scholarly journals Occurrence, thromboembolic risk, and mortality in Danish patients with cold agglutinin disease

2019 ◽  
Vol 3 (20) ◽  
pp. 2980-2985 ◽  
Author(s):  
Lauren C. Bylsma ◽  
Anne Gulbech Ording ◽  
Adam Rosenthal ◽  
Buket Öztürk ◽  
Jon P. Fryzek ◽  
...  
Keyword(s):  
General Population ◽  
Mortality Risk ◽  
Cold Agglutinin ◽  
Cold Agglutinin Disease ◽  
Thromboembolic Risk ◽  
Risk Of Death ◽  
Population Cohort ◽  
Increased Risk ◽  
Key Points ◽  
General Population Cohort

Key Points This is the first study to compare thromboembolism and mortality risk in CAD against a general population cohort. Patients with CAD were at a significantly increased risk of death, especially during the first 5 years after diagnosis.

scholarly journals Endocrine and Metabolic Diseases Among Colorectal Cancer Survivors in a Population-Based Cohort

2019 ◽  
Vol 112 (1) ◽  
pp. 78-86
Author(s):  
Makenzie L Hawkins ◽  
Brenna E Blackburn ◽  
Kerry Rowe ◽  
John Snyder ◽  
Vikrant G Deshmukh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factor ◽  
General Population ◽  
Metabolic Diseases ◽  
The United States ◽  
Population Cohort ◽  
Increased Risk ◽  
General Population Cohort ◽  
Time Periods

Abstract Background There are an estimated 1.4 million colorectal cancer (CRC) survivors in the United States. Research on endocrine and metabolic diseases over the long term in CRC survivors is limited. Obesity is a risk factor for CRC; thus it is of interest to investigate diseases that may share this risk factor, such as diabetes, for long-term health outcomes among CRC survivors. Methods A total of 7114 CRC patients were identified from the Utah Population Database and matched to a general population cohort of 25 979 individuals on birth year, sex, and birth state. Disease diagnoses (assessed over three time periods of 1–5 years, 5–10 years, and >10 years) were identified using electronic medical records and statewide ambulatory and inpatient discharge data. Cox proportional hazard models were used to estimate the risk of endocrine and metabolic disease. Results Across all three time periods, risks for endocrine and metabolic diseases were statistically significantly greater for CRC survivors compared with the general population cohort. At 1–5 years postdiagnosis, CRC survivors’ risk for diabetes mellitus with complications was statistically significantly elevated (hazard ratio [HR] = 1.36, 99% confidence interval [CI] = 1.09 to 1.70). CRC survivors also experienced a 40% increased risk of obesity at 1–5 years postcancer diagnosis (HR= 1.40, 99% CI= 1.66 to 2.18) and a 50% increased risk at 5–10 years postdiagnosis (HR = 1.50, 99% CI= 1.16 to 1.95). Conclusions Endocrine and metabolic diseases were statistically significantly higher in CRC survivors throughout the follow-up periods of 1–5 years, 5–10 years, and more than 10 years postdiagnosis. As the number of CRC survivors increases, understanding the long-term trajectory is critical for improved survivorship care.

Risk of osteoarthritis in an incident cohort of people with psoriatic arthritis: a population-based cohort study

2020 ◽  
pp. jrheum.200564
Author(s):  
Rachel Charlton ◽  
Amelia Green ◽  
Gavin Shaddick ◽  
Julia Snowball ◽  
Alison Nightingale ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
General Population ◽  
Population Based ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Study Cohort ◽  
Relative Risks ◽  
Population Cohort ◽  
Increased Risk ◽  
General Population Cohort

