scholarly journals Incidence of Benign and Malignant Tumors in Patients with Acromegaly is Increased: a Nationwide Population-Based Study

2021 ◽  
Author(s):  
Daniela Esposito ◽  
Oskar Ragnarsson ◽  
Gudmundur Johannsson ◽  
Daniel S Olsson
Keyword(s):  
General Population ◽  
Anal Cancer ◽  
Malignant Tumors ◽  
Population Based ◽  
Benign Tumors ◽  
Medical Surveillance ◽  
Population Based Study ◽  
Increased Risk ◽  
National Patient ◽  
Standardized Mortality Ratios

Abstract Context Whether cancer risk in acromegaly is increased remains controversial. Also, the risk of benign tumors has been little studied. Objective To investigate the incidence of benign and malignant tumors in acromegaly in a nationwide population-based study. Design Adult patients diagnosed with acromegaly between 1987 and 2017 were identified in the Swedish National Patient Registry. The diagnoses of benign and malignant tumors were recorded. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for neoplasms with 95% confidence intervals (CIs) were calculated using the Swedish general population as reference. Results The study included 1296 patients (52% women). Mean (SD) age at diagnosis was 51.6 (14.7) years. Median (range) follow-up time was 11.7 (0-31) years. Overall, 186 malignancies were identified in acromegalic patients compared to 144 expected in the general population (SIR 1.3; 95% CI, 1.1-1.5). The incidence of colorectal and anal cancer (SIR 1.5; 95% CI, 1.0-2.2), and renal and ureteral cancer (SIR 4.0; 95% CI, 2.3-6.5) was increased, whereas the incidence of malignancies of the respiratory system, brain, prostate, and breast was not. Only three cases of thyroid cancer were recorded. Mortality due to malignancies was not increased (SMR 1.1; 95% CI, 0.9-1.4). Incidence of benign tumors was increased more than 2-fold (SIR 2.4; 95% CI, 2.1-2.7). Conclusions Patients with acromegaly had an increased risk of both benign and malignant tumors including colorectal and anal cancer, and renal and ureteral cancer. Whether this is associated with acromegaly itself or due to more intensive medical surveillance remains to be shown.

scholarly journals Population-based study of amyotrophic lateral sclerosis and occupational lead exposure in Denmark

2019 ◽  
pp. oemed-2018-105469 ◽  
Author(s):  
Aisha S Dickerson ◽  
Johnni Hansen ◽  
Aaron J Specht ◽  
Ole Gredal ◽  
Marc G Weisskopf
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Population Based Study ◽  
Employment History ◽  
National Patient Registry ◽  
Increased Risk ◽  
National Patient ◽  
Pb Exposure ◽  
Lateral Sclerosis

ObjectivesPrevious research has indicated links between lead (Pb) exposure and increased risk of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). In this study, we evaluated the association between occupational Pb exposures and ALS.MethodsALS cases were ascertained through the Danish National Patient Registry from 1982 to 2013 and age and sex-matched to 100 controls. Using complete employment history since 1964 from the Danish Pension Fund, cumulative Pb exposure was estimated for each subject via a Danish job exposure matrix. Associations were evaluated using conditional logistic regression analyses and stratified by sex.ResultsFor men with >50% probability of exposure, there was an increase in odds of ALS for exposures in the 60th percentile or higher during any time 5 years prior to diagnosis (aOR: 1.35; 95% CI 1.04 to 1.76) and 10 years prior to diagnosis (aOR: 1.33; 95% CI 1.03 to 1.72). No significant associations were observed in women, and there were no linear trends seen for Pb exposures for either sex.ConclusionsOur study indicates an association between consistently higher occupational Pb exposures and ALS. These findings support those of previously reported associations between ALS and specific occupations that commonly experience Pb exposure.

