidence of tubal occlusion over the study period. There was no change in vasectomy rates over time. About one-third of all vasectomies in the UK are estimated to be performed outside hospital and community clinic settings. The rates of sterilisation in both sexes were much lower in Greater London than elsewhere in the UK. CONCLUSIONS: The popularity of tubal occlusion appears to be on the decline. Since 1996, the UK has been one of very few countries in which sterilisation incidence in men is greater than that in women.
@article{rowlands_incidence_2003,
title = {The incidence of sterilisation in the {UK}},
volume = {110},
issn = {1470-0328},
abstract = {OBJECTIVE: To estimate incidence rates for tubal occlusion and vasectomy, and to examine how these vary with age, geographical area and time.
DESIGN: Search of patient files for operation codes in the years 1992-1999 and calculation of person time.
POPULATION AND SETTING: General Practice Research Database.
METHODS: Patient files of women aged 20-54 years and men aged 20-64 years were searched for sterilisation operation codes. Annual incidence rates in five year aged bands were calculated for sterilisation operations for both sexes. Figures were examined according to National Health Service Region and population density category of the general practices. The relationship between year of operation and mean age at operation was also examined.
MAIN OUTCOME MEASURES: Incidence rates by year, age group and geographical area.
RESULTS: The average annual incidence of sterilisation in the eight year period was 4.75 per 1000 person years at risk for women aged 20-54 and 4.48 per 1000 person years at risk for men aged 20-64. For women, there was a statistically significant 30\% decrease in incidence of tubal occlusion over the study period. There was no change in vasectomy rates over time. About one-third of all vasectomies in the UK are estimated to be performed outside hospital and community clinic settings. The rates of sterilisation in both sexes were much lower in Greater London than elsewhere in the UK.
CONCLUSIONS: The popularity of tubal occlusion appears to be on the decline. Since 1996, the UK has been one of very few countries in which sterilisation incidence in men is greater than that in women.},
language = {eng},
number = {9},
journal = {BJOG: an international journal of obstetrics and gynaecology},
author = {Rowlands, Sam and Hannaford, Philip},
month = sep,
year = {2003},
pmid = {14511963},
keywords = {Adult, Age Distribution, Female, Great Britain, Humans, Male, Middle Aged, Risk Factors, Sterilization, Reproductive, Sterilization, Tubal, Vasectomy, incidence},
pages = {819--824}
}Predictors of mortality in 2,249 nonagenarians--the Danish 1905-Cohort Survey. Nybo, H., Petersen, H., C., Gaist, D., Jeune, B., Andersen, K., McGue, M., Vaupel, J., W., & Christensen, K. J Am Geriatr Soc, 51(10):1365-1373, 2003.
Paper Website abstract bibtex
Paper Website abstract bibtex OBJECTIVES: : To elucidate whether well-known predictions of mortality are reduced or even reversed, or whether mortality is a stochastic process in the oldest old. DESIGN: : A multidimensional survey of the Danish 1905 cohort conducted in 1998 with follow-up of vital status after 15 months. SETTING: : Denmark. PARTICIPANTS: : All Danes born in 1905, irrespective of physical and mental status were approached. Two thousand two hundred sixty-two persons of 3,600 participated in this survey. MEASUREMENTS: : Professional interviewers collected data concerning sociodemographic factors, smoking, alcohol consumption, body mass index, physical and cognitive performance, and health during a visit at the participant's residency. Cox regression models were used to evaluate predictors of mortality. RESULTS: : Five hundred seventy-nine (25.7%) of the 2,249 participants eligible for the analysis died during the 15 months follow-up. Multivariate analyses showed that marital status, education, smoking, obesity, consumption of alcohol, and number of self-reported diseases were not associated with mortality. Disability and cognitive impairment were significant risk factors in men and women. In addition poor self-rated health was associated with an increase in mortality in women. CONCLUSION: : In the oldest old, several known predictors of mortality, such as sociodemographic factors, smoking, and obesity, have lost their importance, but a high disability level, poor physical and cognitive performance, and self-rated health (women only), predict mortality, which shows that mortality in the oldest old is not a stochastic process.
@article{
title = {Predictors of mortality in 2,249 nonagenarians--the Danish 1905-Cohort Survey},
type = {article},
year = {2003},
identifiers = {[object Object]},
keywords = {Activities of Daily Living,Aged,Aged, 80 and over/*statistics & numerical data,Cohort Studies,Denmark/epidemiology,Female,Geriatric Assessment,Humans,Interviews,Male,Mortality/*trends,Predictive Value of Tests,Proportional Hazards Models,Research Support, Non-U.S. Gov't,Research Support, U.S. Gov't, P.H.S.,Risk Factors},
pages = {1365-1373},
volume = {51},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14511155},
id = {fd707acd-8637-3890-90ca-bf1c90ed0a7a},
created = {2017-06-19T13:45:56.028Z},
file_attached = {true},
profile_id = {de68dde1-2ff3-3a4e-a214-ef424d0c7646},
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last_modified = {2017-06-19T13:45:56.207Z},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>0002-8614<m:linebreak/>Journal Article</m:note>},
abstract = {OBJECTIVES: : To elucidate whether well-known predictions of mortality are reduced or even reversed, or whether mortality is a stochastic process in the oldest old. DESIGN: : A multidimensional survey of the Danish 1905 cohort conducted in 1998 with follow-up of vital status after 15 months. SETTING: : Denmark. PARTICIPANTS: : All Danes born in 1905, irrespective of physical and mental status were approached. Two thousand two hundred sixty-two persons of 3,600 participated in this survey. MEASUREMENTS: : Professional interviewers collected data concerning sociodemographic factors, smoking, alcohol consumption, body mass index, physical and cognitive performance, and health during a visit at the participant's residency. Cox regression models were used to evaluate predictors of mortality. RESULTS: : Five hundred seventy-nine (25.7%) of the 2,249 participants eligible for the analysis died during the 15 months follow-up. Multivariate analyses showed that marital status, education, smoking, obesity, consumption of alcohol, and number of self-reported diseases were not associated with mortality. Disability and cognitive impairment were significant risk factors in men and women. In addition poor self-rated health was associated with an increase in mortality in women. CONCLUSION: : In the oldest old, several known predictors of mortality, such as sociodemographic factors, smoking, and obesity, have lost their importance, but a high disability level, poor physical and cognitive performance, and self-rated health (women only), predict mortality, which shows that mortality in the oldest old is not a stochastic process.},
bibtype = {article},
author = {Nybo, H and Petersen, H C and Gaist, D and Jeune, B and Andersen, K and McGue, M and Vaupel, J W and Christensen, K},
journal = {J Am Geriatr Soc},
number = {10}
}MMR vaccine and idiopathic thrombocytopaenic purpura. Black, C., Kaye, J. A., & Jick, H. British Journal of Clinical Pharmacology, 55(1):107--111, January, 2003.
abstract bibtex
abstract bibtex
AIMS: To estimate the relationship between idiopathic thrombocytopaenic purpura (ITP) and the measles, mumps and rubella (MMR) vaccination in children; calculating the relative risk estimate for ITP with in 6 weeks after MMR vaccination and the attributable risk of ITP within 6 weeks after MMR vaccination. METHODS: Using the General Practice Research Database we identified children with a first-time diagnosis of ITP from a base population of children aged less than 6 years between January 1988 and December 1999. After describing the characteristics of all the children identified with ITP, we focused on cases aged 13-24 months to perform a population-based, case-control analysis to estimate the relative risk of developing ITP within 6 weeks after MMR vaccination. We also calculated the risk of ITP attributable to the MMR vaccination. RESULTS: Sixty-three children with a first time diagnosis of ITP were identified; 23 cases were between 13 and 24 months old. The relative risk estimate for ITP within 6 weeks after MMR vaccination, compared to the combined group of unvaccinated children and children vaccinated with MMR more than 26 weeks previously was 6.3 (95% CI 1.3-30.1). The attributable risk of developing ITP within 6 weeks after MMR vaccination was estimated to be 1 in 25,000 vaccinations (95% confidence interval 21,300, 89,400). CONCLUSION: This study confirms the increased risk of ITP within 6 weeks after MMR vaccination. However, the attributable risk of ITP within 6 weeks after MMR vaccination is low.
@article{black_mmr_2003,
title = {{MMR} vaccine and idiopathic thrombocytopaenic purpura},
volume = {55},
issn = {0306-5251},
abstract = {AIMS: To estimate the relationship between idiopathic thrombocytopaenic purpura (ITP) and the measles, mumps and rubella (MMR) vaccination in children; calculating the relative risk estimate for ITP with in 6 weeks after MMR vaccination and the attributable risk of ITP within 6 weeks after MMR vaccination.
METHODS: Using the General Practice Research Database we identified children with a first-time diagnosis of ITP from a base population of children aged less than 6 years between January 1988 and December 1999. After describing the characteristics of all the children identified with ITP, we focused on cases aged 13-24 months to perform a population-based, case-control analysis to estimate the relative risk of developing ITP within 6 weeks after MMR vaccination. We also calculated the risk of ITP attributable to the MMR vaccination.
RESULTS: Sixty-three children with a first time diagnosis of ITP were identified; 23 cases were between 13 and 24 months old. The relative risk estimate for ITP within 6 weeks after MMR vaccination, compared to the combined group of unvaccinated children and children vaccinated with MMR more than 26 weeks previously was 6.3 (95\% CI 1.3-30.1). The attributable risk of developing ITP within 6 weeks after MMR vaccination was estimated to be 1 in 25,000 vaccinations (95\% confidence interval 21,300, 89,400).
CONCLUSION: This study confirms the increased risk of ITP within 6 weeks after MMR vaccination. However, the attributable risk of ITP within 6 weeks after MMR vaccination is low.},
language = {eng},
number = {1},
journal = {British Journal of Clinical Pharmacology},
author = {Black, Corri and Kaye, James A. and Jick, Hershel},
month = jan,
year = {2003},
pmid = {12534647},
pmcid = {PMC1884189},
keywords = {Case-Control Studies, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Measles-Mumps-Rubella Vaccine, Purpura, Thrombocytopenic, Idiopathic, Risk Factors},
pages = {107--111}
}2002 (2)
Use of nonsteroidal anti-inflammatory drugs and the risk of first-time acute myocardial infarction. Schlienger, R. G., Jick, H., & Meier, C. R. British Journal of Clinical Pharmacology, 54(3):327--332, September, 2002.
abstract bibtex
abstract bibtex
AIMS: Aspirin decreases the risk of clinical manifestations of atherothrombosis. This effect is mainly due to inhibition of platelet aggregation and potentially due to anti-inflammatory properties of aspirin. To evaluate whether use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) may also be associated with a decreased risk of first-time acute myocardial infarction (AMI), we performed a population-based case-control analysis using the United Kingdom-based General Practice Research Database (GPRD) METHODS: We identified first-time AMI-patients free of preexisting diagnosed cardiovascular or metabolic diseases. We compared use of NSAIDs prior to the index date between cases and control patients who were matched to cases on age, gender, practice and calendar time. RESULTS: A total of 3319 cases (\textlessor=75 years) with a diagnosis of first-time AMI between 1992 and 1997 and 13139 controls (matched to cases on age, sex, general practice attended, calendar time, years of prior history in the GPRD) were included. Overall, the relative risk estimate of AMI (adjusted for smoking, body mass index, hormone replacement therapy and aspirin) in current NSAID users was 1.17 (95% CI 0.99, 1.37). Long-term current NSAID use (\textgreateror=30 prescriptions) yielded an adjusted odds ratio (OR) of 1.20 (95% CI 0.94, 1.55). Stratification by age (\textless65 years vs\textgreateror=65 years) and sex did not materially change the results. CONCLUSIONS: Our findings indicate that current NSAID exposure in patients free of diagnosed cardiovascular or metabolic conditions predisposing to cardiovascular diseases does not decrease the risk of AMI.
