scholarly journals Thyrotoxicosis in an Indigenous New Zealand Population – a Prospective Observational Study

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Jade A U Tamatea ◽  
Papaarangi Reid ◽  
John V Conaglen ◽  
Marianne S Elston
Keyword(s):  
New Zealand ◽  
Incidence Rate ◽  
Indigenous People ◽  
Multinodular Goiter ◽  
Demographic Data ◽  
Incidence Rates ◽  
Graves Disease ◽  
Toxic Multinodular Goiter ◽  
Rate Ratios ◽  
A Prospective Study

Abstract Background Reported international incidence rates of thyrotoxicosis vary markedly, ranging from 6 to 93 cases per 100 000 per annum. Along with population demographics, exposures, and study design factors, ethnicity is increasingly being recognized as a potential factor influencing incidence. This study aimed to document the epidemiology and clinical presentation of thyrotoxicosis for Māori, the indigenous population in New Zealand. Methods A prospective study of adult patients presenting with a first diagnosis of thyrotoxicosis between January 2013 and October 2014 to a single New Zealand center. Demographic data were collected, and detailed clinical assessment performed. Results With 375 patients, an incidence rate of thyrotoxicosis of 73.0 per 100 000 per annum was identified. Of these, 353 (94.1%) participated in the study. The median age of the cohort was 47 years, 81% were female, and 58% had Graves disease. The overall incidence of thyrotoxicosis for Māori, the indigenous people of New Zealand, was higher than non-Māori (123.9 vs 57.3 per 100 000 per annum). Rates of both Graves disease and toxic multinodular goiter were higher in Māori as compared to non-Māori (incidence rate ratios of 1.9 [1.4, 2.6] and 5.3 [3.4, 8.3], respectively), with this increase being maintained after controlling for age, deprivation, and smoking. Conclusions Māori, the indigenous people of New Zealand, have an increased incidence of thyrotoxicosis compared to non-Māori and, in particular, toxic multinodular goiter. A greater understanding of the epidemiology of thyrotoxicosis in other indigenous and marginalized ethnic groups may help to optimize therapeutic pathways, equitable care and outcomes.

scholarly journals Injury Incidence Across the Menstrual Cycle in International Footballers

2021 ◽  
Vol 3 ◽  
Author(s):  
Dan Martin ◽  
Kate Timmins ◽  
Charlotte Cowie ◽  
Jon Alty ◽  
Ritan Mehta ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Incidence Rate ◽  
Luteal Phase ◽  
Incidence Rates ◽  
Follicular Phase ◽  
Tendon Injuries ◽  
Cycle Phase ◽  
Injury Incidence ◽  
Rate Ratios ◽  
Late Follicular Phase

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.

scholarly journals Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes

2020 ◽  
Vol 55 (2) ◽  
pp. 195-204 ◽  
Author(s):  
Matthew C. Hess ◽  
David I. Swedler ◽  
Christine S. Collins ◽  
Brent A. Ponce ◽  
Eugene W. Brabston
Keyword(s):  
Incidence Rate ◽  
Epidemiologic Study ◽  
Incidence Rates ◽  
Thigh Muscle ◽  
Surveillance Program ◽  
Injury Incidence ◽  
Descriptive Epidemiology ◽  
Injury Rates ◽  
Ultimate Frisbee ◽  
Rate Ratios

Context Injuries in professional ultimate Frisbee (ultimate) athletes have never been described. Objective To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate. Design Descriptive epidemiology study. Setting American Ultimate Disc League professional ultimate teams during the 2017 season. Patients or Other Participants Sixteen all-male teams. Main Outcome Measure(s) Injury incidence rates (IRs) were calculated as injuries per 1000 athlete-exposures (AEs). Incidence rate ratios were determined to compare IRs with 95% confidence intervals, which were used to calculate differences. Results We observed 299 injuries over 8963 AEs for a total IR of 33.36 per 1000 AEs. Most injuries affected the lower extremity (72%). The most common injuries were thigh-muscle strains (12.7%) and ankle-ligament sprains (11.4%). Running was the most frequent injury mechanism (32%). Twenty-nine percent of injuries involved collisions; however, the concussion rate was low (IR = 0.22 per 1000 AEs). Injuries were more likely to occur during competition and in the second half of games. An artificial turf playing surface did not affect overall injury rates (Mantel-Haenszel incidence rate ratio = 1.28; 95% confidence interval = 0.99, 1.67). Conclusions To our knowledge, this is the first epidemiologic study of professional ultimate injuries. Injury rates were comparable with those of similar collegiate- and professional-level sports.

