Bipolar Disorder Associated with Another Autoimmune Disease—Pemphigus: A Population-based Study

Objectives: Recent evidence suggests a notable role for inflammation and immune dysregulation in the neuroprogression of bipolar disorders (BD). Several autoimmune comorbidities have been reported in association with BD. However, the epidemiological relationship between pemphigus and BD has not yet been elucidated. We aimed to estimate the association between pemphigus and BD using a large-scale, real-life computerized database. Methods: Data for this study were retrieved from the database of the Clalit Health Services, the largest, state-mandated, health service organization in Israel. This study was designed as a cross-sectional study. The proportion of patients with BD was compared between patients diagnosed with pemphigus and age-, sex-, and ethnicity-matched control subjects. A logistic regression model was performed to estimate how pemphigus and other covariates contributed as risk factors for BD. Results: A total of 1,985 pemphigus cases and 9,874 controls were included in the study. The prevalence of BD was greater in cases with pemphigus than in controls (1.0% v. 0.5%, respectively; P = 0.023). This coexistence was more prominent among patients of Jewish ethnicity. After controlling for confounders, such as age, sex, ethnicity, socioeconomic status, drug abuse, alcohol abuse, smoking, healthcare utilization, and comorbidities, pemphigus demonstrated a substantial independent association with BD (OR, 1.7; 95% CI, 1.0 to 2.9). Conclusions: Pemphigus is significantly associated with BD. Patients with pemphigus should be assessed for comorbid BD. Experimental research is needed to better recognize the biological mechanisms underlying this observation.

Download Full-text

Association between schizophrenia and an autoimmune bullous skin disease-pemphigus: a population-based large-scale study

Epidemiology and Psychiatric Sciences ◽

10.1017/s204579601700052x ◽

2017 ◽

Vol 28 (2) ◽

pp. 191-198 ◽

Cited By ~ 5

Author(s):

K. Kridin ◽

S. Zelber-Sagi ◽

D. Comaneshter ◽

A. D. Cohen

Keyword(s):

Multivariate Analysis ◽

Large Scale ◽

Matched Control ◽

Univariate Analysis ◽

Real Life ◽

Population Based ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Wide Range

Aims.Immunological hypotheses have become increasingly prominent suggesting that autoimmunity may be involved in the pathogenesis of schizophrenia. Schizophrenia was found to be associated with a wide range of autoimmune diseases. However, the association between pemphigus and schizophrenia has not been established yet. We aimed to estimate the association between pemphigus and schizophrenia using a large-scale real-life computerised database.Methods.This study was conducted as a cross-sectional study utilising the database of Clalit Health Services. The proportion of schizophrenia was compared between patients diagnosed with pemphigus and age-, gender- and ethnicity-matched control subjects. Univariate analysis was performed usingχ2and Student'st-test and a multivariate analysis was performed using a logistic regression model.Results.A total of 1985 pemphigus patients and 9874 controls were included in the study. The prevalence of schizophrenia was greater in patients with pemphigus as compared to the control group (2.0%v. 1.3%, respectively;p= 0.019). In a multivariate analysis, pemphigus was significantly associated with schizophrenia (OR, 1.5; 95% CI, 1.1–2.2). The association was more prominent among females, patients older than 60 years, and Jews.Conclusions.Pemphigus is significantly associated with schizophrenia. Physicians treating patients with pemphigus should be aware of this possible association. Patients with pemphigus should be carefully assessed for comorbid schizophrenia and be treated appropriately.

Download Full-text

The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)

BMC Endocrine Disorders ◽

10.1186/s12902-021-00773-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Batul Birjandi ◽

Fahimeh Ramezani Tehrani ◽

Atieh Amouzegar ◽

Maryam Tohidi ◽

Razieh Bidhendi Yarandi ◽

...