@article{schlienger_use_2002,
title = {Use of nonsteroidal anti-inflammatory drugs and the risk of first-time acute myocardial infarction},
volume = {54},
issn = {0306-5251},
abstract = {AIMS: Aspirin decreases the risk of clinical manifestations of atherothrombosis. This effect is mainly due to inhibition of platelet aggregation and potentially due to anti-inflammatory properties of aspirin. To evaluate whether use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) may also be associated with a decreased risk of first-time acute myocardial infarction (AMI), we performed a population-based case-control analysis using the United Kingdom-based General Practice Research Database (GPRD) METHODS: We identified first-time AMI-patients free of preexisting diagnosed cardiovascular or metabolic diseases. We compared use of NSAIDs prior to the index date between cases and control patients who were matched to cases on age, gender, practice and calendar time.
RESULTS: A total of 3319 cases ({\textless}or=75 years) with a diagnosis of first-time AMI between 1992 and 1997 and 13139 controls (matched to cases on age, sex, general practice attended, calendar time, years of prior history in the GPRD) were included. Overall, the relative risk estimate of AMI (adjusted for smoking, body mass index, hormone replacement therapy and aspirin) in current NSAID users was 1.17 (95\% CI 0.99, 1.37). Long-term current NSAID use ({\textgreater}or=30 prescriptions) yielded an adjusted odds ratio (OR) of 1.20 (95\% CI 0.94, 1.55). Stratification by age ({\textless}65 years vs{\textgreater}or=65 years) and sex did not materially change the results.
CONCLUSIONS: Our findings indicate that current NSAID exposure in patients free of diagnosed cardiovascular or metabolic conditions predisposing to cardiovascular diseases does not decrease the risk of AMI.},
language = {eng},
number = {3},
journal = {British Journal of Clinical Pharmacology},
author = {Schlienger, Raymond G. and Jick, Hershel and Meier, Christoph R.},
month = sep,
year = {2002},
pmid = {12236854},
pmcid = {PMC1874430},
keywords = {Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal, Case-Control Studies, Female, Great Britain, Humans, Male, Middle Aged, Myocardial Infarction, Risk Assessment, Risk Factors},
pages = {327--332}
}What is the Birth Defect Risk Associated With Consanguineous Marriages ?. Zlotogora, J. American journal of medical genetics, 109(1):70-71, 2002.
Paper bibtex
Paper bibtex @article{
title = {What is the Birth Defect Risk Associated With Consanguineous Marriages ?},
type = {article},
year = {2002},
identifiers = {[object Object]},
keywords = {*Consanguinity,Abnormalities/*genetics,Child,Female,Human,Infant,Male,Preschool,Risk Factors},
pages = {70-71},
volume = {109},
id = {f8021355-3e47-3c4b-b4f4-b8bb58d6fc41},
created = {2017-06-19T13:42:00.462Z},
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notes = {<m:note> <m:bold>From Duplicate 1 ( </m:bold> <m:bold> </m:bold><m:bold><m:italic>What is the birth defect risk associated with consanguineous marriages?</m:italic></m:bold><m:bold> </m:bold> <m:bold> - Zlotogora, J )<m:linebreak/> </m:bold> <m:linebreak/>Case Reports<m:linebreak/>Letter<m:linebreak/> <m:linebreak/> </m:note>},
bibtype = {article},
author = {Zlotogora, Joël},
journal = {American journal of medical genetics},
number = {1}
}2001 (6)
The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents. Garcia Rodríguez, L. A. & Hernández-Díaz, S. Arthritis Research, 3(2):98--101, 2001.
doi abstract bibtex
doi abstract bibtex
Most anti-inflammatory drugs have been associated with an increased risk of serious upper gastrointestinal complications. Epidemiological studies have estimated the magnitude of the risk for specific anti-inflammatory drugs. The risk of upper gastrointestinal tract bleeding or perforation increases around twofold with use of oral steroids or low dose aspirin, and increases around fourfold with use of nonaspirin nonsteroidal anti-inflammatory drugs. Acetaminophen at daily doses of 2000 mg and higher has also been associated with an increased risk. Overall, the risk is dose dependent and is greater with more than one anti-inflammatory drug taken simultaneously. Hence, whenever possible, anti-inflammatory drugs should be given in monotherapy and at the lowest effective dose in order to reduce the risk of serious upper gastrointestinal complications.
@article{garcia_rodriguez_risk_2001,
title = {The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents},
volume = {3},
issn = {1465-9905},
doi = {10.1186/ar146},
abstract = {Most anti-inflammatory drugs have been associated with an increased risk of serious upper gastrointestinal complications. Epidemiological studies have estimated the magnitude of the risk for specific anti-inflammatory drugs. The risk of upper gastrointestinal tract bleeding or perforation increases around twofold with use of oral steroids or low dose aspirin, and increases around fourfold with use of nonaspirin nonsteroidal anti-inflammatory drugs. Acetaminophen at daily doses of 2000 mg and higher has also been associated with an increased risk. Overall, the risk is dose dependent and is greater with more than one anti-inflammatory drug taken simultaneously. Hence, whenever possible, anti-inflammatory drugs should be given in monotherapy and at the lowest effective dose in order to reduce the risk of serious upper gastrointestinal complications.},
language = {eng},
number = {2},
journal = {Arthritis Research},
author = {Garcia Rodríguez, L. A. and Hernández-Díaz, S.},
year = {2001},
pmid = {11178116},
pmcid = {PMC128885},
keywords = {Acetaminophen, Analgesics, Non-Narcotic, Anti-Inflammatory Agents, Non-Steroidal, Arthritis, Drug Therapy, Combination, Gastrointestinal Diseases, Glucocorticoids, Humans, Risk Factors},
pages = {98--101}
}Differences in disease frequency between Europeans and Polynesians: directions for future research into genetic risk factors. Abbott, W., Scragg, R., & Marbrook, J. Pac Health Dialog, 8(1):129-56., 2001.
abstract bibtex
abstract bibtex
The purpose of this review is to identify complex genetic diseases that might be common in Polynesian ethnic groups because of a high frequency of susceptibility genes. Since a number of Polynesian ethnic groups are descended from recent founder populations, they may be especially suitable for studies designed to identify these genes. We have reviewed the epidemiological literature looking for diseases that i) have a higher frequency in at least two Polynesian groups than in Europeans living in the same geographic areas, ii) are not at high frequency in Polynesia entirely because of high levels of known environmental risk factors, and iii) are known to be inherited in other ethnic groups. Twenty-one diseases fulfilling these three criteria were identified. It may be possible to design studies to identify the genes that cause these diseases in Polynesian ethnic groups.
@article{
title = {Differences in disease frequency between Europeans and Polynesians: directions for future research into genetic risk factors},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {Cardiovascular Diseases/epidemiology/ethnology/gen,Communicable Diseases/epidemiology/ethnology/genet,Comparative Study,Cross-Sectional Studies,Ethnic Groups/*genetics,Europe,Female,Genetic Predisposition to Disease/*ethnology,Human,Male,Mental Disorders/epidemiology/ethnology/genetics,Neoplasms/epidemiology/ethnology/genetics,Polynesia,Respiratory Tract Infections/epidemiology/ethnolog,Risk Factors,Support, Non-U.S. Gov't},
pages = {129-56.},
volume = {8},
id = {d2b1e45e-388c-3f80-aade-5bb60895ae60},
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hidden = {false},
source_type = {Journal Article},
notes = {<m:note>eng<m:linebreak/>Journal Article<m:linebreak/>Review<m:linebreak/>Review, Academic</m:note>},
abstract = {The purpose of this review is to identify complex genetic diseases that might be common in Polynesian ethnic groups because of a high frequency of susceptibility genes. Since a number of Polynesian ethnic groups are descended from recent founder populations, they may be especially suitable for studies designed to identify these genes. We have reviewed the epidemiological literature looking for diseases that i) have a higher frequency in at least two Polynesian groups than in Europeans living in the same geographic areas, ii) are not at high frequency in Polynesia entirely because of high levels of known environmental risk factors, and iii) are known to be inherited in other ethnic groups. Twenty-one diseases fulfilling these three criteria were identified. It may be possible to design studies to identify the genes that cause these diseases in Polynesian ethnic groups.},
bibtype = {article},
author = {Abbott, W and Scragg, R and Marbrook, J},
journal = {Pac Health Dialog},
number = {1}
}After BRCA1 and BRCA2-what next? Multifactorial segregation analyses of three-generation, population-based Australian families affected by female breast cancer. Cui, J., Antoniou, A., C., Dite, G., S., Southey, M., C., Venter, D., J., Easton, D., F., Giles, G., G., McCredie, M., R., & Hopper, J., L. Am J Hum Genet, 68(2):420-31., 2001.
Paper abstract bibtex
Paper abstract bibtex Mutations in BRCA1 and BRCA2 that cause a dominantly inherited high risk of female breast cancer seem to explain only a small proportion of the aggregation of the disease. To study the possible additional genetic components, we conducted single-locus and two-locus segregation analyses, with and without a polygenic background, using three-generation families ascertained through 858 women with breast cancer diagnosed at age <40 years, ascertained through population cancer registries in Melbourne and Sydney, Australia. Extensive testing for deleterious mutations in BRCA1 and BRCA2, to date, has identified 34 carriers. Our analysis suggested that, after other possible unmeasured familial factors are adjusted for and the known BRCA1 and BRCA2 mutation carriers are excluded, there appears to be a residual dominantly inherited risk of female breast cancer in addition to that derived from mutations in BRCA1 and BRCA2. This study also suggests that there is a substantial recessively inherited risk of early-onset breast cancer. According to the best-fitting model, after excluding known carriers of mutations in BRCA1 and BRCA2, about 1/250 (95% confidence interval [CI] 1/500 to 1/125) women have a recessive risk of 86% (95% CI 69%-100%) by age 50 years and of almost 100% by age 60 years. Possible reasons that our study has implicated a novel strong recessive effect include our inclusion of data on lineal aunts and grandmothers, study of families ascertained through women with early-onset breast cancer, allowance for multiple familial factors in the analysis, and removal of families for whom the cause (i.e., BRCA1 or BRCA2) is known. Our findings may have implications for attempts to identify new breast cancer-susceptibility genes.
