Enterovirus Meningitis in Adults: A Prospective Nationwide Population-Based Cohort Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012294
Author(s):  
Jacob Bodilsen ◽  
Helene Mens ◽  
Sofie Midgley ◽  
Christian Thomas Brandt ◽  
Pelle Trier Petersen ◽  
...  
Keyword(s):  
Lumbar Puncture ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Unfavorable Outcome ◽  
Cns Infection ◽  
Neck Stiffness ◽  
Echovirus 30 ◽  
Relative Risks ◽  
Long Term Prognosis ◽  
Limiting Condition

Objective:To test the hypothesis that enterovirus meningitis (EM) is a frequent and self-limiting condition, the epidemiology of enterovirus meningitis (EM) in adults was examined.Methods:Using a prospective, nationwide, population-based database, all adults with EM confirmed by PCR of the cerebrospinal fluid (CSF) from 2015-2019 were included. Unfavorable outcome was defined as Glasgow Outcome Scale (GOS) scores of 1-4 at discharge. Modified Poisson regression was used to compute adjusted relative risks (RRs).Results:419 cases of EM in 418 adults (46% female, median age 31 years [IQR 27-35]) yielded an incidence of 1.80/100,000/year. Admission diagnoses included CNS infection 247/397 (62%), other neurological conditions 89/397 (22%), and cerebrovascular diseases 33/397 (8%). Genotype was available for 271 cases, of which Echovirus 30 accounted for 155 (57%).Patients presented with headache 412/415 (99%), history of fever 303/372 (81%), photophobia 292/379 (77%), and neck stiffness 159/407 (39%). Fever (≥38.0 °C) was observed in 192/399 (48%) at admission. The median CSF leukocyte count was 130 106/L (range 0-2,100) with polymorphonuclear predominance (>50%) in 110/396 (28%). Cranial imaging preceded lumbar puncture in 127/417 (30%) and was associated with non-CNS infection admission diagnoses and delayed lumbar puncture (median 4.8 hours [IQR 3.4-7.9] vs. 1.5 [IQR 0.8-2.8], p<0.001). Unfavorable outcome occurred in 99/419 (24%) at discharge; more often in females (RR 2.30 [1.58-3.33]) and less frequent in Echovirus 30 (RR 0.67 [0.46-1.00]) in adjusted analyses. Outcome remained unfavorable in 22/379 (6%) after six months.Conclusions:EM is common among young, healthy adults. Although the long-term prognosis remains reassuring, a substantial proportion have moderate disability at discharge, especially females.

Long-Term Exposure to PM2.5 and Cognitive Decline: A Longitudinal Population-Based Study

2021 ◽  
pp. 1-9
Author(s):  
Giulia Grande ◽  
Jing Wu ◽  
Petter L.S. Ljungman ◽  
Massimo Stafoggia ◽  
Tom Bellander ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cognitive Decline ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Air Pollutant ◽  
National Study ◽  
Piecewise Regression ◽  
Risk Increase ◽  
Restricted Cubic Splines

Background: A growing but contrasting evidence relates air pollution to cognitive decline. The role of cerebrovascular diseases in amplifying this risk is unclear. Objectives: 1) Investigate the association between long-term exposure to air pollution and cognitive decline; 2) Test whether cerebrovascular diseases amplify this association. Methods: We examined 2,253 participants of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). One major air pollutant (particulate matter ≤2.5μm, PM2.5) was assessed yearly from 1990, using dispersion models for outdoor levels at residential addresses. The speed of cognitive decline (Mini-Mental State Examination, MMSE) was estimated as the rate of MMSE decline (linear mixed models) and further dichotomized into the upper (25%fastest cognitive decline), versus the three lower quartiles. The cognitive scores were used to calculate the odds of fast cognitive decline per levels of PM2.5 using regression models and considering linear and restricted cubic splines of 10 years exposure before the baseline. The potential modifier effect of cerebrovascular diseases was tested by adding an interaction term in the model. Results: We observed an inverted U-shape relationship between PM2.5 and cognitive decline. The multi-adjusted piecewise regression model showed an increased OR of fast cognitive decline of 81%(95%CI = 1.2–3.2) per interquartile range difference up to mean PM2.5 level (8.6μg/m3) for individuals older than 80. Above such level we observed no further risk increase (OR = 0.89;95%CI = 0.74–1.06). The presence of cerebrovascular diseases further increased such risk by 6%. Conclusion: Low to mean PM2.5 levels were associated with higher risk of accelerated cognitive decline. Cerebrovascular diseases further amplified such risk.

