Fibromyalgia and the Risk of a Subsequent Motor Vehicle Crash

2015 ◽  
Vol 42 (8) ◽  
pp. 1502-1510 ◽  
Author(s):  
Donald A. Redelmeier ◽  
Jeremy D. Zung ◽  
Deva Thiruchelvam ◽  
Robert J. Tibshirani
Keyword(s):  
Incidence Rate ◽  
Traffic Safety ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Motor Vehicle ◽  
Cohort Analysis ◽  
Motor Vehicle Crash ◽  
Vehicle Crash ◽  
Increased Risk ◽  
Population Norm

Objective.Motor vehicle crashes are a widespread contributor to mortality and morbidity, sometimes related to medically unfit motorists. We tested whether patients diagnosed with fibromyalgia (FM) have an increased risk of a subsequent serious motor vehicle crash.Methods.We conducted a population-based self-matched longitudinal cohort analysis to estimate the incidence rate ratio of crashes among patients diagnosed with FM relative to the population norm in Ontario, Canada. We included adults diagnosed from April 1, 2006, to March 31, 2012, excluding individuals younger than 18 years, living outside Ontario, lacking valid identifiers, or having only a single visit for the diagnosis. The primary outcome was an emergency department visit as a driver involved in a motor vehicle crash.Results.The patients (n = 137,631) accounted for 738 crashes during the first year of followup after diagnosis, equal to an incidence rate ratio of 2.44 compared with the population norm (95% CI 2.27–2.63, p < 0.001). The crash rate was more than twice the population norm for those with a new or a persistent diagnosis. The increased risk included patients with diverse characteristics, approached the rate observed among other patients diagnosed with alcoholism, and was mitigated among those who received dedicated FM care or a physician warning for driving safety.Conclusion.A diagnosis of FM is associated with an increased risk of a subsequent motor vehicle crash that might justify medical interventions for traffic safety.

scholarly journals Educational and health outcomes of children treated for asthma: Scotland-wide record linkage study of 683 716 children

2019 ◽  
Vol 54 (3) ◽  
pp. 1802309 ◽  
Author(s):  
Michael Fleming ◽  
Catherine A. Fitton ◽  
Markus F.C. Steiner ◽  
James S. McLay ◽  
David Clark ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Hospital Admissions ◽  
Incidence Rate Ratio ◽  
Educational Interventions ◽  
Linkage Study ◽  
Increased Risk ◽  
Educational Need ◽  
Psychosocial Morbidity

BackgroundThe global prevalence of childhood asthma is increasing. The condition impacts physical and psychosocial morbidity; therefore, wide-ranging effects on health and education outcomes are plausible.MethodsLinkage of eight Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions and unemployment, provided data on 683 716 children attending Scottish schools between 2009 and 2013. We compared schoolchildren on medication for asthma with peers, adjusting for sociodemographic, maternity and comorbidity confounders, and explored effect modifiers and mediators.ResultsThe 45 900 (6.0%) children treated for asthma had an increased risk of hospitalisation, particularly within the first year of treatment (incidence rate ratio 1.98, 95% CI 1.93–2.04), and increased mortality (HR 1.77, 95% CI 1.30–2.40). They were more likely to have special educational need for mental (OR 1.76, 95% CI 1.49–2.08) and physical (OR 2.76, 95% CI 2.57–2.95) health reasons, and performed worse in school exams (OR 1.11, 95% CI 1.06–1.16). Higher absenteeism (incidence rate ratio 1.25, 95% CI 1.24–1.26) partially explained their poorer attainment.ConclusionsChildren with treated asthma have poorer education and health outcomes than their peers. Educational interventions that mitigate the adverse effects of absenteeism should be considered.

scholarly journals The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 91
Author(s):  
Jonathan Davis ◽  
Cara Hamann ◽  
Brandon Butcher ◽  
Corinne Peek-Asa
Keyword(s):  
Review Process ◽  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Crash ◽  
Driving Ability ◽  
Crash Risk ◽  
Referral Process ◽  
Vehicle Crash ◽  
Increased Risk ◽  
Medical Referral

Cognitive and physical impairment can occur with dementia and reduce driving ability. In the United States, individual states have procedures to refer and evaluate drivers who may no longer be fit to drive. The license review process is not well understood for drivers with dementia. This study uses comprehensive data from the Iowa Department of Transportation to compare the referral process for drivers with and without dementia from January 2014 through November 2019. The likelihood of failing an evaluation test was compared between drivers with and without dementia using logistic regression. The risk of motor-vehicle crash after referral for review of driving ability was compared using a Cox proportional hazard model. Analysis controlled for the age and sex of the referred driver. Drivers with dementia performed worse on all tests evaluated except the visual screening test. After the referral process, the risk of crash was similar between those with and without dementia. Drivers with dementia were denied their license more frequently than referred drivers without dementia. However, drivers with dementia who successfully kept their license as a result of the license review process were not at an increased risk of crash compared to other referred drivers.

