P3661Two-fold increase in incidence of infective endocarditis in the period 1997–2016: a Danish nationwide study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Dalsgaard Jensen ◽  
L Ostergaard ◽  
N Eske Bruun ◽  
M Voldstedlund ◽  
C Torp-Pedersen ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Temporal Trends ◽  
Fold Increase ◽  
Patient Characteristics ◽  
Incidence Rates ◽  
Study Cohort ◽  
Incidence And Mortality ◽  
First Time

Abstract Background Infective Endocarditis (IE) is a disease with high mortality. Previous studies have shown considerable differences and contradicting trends in overall incidence and mortality why data from an unselected nationwide cohort is needed. Purpose We investigated temporal trends in the incidence rate and in-hospital mortality of IE in Denmark in the period of 1997–2016. Methods We included cases of first-time IE (1997–2016) using Danish nationwide registries. Crude incidence rates were given for each calendar year. Further, incidence rates were reported for subgroups of age and sex. For the analysis of patient characteristics and in-hospital mortality, the study cohort was grouped into four 5-year intervals (1997–2001, 2002–2006, 2007–2011, 2012–2016). Multivariable adjusted Cox proportional hazard model was used to compare in-hospital mortality between groups. Results A total of 8,147 patients with IE were identified in the period of 1997–2016. The median age and proportion of males increased from 64.3 years (P25-P75: 48–75.5) and 59.1% to 71.8 years (P25-P75: 62.1–79.9) and 67.1% in 1997–2001 and 2012–2016, respectively. The overall incidence rate (Figure 1) increased from 4.68/100.000-person-years (PY) (CI95: 4.17–5.26) to 8.23/100.000 PY (CI95: 7.53–8.99) in 1997 and 2016, respectively. Male incidence increased from 5.35/100.000 PY (CI95: 4.59–6.23) to 11.03/100.000 PY (CI95: 9.9–12.29) and female incidence increased from 4.03/100.000 PY (CI95: 3.38–4.8) to 5.44/100.000 PY (CI95: 4.67–6.35) in 1997 and 2016 respectively. Incidence rates increased more than seven-fold for the oldest age group (≥80 years) from 1997 to 2016 (6.95/100.000 PY [CI95: 5.32–9.08] to 51.19/100.000 PY [CI95: 43.41–60.38], respectively). In-hospital mortality was significantly lower for patients with IE in the period of 2011–2016 compared with 1997–2001 HR: 0.8 (CI95: 0.69–0.92). Figure 1 Conclusion Infective endocarditis incidences are increasing mostly among men and elderly patients. In order to prevent this disease as best as possible, we need more knowledge on causes for this increasing incidence.

scholarly journals National and Subnational Trends of Incidence and Mortality of Female Genital Cancers in Iran; 1990–2016

2020 ◽  
Vol 23 (7) ◽  
pp. 434-444
Author(s):  
Sahar Eftekharzadeh ◽  
Narges Ebrahimi ◽  
Mehrnoosh Samaei ◽  
Farnam Mohebi ◽  
Bahram Mohajer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Incidence Rate ◽  
Gynecological Cancer ◽  
Fold Increase ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Gynecological Cancers ◽  
Corpus Uteri ◽  
National Mortality ◽  
Incidence And Mortality

Background: The present study aims to assess the incidence and mortality rates of gynecological cancers and their changes from 1990 to 2016 at national and subnational levels in Iran. Methods: Annual estimates of incidence and mortality for gynecological cancers from 1990 to 2016 at national and subnational levels were generated as part of a larger project entitled National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD). After the precise processing of data extracted from the Iran Cancer Registry, annual age-standardized incidence and mortality rates were calculated for each cancer, province, year and age group during the period of the study. Results: In 2016, gynecological cancers constituted 8.0% of new cancer cases among women of all ages compared to 3.7% of new cases of cancer among women in 1990. The incidence rate of gynecological cancers has increased from 2.5 (0.9-5.6) per 100000 women in 1990 to 12.3 (9.3–15.7) per 100000 women in 2016, and the most common gynecological cancer has changed from cervical cancer in 1990 to corpus uteri cancer in 2016. Age-standardized incidence rates of ovarian, corpus uteri and vulvovaginal cancers increased from 1.3 (0.5–2.4), 1.7 (0.6–3.0), and 0.3 (0.0–0.7) in 1990 to 4.4 (3.6–5.2), 9.9 (6.8–13.4), and 0.6 (0.2–1.0) in 2016, respectively, showing a 3.3, 5.8 and 1.7-fold increase during this period. Age-standardized incidence rate of cervical cancer was 2.4 (1.7–3.3) cases per 100000 women in 2016 and did not differ significantly from the beginning of the study. An overall reduction was seen in national mortality to incidence ratios (MIR) from 2000 to 2015. Conclusion: The incidence rates of all gynecological cancers in different provinces have shown a converging trend that could indicate that attempts toward health equality have been effective. The declining trend of MIR could be interpreted as advancements in detection of cancer in its early stages and also improvements in treatments, in turn reflecting improvements in access to and quality of care.

