Association between diabetes and subsequent Parkinson disease

Neurology ◽  
2018 ◽  
Vol 91 (2) ◽  
pp. e139-e142 ◽  
Author(s):  
Eduardo De Pablo-Fernandez ◽  
Raph Goldacre ◽  
Julia Pakpoor ◽  
Alastair J. Noyce ◽  
Thomas T. Warner
Keyword(s):  
Cohort Study ◽  
Parkinson Disease ◽  
Cox Regression ◽  
Normal Pressure ◽  
Relative Increase ◽  
Mortality Data ◽  
Drug Induced ◽  
Therapeutic Implications ◽  
Large Cohort Study ◽  
Reference Cohort

ObjectiveTo investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD).MethodsLinked English national Hospital Episode Statistics and mortality data (1999–2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort. Subsequent PD risk was estimated using Cox regression models. Individuals with a coded diagnosis of cerebrovascular disease, vascular parkinsonism, drug-induced parkinsonism, and normal pressure hydrocephalus were excluded from the analysis.ResultsA total of 2,017,115 individuals entered the T2DM cohort and 6,173,208 entered the reference cohort. There were significantly elevated rates of PD following T2DM (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.29–1.35; p < 0.001). The relative increase was greater in those with complicated T2DM (HR 1.49, 95% CI 1.42–1.56) and when comparing younger individuals (HR 3.81, 95% CI 2.84–5.11 in age group 25–44 years).ConclusionsWe report an increased rate of subsequent PD following T2DM in this large cohort study. These findings may reflect shared genetic predisposition and/or disrupted shared pathogenic pathways with potential clinical and therapeutic implications.

scholarly journals Variation in cardiovascular disease care: an Australian cohort study on sex differences in receipt of coronary procedures

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026507 ◽  
Author(s):  
Alexandra Jane Fogg ◽  
Jennifer Welsh ◽  
Emily Banks ◽  
Walter Abhayaratna ◽  
Rosemary J Korda
Keyword(s):  
Sex Differences ◽  
Cohort Study ◽  
Cox Regression ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Primary Diagnosis ◽  
Mortality Data ◽  
Event Analysis ◽  
Crude Rate ◽  
Coronary Procedures

ObjectivesThe aim of this study was to quantify sex differences in diagnostic and revascularisation coronary procedures within 1 year of hospitalisation for acute myocardial infarction (AMI) or angina.DesignThis is a prospective cohort study. Baseline questionnaire (January 2006–April 2009) data from the Sax Institute’s 45 and Up Study were linked to hospitalisation and mortality data (to 30 June 2016) in a time-to-event analysis, treating death as a censoring event.SettingThis was conducted in New South Wales, Australia.ParticipantsThe study included participants aged ≥45 years with no history of ischaemic heart disease (IHD) who were admitted to hospital with a primary diagnosis of AMI (n=4580) or a primary diagnosis of angina or chronic IHD with secondary diagnosis of angina (n=4457).Outcome measuresThe outcome of this study was coronary angiography and coronary revascularisation with percutaneous coronary intervention or coronary artery bypass graft (PCI/CABG) within 1 year of index admission. Cox regression models compared coronary procedure rates in men and women, adjusting sequentially for age, sociodemographic variables and health characteristics.ResultsAmong patients with AMI, 71.6% of men (crude rate 3.45/person-year) and 64.7% of women (2.62/person-year) received angiography; 57.8% of men (1.73/person-year) and 37.4% of women (0.77/person-year) received PCI/CABG. Adjusted HRs for men versus women were 1.00 (0.92–1.08) for angiography and 1.51 (1.38–1.67) for PCI/CABG. In the angina group, 67.3% of men (crude rate 2.36/person-year) and 54.9% of women (1.32/person-year) received angiography; 44.6% of men (0.90/person-year) and 19.5% of women (0.26/person-year) received PCI/CABG. Adjusted HRs were 1.24 (1.14–1.34) and 2.44 (2.16–2.75), respectively.ConclusionsMen are more likely than women to receive coronary procedures, particularly revascularisation. This difference is most evident among people with angina, where clinical guidelines are less prescriptive than for AMI.

Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors – a Nordic cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Karin Hellgren ◽  
Christine Ballegaard ◽  
Bénédicte Delcoigne ◽  
René Cordtz ◽  
Dan Nordström ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Cox Regression ◽  
Tnf Inhibitors ◽  
Solid Cancer ◽  
Increased Risk ◽  
National Patient ◽  
Large Cohort Study ◽  
Cancer Types ◽  
Estimate Hazard Ratio

Abstract Objectives To investigate whether TNF inhibitors (TNFi) are associated with increased risk of solid cancer in patients with psoriatic arthritis (PsA). Methods From the Nordic clinical rheumatology registers (CRR) here: SRQ/ARTIS (Sweden), DANBIO (Denmark), NOR-DMARD (Norway), ROB-FIN (Finland) and ICEBIO (Iceland) we identified PsA patients who started a first TNFi 2001–2017 (n = 9655). We identified patients with PsA not treated with biologics from (i) the CRR (n = 14 809) and (ii) the national patient registers (PR, n = 31 350). By linkage to the national cancer registers, we collected information on incident solid cancer overall and for eight cancer types. We used Cox regression to estimate hazard ratio (HR) with 95% CI of cancer (per country and pooled) in TNFi-exposed vs biologics-naïve, adjusting for age, sex, calendar period, comorbidities and disease activity. We also assessed standardized incidence ratios (SIR) in TNFi-exposed PsA vs the general population (GP). Results We identified 296 solid cancers among the TNFi-exposed PsA patients (55 850 person-years); the pooled adjusted HR for solid cancer overall was 1.0 (0.9–1.2) for TNFi-exposed vs biologics-naïve PsA from the CRR, and 0.8 (0.7–1.0) vs biologics-naïve PsA from the PRs. There were no significantly increased risks for any of the cancer types under study. The pooled SIR of solid cancer overall in TNFi treated PsA vs GP was 1.0 (0.9–1.1). Conclusion In this large cohort study from five Nordic countries, we found no increased risk of solid cancer in TNFi-treated PsA patients, neither for solid cancer overall nor for eight common cancer types.

Parkinsonism and Related Disorders

2019 ◽  
Author(s):  
Elizabeth J. Slow ◽  
Anthony E. Lang
Keyword(s):  
Differential Diagnosis ◽  
Parkinson Disease ◽  
Lewy Bodies ◽  
Corticobasal Degeneration ◽  
Normal Pressure ◽  
Vascular Parkinsonism ◽  
Drug Induced ◽  
Clinical Criteria ◽  
The Core ◽  
Lewy Neurite

Parkinsonism describes the core clinical criteria of tremor, bradykinesia, rigidity, and postural instability. There is a large differential diagnosis, but the most common cause of parkinsonism is due to Parkinson disease. This review details the epidemiology, etiology/genetics, pathogenesis, diagnosis and differential diagnosis, management, and prognosis of Parkinson disease, dementia with Lewy bodies, progressive supranuclear palsy, corticobasal degeneration, vascular parkinsonism, normal pressure hydrocephalus, and drug-induced parkinsonism.  This review contains 8 figures, 32 tables, and 73 references. Keywords: Parkinson disease, parkinsonism, levodopa, cogwheel ridigity, multiple system atrophy, dementia, substantia nigra, palsy, neurodegenerative disease, hydrocephalus, Lewy body, Lewy neurite

Parkinsonism and Related Disorders

2019 ◽  
Author(s):  
Elizabeth J. Slow ◽  
Anthony E. Lang
Keyword(s):  
Differential Diagnosis ◽  
Parkinson Disease ◽  
Lewy Bodies ◽  
Corticobasal Degeneration ◽  
Normal Pressure ◽  
Vascular Parkinsonism ◽  
Drug Induced ◽  
Clinical Criteria ◽  
The Core ◽  
Lewy Neurite

Parkinsonism describes the core clinical criteria of tremor, bradykinesia, rigidity, and postural instability. There is a large differential diagnosis, but the most common cause of parkinsonism is due to Parkinson disease. This review details the epidemiology, etiology/genetics, pathogenesis, diagnosis and differential diagnosis, management, and prognosis of Parkinson disease, dementia with Lewy bodies, progressive supranuclear palsy, corticobasal degeneration, vascular parkinsonism, normal pressure hydrocephalus, and drug-induced parkinsonism.  This review contains 8 figures, 32 tables, and 73 references. Keywords: Parkinson disease, parkinsonism, levodopa, cogwheel ridigity, multiple system atrophy, dementia, substantia nigra, palsy, neurodegenerative disease, hydrocephalus, Lewy body, Lewy neurite