@article{
title = {After BRCA1 and BRCA2-what next? Multifactorial segregation analyses of three-generation, population-based Australian families affected by female breast cancer},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {Age Factors,Age of Onset,Australia,BRCA1 Protein/*genetics,BRCA2 Protein,Breast Neoplasms/*genetics,Cohort Studies,Family Health,Female,Heterozygote,Human,Male,Models, Genetic,Molecular Sequence Data,Mutation,Neoplasm Proteins/*genetics,Pedigree,Probability,Risk Factors,Statistics,Support, Non-U.S. Gov't,Support, U.S. Gov't, P.H.S.,Transcription Factors/*genetics},
pages = {420-31.},
volume = {68},
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confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>eng<m:linebreak/>Journal Article</m:note>},
abstract = {Mutations in BRCA1 and BRCA2 that cause a dominantly inherited high risk of female breast cancer seem to explain only a small proportion of the aggregation of the disease. To study the possible additional genetic components, we conducted single-locus and two-locus segregation analyses, with and without a polygenic background, using three-generation families ascertained through 858 women with breast cancer diagnosed at age <40 years, ascertained through population cancer registries in Melbourne and Sydney, Australia. Extensive testing for deleterious mutations in BRCA1 and BRCA2, to date, has identified 34 carriers. Our analysis suggested that, after other possible unmeasured familial factors are adjusted for and the known BRCA1 and BRCA2 mutation carriers are excluded, there appears to be a residual dominantly inherited risk of female breast cancer in addition to that derived from mutations in BRCA1 and BRCA2. This study also suggests that there is a substantial recessively inherited risk of early-onset breast cancer. According to the best-fitting model, after excluding known carriers of mutations in BRCA1 and BRCA2, about 1/250 (95% confidence interval [CI] 1/500 to 1/125) women have a recessive risk of 86% (95% CI 69%-100%) by age 50 years and of almost 100% by age 60 years. Possible reasons that our study has implicated a novel strong recessive effect include our inclusion of data on lineal aunts and grandmothers, study of families ascertained through women with early-onset breast cancer, allowance for multiple familial factors in the analysis, and removal of families for whom the cause (i.e., BRCA1 or BRCA2) is known. Our findings may have implications for attempts to identify new breast cancer-susceptibility genes.},
bibtype = {article},
author = {Cui, J and Antoniou, A C and Dite, G S and Southey, M C and Venter, D J and Easton, D F and Giles, G G and McCredie, M R and Hopper, J L},
journal = {Am J Hum Genet},
number = {2}
}Social and health status of arrivals in a French prison: a consecutive case study from 1989 to 1995. Duhamel, A, Renard, J M, Nuttens, M C, Devos, P, Beuscart, R, & Archer, E Revue d'épidémiologie et de santé publique, 49(3):229–238, June, 2001.
Paper abstract bibtex
Paper abstract bibtex BACKGROUND To assess the demographic, socioeconomic and health status of male arrivals in French jails and to analyze the time trends of these characteristics. METHODS The study was carried out in a prison for detained persons and short term prisoners. Using a standardized questionnaire, we recorded the characteristics of all male detainees and prisoners arriving in the prison between 1989 and 1995. The information collected concerned: demographic data, level of education and professional status, reasons for detention or imprisonment, social and family background, lifestyle, medical and psychiatric history, suicide attempts and illicit use of drugs. The characteristics of the study population were compared with those found in the general regional population. We analyzed developing trends in the health status of the prison population as well as their socio-economic profile over a period of seven years (1989 to 1995). RESULTS A total of 14,785 questionnaires were analyzed. Of the study population, 56% had no professional qualification, and 62% was unemployed. About two-thirds of the inmates presented psychiatric problems or problems with illicit drug use (one or several drugs). Amongst these, 70% had not had any form of care -neither therapeutic nor educational- before their arrival in prison. Between 1989 and 1995, the proportion of drug users increased by 30%. A parallel increase was observed in the level of unemployment and in the frequency of mental problems. CONCLUSIONS Our results suggest a need for therapeutic and educational care to be provided for prison inmates. This poses a problem which needs to be addressed in terms of public health. The study also illustrates the usefulness of a standardised questionnaire for each arrival. The systematic use of such a tool would make it possible to identify inmates'needs and to propose adapted care solutions.
@article{duhamel_social_2001,
title = {Social and health status of arrivals in a {French} prison: a consecutive case study from 1989 to 1995},
volume = {49},
issn = {0398-7620},
shorttitle = {Social and health status of arrivals in a {French} prison},
url = {http://www.ncbi.nlm.nih.gov/pubmed/11427826},
abstract = {BACKGROUND
To assess the demographic, socioeconomic and health status of male arrivals in French jails and to analyze the time trends of these characteristics.
METHODS
The study was carried out in a prison for detained persons and short term prisoners. Using a standardized questionnaire, we recorded the characteristics of all male detainees and prisoners arriving in the prison between 1989 and 1995. The information collected concerned: demographic data, level of education and professional status, reasons for detention or imprisonment, social and family background, lifestyle, medical and psychiatric history, suicide attempts and illicit use of drugs. The characteristics of the study population were compared with those found in the general regional population. We analyzed developing trends in the health status of the prison population as well as their socio-economic profile over a period of seven years (1989 to 1995).
RESULTS
A total of 14,785 questionnaires were analyzed. Of the study population, 56\% had no professional qualification, and 62\% was unemployed. About two-thirds of the inmates presented psychiatric problems or problems with illicit drug use (one or several drugs). Amongst these, 70\% had not had any form of care -neither therapeutic nor educational- before their arrival in prison. Between 1989 and 1995, the proportion of drug users increased by 30\%. A parallel increase was observed in the level of unemployment and in the frequency of mental problems.
CONCLUSIONS
Our results suggest a need for therapeutic and educational care to be provided for prison inmates. This poses a problem which needs to be addressed in terms of public health. The study also illustrates the usefulness of a standardised questionnaire for each arrival. The systematic use of such a tool would make it possible to identify inmates'needs and to propose adapted care solutions.},
number = {3},
urldate = {2012-05-10},
journal = {Revue d'épidémiologie et de santé publique},
author = {Duhamel, A and Renard, J M and Nuttens, M C and Devos, P and Beuscart, R and Archer, E},
month = jun,
year = {2001},
pmid = {11427826},
keywords = {*Health Status, Adolescent, Adult, Aged, Aged, 80 and over, Crime, Crime/statistics \& numerical data/trends, Educational Status, Family, Family/psychology, France, France/epidemiology, Health Status, Health Surveys, Humans, Interview, Psychological, Life Style, Male, Marital Status, Marital Status/statistics \& numerical data, Mental Disorders, Mental Disorders/diagnosis/epidemiology, Middle Aged, Needs Assessment, Occupations, Occupations/statistics \& numerical data, Prisoners, Prisoners/education/psychology/*statistics \& numerical data, Questionnaires, Risk Factors, Socioeconomic Factors, Substance-Related Disorders, Substance-Related Disorders/epidemiology, Suicide, Attempted, Suicide, Attempted/statistics \& numerical data, Surveys and Questionnaires},
pages = {229--238},
}Trends in risk factors for caesarean sections in France between 1981 and 1995: lessons for reducing the rates in the future. Guihard, P. & Blondel, B. BJOG: an international journal of obstetrics and gynaecology, 108(1):48–55, January, 2001.
abstract bibtex
abstract bibtex
OBJECTIVE: To assess the effects of the characteristics of mothers, fetuses and maternity units on the trends in caesarean section use, especially for primiparae. DESIGN: Cross sectional surveys. SETTING: Maternity units. POPULATION: Two representative national samples of births including 5410 newborns in 1981 and 13318 in 1995. METHOD: Univariate analysis and logistic regression analysis. RESULTS: The overall rate of caesarean section rose from 10.7% in 1981 to 15.3% in 1995. This trend is mainly attributable to the increases in the proportion of previously sectioned women (from 4.1% to 8.2%) and in caesarean sections for primiparae (from 12.6% to 17.8%). Among primiparae several maternal risk factors such as late childbearing and obesity before pregnancy were more frequent in 1995 than in 1981. The increase in caesarean sections affected both the high risk group (25.4% to 32.4%) and the low risk group (8.1% to 12.0%). CONCLUSION: A significant reduction in the overall rate cannot be achieved without regulating caesarean section use for primiparae. Strategies to change delivery patterns should be aimed at both high and low risk women.
@article{guihard_trends_2001,
title = {Trends in risk factors for caesarean sections in {France} between 1981 and 1995: lessons for reducing the rates in the future},
volume = {108},
issn = {1470-0328},
shorttitle = {Trends in risk factors for caesarean sections in {France} between 1981 and 1995},
abstract = {OBJECTIVE: To assess the effects of the characteristics of mothers, fetuses and maternity units on the trends in caesarean section use, especially for primiparae.
DESIGN: Cross sectional surveys.
SETTING: Maternity units.
POPULATION: Two representative national samples of births including 5410 newborns in 1981 and 13318 in 1995.
METHOD: Univariate analysis and logistic regression analysis.
RESULTS: The overall rate of caesarean section rose from 10.7\% in 1981 to 15.3\% in 1995. This trend is mainly attributable to the increases in the proportion of previously sectioned women (from 4.1\% to 8.2\%) and in caesarean sections for primiparae (from 12.6\% to 17.8\%). Among primiparae several maternal risk factors such as late childbearing and obesity before pregnancy were more frequent in 1995 than in 1981. The increase in caesarean sections affected both the high risk group (25.4\% to 32.4\%) and the low risk group (8.1\% to 12.0\%).
CONCLUSION: A significant reduction in the overall rate cannot be achieved without regulating caesarean section use for primiparae. Strategies to change delivery patterns should be aimed at both high and low risk women.},
language = {ENG},
number = {1},
journal = {BJOG: an international journal of obstetrics and gynaecology},
author = {Guihard, P. and Blondel, B.},
month = jan,
year = {2001},
keywords = {Adult, Birth Weight, Body Weight, Cesarean Section, Cesarean Section, Repeat, Cross-Sectional Studies, Educational Status, Female, France, Humans, Labor Presentation, Maternal Health Services, Parity, Pregnancy, Risk Factors},
pages = {48--55}
}Consanguinity decreases risk of breast cancer--cervical cancer unaffected. Denic, S. & Bener, A. Br J Cancer, 85(11):1675-9., 2001.
abstract bibtex
abstract bibtex
Marriages between third-degree and more distant relatives are common in many parts of the world. Offspring of consanguineous parents have increased morbidity and mortality related to recessive gene disorders. In a population with a high frequency of consanguinity, we examined the frequency of breast cancer (related in part to tumour genes) and cervical cancers (related to virus infection) among offspring of consanguineous and non-consanguineous parents. Study was done prospectively in the United Arab Emirates. Selected were married female citizens, ages 40-65, who attended 12 primary health care clinics for whatever reason. In a face-to-face interview, subjects were asked: (a) about consanguineous marriages in family; (b) if they have or have had breast or cervical cancer; (c) about family history of cancer, cancer screening and other parameters. Tumour diagnosis was confirmed by review of medical records. Of 1750 women invited into study, 1445 (79%) could be used in analysis. Among 579 (40%) women of consanguineous and 866 (60%) of non-consanguineous parents there were 24 and 54 with breast cancer, respectively (RR = 0.66, CI 0.42 - 1.06). In the 40 to 50 age group, breast cancer reported 13 of 446 women of consanguineous and 37 of 633 of non-consanguineous parents (RR = 0.50, Cl 0.27 - 0.93). Cervical cancer had 15 women in consanguineous and 32 in non-consanguineous group (RR = 0.70, Cl 0.38 - 1.28). Number of families with history of breast cancer in consanguineous and non-consanguineous group was 21 and 23, respectively (P = 0.29). The cancer screening rates and other variable values had fairly balanced distribution between the 2 groups. Having consanguineous parents decreases the risk of breast cancer especially in younger women, risk of cervical cancer being unaffected.