scholarly journals Breast cancer incidence rates in women exposed to occupational ionizing radiation

2021 ◽  
Vol 65 (3) ◽  
pp. 245-250
Author(s):  
Anna V. Rumyantseva ◽  
Tamara V. Azizova ◽  
Mariya V. Bannikova ◽  
Ol’ga V. Zubkova
Keyword(s):  
Breast Cancer ◽  
Ionizing Radiation ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Study Cohort ◽  
Female Population ◽  
Study Objective ◽  
Incidence And Mortality ◽  
Increasing Trend

Introduction. Breast cancer (BC) is one of the most common malignancies within female incidence and mortality patterns in the RF. Study objective. To analyze BC incidence in females exposed to occupational ionizing radiation over prolonged periods. Materials and methods. The study cohort included 5689 females who had been occupationally exposed to ionizing radiation throughout 1948-1982 and followed up until 31.12.2018. Results. BC was on the top of the list among females of the study cohort (11.9%). BC prevalence rate in the female cohort understudy was 28.3% as of 31.12.2018. The standardized BrCa incidence rate was 0.88 ± 0.07 per 1000 person-years of the follow-up. The absolute BrCa case increase in the females was 1.29, with the rise of 232.48% by the end of the follow-up due to the rise in age categories of females and the elevating risk of the disease occurrence. Discussion. The study cohort of females demonstrated standardized BrCa incidence rates consistent with the corresponding estimates for the general female population of the RF. Meanwhile, the observed rates were lower than those estimated for the female population of the Chelyabinsk region. The increasing trend of the standardized BC incidence rate by the end of the follow-up period (31.12.2018) was consistent with WHO statistics. The extended follow-up for an updated assessment of ionizing radiation effect on BC incidence is required to develop new cancer prevention strategies. Conclusion. The study demonstrated that BC incidence rates in the study cohort varied by age and calendar period of the follow-up. The increasing trend of the standardized rates of BC incidence was observed by the end of the follow-up.

Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project

2020 ◽  
pp. 1-8
Author(s):  
Mandeep S. Tamber ◽  
John R. W. Kestle ◽  
Ron W. Reeder ◽  
Richard Holubkov ◽  
Jessica Alvey ◽  
...  
Keyword(s):  
Clinical Research ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Research Network ◽  
Third Ventriculostomy ◽  
Study Cohort ◽  
Core Data ◽  
Pediatric Hydrocephalus ◽  
Short Period ◽  
New Procedures

