scholarly journals Myocarditis Incidence, Complications and Mortality in Sweden: A Retrospective Registry Study From 2000-2014

Author(s):  
Michael Fu ◽  
Silvana Kontogeorgos ◽  
Erik Thunström ◽  
Tatiana Zverkova Sandström ◽  
Christian Kroon ◽  
...  

Abstract Objectives: Investigate trends in incidence and prognosis of myocarditis in Sweden during 2000-2014.Background: Myocarditis is an inflammatory heart disease, with scarce data concerning incidence and prognosis.Methods: Linking Swedish National Patient and Cause of Death Register, we identified individuals ≥16 years with first-time diagnosis of myocarditis during 2000-2014. Reference population, matched for age and birth year (n=16 622) was selected from the Swedish Total Population Register. Results: Among the 8 679 cases, (75% men, 64% <50 years), incidence rate/100 000 inhabitants rose from 6.3 to 8.6, mostly in men and those <50 years. Incident heart failure/dilated cardiomyopathy occurred in 6.2% within 1 year after index hospitalization and in 10.2% during 2000-2014, predominantly in those ≥50 years (12.1% within 1 year, 20.8% during 2000-2014). In all, 8.1% died within 1 year, 0.9% (<50 years) and 20.8% (≥50 years). Hazard ratios (adjusted for age, sex) for 1-year mortality comparing cases and controls were 4.00 (95% confidence interval 1.37-11.70), 4.48 (2.57-7.82), 4.57 (3.31-6.31) and 3.93 (3.39-4.57) for individuals aged <30, 30-<50, 50-<70, and ≥70 years, respectively. Conclusion: The incidence of myocarditis during 2000-2014 increased, predominantly in younger men. One-year mortality in the young was low, but fourfold higher compared with reference population.

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 49
Author(s):  
Maria D’Souza ◽  
Mette Bagger ◽  
Mark Alberti ◽  
Morten Malmborg ◽  
Morten Schou ◽  
...  

Purpose: To estimate the frequency of first-time ocular events in patients treated with immune checkpoint inhibitors (ICI). Methods: Patients with cancer in 2011–2018 in Denmark were included and followed. The outcomes were first-time ophthalmologist consultation and ocular inflammation. One-year absolute risks of outcomes and hazard ratios were estimated. Results: 112,289 patients with cancer were included, and 2195 were treated with ICI. One year after the first ICI treatment, 6% of the patients with cancer, 5% and 8% of the lung cancer (LC) and malignant cutaneous melanoma (MM) patients, respectively, had a first-time ophthalmologist consultation. The risk of ocular inflammation was 1% (95% confidence interval (CI) 0.4–1.2). Among patients with MM, ICI was associated with ocular inflammation in women (HR 12.6 (95% CI 5.83–27.31) and men (4.87 (95% CI 1.79–13.29)). Comparing patients with and without ICI treatment, the risk of first-time ophthalmologist consultation was increased in patients with LC (HR 1.74 (95% CI 1.29–2.34) and MM (HR 3.21 (95% CI 2.31–4.44). Conclusions: The one-year risks of first-time ophthalmologist consultation and ocular inflammation were 6% and 1%, respectively, in patients treated with ICI. In patients with LC and MM, the risk was increased in patients with ICI compared with patients without ICI.


Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0000362021
Author(s):  
Søren Viborg Vestergaard ◽  
Henrik Birn ◽  
Anette Tarp Hansen ◽  
Mette Nørgaard ◽  
Dorothea Nitsch ◽  
...  

Background: Registry-based studies of nephrotic syndrome (NS) may only include a subset of patients with biochemical features of NS. To address this, we compared patients with laboratory-recorded nephrotic proteinuria and hypoalbuminemia to patients with hospital-recorded NS. Methods: We identified adult patients with first-time hospital-recorded NS (inpatients, outpatients or emergency room visitors) in the Danish National Patient Registry and compared them to adults with first-time recorded nephrotic proteinuria and hypoalbuminemia in Danish laboratory databases during 2004-2018, defining date of admission or laboratory findings as index date. We characterised these cohorts by demographics, comorbidity, medication use, and laboratory and histopathological findings. Results: We identified 1,139 patients with hospital-recorded NS and 5,268 patients with nephrotic proteinuria and hypoalbuminemia of which 760 patients were identified with both. Within one year of the first recorded nephrotic proteinuria and hypoalbuminemia, 18% had recorded hospital diagnoses indicating the presence of NS, while 87% had diagnoses reflecting any kind of nephropathy. Among patients identified with nephrotic proteinuria and hypoalbuminemia, most recent eGFR was substantially lower (median of 35 vs. 61 ml/min/1.73 m2), fewer underwent kidney biopsies around index date (34% vs. 61%), and prevalence of thromboembolic disease (25% vs 17%) and diabetes (39% vs. 18%) was higher when compared to patients with hospital-recorded NS. Conclusions: Patients with nephrotic proteinuria and hypoalbuminemia are five-fold more common than patients with hospital-recorded NS, and they reveal a lower eGFR and more comorbidity. Selective and incomplete recording of NS may be an important issue when designing and interpreting studies of risks and prognosis of NS.