Conjugal multiple sclerosis in Isfahan, Iran: a population-based study

2007 ◽  
Vol 13 (5) ◽  
pp. 673-675 ◽  
Author(s):  
A.H. Maghzi ◽  
M. Etemadifar ◽  
V. Shaygannejad ◽  
M. Saadatnia ◽  
M. Salehi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Environmental Factors ◽  
Adult Life ◽  
Marital Relationship ◽  
Population Based ◽  
Rare Form ◽  
Population Based Study ◽  
Increased Risk ◽  
Estimated Risk

Conjugal multiple sclerosis (MS) is a rare form of MS in which both spouses are affected, and at least one is affected after marriage. Among 1606 definite MS patients, 1076 were in marital relationship, among whom we identified six conjugal pairs, giving the conjugal rate of 0.5%. This rate is 12.5 times higher than the estimated risk of MS for the general population (0.04%). The observed conjugal rate suggests an increased risk of developing MS for MS patients' spouses, this could be due to transmission or, more likely, to the same environmental factors shared in adult life. Multiple Sclerosis 2007; 13: 673-675. http://msj.sagepub.com

scholarly journals The risk and trend of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a general population-based study

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 188-195
Author(s):  
Lingyi Li ◽  
Na Lu ◽  
Ana Michelle Avina-Galindo ◽  
Yufei Zheng ◽  
Diane Lacaille ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
General Population ◽  
Population Based ◽  
Case Definition ◽  
Population Based Study ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein

Abstract Objectives To estimate the overall risk of venous thromboembolism (VTE), pulmonary embolism (PE) and deep vein thrombosis (DVT) among patients newly diagnosed with RA compared with the general population without RA; and to estimate the risk trends of VTE, PE and DVT after RA diagnosis up to 5 years compared with the general population. Methods Using previously validated RA case definition, we conducted a matched cohort study using the population-based administrative health database from the province of British Columbia, Canada. We calculated incidence rates (IRs) and fully adjusted hazard ratios (HRs) for the risk of VTE, DVT and PE after RA index date. Results Among 39 142 incident RA patients (66% female, mean age 60), 1432, 543 and 1068 developed VTE, PE and DVT, respectively. IRs for the RA cohort were 3.79, 1.43 and 2.82 per 1000 person-years vs 2.70, 1.03 and 1.94 per 1000 person-years for the non-RA cohort. After adjusting for VTE risk factors, the HRs (95% CI) were 1.28 (1.20, 1.36), 1.25 (1.13, 1.39) and 1.30 (1.21, 1.40) for VTE, PE and DVT, respectively. The fully adjusted HRs for VTE during the first five years after RA diagnosis were 1.60, 1.47, 1.40, 1.30 and 1.28, respectively. A similar trend was shown in PE. Conclusion This population-based study demonstrates that RA patients have an increased risk of VTE, PE and DVT after diagnosis compared with the general population. This risk is independent of traditional VTE risk factors and is highest during the first year after RA diagnosis, then progressively declined.

Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study

2010 ◽  
Vol 69 (6) ◽  
pp. 1165-1168 ◽  
Author(s):  
Jiunn-Horng Kang ◽  
Yi-Hua Chen ◽  
Herng-Ching Lin
Keyword(s):  
Ankylosing Spondylitis ◽  
General Population ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Peptic Ulcers ◽  
Population Based Study ◽  
Medical Comorbidities ◽  
Increased Risk ◽  
Systemic Inflammatory Disease ◽  
Comorbidity Index

ObjectiveAnkylosing spondylitis (AS) is a systemic inflammatory disease that can result in chronic pain and disability. This study aimed to analyse the prevalence and risk of medical comorbidities in patients with AS compared with the general population.Methods11 701 patients with AS and 58 505 matching controls were selected for analysis from the National Health Insurance Research Dataset (NHIRD) in Taiwan. The Elixhauser comorbidity index was used for selecting medical comorbidities. Pearson χ2 tests and conditional logistic regression a nalyses were performed to examine the prevalence and risk of comorbidities between these two groups.ResultsPatients with AS were at increased risk for multiple systemic comorbidities including cardiovascular, neurological, pulmonary, gastrointestinal, endocrine, haematological and mental illness. The most prevalent comorbidities in patients with AS were hypertension (16.4%), peptic ulcers (13.9%) and headaches (10.2%).ConclusionThe results show that patients with AS have a higher prevalence of multiple comorbidities than the general population in Taiwan. These findings are consistent with previous studies done in Western populations. The results could be useful for both the clinical management of patients with AS and for researching the underlying pathological mechanisms.