OBJECTIVEAnalysis of temporal trends in patient populations and procedure types may provide important information regarding the evolution of hydrocephalus treatment. The purpose of this study was to use the Hydrocephalus Clinical Research Network’s Core Data Project to identify meaningful trends in patient characteristics and the surgical management of pediatric hydrocephalus over a 9-year period.METHODSThe Core Data Project prospectively collected patient and procedural data on the study cohort from 9 centers between 2008 and 2016. Logistic and Poisson regression were used to test for significant temporal trends in patient characteristics and new and revision hydrocephalus procedures.RESULTSThe authors analyzed 10,149 procedures in 5541 patients. New procedures for hydrocephalus (shunt or endoscopic third ventriculostomy [ETV]) decreased by 1.5%/year (95% CI −3.1%, +0.1%). During the study period, new shunt insertions decreased by 6.5%/year (95% CI −8.3%, −4.6%), whereas new ETV procedures increased by 12.5%/year (95% CI 9.3%, 15.7%). Revision procedures for hydrocephalus (shunt or ETV) decreased by 4.2%/year (95% CI −5.2%, −3.1%), driven largely by a decrease of 5.7%/year in shunt revisions (95% CI −6.8%, −4.6%). Concomitant with the observed increase in new ETV procedures was an increase in ETV revisions (13.4%/year, 95% CI 9.6%, 17.2%). Because revisions decreased at a faster rate than new procedures, the Revision Quotient (ratio of revisions to new procedures) for the Network decreased significantly over the study period (p = 0.0363). No temporal change was observed in the age or etiology characteristics of the cohort, although the proportion of patients with one or more complex chronic conditions significantly increased over time (p = 0.0007).CONCLUSIONSOver a relatively short period, important changes in hydrocephalus care have been observed. A significant temporal decrease in revision procedures amid the backdrop of a more modest change in new procedures appears to be the most notable finding and may be indicative of an improvement in the quality of surgical care for pediatric hydrocephalus. Further studies will be directed at elucidation of the possible drivers of the observed trends.

Temporal trends in utilization of transcatheter aortic valve implantation and patient characteristics – a nationwide cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.E Strange ◽  
C Sindet-Pedersen ◽  
G Gislason ◽  
C Torp-Pedersen ◽  
E.L Fosboel ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
P Value ◽  
Transcatheter Aortic Valve ◽  
History Of ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
First Time

Abstract Introduction In recent years, there has been a surge in the utilization of transcatheter aortic valve implantation (TAVI) for the treatment of severe symptomatic aortic stenosis. Randomized controlled trials have compared TAVI to surgical aortic valve replacement (SAVR) in patients at high-, intermediate-, and low perioperative risk. As TAVI continues to be utilized in patients with lower risk profiles, it is important to investigate the temporal trends in “real-world” patients undergoing TAVI. Purpose To investigate temporal trends in the utilization of TAVI and examine changes in patient characteristics of patients undergoing first-time TAVI. Methods Using complete Danish nationwide registries, we included all patients undergoing first-time TAVI between 2008 and 2017. To compare patient characteristics, the study population was stratified according to calendar year in the following groups: 2008–2009, 2010–2011, 2012–2013, 2014–2015, and 2016–2017. Results We identified 3,534 patients undergoing first-time TAVI. In 2008–2009, 180 patients underwent first-time TAVI compared with 1,417 patients in 2016–2017, resulting in a 687% increase in TAVI procedures performed. During the study period, the median age remained stable (2008–2009: Median age 82 year [25th–75th percentile: 78–85] vs. 2016–2017: Median age 81 years [25th–75th percentile: 76–85]; P-value: 0.06). The proportion of men undergoing first-time TAVI increased over the years (2008–2009: 49.4% vs 2016–2017: 54.9%; P-value for trend: <0.05), also the proportion with diabetes increased (2008–2009: 12.2% vs. 2016–2017: 19.3%; P-value for trend: <0.05). The proportion of patients with a history of stroke decreased over the years (2008–2009: 13.9% vs. 2016–2017: 12.1%; P-value for trend: <0.05). The same trend was seen in patients with a history of myocardial infarction (2008–2009: 24.4% vs. 2016–2017: 11.9%; P-value for trend: <0.05), ischaemic heart disease (2008–2009: 71.7% vs. 2016–2017: 29.4%; P-value for trend: <0.05), and heart failure (2008–2009: 45.6% vs. 2016–2017: 29.4%; P-value for trend: <0.05). Conclusions In this nationwide study, there was a marked increase in the utilization of TAVI in the years 2008–2017. Patients undergoing first-time TAVI had a decreasing comorbidity burden, while the age of the patients at first-time TAVI remained stable. Funding Acknowledgement Type of funding source: None

scholarly journals Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries

2021 ◽  
Vol 28 ◽  
pp. 107327482199686
Author(s):  
Najla A. Lakkis ◽  
Ola El-Kibbi ◽  
Mona H. Osman
Keyword(s):  
Colorectal Cancer ◽  
Cancer Incidence ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Steady Increase ◽  
P Value ◽  
Western Countries ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence ◽  
Males And Females

Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.

scholarly journals 146. Infective Endocarditis in South Korea: a 12-year Single-Center Experience of 419 Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S100-S101
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Jin young Ahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Logistic Regression Analysis

