scholarly journals Increased Risk for Nonmedullary Thyroid Cancer in the First Degree Relatives of Prevalent Cases of Nonmedullary Thyroid Cancer: A Hospital-Based Study

2001 ◽  
Vol 86 (11) ◽  
pp. 5307-5312 ◽  
Author(s):  
Tuya Pal ◽  
Florian D. Vogl ◽  
Pierre O. Chappuis ◽  
Richard Tsang ◽  
James Brierley ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Genetic Basis ◽  
Incidence Rate Ratio ◽  
Cancer Susceptibility ◽  
Degree Relative ◽  
First Degree Relatives ◽  
Increased Risk

The genetic basis for nonmedullary forms of thyroid cancer (NMTC) is less well established than that of medullary thyroid cancer. However, epidemiological and family studies suggest that a proportion of NMTC may be due to inherited predisposition. To estimate the familial risk of thyroid cancer, we conducted a hospital-based case-control study at the Princess Margaret Hospital in Toronto, Ontario, Canada, and at 2 university hospitals in Montréal, Québec, Canada. We obtained pedigrees from 339 unselected patients diagnosed with NMTC and from 319 unaffected ethnically matched controls. Family histories of cancer were obtained from the cases and controls for 3292 first degree relatives of cases and controls. Seventeen cases (5.0%) and 2 controls (0.6%) reported at least one first degree relative with thyroid cancer. In relatives of patients with thyroid cancer, the incidence of any type of cancer (including NMTC) was 38% higher than in relatives of controls (incidence rate ratio, 1.4; 95% confidence interval, 1.1–1.7). The relative risk for thyroid cancer was 10-fold higher in relatives of cancer patients than in controls (incidence rate ratio, 10.3; 95% confidence interval, 2.2–47.6). Our findings suggest that hereditary or other familial factors are important in a small proportion of NMTC. Molecular studies are needed to determine the genetic basis of cancer susceptibility in these families.

scholarly journals Educational and health outcomes of children treated for asthma: Scotland-wide record linkage study of 683 716 children

2019 ◽  
Vol 54 (3) ◽  
pp. 1802309 ◽  
Author(s):  
Michael Fleming ◽  
Catherine A. Fitton ◽  
Markus F.C. Steiner ◽  
James S. McLay ◽  
David Clark ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Hospital Admissions ◽  
Incidence Rate Ratio ◽  
Educational Interventions ◽  
Linkage Study ◽  
Increased Risk ◽  
Educational Need ◽  
Psychosocial Morbidity

BackgroundThe global prevalence of childhood asthma is increasing. The condition impacts physical and psychosocial morbidity; therefore, wide-ranging effects on health and education outcomes are plausible.MethodsLinkage of eight Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions and unemployment, provided data on 683 716 children attending Scottish schools between 2009 and 2013. We compared schoolchildren on medication for asthma with peers, adjusting for sociodemographic, maternity and comorbidity confounders, and explored effect modifiers and mediators.ResultsThe 45 900 (6.0%) children treated for asthma had an increased risk of hospitalisation, particularly within the first year of treatment (incidence rate ratio 1.98, 95% CI 1.93–2.04), and increased mortality (HR 1.77, 95% CI 1.30–2.40). They were more likely to have special educational need for mental (OR 1.76, 95% CI 1.49–2.08) and physical (OR 2.76, 95% CI 2.57–2.95) health reasons, and performed worse in school exams (OR 1.11, 95% CI 1.06–1.16). Higher absenteeism (incidence rate ratio 1.25, 95% CI 1.24–1.26) partially explained their poorer attainment.ConclusionsChildren with treated asthma have poorer education and health outcomes than their peers. Educational interventions that mitigate the adverse effects of absenteeism should be considered.