scholarly journals Injuries in Korean Elite Taekwondo Athletes: A Prospective Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5143
Author(s):  
Boae Son ◽  
Young Jae Cho ◽  
Hee Seong Jeong ◽  
Sae Yong Lee
Keyword(s):  
Female Athletes ◽  
Injury Rate ◽  
Incidence Rates ◽  
Injury Incidence ◽  
Event Type ◽  
Severe Injuries ◽  
Injury Surveillance System ◽  
Common Location ◽  
Rate Ratios ◽  
A Prospective Study

This prospective cohort study aimed to identify the incidence and characteristics of Taekwondo-related injuries according to age, sex, and event type (i.e., practice or competition) based on a web-based injury surveillance system (ISS) with a follow-up period of 12 months. A total of 285 members of the Korea Taekwondo Association who competed in the 2016 season participated. Injury incidence rates (IRs) were calculated per 1000 athlete-exposures (AEs). Injury rate ratios (RRs) with 95% confidence intervals were calculated and compared regarding age, sex, and event type. During the season, 336 injuries were reported, resulting in a rate of 6.31/1000 AEs. The most common location, type, and mechanism of injury in Taekwondo athletes were the foot/ankle, ligament sprain, and contact with another player, respectively. The overall injury IRs associated with Taekwondo practicing and competition were 4.79/1000 AEs and 24.86/1000 AEs, respectively. The overall injury RR related to both practice and competition was higher in youth athletes than in adult athletes. However, adult athletes were more likely to sustain more severe injuries. Korean elite Taekwondo athletes were commonly exposed to injury, especially youth and female athletes. Therefore, continuation of the ISS suggests the development of interventions for preventing injuries sustained by Taekwondo athletes.

scholarly journals Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis: results from a national register-based cohort study

Rheumatology ◽  
2020 ◽  
Author(s):  
Karin Bengtsson ◽  
Helena Forsblad-d'Elia ◽  
Anna Deminger ◽  
Eva Klingberg ◽  
Mats Dehlin ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Incidence Rates ◽  
The Other ◽  
Population Register ◽  
Swedish Population ◽  
National Patient Register ◽  
National Patient ◽  
Rate Ratios ◽  
Strength Of Association

Abstract Objectives To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods Three mutually exclusive cohorts of patients aged 18–69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001–2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD.

scholarly journals Open angle glaucoma, glaucoma suspect and ocular hypertension in thyroid related immune orbitopathy and other thyroid diseases

2016 ◽  
Vol 8 (1) ◽  
pp. 50
Author(s):  
Saleha Sultana ◽  
Syed Abdul Wadud ◽  
Shabeena Huda ◽  
Sharfuddin Ahmed
Keyword(s):  
Ocular Hypertension ◽  
Multinodular Goiter ◽  
Open Angle Glaucoma ◽  
Thyroid Diseases ◽  
Graves Disease ◽  
Open Angle ◽  
Glaucoma Suspect ◽  
Toxic Multinodular Goiter ◽  
Group A ◽  
Group B

<p><strong>Background:</strong> The eye changes associated with thyroid disease are referred to as Thyroid related Orbitopathy. A well described association exist between open angle glaucoma and thyroid related orbitopathy, the possible relationship between open angle glaucoma and either hypothyroidism or hyperthyroidism without orbitopathy is variable.</p><p><strong>Objective:</strong> To observe the relation of open angle glaucoma (OAG), glaucoma suspect (GS) and ocular hypertension(OHT) between Thyroid related immune orbitopathy (TRIO) and other thyroid diseases (toxic multinodular goiter and hypothyroidism).</p><p><strong>Method:</strong> With purposive type of sampling technique 40 patients of Graves' disease disease in Group-A and 40 patients of other thyroid diseases in Group-B which was subdivided into 20 patients of toxic multinodular goiter in Group-B 1, 20 patients of hypothyroidism in Group-B2 were selected in Bangabandhu Sheikh Mujib Medical University (BSMMU) for this cross sectional study. The diagnosis of Graves' disease, toxic multinodular goiter and hypothyroidism were carried out by history, clinical examination and clinical test in endocrinology department. All the patients underwent complete ocular examinations, measuring of intraocular pressure (IOP), fundus examination, visual field analysis, gonioscopy and exophthalmometry.</p><p><strong>Result:</strong> The OAG, GS and OHT was 7.5% (3 cases), 5.0% (2 cases) and 17.5% (7 cases) respectively in Group-A. In contrast OAG, GS was 5% (lease), 5% (1 case) respectively in Group-Bl, only 5% (1 case) OAG in Group-B2. There was no incidence of OHT in Group-B (B1+B2). Although the occurrence of OAG and GS were higher in Group-A than Group-B, this difference was not statistically significant (p&gt;0.05). However OHT was more common in Group-A than Group-B and is statistically significant (p&lt;0.05). Among the 12 patients with OAG, GS and OHT in Group-A, 11 had ≥22mm exophthalmos. In Group-A, ≥22mm exophthalmos in 60% cases, in contrast none of Group-B have ≥22mm.</p><p><strong>Conclusion:</strong> The occurrence of OHT was higher in thyroid related immune orbitopathy than other thyroid diseases.</p>

