Human anthrax outbreak associated with livestock exposure: Georgia, 2012

SUMMARYHuman anthrax cases reported in the country of Georgia increased 75% from 2011 (n= 81) to 2012 (n= 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by residence and gender to investigate risk factor(s) for infection during the month before case onset. Independent predictors most strongly associated with disease in the multivariable modelling were slaughtering animals [odds ratio (OR) 7·3, 95% confidence interval (CI) 2·9–18·1,P< 0·001] and disposing of dead animals (OR 13·6, 95% CI 1·5–119·8,P= 0·02). Participants owning or working with livestock (n= 131) were additionally interviewed about livestock management practices during the previous 6 months: 53 (44%) of 121 respondents vaccinated livestock against anthrax; 19 (16%) of 116 moved livestock >1 km; 15 (12%) of 125 had sick livestock; and 11 (9%) of 128 respondents reported finding dead livestock. We recommend joint public health and veterinary anthrax case investigations to identify areas of increased risk for livestock anthrax outbreaks, annual anthrax vaccination of livestock in those areas, and public awareness education.

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Association between schizophrenia and social inequality at birth: case–control study

The British Journal of Psychiatry ◽

10.1192/bjp.179.4.346 ◽

2001 ◽

Vol 179 (4) ◽

pp. 346-350 ◽

Cited By ~ 69

Author(s):

Glynn Harrison ◽

David Gunnell ◽

Cris Glazebrook ◽

Kim Page ◽

Rosemary Kwiecinski

Keyword(s):

Social Class ◽

Social Inequality ◽

Odds Ratio ◽

Positive Family History ◽

Case Control ◽

Birth Certificates ◽

First Episode ◽

Adult Onset ◽

Increased Risk ◽

And Gender

BackgroundThe association between social inequality at birth and subsequent risk of schizophrenia is uncertain.AimsTo investigate the relationship between adult-onset schizophrenia and two indicators of social inequality at birth: social class and area of residence.MethodA matched case–control design was used with data from birth certificates of first-episode cases and age— and gender-matched controls.ResultsRisk increased with increasing levels of deprivation at birth. Subjects whose fathers were social class IV–V or who were born in deprived areas were at increased risk of schizophrenia (odds ratio=2.1; 95% Cl=0.8–5.5). Risk was greater in those with both of these indicators (odds ratio=8.1; 95% CI=2.7–23.9). There was some evidence that associations were stronger in older subjects. Exclusion of African–Caribbeans or cases with positive family history somewhat attenuated the association.ConclusionsIndicators of social inequality at birth are associated with increased risk of adult-onset schizophrenia, suggesting that environmental factors are important determinants of schizophrenic disorders.

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Psychosis in children of separated parents: A systematic review and meta-analysis

European Psychiatry ◽

10.1192/j.eurpsy.2019.15 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Luis Ayerbe ◽

María Pérez-Piñar ◽

Quintí Foguet-Boreu ◽

Salma Ayis

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Psychotic Disorders ◽

Meta Analysis ◽

Childhood Adversity ◽

Case Control ◽

Parental Separation ◽

Cross Sectional ◽

Increased Risk ◽

Cross Sectional Studies

Abstract Background. Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case–control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. Methods. Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents. Results. Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29–1.76), p < 0.001. The association remained significant when cohort, case–control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26–1.69), p < 0.001. Conclusions. Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.

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Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case–control study and sib-pair analysis

The British Journal of Psychiatry ◽

10.1192/bjp.2018.23 ◽

2018 ◽

Vol 212 (6) ◽

pp. 370-376 ◽

Cited By ~ 15

Author(s):

J. H. MacCabe ◽

A. Sariaslan ◽

C. Almqvist ◽

P. Lichtenstein ◽

H. Larsson ◽

...