Abstract Background Infective endocarditis (IE) is a potentially lethal disease that has undergone constant changes in epidemiology and pathogen. Treatment of IE has become more complex with today’s myriad healthcare-associated factors as well as regional differences in causative organisms. Therefore, it is necessary to investigate the overall trends, microbiological features, clinical characteristics and outcomes of IE in South Korea. Methods We performed a retrospective cohort study of patients with the diagnosis of probable or definite IE according to the modified Duke Criteria admitted to a tertiary care center in South Korea between November 2005 and August 2017. Poisson log-linear regression was used to estimate time trends of IE incidence rate and mortality rate. Risk factors for in-hospital mortality were evaluated by multivariate logistic regression analysis including an interaction term. Results There were 419 IE patients (275 male vs. 144 female) during the study period. The median age of the patients was 56 years. The annual incidence rate of IE of our institution was significantly increased. (RR 1.05; 95% CI, 1.02–1.08; P = 0.006) The mortality rate showed trends toward down, but not statistically significant (P = 0.875). IE was related to a prosthetic valve in 15.0% and 21.7% patients developed IE during hospitalization. The mitral valve was the most commonly affected valve (61.3%). Causative microorganisms were identified in 309 patients (73.7%) and included streptococci (34.6%), followed by Staphylococcus aureus (15.8%) and enterococci (7.9%). The in-hospital mortality rate was 14.6%. Logistic regression analysis found aortic valve endocarditis (OR 3.18; P = 0.001), IE caused by staphylococcus aureus (OR 2.32; P = 0.026), a presence of central nervous system embolic complication (OR 1.98; P = 0.031), a high SOFA score (OR 1.22; P = 0.023) and a high Charlson’s comorbidity index (OR 1.11; P = 0.019) as predictors of in-hospital mortality. On the other hand, surgical intervention for IE was found to be a protective factor against mortality. (OR 0.25, P < 0.001) Conclusion Although IE has been increasing, the mortality rate has not yet reduced significantly. Studies on causative organisms of IE and risk factors for mortality are warranted in improving prognosis. Disclosures All authors: No reported disclosures.

Solitary Plasmacytoma Incidence, Mortality, and Survival Trends in the United States

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5629-5629
Author(s):  
Anirudh Bikmal ◽  
Lakshmi Radhakrishnan ◽  
Ajay K. Nooka
Keyword(s):  
Regression Analysis ◽  
Black Males ◽  
Survival Rates ◽  
The United States ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Study Cohort ◽  
Solitary Plasmacytoma ◽  
Incidence And Mortality ◽  
Adjusted Incidence