scholarly journals Risk Factors for Pneumonia and Death in Adult Patients With Seasonal Influenza and Establishment of Prediction Scores: A Population-Based Study

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Koichi Miyashita ◽  
Eiji Nakatani ◽  
Hironao Hozumi ◽  
Yoko Sato ◽  
Yoshiki Miyachi ◽  
...  
Keyword(s):  
High Risk ◽  
Seasonal Influenza ◽  
Prediction Models ◽  
Validation Cohort ◽  
Risk Groups ◽  
Population Based ◽  
Limited Data ◽  
Population Based Study ◽  
Relative Risks ◽  
Primary Care Settings

Abstract Background Seasonal influenza remains a global health problem; however, there are limited data on the specific relative risks for pneumonia and death among outpatients considered to be at high risk for influenza complications. This population-based study aimed to develop prediction models for determining the risk of influenza-related pneumonia and death. Methods We included patients diagnosed with laboratory-confirmed influenza between 2016 and 2017 (main cohort, n = 25 659), those diagnosed between 2015 and 2016 (validation cohort 1, n = 16 727), and those diagnosed between 2017 and 2018 (validation cohort 2, n = 34 219). Prediction scores were developed based on the incidence and independent predictors of pneumonia and death identified using multivariate analyses, and patients were categorized into low-, medium-, and high-risk groups based on total scores. Results In the main cohort, age, gender, and certain comorbidities (dementia, congestive heart failure, diabetes, and others) were independent predictors of pneumonia and death. The 28-day pneumonia incidence was 0.5%, 4.1%, and 10.8% in the low-, medium-, and high-risk groups, respectively (c-index, 0.75); the 28-day mortality was 0.05%, 0.7%, and 3.3% in the low-, medium-, and high-risk groups, respectively (c-index, 0.85). In validation cohort 1, c-indices for the models for pneumonia and death were 0.75 and 0.87, respectively. In validation cohort 2, c-indices for the models were 0.74 and 0.87, respectively. Conclusions We successfully developed and validated simple-to-use risk prediction models, which would promptly provide useful information for treatment decisions in primary care settings.

The national burden of cerebrovascular diseases in Spain: A population-based study using disability-adjusted life years

2015 ◽  
Vol 144 (8) ◽  
pp. 353-359 ◽  
Author(s):  
Ferrán Catalá-López ◽  
Nerea Fernández de Larrea-Baz ◽  
Consuelo Morant-Ginestar ◽  
Elena Álvarez-Martín ◽  
Jaime Díaz-Guzmán ◽  
...  
Keyword(s):  
Population Based ◽  
Cerebrovascular Diseases ◽  
Disability Adjusted Life Years ◽  
Population Based Study ◽  
Disability Adjusted Life ◽  
Life Years ◽  
National Burden

scholarly journals Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study

2008 ◽  
Vol 68 (4) ◽  
pp. 490-496 ◽  
Author(s):  
L S Lohmander ◽  
M Gerhardsson de Verdier ◽  
J Rollof ◽  
P M Nilsson ◽  
G Engström
Keyword(s):  
Cohort Study ◽  
Waist Circumference ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Hip Osteoarthritis ◽  
Population Based ◽  
Normal Weight ◽  
Men And Women ◽  
Relative Risks ◽  
Percentage Of Body Fat