@article{
title = {Consanguinity decreases risk of breast cancer--cervical cancer unaffected},
type = {article},
year = {2001},
identifiers = {[object Object]},
keywords = {*Consanguinity,Adult,Aged,Breast Neoplasms/*genetics,Cervix Neoplasms/*genetics,Cross-Sectional Studies,Family Health,Female,Health Surveys,Human,Male,Middle Age,Risk Factors,Socioeconomic Factors,Support, Non-U.S. Gov't,United Arab Emirates},
pages = {1675-9.},
volume = {85},
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tags = {02/07/11},
read = {false},
starred = {false},
authored = {false},
confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>eng<m:linebreak/>Journal Article</m:note>},
abstract = {Marriages between third-degree and more distant relatives are common in many parts of the world. Offspring of consanguineous parents have increased morbidity and mortality related to recessive gene disorders. In a population with a high frequency of consanguinity, we examined the frequency of breast cancer (related in part to tumour genes) and cervical cancers (related to virus infection) among offspring of consanguineous and non-consanguineous parents. Study was done prospectively in the United Arab Emirates. Selected were married female citizens, ages 40-65, who attended 12 primary health care clinics for whatever reason. In a face-to-face interview, subjects were asked: (a) about consanguineous marriages in family; (b) if they have or have had breast or cervical cancer; (c) about family history of cancer, cancer screening and other parameters. Tumour diagnosis was confirmed by review of medical records. Of 1750 women invited into study, 1445 (79%) could be used in analysis. Among 579 (40%) women of consanguineous and 866 (60%) of non-consanguineous parents there were 24 and 54 with breast cancer, respectively (RR = 0.66, CI 0.42 - 1.06). In the 40 to 50 age group, breast cancer reported 13 of 446 women of consanguineous and 37 of 633 of non-consanguineous parents (RR = 0.50, Cl 0.27 - 0.93). Cervical cancer had 15 women in consanguineous and 32 in non-consanguineous group (RR = 0.70, Cl 0.38 - 1.28). Number of families with history of breast cancer in consanguineous and non-consanguineous group was 21 and 23, respectively (P = 0.29). The cancer screening rates and other variable values had fairly balanced distribution between the 2 groups. Having consanguineous parents decreases the risk of breast cancer especially in younger women, risk of cervical cancer being unaffected.},
bibtype = {article},
author = {Denic, S and Bener, A},
journal = {Br J Cancer},
number = {11}
}2000 (4)
Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. van Staa, T. P., Leufkens, H. G., Abenhaim, L., Zhang, B., & Cooper, C. Rheumatology (Oxford, England), 39(12):1383--1389, December, 2000.
abstract bibtex
abstract bibtex
OBJECTIVE: This study examined the effects of daily and cumulative oral corticosteroid doses on the risk of fractures. METHODS: Information was obtained from the General Practice Research Database, which contains medical records of general practitioners in England and Wales. The study included 244 235 oral corticosteroid users and 244 235 controls. RESULTS: Patients taking higher doses (at least 7. 5 mg daily of prednisolone or equivalent) had significantly increased risks of non-vertebral fracture [relative rate (RR)=1.44, 95% confidence interval (CI) 1.34-1.54], hip fracture (RR=2.21, 95% CI 1.85-2.64) and vertebral fracture (RR=2.83, 95% CI 2.35-2.40) relative to patients using oral corticosteroids at lower doses (less than 2.5 mg per day). Fracture risk was also elevated among people with higher cumulative exposure to oral corticosteroids over the study period, but this effect was almost wholly removed by adjustment for daily dose, age, gender and other confounding variables. CONCLUSIONS: These findings suggest that the adverse skeletal effects of oral corticosteroids manifest rapidly and are related to daily dose. The level of previous exposure to oral corticosteroids was not a strong determinant of the risk of fracture. Preventive measures against corticosteroid-induced osteoporosis should therefore be instituted as soon after the commencement of glucocorticoid therapy as possible.
@article{van_staa_oral_2000,
title = {Oral corticosteroids and fracture risk: relationship to daily and cumulative doses},
volume = {39},
issn = {1462-0324},
shorttitle = {Oral corticosteroids and fracture risk},
abstract = {OBJECTIVE: This study examined the effects of daily and cumulative oral corticosteroid doses on the risk of fractures.
METHODS: Information was obtained from the General Practice Research Database, which contains medical records of general practitioners in England and Wales. The study included 244 235 oral corticosteroid users and 244 235 controls.
RESULTS: Patients taking higher doses (at least 7. 5 mg daily of prednisolone or equivalent) had significantly increased risks of non-vertebral fracture [relative rate (RR)=1.44, 95\% confidence interval (CI) 1.34-1.54], hip fracture (RR=2.21, 95\% CI 1.85-2.64) and vertebral fracture (RR=2.83, 95\% CI 2.35-2.40) relative to patients using oral corticosteroids at lower doses (less than 2.5 mg per day). Fracture risk was also elevated among people with higher cumulative exposure to oral corticosteroids over the study period, but this effect was almost wholly removed by adjustment for daily dose, age, gender and other confounding variables.
CONCLUSIONS: These findings suggest that the adverse skeletal effects of oral corticosteroids manifest rapidly and are related to daily dose. The level of previous exposure to oral corticosteroids was not a strong determinant of the risk of fracture. Preventive measures against corticosteroid-induced osteoporosis should therefore be instituted as soon after the commencement of glucocorticoid therapy as possible.},
language = {eng},
number = {12},
journal = {Rheumatology (Oxford, England)},
author = {van Staa, T. P. and Leufkens, H. G. and Abenhaim, L. and Zhang, B. and Cooper, C.},
month = dec,
year = {2000},
pmid = {11136882},
keywords = {Administration, Oral, Adrenal Cortex Hormones, Adult, Aged, Dose-Response Relationship, Drug, Female, Fractures, Bone, Humans, Middle Aged, Osteoporosis, Registries, Risk Factors},
pages = {1383--1389}
}Risk of venous thromboembolism among users of third generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995: cohort and case-control analysis. Jick, H., Kaye, J. A., Vasilakis-Scaramozza, C., & Jick, S. S. BMJ (Clinical research ed.), 321(7270):1190--1195, November, 2000.
abstract bibtex
abstract bibtex
OBJECTIVE: To compare the risk of idiopathic venous thromboembolism among women taking third generation oral contraceptives (with gestodene or desogestrel) with that among women taking oral contraceptives with levonorgestrel. DESIGN: Cohort and case-control analyses derived from the General Practice Research Database. SETTING: UK general practices, January 1993 to December 1999. PARTICIPANTS: Women aged 15-39 taking third generation oral contraceptives or oral contraceptives with levonorgestrel. MAIN OUTCOME MEASURES: Relative incidence (cohort study) and odds ratios (case-control study) as measures of the relative risk of venous thromboembolism. RESULTS: The adjusted estimates of relative risk for venous thromboembolism associated with third generation oral contraceptives compared with oral contraceptives with levonorgestrel was 1.9 (95% confidence interval 1.3 to 2.8) in the cohort analysis and 2.3 (1.3 to 3.9) in the case-control study. The estimates for the two types of oral contraceptives were similar before and after the warning issued by the Committee on Safety of Medicines in October 1995. A shift away from the use of third generation oral contraceptives after the scare was more pronounced among younger women (who have a lower risk of venous thromboembolism) than among older women. Fewer cases of venous thromboembolism occurred in 1996 and later than would have been expected if the use of oral contraceptives had remained unchanged. CONCLUSIONS: These findings are consistent with previously reported studies, which found that compared with oral contraceptives with levonorgestrel, third generation oral contraceptives are associated with around twice the risk of venous thromboembolism.
@article{jick_risk_2000-1,
title = {Risk of venous thromboembolism among users of third generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995: cohort and case-control analysis},
volume = {321},
issn = {0959-8138},
shorttitle = {Risk of venous thromboembolism among users of third generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995},
abstract = {OBJECTIVE: To compare the risk of idiopathic venous thromboembolism among women taking third generation oral contraceptives (with gestodene or desogestrel) with that among women taking oral contraceptives with levonorgestrel.
DESIGN: Cohort and case-control analyses derived from the General Practice Research Database.
SETTING: UK general practices, January 1993 to December 1999.
PARTICIPANTS: Women aged 15-39 taking third generation oral contraceptives or oral contraceptives with levonorgestrel.
MAIN OUTCOME MEASURES: Relative incidence (cohort study) and odds ratios (case-control study) as measures of the relative risk of venous thromboembolism.
RESULTS: The adjusted estimates of relative risk for venous thromboembolism associated with third generation oral contraceptives compared with oral contraceptives with levonorgestrel was 1.9 (95\% confidence interval 1.3 to 2.8) in the cohort analysis and 2.3 (1.3 to 3.9) in the case-control study. The estimates for the two types of oral contraceptives were similar before and after the warning issued by the Committee on Safety of Medicines in October 1995. A shift away from the use of third generation oral contraceptives after the scare was more pronounced among younger women (who have a lower risk of venous thromboembolism) than among older women. Fewer cases of venous thromboembolism occurred in 1996 and later than would have been expected if the use of oral contraceptives had remained unchanged.
CONCLUSIONS: These findings are consistent with previously reported studies, which found that compared with oral contraceptives with levonorgestrel, third generation oral contraceptives are associated with around twice the risk of venous thromboembolism.},
language = {eng},
number = {7270},
journal = {BMJ (Clinical research ed.)},
author = {Jick, H. and Kaye, J. A. and Vasilakis-Scaramozza, C. and Jick, S. S.},
month = nov,
year = {2000},
pmid = {11073511},
pmcid = {PMC27524},
keywords = {Adolescent, Adult, Age Distribution, Body Mass Index, Case-Control Studies, Cohort Studies, Contraceptives, Oral, Contraceptives, Oral, Synthetic, Female, Humans, Levonorgestrel, Odds Ratio, Risk Factors, Smoking, Thromboembolism, Time Factors},
pages = {1190--1195}
}Adult height and cryptogenic fibrosing alveolitis: a case-control study using the UK general practice research database. Hubbard, R. & Venn, A. Thorax, 55(10):864--866, October, 2000.
abstract bibtex
abstract bibtex
BACKGROUND: The reasons why cryptogenic fibrosing alveolitis has emerged as a new clinical entity during the second half of the 20th century are unclear. Some environmental exposures have been identified as potential risk factors including occupational dust, cigarette smoking and antidepressants, but there have been no studies of the role of early life exposures. Since adult height reflects, in part, early life experience, we have examined the relation between adult height and the risk of cryptogenic fibrosing alveolitis. METHODS: A case-control study of 569 cases and 3669 age, sex, and community matched controls drawn from the UK General Practice Research Database was undertaken. RESULTS: Evidence was found of an inverse association between quintile of height and cryptogenic fibrosing alveolitis (odds ratio (OR) per increase in height quintile 0.93, 95% CI 0.86 to 0.99). This association was not diminished by adjustment for smoking status (OR 0.93, 95% CI 0.87 to 1.00), but some minor attenuation did occur after adjustment for oral corticosteroid use (OR 0.94, 95% CI 0.88 to 1.02). There was a significant interaction with sex such that the effect of height was strong in women (OR 0.85, 95% CI 0.75 to 0.97) and absent in men (OR 1.00, 95% CI 0.91 to 1.09). CONCLUSIONS: These findings raise the possibility that early life exposures may be important in determining the lifetime risk of developing cryptogenic fibrosing alveolitis.