Keyword(s):

Bipolar Disorder ◽

Mental Disorder ◽

Odds Ratio ◽

Case Control Study ◽

Tertiary Education ◽

Unipolar Depression ◽

Population Based ◽

Case Control ◽

Increased Risk ◽

Control Study

BackgroundMany studies have addressed the question of whether mental disorder is associated with creativity, but high-quality epidemiological evidence has been lacking.AimsTo test for an association between studying a creative subject at high school or university and later mental disorder.MethodIn a case–control study using linked population-based registries in Sweden (N = 4 454 763), we tested for associations between tertiary education in an artistic field and hospital admission with schizophrenia (N = 20 333), bipolar disorder (N = 28 293) or unipolar depression (N = 148 365).ResultsCompared with the general population, individuals with an artistic education had increased odds of developing schizophrenia (odds ratio = 1.90, 95% CI = [1.69; 2.12]) bipolar disorder (odds ratio = 1.62 [1.50; 1.75]) and unipolar depression (odds ratio = 1.39 [1.34; 1.44]. The results remained after adjustment for IQ and other potential confounders.ConclusionsStudents of artistic subjects at university are at increased risk of developing schizophrenia, bipolar disorder and unipolar depression in adulthood.Declaration of interestNone.

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The C1542G and G505A Polymorphisms of Thrombin-Activatable Fibrinolysis Inhibitor (TAFI) in Patients with Thrombotic Microangiopathies.

Blood ◽

10.1182/blood.v106.11.2141.2141 ◽

2005 ◽

Vol 106 (11) ◽

pp. 2141-2141

Author(s):

Christoph Sucker ◽

Firuseh Farokhzad ◽

Fieras Dahhan ◽

Michael Schmitz ◽

Gerd R. Hetzel ◽

...

Keyword(s):

Odds Ratio ◽

Arterial Thrombosis ◽

Case Control ◽

Thrombotic Microangiopathies ◽

Thrombin Activatable Fibrinolysis Inhibitor ◽

Increased Risk ◽

Fibrinolysis Inhibitor ◽

Inflammatory Processes ◽

History Of

Abstract Background Thrombotic microangiopathies are characterized by vascular microthromboses, microangiopathic hemolytic anemia, and thrombocytopenia. Although recent research has elucidated the pathogenesis of these rare thrombotic disorders to some extent, the determinants contributing to the onset and modulating the severity are largely unknown. It is likely that risk factors of venous and arterial thrombosis also play a role in this clinical setting. Patients and Methods In the present study, we used a case-control and a case-only design, enrolling 23 patients (mean age [± SD] 35 ± 11 years) with a history of thrombotic microangiopathy and 689 control subjects to assess the role of gene polymorphisms of the thrombin-activatable fibrinolysis inhibitor (TAFI). Results The prevalence of the TAFI decreasing G/G genotype of the C1542G polymorphism was significantly higher in patients compared to controls (odds ratio 3.88; 95 % CI 1.07 – 11.47; p=0.02). In addition, in a case-only design the TAFI 1542 G allele was more prevalent in patients suffering from a severe course compared to those with a mild or moderate course (odds ratio 20; 95 % CI 1.85 – 216.17; p=0.009). By contrast, no such association was found for the TAFI G505A polymorphism. Conclusions Our study shows an association of the TAFI decreasing 1542 G/G genotype with an increased risk for thrombotic microangiopathies and a more severe course. This finding might be explained by the role of TAFI as an inhibitor of local inflammatory processes.

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Smoking and Orofacial Clefts: A United Kingdom–Based Case-Control Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/02-142.1 ◽

2004 ◽

Vol 41 (4) ◽

pp. 381-386 ◽

Cited By ~ 69

Author(s):

J. Little ◽

A. Cardy ◽

M. T. Arslan ◽

M. Gilmour ◽

P. A. Mossey ◽

...