Objective To determine the risk of a diagnosis of osteoarthritis (OA) in psoriatic arthritis (PsA) patients compared to patients with psoriasis and a general population cohort. Methods Incident PsA patients aged 18-89 years at diagnosis were identified from the UK Clinical Practice Research Datalink between 1998 and 2014. All PsA patients were matched to two cohorts of patients both at a 1:4 ratio. The first cohort included patients with psoriasis (and no PsA) and the second was a general population cohort (with no psoriasis or PsA). The baseline prevalence of OA was calculated for each study cohort. The incidence of OA was calculated and adjusted relative risks (RRadj) were calculated using conditional Poisson regression. Results We identified 6,783 incident PsA patients. The baseline prevalence of OA ranged from 22.1% (CI9521.1-23.1) in the PsA cohort to 12.6% (CI9512.2-13.0) and 11.0% (CI9510.6- 11.3) in the psoriasis and general population cohorts respectively. The incidence of OA was significantly higher in the PsA cohort compared to the psoriasis and general population cohorts after adjusting for BMI (RRadj 1.68 CI951.46-1.93 and RRadj 1.86 CI951.62-2.14 respectively). Conclusion An increased risk of OA was observed in patients with PsA compared to patients with psoriasis alone and those in the general population. Further work is needed to determine whether this reflects a true increase in OA risk or misdiagnosed PsA and the extent to which it can be explained by differences in the opportunity for OA diagnosis between cohorts.

Mortality in ANCA-associated vasculitis: ameta-analysis of observational studies

2017 ◽  
Vol 76 (9) ◽  
pp. 1566-1574 ◽  
Author(s):  
Ju Ann Tan ◽  
Natasha Dehghan ◽  
Wenjia Chen ◽  
Hui Xie ◽  
John M Esdaile ◽  
...  
Keyword(s):  
General Population ◽  
Publication Bias ◽  
Mortality Risk ◽  
Observational Studies ◽  
Consensus Conference ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Published Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
All Cause Mortality

ObjectiveTo determine the magnitude of all-cause mortality risk in patients with antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) compared with the general population through a meta-analysis of observational studies.MethodsWe searched Medline and Embase databases from their inception to April 2015. Observational studies that met the following criteria were assessed by two researchers: (1) clearly defined AAV identified by either the American College of Rheumatology 1990 classification criteria or the 2012 Chapel Hill Consensus Conference disease definitions, and (2) reported standardised mortality ratios (SMR) and 95% CI. We calculated weighted-pooled summary estimates of SMRs (meta-SMRs) for all-cause mortality using random-effects model, tested for publication bias and heterogeneity.ResultsTen studies met the inclusion criteria, comprising 3338 patients with AAV enrolled from 1966 to 2009, and a total of 1091 observed deaths. Overall, we found a 2.7-fold increased risk of death in patients with AAV when compared with the general population (meta-SMR: 2.71 (95% CI 2.26 to 3.24)). Analysis on studies that included only granulomatosis with polyangiitis cases also indicated a similar mortality risk (meta-SMR: 2.63 (95% CI 2.02 to 3.43)). There was no significant publication bias or small-study effect. Subgroup analyses showed that mortality risks were higher in older cohorts, with a trend towards improvement over time (ie, those with their midpoint of enrolment periods that were between 1980–1993 and 1994–1999, vs 2000–2005).ConclusionPublished data indicate there is a 2.7-fold increase in mortality among patients with AAV compared with the general population.

scholarly journals Standardized Comparison of Cardiovascular Risk Factors Prevalence in Spanish Women and Men Living with HIV and in the General Population

2021 ◽  
Vol 11 (11) ◽  
pp. 1085
Author(s):  
Anna Camps-Vilaró ◽  
Silvia Pérez-Fernández ◽  
Isaac Subirana ◽  
Ramon Teira ◽  
Vicente Estrada ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Direct Method ◽  
Age Groups ◽  
People Living With Hiv ◽  
Population Cohort ◽  
Increased Risk ◽  
Significant Difference ◽  
General Population Cohort ◽  
Living With Hiv

