P1804DIALYSIS AFTERKIDNEY GRAFT LOST: DATA OF THE ITALIAN REGISTRY OF PEDIATRIC DIALYSIS

Abstract Background and Aims An increasing number of patients are returning to dialysis after kidney allograft failure (KAF). These patients are at higher risk of complications and mortality compared with incident ESKD patients.. In the pediatric population these data are missing and outcomes have never been investigated before in a nationally representative sample. The aim of this study was to describe the characteristics and hard outcomes of children entering dialysis after KAF in a large population of pediatric dialysis patients. Method We retrospectively reviewed the files of patients receiving chronic dialysis at <18 years, recorded from January 1990 to June 2019 by the Italian Registry of Pediatric Chronic Dialysis (IRPCD), a nationwide population-based chronic dialysis network involving all 12 Italian pediatric dialysis centers. We identified 126 patients who had returned to dialysis after KAF. All patients were followed from (re)initiation of dialysis until death, re-transplantation or loss to follow-up. Multivariable regression and survival analysis were used to evaluate factors involved in the choice of dialysis modality and patient outcomes. Results After KAF, 45 (35.7 %) patients were treated with PD and 81 (64,3%) with HD. Prior to kidney transplantation (Ktx), 74 (58.7%) were on PD, 45 (35.7%) on HD, and 7 on conservative care (5.5%). Compared with PD patients, those on HD were older (median age of 14.8 years [IQR 11.4-17.5] vs. 10.8 [IQR 2-6.5] vs.; p=0.002), had a longer transplant vintage ([55.2 months [13.2-100.3]) vs. 33 [5.1-82.2], and reentered dialysis in more recent calendar years (2013 [2007-2017] vs. 2004 [2001-2009]). Significant predictors for being treated with PD after KAF were a younger age at dialysis start (OR 0.83 per year increase [95%CI 0.72-0.94]) and a history of PD use before Ktx (OR 12.74 [2.2-74.6]). Patients returning to dialysis in more recent eras (OR 0.87 per year increase [0.81-0.94]) and those who were treated with more than one dialysis modality before Ktx (OR 0.15 for being treated with PD [0.04-0.63]) were more likely to be initiated on HD. Over the observation period, 6 PD (13.6%) and 3 HD (4.2%) patients died. After adjustment for several covariates, patients on PD exhibited an increased risk for mortality compared with HD (HR 4.65 [1.12-19.30], while the difference for modality failure and access to renal transplantation did not reach statistical significance (Fig.1) Conclusion Patients returning to dialysis after KAF in more recent years are more likely to be initiated on HD rather than PD. According to our registry data, the use of PD is associated with a lower survival among patients initiating dialysis after KAF. Fig.1 Cumulative incidences for the competing events, death, transplant and other techniques (solid line: PD, dash line: HD)

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Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

Archives of Dermatological Research ◽

10.1007/s00403-021-02211-4 ◽

2021 ◽

Author(s):

Khalaf Kridin ◽

Jennifer E. Hundt ◽

Ralf J. Ludwig ◽

Kyle T. Amber ◽

Dana Tzur Bitan ◽

...

Keyword(s):

Bullous Pemphigoid ◽

Statistical Significance ◽

Large Population ◽

Underlying Mechanism ◽

Population Based ◽

Control Subjects ◽

Increased Risk ◽

Bidirectional Association ◽

History Of ◽

Incident Cases

AbstractThe association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

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Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽

10.3390/cancers13092254 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2254

Author(s):

Matteo Franchi ◽

Roberta Tritto ◽

Luigi Tarantini ◽

Alessandro Navazio ◽

Giovanni Corrao

Keyword(s):

Breast Cancer ◽

Heart Failure ◽

Adjuvant Therapy ◽

Large Population ◽

Positive Association ◽

Population Based ◽

Study Cohort ◽

Increased Risk ◽

Post Menopausal ◽

New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

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Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort

International Journal of Cancer ◽

10.1002/ijc.21993 ◽

2006 ◽

Vol 119 (6) ◽

pp. 1508-1510 ◽

Cited By ~ 13

Author(s):

Christian C. Abnet ◽

Jin-Hu Fan ◽

Farin Kamangar ◽

Xiu-Di Sun ◽

Philip R. Taylor ◽

...

Keyword(s):

Large Population ◽

Population Based ◽

Increased Risk ◽

Chinese Cohort

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Increased risk of cancer in chronic dialysis patients: a population-based cohort study in Taiwan

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfr464 ◽

2011 ◽

Vol 27 (4) ◽

pp. 1585-1590 ◽

Cited By ~ 66

Author(s):

H.-F. Lin ◽

Y.-H. Li ◽

C.-H. Wang ◽

C.-L. Chou ◽

D.-J. Kuo ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Chronic Dialysis ◽

Dialysis Patients ◽

Increased Risk ◽

Risk Of Cancer

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Coeliac disease and invasive pneumococcal disease: a population-based cohort study

Epidemiology and Infection ◽

10.1017/s0950268816003204 ◽

2017 ◽

Vol 145 (6) ◽

pp. 1203-1209 ◽

Cited By ~ 9

Author(s):

A. RÖCKERT TJERNBERG ◽

J. BONNEDAHL ◽

M. INGHAMMAR ◽

A. EGESTEN ◽

G. KAHLMETER ◽

...