Keyword(s):

Thyroid Autoimmunity ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Population Based Study ◽

History Of ◽

Autoimmune Condition ◽

Biochemical Measurements ◽

Adverse Pregnancy ◽

Adjusted Logistic Regression

Abstract Background Thyroid autoimmunity(TAI) is the most prevalent autoimmune condition in women of fertile age. There are increasing data regarding the association of thyroid dysfunction and thyroid autoimmunity with adverse pregnancy outcomes but there is no consensus regarding infertility and TPOAb positivity; thus we aimed to evaluate the association between thyroid TPOAb positivity and infertility in females and males in a population-based study (TTS). Methods Cross-sectional study of 3197 female and male participants in Tehran Thyroid Study (TTS) at the framework of the Tehran Lipid and Glucose Study (TLGS). Data included biochemical measurements and a self-administered questionnaire. Results A total of 12,823 cases in phase 4, 3719 cases (2108 female and 1611 male) were analyzed. The mean TSH of the infertile female and male was 2.52 ± 2.68 μIU/ml and 3.24 ± 10.26 μIU/ml respectively. The TPO median(IQR) of women with and without a history of infertility were 6.05 (3.30–13.96)and 6.04 (3.17–11.15);(P = 0.613), they were 5.08 (3.20–125.68) and 5.31 (3.93–125.68);(P = 0.490) in male participants, respectively. Results of crude and adjusted logistic regression analysis of the development of infertility by thyroid function and TPOAb, except for fT4 in male subjects, depicted no association between infertility and other variables in both crude and adjusted models. Conclusion Based on the result, thyroid autoimmunity was not associated with infertility in both females and males.

Download Full-text

Falls among the elderly: risk factors in a population-based study

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400030011 ◽

2014 ◽

Vol 17 (3) ◽

pp. 705-718 ◽

Cited By ~ 9

Author(s):

Iara Guimarães Rodrigues ◽

Gustavo Pereira Fraga ◽

Marilisa Berti de Azevedo Barros

Keyword(s):

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Elderly Adults ◽

Cross Sectional ◽

Population Based Study ◽

Factors Associated ◽

Gender And Age ◽

Policies And Programs

Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95%CI 1.61 - 3.88), widowed (PR = 1.74; 95%CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74), headache (PR = 1.59; 95%CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64), dizziness (PR = 2.82; 95%CI 1.98 - 4.02), insomnia (PR = 1.75; 95%CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95%CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93). Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

Download Full-text

Prevalence and service assessment of cataract in Tibetan areas of Sichuan Province, China: population-based study

BMJ Open ◽

10.1136/bmjopen-2019-031337 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031337 ◽

Cited By ~ 1

Author(s):

Danba Jiachu ◽

Ling Jin ◽

Feng Jiang ◽

Li Luo ◽

Hong Zheng ◽

...

Keyword(s):

Visual Impairment ◽

Response Rate ◽

Rapid Assessment ◽

Population Based ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional ◽

Population Based Study ◽

Low Prevalence ◽

Better Than

ObjectivesTo assess the prevalence of visual impairment (VI) and blindness (BL) due to cataract and cataract surgical outcomes in remote dispersed and high-altitude Tibetan areas of China.Design and settingA cross-sectional study was conducted among people aged 50 and above in Tibetan Autonomous Prefecture of Kandze (TAPK), China, in 2017. The Rapid Assessment of Avoidable Blindness protocol was followed.ParticipantsOf 5000 eligible participants, 4764 were examined (response rate 95.3%).Primary and secondary outcome measuresCataract VI was defined as lens opacity at visual acuity (VA) levels of <3/60 (Blindness (BL)), ≥3/60 and <6/60 (severe visual impairment (SVI)), ≥6/60 and <6/18 (moderate visual impairment (MVI)), ≥6/18 and <6/12 (early visual impairment (EVI)).ResultsThe estimated prevalence of cataract BL was 0.61% (95% CI 0.42 to 0.87). With best corrected VA, the estimated prevalence of SVI from cataract was 0.86% (95% CI 0.63 to 1.17); MVI was 2.39% (95% CI 2.00 to 2.87) and EVI was 5.21% (95% CI 4.61 to 5.87). Women in TAPK had a significantly higher prevalence of cataract BL (0.82%, 95% CI 0.54 to 2.15) than men (0.34%, 95% CI 0.16 to 0.70). Women had lower cataract surgical coverage (CSC) by eyes (60.8%, 95% CI 55.5 to 65.8) compared with men (70.1%; 95% CI 63.7 to 75.7). The prevalence of cataract BL was higher among Tibetan (2.28%; 95% CI 1.98 to 2.62) than Han Chinese (1.01%%; 95% CI 0.54% to 1.87%). Overall CSC by person with BL (by better eye) was 82.0% (95% CI 75.2 to 87.6). Among cataract-operated participants, 71.2% had VA equal to or better than 6/18.ConclusionsThe study detected a low prevalence of VI and BL due to cataract with high CSC in the study area compared with many other places in China. Further actions should be taken to improve cataract surgical outcome.