@article{hubbard_adult_2000,
title = {Adult height and cryptogenic fibrosing alveolitis: a case-control study using the {UK} general practice research database},
volume = {55},
issn = {0040-6376},
shorttitle = {Adult height and cryptogenic fibrosing alveolitis},
abstract = {BACKGROUND: The reasons why cryptogenic fibrosing alveolitis has emerged as a new clinical entity during the second half of the 20th century are unclear. Some environmental exposures have been identified as potential risk factors including occupational dust, cigarette smoking and antidepressants, but there have been no studies of the role of early life exposures. Since adult height reflects, in part, early life experience, we have examined the relation between adult height and the risk of cryptogenic fibrosing alveolitis.
METHODS: A case-control study of 569 cases and 3669 age, sex, and community matched controls drawn from the UK General Practice Research Database was undertaken.
RESULTS: Evidence was found of an inverse association between quintile of height and cryptogenic fibrosing alveolitis (odds ratio (OR) per increase in height quintile 0.93, 95\% CI 0.86 to 0.99). This association was not diminished by adjustment for smoking status (OR 0.93, 95\% CI 0.87 to 1.00), but some minor attenuation did occur after adjustment for oral corticosteroid use (OR 0.94, 95\% CI 0.88 to 1.02). There was a significant interaction with sex such that the effect of height was strong in women (OR 0.85, 95\% CI 0.75 to 0.97) and absent in men (OR 1.00, 95\% CI 0.91 to 1.09).
CONCLUSIONS: These findings raise the possibility that early life exposures may be important in determining the lifetime risk of developing cryptogenic fibrosing alveolitis.},
language = {eng},
number = {10},
journal = {Thorax},
author = {Hubbard, R. and Venn, A.},
month = oct,
year = {2000},
pmid = {10992540},
pmcid = {PMC1745612},
keywords = {Aged, Body Height, Body Mass Index, Case-Control Studies, Databases, Factual, Female, Glucocorticoids, Great Britain, Humans, Male, Middle Aged, Odds Ratio, Pulmonary Fibrosis, Risk Factors, Smoking},
pages = {864--866}
}Familial cancer risks to offspring from mothers with 2 primary breast cancers: leads to cancer syndromes. Hemminki, K., Vaittinen, P., & Easton, D. Int J Cancer, 88(1):87-91., 2000.
abstract bibtex
abstract bibtex
The nationwide Swedish Family-Cancer Database was used to analyse the risk of cancer among the offspring of bilateral breast cancer patients. We studied 4,734 such mothers who had 9,391 offspring, of whom 328 presented with a primary cancer in the years 1958-1996. Standardised incidence ratios (SIRs) were increased for breast [SIR 3.05, 95% confidence interval (CI) 2.57-3.59], ovarian (SIR 1.84, 95% CI 1.03-3.05) and anogenital (SIR 1.75, 95% CI 1.11-2.63) cancers and childhood sarcomas (SIR 9.39, 95% CI 1.93-29.13). Additionally, squamous-cell skin cancer was increased among sons and all childhood cancers among daughters. When analysed by histological type, adenocarcinomas of the breast and ovary, all squamous-cell carcinomas and tumours at glandular epithelium (seminomas and intestinal carcinoids) were increased. Mothers with bilateral breast cancer had an excess of 2 or more children with cancer. The increased risk of ovarian cancer is consistent with germline mutations in the BRCA1 and BRCA2 genes, while the risk of soft tissue and bone sarcomas may reflect the association of these tumours with Li-Fraumeni syndrome. The increases in squamous-cell carcinomas at many sites may reflect a new susceptibility syndrome.
@article{
title = {Familial cancer risks to offspring from mothers with 2 primary breast cancers: leads to cancer syndromes},
type = {article},
year = {2000},
identifiers = {[object Object]},
keywords = {Adolescence,Adult,Breast Neoplasms/epidemiology/*genetics,Child,Child, Preschool,Databases, Factual,Family Health,Female,Human,Incidence,Infant,Infant, Newborn,Male,Middle Age,Mothers,Neoplasms, Second Primary/epidemiology/*genetics,Neoplasms/epidemiology/*genetics,Risk Factors,Socioeconomic Factors,Support, Non-U.S. Gov't,Sweden/epidemiology},
pages = {87-91.},
volume = {88},
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notes = {<m:note>eng<m:linebreak/>Journal Article</m:note>},
abstract = {The nationwide Swedish Family-Cancer Database was used to analyse the risk of cancer among the offspring of bilateral breast cancer patients. We studied 4,734 such mothers who had 9,391 offspring, of whom 328 presented with a primary cancer in the years 1958-1996. Standardised incidence ratios (SIRs) were increased for breast [SIR 3.05, 95% confidence interval (CI) 2.57-3.59], ovarian (SIR 1.84, 95% CI 1.03-3.05) and anogenital (SIR 1.75, 95% CI 1.11-2.63) cancers and childhood sarcomas (SIR 9.39, 95% CI 1.93-29.13). Additionally, squamous-cell skin cancer was increased among sons and all childhood cancers among daughters. When analysed by histological type, adenocarcinomas of the breast and ovary, all squamous-cell carcinomas and tumours at glandular epithelium (seminomas and intestinal carcinoids) were increased. Mothers with bilateral breast cancer had an excess of 2 or more children with cancer. The increased risk of ovarian cancer is consistent with germline mutations in the BRCA1 and BRCA2 genes, while the risk of soft tissue and bone sarcomas may reflect the association of these tumours with Li-Fraumeni syndrome. The increases in squamous-cell carcinomas at many sites may reflect a new susceptibility syndrome.},
bibtype = {article},
author = {Hemminki, K and Vaittinen, P and Easton, D},
journal = {Int J Cancer},
number = {1}
}1998 (2)
Are spouses of patients with hypertension at increased risk of having hypertension? A population-based case-control study. Hippisley-Cox, J. & Pringle, M. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 48(434):1580--1583, September, 1998.
abstract bibtex
abstract bibtex
BACKGROUND: Studies of couples, who tend to share an environment but are genetically dissimilar, can shed light on the contribution of environmental factors to hypertension. There has been renewed interest in these environmental factors following the re-analysis of the INTERSALT study. AIM: To determine whether patients whose spouses have hypertension are at increased risk of hypertension, using a population-based case-control study. METHOD: The total study population consisted of all 3923 patients over 30 years old registered with one general practice. Male cases with hypertension were matched to male controls without hypertension. Female cases with hypertension were matched to female controls without hypertension. The variables were: diagnosed hypertension; having a spouse with diagnosed hypertension; age; sex; weight; height; body-mass index; couple status; diabetes; and systolic and diastolic blood pressure readings. RESULTS: On multivariate analysis, when age, body-mass index, diabetes, couple status, and having a blood pressure reading were included, men whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted odds ratio (OR) 2.24; 95% CI 1.77-2.72; P = 0.001). Similarly, on multivariate analysis, women whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted OR = 2.23; 95% CI 1.75-2.72; P = 0.001). The risk for both male and female subjects persisted after adjustment for other variables. There was a significant correlation between systolic (r = 0.41; P \textless 0.0001) and diastolic (r = 0.25; P \textless 0.0001) blood pressures between spouse pairs. CONCLUSION: The independent association between having a spouse with hypertension and increased risk of hypertension supports the view that there are significant environmental factors in the aetiology of hypertension. The finding has implications for the screening and treatment of hypertension in primary care.
@article{hippisley-cox_are_1998,
title = {Are spouses of patients with hypertension at increased risk of having hypertension? {A} population-based case-control study},
volume = {48},
issn = {0960-1643},
shorttitle = {Are spouses of patients with hypertension at increased risk of having hypertension?},
abstract = {BACKGROUND: Studies of couples, who tend to share an environment but are genetically dissimilar, can shed light on the contribution of environmental factors to hypertension. There has been renewed interest in these environmental factors following the re-analysis of the INTERSALT study.
AIM: To determine whether patients whose spouses have hypertension are at increased risk of hypertension, using a population-based case-control study.
METHOD: The total study population consisted of all 3923 patients over 30 years old registered with one general practice. Male cases with hypertension were matched to male controls without hypertension. Female cases with hypertension were matched to female controls without hypertension. The variables were: diagnosed hypertension; having a spouse with diagnosed hypertension; age; sex; weight; height; body-mass index; couple status; diabetes; and systolic and diastolic blood pressure readings.
RESULTS: On multivariate analysis, when age, body-mass index, diabetes, couple status, and having a blood pressure reading were included, men whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted odds ratio (OR) 2.24; 95\% CI 1.77-2.72; P = 0.001). Similarly, on multivariate analysis, women whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted OR = 2.23; 95\% CI 1.75-2.72; P = 0.001). The risk for both male and female subjects persisted after adjustment for other variables. There was a significant correlation between systolic (r = 0.41; P {\textless} 0.0001) and diastolic (r = 0.25; P {\textless} 0.0001) blood pressures between spouse pairs.
CONCLUSION: The independent association between having a spouse with hypertension and increased risk of hypertension supports the view that there are significant environmental factors in the aetiology of hypertension. The finding has implications for the screening and treatment of hypertension in primary care.},
language = {eng},
number = {434},
journal = {The British Journal of General Practice: The Journal of the Royal College of General Practitioners},
author = {Hippisley-Cox, J. and Pringle, M.},
month = sep,
year = {1998},
pmid = {9830183},
pmcid = {PMC1313221},
keywords = {Adult, Analysis of Variance, Case-Control Studies, England, Female, Humans, Hypertension, Male, Risk Assessment, Risk Factors, Rural Health, Spouses},
pages = {1580--1583}
}Hospital mortality after urgent and emergency laparotomy in patients aged 65 yr and over. Risk and prediction of risk using multiple logistic regression analysis. Cook, T., M. & Day, C., J. British journal of anaesthesia, 80(6):776-81, 6, 1998.
Paper Website abstract bibtex
Paper Website abstract bibtex We studied 107 patients aged over 65 years undergoing urgent or emergency laparotomy. Aspects of preoperative assessment, perioperative management and postoperative care were analysed by multiple logistic regression to determine the factors that predicted hospital survival. We determined which factors influenced anaesthetists' prediction that patients would survive. These predictions were made both before and immediately after operation. The factors associated with the use of invasive cardiovascular monitoring were also studied. We obtained a model that accounted for 93% of the variability in the likelihood of survival. Age and ASA status were significant predictors of survival (P < 0.05), and of anaesthetists' prediction of mortality both before and after operation. Several other factors were significant determinants of survival but were not determinants of the anaesthetist's opinion regarding survival.
