Two waves of coeliac disease incidence in Sweden: a nationwide population-based cohort study from 1990 to 2015

ObjectivesTo assess the incidence of biopsy-verified coeliac disease (CD) in Sweden and examine the incidence of duodenal/jejunal biopsies with normal mucosa over time as a proxy for CD awareness and investigation.DesignNationwide population-based cohort study 1990–2015 based on biopsy reports indicating villous atrophy (VA) or normal mucosa in the duodenum/jejunum.ResultsWe identified 44 771 individuals (63% females) with a biopsy report specifying VA and 412 279 (62% females) with a biopsy report indicating normal mucosa (without a prior biopsy indicating VA). The median age at diagnosis of CD was 28 years. The mean age-standardised incidence rate during the study period was 19.0 per 100 000 person-years (95% CI 17.3 to 20.8). The incidence reached a peak in 1994 for both sexes and a second higher peak in 2002–2003 for females and in 2006 for males. The lifetime risk of developing CD was 1.8% (2.3% in females and 1.4% in males).Prior to 2015, there was a parallel rise in rates for biopsies showing normal duodenal/jejunal mucosa.ConclusionsIn Sweden, the incidence of CD increased until 2002–2003 in females and until 2006 in males. Since then, the incidence of CD has declined despite increasing duodenal/jejunal biopsies, suggesting that increased awareness and investigation are unlikely to elevate the incidence of the disease in Sweden. Across a lifetime, 1 in 44 females and 1 in 72 males are expected to be diagnosed with CD in Sweden, indicating a relatively high societal burden of disease.

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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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Gender Inequalities in Diagnostic Inertia around the Three Most Prevalent Cardiovascular Risk Studies: Protocol for a Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084054 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4054

Author(s):

Concepción Carratala-Munuera ◽

Adriana Lopez-Pineda ◽

Domingo Orozco-Beltran ◽

Jose A. Quesada ◽

Jose L. Alfonso-Sanchez ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Health Care ◽

Cohort Study ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Disease Incidence ◽

Population Based ◽

Gender Inequalities ◽

Primary Health Care Centers

Evidence shows that objectives for detecting and controlling cardiovascular risk factors are not being effectively met, and moreover, outcomes differ between men and women. This study will assess the gender-related differences in diagnostic inertia around the three most prevalent cardiovascular risk factors: dyslipidemia, arterial hypertension, and diabetes mellitus, and to evaluate the consequences on cardiovascular disease incidence. This is an epidemiological and cohort study. Eligible patients will be adults who presented to public primary health care centers in a Spanish region from 2008 to 2011, with hypertension, dyslipidemia, or/and diabetes and without cardiovascular disease. Participants’ electronic health records will be used to collect the study variables in a window of six months from inclusion. Diagnostic inertia of hypertension, dyslipidemia, and/or diabetes is defined as the registry of abnormal diagnostic parameters—but no diagnosis—on the person’s health record. The cohort will be followed from the date of inclusion until the end of 2019. Outcomes will be cardiovascular events, defined as hospital admission due to ischemic cardiopathy, stroke, and death from any cause. The results of this study could inform actions to rectify the structure, organization and training of health care teams in order to correct the inequality.

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End-Of-Life Discussions Reduce The Utilization of Life-Sustaining Treatments During The Last Three Months of Life in Cancer Patients : A Nationwide Population-Based Cohort Study

10.21203/rs.3.rs-634427/v1 ◽

2021 ◽

Author(s):

Shang-Yih Chan ◽

Yun-Ju Lai ◽

Yu-Yen Hsin Chen ◽

Shuo-Ju Chiang ◽

Yi-Fan Tsai ◽

...

Keyword(s):

Cohort Study ◽

Cardiopulmonary Resuscitation ◽

End Of Life ◽

Cancer Patients ◽

Medical Records ◽

Population Based ◽

Lower Likelihood ◽

The Mean ◽

The Impact ◽

To Receive

Abstract Purpose Studies to examine the impact of end-of-life (EOL) discussions on the utilization of life-sustaining treatments near death were limited and had inconsistent findings. This nationwide population-based cohort study determined the impact of EOL discussions on the utilization of life-sustaining treatments in the last three months of life in Taiwanese cancer patients. Methods This cohort study included adult cancer patients from 2012–2018, which were confirmed by pathohistological reports. Life-sustaining treatments during the last three months of life included cardiopulmonary resuscitation, intubation, and defibrillation. EOL discussions in cancer patients were confirmed by their medical records. Association of EOL discussions with utilization of life-sustaining treatments were assessed using multiple logistic regression. Results Of 381,207 patients, the mean age was 70.5 years and 19.4% of the subjects utilized life-sustaining treatments during the last three months of life. After adjusting for other covariates, those who underwent EOL discussions were less likely to receive life-sustaining treatments during the last three months of life compared to those who did not (Adjusted odds ratio [AOR]: 0.82; 95% confidence interval [CI]: 0.80–0.84). Considering the type of treatments, EOL discussions correlated with a lower likelihood of receiving cardiopulmonary resuscitation (AOR = 0.43, 95% CI: 0.41–0.45), endotracheal intubation (AOR = 0.87, 95%CI: 0.85–0.89), and defibrillation (AOR = 0.52, 95%CI: 0.48–0.57). Conclusion EOL discussions correlated with a lower utilization of life-sustaining treatments during the last three months of life among cancer patients. Our study supports the importance of providing these discussions to cancer patients to better align care with preferences during the EOL treatment.

