Signal Detection of Potential Hepatotoxic Drugs: Case-Control Study Using Both a Spontaneous Reporting System and Electronic Medical Records

Background: Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder that is difficult for primary care physicians to recognize due to its progressive nature and similarities to other neurologic disorders. This case-control study aimed to identify clinical features observed in general practice associated with a subsequent diagnosis of PSP.Methods: We analyzed a de-identified dataset of 152 PSP cases and 3,122 matched controls from electronic medical records of general practices in Germany. We used a random forests algorithm based on machine learning techniques to identify clinical features (medical conditions and treatments received) associated with pre-diagnostic PSP without using an a priori hypothesis. We then assessed the relative effects of the features with the highest importance scores and generated multivariate models using clustered logistic regression analyses to identify a subset of clinical features associated with subsequent PSP diagnosis.Results: Using the random forests approach, we identified 21 clinical features associated with pre-diagnostic PSP (odds ratio ≥2.0 in univariate analyses). From these, we constructed a multivariate model comprising 9 clinical features with ~90% likelihood of identifying a subsequent PSP diagnosis. These features included known PSP symptoms, common misdiagnoses, and 2 novel associations, diabetes mellitus and cerebrovascular disease, which are possible modifiable risk factors for PSP.Conclusion: In this case-control study using data from electronic medical records, we identified 9 clinical features, including 2 previously unknown factors, associated with the pre-diagnostic stage of PSP. These may be used to facilitate recognition of PSP and reduce time to referral by primary care physicians.

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The impact of regulation changes in the spontaneous reporting system for vaccines on reporting trends and signal detection in Japan

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.5231 ◽

2021 ◽

Author(s):

Makoto Miyazaki ◽

Takamasa Sakai ◽

Taku Obara ◽

Nariyasu Mano

Keyword(s):

Signal Detection ◽

Spontaneous Reporting ◽

Reporting System ◽

Spontaneous Reporting System ◽

The Impact ◽

Regulation Changes

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Risk of Agricultural Pesticide Exposure to Malaria Incidence and Anopheles Susceptibility at an Endemic Area in Central Java, Indonesia – A Case–control Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.3024 ◽

2020 ◽

Vol 8 (E) ◽

pp. 52-59

Author(s):

Renti Mahkota ◽

Fajaria Nurcandra ◽

Fitria Dewi Puspita Anggraini ◽

Annisa Ika Putri ◽

Bambang Wispriyono

Keyword(s):

Medical Records ◽

Endemic Area ◽

Case Control Study ◽

Pesticide Exposure ◽

Malaria Incidence ◽

Case Control ◽

Susceptibility Test ◽

Agricultural Pesticide ◽

Central Java ◽

Control Study

BACKGROUND: Malaria is an infectious disease caused by Plasmodium sp. This disease often occurs in tropical countries and has sometimes been reported in agricultural countries. This vector-borne disease is associated with environmental factors and the presence of vectors. Some studies found that Anopheles is resistant to insecticide, and this topic was encouraged by the WHO for malaria control. AIM: This research aimed to explain the causal effects of agricultural pesticide exposure on malaria incidence and Anopheles susceptibility in an endemic area of Indonesia. METHODS: A case–control study was conducted between September and October 2016 in Purworejo, Central Java. The case group involved 131 individuals who had malaria in 2016 based on their medical records, whereas the control group comprised 131 individuals who were neighbors of the cases and never had a history of malaria. Cases were selected randomly from hospital medical records. Both case and control groups were interviewed using the same questionnaire, and data were analyzed using logistic regression. Insecticide susceptibility test was used to test the 80 mosquito samples collected from the neighborhood of recent malaria cases. RESULTS: The quantity of agricultural pesticide remains a potential health risk to malaria (odds ratio = 2.15; 95% confidence interval 1.000–4.638), which was adjusted by confounders (sex, resting place, and insecticide net). The susceptibility test indicated that Anopheles was resistant to both permethrin (86.25%) and bendiocarb (68.75%). CONCLUSIONS: The quantity of agricultural pesticide contributes as a risk factor to malaria incidences, and Anopheles was indicated to be resistant to bendiocarb in Purworejo, Central Java.