Movement Disorders

2018 ◽  
Author(s):  
Bradley J. Robottom ◽  
Jason S. Hawley ◽  
William J. Weiner
Keyword(s):  
Parkinson Disease ◽  
Movement Disorders ◽  
Wilson Disease ◽  
Normal Pressure ◽  
Vascular Parkinsonism ◽  
Drug Induced ◽  
Parkinsonian Syndromes ◽  
Abnormal Movements ◽  
Wide Range ◽  
Generalized Dystonia

The term movement disorders encompasses a wide range of conditions that cause abnormal movements. This review discusses hypokinetic movement disorders, including bradykinesia, akinesia, akinetic rigid syndrome, and Parkinsonism, an akinetic rigid syndrome that is one of the most common of all the movement disorders which is most often a manifestation of Parkinson disease (PD). The review looks at the epidemiology, etiology, pathology, diagnosis, treatment, and management of PD. Other parkinsonian syndromes include progressive supranuclear palsy, corticobasal syndrome, multiple system atrophy, vascular parkinsonism, normal pressure hydrocephalus, drug-induced parkinsonism, and dementia associated with Parkinson disease. Hyperkinetic movement disorders include tremor, dystonia, tics, myoclonus, and chorea. They include Huntington disease, Wilson disease, tardive dyskinesia, Tourette syndrome, and essential tremor. Figures in this review include examples of generalized dystonia, moderate parkinson disease, affected handwriting, Kayser-Fleischer ring, cervical dystonia, head deviation, and writer's cramp. Tables provide clinical definitions, clues to drug-induced parkinsonism, and a list of drugs that can cause parkinsonism. This review contains 129 references.

Parkinsonism and Related Disorders

2019 ◽  
Author(s):  
Elizabeth J. Slow ◽  
Anthony E. Lang
Keyword(s):  
Differential Diagnosis ◽  
Parkinson Disease ◽  
Lewy Bodies ◽  
Corticobasal Degeneration ◽  
Normal Pressure ◽  
Vascular Parkinsonism ◽  
Drug Induced ◽  
Clinical Criteria ◽  
The Core ◽  
Lewy Neurite

Parkinsonism describes the core clinical criteria of tremor, bradykinesia, rigidity, and postural instability. There is a large differential diagnosis, but the most common cause of parkinsonism is due to Parkinson disease. This review details the epidemiology, etiology/genetics, pathogenesis, diagnosis and differential diagnosis, management, and prognosis of Parkinson disease, dementia with Lewy bodies, progressive supranuclear palsy, corticobasal degeneration, vascular parkinsonism, normal pressure hydrocephalus, and drug-induced parkinsonism.  This review contains 8 figures, 32 tables, and 73 references. Keywords: Parkinson disease, parkinsonism, levodopa, cogwheel ridigity, multiple system atrophy, dementia, substantia nigra, palsy, neurodegenerative disease, hydrocephalus, Lewy body, Lewy neurite

Movement Disorders

2015 ◽  
Author(s):  
Bradley J. Robottom ◽  
Jason S. Hawley ◽  
William J. Weiner
Keyword(s):  
Parkinson Disease ◽  
Movement Disorders ◽  
Wilson Disease ◽  
Normal Pressure ◽  
Vascular Parkinsonism ◽  
Drug Induced ◽  
Parkinsonian Syndromes ◽  
Abnormal Movements ◽  
Wide Range ◽  
Generalized Dystonia

The term movement disorders encompasses a wide range of conditions that cause abnormal movements. This review discusses hypokinetic movement disorders, including bradykinesia, akinesia, akinetic rigid syndrome, and Parkinsonism, an akinetic rigid syndrome that is one of the most common of all the movement disorders which is most often a manifestation of Parkinson disease (PD). The review looks at the epidemiology, etiology, pathology, diagnosis, treatment, and management of PD. Other parkinsonian syndromes include progressive supranuclear palsy, corticobasal syndrome, multiple system atrophy, vascular parkinsonism, normal pressure hydrocephalus, drug-induced parkinsonism, and dementia associated with Parkinson disease. Hyperkinetic movement disorders include tremor, dystonia, tics, myoclonus, and chorea. They include Huntington disease, Wilson disease, tardive dyskinesia, Tourette syndrome, and essential tremor. Figures in this review include examples of generalized dystonia, moderate parkinson disease, affected handwriting, Kayser-Fleischer ring, cervical dystonia, head deviation, and writer's cramp. Tables provide clinical definitions, clues to drug-induced parkinsonism, and a list of drugs that can cause parkinsonism. This review contains 129 references.

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