Possible association between ocular chloramphenicol and aplastic anaemia—the absolute risk is very low

Background: Acute myocardial infarction (MI) has long been reported as a risk factor for ischemic stroke, but the magnitude and duration of risk remains uncertain. Methods: We performed a crossover-cohort study using inpatient and outpatient claims data from a nationally representative 5% sample of Medicare beneficiaries from 2008 through 2014. We identified all patients ≥66 years of age with a first-recorded hospitalization for acute MI. The primary outcome was ischemic stroke. All predictors and outcomes were defined using previously validated ICD-9-CM codes. To exclude stroke that may have been due to percutaneous coronary intervention, we included only cases of ischemic stroke that occurred after discharge from the MI hospitalization. We compared the risk of ischemic stroke in successive 4-week periods during the 12 weeks after MI versus the corresponding 4-week periods 1 year later. To avoid immortal time bias, we limited our cohort to patients who remained alive and insured throughout the 15 month study period. Odds ratios (OR) and absolute risk differences were calculated using the Mantel-Haenszel estimator for matched data. Results: We identified 22,798 patients with an acute MI in whom the mean age was 77.4 (±7.9) years and 50.3% were women. In the 12 weeks after discharge, 216 patients (0.95%) developed a stroke, as compared to 21 (0.09%) patients in the corresponding 12-week period 1 year later. The absolute increase in stroke risk was 0.45% (95% confidence interval [CI], 0.36-0.55%) in the first 4 weeks after acute MI compared to the 4-week time period 1 year later, corresponding to an OR of 18.2 (95% CI, 8.1-50.6). The absolute risk increase was 0.24% (95% CI, 0.16-0.31%) during weeks 5-8 (OR, 8.7; 95% CI, 4.0-22.6) and 0.17% (95% CI, 0.10-0.23%) during weeks 9-12 (OR, 5.8; 95% CI, 2.7-14.1). Conclusions: Acute MI is associated with a substantially elevated short-term risk of ischemic stroke. This risk was independent of periprocedural stroke risk in the setting of coronary reperfusion therapies.

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Nevus Spilus with Synchronous Melanomas: Case Report and Literature Review

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2008.07090 ◽

2009 ◽

Vol 13 (2) ◽

pp. 96-101 ◽

Cited By ~ 7

Author(s):

Ari-Nareg Meguerditchian ◽

Richard T. Cheney ◽

John M. Kane

Keyword(s):

Case Report ◽

Literature Review ◽

Malignant Transformation ◽

Absolute Risk ◽

Cutaneous Lesion ◽

Pertinent Literature ◽

The Absolute ◽

Management Recommendations

Background: Nevus spilus is a rare, acquired, and often large cutaneous lesion consisting of a light brown background macule containing varying numbers of small darker macular or papular areas. Objective: Nevus spilus may contain dysplastic melanocytic elements, and there are also reports of melanoma arising from nevus spilus. However, the absolute risk for malignant transformation is not well defined. Conclusion: We discuss a case of synchronous melanomas arising from a nevus spilus and potential management recommendations based on a review of the pertinent literature.

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The application of the FRIDEX calibration of the FRAX tool to determine the absolute risk of osteoporotic fracture among Spanish women

Reumatología Clínica (English Edition) ◽

10.1016/j.reumae.2017.10.003 ◽

2019 ◽

Vol 15 (5) ◽

pp. e68-e69

Author(s):

Rafael Azagra ◽

Paula Gabriel ◽

Amada Aguyé ◽

David Moriña

Keyword(s):

Osteoporotic Fracture ◽

Absolute Risk ◽

Spanish Women ◽

The Absolute

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Air travel and fatal pulmonary embolism

Thrombosis and Haemostasis ◽

10.1160/th05-12-0813 ◽

2006 ◽

Vol 95 (05) ◽

pp. 807-814 ◽

Cited By ~ 20

Author(s):

Melanie Bell ◽

Peter Herbison ◽

Charlotte Paul ◽

David Skegg ◽

Lianne Parkin

Keyword(s):