Abstract Background: The trends of incidence of solitary bone plasmacytoma (SBP) varied over time due to the changing definitions and the absence of clarity of the criteria. Prior studies have attempted to identify factors such as older age, gender, race as prognostic factors that influence survival of patients with SBP, but with changing paradigm of myeloma treatments, there is limited literature regarding the incidence, mortality and survival trends of SBP. Methods: We used the SEER registry from 1973-2009 to evaluate the incidence, mortality and survival trends in patients with SBP. The results were reported as crude incidence, mortality and survival rates. Two-sample t-tests, ANOVA as well regression analysis were used to examine correlation. Statistics were computed using the National Cancer Institute SEER*Stat software, version 8.2.0. and SAS software, version 9.4 (SAS Institute Inc, Cary, NC). Using the ICD-O-3 and morphologic codes of 9731/3 to identify cases, the final study cohort consisted of 2,734 cases. Trends were evaluated by the eras of diagnosis: 1973-1980, 1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2009. Age-adjusted incidence rates (IR), standard mortality rates (SMR), survival rate (SR) were expressed as new cases per 100,000 person-years, and age-adjusted to the 2000 US standard population. Results: The median age of diagnosis of SBP among blacks is 61 years (range, 21-91) compared to others: 60 years (range, 28-88) and whites: 66 years (20-97). The age adjusted incidence rates for black males is: 0.3 (95%CI 0.2, 0.3) followed by black females 0.2 (95%CI 0.1, 0.2) white males 0.2 (95%CI 0.2, 0.2) white females 0.1 (95%CI 0.1, 0.1). The trends in incidence and mortality rates are illustrated in table 1 with highest IR noted for black males during the era 2006-2009. The 5-year survival rates for both males (figure 1) and females (figure 2) seem to be trending down over the eras examined. Regression analysis suggests males and other race have increased odds of survival (HR = 0.829, p=0.0078; HR = 0.54 and p=0.0038, respectively). Conclusions: Similar to myeloma, black patients tend to be diagnosed with SBP younger and have increased incidence. The incidence rates seem to be increasing, highest among blacks males, more likely from increased awareness and diagnosis. The mortality and survival patterns are comparable to whites. Interestingly, while the 5-year survival for myeloma among all racial groups is improving this analysis shows a decreasing trend for SBP. This observation is more likely from including myeloma patients under the diagnosis of SBP over the period of study. Recently, the International Myeloma Working Group (IMWG) clarified the definition of SBP which will help in accurate diagnosis and ultimately can help in accurate representation of the survival trends. Table 1. Incidence and Mortality Rates across Study Eras (SEER-9), 1973-2009 Years White (IR) White (MR) Black (IR) Black (MR) Other (IR) Other (MR) Male 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1986-1990 0.1 (0.1, 0.2) 0.1 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 0.3 (0.1, 0.5) 0 (0, 0.2) 1991-1995 0.2 (0.1, 0.2) 0.1 (0.1, 0.2) 0.2 (0.1, 0.4) 0 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 1996-2000 0.2 (0.2, 0.3) 0.1 (0.1, 0.1) 0.3 (0.1, 0.5) 0.2 (0.1, 0.4) 0.2 (0.1, 0.4) 0.2 (0, 0.4) 2001-2005 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.5 (0.3, 0.7) 0.3 (0.1, 0.6) 0.2 (0, 0.2) 0 (0, 0.2) 2006-2009 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.7 (0.4, 1) 0.3 (0.1, 0.5) 0.1 (0, 0.2) 0.1 (0, 0.2) Female 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1986-1990 0.1 (0, 0.1) 0 (0, 0.1) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.2) 1991-1995 0.1 (0.1, 0.1) 0 (0, 0.1) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.1) 1996-2000 0.1 (0.1, 0.1) 0.1 (0.1, 0.1) 0.1 (0, 0.2) 0.1 (0, 0.2) 0.1 (0.2) 0 (0, 0.1) 2001-2005 0.2 (0.2, 0.2) 0.1 (0.1, 0.2) 0.3 (0.2, 0.4) 0.1 (0, 0.2) 0.1 (0, 0.2) 0 (0, 0.1) 2006-2009 0.2 (0.2, 0.3) 0.1 (0.1, 0.2) 0.3 (0.2, 0.5) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Disclosures Nooka: Spectrum Pharmaceuticals: Consultancy; Onyx Pharmaceuticals: Consultancy.

scholarly journals Burden of comorbid conditions in children and young people with juvenile idiopathic arthritis: a collaborative analysis of 3 JIA registries

Rheumatology ◽  
2021 ◽  
Author(s):  
Lianne Kearsley-Fleet ◽  
Jens Klotsche ◽  
Joeri W van Straalen ◽  
Wendy Costello ◽  
Gianfranco D’Angelo ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Incidence Rates ◽  
Varicella Vaccination ◽  
Patient Registries ◽  
Biologic Treatment ◽  
Systemic Jia ◽  
History Of ◽  
First Time

Abstract Objectives Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe/internationally—UK JIA Biologic Registers (BCRD/BSPAR-ETN), German biologic registers (BiKeR/JuMBO), multinational Pharmachild—to quantify the occurrence of selected comorbidities in patients with JIA. Methods Information on which data the registers collect were compared. Patient characteristics and levels of comorbidity were presented, focussing on four key conditions: uveitis, MAS, varicella, and history of tuberculosis. Incidence rates of these on MTX/biologic therapy were determined. Results 8066 patients were registered into the three JIA registers with similar history of the four comorbidities across the studies; however, varicella vaccination coverage was higher in Germany (56%) vs UK/Pharmachild (16%/13%). At final follow-up, prevalence of varicella infection was lower in Germany (15%) vs UK/Pharmachild (37%/50%). Prevalence of TB (0.1–1.8%) and uveitis (15–19%) was similar across all registers. The proportion of systemic-JIA patients who ever had MAS was lower in Germany (6%) vs UK (15%) and Pharmachild (17%). Conclusion This analysis is the first and largest to investigate the occurrence of four important comorbidities in three JIA registries in Europe and the role of anti-rheumatic drugs. Combined, these three registries represent one of the biggest collection of cases of JIA worldwide and offer a unique setting for future JIA outcome studies.