Keyword(s):

Cohort Study ◽

Coeliac Disease ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Cox Regression ◽

Statistical Significance ◽

Pneumococcal Vaccination ◽

Population Based ◽

Increased Risk ◽

Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

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Sleep problems increase the risk of musculoskeletal pain in boys but not girls: a prospective cohort study

European Journal of Pediatrics ◽

10.1007/s00431-020-03667-8 ◽

2020 ◽

Vol 179 (11) ◽

pp. 1711-1719

Author(s):

Alessandro Andreucci ◽

Paul Campbell ◽

Lisa K Mundy ◽

Susan M Sawyer ◽

Silja Kosola ◽

...

Keyword(s):

Cohort Study ◽

Musculoskeletal Pain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Sleep Problems ◽

Large Population ◽

Population Based ◽

School Aged Children ◽

Increased Risk ◽

One Year

Abstract Adults with sleep problems are at higher risk for onset of musculoskeletal pain, but the evidence is less clear for children. This prospective cohort study investigated whether children with sleep problems are at higher risk for onset of musculoskeletal pain and explored whether sex is a modifier of this association. In a prospective cohort study of Australian schoolchildren (n = 1239, mean age 9 years), the associations between sleep problems at baseline and new onset of both musculoskeletal pain and persistent musculoskeletal pain (pain lasting > 3 months) 1 year later were investigated using logistic regression. The potential modifying effect of sex was also assessed. One-year incidence proportion for musculoskeletal pain onset is 43% and 7% for persistent musculoskeletal pain. Sleep problems were associated with musculoskeletal pain onset and persistent musculoskeletal pain onset in boys, odds ratio 2.80 (95% CI 1.39, 5.62) and OR 3.70 (1.30, 10.54), respectively, but not girls OR 0.58 (0.28, 1.19) and OR 1.43 (0.41, 4.95), respectively. Conclusions: Rates of musculoskeletal pain are high in children. Boys with sleep problems are at greater risk of onset of musculoskeletal pain, but girls do not appear to have higher risk. Consideration of sleep health may help prevent persistent musculoskeletal pain in children. What is Known:• Sleep problems are associated with the onset of musculoskeletal pain in adults.• It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present also in children and if sex plays a role in this association. What is New:• This is the first large population-based study that has prospectively investigated the relationship between sleep problems and onset of musculoskeletal pain in school-aged children.• Children, especially boys with sleep problems, were at increased risk for the development of persistent musculoskeletal pain.

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Blood Neutrophil Counts are Associated with Exacerbation Frequency and Mortality in COPD

10.21203/rs.3.rs-16064/v1 ◽

2020 ◽

Author(s):

Mike Lonergan ◽

Alison J Dicker ◽

Megan L Crichton ◽

Holly R Keir ◽

Melissa K. Van Dyke ◽

...

Keyword(s):

Large Population ◽

Real Life ◽

Population Based ◽

Blood Eosinophil ◽

Blood Neutrophil ◽

Disease Heterogeneity ◽

Disease Information ◽

Increased Risk ◽

Eosinophil Counts

Abstract Background Identifying patients with COPD at increased risk of poor outcomes is challenging due to disease heterogeneity. Potential biomarkers need to be readily available in real-life clinical practice. Blood eosinophil counts are widely studied but few studies have examined the prognostic value of blood neutrophil counts (BNC). Methods In a large population-based COPD registry in the East of Scotland (TARDIS: Tayside Allergic and Respiratory Disease Information System), BNC were compared to measures of disease severity and mortality over up to 15 years follow-up. Potential mechanisms of disease modification by BNC were explored in a nested microbiome substudy. Results 178120 neutrophil counts were obtained from 7220 people (mean follow up 9 years) during stable disease periods. Median BNC was 5200cells/µL (IQR 4000-7000cells/µL). Mortality rates among those 34% with elevated BNCs (defined as 6000-15000cells/µL) at the study start were 80% higher (14.0/100 person years v 7.8/100py, P<0.001) than those with BNC in the normal range (2000-6000cells/µL). People with elevated BNC were more likely to be classified as GOLD D (46% v 33% P<0.001), have more exacerbations (mean 2.3 v 1.3/year, P<0.001), and were more likely to have severe exacerbations (13% vs. 5%, P<0.001) in the following year. Eosinophil counts were much less predictive of these outcomes. In a sub-cohort (N=276), patients with elevated BNC had increased relative abundance of Proteobacteria and reduced microbiome diversity. Conclusion High BNC may provide a useful indicator of risk of exacerbations and mortality in COPD patients.

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Effect of IBD medications on COVID-19 outcomes: results from an international registry

Gut ◽

10.1136/gutjnl-2020-322539 ◽

2020 ◽

pp. gutjnl-2020-322539 ◽

Cited By ~ 3

Author(s):

Ryan C Ungaro ◽

Erica J Brenner ◽

Richard B Gearry ◽

Gilaad G Kaplan ◽

Michele Kissous-Hunt ◽

...

