What Increases the Risk of Dental Traumatism in Patients with Developmental Disabilities?

Abstract This study investigated risk factors for tooth injuries in individuals from a dental clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 493 dental charts of individuals with or without tooth injuries at their first dental appointment. The dependent variable was the time of occurrence of new dental traumatic injuries and was measured in months. Gender, age, International Code of Diseases, mother’s education, mouth breathing, hyperkinesis, pacifier use, thumb sucking, psychotropic drug use, tooth injuries at the first dental examination, involuntary movements, open bite, having one or more siblings and reports of seizures were the covariates. The Cox proportional hazards regression model was used to estimate the unadjusted and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental traumatism was 170.78 months (95% CI, 157.89-183.66) with median of 216 months. The incidence of new events was 11.88%. The covariate associated with an increased risk of dental traumatism was a history of tooth injuries at the first dental appointment. The increase in dental trauma risk was 3.59 (95% CI, 1.94-6.65). A history of traumatic dental injury was the risk factor for the dental trauma found in this group of individuals with developmental disabilities.

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Pain in Patients With Type 2 Diabetes-Related Polyneuropathy Is Associated With Vascular Events and Mortality

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa394 ◽

2020 ◽

Vol 105 (9) ◽

pp. 3005-3014

Author(s):

Brittany R Lapin ◽

Kevin M Pantalone ◽

Alex Milinovich ◽

Shannon Morrison ◽

Andrew Schuster ◽

...

Keyword(s):

Type 2 Diabetes ◽

Proportional Hazards ◽

Negative Binomial ◽

Cox Proportional Hazards ◽

Vascular Events ◽

Proportional Hazards Regression ◽

Increased Risk ◽

History Of ◽

Mortality Hazard Ratio

Abstract Purpose Type 2 diabetes–related polyneuropathy (DPN) is associated with increased vascular events and mortality, but determinants and outcomes of pain in DPN are poorly understood. We sought to examine the effect of neuropathic pain on vascular events and mortality in patients without DPN, DPN with pain (DPN + P), and DPN without pain (DPN-P). Methods A retrospective cohort study was conducted within a large health system of adult patients with type 2 diabetes from January 1, 2009 through December 31, 2016. Using an electronic algorithm, patients were classified as no DPN, DPN + P, or DPN-P. Primary outcomes included number of vascular events and time to mortality. Independent associations with DPN + P were evaluated using multivariable negative binomial and Cox proportional hazards regression models, adjusting for demographics, socioeconomic characteristics, and comorbidities. Results Of 43 945 patients with type 2 diabetes (age 64.6 ± 14.0 years; 52.1% female), 13 910 (31.7%) had DPN: 9104 DPN + P (65.4%) vs 4806 DPN-P (34.6%). Vascular events occurred in 4538 (15.1%) of no DPN patients, 2401 (26.4%) DPN + P, and 1006 (20.9%) DPN-P. After adjustment, DPN + P remained a significant predictor of number of vascular events (incidence rate ratio [IRR] = 1.55, 95% CI, 1.29-1.85), whereas no DPN was protective (IRR = 0.70, 95% CI, 0.60-0.82), as compared to DPN-P. Compared to DPN-P, DPN + P was also a significant predictor of mortality (hazard ratio = 1.42, 95% CI, 1.25-1.61). Conclusions Our study found a significant association between pain in DPN and an increased risk of vascular events and mortality. This observation warrants longitudinal study of the risk factors and natural history of pain in DPN.