Download Full-text

The impact of C-reactive protein levels on headache frequency in the HUNT study 2006–2008

BMC Neurology ◽

10.1186/s12883-019-1462-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Knut Hagen ◽

Lars Jacob Stovner ◽

Kristian Bernhard Nilsen ◽

Espen Saxhaug Kristoffersen ◽

Bendik Slagsvold Winsvold

Keyword(s):

Migraine With Aura ◽

Large Scale ◽

Population Based ◽

C Reactive Protein ◽

Cross Sectional ◽

Population Based Study ◽

Reactive Protein ◽

Scale Population ◽

Hs Crp ◽

The Impact

Abstract Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006–2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as > 3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04–1.25) and migraine with aura (OR 1.15, 95% CI 1.03–1.29). The association was strongest among individuals with headache ≥15 days/month for any headache (OR 1.26, 95% CI 1.08–1.48), migraine (OR 1.62, 95% CI 1.21–2.17), and migraine with aura (OR 1.84, 95% CI 1.27–2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥7 days/month, especially evident for migraine with aura.

Download Full-text

Public Awareness of Tuberculosis in Southeast China: A Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214290 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4290 ◽

Cited By ~ 1

Author(s):

Xinyi Chen ◽

Wei Wang ◽

Xiaomeng Wang ◽

Chengliang Chai ◽

Kui Liu ◽

...

Keyword(s):

Rural Areas ◽

Public Awareness ◽

Population Based ◽

Cross Sectional Study ◽

Zhejiang Province ◽

First Line ◽

Cross Sectional ◽

Population Based Study ◽

Therapeutic Drugs ◽

And Control

Few provinces in China have recently conducted population-based surveys on tuberculosis (TB) awareness at the provincial level. Hence, we conducted a population-based, cross-sectional study to evaluate the level of awareness of TB knowledge among residents of Zhejiang Province, China from October 2018 to December 2018. A total of 7174 individuals were randomly selected to participate in this survey. The rate of awareness of key information on TB was found to be 48.0%. The study’s participants exhibited a good understanding of the transmission route (80.8%), curable outcome (78.3%), and designated treatment sites (67.0%) of TB. The rate of awareness of suspicious TB symptoms (36.1%) and the relief policy on diagnosis and first-line therapeutic drugs (38.0%) were found to be relatively low among the respondents. People living in rural areas, those who were less educated, and students all showed a low level of awareness of key knowledge about TB. In conclusion, residents in Zhejiang Province generally lacked key information about TB, which is not conducive to the early detection and treatment of TB. Corresponding efforts should be made for different groups of people to achieve favorable effects on the prevention and control of TB.

Download Full-text

Drug use in French children: a population-based study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307224 ◽

2015 ◽

Vol 100 (10) ◽

pp. 960-965 ◽

Cited By ~ 20

Author(s):

Anne Bénard-Laribière ◽

Jérémy Jové ◽

Régis Lassalle ◽

Philip Robinson ◽

Cécile Droz-Perroteau ◽

...

Keyword(s):

Drug Use ◽

Anatomical Therapeutic Chemical ◽

Median Number ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Population Based Study ◽

Significant Toxicity ◽

Healthcare Insurance ◽

Outpatient Children

Background and objectiveTo provide an overview of drug use in outpatient children in France, a population-based study using a national reimbursement claims database representative of 90% of the French population was conducted.DesignCross-sectional study performed between January and December 2011 using the EGB database (Echantillon Généraliste de Bénéficiaires), a 1/97th sample of the national healthcare insurance system beneficiaries. Drug use in children <18 years old was estimated through reimbursements for prescribed drugs excluding vaccines. Prevalences of use were calculated for different levels of the Anatomical Therapeutic Chemical classification by considering as users children who had at least one reimbursement during the study period.ResultsIn 2011, 133 800 children were included in the study. The overall prevalence of drug use was 84% and the median number of different drugs per child was 5. Drug use was greatest in children aged <2 years. The most widely used drugs were paracetamol, systemic anti-infectives, nasal corticosteroids and decongestants, and anti-histamines. 21% children <2 years received domperidone.ConclusionsThere is widespread use of medicines that are unlikely to be effective and may have significant toxicity in French children. Irrational use of medicines appears to be greatest in children aged 5 years and under.