scholarly journals SAT-415 Clinical Performance of Thyroid-Stimulating Immunoglobulin for Graves′ Disease Diagnosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Suemi Marui ◽  
Aline Lenczuk ◽  
Nelisa Helena Rocha ◽  
Tomoco Watanabe ◽  
Luciana Pinto Brito
Keyword(s):  
Multinodular Goiter ◽  
Clinical Performance ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Serum Samples ◽  
Toxic Multinodular Goiter ◽  
Analytical Range ◽  
Roche Diagnostics ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Abstract INTRODUCTION The diagnosis of Graves′disease (GD) is likely when patient presents hyperthyroidism, symmetrical goiter and orbitopathy and further evaluation is unnecessary. Nevertheless patient with nodular thyroid or in the absence of clinical orbitopathy, measurement of TSH receptor antibodies (TRAb) is recommended to distinguish GD from toxic multinodular goiter, toxic adenoma and other etiologies. Radioiodine uptake (RAIU) also helps to diagnosis when TRAb is unavailable. Third generation TRAb assays measure all types of TSH receptor antibodies: stimulating, blocking and neutral with an excellent sensitivity and specificity for GD diagnosis. Recently, an automated bioassay for the thyroid stimulating immunoglobulin (TSI) was introduced to improve GD diagnosis. OBJECTIVE To analyze clinical performance of TSI and compare with TRAb assay for GD diagnosis. MATERIAL AND METHODS Serum samples of 117 patients with thyrotoxicosis due to GD, toxic multinodular goiter and toxic adenoma were runned simultaneously in two analytical system commercially available. TRAb was analyzed by Elecsys Anti-TSHR assay (Roche Diagnostics, Germany) in a Cobase411 analyzer (Roche Diagnostics, Germany) and results, according to the manufacturer interval reference, were negative if &lt; 1.75 IU/L (analytical range: 0.3 to 40 IU/L). TSI was measured by Immulite TSI assay (Siemens Healthcare, UK) in Immulite XPi 2000 and results, according to the manufacturer interval reference, were negative if &lt; 0.55 IU/L (analytical range: 0.1 to 40 IU/L). Clinical diagnoses of thyrotoxicosis were determined according to ATA guideline (2016). Statistical analyses were performed using SPSS and MedCalc softwares. Comparison were evaluated by regression equations and were considered significant when p values were &lt; .05. RESULTS From 2017 to 2019 a total of 312 serum samples from 117 patients (96 females) were evaluated with mean age 49.5 ±15.8 years-old (18 to 90 yrs). We excluded 26 results above the analytical measurement range of both assays. A high degree correlation was observed with a slope of 0.647 and an intercept -.094 IU/L. Spearman correlation coefficient was 0.858 (p &lt; 0.0001, 95% CI 0.825 to 0.886). TSI assay had higher sensibility and negative predictive value compared to TRAb (95.6% vs 88.5% and 83.6% vs 54.8%, respectively) but lower specificity and positive predictive value (90.3% vs 100% and 97.5% vs 100%, respectively). The results of TSI assay showed good agreement with those of the TRAb assay (k=0.74). A total of 31 samples were discordant, favoring to TSI assay in all but one case of GD according to clinical diagnosis (TRAb positive and TSI negative). CONCLUSION TSI assay showed an excellent performance for GD diagnosis with a better sensibility than TRAb assay.

scholarly journals The initial impact of a national BNT162b2 mRNA COVID-19 vaccine rollout