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Increased risk of prostate cancer following sexually transmitted infection in an Asian population

Epidemiology and Infection ◽

10.1017/s0950268813000459 ◽

2013 ◽

Vol 141 (12) ◽

pp. 2663-2670 ◽

Cited By ~ 6

Author(s):

S. D. CHUNG ◽

Y. K. LIN ◽

C. C. HUANG ◽

H. C. LIN

Keyword(s):

Prostate Cancer ◽

Proportional Hazards ◽

Asian Population ◽

Population Based ◽

Cox Proportional Hazards ◽

Study Cohort ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Increased Risk ◽

History Of

SUMMARYThe relationship between sexually transmitted infections (STIs) and prostate cancer (PC) remains inconclusive. Moreover, all such studies to date have been conducted in Western populations. This study aimed to investigate the risk of PC following STI using a population-based matched-cohort design in Taiwan. The study cohort comprised 1055 patients with STIs, and 10 550 randomly selected subjects were used as a comparison cohort. Cox proportional hazards regression analysis revealed that the hazard ratio for PC during the 5-year follow-up period for patients with a STI was 1·95 (95% confidence interval 1·18–3·23), that of comparison subjects after adjusting for urbanization level, geographical region, monthly income, hypertension, diabetes, hyperlipidaemia, obesity, chronic prostatitis, history of vasectomy, tobacco use disorder, and alcohol abuse. We concluded that the risk of PC was higher for men who were diagnosed with a STI in an Asian population.

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History of premorbid depression is a risk factor for COVID-related mortality: Analysis of a retrospective cohort of 1,387 COVID+ patients

10.1101/2020.12.17.20248362 ◽

2020 ◽

Author(s):

Sean Clouston ◽

Benjamin J Luft ◽

Edward Sun

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Risk Of Mortality ◽

Increased Risk ◽

History Of ◽

History Of Depression ◽

Related Mortality

Background: The goal of the present work was to examine risk factors for mortality in a 1,387 COVID+ patients admitted to a hospital in Suffolk County, NY. Methods: Data were collated by the hospital epidemiological service for patients admitted from 3/7/2020-9/1/2020. Time until final discharge or death was the outcome. Cox proportional hazards models were used to estimate time until death among admitted patients. Findings: In total, 99.06% of cases had resolved leading to 1,179 discharges and 211 deaths. Length of stay was significantly longer in those who died as compared to those who did not p=0.007). Of patients who had been discharged (n=1,179), 54 were readmitted and 9 subsequently died. Multivariable-adjusted Cox proportional hazards regression revealed that in addition to older age, male sex, and heart failure, a history of premorbid depression was a risk factor for COVI-19 mortality. Interpretation: While an increasing number of studies have shown effects linking cardiovascular risk factors with increased risk of mortality in COVID+ patients, this study reports that history of depression is a risk factor for COVID mortality.

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Migraine and the risk of incident hypertension among women

Cephalalgia ◽

10.1177/0333102418756865 ◽

2018 ◽

Vol 38 (12) ◽

pp. 1817-1824 ◽

Cited By ~ 8

Author(s):

Pamela M Rist ◽

Anke C Winter ◽

Julie E Buring ◽

Howard D Sesso ◽

Tobias Kurth

Keyword(s):

Migraine With Aura ◽

Migraine Without Aura ◽

Proportional Hazards ◽

Past History ◽

Cox Proportional Hazards ◽

Incident Hypertension ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

History Of

Background Few studies have examined whether migraine is associated with an increased risk of incident hypertension. Methods We performed a prospective cohort study among 29,040 women without hypertension at baseline. Women were classified as having active migraine with aura, active migraine without aura, a past history of migraine, or no history of migraine. Incident hypertension was defined as new physician diagnosis or newly self-reported systolic or diastolic blood pressure ≥140 mmHg or ≥90 mmHg respectively. Cox proportional hazards models were used to evaluate the association between migraine and incident hypertension. Results During a mean follow-up of 12.2 years, 15,176 incident hypertension cases occurred. Compared to those with no history of migraine, women who experience migraine with aura had a 9% increase in their risk of developing hypertension (95% CI: 1.02, 1.18); women who experience migraine without aura had a 21% increase in their risk of developing hypertension (95% CI: 1.14, 1.28); and women with a past history of migraine had a 15% increase in their risk of developing hypertension (95% CI: 1.07, 1.23). Conclusions Women with migraine have a higher relative risk of developing hypertension compared to women without migraine.