scholarly journals Temporal Trends in Sepsis Incidence and Mortality in Patients With Cancer in the US Population

2021 ◽  
Vol 30 (4) ◽  
pp. e71-e79
Author(s):  
Michael A. Liu ◽  
Brianna R. Bakow ◽  
Tzu-Chun Hsu ◽  
Jia-Yu Chen ◽  
Ke-Ying Su ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Hazard Ratio ◽  
Patients With Cancer ◽  
Incidence And Mortality ◽  
The Impact

Background Few population-based studies assess the impact of cancer on sepsis incidence and mortality. Objectives To evaluate epidemiological trends of sepsis in patients with cancer. Methods This retrospective cohort study included adults (≥20 years old) identified using sepsis-indicator International Classification of Diseases codes from the Nationwide Inpatient Sample database (2006-2014). A generalized linear model was used to trend incidence and mortality. Outcomes in patients with cancer and patients without cancer were compared using propensity score matching. Cox regression modeling was used to calculate hazard ratios for mortality rates. Results The study included 13 996 374 patients, 13.6% of whom had cancer. Gram-positive infections were most common, but the incidence of gram-negative infections increased at a greater rate. Compared with patients without cancer, those with cancer had significantly higher rates of lower respiratory tract (35.0% vs 31.6%), intra-abdominal (5.5% vs 4.6%), fungal (4.8% vs 2.9%), and anaerobic (1.2% vs 0.9%) infections. Sepsis incidence increased at a higher rate in patients with cancer than in those without cancer, but hospital mortality rates improved equally in both groups. After propensity score matching, hospital mortality was higher in patients with cancer than in those without cancer (hazard ratio, 1.25; 95% CI, 1.24-1.26). Of patients with sepsis and cancer, those with lung cancer had the lowest survival (hazard ratio, 1.65) compared with those with breast cancer, who had the highest survival. Conclusions Cancer patients are at high risk for sepsis and associated mortality. Research is needed to guide sepsis monitoring and prevention in patients with cancer.

scholarly journals 933Outbreak investigation of canine acquired idiopathic megaoesophagus in Australia, 2017-2018

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Michelle Renwick ◽  
Mark Stevenson ◽  
Anke Wiethoelter ◽  
Caroline Mansfield
Keyword(s):  
Management Practices ◽  
Case Control Study ◽  
Small Animal ◽  
Fold Increase ◽  
Companion Animal ◽  
Incidence Rates ◽  
Seasonal Patterns ◽  
First Time ◽  
Large Representative ◽  
Control Study

Abstract Background VetCompass Australia collects de-identified data from primary-care, companion animal practices across Australia, providing a large, representative database. VetCompass data were used to investigate an outbreak of megaoesophagus in dogs in Australia in 2017/2018. A specific proprietary dogfood was hypothesized as the cause. Methods The instantaneous daily hazard of megaoesophagus for the period January 2012 to February 2018 was plotted using survival analyses. A case-control study focused on dog demographics and management practices was performed to determine risk factors for megaoesophagus. Results There was a 7-fold increase in the incidence rate of canine megaoesophagus from 2014 (0.11 [95% CI 0.02 to 0.58] cases per 100,000 dogs per day) to 2018 (0.82 [95% CI 0.19 to 4.2] cases per 100,000 dogs per day) with greater numbers diagnosed during summer months of the year. The odds of feeding one specific dry dogfood was 325 (95% CI 64 to 1644) times greater for cases, compared with controls. Conclusions Evidence obtained through this study strongly suggests that a specific dogfood was responsible for most cases. The food was recalled prior to completion of this research. Further investigation into incidence rates and seasonal patterns of canine megaoesophagus are ongoing. Key messages Use of aggregated, de-identified data collected across small animal practices in Australia allowed identification of trends and seasonal patterns of a rare disease in dogs for the first time and provides opportunity for surveillance of this and other companion animal diseases.

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