scholarly journals Increasing Incidence in Relapsing-Remitting MS and High Rates among Young Women in Finland: A Thirty-Year Follow-Up

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Marja-Liisa Sumelahti ◽  
Markus H. A. Holmberg ◽  
Annukka Murtonen ◽  
Heini Huhtala ◽  
Irina Elovaara

Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland.Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test.Results. 1419 (89%) RRMS and 198 (11%) PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M) from 4,2/105(F/M 1.9) to 9,7 (2.3), while that of PPMS decreased from 1,2 (1.6) to 0,7 (1.2). The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region.Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.

2002 ◽  
Vol 8 (2) ◽  
pp. 115-118 ◽  
Author(s):  
A Ghezzi ◽  
C Pozzilli ◽  
M Liguori ◽  
M G Marrosu ◽  
N Milani ◽  
...  

Fifty-four subjects (36 females and 18 males) affected by clinically definite multiple sclerosis (MS) and with onset of the disease at 15 years of age or before were prospectively studied in five Italian MS centres. Female/male ratio was 4.7 in subjects with age ≥12 years, suggesting a role of hormonal changes in triggering MS onset. The mean follow-up duration was 10.9-5.6 years. The functional systems more frequently involved at onset were the pyramidal and brainstem (both in 28% of cases). The onset was monosymptomatic in 31 subjects (57%). The course was relapsing-remitting in 39 subjects (72%) and relapsing-progressive in 15 (28%). Disability was assessed by the Expanded Disability Status Scale (EDSS): the mean score after 8 years of follow up was 3.5 (-2.5). The score was <4 in 68% of cases, between 4 and 6 in 8% of cases, > 6 in 24% of cases. Disability after 8 years was highly predicted by disability in the first year (p=0.008). There was a tendency to a worse prognosis in relation to the number of relapses in the first 2 years (p=0.08). The outcome was not influenced by the characteristics of symptoms at onset, age and gender.


2020 ◽  
Vol 40 (11) ◽  
pp. 2764-2775
Author(s):  
Diana Maria Ronderos Botero ◽  
Alaa Mabrouk Salem Omar ◽  
Haozhe Keith Sun ◽  
Nikhitha Mantri ◽  
Ked Fortuzi ◽  
...  

Objective: Coronavirus disease 2019 (COVID-19) can infect patients in any age group including those with no comorbid conditions. Understanding the demographic, clinical, and laboratory characteristics of these patients is important toward developing successful treatment strategies. Approach and Results: In a retrospective study design, consecutive patients without baseline comorbidities hospitalized with confirmed COVID-19 were included. Patients were subdivided into ≤55 and >55 years of age. Predictors of in-hospital mortality or mechanical ventilation were analyzed in this patient population, as well as subgroups. Stable parameters in overall and subgroup models were used to construct a cluster model for phenotyping of patients. Of 1207 COVID-19–positive patients, 157 met the study criteria (80≤55 and 77>55 years of age). Most reliable predictors of outcomes overall and in subgroups were age, initial and follow-up d -dimer, and LDH (lactate dehydrogenase) levels. Their predictive cutoff values were used to construct a cluster model that produced 3 main clusters. Cluster 1 was a low-risk cluster and was characterized by younger patients who had low thrombotic and inflammatory features. Cluster 2 was intermediate risk that also consisted of younger population that had moderate level of thrombosis, higher inflammatory cells, and inflammatory markers. Cluster 3 was a high-risk cluster that had the most aggressive thrombotic and inflammatory feature. Conclusions: In healthy patient population, COVID-19 remains significantly associated with morbidity and mortality. While age remains the most important predictor of in-hospital outcomes, thromboinflammatory interactions are also associated with worse clinical outcomes regardless of age in healthy patients.


2021 ◽  
Vol 27 ◽  
Author(s):  
Lilla Tamási ◽  
Krisztián Horváth ◽  
Zoltán Kiss ◽  
Krisztina Bogos ◽  
Gyula Ostoros ◽  
...  

Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database.Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded.Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p &lt; 0.0001) among the 70–79 age group. We found 2–11% decrease in male incidence rate at most age groups, while a significant 1–3% increase was observed in older females (&gt;60) annually during the study period.Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.