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Road proximity, air pollution, noise, green space and neurologic disease incidence: a population-based cohort study

Environmental Health ◽

10.1186/s12940-020-0565-4 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 8

Author(s):

Weiran Yuchi ◽

Hind Sbihi ◽

Hugh Davies ◽

Lillian Tamburic ◽

Michael Brauer

Keyword(s):

Air Pollution ◽

Cohort Study ◽

Green Space ◽

Disease Incidence ◽

Population Based ◽

Neurologic Disease

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Risk of Congenital Anomalies in Children of Mothers with Coeliac Disease: A United Kingdom Population-based Cohort Study.

International Journal of Epidemiology ◽

10.1093/ije/dyv097.284 ◽

2015 ◽

Vol 44 (suppl_1) ◽

pp. i76-i76

Author(s):

L. Ban ◽

J. West ◽

A. Abdul Sultan ◽

N. N. Dhalwani ◽

J. F. Ludvigsson ◽

...

Keyword(s):

Cohort Study ◽

United Kingdom ◽

Coeliac Disease ◽

Congenital Anomalies ◽

Population Based ◽

United Kingdom Population

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Coeliac disease in the father and risk of adverse pregnancy outcome: A population-based cohort study

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520510024124 ◽

2006 ◽

Vol 41 (2) ◽

pp. 178-185 ◽

Cited By ~ 10

Author(s):

Jonas F. Ludvigsson ◽

Scott M. Montgomery ◽

Anders Ekbom

Keyword(s):

Cohort Study ◽

Coeliac Disease ◽

Pregnancy Outcome ◽

Adverse Pregnancy Outcome ◽

Population Based ◽

Adverse Pregnancy

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Limited risks of major congenital anomalies in children of mothers with coeliac disease: a population-based cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.13102 ◽

2014 ◽

Vol 122 (13) ◽

pp. 1833-1841 ◽

Cited By ~ 2

Author(s):

L Ban ◽

J West ◽

A Abdul Sultan ◽

NN Dhalwani ◽

JF Ludvigsson ◽

...

Keyword(s):

Cohort Study ◽

Coeliac Disease ◽

Congenital Anomalies ◽

Population Based

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Abstract 017: Meal Intervals And Weight Trajectories In Adults Using The Daily24 Mobile Application: A Prospective Cohort Study

Circulation ◽

10.1161/circ.143.suppl_1.017 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Di Zhao ◽

Thomas Woolf ◽

Lindsay Martin ◽

Eliseo Guallar ◽

Harold Lehmann ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Weight Change ◽

Prospective Cohort ◽

Mobile Application ◽

Population Based ◽

Randomized Controlled Studies ◽

The Mean ◽

Weight Decrease ◽

Weight Trajectories

Background: Small pilot and randomized controlled studies suggest that time-restricted feeding may decrease body weight. However, the role of meal timing and intervals, measured using mobile applications, has not been examined in larger population-based studies. The objective of this study is to evaluate the association between meal intervals and weight trajectories among adults from a population-based clinical cohort. Methods: Multi-site prospective cohort study of adults recruited from three health systems. Over the 6-month study period, 547 participants downloaded and used the Daily24 mobile application to record the timing of meals and sleep for at least one day. Intervals were calculated as the average of all available daily entries for each participant. We obtained information on weight and comorbidities at each outpatient visit from electronic health records available for up to 10 years prior to until 10 months after baseline. We used mixed linear regression to model weight trajectories. Results: The mean (SD) baseline (at consent) age was 51.1 (15.0) years and body mass index (BMI) 30.8 (7.8) kg/m 2 ; 77.9% were women and 77.5% were White. Average time in the cohort was 5.9 years prior to and 0.3 years after baseline. The mean interval from first to last meal was 11.5 (2.3) hours. The associations between meal intervals and weight trajectories are shown in the Table . The number of meals per day was positively associated with weight change before baseline, and number of snacks and drinks per day was inversely associated with weight change after baseline. Each additional occasion of snacks and drinks was associated with a 3.20 kg weight decrease (95% CI 1.41 to 4.99). None of the other associations were statistically significant. Conclusions: Number of daily meals was positively associated with weight change in previous periods, while the number of daily snacks and drinks was inversely associated with weight trajectory. The intervals from first to last meal was not associated with weight change.

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