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Rotating night shift work and risk of multiple sclerosis in the Nurses’ Health Studies

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106016 ◽

2019 ◽

Vol 76 (10) ◽

pp. 733-738 ◽

Cited By ~ 1

Author(s):

Kyriaki Papantoniou ◽

Jennifer Massa ◽

Elizabeth Devore ◽

Kassandra L Munger ◽

Tanuja Chitnis ◽

...

Keyword(s):

Multiple Sclerosis ◽

Shift Work ◽

Proportional Hazards ◽

Night Shift ◽

Cox Proportional Hazards ◽

Health Study ◽

Work History ◽

Night Shift Work ◽

Increased Risk ◽

History Of

ObjectivesNight shift work has been suggested as a possible risk factor for multiple sclerosis (MS). The objective of the present analysis was to prospectively evaluate the association of rotating night shift work history and MS risk in two female cohorts, the Nurses’ Health Study (NHS) and NHSII.MethodsA total of 83 992 (NHS) and 114 427 (NHSII) women were included in this analysis. We documented 579 (109 in NHS and 470 in NHSII) incident physician-confirmed MS cases (moderate and definite diagnosis), including 407 definite MS cases. The history (cumulative years) of rotating night shifts (≥3 nights/month) was assessed at baseline and updated throughout follow-up. Cox proportional hazards models were used to estimate HRs and 95% CIs for the association between rotating night shift work and MS risk adjusting for potential confounders.ResultsWe observed no association between history of rotating night shift work and MS risk in NHS (1–9 years: HR 1.03, 95% CI 0.69 to 1.54; 10+ years: 1.15, 0.62 to 2.15) and NHSII (1–9 years: HR 0.90, 95% CI 0.74 to 1.09; 10+ years: 1.03, 0.72 to 1.49). In NHSII, rotating night shift work history of 20+ years was significantly associated with MS risk, when restricting to definite MS cases (1–9 years: HR 0.88, 95% CI 0.70 to 1.11; 10–19 years: 0.98, 0.62 to 1.55; 20+ years: 2.62, 1.06 to 6.46).ConclusionsOverall, we found no association between rotating night shift work history and MS risk in these two large cohorts of nurses. In NHSII, shift work history of 20 or more years was associated with an increased risk of definite MS diagnosis.

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Risk of non-infectious uveitis or myasthenia gravis in patients on checkpoint inhibitors in a large healthcare claims database

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317060 ◽

2020 ◽

pp. bjophthalmol-2020-317060 ◽

Cited By ~ 1

Author(s):

Tian Xia ◽

Alexander J Brucker ◽

Brendan McGeehan ◽

Brian L VanderBeek

Keyword(s):