Medicina ◽  
2009 ◽  
Vol 45 (5) ◽  
pp. 412
Author(s):  
Vitalija Samerdokienė ◽  
Vydmantas Atkočius ◽  
Konstantinas Valuckas

Objectives. To describe the cohort of Lithuanian medical radiation workers and to estimate the risk of cancer during 1978–2004. Methods. Analysis of cancer risk evaluation was done using the retrospective cohort method, an indirect standardization. The observed numbers of cancer cases were obtained from the National Cancer Registry. The expected numbers were based on the age- and gender-specific incidence rates for the general Lithuanian population in 5-year periods. The standardized incidence ratios and 95% confidence intervals (assuming that the incidence of cancer follows the Poisson distribution) were calculated. Results. During the follow-up of 1978–2004, 159 cases of cancer were observed. There was no increased overall cancer risk in men (SIR=0.92, 95% CI=0.62–1.33, based on 29 cases) and women (SIR=0.97, 95% CI=0.81–1.15, based on 130 cases). The risk of leukemia among men and women was insignificantly increased. Conclusions. During the follow-up period, the overall cancer risk among medical radiation workers was the same as in the general population of Lithuania


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Rammos ◽  
O Petrikhovich ◽  
A Mahabadi ◽  
M Steinmetz ◽  
J Lortz ◽  
...  

Abstract Background Cardiovascular diseases are the leading causes of death in the industrialized world. In addition to coronary heart disease, PAD defines morbidity and is associated with increased mortality. Guideline-recommended therapy and specialized ambulatory care is essential for optimal treatment. Knowledge of the treatment structures, contact with dedicated specialists and pharmacotherapy in the outpatient area are essential for improving treatment, reducing symptoms and finally improve mortality in this high-risk population. Methods The study is based on the ambulatory claims data of the panel doctors services according to § 295 SGB V and drug prescription data according to § 300 SGB V. The prevalence of PAD in Germany (medical diagnoses of PAD ICD I70.2–9) was analyzed by age and gender-specific characteristics with a timeframe of 10 years (2009–2018). In addition, the current ambulatory care structure was examined subdivided by vascular specialist (vascular surgeons or angiologists) and primary care physicians (internal medicine or general practitioners). Additionally, the prescription of guideline-recommended pharmacotherapy like statins and antiplatelet inhibitors was analyzed for the years 2009–2016. Results An increase of PAD diagnosis was observed with a maximum in 2018 with 2.280.000 patients in Germany. The rise of PAD patients strongly correlates with increased age (age group 50–59: 243.000, age group 60–69: 533.000, age group 70–79: 735.000, age group 75–79: 438.000, age group 80–89: 710.000) and more commonly affects males (55%) than females (45%). Access to vascular specialist was low for all age groups with only 11% of patients receiving care from vascular surgeons and only 9% from angiologists. However, 99% received care by a primary care physician. The prescription of lipid-lowering drugs and platelet aggregation inhibitors in the current analysis period from 2009–2016 is insufficient, with only 46% receiving statins and 29% receiving antiplatelets and 15% oral anticoagulation, Conclusion There are relevant differences in age and gender-specific prevalence of PAD in Germany. In addition to the regular care provided by primary care physicians, PAD patients are in need for specialized vascular care. Guideline recommended prescriptions are alarmingly low in PAD patients. There is a clear need to improve the treatment algorithms in the high-risk PAD population. Funding Acknowledgement Type of funding source: None


Author(s):  
Annina Ropponen ◽  
Mo Wang ◽  
Jurgita Narusyte ◽  
Karri Silventoinen ◽  
Petri Böckerman ◽  
...  

Background: A unified or consensus definition of “sustainable working life” remains lacking, although studies investigating risk factors for labour market exit are numerous. In this study, we aimed (1) to update the information and to explore a definition of “sustainable working life” via a systematic literature review and (2) to describe the working life trajectories via the prevalence of sickness absence (SA), disability pension (DP), and unemployment in a Swedish twin cohort to provide a sample overview in our Sustainable Working Life-project. Methods: A systematic literature review was conducted to explore the studies with the search phrase “sustainable working life” in PubMed, PsycInfo, and the Web of Science Database of Social Sciences in January 2021, resulting in a total of 51 references. A qualitative synthesis was performed for the definitions and the measures of “sustainable working life.” Based on the Swedish Twin project Of Disability pension and Sickness absence (STODS), the current dataset to address sustainable working life includes 108 280 twin individuals born between 1925 and 1990. Comprehensive register data until 2016 for unemployment, SA and DP were linked to all individuals. Using STODS, we analysed the annual prevalence of SA, DP, and unemployment as working life trajectories over time across education and age groups. Results: The reviewed 16 full articles described several distinct definitions for sustainable working life between 2007 and 2020 from various perspectives, i.e., considering workplaces or employees, the individual, organizational or enterprise level, and the society level. The definition of “sustainable working life” appearing most often was the swAge-model including a broad range of factors, e.g., health, physical/mental/psychosocial work environment, work motivation/satisfaction, and the family situation and leisure activities. Our dataset comprised of 81%–94% of individuals who did not meet SA, DP, or unemployment during the follow-up in 1994–2016, being indicative for “sustainable working life.” The annual prevalence across years had a decreasing trend of unemployment over time, whereas the prevalence of SA had more variation, with DP being rather stable. Both unemployment and DP had the highest prevalence among those with a lower level of education, whereas in SA, the differences in prevalence between education levels were minor. Unemployment was highest across the years in the youngest age group (18–27 years), the age group differences for SA were minor, and for DP, the oldest age group (58–65 years) had the highest prevalence. Conclusions: No consensus exists for a “sustainable working life,” hence meriting further studies, and we intend to contribute by utilising the STODS database for the Sustainable Working Life project. In the upcoming studies, the existing knowledge of available definitions and frameworks will be utilised. The dataset containing both register data and self-reports enables detailed follow-up for labour market participation for sustainable working life.