Objective:To determine in a prospective population-based cohort study relationships between different measures of body mass and the incidence of severe knee and hip osteoarthritis defined as arthroplasty of knee or hip due to osteoarthritis.Materials and methods:Body mass index (BMI), waist circumference, waist–hip ratio (WHR), weight and percentage of body fat (BF%) were measured at baseline in 11 026 men and 16 934 women from the general population. The incidence of osteoarthritis over 11 years was monitored by linkage with the Swedish hospital discharge register.Results:471 individuals had knee osteoarthritis and 551 had hip osteoarthritis. After adjustment for age, sex, smoking and physical activity, the relative risks (RR) of knee osteoarthritis (fourth vs first quartile) were 8.1 (95% CI 5.3 to 12.4) for BMI, 6.7 (4.5 to 9.9) for waist circumference, 6.5 (4.6 to 9.43) for weight, 3.6 (2.6 to 5.0) for BF% and 2.2 (1.7 to 3.0) for WHR. Corresponding RR for hip osteoarthritis were 2.6 (2.0 to 3.4) for BMI, 3.0 (2.3 to 4.0) for weight, 2.5 (1.9 to 3.3) for waist, 1.3 (0.99 to 1.6) for WHR and 1.5 (1.2 to 2.0) for BF%.Conclusion:All measures of overweight were associated with the incidence of knee osteoarthritis, with the strongest relative risk gradient observed for BMI. The incidence of hip osteoarthritis showed smaller but significant differences between normal weight and obesity. Our results support a major link between overweight and biomechanics in increasing the risk of knee and hip osteoarthritis in men and women.

Abstract WP199: Higher Stroke Prevalence Rates among Ribeirinhos Compared to Townsmen in the Brazilian Amazon.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Tiotrefis G Fernandes ◽  
Isabela M Bensenor ◽  
Paulo A Lotufo
Keyword(s):  
Urban Area ◽  
Health Workers ◽  
Prevalence Ratio ◽  
Epidemiological Studies ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Prevalence Rates ◽  
Family Health Program ◽  
Stroke Prevalence ◽  
The Family

There is a lack of epidemiological studies addressing cerebrovascular diseases in remote places as the Amazon river basin. We aimed to calculate the stroke prevalence rates among "ribeirinhos", rural inhabitants who living in riverbanks fishing and extracting fruit and nuts, in the rainforest comparing to townsmen in the same municipality. Methods: From May to October 2011, 6216 residents aged over 35 years in the of Coari, a municipality that is coverage by the Family Health Program with of 76 000 inhabitants, 35% of them are "ribeirinhos”. We trained all community health workers to carry out a door-to-door application of the “Stroke Symptom Questionnaire” for people over 35 years-old. This tool was applied first for the family for stroke screening and further for the index stroke case, including questions about six key functional impairment. It was previously translated to Portuguese and validated by a neurologist. Results: From a total of of 4897 respondents of urban area and 1028 "ribeirinhos", we calculated crude prevalence of stroke of 6.3% (95% CI; 5.0-7.7) among the "ribeirinhos" and of 3.7% (95% CI; 3.3-4.1) among townsmen. This difference was maintained after sex-age-adjustment. The female:male prevalence ratio was 1.37 (95% CI; 1.02-1.85) in urban area and the rural area of 0.93 (95% CI; 0.57-1.52). Among stroke suffers, the "ribeirinhos" were those with less access to medical care (32.1% vs. 52.5%, p=0.01) and a lower proportion of stroke survivors requiring help with least 1 activity of daily living (16.9% vs. 39.3%, p=0.001) in comparison to townsmen. Conclusion: To our knowledge it was the first study that provided a population-based stroke survey in the Amazon rainforest revealing a higher stroke prevalence among "ribeirinhos" compared to townsmen of the same municipality.

scholarly journals Diagnostic stability in a Dutch psychosis incidence cohort

2004 ◽  
Vol 185 (6) ◽  
pp. 460-464 ◽  
Author(s):  
Natalie D. Veen ◽  
Jean-Paul Selten ◽  
Diede Schols ◽  
Winfried Laan ◽  
Hans W. Hoek ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Population Based ◽  
Schizophrenic Disorder ◽  
Diagnostic Stability ◽  
Face To Face ◽  
Follow Up Study ◽  
Relative Risks ◽  
Diagnostic Interviews ◽  
The Uk

BackgroundNo study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.AimsTo determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.MethodA 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.ResultsDiagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.ConclusionsSchizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation.

Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

2018 ◽  
Vol 49 (14) ◽  
pp. 2397-2404 ◽  
Author(s):  
Mu-Hong Chen ◽  
Ju-Wei Hsu ◽  
Kei-Lin Huang ◽  
Tung-Ping Su ◽  
Cheng-Ta Li ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Population Based ◽  
Autism Spectrum ◽  
The Public ◽  
First Degree Relatives ◽  
Relative Risks ◽  
Dependent Relationship ◽  
Increased Risk ◽  
Bipolar Patients

AbstractBackgroundBipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.MethodsAmong the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.ResultsFDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.ConclusionsOur study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

scholarly journals Familial Aggregation of Psoriasis and Co-Aggregation of Autoimmune Diseases in Affected Families

2019 ◽  
Vol 8 (1) ◽  
pp. 115 ◽  
Author(s):  
Yu-Huei Huang ◽  
Chang-Fu Kuo ◽  
Lu-Hsiang Huang ◽  
Mei-Yun Hsieh
Keyword(s):  
Autoimmune Diseases ◽  
Genetic Factors ◽  
Familial Aggregation ◽  
Population Based ◽  
Study Cohort ◽  
Genetic Contribution ◽  
Degree Relative ◽  
Nationwide Study ◽  
Relative Risks ◽  
History Of

Psoriasis is considered to result from the interaction of genetic factors and environmental exposure. The evidence for familial aggregation in psoriasis has been reported but population-based studies related to the magnitude of genetic contribution to psoriasis are rare. This study aimed to evaluate the relative risks of psoriasis in individuals with affected relatives and to calculate the proportion of genetic, shared, and non-shared environmental factors contributing to psoriasis. The study cohort included 69,828 patients diagnosed with psoriasis enrolled in National health Insurance in 2010. The adjusted relative risks (RR) for individuals with an affected first-degree relative and affected second-degree relative were 5.50 (95% CI (Confidence Interval), 5.19–5.82) and 2.54 (95% CI, 2.08–3.12) respectively. For those who have affected first-degree relatives, their RR was 1.45 (95% CI, 1.17–1.79) for Sjogren’s syndrome and 1.94 (95% CI, 1.15–3.27) for systemic sclerosis. This nationwide study ascertains that family history of psoriasis is a risk factor for psoriasis. Individuals with relatives affected by psoriasis have higher risks of developing some autoimmune diseases.

scholarly journals Mobile phone use and incidence of brain tumour histological types, grading or anatomical location: a population-based ecological study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024489 ◽  
Author(s):  
Ken Karipidis ◽  
Mark Elwood ◽  
Geza Benke ◽  
Masoumeh Sanagou ◽  
Lydiawati Tjong ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Ecological Study ◽  
Population Based ◽  
Incidence Rates ◽  
Anatomical Location ◽  
Mobile Phone Use ◽  
Registration Data ◽  
Relative Risks

ObjectiveSome studies have reported increasing trends in certain brain tumours and a possible link with mobile phone use has been suggested. We examined the incidence time trends of brain tumour in Australia for three distinct time periods to ascertain the influence of improved diagnostic technologies and increase in mobile phone use on the incidence of brain tumours.DesignIn a population-based ecological study, we examined trends of brain tumour over the periods 1982–1992, 1993–2002 and 2003–2013. We further compared the observed incidence during the period of substantial mobile phone use (2003–2013) with predicted (modelled) incidence for the same period by applying various relative risks, latency periods and mobile phone use scenarios.SettingNational Australian incidence registration data on primary cancers of the brain diagnosed between 1982 and 2013.Population16 825 eligible brain cancer cases aged 20–59 from all of Australia (10 083 males and 6742 females).Main outcome measuresAnnual percentage change (APC) in brain tumour incidence based on Poisson regression analysis.ResultsThe overall brain tumour rates remained stable during all three periods. There was an increase in glioblastoma during 1993–2002 (APC 2.3, 95% CI 0.8 to 3.7) which was likely due to advances in the use of MRI during that period. There were no increases in any brain tumour types, including glioma (−0.6, –1.4 to 0.2) and glioblastoma (0.8, –0.4 to 2.0), during the period of substantial mobile phone use from 2003 to 2013. During that period, there was also no increase in glioma of the temporal lobe (0.5, –1.3 to 2.3), which is the location most exposed when using a mobile phone. Predicted incidence rates were higher than the observed rates for latency periods up to 15 years.ConclusionsIn Australia, there has been no increase in any brain tumour histological type or glioma location that can be attributed to mobile phones.

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