Multivariate Analysis ◽

Myasthenia Gravis ◽

Index Date ◽

Proportional Hazards ◽

Checkpoint Inhibitors ◽

Cox Proportional Hazards ◽

Proportional Hazards Regression ◽

Increased Risk ◽

History Of ◽

Infectious Uveitis

AimTo determine if checkpoint inhibitors (CPIs) confer an increased risk of non-infectious uveitis or myasthenia gravis (MG) compared to patients on non-checkpoint inhibitor (N-CPI) chemotherapy.MethodsA retrospective cohort study was performed comparing patients in a large commercial and Medicare advantage database exposed to CPI compared to N-CPI. All patients who initiated a CPI (ipilimumab, pembrolizumab, nivolumab, atezolizumab, avelumab, cemiplimab and durvalumab) were eligible. Date of earliest CPI in the exposure group and N-CPI chemotherapy in the comparator group was considered the index date. Exclusion occurred in both cohorts for any history of uveitis or MG diagnosis and having <1 year in the insurance plan prior to the index date, and <6 months in plan following the index date. Every exposed patient was matched up to 1:10 based on demographics and index year to patients on N-CPI chemotherapy. Multivariate Cox proportional hazards regression modelling was performed.ResultsFor evaluation of incidence of non-infectious uveitis, 26 (0.3%) of 8678 patients on CPI and 123 (0.2%) of 76 153 N-CPI comparators were found to have non-infectious uveitis. After multivariate analysis, CPIs showed an increased hazard for uveitis compared to N-CPI (HR=2.09; 95% CI 1.36 to 3.22, p=0.001). For the MG analysis, 11 (0.1%) of 9210 patients developed MG in the CPI group and 36 (0.04%) of 80 620 comparators. The CPI cohort had a higher hazard of developing MG (HR=2.60; 95% CI 1.34 to 5.07, p=0.005) compared to controls in multivariate analysis.ConclusionsExposure to CPI confers a higher risk for non-infectious uveitis and MG compared to N-CPI chemotherapy.

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A Prospective Study of Periodontal Disease and Risk of Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.091398 ◽

2010 ◽

Vol 37 (9) ◽

pp. 1800-1804 ◽

Cited By ~ 62

Author(s):

ELIZABETH V. ARKEMA ◽

ELIZABETH W. KARLSON ◽

KAREN H. COSTENBADER

Keyword(s):

Rheumatoid Arthritis ◽

Periodontal Disease ◽

Prospective Cohort ◽

Tooth Loss ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Health Study ◽

Periodontal Surgery ◽

Increased Risk ◽

History Of

Objective.To test for an association between periodontal disease (PD) and incident rheumatoid arthritis (RA) in a large prospective cohort.Methods.We conducted a prospective analysis of history of periodontal surgery, tooth loss, and risk of RA among 81,132 women in the Nurses’ Health Study prospective cohort. Periodontal surgery and tooth loss were used as proxies for history of PD. There were 292 incident RA cases diagnosed from 1992 to 2004. Information on periodontal surgery and tooth loss in the past 2 years was collected by questionnaire in 1992. Cox proportional hazards models were used to assess relationships between periodontal surgery, tooth loss, and risk of RA adjusting for age, smoking, number of natural teeth, body mass index, parity, breastfeeding, postmenopausal status, postmenopausal hormone use, father’s occupation, and alcohol intake.Results.Compared with those who reported no history of periodontal surgery or tooth loss, women with periodontal surgery or tooth loss did not have a significantly elevated risk of RA in multivariable-adjusted models (RR 1.24, 95% CI 0.83, 1.83; and RR 1.18, 95% CI 0.47, 2.95, respectively). In analyses stratified by ever and never-smokers, ever-smokers with periodontal surgery had an increased risk that was also nonsignificant. Those with severe PD (both history of periodontal surgery and tooth loss) did not have a significant increased risk.Conclusion.In this large cohort of American women, there was no evidence of an increased risk of later-onset RA among those with a history of periodontal surgery and/or tooth loss.

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Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Blood Purification ◽

10.1159/000433416 ◽

2015 ◽

Vol 40 (2) ◽

pp. 160-166 ◽

Cited By ~ 2

Author(s):

Liping Xiong ◽

Li Fan ◽

Qingdong Xu ◽

Qian Zhou ◽

Huiyan Li ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

All Cause Mortality ◽

History Of ◽

The Relationship

Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

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Abstract P089: Adiposity and risk of stroke: body shape matters more than body weight

Circulation ◽

10.1161/circ.129.suppl_1.p089 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Suzanne E Judd ◽

Virginia J Howard ◽

George Howard ◽

Susan Lakoski ◽

Mary Cushman ◽

...