Keyword(s):

Combination Therapy ◽

Reference Group ◽

Large Population ◽

Random Effect ◽

Estimating Equation ◽

Population Based ◽

Interleukin 12 ◽

International Registry ◽

Increased Risk ◽

Tnf Antagonist

ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a large, international registry created to monitor outcomes of IBD patients with confirmed COVID-19. We used multivariable regression with a generalised estimating equation accounting for country as a random effect to analyse the association of different medication classes with severe COVID-19, defined as intensive care unit admission, ventilator use and/or death.Results1439 cases from 47 countries were included (mean age 44.1 years, 51.4% men) of whom 112 patients (7.8%) had severe COVID-19. Compared with tumour necrosis factor (TNF) antagonist monotherapy, thiopurine monotherapy (adjusted OR (aOR) 4.08, 95% CI 1.73 to 9.61) and combination therapy with TNF antagonist and thiopurine (aOR 4.01, 95% CI 1.65 to 9.78) were associated with an increased risk of severe COVID-19. Any mesalamine/sulfasalazine compared with no mesalamine/sulfasalazine use was associated with an increased risk (aOR 1.70, 95% CI 1.26 to 2.29). This risk estimate increased when using TNF antagonist monotherapy as a reference group (aOR 3.52, 95% CI 1.93 to 6.45). Interleukin-12/23 and integrin antagonists were not associated with significantly different risk than TNF antagonist monotherapy (aOR 0.98, 95% CI 0.12 to 8.06 and aOR 2.42, 95% CI 0.59 to 9.96, respectively).ConclusionCombination therapy and thiopurines may be associated with an increased risk of severe COVID-19. No significant differences were observed when comparing classes of biologicals. These findings warrant confirmation in large population-based cohorts.MKH should be changed to MDK for co-last author line

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SURVIVAL ADVANTAGE OF APOE2

Innovation in Aging ◽

10.1093/geroni/igz038.2313 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S621-S621

Author(s):

Sudha Seshadri

Keyword(s):

Lower Risk ◽

Large Population ◽

Population Based ◽

European Ancestry ◽

Aggregated Data ◽

Risk Of Death ◽

Apoe Ε4 ◽

Increased Risk ◽

Ε4 Allele

Abstract Apolipoprotein E is a glycoprotein mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has been associated with higher risk of Alzheimer’s disease and of mortality, but the effect of the less prevalent APOE-ε2 on survival remains elusive. We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six large population-based cohorts to determine the association of APOE-ε2, with survival in the general population. During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90-0.99; P=1.1*10-2), whereas APOE-ε4 carriers were at increased risk (HR 1.17,1.12-1.21; P=2.8*10-16). Risk was lowest for homozygous APOE-ε2 (HR 0.89,0.74-1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37-1.70). Results did not differ by sex. The association was unaltered after adjustment for baseline LDL or cardiovascular disease. Larger, multiethnic collaborations are ongoing.

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Intrauterine Growth and Cerebral Palsy in Twins: A European Multicenter Study

Twin Research and Human Genetics ◽

10.1375/twin.9.3.460 ◽

2006 ◽

Vol 9 (3) ◽

pp. 460-466 ◽

Cited By ~ 14

Author(s):

Svetlana V. Glinianaia ◽

Stephen Jarvis ◽

Monica Topp ◽

Pascale Guillem ◽

Mary J. Platt ◽

...

Keyword(s):

Cerebral Palsy ◽

Statistical Significance ◽

A Priori ◽

Population Based ◽

Aggregated Data ◽

Growth Standards ◽

Intrauterine Growth ◽

Increased Risk ◽

Multi Center Study ◽

Rate Ratios

AbstractPopulation-based studies in twins have been of insufficient size to explore the relationship between risk of cerebral palsy and intrauterine growth. Earlier studies in singletons have suggested an optimum size at birth for minimum cerebral palsy risk between the 75th and 90th percentiles of weight for gestational age. We aggregated data from nine European cerebral palsy registers for 1976 to 1990. Using sex-specific fetal growth standards for twins, a z score of weight-for-gestation was derived for each of the 373 twin cases. The rates of cerebral palsy in each z-score band were compared to the rate in the a priori reference band of 0.67 to less than 1.28 (equivalent to the 75th to less than 90th percentiles). In twins born at 32 weeks' gestation or more (92% of all twins), cerebral palsy rates were higher for both light and heavy-forgestation babies compared to an optimum (i.e., minimum risk) in the reference band. However, the rate ratio for heavy babies (90th percentile or greater) did not reach conventional (95% confidence intervals [CI]) statistical significance (rate ratios = 1.76; 90% CI 1.02–3.03). For twins born at less than 32 weeks, the significantly higher risk for cerebral palsy was observed consistently in all z-score bands less than average compared to the reference band. This multi-center study demonstrates that for twins born at 32 weeks' gestation or more, an increased risk of cerebral palsy is associated with deviations from optimal intrauterine growth at about 1 standard deviation above mean weight, as was earlier reported for singletons. For twins born at less than 32 weeks' gestation, this pattern is only demonstrable for babies weighing below the optimum weight-for-gestation.

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