2021 ◽  
Author(s):  
Ahmed Zaqout ◽  
Joanne Daghfal ◽  
Israa Alaqad ◽  
Saleh A.N. Hussein ◽  
Abdullah Aldushain ◽  
...  
Keyword(s):  
Protective Effect ◽  
Incidence Rate ◽  
Confidence Intervals ◽  
Poisson Regression ◽  
Incidence Rates ◽  
Post Vaccination ◽  
Time Periods ◽  
Rate Ratios ◽  
Vaccination Period

AbstractObjectiveWe herein report the initial impact of a national BNT162b2 rollout on SARS-CoV-2 infections in Qatar.MethodsWe included all individuals who by 16 March 2021 had completed ≥14 days of follow up after the receipt of BNT162b2. We calculated incidence rates (IR) and their 95% confidence intervals (CI), during days 1–7, 8–14, 15–21, 22–28, and >28 days post-vaccination. Poisson regression was used to calculate incidence rate ratios (IRR) relative to the first 7-day post-vaccination period.ResultsWe included 199,219 individuals with 6,521,124 person-days of follow up. SARS-CoV-2 infection was confirmed in 1,877 (0.9%), of which 489 (26.1%) were asymptomatic and 123 (6.6%) required oxygen support. The median time from first vaccination to SARS-CoV-2 confirmation was 11.9 days (IQR 7.7–18.2). Compared with the first 7-day post-vaccination period, SARS-CoV-2 infections were lower by 65.8–84.7% during days 15–21, days 22–28, and >28 days (P <0.001 for each). For severe COVID-19, the incidence rates were 75.7– 93.3% lower (P <0.001 for each) during the corresponding time periods.ConclusionOur results are consistent with an early protective effect of BNT162b2 against all degrees of SARS-CoV-2 severity.

Lamb boning — an occupational cause of carpal tunnel syndrome?

2012 ◽  
Vol 38 (1) ◽  
pp. 61-66 ◽  
Author(s):  
M. C. Wyatt ◽  
D. P. Gwynne-Jones ◽  
G. A. Veale
Keyword(s):  
Carpal Tunnel Syndrome ◽  
General Population ◽  
Incidence Rate ◽  
Carpal Tunnel ◽  
Incidence Rates ◽  
Tunnel Syndrome ◽  
Rate Ratios

Whether an occupation can cause carpal tunnel syndrome requiring carpal tunnel decompression (CTD) is contentious. We compared the demographics and incidence rates in lamb-freezing workers with the general population who had CTD. In the general population there were 1002 (63%) females and 583 (37%) males, mean age 48 years, and the rate of CTD was 1.36/1000 per annum. In lamb-freezing workers there were 225 males (mean age 38.4 years) and 60 females (mean age 44.6 years); most workers required CTD in their first three seasons. Compared with the general population, the incidence rate ratios in all freezing workers was 16.8; boners, 51.6; meat packers, 22.8; and slaughtermen, 5.4. All groups had a greater rate of CTD than the general population. This study suggests that carpal tunnel syndrome can be directly caused by an occupation.

Age and sex-specific incidence rates of group A streptococcal pharyngitis between 2010 and 2018: a population-based study

2021 ◽  
Vol 16 (14) ◽  
pp. 1053-1062
Author(s):  
Kwadwo Mponponsuo ◽  
Deirdre L Church ◽  
Sheng Jie Lu ◽  
Jeannine Viczko ◽  
Christopher Naugler ◽  
...  
Keyword(s):  
Standardized Testing ◽  
Incidence Rate ◽  
Group A Streptococcus ◽  
Population Based ◽  
Streptococcal Pharyngitis ◽  
Incidence Rates ◽  
Population Based Study ◽  
Group A ◽  
Rate Ratios ◽  
Age And Sex

Aim: Group A streptococcus (GAS) pharyngitis is a common clinical infection with significant morbidity but remains understudied. Materials & methods: We sought to assess the rates of testing and incidence of GAS pharyngitis in Calgary, Alberta based on age and sex. Results: A total of 1,074,154 tests were analyzed (58.8% female, mean age 24.8 years) of which 16.6% were positive. Age-standardized testing and positivity was greatest in the 5–14 years age group and lowest in persons over 75 years. Females had greater rates of testing and positivity throughout. Testing rates (incidence rate ratios: 1.40, 95% CI: 1.39–1.41) and case rates (incidence rate ratios: 1.36, 95% CI: 1.33–1.39) increased over time. Conclusion: Future studies should focus on evaluating disparities in testing and treatment outcomes to optimize the approach to this infection.

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