@article{
title = {Hospital mortality after urgent and emergency laparotomy in patients aged 65 yr and over. Risk and prediction of risk using multiple logistic regression analysis.},
type = {article},
year = {1998},
identifiers = {[object Object]},
keywords = {Aged,Aged, 80 and over,Emergencies,Female,Hospital Mortality,Humans,Laparotomy,Laparotomy: mortality,Male,Models, Theoretical,Pilot Projects,Prospective Studies,ROC Curve,Regression Analysis,Risk Assessment,Risk Factors},
pages = {776-81},
volume = {80},
websites = {http://www.ncbi.nlm.nih.gov/pubmed/9771307},
month = {6},
id = {cf549134-d04c-3e97-aa7b-e90c35003dc0},
created = {2014-10-14T09:23:23.000Z},
file_attached = {true},
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read = {false},
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confirmed = {true},
hidden = {false},
private_publication = {false},
abstract = {We studied 107 patients aged over 65 years undergoing urgent or emergency laparotomy. Aspects of preoperative assessment, perioperative management and postoperative care were analysed by multiple logistic regression to determine the factors that predicted hospital survival. We determined which factors influenced anaesthetists' prediction that patients would survive. These predictions were made both before and immediately after operation. The factors associated with the use of invasive cardiovascular monitoring were also studied. We obtained a model that accounted for 93% of the variability in the likelihood of survival. Age and ASA status were significant predictors of survival (P < 0.05), and of anaesthetists' prediction of mortality both before and after operation. Several other factors were significant determinants of survival but were not determinants of the anaesthetist's opinion regarding survival.},
bibtype = {article},
author = {Cook, T M and Day, C J},
journal = {British journal of anaesthesia},
number = {6}
}1997 (2)
Omeprazole, H2 blockers, and polyarthralgia: case-control study. Meier, C. R. & Jick, H. BMJ (Clinical research ed.), 315(7118):1283, November, 1997.
bibtex
bibtex
@article{meier_omeprazole_1997,
title = {Omeprazole, {H}2 blockers, and polyarthralgia: case-control study},
volume = {315},
issn = {0959-8138},
shorttitle = {Omeprazole, {H}2 blockers, and polyarthralgia},
language = {eng},
number = {7118},
journal = {BMJ (Clinical research ed.)},
author = {Meier, C. R. and Jick, H.},
month = nov,
year = {1997},
pmid = {9390057},
pmcid = {PMC2127801},
keywords = {Adult, Anti-Ulcer Agents, Arthralgia, Case-Control Studies, Cimetidine, Cohort Studies, Histamine H2 Antagonists, Humans, Middle Aged, Omeprazole, Ranitidine, Risk Factors},
pages = {1283}
}Genetics of aging. Finch, C., E. & Tanzi, R., E. Science, 278(5337):407-411, 1997.
Website abstract bibtex
Website abstract bibtex The role of genetics in determining life-span is complex and paradoxical. Although the heritability of life-span is relatively minor, some genetic variants significantly modify senescence of mammals and invertebrates, with both positive and negative impacts on age-related disorders and life-spans. In certain examples, the gene variants alter metabolic pathways, which could thereby mediate interactions with nutritional and other environmental factors that influence life-span. Given the relatively minor effect and variable penetrance of genetic risk factors that appear to affect survival and health at advanced ages, life-style and other environmental influences may profoundly modify outcomes of aging.
@article{
title = {Genetics of aging},
type = {article},
year = {1997},
identifiers = {[object Object]},
keywords = {Aging/*genetics,Alzheimer Disease/genetics,Animals,Apoptosis/genetics,Gene Expression,Humans,Longevity/*genetics,Mutation,Research Support, Non-U.S. Gov't,Research Support, U.S. Gov't, P.H.S.,Risk Factors,Variation (Genetics)},
pages = {407-411},
volume = {278},
websites = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9334291},
id = {7125e0bf-17e5-32ca-b8ec-f153683043d6},
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read = {false},
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confirmed = {true},
hidden = {false},
source_type = {Journal Article},
notes = {<m:note>0036-8075<m:linebreak/>Journal Article<m:linebreak/>Review<m:linebreak/>Review, Tutorial</m:note>},
abstract = {The role of genetics in determining life-span is complex and paradoxical. Although the heritability of life-span is relatively minor, some genetic variants significantly modify senescence of mammals and invertebrates, with both positive and negative impacts on age-related disorders and life-spans. In certain examples, the gene variants alter metabolic pathways, which could thereby mediate interactions with nutritional and other environmental factors that influence life-span. Given the relatively minor effect and variable penetrance of genetic risk factors that appear to affect survival and health at advanced ages, life-style and other environmental influences may profoundly modify outcomes of aging.},
bibtype = {article},
author = {Finch, C E and Tanzi, R E},
journal = {Science},
number = {5337}
}1996 (3)
Family history and risk of colorectal cancer in the multiethnic population of Hawaii. Le Marchand, L., Zhao, L., P., Quiaoit, F., Wilkens, L., R., & Kolonel, L., N. Am J Epidemiol, 144(12):1122-8., 1996.
abstract bibtex
abstract bibtex
Increased risk of colorectal cancer in individuals with family history of the disease has been observed consistently in past studies. However, limited attention has been given to the influence of ethnicity, the characteristics of the proband's tumor, and kinship. A population-based case-control study was conducted between 1987 and 1991 in Hawaii among 1,192 incident colorectal cancer cases and 1,192 sex-, age-, and ethnicity-matched population controls. The study identified 7,673 relatives for the cases and 7,823 relatives for the controls. With an estimating equation-based regression method, relatives of cases were found to have a 2.5-fold increased risk of colorectal cancer compared with relatives of controls (95% confidence interval (CI) 1.8-3.4) after adjustment for covariates. This increase in risk was greater for Japanese (odds ratio (OR) = 3.0, 95% CI 1.7-5.4) than Caucasians (OR = 1.8, 95% CI 1.2-2.9), for siblings (OR = 3.1, 95% CI 2.1-4.6) than parents (OR = 2.0, 95% CI 1.1-3.1), and when the index patient was diagnosed before the age of 55 years (OR = 4.1, 95% CI 2.1-8.0) with multiple tumors (OR = 9.5, 95% CI 4.4-20.6), with a distant stage (OR = 4.6, 95% CI 2.7-7.8), or with cancer of the right colon (OR = 3.0, 95% CI 2.0-4.4) or the rectum (OR = 3.0, 95% CI 1.8-4.8). The increase in risk was not affected by the relative's sex. Relatives of cases were not at increased risk for other common cancers. It is estimated that approximately 11.1% and 6.5% of colorectal cancers are attributable to a first degree family history of the disease for Japanese and Caucasians, respectively. These data and those of previous studies strongly suggest that individuals with a family history of colorectal cancer in a first degree relative are at increased risk for the disease and should receive regular diagnostic screening. Characteristics of the index case, such as age and stage at diagnosis, subsite and number of tumors, and race, as well as kinship, may be important in assessing the colorectal cancer risk of a relative.
@article{
title = {Family history and risk of colorectal cancer in the multiethnic population of Hawaii},
type = {article},
year = {1996},
identifiers = {[object Object]},
keywords = {*Family,Aged,Asian Americans,Case-Control Studies,Colorectal Neoplasms/epidemiology/*ethnology,Comparative Study,Female,Hawaii/epidemiology,Human,Japan/ethnology,Male,Middle Age,Questionnaires,Risk Factors,Support, U.S. Gov't, P.H.S.},
pages = {1122-8.},
volume = {144},
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hidden = {false},
source_type = {Journal Article},
notes = {<m:note>eng<m:linebreak/>Journal Article</m:note>},
abstract = {Increased risk of colorectal cancer in individuals with family history of the disease has been observed consistently in past studies. However, limited attention has been given to the influence of ethnicity, the characteristics of the proband's tumor, and kinship. A population-based case-control study was conducted between 1987 and 1991 in Hawaii among 1,192 incident colorectal cancer cases and 1,192 sex-, age-, and ethnicity-matched population controls. The study identified 7,673 relatives for the cases and 7,823 relatives for the controls. With an estimating equation-based regression method, relatives of cases were found to have a 2.5-fold increased risk of colorectal cancer compared with relatives of controls (95% confidence interval (CI) 1.8-3.4) after adjustment for covariates. This increase in risk was greater for Japanese (odds ratio (OR) = 3.0, 95% CI 1.7-5.4) than Caucasians (OR = 1.8, 95% CI 1.2-2.9), for siblings (OR = 3.1, 95% CI 2.1-4.6) than parents (OR = 2.0, 95% CI 1.1-3.1), and when the index patient was diagnosed before the age of 55 years (OR = 4.1, 95% CI 2.1-8.0) with multiple tumors (OR = 9.5, 95% CI 4.4-20.6), with a distant stage (OR = 4.6, 95% CI 2.7-7.8), or with cancer of the right colon (OR = 3.0, 95% CI 2.0-4.4) or the rectum (OR = 3.0, 95% CI 1.8-4.8). The increase in risk was not affected by the relative's sex. Relatives of cases were not at increased risk for other common cancers. It is estimated that approximately 11.1% and 6.5% of colorectal cancers are attributable to a first degree family history of the disease for Japanese and Caucasians, respectively. These data and those of previous studies strongly suggest that individuals with a family history of colorectal cancer in a first degree relative are at increased risk for the disease and should receive regular diagnostic screening. Characteristics of the index case, such as age and stage at diagnosis, subsite and number of tumors, and race, as well as kinship, may be important in assessing the colorectal cancer risk of a relative.},
bibtype = {article},
author = {Le Marchand, L and Zhao, L P and Quiaoit, F and Wilkens, L R and Kolonel, L N},
journal = {Am J Epidemiol},
number = {12}
}Emergency medical vehicle collisions in an urban system. Biggers, W. A., Zachariah, B. S., & Pepe, P. E. Prehospital and Disaster Medicine, 11(3):195--201, September, 1996.
abstract bibtex
abstract bibtex
INTRODUCTION: Emergency medical services collisions (EMVCs) are a largely unexplored area of emergency medical services (EMS) research. Factors that might contribute to an EMVC are numerous and include use of warning lights and siren (WL&S). Few of these factors have been evaluated scientifically. Similarly, the incidence and severity of EMVCs is poorly documented in the literature. This study sought to define the incidence and severity of, and where possible, identify any contributing factors to EMVCs in a large urban system. METHODS: Retrospective study of all collisions involving vehicles assigned to the EMS Division of the Houston Fire Department in calendar year 1993. Fifty-one ambulances were operational 24 hours per day during calendar year 1993. Houston EMS received 150,000 requests for assistance, made 180,000 vehicular responses, and accrued 2,651,760 miles in 1993. RESULTS: Eighty-six EMVCs were identified during the study period. The gross incidence rate was therefore 3.2 EMVC/100,000 miles driven or 4.8 collisions/10,000 responses. Of the 86 EMVCs, 74 (86%) files were complete and available for evaluation. Major collisions, determined according to injuries or vehicular damage, accounted for 10.8% of all EMVCs. There were 17 persons transported to hospitals from EMS collisions, yielding an injury incidence of 0.64 injuries/100,000 miles driven or 0.94 injuries/10,000 responses. There were no fatalities. The majority of collisions (85.1%) occurred at some site other than an intersection. There was no statistical association between occurrence at an intersection and severity, day versus night, weekend versus weekday, presence or absence of precipitation, or use of WL & S versus severity of collision. Drivers with a history of previous EMVCs were involved in 33% of all collisions. The presence of prior EMVCs was associated (p \textless 0.001) with the number of persons transported from the collision to a local hospital. Five drivers, all with previous EMVCs, accounted for 88.2% (15/17) of all injuries. CONCLUSIONS: A few drivers with previous EMVCs account for a disproportionate number of EMVCs and nearly 90% of all injuries. This risk factor--history of previous EMVC--has not been reported in the EMS literature. It is postulated that this factor ultimately will prove to be the major determinant of EMVCs. Data collection of EMS collisions needs to be standardized and a proposed collection tool is provided.
