Past Methylphenidate Exposure and Stress Fractures in Combat Soldiers: A Case-Control Study

2017 ◽  
Vol 46 (3) ◽  
pp. 728-733 ◽  
Author(s):  
Haggai Schermann ◽  
Ilan Shalom Ben-Ami ◽  
Adrian Tudor ◽  
Eyal Amar ◽  
Ehud Rath ◽  
...  
Keyword(s):  
Stress Fracture ◽  
Clinical Effect ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Case Control ◽  
Stress Fractures ◽  
Attributable Fraction ◽  
Place Of Birth ◽  
Control Study ◽  
Combat Soldiers

Background: Previous research has revealed decreased bone mineral density (BMD) among children and adolescents who receive methylphenidate (MP) treatment for attention deficit hyperactivity disorder (ADHD). These findings have major clinical implications given that the prevalence of medication-treated ADHD is on the rise worldwide. We decided to investigate the clinical effect of MP exposure on the incidence of stress fractures, for which a low BMD is a risk factor. Hypothesis: Exposure to MP is a risk factor for stress fractures. Study Design: Case-control study; Level of evidence, 3. Methods: This is a case-control study of combat soldiers who served in the military for 3 years between 2005 and 2015. The case group included 2400 soldiers with at least 1 stress fracture diagnosed by a bone scan. The control group comprised 6187 combat soldiers without a diagnosis of a stress fracture. The use of MP was determined by an automated text search of medical records and manual sorting of the results. Other study variables included age; sex; weight; height; body mass index (BMI); place of birth; and characterization of fractures by location, side, and grade. Odds ratios of stress fractures, the attributable proportion among the exposed, and the population attributable fraction were calculated using standard contingency tables. Logistic regression was fitted after adjusting for covariates. Results: The previous use of MP was associated with a higher risk of stress fractures (odds ratio, 1.15 [95% CI, 1.07-1.24]). The attributable proportion was 13.2%, and the population attributable fraction was 0.3%. Logistic regression demonstrated an increased risk of stress fractures associated with past MP use, preserved after adjusting for BMI, sex, and place of birth ( P = .005). Female sex, BMI ≤20 kg/m2, and 20 < BMI ≤25 kg/m2 were independent positive predictors of a stress fracture, while African origin was a negative predictor. Most participants who used MP had only 1 fracture (77.8%), while the majority of participants who did not use MP in the past had ≥2 coincident fractures (53.5%) ( P = .003). Conclusion: This study supports the hypothesis that an MP-associated reduction in BMD has a clinical effect in the form of an increased incidence of stress fractures. The high percentage of fractures attributed to MP use may serve as a basis for risk stratification, that is, the referral of patients with a history of MP use to BMD measurements.

Past methylphenidate exposure and stress fractures in combat soldiers: A case–control study

2017 ◽  
Vol 20 ◽  
pp. S162
Author(s):  
Ran Yanovich ◽  
Ilan S. Ben Ami ◽  
Tudor Adrian ◽  
Eyal Amar ◽  
Ehud Rath ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Stress Fractures ◽  
Control Study ◽  
Combat Soldiers

scholarly journals A Canadian Multicentre Case-Control Study of SporadicEscherichia coli0157:H7 Infection

1999 ◽  
Vol 10 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Donna Holton ◽  
Jeff Wilson ◽  
Andrea Ellis ◽  
David Haldane ◽  
Nicole April ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Ground Beef ◽  
Case Control ◽  
Attributable Fraction ◽  
Personal Hygiene ◽  
E Coli ◽  
Control Study

OBJECTIVE: To evaluate further risk factors forEscherichia coli0157:H7 infection including consumer preferences related to the consumption of ground beef and the role of person-to-person transmission of this infection.PATIENTS AND METHODS: A case-control study of sporadicE coli0157:H7 infection was undertaken in five Canadian cites from June to December 1991. One hundred cases ofE coli0157:H7 infection were age- and sex-matched to 200 neighbourhood controls. Cases and controls were interviewed face-to-face to obtain information on potential risk factors for infection and health outcomes. Daycare providers of case and control children were interviewed regarding risk factors for infection at the institutional level. Contacts of cases and controls who reported diarrhea in the seven days before the case onset date were also interviewed about their symptoms and risk factors.RESULTS: All cases had diarrhea during the course of their illness and 90 (90%) reported bloody diarrhea. Four (4%) were reported to have developed hemolytic uremic syndrome; however, there were no fatalities. Sixty-one (61%) of patients were hospitalized. Two variables were associated with infection in the final conditional logistic regression model: eating pink hamburger patties (odds ratio = 12.4, P=0.0001, population attributable fraction =40.2%) and contact with a nonhousehold member suffering from diarrhea (odds ratio = 7.0, P=0.0054, population attributable fraction = 10.3%) in the seven days before illness. Forty per cent of cases and controls who indicated that they prefer well done hamburgers said they would eat a ‘pink’ hamburger if served to them rather than ask that the hamburger be cooked longer.CONCLUSIONS: Health care workers should remain vigilant in their efforts to educate the public as to the risks associated with the consumption of ground beef that is inadequately cooked, and the importance of personal hygiene in the prevention of enteric illness.