Keyword(s):

Confidence Interval ◽

Cleft Palate ◽

Odds Ratio ◽

Maternal Smoking ◽

Cleft Lip ◽

Case Control Study ◽

Case Control ◽

Orofacial Clefts ◽

Increased Risk ◽

Control Study

Objective To investigate the association between smoking and orofacial clefts in the United Kingdom. Design Case-control study in which the mother's exposure to tobacco smoke was assessed by a structured interview. Setting Scotland and the Manchester and Merseyside regions of England. Participants One hundred ninety children born with oral cleft between September 1, 1997, and January 31, 2000, and 248 population controls, matched with the cases on sex, date of birth, and region. Main Outcome Measure Cleft lip with or without cleft palate and cleft palate. Results There was a positive association between maternal smoking during the first trimester of pregnancy and both cleft lip with or without cleft palate (odds ratio 1.9, 95% confidence interval 1.1 to 3.1) and cleft palate (odds ratio 2.3, 95% confidence interval 1.3 to 4.1). There was evidence of a dose-response relationship for both types of cleft. An effect of passive smoking could not be excluded in mothers who did not smoke themselves. Conclusion The small increased risk for cleft lip with or without cleft palate in the offspring of women who smoke during pregnancy observed in this study is in line with previous evidence. In contrast to some previous studies, an increased risk was also apparent for cleft palate. In these U.K. data, there was evidence of a dose-response effect of maternal smoking for both types of cleft. The data were compatible with a modest effect of maternal passive smoking, but the study lacked statistical power to detect or exclude such an effect with confidence. It may be useful to incorporate information on the effects of maternal smoking on oral clefts into public health campaigns on the consequences of maternal smoking.

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Smoking and risk of treatment-induced neutralizing antibodies to interferon β-1a

Multiple Sclerosis Journal ◽

10.1177/1352458513498635 ◽

2013 ◽

Vol 20 (4) ◽

pp. 445-450 ◽

Cited By ~ 33

Author(s):

Anna Karin Hedström ◽

Malin Ryner ◽

Katarina Fink ◽

Anna Fogdell-Hahn ◽

Lars Alfredsson ◽

...

Keyword(s):

Multiple Sclerosis ◽

Gender Differences ◽

Odds Ratio ◽

Neutralizing Antibodies ◽

Case Control ◽

Smoking Habits ◽

Interferon Β ◽

Case Control Studies ◽

Increased Risk ◽

Risk Of Treatment

Background: Neutralizing antibodies (NAbs) to interferon β (IFNβ) products that develop during treatment are associated with a loss of clinical efficacy. Objectives: The aim of this study was to investigate the influence of smoking habits on the risk of developing NAbs to IFNβ, in the treatment of multiple sclerosis (MS). Methods: This report is based on 695 MS patients treated with IFNβ-1a, included in two Swedish case-control studies that collected information on smoking habits. Using logistic regression, the development of NAbs to IFNβ-1a among current smokers was compared with that of non-smokers, by calculating the odds ratio (OR) with a 95% confidence interval (CI). Results: Current smokers showed an increased risk of developing NAbs to IFNβ-1a, compared with non-smokers (OR 1.9; 95% CI 1.3–2.8; p = 0.002). There were no gender differences. We observed no association between past smoking and the risk of developing NAbs to IFNβ-1a. Conclusions: The finding that current smokers have an increased risk of developing NAbs to IFNβ-1a has implications, both for the practical care and the treatment of MS; it also provides an interesting perspective of the lungs as an immune-reactive organ, reacting upon irritation.

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Smokers run increased risk of developing anti-natalizumab antibodies

Multiple Sclerosis Journal ◽

10.1177/1352458513515086 ◽

2013 ◽

Vol 20 (8) ◽

pp. 1081-1085 ◽

Cited By ~ 23

Author(s):

AK Hedström ◽

L Alfredsson ◽

M Lundkvist Ryner ◽

A Fogdell-Hahn ◽

Jan Hillert ◽

...