Gender Differences in Anterior Cruciate Ligament Injury vary with Activity

2007 ◽  
Vol 35 (10) ◽  
pp. 1635-1642 ◽  
Author(s):  
Sally B. Mountcastle ◽  
Matthew Posner ◽  
John F. Kragh ◽  
Dean C. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Men And Women ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background Previous studies have shown that women involved in similar activities as men are at increased risk for anterior cruciate ligament injuries. Hypothesis The incidence rate of complete anterior cruciate ligament tears for men and women in our athletic, college-aged population is similar. Study Design Descriptive epidemiology study. Methods Students graduating in class years 1994 to 2003 at our institution who sustained complete anterior cruciate ligament tears were assessed for mechanism of injury and type of sport played at time of injury. We calculated the incidence proportion, an estimation of risk, by gender and class year, and the incidence proportion ratio comparing men and women by class year. We also calculated incidence rates by gender and type of sport played and incidence rate ratios comparing men and women. Results There were 353 anterior cruciate ligament injuries in the 10 classes studied. We found an overall, 4-year incidence proportion of 3.24 per 100 (95% confidence interval, 2.89-3.63) for men and 3.51 (95% confidence interval, 2.65-4.65) for women (incidence proportion ratio, 1.09 [95% confidence interval, 0.80-1.47]). The overall anterior cruciate ligament injury rate, excluding male-only sports, was significantly greater in women (incidence rate ratio, 1.51 [95% confidence interval, 1.03-2.21]). We found significantly greater injury rates among women in a gymnastics course (incidence rate ratio, 5.67 [95% confidence interval, 1.99-16.16]), indoor obstacle course test (incidence rate ratio, 3.72 [95% confidence interval, 1.25-11.10]), and basketball (incidence rate ratio, 2.42 [95% confidence interval, 1.05-5.59]). Conclusion We found little gender difference in the overall risk of an anterior cruciate ligament tear; however, there were gender differences in injury rates when specific sports and activities were compared and when male-only sports were removed from the overall rate assessment.

scholarly journals The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia

2021 ◽  
pp. 000486742110535
Author(s):  
Brian O’Donoghue ◽  
Hannah Collett ◽  
Sophie Boyd ◽  
Yuanna Zhou ◽  
Emily Castagnini ◽  
...  
Keyword(s):  
Young People ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Odds Ratio ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Incident Cases

Objective: The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission). Methods: Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared. Results: Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]). Conclusion: There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.

scholarly journals Self-harm following release from prison: A prospective data linkage study

2016 ◽  
Vol 51 (3) ◽  
pp. 250-259 ◽  
Author(s):  
Rohan Borschmann ◽  
Emma Thomas ◽  
Paul Moran ◽  
Megan Carroll ◽  
Ed Heffernan ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Confidence Interval ◽  
Mental Disorder ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
History Of ◽  
Self Harm ◽  
Release From Prison

Objective: Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison. Method: Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations. Results: During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In all, 83 (6.4%) participants presented due to self-harm, accounting for 165 (4.4%) presentations. The crude incidence rates of self-harm for males and females were 49.2 (95% confidence interval: [41.2, 58.7]) and 60.5 (95% confidence interval: [44.9, 81.6]) per 1000 person-years, respectively. Presenting due to self-harm was associated with being Indigenous (incidence rate ratio: 2.01; 95% confidence interval: [1.11, 3.62]), having a lifetime history of a mental disorder (incidence rate ratio: 2.13; 95% confidence interval: [1.19, 3.82]), having previously been hospitalised for psychiatric treatment (incidence rate ratio: 2.68; 95% confidence interval: [1.40, 5.14]) and having previously presented due to self-harm (incidence rate ratio: 3.91; 95% confidence interval: [1.85, 8.30]). Conclusion: Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release. Demographic and mental health variables help to identify at-risk groups, and such presentations could provide opportunities for suicide prevention in this population. Transition from prison to the community is challenging, particularly for those with a history of mental disorder; mental health support during and after release may reduce the risk of adverse outcomes, including self-harm.

scholarly journals Accuracy of inter-hospital transfer information in Australian hospital administrative databases

2017 ◽  
Vol 25 (3) ◽  
pp. 960-972 ◽  
Author(s):  
Hassan Assareh ◽  
Helen M Achat ◽  
Jean-Frederic Levesque
Keyword(s):  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Care Delivery ◽  
Hospital Performance ◽  
Administrative Databases ◽  
Accuracy Rate ◽  
Hospital Variation ◽  
Hospital Administrative