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Outcome of children with severe traumatic brain injury who are treated with decompressive craniectomy

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.10.peds14117 ◽

2015 ◽

Vol 16 (5) ◽

pp. 508-514 ◽

Cited By ~ 9

Author(s):

Maroun J. Mhanna ◽

Wael EI Mallah ◽

Margaret Verrees ◽

Rajiv Shah ◽

Dennis M. Super

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Decompressive Craniectomy ◽

Cerebral Edema ◽

Severe Traumatic Brain Injury ◽

Medical Records ◽

Case Control Study ◽

Case Control ◽

Severe Tbi ◽

Control Study

OBJECT Decompressive craniectomy (DC) for the management of severe traumatic brain injury (TBI) is controversial. The authors sought to determine if DC improves the outcome of children with severe TBI. METHODS In a retrospective, case-control study, medical records of all patients admitted to the pediatric ICU between May 1998 and May 2008 with severe TBI and treated with DC were identified and matched to patients who were treated medically without DC. Medical records were reviewed for patients’ demographic data and baseline characteristics. RESULTS During the study period, 17 patients with severe TBI treated with DC at a median of 2 hours (interquartile range [IQR] 1–14 hours) after admission were identified and matched to 17 contemporary controls. On admission, there were no differences between DC and control patients regarding age (10.2 ± 5.9 years vs 12.4 ± 5.4 years, respectively [mean ± SD]), sex, weight, Glasgow Coma Scale score (median 5 [IQR 3–7] vs 4 [IQR 3–6], respectively; p = 0.14), or the highest intracranial pressure (median 42 [IQR 22–54] vs 30 [IQR 21–36], respectively; p = 0.77). However, CT findings were significant for a higher rate of herniation and cerebral edema among patients with DC versus controls (7/17 vs 2/17, respectively, had herniation [p = 0.05] and 14/17 vs 6/17, respectively, had cerebral edema [p = 0.006]). Overall there were no significant differences in survival between patients with DC and controls (71% [12/17] vs 82% [14/17], respectively; p = 0.34). However, among survivors, at 4 years (IQR 1–6 years) after the TBI, 42% (5/12) of the DC patients had mild disability or a Glasgow Outcome Scale score of 5 vs none (0/14) of the controls (p = 0.012). CONCLUSIONS In this retrospective, small case-control study, the authors have shown that early DC in pediatric patients with severe TBI improves outcome in survivors. Future prospective randomized controlled studies are needed to confirm these findings.

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The proportion of patient reports of suspected ADRs to signal detection in the Netherlands: case-control study

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.2092 ◽

2010 ◽

Vol 20 (3) ◽

pp. 286-291 ◽

Cited By ~ 39

Author(s):

Florence van Hunsel ◽

Attje Talsma ◽

Eugène van Puijenbroek ◽

Lolkje de Jong-van den Berg ◽

Kees van Grootheest

Keyword(s):

The Netherlands ◽

Signal Detection ◽

Case Control Study ◽

Case Control ◽

Patient Reports ◽

Control Study

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Outbreak of Multidrug-Resistant Serratia marcescens Infection in a Neonatal Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1086/587969 ◽

2008 ◽

Vol 29 (5) ◽

pp. 418-423 ◽

Cited By ~ 69

Author(s):

Lisa L. Maragakis ◽

Amy Winkler ◽

Margaret G. Tucker ◽

Sara E. Cosgrove ◽

Tracy Ross ◽

...

Keyword(s):

Intensive Care ◽

Serratia Marcescens ◽

Medical Records ◽

Neonatal Intensive Care ◽

Case Control Study ◽

Multidrug Resistant ◽

Case Control ◽

Outbreak Investigation ◽

Case Identification ◽

Control Study

Background.Serratia marcescens causes healthcare-associated infections and significant morbidity and mortality in neonatal intensive care units (NICUs). We report the investigation and control of an outbreak of multidrug-resistant (MDR) S. marcescens infection at an NICU.Methods.An outbreak investigation and a case-control study were undertaken at a 36-bed NICU in a tertiary care hospital in Baltimore, Maryland, for the period from October 2004 through February 2005. The outbreak investigation included case identification, review of medical records, environmental cultures, patient surveillance cultures, personnel hand cultures, and pulsed-field gel electrophoresis (PFGE). The case-control study included case identification and review of medical records. Infection control measures were implemented. Eighteen NICU neonates had cultures that grew MDR S. marcescens during the study period. The case-control study included 16 patients with the outbreak strain or an unidentified strain of MDR S. marcescens and 32 control patients not infected and/or colonized with MDR S. marcescens, treated in the NICU for at least 48 hours during the study period.Results.PFGE analysis identified a single strain of MDR S. marcescens that infected or colonized 15 patients. Two patients had unique strains, and 1 patient's isolate could not be subtyped. An unrelated MDR S. marcescens isolate was recovered from a sink drain. Exposure to inhalational therapy was an independent risk factor for MDR S. marcescens acquisition after adjusting for birth weight. Extensive investigation failed to reveal a point source for the outbreak.Conclusion.A single epidemic strain of MDR S. marcescens spread rapidly and threatened to become endemic in this NICU. Transient carriage on the hands of healthcare personnel or on respiratory care equipment was the likely mode of transmission. Cohorting patients and staff, at the cost of bed closures and additional personnel, interrupted transmission and halted the outbreak.

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