Keyword(s):

Multiple Sclerosis ◽

Odds Ratio ◽

Neutralizing Antibodies ◽

Case Control ◽

Smoking Habits ◽

Interferon Β ◽

Case Control Studies ◽

Biological Drug ◽

Increased Risk ◽

Multiple Sclerosis Patients

Background: Smoking may contribute to the induction of neutralizing antibodies to interferon β-1a. Objective: In this study, we aimed to investigate the influence of smoking on the risk of developing antibodies to natalizumab, another biological drug in the treatment of multiple sclerosis. Methods: This report is based on 1338 natalizumab-treated multiple sclerosis patients included in either of two Swedish case-control studies in which information on smoking habits was collected. Using logistic regression, patients with different smoking habits were compared regarding risk of developing anti-natalizumab antibodies, by calculating odds ratios with 95% confidence intervals. Results: Compared with nonsmokers, the odds ratio of developing anti-natalizumab antibodies was 2.4 (95% CI 1.2–4.4) for patients who smoked at the time of screening, and a significant trend showed higher risk of developing antibodies with higher intensity of smoking. When smoking within two years prior to screening was considered, the odds ratio of developing anti-natalizumab antibodies was 2.7 (1.5–5.1). Interpretations: The finding strengthens our hypothesis of the lungs as immune-reactive organs on irritation in relation to autoimmune responses, and may also be of clinical relevance since antibodies against natalizumab abrogate the therapeutic effect of the treatment.

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Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort

BMJ ◽

10.1136/bmj.l231 ◽

2019 ◽

pp. l231 ◽

Cited By ~ 17

Author(s):

Christian R Kahrs ◽

Katerina Chuda ◽

German Tapia ◽

Lars C Stene ◽

Karl Mårild ◽

...

Keyword(s):

Coeliac Disease ◽

Birth Cohort ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Case Control Study ◽

Viral Infections ◽

Case Control ◽

Human Enterovirus ◽

Increased Risk ◽

Control Study

AbstractObjectiveTo determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease.DesignCase-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016.SettingNorwegian population.ParticipantsChildren carrying the HLA genotype DR4-DQ8/DR3-DQ2 conferring increased risk of coeliac disease.ExposuresEnterovirus and adenovirus detected using real time polymerase chain reaction in monthly stool samples from age 3 to 36 months.Main outcome measureCoeliac disease diagnosed according to standard criteria. Coeliac disease antibodies were tested in blood samples taken at age 3, 6, 9, and 12 months and then annually. Adjusted odds ratios from mixed effects logistic regression model were used to assess the relation between viral infections before development of coeliac disease antibodies and coeliac disease.ResultsAmong 220 children, and after a mean of 9.9 (SD 1.6) years, 25 children were diagnosed as having coeliac disease after screening and were matched to two controls each. Enterovirus was found in 370 (17%) of 2135 samples and was significantly more frequent in samples collected before development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49, 95% confidence interval 1.07 to 2.06; P=0.02). The association was restricted to infections after introduction of gluten. High quantity samples (>100 000 copies/μL) (adjusted odds ratio 2.11, 1.24 to 3.60; P=0.01) and long lasting infections (>2 months) (2.16, 1.16 to 4.04; P=0.02) gave higher risk estimates. Both the commonly detected enterovirus species Enterovirus A and Enterovirus B were significantly associated with coeliac disease. The association was not found for infections during or after development of coeliac disease antibodies. Adenovirus was not associated with coeliac disease.ConclusionsIn this longitudinal study, a higher frequency of enterovirus, but not adenovirus, during early childhood was associated with later coeliac disease. The finding adds new information on the role of viral infections in the aetiology of coeliac disease.

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The risk of being culpable for or involved in a road crash after using cannabis: A systematic review and meta-analyses

Drug Science Policy and Law ◽

10.1177/20503245211055381 ◽

2021 ◽

Vol 7 ◽

pp. 205032452110553

Author(s):

Michael A. White ◽

Nicholas R. Burns

Keyword(s):

