scholarly journals Intrauterine Growth and Cerebral Palsy in Twins: A European Multicenter Study

2006 ◽  
Vol 9 (3) ◽  
pp. 460-466 ◽  
Author(s):  
Svetlana V. Glinianaia ◽  
Stephen Jarvis ◽  
Monica Topp ◽  
Pascale Guillem ◽  
Mary J. Platt ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Statistical Significance ◽  
A Priori ◽  
Population Based ◽  
Aggregated Data ◽  
Growth Standards ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Multi Center Study ◽  
Rate Ratios

AbstractPopulation-based studies in twins have been of insufficient size to explore the relationship between risk of cerebral palsy and intrauterine growth. Earlier studies in singletons have suggested an optimum size at birth for minimum cerebral palsy risk between the 75th and 90th percentiles of weight for gestational age. We aggregated data from nine European cerebral palsy registers for 1976 to 1990. Using sex-specific fetal growth standards for twins, a z score of weight-for-gestation was derived for each of the 373 twin cases. The rates of cerebral palsy in each z-score band were compared to the rate in the a priori reference band of 0.67 to less than 1.28 (equivalent to the 75th to less than 90th percentiles). In twins born at 32 weeks' gestation or more (92% of all twins), cerebral palsy rates were higher for both light and heavy-forgestation babies compared to an optimum (i.e., minimum risk) in the reference band. However, the rate ratio for heavy babies (90th percentile or greater) did not reach conventional (95% confidence intervals [CI]) statistical significance (rate ratios = 1.76; 90% CI 1.02–3.03). For twins born at less than 32 weeks, the significantly higher risk for cerebral palsy was observed consistently in all z-score bands less than average compared to the reference band. This multi-center study demonstrates that for twins born at 32 weeks' gestation or more, an increased risk of cerebral palsy is associated with deviations from optimal intrauterine growth at about 1 standard deviation above mean weight, as was earlier reported for singletons. For twins born at less than 32 weeks' gestation, this pattern is only demonstrable for babies weighing below the optimum weight-for-gestation.

scholarly journals Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

2021 ◽  
Author(s):  
Khalaf Kridin ◽  
Jennifer E. Hundt ◽  
Ralf J. Ludwig ◽  
Kyle T. Amber ◽  
Dana Tzur Bitan ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Statistical Significance ◽  
Large Population ◽  
Underlying Mechanism ◽  
Population Based ◽  
Control Subjects ◽  
Increased Risk ◽  
Bidirectional Association ◽  
History Of ◽  
Incident Cases

AbstractThe association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

Is Intrauterine Growth Retardation a Risk Factor for Child Abuse?

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 515-519
Author(s):  
John M. Leventhal ◽  
Anne Berg ◽  
Susan A. Egerter
Keyword(s):  
Child Abuse ◽  
Growth Retardation ◽  
Kansas City ◽  
Intrauterine Growth Retardation ◽  
Case Control ◽  
Ponderal Index ◽  
Growth Standards ◽  
Physically Abused ◽  
Intrauterine Growth ◽  
Increased Risk

A case-control study was conducted to determine whether infants with intrauterine growth retardation are at an increased risk of child abuse. Case children were those who had been born at Yale-New Haven Hospital and were reported to the hospital's child abuse committee because they had been physically abused. For each case, one control child was chosen from the hospital's log of births and matched to the case child by age, gender, race of the mother, method of payment for the hospitalization, and the provider of the child's health care at the time of birth. Infants were defined as having intrauterine growth retardation if they had either a ponderal index or a birth weight that was less than the tenth percentile for gestational age using the Kansas City or Denver growth standards. We identified 117 case-Control l pairs that met those criteria. The matched odds ratios for each of the four definitions of intrauterine growth retardation were less than one, indicating that infants with intrauterine growth retardation are at a decreased risk of abuse. The matched odds ratio for a low ponderal index according to the Kansas City standard was 0.4 (95% confidence interval 0.19, 0.83). This result was not affected by such possible confounding factors as the mother's age. We conclude that infants with intrauterine growth retardation are not at an increased risk and may be at a decreased risk of physical abuse.