scholarly journals Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study

2009 ◽  
Vol 14 (7) ◽  
Author(s):  
K Danis ◽  
M Di Renzi ◽  
W O’Neill ◽  
B Smyth ◽  
P McKeown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Case Control ◽  
Control Measures ◽  
Safety Education ◽  
First Case ◽  
The Republic ◽  
Campylobacter Infection ◽  
Control Study

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.

scholarly journals Factors associated with stress fracture: A case-control study in a Peruvian navy medical center

Medwave ◽  
2020 ◽  
Vol 20 (05) ◽  
pp. e7936-e7936
Author(s):  
John C Becerra Sandoval ◽  
Lissette Ventura Huamán ◽  
Jhony A De La Cruz-Vargas
Keyword(s):  
Stress Fracture ◽  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Factors Associated ◽  
Control Study

scholarly journals Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case–control study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020646 ◽  
Author(s):  
Mejbah Uddin Bhuiyan ◽  
Thomas L Snelling ◽  
Rachel West ◽  
Jurissa Lang ◽  
Tasmina Rahman ◽  
...  
Keyword(s):  
Local Community ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Developed Countries ◽  
Case Control ◽  
Pneumococcal Vaccines ◽  
Healthy Children ◽  
Pathogen Load ◽  
Asymptomatic Children ◽  
Control Study

IntroductionPneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugateHaemophilus influenzaeB and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia. With the availability of molecular diagnostics, viruses are frequently detected in children with pneumonia either as primary pathogens or predispose to secondary bacterial infection. Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear. Since the introduction of pneumococcal vaccines, very few comprehensive studies from developed countries have attempted to determine the bacterial and viral aetiology of pneumonia. We aim to determine the contribution of bacteria and viruses to childhood CAP to inform further development of effective diagnosis, treatment and preventive strategies.Methods and analysisWe are conducting a prospective case–control study (PneumoWA) where cases are children with radiologically confirmed pneumonia admitted to Princess Margaret Hospital for Children (PMH) and controls are healthy children identified from PMH outpatient clinics and from local community immunisation clinics. The case–control ratio is 1:1 with 250 children to be recruited in each arm. Nasopharyngeal swabs are collected from both cases and controls to detect the presence of viruses and bacteria by PCR; pathogen load will be assessed by quantitative PCR. The prevalence of pathogens detected in cases and controls will be compared, the OR of detection and population attributable fraction to CAP for each pathogen will be determined; relationships between pathogen load and disease status and severity will be explored.Ethics and disseminationThis study has been approved by the human research ethics committees of PMH, Perth, Australia (PMH HREC REF 2014117EP). Findings will be disseminated at research conferences and in peer-reviewed journals.

scholarly journals Attributable fraction of work accidents related to occupational noise exposure in a Southeastern city of Brazil

2007 ◽  
Vol 23 (7) ◽  
pp. 1649-1655 ◽  
Author(s):  
Adriano Dias ◽  
Ricardo Cordeiro
Keyword(s):  
Noise Exposure ◽  
Case Control Study ◽  
Case Control ◽  
Attributable Fraction ◽  
Occupational Noise ◽  
Occupational Noise Exposure ◽  
Auditory Dysfunction ◽  
Work Accidents ◽  
Four Levels ◽  
Control Study

Noise is the most frequent type of occupational exposure and can lead to both auditory and extra-auditory dysfunction as well as increasing the risk of work accidents. The purpose of this study was to estimate the attributable fraction of work accidents related to occupational noise exposure in a medium-sized city in Southeast Brazil. In this hospital-based case-control study, including 600 cases and 822 controls, the odds ratio of work accidents (controlled for several covariables) was obtained classifying occupational noise exposure into four levels and determining the prevalence at each level. Based on these data, the calculated attributable fraction was 0.3041 (95%CI: 0.2341-0.3676), i.e., 30% of work accidents in the study area were statistically associated with occupational noise exposure. The authors discuss the causes of this association and the implications for the prevention of work accidents.

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