@article{biggers_emergency_1996,
title = {Emergency medical vehicle collisions in an urban system},
volume = {11},
issn = {1049-023X},
abstract = {INTRODUCTION: Emergency medical services collisions (EMVCs) are a largely unexplored area of emergency medical services (EMS) research. Factors that might contribute to an EMVC are numerous and include use of warning lights and siren (WL\&S). Few of these factors have been evaluated scientifically. Similarly, the incidence and severity of EMVCs is poorly documented in the literature. This study sought to define the incidence and severity of, and where possible, identify any contributing factors to EMVCs in a large urban system.
METHODS: Retrospective study of all collisions involving vehicles assigned to the EMS Division of the Houston Fire Department in calendar year 1993. Fifty-one ambulances were operational 24 hours per day during calendar year 1993. Houston EMS received 150,000 requests for assistance, made 180,000 vehicular responses, and accrued 2,651,760 miles in 1993.
RESULTS: Eighty-six EMVCs were identified during the study period. The gross incidence rate was therefore 3.2 EMVC/100,000 miles driven or 4.8 collisions/10,000 responses. Of the 86 EMVCs, 74 (86\%) files were complete and available for evaluation. Major collisions, determined according to injuries or vehicular damage, accounted for 10.8\% of all EMVCs. There were 17 persons transported to hospitals from EMS collisions, yielding an injury incidence of 0.64 injuries/100,000 miles driven or 0.94 injuries/10,000 responses. There were no fatalities. The majority of collisions (85.1\%) occurred at some site other than an intersection. There was no statistical association between occurrence at an intersection and severity, day versus night, weekend versus weekday, presence or absence of precipitation, or use of WL \& S versus severity of collision. Drivers with a history of previous EMVCs were involved in 33\% of all collisions. The presence of prior EMVCs was associated (p {\textless} 0.001) with the number of persons transported from the collision to a local hospital. Five drivers, all with previous EMVCs, accounted for 88.2\% (15/17) of all injuries.
CONCLUSIONS: A few drivers with previous EMVCs account for a disproportionate number of EMVCs and nearly 90\% of all injuries. This risk factor--history of previous EMVC--has not been reported in the EMS literature. It is postulated that this factor ultimately will prove to be the major determinant of EMVCs. Data collection of EMS collisions needs to be standardized and a proposed collection tool is provided.},
language = {eng},
number = {3},
journal = {Prehospital and Disaster Medicine},
author = {Biggers, W. A. and Zachariah, B. S. and Pepe, P. E.},
month = sep,
year = {1996},
pmid = {10163382},
keywords = {Accidents, Traffic, Ambulances, Automobile Driving, Hospitalization, Humans, Incidence, Retrospective Studies, Risk Factors, Safety, Texas, Time Factors, Urban Health},
pages = {195--201}
}Epidural anaesthesia and spinal haematoma. Wulf, H Canadian journal of anaesthesia = Journal canadien d'anesthésie, 43(12):1260–1271, December, 1996.
doi abstract bibtex
doi abstract bibtex
PURPOSE Haematoma formation in the spinal canal due to epidural anaesthesia is a very rare but serious complication. This paper presents a comprehensive review of case reports. SOURCE Sampling of case reports over a 10 yr period, medline-research (1966-1995) and cross-check with former reviews. FINDINGS Fifty-one confirmed spinal haematomas associated with epidural anaesthesia were found. Most were related to the insertion of a catheter, a procedure that was graded as difficult or traumatic in 21 patients. Other risk factors were: fibrinolytic therapy (n = 2), previously unknown spinal pathology (n = 2), low molecular weight heparin (n = 2), aspirin or other NSAID (n = 3), epidural catheter inserted during general anaesthesia (n = 3), thrombocytopenia (n = 5), ankylosing spondylitis (n = 5), preexisting coagulopathy (n = 14), and intravenous heparin therapy (n = 18). CONCLUSION Coagulopathies or anticoagulant therapy (e.g., full heparinization) were the predominant risk factors, where-as low-dose heparin thromboprophylaxis or NSAID treatment was rarely associated with spinal bleeding complications. Ankylosing spondylitis was identified as a new, previously unreported risk factor. Analysis of reported clinical practice suggests an incidence of haematoma of 1:190,000 epidurals.
@article{wulf_epidural_1996,
title = {Epidural anaesthesia and spinal haematoma},
volume = {43},
issn = {0832-610X},
doi = {10.1007/BF03013437},
abstract = {PURPOSE
Haematoma formation in the spinal canal due to epidural anaesthesia is a very rare but serious complication. This paper presents a comprehensive review of case reports.
SOURCE
Sampling of case reports over a 10 yr period, medline-research (1966-1995) and cross-check with former reviews.
FINDINGS
Fifty-one confirmed spinal haematomas associated with epidural anaesthesia were found. Most were related to the insertion of a catheter, a procedure that was graded as difficult or traumatic in 21 patients. Other risk factors were: fibrinolytic therapy (n = 2), previously unknown spinal pathology (n = 2), low molecular weight heparin (n = 2), aspirin or other NSAID (n = 3), epidural catheter inserted during general anaesthesia (n = 3), thrombocytopenia (n = 5), ankylosing spondylitis (n = 5), preexisting coagulopathy (n = 14), and intravenous heparin therapy (n = 18).
CONCLUSION
Coagulopathies or anticoagulant therapy (e.g., full heparinization) were the predominant risk factors, where-as low-dose heparin thromboprophylaxis or NSAID treatment was rarely associated with spinal bleeding complications. Ankylosing spondylitis was identified as a new, previously unreported risk factor. Analysis of reported clinical practice suggests an incidence of haematoma of 1:190,000 epidurals.},
number = {12},
journal = {Canadian journal of anaesthesia = Journal canadien d'anesthésie},
author = {Wulf, H},
month = dec,
year = {1996},
pmid = {8955979},
keywords = {Anesthesia, Epidural, Hematoma, Humans, Risk Factors, Spinal Canal, Spondylitis, Ankylosing},
pages = {1260--1271}
}1995 (1)
The risk of sulfasalazine- and mesalazine-associated blood disorders. Jick, H., Myers, M. W., & Dean, A. D. Pharmacotherapy, 15(2):176--181, April, 1995.
abstract bibtex
abstract bibtex
Sulfasalazine (SASP) has often been reported to cause serious blood disorders, particularly agranulocytosis; however, little quantitative information is available to estimate the risk or to identify possible modifiers of the risk. We used comprehensive clinical information recorded on office computers by selected general practitioners in Britain to conduct a follow-up study of some 10,000 users of SASP and some 4000 users of mesalazine to estimate the risk of blood disorders associated with these drugs. Overall, the frequency of blood disorders attributable to SASP was 27/10,332 (2.6/1000 users). The risk for SASP users who were treated for arthritic disorders (6.1/1000 users) was some 10 times higher than that for users who were treated for inflammatory bowel disease (0.6/1000 users). There were no cases of blood disorders in users of mesalazine.
@article{jick_risk_1995,
title = {The risk of sulfasalazine- and mesalazine-associated blood disorders},
volume = {15},
issn = {0277-0008},
abstract = {Sulfasalazine (SASP) has often been reported to cause serious blood disorders, particularly agranulocytosis; however, little quantitative information is available to estimate the risk or to identify possible modifiers of the risk. We used comprehensive clinical information recorded on office computers by selected general practitioners in Britain to conduct a follow-up study of some 10,000 users of SASP and some 4000 users of mesalazine to estimate the risk of blood disorders associated with these drugs. Overall, the frequency of blood disorders attributable to SASP was 27/10,332 (2.6/1000 users). The risk for SASP users who were treated for arthritic disorders (6.1/1000 users) was some 10 times higher than that for users who were treated for inflammatory bowel disease (0.6/1000 users). There were no cases of blood disorders in users of mesalazine.},
language = {eng},
number = {2},
journal = {Pharmacotherapy},
author = {Jick, H. and Myers, M. W. and Dean, A. D.},
month = apr,
year = {1995},
pmid = {7624265},
keywords = {Adolescent, Adult, Aged, Agranulocytosis, Aminosalicylic Acids, Anti-Inflammatory Agents, Non-Steroidal, Arthritis, Child, Child, Preschool, Female, Follow-Up Studies, Great Britain, Hematologic Diseases, Humans, Infant, Inflammatory Bowel Diseases, Male, Mesalamine, Middle Aged, Product Surveillance, Postmarketing, Risk Factors, Sulfasalazine},
pages = {176--181}
}1992 (1)
An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Sagie, A, Larson, M G, Goldberg, R J, Bengtson, J R, & Levy, D The American journal of cardiology, 70(7):797–801, September, 1992.