Endocrine ◽  
2019 ◽  
Vol 66 (3) ◽  
pp. 660-665 ◽  
Author(s):  
Buster Mannheimer ◽  
Jakob Skov ◽  
Henrik Falhammar ◽  
Jan Calissendorff ◽  
Jonatan D. Lindh ◽  
...  

Abstract Purpose Several studies have reported an association between hyponatremia and lethality. However, it remains elusive whether hyponatremia independently contributes to lethality. The aim of the study was to investigate associations between hyponatremia and lethality and differences in lethality between men and women hospitalized due to hyponatremia. Methods Four registries were utilized in this population-based retrospective study: The National Patient Registry, the Cause of Death Register, the Swedish Prescribed Drug Register and the Total Population Register (NPR) from which the controls were sampled. All hospitalized patients with a first-ever principal ICD10 diagnosis of hyponatremia or syndrome of inappropriate ADH secretion in the NPR between 1 October 2005 and 31 December 2014 were defined as cases. Cox regression with adjustment for potential confounders was used. Results 14,359 individuals with a principal diagnosis of hyponatremia, and 57,382 matched controls were identified. Median age was 76 years and the majority were women (72%). Median age for women and men was 79 and 68 years, respectively. Adjusted hazard ratios (and 95% CI) for lethality in those with hyponatremia compared with controls were for the entire population 5.5 (4.4–7.0) and in the subgroup free from previously known underlying disease 6.7 (3.3–13.3). Lethality in women with hyponatremia was lower compared with men: HR: 0.56 (0.49–0.64). In the healthier group the lethality remained lower for women: HR: 0.49 (0.34–0.71). Conclusions Patients hospitalized due to hyponatremia faced an increased subsequent lethality that was independent of concomitant disease. This increase was nearly twice as large among men compared with women.


ADALAH ◽  
2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Munadhil Abdul Muqsith

Abstract:The internet developed for the first time in Indonesia in the early 1990s. Starting from the pagayuban network, it is now expanding without boundaries anywhere. A survey conducted by the Indonesian Internet Service Providers Association (APJII) said that the number of internet users in Indonesia in 2012 reached 63 million people or 24.23 percent of the country's total population. Next year, that figure is predicted to increase by close to 30 percent to 82 million users and continue to grow to 107 million in 2014 and 139 million or 50 percent of the total population in 2015. million people. This matter also results in political communication with the internet media, or is often said to be cyber politics. Cyber politics in Indonesia has faced growth in recent years. There are many facilities that support the growth of cyber politics, such as Facebook, Twitter, mailing list, YouTube, and others.Keywords: Cyberpolitik, Internet  Abstrak:Internet berkembang pertama kali di Indonesia pada awal tahun 1990-an. Diawali dari pagayuban network kini berkembang luas tanpa batas dimanapun juga. Suatu survei yang diselenggarakan Asosiasi Penyelenggara Jasa Internet Indonesia (APJII) mengatakan kalau jumlah pengguna internet di Indonesia tahun 2012 menggapai 63 juta orang ataupun 24,23 persen dari total populasi negeri ini. Tahun depan, angka itu diprediksi naik dekat 30 persen jadi 82 juta pengguna serta terus berkembang jadi 107 juta pada 2014 serta 139 juta ataupun 50 persen total populasi pada 2015. juta orang. Perihal ini pula berakibat pada komunikasi politik dengan media internet, ataupun kerap diucap dengan cyber politic. Cyber politic di Indonesia hadapi pertumbuhan sebagian tahun terakhir. Banyaknya fasilitas yang menunjang pertumbuhan cyber politic semacam terdapatnya facebook, Twitter, mailing list, youtobe, serta lain-lain.Kata Kunci: Cyberpolitik, Internet 


2020 ◽  
Vol 62 ◽  
pp. 32-38
Author(s):  
E. A. Dolmatov ◽  
R. B. Borzayev ◽  
A. N. Shaipov