People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared the age-standardized prevalence and management of CV risk factors in PLWH to that of the general population in Spain. Blood pressure, lipid, glucose, and anthropometric profiles were cross-sectionally compared along with the treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations and stratified by gender. We included 47,593 individuals aged 35 to 74 years, 28,360 from the general population cohort and 19,233 from the PLWH cohort. Compared to the general population, PLWH had a higher concentration of triglycerides (>35 mg/dL in women and >26 mg/dL in men) and a higher prevalence of smoking (>23% and >17%) and diabetes (>9.9% and >8.5%). The prevalence of treated diabetes, hypertension, and dyslipidemia were up to three-fold lower in both women and men living with HIV. There was a significant difference in PLWH compared to the general population in the lipid, glucose, and anthropometric profile. In addition, PLWH were less often treated for diagnosed diabetes, hypertension, and dyslipidemia.

scholarly journals Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort

2016 ◽  
Vol 10 (4) ◽  
pp. 291-300 ◽  
Author(s):  
Ellen Fragaszy ◽  
David A. Ishola ◽  
Ian H. Brown ◽  
Joanne Enstone ◽  
Jonathan S. Nguyen‐Van‐Tam ◽  
...  
Keyword(s):  
General Population ◽  
Influenza Infection ◽  
Population Cohort ◽  
Increased Risk ◽  
General Population Cohort

scholarly journals Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort

2021 ◽  
Author(s):  
Amedeo Minichino ◽  
Matthew A. Jackson ◽  
Marta Francesconi ◽  
Claire J. Steves ◽  
Cristina Menni ◽  
...  
Keyword(s):  
General Population ◽  
Microbial Diversity ◽  
Gut Microbiome ◽  
Endocannabinoid System ◽  
Alpha Diversity ◽  
Serum Levels ◽  
Population Cohort ◽  
Random Intercept ◽  
General Population Cohort ◽  
Antidepressant Use

AbstractAnhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2 ± 7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (β = −0.37; 95%CI: −0.71 to −0.03; P = 0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (β = −0.13; 95%CI: −0.24 to −0.01; P = 0.03), as was the total effect (β = −0.38; 95%CI: −0.72 to −0.04; P = 0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (β = −0.25; 95%CI: −0.60 to 0.09; P = 0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.

scholarly journals 416 - Risk of Mortality Associated with Antipsychotics in Alzheimer's Disease

2020 ◽  
Vol 32 (S1) ◽  
pp. 132-132
Author(s):  
Liliana P. Ferreira ◽  
Núria Santos ◽  
Nuno Fernandes ◽  
Carla Ferreira
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Adverse Events ◽  
Mortality Risk ◽  
Antipsychotic Treatment ◽  
Serious Adverse Events ◽  
Risk Of Death ◽  
Mesh Terms ◽  
Risk Of Mortality ◽  
Increased Risk

Objectives: Alzheimer's disease (AD) is the most common cause of dementia and it is associated with increased mortality. The use of antipsychotics is common among the elderly, especially in those with dementia. Evidence suggests an increased risk of mortality associated with antipsychotic use. Despite the short-term benefit of antipsychotic treatment to reduce the behavioral and psychological symptoms of dementia, it increases the risk of mortality in patients with AD. Our aim is to discuss the findings from the literature about risk of mortality associated with the use of antipsychotics in AD.Methods: We searched Internet databases indexed at MEDLINE using following MeSH terms: "Antipsychotic Agents" AND "Alzheimer Disease" OR "Dementia" AND "Mortality" and selected articles published in the last 5 years.Results: Antipsychotics are widely used in the pharmacological treatment of agitation and aggression in elderly patients with AD, but their benefit is limited. Serious adverse events associated with antipsychotics include increased risk of death. The risk of mortality is associated with both typical and atypical antipsychotics. Antipsychotic polypharmacy is associated with a higher mortality risk than monotherapy and should be avoided. The mortality risk increases after the first few days of treatment, gradually reducing but continues to increase after two years of treatment. Haloperidol is associated with a higher mortality risk and quetiapine with a lower risk than risperidone.Conclusions: If the use of antipsychotics is considered necessary, the lowest effective dose should be chosen and the duration should be limited because the mortality risk remains high with long-term use. The risk / benefit should be considered when choosing the antipsychotic. Further studies on the efficacy and risk of adverse events with antipsychotics are needed for a better choice of treatment and adequate monitoring with risk reduction.

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