Pulmonary Embolism ◽

New Zealand ◽

Absolute Risk ◽

International Classification Of Diseases ◽

Population Based ◽

Air Travel ◽

Fatal Pulmonary Embolism ◽

Long Distance ◽

Electoral Roll ◽

The Absolute

SummaryAlthough long-distance air travel is commonly regarded as a risk factor for venous thromboembolism, the risk of clinically important events has not been well defined. We estimated the absolute risk of dying from pulmonary embolism following longdistance air travel in a national population-based descriptive study of 121 men and women who were aged 15–59 years (the age range in which the majority of international arrivals are found) and whose underlying cause of death was certified as codes 415.1, 451, or 453 of the International Classification of Diseases (ninth revision). Eleven cases had undertaken longdistance air travel in the four weeks before the onset of the fatal episode. The estimated risks of fatal pulmonary embolism following a flight of at least three hours’ duration were 0.5 (95% CI 0.2–1.2) and 0.6 (95% CI 0.2–1.4) per million arrivals for overseas visitors and New Zealand residents, respectively. For air travel of more than eight hours’ duration, the risk in New Zealand residents was 1.3 (95% CI 0.4–3.0) per million arrivals. We also conducteda case-control study based on those cases who were normally resident in New Zealand and registered on the electoral roll (n=99). For each case, four controls matched for sex, age, and electorate, were randomly selected from the electoral roll. In the key analysis (based on 88 cases and 334 controls), the adjusted odds ratio for travellers who had flown for more than eight hours was 7.9 (95% CI 1.1–55.1) compared with those who did not undertake a long-distance flight. Longdistance air travellers have a higher risk of dying from pulmonary embolism than non-travellers, but the absolute risk in people aged 15–59 years appears to be very small.

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Venous thromboembolism in pregnant and puerperal women in Denmark 1995–2005

Thrombosis and Haemostasis ◽

10.1160/th10-12-0823 ◽

2011 ◽

Vol 106 (08) ◽

pp. 304-309 ◽

Cited By ~ 54

Author(s):

Rie Adser Virkus ◽

Ellen Christine Leth Løkkegaard ◽

Thomas Bergholt ◽

Ulla Mogensen ◽

Jens Langhoff-Roos ◽

...

Keyword(s):

Venous Thromboembolism ◽

Pregnant Women ◽

Incidence Rate Ratio ◽

Absolute Risk ◽

National Registry ◽

Postnatal Period ◽

Western World ◽

Medical Products ◽

National Cohort ◽

The Absolute

SummaryVenous thromboembolism (VTE) is the leading cause of maternal death in the Western world, and the risk increases during pregnancy and puerperal period. It was the objective of the present study to estimate the absolute and the relative risk of VTE at different weeks of gestation and in the postnatal period as compared to non-pregnant women. This was a historical controlled national cohort study. The National Registry of Patients identified relevant diagnoses. These data were linked to The National Registry of Medical Products Statistics for information about current use of oral contraceptives. Danish women 15 to 49 years old during the period January 1995 through December 2005 were included in the study. In total 819,751 pregnant women were identified of whom 727 had a diagnosis of VTE. The absolute risk of VTE per 10,000 pregnancy-years increased from 4.1 (95% CI, 3.2 to 5.2) during week 1–11 up to 59.0 (95% CI: 46.1 to 76.4) in week 40 and decreased in the puerperal period from 60.0 (95% CI:47.2–76.4) during the first week after birth to 2.1 (95% CI:1.1 to 4.2) during week 9–12 after birth. Compared with non-pregnant women, the incidence rate ratio rose from 1.5 (95% CI:1.1 to1.9) in week 1–11, to 21.0 (95%CI16.7 to 27.4) in week 40 and 21.5 (95% CI:16.8 to 27.6) in the first week after delivery, declining to 3.8 (95% CI:2.5 to 5.8) 5–6 weeks after delivery. In conclusion, the risk of VTE increases almost exponentially through pregnancy and reaches maximum just after delivery and is no longer significantly increased six weeks after delivery.

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High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance) [see comments]

Blood ◽

10.1182/blood.v85.6.1504.bloodjournal8561504 ◽

1995 ◽

Vol 85 (6) ◽

pp. 1504-1508 ◽

Cited By ~ 648

Author(s):

FR Rosendaal ◽

T Koster ◽

JP Vandenbroucke ◽

PH Reitsma

Keyword(s):