The results of the study of the duration of the juvenile period of indigenous Chechen willow leaf pear genotypes (Pyrus salicifolia Pall.) are given in connection with the acceleration of the breeding process and the use of selected forms in pear breeding for high precocity. The studies were carried out in 2016-2019 at OOO “Orchards of Chechnya” in accordance with the Agreement on creative cooperation with the Russian Research Institute of Fruit Crop Breeding. The work was carried out in accordance with generally accepted programs and methods. The objects of the study were one-year and two-year-old pear seedlings obtained from sowing seeds of selected dwarf and low-growing local Chechen forms of willow pear (P. salicifolia Pall.), laying fruit buds on annual growths and seedlings of Caucasian pear (P. caucasica Fed.), 20 500 pcs. of each specie. The aim of the research was to study the potential of precocity of willow pear seedlings and to reveal of selected forms with the greatest degree of this trait. Stratified seeds were sown in the sowing department of the OOO “Orchards of Chechnya” production nursery in April, 2017. The seedlings were grown according to the common technology in dryland conditions on the plot with chestnut soil. The first fl owering of plants was noted in the spring, 2019. As a result of the research, for the first time on a large number of the experimental material it was found that in the off spring of the indigenous Chechen willow leaf pear genotypes, the selection of a little more than 2% of seedlings with a very short juvenile period (2 years) was possible. They are of great interest in accelerating the breeding process and in the selection of new pear varieties with high precocity. 20 willow leaf pear genotypes were selected for the further use in breeding for high precocity and as sources of the trait of short juvenile period.


2020 ◽  
Vol 20 (10) ◽  
pp. 1711-1718
Author(s):  
Maryam Tohidi ◽  
Aidin Baghbani-Oskouei ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
Fereidoun Azizi ◽  
...  

Background: Dysfunction of the thyroid gland has profound effects on the cardiovascular system. Objective: We aimed to explore the relation of serum thyroid peroxidase antibody (TPO-Ab), as a marker of thyroid autoimmunity with incident hypertension among a euthyroid population. Methods: A total of 3681 participants (1647 men) entered the study. Multivariate Cox proportional hazard models were conducted to estimate the association between TPO-Ab and incident hypertension. Results: The mean age (standard deviation) of the participants was 37.5 (12.8) years. During a median follow-up of 12.2 years, 511 men and 519 women developed hypertension. The multivariable hazard ratios (HRs) and related 95% confidence intervals (CIs) of 1-unit increase in natural logarithm (ln) of TPO-Ab for incident hypertension were 1.09 (1.00-1.19), 1.03 (0.97-1.10), and 1.05 (1.00-1.11) for men, women, and total population, respectively. Moreover, considering the TPO-Ab status as a categorical variable (i.e. TPO-Ab positive or TPO-Ab negative), the multivariate-adjusted HRs (95% CIs) of TPO-Ab positivity for incident hypertension, were 1.33 (0.95-1.85), 1.12 (0.86-1.45) and 1.19 (0.97- 1.46) for men, women, and total population, respectively. Conclusion: Elevated serum TPO-Ab level can contribute to the development of hypertension among euthyroid men during a long follow-up; suggesting a role for thyroid autoimmunity.


Author(s):  
Conrad Krawiec ◽  
Xinying Fang ◽  
Shouhao Zhou ◽  
Duane Williams ◽  
Neal J. Thomas

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Kamil ◽  
T.S.G Sehested ◽  
K Houlind ◽  
J.F Lassen ◽  
G Gislason ◽  
...  

Abstract Background Peripheral artery disease (PAD) is associated with increased cardiovascular (CV) morbidity and mortality. Aggressive management of risk factors and lifestyle modification may improve outcomes for patients with PAD. The present study aims to investigate changes in use of cardioprotective medication after the incident diagnosis of PAD between 1997 and 2016. Methods By using Danish national healthcare registries, we identified all patients with first-time diagnosis of PAD between 1997 and 2016. These patients were classified into 2 main groups: PAD-all (n=167,762) that includes all PAD patients with or without a history of CVD, including myocardial infarction (MI), atrial fibrillation (AF), and stroke (n=167,761) and PAD-only (n=87,935) that comprise patients with PAD without a history of AF, MI, and stroke. We calculated temporal trends and assessed comparative use of cardioprotective medication in the first 12 months after the incident diagnosis of PAD. Results Our results showed an improved use of cardioprotective medication temporally in both groups. However, PAD-all were marginally better treated (Aspirin, 3.5% - 48.4%; Clopidogrel, 0% - 17.6%; VKA 0.9% - 7.8%; NOACs 0.0% - 10.1%; Statins, 1.9%- 58.1%; ACE-inhibitors, 1.2% - 20.6%), compared to PAD-only (Aspirin, 2.9% - 54.4%; Clopidogrel, 0% - 11.9%; VKA 0.9% - 2.4%; NOACs 0.0% - 3.4%; Statins, 1.5%- 56.9%; ACE-inhibitors, 0.9% - 17.2%), respectively. Proportion of PAD patients treated with any cardioprotective medication was greater among those with a history of MI or stroke. Whereas, PAD patients with a history of AF were substantially better treated with VKA and NOACs. Conclusion In this nationwide study, use of cardioprotective medication increased considerably with time, but there remains an underuse of guideline-recommended therapy in patients with PAD. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 12 (1) ◽  
pp. 17-26
Author(s):  
Genevieve C. Tuite ◽  
James A. Quintessenza ◽  
Alfred Asante-Korang ◽  
Sharon R. Ghazarian ◽  
Bethany L. Wisotzkey ◽  
...  