Inter-hospital transfers improve care delivery for which sending and receiving hospitals both accountable for patient outcomes. We aim to measure accuracy in recorded patient transfer information (indication of transfer and hospital identifier) over 2 years across 121 acute hospitals in New South Wales, Australia. Accuracy rate for 127,406 transfer-out separations was 87 per cent, with a low variability across hospitals (10% differences); it was 65 per cent for 151,978 transfer-in admissions with a greater inter-hospital variation (36% differences). Accuracy rate varied by departure and arrival pathways; at receiving hospitals, it was lower for transfer-in admission via emergency department (incidence rate ratio = 0.52, 95% confidence interval: 0.51–0.53) versus direct admission. Transfer-out data were more accurate for transfers to smaller hospitals (incidence rate ratio = 1.06, 95% confidence interval: 1.03–1.08) or re-transfers (incidence rate ratio > 1.08). Incorporation of transfer data from sending and receiving hospitals at patient level in administrative datasets and standardisation of documentation across hospitals would enhance accuracy and support improved attribution of hospital performance measures.

scholarly journals Cognitive function predicts work disability among multiple sclerosis patients

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731882213 ◽  
Author(s):  
Andrius Kavaliunas ◽  
Petter Tinghög ◽  
Emilie Friberg ◽  
Tomas Olsson ◽  
Kristina Alexanderson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Work Disability ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
One Year ◽  
Multiple Sclerosis Patients

Background In multiple sclerosis various aspects of cognitive function can be detrimentally affected. More than that, patients´ employment and social functioning is likely to be impacted. Objective To determine whether work disability among multiple sclerosis patients could be predicted by the symbol digit modalities test. Methods A register-based cohort study was conducted. Individual data on work disability, operationalised as annual net days of sickness absence and/or disability pension were retrieved at baseline, when the symbol digit modalities test was performed, after one-year and 3-year follow-up for 903 multiple sclerosis patients. The incidence rate ratios for work disability were calculated with general estimating equations using a negative binomial distribution and were adjusted for gender, age, educational level, family composition, type of living area and physical disability. Results After one year of follow-up, the patients in the lowest symbol digit modalities test quartile were estimated to have a 73% higher rate of work disability when compared to the patients in the highest symbol digit modalities test quartile (incidence rate ratio 1.73, 95% confidence interval 1.42‒2.10). This estimate after 3-year follow-up was similar (incidence rate ratio 1.68, 95% confidence interval 1.40‒2.02). Conclusion Cognitive function is to a high extent associated with multiple sclerosis patients’ future work disability, even after adjusting for other factors.

scholarly journals Mass Gatherings and Diarrheal Disease Transmission Among Rural Communities in Coastal Ecuador

2019 ◽  
Vol 188 (8) ◽  
pp. 1475-1483 ◽  
Author(s):  
Philip A Collender ◽  
Christa Morris ◽  
Rose Glenn-Finer ◽  
Andrés Acevedo ◽  
Howard H Chang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Incidence Rate ◽  
Disease Transmission ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Diarrheal Disease ◽  
Coverage Rate ◽  
Epidemic Disease ◽  
Mass Gatherings ◽  
Epidemiologic Surveillance

Abstract Mass gatherings exacerbate infectious disease risks by creating crowded, high-contact conditions and straining the capacity of local infrastructure. While mass gatherings have been extensively studied in the context of epidemic disease transmission, the role of gatherings in incidence of high-burden, endemic infections has not been previously studied. Here, we examine diarrheal incidence among 17 communities in Esmeraldas, Ecuador, in relation to recurrent gatherings characterized using ethnographic data collected during and after the epidemiologic surveillance period (2004–2007). Using distributed-lag generalized estimating equations, adjusted for seasonality, trend, and heavy rainfall events, we found significant increases in diarrhea risk in host villages, peaking 2 weeks after an event’s conclusion (incidence rate ratio, 1.21; confidence interval, adjusted for false coverage rate of ≤0.05: 1.02, 1.43). Stratified analysis revealed heightened risks associated with events where crowding and travel were most likely (2-week-lag incidence rate ratio, 1.51; confidence interval, adjusted for false coverage rate of ≤0.05: 1.09, 2.10). Our findings suggest that community-scale mass gatherings might play an important role in endemic diarrheal disease transmission and could be an important focus for interventions to improve community health in low-resource settings.

scholarly journals Minocycline and the risk of acute psychiatric events in adolescence: A self-controlled case series

2019 ◽  
Vol 33 (4) ◽  
pp. 466-471 ◽  
Author(s):  
Ruth Brauer ◽  
Maria Herrero-Zazo ◽  
David J Barlow ◽  
Fiona Gaughran ◽  
David Taylor ◽  
...  
Keyword(s):  
United Kingdom ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Psychiatric Symptoms ◽  
Case Series ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Psychiatric Referral