abstract bibtex
abstract bibtex
Several formulas have been proposed to adjust the QT interval for heart rate, the most commonly used being the QT correction formula (QTc = QT/square root of RR) proposed in 1920 by Bazett. The QTc formula was derived from observations in only 39 young subjects. Recently, the adequacy of Bazett's formula has been questioned. To evaluate the heart rate QT association, the QT interval was measured on the initial baseline electrocardiogram of 5,018 subjects (2,239 men and 2,779 women) from the Framingham Heart Study with a mean age of 44 years (range 28 to 62). Persons with coronary artery disease were excluded. A linear regression model was developed for correcting QT according to RR cycle length. The large sample allowed for subdivision of the population into sex-specific deciles of RR intervals and for comparison of QT, Bazett's QTc and linear corrected QT (QTLC). The mean RR interval was 0.81 second (range 0.5 to 1.47) heart rate 74 beats/min (range 41 to 120), and mean QT was 0.35 second (range 0.24 to 0.49) in men and 0.36 second (range 0.26 to 0.48) in women. The linear regression model yielded a correction formula (for a reference RR interval of 1 second): QTLC = QT + 0.154 (1-RR) that applies for men and women. This equation corrects QT more reliably than the Bazett's formula, which overcorrects the QT interval at fast heart rates and undercorrects it at low heart rates. Lower and upper limits of normal QT values in relation to RR were generated.(ABSTRACT TRUNCATED AT 250 WORDS)
@article{sagie_improved_1992,
title = {An improved method for adjusting the {QT} interval for heart rate (the {Framingham} {Heart} {Study})},
volume = {70},
issn = {0002-9149},
abstract = {Several formulas have been proposed to adjust the QT interval for heart rate, the most commonly used being the QT correction formula (QTc = QT/square root of RR) proposed in 1920 by Bazett. The QTc formula was derived from observations in only 39 young subjects. Recently, the adequacy of Bazett's formula has been questioned. To evaluate the heart rate QT association, the QT interval was measured on the initial baseline electrocardiogram of 5,018 subjects (2,239 men and 2,779 women) from the Framingham Heart Study with a mean age of 44 years (range 28 to 62). Persons with coronary artery disease were excluded. A linear regression model was developed for correcting QT according to RR cycle length. The large sample allowed for subdivision of the population into sex-specific deciles of RR intervals and for comparison of QT, Bazett's QTc and linear corrected QT (QTLC). The mean RR interval was 0.81 second (range 0.5 to 1.47) heart rate 74 beats/min (range 41 to 120), and mean QT was 0.35 second (range 0.24 to 0.49) in men and 0.36 second (range 0.26 to 0.48) in women. The linear regression model yielded a correction formula (for a reference RR interval of 1 second): QTLC = QT + 0.154 (1-RR) that applies for men and women. This equation corrects QT more reliably than the Bazett's formula, which overcorrects the QT interval at fast heart rates and undercorrects it at low heart rates. Lower and upper limits of normal QT values in relation to RR were generated.(ABSTRACT TRUNCATED AT 250 WORDS)},
language = {eng},
number = {7},
journal = {The American journal of cardiology},
author = {Sagie, A and Larson, M G and Goldberg, R J and Bengtson, J R and Levy, D},
month = sep,
year = {1992},
pmid = {1519533},
keywords = {Adolescent, Cohort Studies, Electrocardiography, Female, Heart Rate, Humans, Male, Massachusetts, Prospective Studies, Regression Analysis, Risk Factors},
pages = {797--801}
}1990 (1)
A comparison of the risk of hypoglycemia between users of human and animal insulins. 1. Experience in the United Kingdom. Jick, H., Hall, G. C., Dean, A. D., Jick, S. S., & Derby, L. E. Pharmacotherapy, 10(6):395--397, 1990.
abstract bibtex
abstract bibtex
In a case-control study of 121 young insulin-dependent diabetics diagnosed as having an episode of hypoglycemia, the relative risk estimate comparing human with animal insulins was 0.8 (95% confidence interval 0.4, 1.6) controlling for age, general practice, and calendar time. We conclude that in this study population derived from general practices in the United Kingdom, the risk of hypoglycemia was no higher in users of human insulin than it was in users of animal insulins.
@article{jick_comparison_1990,
title = {A comparison of the risk of hypoglycemia between users of human and animal insulins. 1. {Experience} in the {United} {Kingdom}},
volume = {10},
issn = {0277-0008},
abstract = {In a case-control study of 121 young insulin-dependent diabetics diagnosed as having an episode of hypoglycemia, the relative risk estimate comparing human with animal insulins was 0.8 (95\% confidence interval 0.4, 1.6) controlling for age, general practice, and calendar time. We conclude that in this study population derived from general practices in the United Kingdom, the risk of hypoglycemia was no higher in users of human insulin than it was in users of animal insulins.},
language = {eng},
number = {6},
journal = {Pharmacotherapy},
author = {Jick, H. and Hall, G. C. and Dean, A. D. and Jick, S. S. and Derby, L. E.},
year = {1990},
pmid = {2287559},
keywords = {Adolescent, Adult, Animals, Case-Control Studies, Child, Diabetes Mellitus, Type 1, Great Britain, Humans, Hypoglycemia, Insulin, Middle Aged, Risk Factors},
pages = {395--397}
}undefined (2)
Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Englund, M. & Lohmander, L. S. 50(9):2811--2819.
doi abstract bibtex
doi abstract bibtex
OBJECTIVE: To evaluate the influence of age, sex, body mass index (BMI), extent of meniscal resection, cartilage status, and knee load on the development of radiographically evident osteoarthritis (OA) of the knee and knee symptoms after meniscal resection. METHODS: We evaluated 317 patients with no cruciate ligament injury (mean +/- SD age 54 +/- 11 years) who had undergone meniscal resection 15-22 years earlier (followup rate 70%), with radiographic and clinical examination. The Knee injury and Osteoarthritis Outcome Score was used to quantify knee-related symptoms. Sixty-eight unoperated subjects identified from national population records were included as a reference group. RESULTS: Symptomatic radiographic OA (corresponding to Kellgren/Lawrence grade \textgreater or =2) was present in 83 of 305 operated knees (27%) and 7 of 68 control knees (10%) (relative risk 2.6, 95% confidence interval [95% CI] 1.3-6.1). Patients who had undergone total meniscectomy and subjects with obesity (BMI \textgreater or =30) had a greater likelihood of tibiofemoral radiographic OA than those who had undergone partial meniscal resection and those with a BMI \textless25, respectively. Furthermore, degenerative meniscal tear, intraoperative cartilage changes, and lateral meniscectomy were associated with radiographic OA more frequently than were longitudinal tear, absence of cartilage changes, and medial meniscectomy, respectively. Symptomatic tibiofemoral or patellofemoral radiographic OA was associated with obesity, female sex, and degenerative meniscal tear. CONCLUSION: Contributing risk factors for OA development after meniscal resection are similar to risk factors for common knee OA. Systemic factors and local biomechanical factors interact. Obesity, female sex, and preexisting early-stage OA are features associated with poor self-reported and radiographic outcome. Partial meniscal resection is associated with less radiographic OA over time than is total meniscectomy.
@article{englund_risk_2004,
title = {Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy},
volume = {50},
issn = {0004-3591},
doi = {10.1002/art.20489},
abstract = {{OBJECTIVE}: To evaluate the influence of age, sex, body mass index ({BMI}), extent of meniscal resection, cartilage status, and knee load on the development of radiographically evident osteoarthritis ({OA}) of the knee and knee symptoms after meniscal resection.
{METHODS}: We evaluated 317 patients with no cruciate ligament injury (mean +/- {SD} age 54 +/- 11 years) who had undergone meniscal resection 15-22 years earlier (followup rate 70\%), with radiographic and clinical examination. The Knee injury and Osteoarthritis Outcome Score was used to quantify knee-related symptoms. Sixty-eight unoperated subjects identified from national population records were included as a reference group.
{RESULTS}: Symptomatic radiographic {OA} (corresponding to Kellgren/Lawrence grade {\textgreater} or =2) was present in 83 of 305 operated knees (27\%) and 7 of 68 control knees (10\%) (relative risk 2.6, 95\% confidence interval [95\% {CI}] 1.3-6.1). Patients who had undergone total meniscectomy and subjects with obesity ({BMI} {\textgreater} or =30) had a greater likelihood of tibiofemoral radiographic {OA} than those who had undergone partial meniscal resection and those with a {BMI} {\textless}25, respectively. Furthermore, degenerative meniscal tear, intraoperative cartilage changes, and lateral meniscectomy were associated with radiographic {OA} more frequently than were longitudinal tear, absence of cartilage changes, and medial meniscectomy, respectively. Symptomatic tibiofemoral or patellofemoral radiographic {OA} was associated with obesity, female sex, and degenerative meniscal tear.
{CONCLUSION}: Contributing risk factors for {OA} development after meniscal resection are similar to risk factors for common knee {OA}. Systemic factors and local biomechanical factors interact. Obesity, female sex, and preexisting early-stage {OA} are features associated with poor self-reported and radiographic outcome. Partial meniscal resection is associated with less radiographic {OA} over time than is total meniscectomy.},
pages = {2811--2819},
number = {9},
journaltitle = {Arthritis and Rheumatism},
shortjournal = {Arthritis Rheum.},
author = {Englund, M. and Lohmander, L. S.},
date = {2004-09},
pmid = {15457449},
keywords = {Aged, Cohort Studies, Comorbidity, Disease Progression, Female, Humans, Male, Menisci, Tibial, Middle Aged, Obesity, Orthopedic Procedures, Osteoarthritis, Knee, Retrospective Studies, Risk Factors, Sex Factors, Time Factors}
}The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Lohmander, L. S., Englund, P. M., Dahl, L. L., & Roos, E. M. 35(10):1756--1769.
doi abstract bibtex
doi abstract bibtex
The objectives of this study are to review the long-term consequences of injuries to the anterior cruciate ligament and menisci, the pathogenic mechanisms, and the causes of the considerable variability in outcome. Injuries of the anterior cruciate ligament and menisci are common in both athletes and the general population. At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have osteoarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall osteoarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against osteoarthritis development. A consistent finding in a review of the literature is the often poor reporting of critical study variables, precluding data pooling or a meta-analysis. Osteoarthritis development in the injured joints is caused by intra-articular pathogenic processes initiated at the time of injury, combined with long-term changes in dynamic joint loading. Variation in outcome is reinforced by additional variables associated with the individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury. A better understanding of these variables may improve future prevention and treatment strategies. In evaluating medical treatment, we now expect large randomized clinical trials complemented by postmarketing monitoring. We should strive toward a comparable level of quality of evidence in surgical treatment of knee injuries. In instances in which a randomized clinical trial is not feasible, natural history and other observational cohort studies need to be as carefully designed and reported as the classic randomized clinical trial, to yield useful information.
@article{lohmander_long-term_2007,
title = {The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis},
volume = {35},
issn = {1552-3365 0363-5465},
doi = {10.1177/0363546507307396},
abstract = {The objectives of this study are to review the long-term consequences of injuries to the anterior cruciate ligament and menisci, the pathogenic mechanisms, and the causes of the considerable variability in outcome. Injuries of the anterior cruciate ligament and menisci are common in both athletes and the general population. At 10 to 20 years after the diagnosis, on average, 50\% of those with a diagnosed anterior cruciate ligament or meniscus tear have osteoarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall osteoarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against osteoarthritis development. A consistent finding in a review of the literature is the often poor reporting of critical study variables, precluding data pooling or a meta-analysis. Osteoarthritis development in the injured joints is caused by intra-articular pathogenic processes initiated at the time of injury, combined with long-term changes in dynamic joint loading. Variation in outcome is reinforced by additional variables associated with the individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury. A better understanding of these variables may improve future prevention and treatment strategies. In evaluating medical treatment, we now expect large randomized clinical trials complemented by postmarketing monitoring. We should strive toward a comparable level of quality of evidence in surgical treatment of knee injuries. In instances in which a randomized clinical trial is not feasible, natural history and other observational cohort studies need to be as carefully designed and reported as the classic randomized clinical trial, to yield useful information.},
pages = {1756--1769},
number = {10},
journaltitle = {The American journal of sports medicine},
shortjournal = {Am J Sports Med},
author = {Lohmander, L. Stefan and Englund, P. Martin and Dahl, Ludvig L. and Roos, Ewa M.},
date = {2007-10},
pmid = {17761605},
keywords = {Adolescent, Adult, Age Distribution, Anterior Cruciate Ligament/*injuries, Athletic Injuries/epidemiology/surgery, Causality, Child, Comorbidity, Female, Follow-Up Studies, Global Health, Humans, Incidence, Knee Injuries/*epidemiology/surgery, Male, Menisci, Tibial/*injuries, Middle Aged, Osteoarthritis, Knee/*epidemiology/surgery, Outcome Assessment (Health Care), Quality of life, Risk Factors, Rupture/epidemiology/surgery, Sex Distribution}
}