Download Full-text

Nutrient Patterns and Their Relation With Obesity in Iranian Adults: A Population-based Study

10.21203/rs.3.rs-40532/v1 ◽

2020 ◽

Author(s):

Mohammad Reza Amini ◽

Zahra Akbarzade ◽

Farhang Djafari ◽

Habib Yarizadeh ◽

Mahshid Shahavandi ◽

...

Keyword(s):

Blood Pressure ◽

Nutrient Intake ◽

Factor Loading ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Population Based Study ◽

Significant Difference ◽

Major Nutrient ◽

Nutrient Patterns

Abstract Objective: In spite of growing evidence on the associations between nutrient patterns and obesity. A few study examined the association between patterns of nutrient intake and obesity we aimed to explore the association between nutrient pattern and obesity in Iranian adults.Results: In this cross-sectional study, a total of 850 subjects aged years 20 to 59 were randomly selected. Our statistical analysis revealed three major nutrient patterns that show the principle factor loading of nutrient intake. We observed a significant association between quintiles in men for Fasting Blood Sugar (FBS) (P<0.006) in the first nutrient pattern. Moreover, we identified a significant difference between quintiles in the first nutrient pattern in women for obesity (P=0.007), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) (P<0.02). In the third nutrient pattern, we identified a significant association for SBP in women (P<0.02).

Download Full-text

Normative data for the 6-min walk test in 11–14 year-olds: a population-based study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01666-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mario Kasović ◽

Lovro Štefan ◽

Vilko Petrić

Keyword(s):

Normative Data ◽

Outcome Measure ◽

Population Based ◽

Cross Sectional Study ◽

Healthy Children ◽

Walk Test ◽

Target Groups ◽

Cross Sectional ◽

Population Based Study ◽

The Mean

Abstract Background The 6-min walk test (6MWT) has become an established measure for assessing exercise capacity in children with chronic diseases. However, little evidence has been provided regarding population-based normal data in healthy children. The main purpose of the study was to provide normative data in a large sample of children. Methods In this cross-sectional study, 4352 children between 11 and 14 years were recruited (66% girls). The main outcome measure was the distance walked for six minutes. Sex- and age-specific percentile values (5th, 15th, 25th, 50th, 75th, 85th and 95th) for the 6MWT were created and the differences and correlations were examined by the analysis of variance and Pearson’s coefficient of correlation. Results The mean distance walked in 6 min was 576 ± 93 m in boys and 545 ± 92 m in girls, respectively. The mean walking speed for boys and girls was 98 ± 5 m/min and 91 ± 6 m/min. Older boys and girls performed better, compared to their younger counterparts (p for age < 0.001). The 6MWT was significantly correlated with age (r = 0.24, p < 0.001), height (r = 0.09, p < 0.001), weight (r = − 0.13, p < 0.001) and body-mass index (r = − 0.26, p < 0.001). Conclusions This is the first population-based study aiming to provide normative data for the 6MWT in healthy children between 11 to 14 years. Children in lower percentiles are ‘target groups’ for special intervention aiming to enhance the performance.

Download Full-text

Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124242 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4242

Author(s):

Ignatios Ioakeim-Skoufa ◽

Beatriz Poblador-Plou ◽

Jonás Carmona-Pírez ◽

Jesús Díez-Manglano ◽

Rokas Navickas ◽

...

Keyword(s):

General Population ◽

Large Scale ◽

Musculoskeletal Diseases ◽

Epidemiological Studies ◽

Population Based ◽

Cross Sectional Study ◽

Real World Data ◽

Cross Sectional ◽

Complex Interactions ◽

And Gender

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.

Download Full-text