Venous Thrombosis ◽

Protein C ◽

Absolute Risk ◽

Thrombotic Event ◽

Activated Protein C ◽

Factor V Leiden ◽

Coagulation Factor ◽

Factor V ◽

Increased Risk ◽

The Absolute

Resistance to activated protein C (APC) is a common inherited risk factor for venous thrombosis, which is associated with a mutation in coagulation factor V (factor V Leiden). We investigated the risk of venous thrombosis in individuals homozygous for this abnormality. We determined the factor V Leiden genotype in 471 consecutive patients aged less than 70 years with a first objectively confirmed deep-vein thrombosis and in 474 healthy controls. We found 85 heterozygous and seven homozygous individuals among the cases with thrombosis and 14 heterozygous individuals among the control subjects. The expected number of homozygous individuals among the controls was calculated from Hardy-Weinberg equilibrium and estimated at 0.107 (allele frequency, 1.5%). Whereas the relative risk was increased sevenfold for heterozygous individuals, it was increased 80-fold for homozygous individuals. These patients experienced their thrombosis at a much younger age (31 v 44 years). The homozygous individuals were predominantly women, most likely due to the effect of oral contraceptives. Because of the increased risk of thrombosis with age, the absolute risk becomes most pronounced in older patients, both for heterozygous and homozygous individuals. For the homozygous individuals, the absolute risk may become several percentage points per year. This implies that most individuals homozygous for factor V Leiden will experience at least one thrombotic event in their lifetime.

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Clinical Effects of Desensitizing Prefilled Disposable Trays in In-office Bleaching: A Randomized Single-blind Clinical Trial

Operative Dentistry ◽

10.2341/18-149-c ◽

2020 ◽

Vol 45 (1) ◽

pp. E1-E10

Author(s):

LM Martins ◽

LA Lima e Souza ◽

E Sutil ◽

LM da Silva ◽

JOS Silva ◽

...

Keyword(s):

Clinical Trial ◽

Color Change ◽

Absolute Risk ◽

Potassium Nitrate ◽

Clinical Effects ◽

Bleaching Agent ◽

Chi Square ◽

Peroxide Bleaching ◽

The Absolute ◽

Single Blind

SUMMARY Objectives: This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial. Methods and Materials: Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05). Results: Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed. Conclusion: The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.

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Prognostic prediction models for pregnancy complications in women with gestational diabetes: a protocol for systematic review, critical appraisal and meta-analysis

Systematic Reviews ◽

10.1186/s13643-019-1151-0 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 7

Author(s):

Shamil D. Cooray ◽

Jacqueline A. Boyle ◽

Georgia Soldatos ◽

Lihini A. Wijeyaratne ◽

Helena J. Teede

Keyword(s):

Systematic Review ◽

Decision Making ◽

Gestational Diabetes ◽

Pregnancy Complications ◽

Prediction Models ◽

Absolute Risk ◽

Meta Analysis ◽

External Validation ◽

The Absolute ◽

Prognostic Prediction

Abstract Background Gestational diabetes (GDM) is increasingly common and has significant implications during pregnancy and for the long-term health of the mother and offspring. However, it is a heterogeneous condition with inter-related factors including ethnicity, body mass index and gestational weight gain significantly modifying the absolute risk of complications at an individual level. Predicting the risk of pregnancy complications for an individual woman with GDM presents a useful adjunct to therapeutic decision-making and patient education. Diagnostic prediction models for GDM are prevalent. In contrast, prediction models for risk of complications in those with GDM are relatively novel. This study will systematically review published prognostic prediction models for pregnancy complications in women with GDM, describe their characteristics, compare performance and assess methodological quality and applicability. Methods Studies will be identified by searching MEDLINE and Embase electronic databases. Title and abstract screening, full-text review and data extraction will be completed independently by two reviewers. The included studies will be systematically assessed for risk of bias and applicability using appropriate tools designed for prediction modelling studies. Extracted data will be tabulated to facilitate qualitative comparison of published prediction models. Quantitative data on predictive performance of these models will be synthesised with meta-analyses if appropriate. Discussion This review will identify and summarise all published prognostic prediction models for pregnancy complications in women with GDM. We will compare model performance across different settings and populations with meta-analysis if appropriate. This work will guide subsequent phases in the prognosis research framework: further model development, external validation and model updating, and impact assessment. The ultimate model will estimate the absolute risk of pregnancy complications for women with GDM and will be implemented into routine care as an evidence-based GDM complication risk prediction model. It is anticipated to offer value to women and their clinicians with individualised risk assessment and may assist decision-making. Ultimately, this systematic review is an important step towards a personalised risk-stratified model-of-care for GDM to allow preventative and therapeutic interventions for the maximal benefit to women and their offspring, whilst sparing expense and harm for those at low risk. Systematic review registration PROSPERO registration number CRD42019115223

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