scholarly journals Population-Based Study on the All-Cause and Cause-Specific Risks of Mortality among Long-Term Opioid Analgesics Users without Cancer in Taiwan

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1402
Author(s):  
Po-Feng Lee ◽  
Chung-Yi Li ◽  
Yen-Chin Liu ◽  
Chang-Ta Chiu ◽  
Wen-Hsuan Hou
Keyword(s):  
General Population ◽  
Opioid Analgesics ◽  
Population Based ◽  
Opioid Use ◽  
Data Set ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Underlying Causes ◽  
Standardized Mortality Ratios

(1) Background: The prevalence of opioid use in Taiwan increased by 41% between 2002 and 2014. However, little is known regarding the risk of mortality among long-term opioid analgesics users who do not have cancer. This study investigated this mortality risk with an emphasis on the calendar year and patients’ age and sex. (2) Methods: This retrospective cohort study included 12,990 adult individuals without cancer who were long-term users of opioid analgesics and were randomly selected from the data set of Taiwan’s National Health Insurance program from 2000 to 2012. They were then followed up through 2013. Information on the underlying causes of death was retrieved from the Taiwan Death Registry. Age, sex, and calendar year-standardized mortality ratios (SMRs) of all-cause and cause-specific mortality were calculated with reference to those of the general population. (3) Results: With up to 14 years of follow-up, 558 individuals had all-cause mortality in 48,020 person-years (cumulative mortality: 4.3%, mortality rate: 11.62 per 1000 person-years). Compared with the general population, the all-cause SMR of 4.30 (95% confidence interval (95% CI): 3.95–4.66) was significantly higher: it was higher in men than in women, declined with calendar year and age, and was significantly higher for both natural (4.15, 95% CI: 3.78–4.53) and unnatural (5.04, 95% CI: 3.88–6.45) causes. (4) Conclusions: Long-term opioid analgesics use among individuals without cancer in Taiwan was associated with a significantly increased risk of mortality. The notably increased mortality in younger adults warrants attention. Strategies to reduce long-term opioid analgesics use, especially their overuse or misuse, are in an urgent need.

scholarly journals Sarcoidosis mortality in Sweden: a population-based cohort study

2018 ◽  
Vol 51 (2) ◽  
pp. 1701815 ◽  
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Askling ◽  
Anders Eklund ◽  
Johan Grunewald ◽  
...  
Keyword(s):  
General Population ◽  
Large Population ◽  
Population Based ◽  
Disease Heterogeneity ◽  
International Classification Of Disease ◽  
Risk Of Death ◽  
Drug Register ◽  
Hazard Ratios ◽  
Increased Risk ◽  
National Patient

We aimed to investigate sarcoidosis mortality in a large, population-based cohort, taking into account disease heterogeneity.Individuals with incident sarcoidosis (n=8207) were identified from the Swedish National Patient Register using International Classification of Disease codes (2003‒2013). In a subset, cases receiving treatment ±3 months from diagnosis were identified from the Prescribed Drug Register. Nonsarcoidosis comparators from the general population were matched to cases 10:1 on birth year, sex and county. Individuals were followed for all-cause death in the Cause of Death Register. Adjusted mortality rates, rate differences and hazard ratios (HRs) were estimated, stratifying by age, sex and treatment status.The mortality rate was 11.0 per 1000 person-years in sarcoidosis versus 6.7 in comparators (rate difference 2.7 per 1000 person-years). The HR for death was 1.61 (95% CI 1.47‒1.76), with no large variation by age or sex. For cases not receiving treatment within the first 3 months, the HR was 1.13 (95% CI 0.94‒1.35). The HR was 2.34 (95% CI 1.99‒2.75) for those receiving treatment.Individuals with sarcoidosis are at a higher risk of death compared to the general population. For the majority, the increased risk is small. However, patients whose disease leads to treatment around diagnosis have a two-fold increased risk of death. Future interventions should focus on this vulnerable group.