scholarly journals Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Hyewon Kim ◽  
Yuwon Kim ◽  
Woojae Myung ◽  
Maurizio Fava ◽  
David Mischoulon ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Medical Records ◽  
Suicide Attempts ◽  
Case Series ◽  
Population Based ◽  
Additional Increase ◽  
Series Design ◽  
Increased Risk ◽  
Before And After ◽  
Rate Ratios

Abstract Objectives To investigate the association between zolpidem prescription and suicide attempts in people with depression Methods A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. Results In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58–191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99–174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50–28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21–18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Conclusions Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.

scholarly journals Long-Lasting Increased Risk of Human Papillomavirus–Related Carcinomas and Premalignancies After Cervical Intraepithelial Neoplasia Grade 3: A Population-Based Cohort Study

2017 ◽  
Vol 35 (22) ◽  
pp. 2542-2550 ◽  
Author(s):  
Renée M.F. Ebisch ◽  
Dominiek W.E. Rutten ◽  
Joanna IntHout ◽  
Willem J.G. Melchers ◽  
Leon F.A.G. Massuger ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Incidence Rate ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Increased Risk ◽  
History Of ◽  
Grade 3 ◽  
Rate Ratios

Purpose The aim of this study was to determine the risk of human papillomavirus (HPV)–related carcinomas and premalignancies in women diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3). Knowledge of this risk is important to preventing the development and progression of other HPV-related premalignancies and carcinomas, by considering prophylactic HPV vaccination and/or by paying increased attention to other HPV-related carcinomas and premalignancies when CIN3 is identified. Methods Women diagnosed with a CIN3 between 1990 and 2010 were identified from the Dutch nationwide registry of histopathology and cytopathology (PALGA) and matched with a control group of women without CIN3. Subsequently, all cases of high-risk (hr) HPV–associated high-grade lesions and carcinomas in the anogenital region and oropharynx between 1990 and 2015 were extracted. Incidence rate ratios were estimated for carcinomas and premalignancies of the vulva, vagina, anus, and oropharynx. Results A total of 178,036 women were identified: 89,018 with a previous diagnosis of CIN3 and 89,018 matched control subjects without a history of CIN3. Women with a history of CIN3 showed increased risk of HPV-related carcinomas and premalignancies, with incidence rate ratios of 3.85 (95% CI, 2.32 to 6.37) for anal cancer, 6.68 (95% CI, 3.64 to 12.25) for anal intraepithelial neoplasia grade 3, 4.97 (95% CI, 3.26 to 7.57) for vulvar cancer, 13.66 (93% CI, 9.69 to 19.25) for vulvar intraepithelial neoplasia grade 3, 86.08 (95% CI, 11.98 to 618.08) for vaginal cancer, 25.65 (95% CI, 10.50 to 62.69) for vaginal intraepithelial neoplasia grade 3, and 5.51 (95% CI, 1.22 to 24.84) for oropharyngeal cancer. This risk remained significantly increased, even after long-term follow-up of up to 20 years. Conclusion This population-based study shows a long-lasting increased risk for HPV-related carcinomas and premalignancies of the anogenital and oropharyngeal region after a CIN3 diagnosis. Studies that investigate methods to prevent this increased risk in this group of patients, such as intensified screening or vaccination, are warranted.

scholarly journals SURVIVAL ADVANTAGE OF APOE2

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S621-S621
Author(s):  
Sudha Seshadri
Keyword(s):  
Lower Risk ◽  
Large Population ◽  
Population Based ◽  
European Ancestry ◽  
Aggregated Data ◽  
Risk Of Death ◽  
Apoe Ε4 ◽  
Increased Risk ◽  
Ε4 Allele

Abstract Apolipoprotein E is a glycoprotein mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has been associated with higher risk of Alzheimer’s disease and of mortality, but the effect of the less prevalent APOE-ε2 on survival remains elusive. We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six large population-based cohorts to determine the association of APOE-ε2, with survival in the general population. During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90-0.99; P=1.1*10-2), whereas APOE-ε4 carriers were at increased risk (HR 1.17,1.12-1.21; P=2.8*10-16). Risk was lowest for homozygous APOE-ε2 (HR 0.89,0.74-1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37-1.70). Results did not differ by sex. The association was unaltered after adjustment for baseline LDL or cardiovascular disease. Larger, multiethnic collaborations are ongoing.