Background Minocycline has neurological anti-inflammatory properties and has been hypothesised to have antipsychotic effects. Aim The aim of this study was to investigate, using routinely collected United Kingdom primary health care data, whether adolescent men and women are more or less likely to receive an urgent psychiatric referral during treatment for acne with minocycline compared with periods of non-treatment. Method A self-controlled case series using United Kingdom Clinical Practice Research Datalink to calculate the incidence rate ratio of urgent psychiatric referrals for individuals, comparing periods during which minocycline was prescribed with unexposed periods, adjusted for age. Results We found 167 individuals who were at the time exposed to minocycline for a mean of 99 days and who received an urgent psychiatric referral. There was no difference in psychiatric referral risk during periods of exposure compared with periods of non-exposure: incidence rate ratio first 6 weeks of exposure 1.96, 95% confidence interval 0.82–4.71, p=0.132; incidence rate ratio remaining exposure period=1.97, 95% confidence interval 0.86–4.47, p=0.107. Conclusions We found no evidence in support of a protective effect of minocycline against severe psychiatric symptoms in adolescence.

scholarly journals Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis

2020 ◽  
Vol 15 (6) ◽  
pp. 805-812 ◽  
Author(s):  
Finnian R. Mc Causland ◽  
Jim A. Tumlin ◽  
Prabir Roy-Chaudhury ◽  
Bruce A. Koplan ◽  
Alexandru I. Costea ◽  
...  
Keyword(s):  
United States ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Negative Binomial ◽  
Incidence Rate Ratio ◽  
The United States ◽  
Maintenance Hemodialysis ◽  
Intradialytic Hypotension ◽  
Clinically Significant

Background and objectivesPatients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.Design, setting, participants, & measurementsWe analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (n=66 from the United States and India) over a 6-month period (n=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH20 (decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH0–20 (decline in systolic BP 0–20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.ResultsThe median age of participants was 58 (25th–75th percentile, 49–66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH0–20 occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH20 occurred and 15 (0.8%) where IDH0–20 occurred. Participants who experienced IDH20 (versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH0–20 was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).ConclusionsIDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia.

scholarly journals Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project

2018 ◽  
Vol 25 (10) ◽  
pp. 1031-1039 ◽  
Author(s):  
Gerhard Sulo ◽  
Jannicke Igland ◽  
Stein Emil Vollset ◽  
Marta Ebbing ◽  
Grace M Egeland ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Incidence Rates ◽  
Myocardial Infarctions ◽  
Men And Women

Background We updated the information on trends of incident acute myocardial infarction in Norway, focusing on whether the observed trends during 2001–2009 continued throughout 2014. Methods All incident (first) acute myocardial infarctions in Norwegian residents age 25 years and older were identified in the Cardiovascular Disease in Norway 1994–2014 project. We analysed overall and age group-specific (25–64 years, 65–84 years and 85 + years) trends by gender using Poisson regression analyses and report the average annual changes in rates with their 95% confidence intervals. Results During 2001–2014, 221,684 incident acute myocardial infarctions (59.4% men) were identified. Hospitalised cases accounted for 79.9% of all incident acute myocardial infarctions. Overall, incident acute myocardial infarction rates declined on average 2.6% per year (incidence rate ratio 0.974, 95% confidence interval 0.972–0.977) in men and 2.8% per year (incidence rate ratio 0.972, 95% confidence interval 0.971–0.974) in women, contributed by declining rates of hospitalisations (1.8% and 1.9% per year in men and women, respectively) and deaths (6.0% and 5.8% per year in men and women, respectively). Declining rates were observed in all three age groups. The overall acute myocardial infarction incidence rates continued to decline from 2009 onwards, with a steeper decline compared to 2001–2009. During 2009–2014, gender-adjusted acute myocardial infarction incidence among adults age 25–44 years declined 5.3% per year, contributed mostly by declines in hospitalisation rates (5.1% per year). Conclusion Acute myocardial infarction incidence rates continued to decline after 2009 in Norway in both men and women. The decline started to involve individuals aged 25–44 years, marking a turning point in the previously reported stagnation of rates during 2001–2009.

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