Odds Ratio ◽

Meta Analysis ◽

Case Control ◽

Odds Ratios ◽

Case Control Studies ◽

Directional Bias ◽

Increased Risk ◽

Meta Analyses ◽

Summary Odds Ratio ◽

Average Measure

Background The development of drug driving policies should rest on sound epidemiological evidence as to the crash risks of driving after using psychoactive drugs. The findings from individual studies of the increased risk of crashing from the acute use of cannabis range in size from no increase (and perhaps even a protective effect) to a 10-fold increase. Coherent cannabis-driving policies cannot readily be developed from such an incoherent evidence base. A weighted average measure of risk, as provided by a meta-analysis, might be useful. However, if the range of risks found in the cannabis-crash studies reflects the different ways that a variety of biases are being expressed, then the simple application of a meta-analysis might provide little more than an average measure of bias. In other words, if the biases were predominantly inflationary, the meta-analysis would give an inflated estimate of crash risk; and if the biases were predominantly deflationary, the meta-analysis would give a deflated estimate of risk. Review We undertook a systematic search of electronic databases, and identified 13 culpability studies and 4 case–control studies from which cannabis-crash odds ratios could be extracted. Random-effects meta-analyses gave summary odds ratios of 1.37 (1.10–1.69) for the culpability studies and 1.45 (0.94–2.25) for the case–control studies. A tool was designed to identify and score biases arising from: confounding by uncontrolled covariates; inappropriate selection of cases and controls; and the inappropriate measurement of the exposure and outcome variables. Each study was scrutinised for the presence of those biases, and given a total ‘directional bias score’. Most of the biases were inflationary. A meta-regression against the total directional bias scores was performed for the culpability studies, giving a bias-adjusted summary odds ratio of 0.68 (0.45–1.05). The same analysis could not be performed for the case–control studies because there were only four such studies. Nonetheless, a monotonic relationship was found between the total bias scores and the cannabis-crash odds ratios, with Spearman's rho = 0.95, p = 0.05, indicating that the summary odds ratio of 1.45 is an overestimate. It is evident that the risks from driving after using cannabis are much lower than from other behaviours such as drink-driving, speeding or using mobile phones while driving. With the medical and recreational use of cannabis becoming more prevalent, the removal of cannabis-presence driving offences should be considered (while impairment-based offences would remain).

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A Nested Case-Control Study of Midgestation Vitamin D Deficiency and Risk of Severe Preeclampsia

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-0996 ◽

2010 ◽

Vol 95 (11) ◽

pp. 5105-5109 ◽

Cited By ~ 141

Author(s):

Arthur M. Baker ◽

Sina Haeri ◽

Carlos A. Camargo ◽

Janice A. Espinola ◽

Alison M. Stuebe

Keyword(s):

Vitamin D ◽

Confidence Interval ◽

Vitamin D Deficiency ◽

Odds Ratio ◽

Case Control Study ◽

Case Control ◽

Severe Preeclampsia ◽

Increased Risk ◽

Nested Case Control ◽

Control Study

Context: Vitamin D may be important in the pathogenesis of severe preeclampsia. Given the few effective preventive strategies for severe preeclampsia, studies establishing this link are needed so that effective interventions can be developed. Objective: Our objective was to assess whether midgestation vitamin D deficiency is associated with development of severe preeclampsia. Design and Setting: We conducted a nested case-control study of pregnant women who had previously given blood for routine genetic multiple marker screening and subsequently delivered at a tertiary hospital between January 2004 and November 2008. Patients: Participants included women with singleton pregnancies in the absence of any chronic medical illnesses. From an overall cohort of 3992 women, 51 cases of severe preeclampsia were matched by race/ethnicity with 204 women delivering at term with uncomplicated pregnancies. Banked maternal serum was used to measure maternal 25-hydroxyvitamin D [25(OH)D]. Main Outcome Measure: The main outcome was severe preeclampsia. Results: Midgestation maternal 25(OH)D concentration was lower in women who subsequently developed severe preeclampsia compared with controls [median (interquartile range), 75 (47–107) nmol/liter vs. 98 (68–113) nmol/liter; P = 0.01]. Midgestation maternal 25(OH)D of less than 50 nmol/liter was associated with an almost 4-fold odds of severe preeclampsia (unadjusted odds ratio, 3.63; 95% confidence interval, 1.52–8.65) compared with midgestation levels of at least 75 nmol/liter. Adjustment for known confounders strengthened the observed association (adjusted odds ratio, 5.41; 95% confidence interval, 2.02–14.52). Conclusion: Maternal midgestation vitamin D deficiency was associated with increased risk of severe preeclampsia. Vitamin D deficiency may be a modifiable risk factor for severe preeclampsia.

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