Methimazole Treatment and Risk of Acute Pancreatitis: A Population-based Cohort Study

2020 ◽  
Vol 105 (12) ◽  
pp. e4527-e4530
Author(s):  
Alessandro Pecere ◽  
Marina Caputo ◽  
Andrea Sarro ◽  
Andrealuna Ucciero ◽  
Angelica Zibetti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Absolute Risk ◽  
Population Based ◽  
Age Classes ◽  
Population Based Study ◽  
Increased Risk ◽  
Hospital Discharge Records ◽  
Adjusted Rate ◽  
Administrative Health Databases ◽  
Rate Ratios

Abstract Context A warning has been recently issued by the European Medicine Agency (EMA) regarding a potential increased risk of acute pancreatitis (AP) in methimazole (MMI) users. Objective To investigate the association between MMI and the diagnosis of AP in a population-based study. Materials and Methods A retrospective analysis of administrative health databases was conducted (2013–2018). Relevant data were obtained from: (1) inhabitants registry, (2) hospital discharge records (ICD-9-CM 577.0), and (3) drug claims registry (ATC H03BB02). We evaluated AP risk in MMI users in 18 months of treatment, stratifying results by trimester. Poisson regression was used to estimate the age- and sex-adjusted rate ratios (RR), and the relative 95% confidence intervals (CI), comparing rates of AP between MMI users and nonusers. The absolute risk of AP in MMI users was also calculated. Results A total of 23 087 new users of MMI were identified. Among them, 61 hospitalizations occurred during the study period. An increase in AP risk was evident during the first 3 trimesters of therapy (RR 3.40 [95% CI: 2.12–5.48]; RR 2.40 [95% CI: 1.36–4.23]; RR 2.80 [95% CI: 1.66–4.73]), but disappeared thereafter. The AP absolute risk in MMI users during the first 18 months of treatment was less than 0.4% in all sex and age classes. Conclusions Our results support the EMA warning, suggesting an increased risk of AP associated with MMI use. However, such an increase seems limited to the first months of MMI treatment. Moreover, in absolute terms, the probability of AP is low among patients, well below 1%.

Increased risk of osteoporotic fractures in patients with systemic sclerosis: a nationwide population-based study

2014 ◽  
Vol 74 (7) ◽  
pp. 1347-1352 ◽  
Author(s):  
Chien-Chih Lai ◽  
Shu-Hung Wang ◽  
Wei-Sheng Chen ◽  
Chia-Jen Liu ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Incidence Rate ◽  
Hip Fractures ◽  
Vertebral Fractures ◽  
Cox Regression ◽  
Osteoporotic Fractures ◽  
Population Based ◽  
High Dose ◽  
Increased Risk ◽  
Rate Ratios

ObjectivesTo identify the incidence rate (IR) and risk factors of osteoporotic fractures (OFs) among systemic sclerosis (SSc) patients.MethodsA cohort study was conducted using the Taiwan National Health Insurance database. Patients with SSc and respective age- and gender-matched controls without SSc were enrolled. The primary endpoint was the first occurrence of OF. The Cox proportional hazard model was used to investigate the risk factor of OFs in the SSc cohort.ResultsAmong 1712 SSc patients (77.8% female, mean age 50.3 years) with a median follow-up of 5.2 years, 54 patients developed vertebral fractures, 17 patients developed hip fractures, and 7 patients developed radius fractures (IR: 6.99, 2.18 and 0.90 per 1000 person-years, respectively). Compared with the controls, the incidence rate ratios (IRRs) (95% CIs) among SSc patients were 1.78 (1.30 to 2.39, p<0.001) for vertebral fractures and 1.89 (1.05 to 3.22, p=0.026) for hip fractures. The IRRs for overall OFs were 1.74 (1.32 to 2.27, p<0.001) for women and 1.06 (0.33 to 2.66, p=0.856) for men. The SSc patients experienced hip fractures at a younger age (67.2 vs 75.2 years, p=0.005), and had a higher 1-year mortality rate (13% vs 3%, p=0.006) of vertebral fractures than did the controls. Multivariable Cox regression analyses indicated that older age, being female, using daily prednisolone equivalent to >7.5 mg, and bowel dysmotility treated with intravenous metoclopramide are associated with OF.ConclusionsSSc patients had a high IR of vertebral and hip fractures, especially those who were female, older, used a high dose of corticosteroid or experienced bowel dysmotility.