Background: To assess changes in patterns of practice and outcomes over time, we reviewed all patients who underwent heart transplantation (HTx) at our institution and compared two consecutive eras with significantly different immunosuppressive protocols (cohort 1 [80 HTx, June 1995-June 2006]; cohort 2 [108 HTx, July 2006-September 2018]). Methods: Retrospective study of 180 patients undergoing 188 HTx (June 1995-September 2018; 176 first time HTx, 10 second HTx, and 2 third HTx). In 2006, we commenced pre-HTx desensitization for highly sensitized patients and started using tacrolimus as our primary postoperative immunosuppressive agent. The primary outcome was mortality. Survival was modeled by the Kaplan-Meier method. Univariable and multivariable Cox proportional hazard models were created to identify prognostic factors for survival. Results: Our 188 HTx included 18 neonates, 85 infants, 83 children, and 2 adults (>18 years). Median age was 260.0 days (range: 5 days-23.8 years). Median weight was 7.5 kg (range: 2.2-113 kg). Patients in cohort 1 were less likely to have been immunosensitized preoperatively (12.5% vs 28.7%, P = .017). Nevertheless, Kaplan-Meier analysis suggested superior survival in cohort 2 ( P = .0045). Patients in cohort 2 were more likely to be alive one year, five years, and ten years after HTx. Multivariable analysis identified the earlier era (hazard ratio [HR] [95% confidence interval] for recent era = 0.32 [0.14-0.73]), transplantation after prior Norwood operation (HR = 4.44 [1.46-13.46]), and number of prior cardiac operations (HR = 1.33 [1.03-1.71]) as risk factors for mortality. Conclusions: Our analysis of 23 years of pediatric and congenital HTx reveals superior survival in the most recent 12-year era, despite the higher proportion of patients with elevated panel reactive antibody in the most recent era. This improvement was temporally associated with changes in our immunosuppressive strategy.


2021 ◽  
Vol 79 (4) ◽  
pp. 1601-1612
Author(s):  
Johan Frederik Håkonsen Arendt ◽  
Erzsébet Horváth-Puhó ◽  
Henrik Toft Sørensen ◽  
Ebba Nexø ◽  
Lars Pedersen ◽  
...  

Background: It is controversial whether B12 deficiency causes dementia or B12 treatment can prevent dementia. Objective: To assess associations between low plasma (P-)B12 levels, B12 treatment, and risk of Alzheimer’s disease (AD; primary outcome) and all-cause or vascular dementia (secondary outcomes). Methods: We conducted a population-based cohort study using Danish registry data to assess associations between low P-B12 levels, high-dose injection or oral B12 treatment, and risk of dementia (study period 2000–2013). The primary P-B12 cohort included patients with a first-time P-B12 measurement whose subsequent B12 treatment was recorded. The secondary B12 treatment cohort included patients with a first-time B12 prescription and P-B12 measurement within one year before this prescription. For both cohorts, patients with low P-B12 levels (<200 pmol/L) were propensity score-matched 1:1 with patients with normal levels (200–600 pmol/L). We used multivariable Cox regression to compute 0–15-year hazard ratios for dementia. Results: For low P-B12 and normal P-B12 level groups, we included 53,089 patients in the primary P-B12 cohort and 13,656 patients in the secondary B12 treatment cohort. In the P-B12 cohort, hazard ratios for AD centered around one, regardless of follow-up period or treatment during follow-up. In the B12 treatment cohort, risk of AD was unaffected by low pre-treatment P-B12 levels, follow-up period and type of B12 treatment. Findings were similar for all-cause and vascular dementia. Conclusion: We found no associatio1n between low P-B12 levels and dementia. Associations were unaffected by B12 treatment. Results do not support routine screening for B12 deficiency in patients with suspected dementia.


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