Gout and the Risk of Incident Erectile Dysfunction: A Body Mass Index-matched Population-based Study

2018 ◽  
Vol 45 (8) ◽  
pp. 1192-1197 ◽  
Author(s):  
Naomi Schlesinger ◽  
Na Lu ◽  
Hyon K. Choi
Keyword(s):  
Body Mass Index ◽  
Erectile Dysfunction ◽  
General Population ◽  
Body Mass ◽  
Population Based ◽  
Health Improvement ◽  
Primary Analysis ◽  
Population Based Study ◽  
Entry Time ◽  
Increased Risk

Objective.Gout is the most common inflammatory arthritis. Erectile dysfunction (ED) is common in the general population; however, evidence regarding ED among patients with gout is limited. Our purpose was to study the association between incident gout and the risk of incident ED in the general population.Methods.We conducted a cohort study using The Health Improvement Network, an electronic medical record database in the United Kingdom. Up to 5 individuals without gout were matched to each case of incident gout by age, enrollment time, and body mass index (BMI). Multivariate HR for ED were calculated after adjusting for smoking, alcohol consumption, comorbidities, and medication use.Results.We identified 2290 new cases of ED among 38,438 patients with gout (mean age 63.6 yrs) and 8447 cases among 154,332 individuals in the comparison cohort over a 5-year median followup (11.9 vs 10.5 per 1000 person-years, respectively). Univariate (matched for age, entry time, and BMI) and multivariate HR for ED among patients with gout were 1.13 (95% CI 1.08–1.19) and 1.15 (95% CI 1.09–1.21), respectively. In our sensitivity analysis, by restricting gout cases to those receiving anti-gout treatment (n = 27,718), the magnitude of relative risk was stronger than the primary analysis (multivariate HR 1.31, 95% CI 1.23–1.39).Conclusion.This population-based study suggests that gout is associated with an increased risk of developing ED, supporting a possible role for hyperuricemia and inflammation as independent risk factors for ED.

scholarly journals Risk of Seizures in Patients with Organophosphate Poisoning: A Nationwide Population-Based Study

2019 ◽  
Vol 16 (17) ◽  
pp. 3147 ◽  
Author(s):  
Chieh-Sen Chuang ◽  
Kai-Wei Yang ◽  
Chia-Ming Yen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
General Population ◽  
Cox Regression ◽  
Population Based ◽  
Organophosphate Poisoning ◽  
Research Database ◽  
Population Based Study ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
History Of

Objective: Previous research has demonstrated that patients with a history of organophosphate poisoning tend to have a higher risk of neurological disorder. However, research on the rate of seizure development in patients after organophosphate poisoning is lacking. This study examined whether individuals with organophosphate poisoning have an increased risk of seizures through several years of follow-up. Patients and Methods: We conducted a retrospective study on a cohort of 45,060 individuals (9012 patients with a history of organophosphate poisoning and 36,048 controls) selected from the Taiwan National Health Insurance Research Database. The individuals were observed for a maximum of 12 years to determine the rate of new-onset seizure disorder. We selected a comparison cohort from the general population that was randomly frequency-matched by age, sex, and index year and further analyzed the risk of seizures using a Cox regression model adjusted for sex, age, and comorbidities. Results: During the study period, the risk of seizure development was 3.57 times greater in patients with organophosphate poisoning compared with individuals without, after adjustments for age, sex, and comorbidities. The absolute incidence of seizures was highest in individuals aged 20 to 34 years in both cohorts (adjusted hazard ratio = 13.0, 95% confidence interval = 5.40−31.4). A significantly higher seizure risk was also observed in patients with organophosphate poisoning and comorbidities other than cirrhosis. Conclusions: This nationwide retrospective cohort study demonstrates that seizure risk is significantly increased in patients with organophosphate poisoning compared with the general population.

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