Oral Contraceptives, Postmenopausal Hormones, and Risk of Asynchronous Bilateral Breast Cancer: The WECARE Study Group

2008 ◽  
Vol 26 (9) ◽  
pp. 1411-1418 ◽  
Author(s):  
Jane C. Figueiredo ◽  
Leslie Bernstein ◽  
Marinela Capanu ◽  
Kathleen E. Malone ◽  
Charles F. Lynch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Conditional Logistic Regression ◽  
Bilateral Breast Cancer ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Risk Factor ◽  
Population Based ◽  
Unilateral Breast Cancer ◽  
Increased Risk ◽  
Rate Ratios

Purpose To investigate whether oral contraceptive (OC) use and postmenopausal hormones (PMH) are associated with an increased risk of developing asynchronous bilateral breast cancer among women diagnosed with breast cancer younger than 55 years. Patients and Methods The WECARE (Women's Environment, Cancer, and Radiation Epidemiology) study is a population-based, multicenter, case-control study of 708 women with asynchronous bilateral breast cancer and 1,395 women with unilateral breast cancer. Risk factor information collected during a telephone interview focused on exposures before and after the first breast cancer diagnosis. Treatment and tumor characteristics were abstracted from medical records. Multivariable conditional logistic regression was used to estimate rate ratios (RR) and 95% CIs. Results OC use before the first breast cancer diagnosis was not associated with risk of asynchronous bilateral breast cancer (RR = 0.88; 95% CI, 0.67 to 1.16). OC use after breast cancer diagnosis was also not significantly associated with risk (RR = 1.56; 95% CI, 0.71 to 3.45). Risk did not increase with longer duration of use or among women who had begun using OCs at a younger age. No evidence of an increased risk of asynchronous bilateral breast cancer was observed with PMH use before (RR = 1.21; 95% CI, 0.90 to 1.61) or after breast cancer diagnosis (RR = 1.10; 95% CI, 0.67 to 1.77). Neither duration nor type of PMH were associated with risk. Age at and time since first breast cancer diagnosis did not substantially affect these results. Conclusion This study provides no strong evidence that OC or PMH use increases the risk of a second cancer in the contralateral breast.

Comorbidities in Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis versus the General Population

2016 ◽  
Vol 43 (8) ◽  
pp. 1553-1558 ◽  
Author(s):  
Martin Englund ◽  
Peter A. Merkel ◽  
Gunnar Tomasson ◽  
Mårten Segelmark ◽  
Aladdin J. Mohammad
Keyword(s):  
General Population ◽  
Statistical Significance ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Population Based ◽  
Endocrine Disorders ◽  
Comorbid Conditions ◽  
Southern Sweden ◽  
Cerebrovascular Accidents ◽  
Diagnostic Codes ◽  
Rate Ratios

Objective.To evaluate the consultation rates of selected comorbidities in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV) compared with the general population in southern Sweden.Methods.We used data from a population-based cohort of patients with AAV diagnosed between 1998 and 2010 in Southern Sweden (701,000 inhabitants). For each patient we identified 4 reference subjects randomly sampled from the general population and matched for year of birth, sex, area of residence, and index year. Using the population-based Skåne Healthcare Register, we identified relevant diagnostic codes, registered between 1998 and 2011, for selected comorbidities assigned after the date of diagnosis of AAV or the index date for the reference subjects. We calculated rate ratios for comorbidities (AAV:reference subjects).Results.There were 186 patients with AAV (95 women, mean age 64.5 yrs) and 744 reference persons included in the analysis. The highest rate ratios (AAV:reference) were obtained for osteoporosis (4.6, 95% CI 3.0–7.0), followed by venous thromboembolism (4.0, 95% CI 1.9–8.3), thyroid diseases (2.1, 95% CI 1.3–3.3), and diabetes mellitus (2.0, 95% CI 1.3–2.9). For ischemic heart disease, the rate ratio of 1.5 (95% CI 1.0–2.3) did not reach statistical significance. No statistically significant differences were found for cerebrovascular accidents.Conclusion.AAV is associated with increased consultation rates of several comorbidities including osteoporosis and thromboembolic and endocrine disorders. Comorbid conditions should be taken into consideration when planning and providing care for patients with AAV.

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