Keyword(s):

Racial Differences ◽

Stroke Risk ◽

Proportional Hazards ◽

Obesity Paradox ◽

The United States ◽

Cox Proportional Hazards ◽

Stroke Risk Factor ◽

Medical Risk ◽

Increased Risk ◽

History Of

Background: Higher body mass index (BMI) and larger waist circumference (WC), characteristics of increased adiposity, are associated with greater risk of cardiovascular disease (CVD). However, an obesity paradox (improved survival in those with history of stroke) has been observed in some populations. We hypothesized that BMI would be associated with decreased risk of stroke but that this association would be attenuated after accounting for WC. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS) study recruited 30,239 black and white participants age 45 years and older from across the United States between 2003 and 2007. WC, height and weight were measured during a baseline in home visit and participants were followed every 6 months. Strokes were adjudicated by physicians after review of medical records. Cox proportional hazards models were used to assess stroke risk. BMI and WC were modeled in quintiles. Results: We observed 1047 incident and recurrent strokes over a mean of 6.3 years. Higher BMI and lower WC were associated with decreased risk of stroke after adjustment for demographic and medical risk factors (Table). Having both BMI and WC in the model dramatically increased the strength of association for the other variable. Collinearity was not present. The observed association was consistent across race, sex, age, WC, and history of stroke (all p for interaction >0.20). Conclusion: Increased BMI, the main measure used to define obesity, was not a stroke risk factor. Increased risk of stroke was observed in WC less than the current recommendations of 88 cm for women and 102 cm for men. Smaller waist sizes and maintenance of lean mass are important targets for stroke prevention.<br

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Associations between allergies and risk of hematologic malignancies: Results from the Vitamins and Lifestyle (VITAL) cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1527 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1527-1527

Author(s):

Mazyar Shadman ◽

Roland B. Walter ◽

Anneclaire DeRoos ◽

Emily White

Keyword(s):

Immune System ◽

Proportional Hazards ◽

Nk Cell ◽

Myeloproliferative Disorders ◽

Hematologic Malignancies ◽

Cox Proportional Hazards ◽

Lymphocytic Leukemia ◽

Case Control Studies ◽

Increased Risk ◽

History Of

1527 Background: Several case-control studies have suggested a reduced risk of hematologic malignancies (HMs) for individuals with allergies, but results have been inconsistent, and prospective cohort studies have not confirmed this association. Herein, we used the large prospective VITAL study to examine this association. Methods: 64,847 men and women, aged 50-76, completed a baseline questionnaire in 2000-2002 and reported on their current allergies and history of physician-diagnosed asthma. Individuals with prior cancer other than non-melanoma skin cancer were excluded from this analysis. Incident HMs were identified through December 2009 by linkage to the SEER registry; those with a diagnosis of a non-HM during follow-up were censored at the time of that diagnosis. Multivariable Cox proportional hazards models were built with adjustment for sex, race/ethnicity, education, smoking, self-rated health, physical activity, history of anemia in the year before baseline, vegetable use and family history of leukemia or lymphoma. Results: Our analysis included 64,839 participants, among whom 681 (1.03%) incident HMs were found (MDS [69], AML (41], myeloproliferative disorders [60], mature B-cell neoplasms [262], chronic lymphocytic leukemia [107], plasma cell disorders [83], Hodgkin lymphoma [23], T-cell/NK-cell neoplasms [22], and others [14]). In multivariable analyses, a history of any allergy was associated with increased risk of HM (HR=1.21; 95% CI 1.02-1.43, p=0.02). This association was seen for current allergies to plants/grass/trees (HR 1.27 [1.06-1.52], p<0.001) but not for allergies to mold/dust, animals, insects, food, or medications. We did not find an association between a history of asthma and incident HMs (HR=0.95 [0.72-1.26]). Conclusions: Our study indicates a moderately increased risk of HMs inindividuals with a history of allergy, especially to plant, grass or trees. While no causality can be inferred, this may suggest a possible carcinogenic role for chronic stimulation of the immune system. However, further mechanistic investigations focusing on the biochemical markers of immune system as well as on possible gene effect modifiers are needed.

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