Author(s):  
Deepak Kumar ◽  
Chaman Verma ◽  
Sanjay Dahiya ◽  
Pradeep Kumar Singh ◽  
Maria Simona Raboaca

Around the world, every year, about 17 million people death cause happen due to CardioVascular Diseases (CVD). As per clinical records, primarily sufferers exhibit myocardial infarctions and Heart Failures (HF). Creatinine is a Musculo - skeletal waste product. The kidneys filter creatinine from the blood and excrete it through the urine in a healthy body. High creatinine levels can suggest renal problems. Elevated Serum Creatinine (SC) has been well established in the HF. Patients&rsquo; electronic medical records can be used to quantify symptoms and other related clinical laboratory test values, which would then be utilized to direct biostatistics exploration to uncover patterns and associations that doctors would otherwise miss. The latest American Heart Association guidelines for 1500 mg/d sodium tend to be sufficiently relevant for patients with stage A and B with HF. In this article, we used a dataset of the year 2015 of heart patients records of 299 patients. The present paper used the data analytic and statistical tools to verify the significant differences between alive and dead patients&rsquo; SC and Serum Sodium (SS). It also demonstrates the impact of significant features on abnormal SC and SS on the Survival-Status levels. The Age-Group feature, which is derived from age attribute and, Ejection Fraction (EF), anemia, platelets, Creatinine Phosphokinase (CPK), Blood-Pressure (BP), gender, diabetes, and smoking-status were utilized to determine the potential contributing features to mortality with Cox regression model. The Kaplan Meier plot was used to investigate the overall pattern of survival concerning age-group. During pre-processing of the dataset, Age and SS were removed due to multicollinear features during performing machine learning algorithms experiments. This paper also predicted patients&rsquo; survival, age group, and gender using supervised machine learning classifiers. Detection of significant features would help in making informed decisions to balance the lifestyle of heart patients. The author revealed that the patient&rsquo;s follow-up months, as well as SC, EF, CPK, and platelets, are sufficient key features to predict heart patient survival using Random Forest (RF) stratified 10-fold CV method with accuracy (96%) with 5% Standard Deviation (SD) from medical records dataset. We identified the age-group and gender of the patient, and the RF model outperformed others with the best accuracy 96% and 94% in both cases having 11% SD. Also, prominent features such as CPK, SC, follow-up month, platelets, and ejection were found to be significant factors in predicting the patient&rsquo;s age-group. Smoking habits, CPK, platelets, follow-up month, and SC of each patient were discovered to be significant predictors of patient gender. The hypothetical study proved that SC and SS making substantial differences in the survival of patients (p &amp;lt; 0.05) and failed to reject that anemia, diabetes, and BP making a significant impact on the creatinine and sodium of each patient (p &amp;gt; 0.05). With &chi;2(1) = 8.565, the Kaplan Meier plot revealed that mortality was high in the extremely elder age-group. The finding has possible effects on clinical practice and becomes a new medical support system when predicting whether a patient can survive a heart attack or not. The doctor should primarily concentrate on follow-up month, SC and EF, CPK, and platelet count since the aim is to understand whether a patient survives after HF.


2004 ◽  
Vol 132 (1) ◽  
pp. 1-5 ◽  
Author(s):  
D. M. FLEMING ◽  
K. W. CROSS ◽  
W. A. COBB ◽  
R. S. CHAPMAN

We investigated age- and gender-specific incidence of shingles reported in a large sentinel practice network monitoring a defined population over the years 1994–2001. In total, 5915 male and 8617 female incident cases were studied. For each age group, we calculated the relative risk of females to males presenting with shingles. Incidence rates of chickenpox and herpes simplex were examined similarly. Shingles incidence was greater in females in each age group (except for 15–24 years). Relative risks (female to male) were greatest in age groups 45–64 years (1·48) and 0–14 years (1·43). There were no gender differences in the incidence of chickenpox except in the 15–24 years age group (female excess): for herpes simplex there were female excesses in all age groups. Gender-specific age-standardized incidence rates of shingles were calculated for each year and showed a consistent female excess in each of the 8 years (average annual excess 28%).


Sign in / Sign up

Export Citation Format

Share Document