scholarly journals Increased Risk for Nonmedullary Thyroid Cancer in the First Degree Relatives of Prevalent Cases of Nonmedullary Thyroid Cancer: A Hospital-Based Study

2001 ◽  
Vol 86 (11) ◽  
pp. 5307-5312 ◽  
Author(s):  
Tuya Pal ◽  
Florian D. Vogl ◽  
Pierre O. Chappuis ◽  
Richard Tsang ◽  
James Brierley ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Genetic Basis ◽  
Incidence Rate Ratio ◽  
Cancer Susceptibility ◽  
Degree Relative ◽  
First Degree Relatives ◽  
Increased Risk

The genetic basis for nonmedullary forms of thyroid cancer (NMTC) is less well established than that of medullary thyroid cancer. However, epidemiological and family studies suggest that a proportion of NMTC may be due to inherited predisposition. To estimate the familial risk of thyroid cancer, we conducted a hospital-based case-control study at the Princess Margaret Hospital in Toronto, Ontario, Canada, and at 2 university hospitals in Montréal, Québec, Canada. We obtained pedigrees from 339 unselected patients diagnosed with NMTC and from 319 unaffected ethnically matched controls. Family histories of cancer were obtained from the cases and controls for 3292 first degree relatives of cases and controls. Seventeen cases (5.0%) and 2 controls (0.6%) reported at least one first degree relative with thyroid cancer. In relatives of patients with thyroid cancer, the incidence of any type of cancer (including NMTC) was 38% higher than in relatives of controls (incidence rate ratio, 1.4; 95% confidence interval, 1.1–1.7). The relative risk for thyroid cancer was 10-fold higher in relatives of cancer patients than in controls (incidence rate ratio, 10.3; 95% confidence interval, 2.2–47.6). Our findings suggest that hereditary or other familial factors are important in a small proportion of NMTC. Molecular studies are needed to determine the genetic basis of cancer susceptibility in these families.

Experimental Application of Global Positioning system To Locate Motor Vehicle Crashes: Impact on Time and Accuracy

1998 ◽  
Vol 1625 (1) ◽  
pp. 41-49 ◽  
Author(s):  
John S. Miller ◽  
Duane Karr
Keyword(s):  
Global Positioning System ◽  
Human Error ◽  
Motor Vehicle ◽  
Motor Vehicle Crash ◽  
Positioning System ◽  
Gps Receivers ◽  
Crash Data ◽  
Vehicle Crash ◽  
Global Positioning ◽  
Conventional Methods

Motor vehicle crash countermeasures often are selected after an extensive data analysis of the crash history of a roadway segment. The value of this analysis depends on the accuracy or precision with which the crash itself is located. yet this crash location only is as accurate as the estimate of the police officer. Global Positioning System (GPS) technology may have the potential to increase data accuracy and decrease the time spent to record crash locations. Over 10 months, 32 motor vehicle crash locations were determined by using both conventional methods and hand-held GPS receivers, and the timeliness and precision of the methods were compared. Local crash data analysts were asked how the improved precision affected their consideration of potential crash countermeasures with regard to five crashes selected from the sample. On average, measuring a crash location by using GPS receivers added up to 10 extra minutes, depending on the definition of the crash location, the technology employed, and how that technology was applied. The average difference between conventional methods of measuring the crash location and either GPS or a wheel ranged from 5 m (16 ft) to 39 m (130 ft), depending on how one defined the crash location. Although there are instances in which improved precision will affect the evaluation of crash countermeasures, survey respondents and the literature suggest that problems with conventional crash location methods often arise from human error, not a lack of precision inherent in the technology employed.

Inflammatory Bowel Disease and Risk of Major Bleeding During Anticoagulation for Venous Thromboembolism

2021 ◽  
Author(s):  
Susanna Scharrer ◽  
Christian Primas ◽  
Sabine Eichinger ◽  
Sebastian Tonko ◽  
Maximilian Kutschera ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Fatal Bleeding ◽  
Adjusted Incidence Rate ◽  
Inflammatory Bowel ◽  
Adjusted Incidence

Abstract Background Little is known about the bleeding risk in patients with inflammatory bowel disease (IBD) and venous thromboembolism (VTE) treated with anticoagulation. Our aim was to elucidate the rate of major bleeding (MB) events in a well-defined cohort of patients with IBD during anticoagulation after VTE. Methods This study is a retrospective follow-up analysis of a multicenter cohort study investigating the incidence and recurrence rate of VTE in IBD. Data on MB and IBD- and VTE-related parameters were collected via telephone interview and chart review. The objective of the study was to evaluate the impact of anticoagulation for VTE on the risk of MB by comparing time periods with anticoagulation vs those without anticoagulation. A random-effects Poisson regression model was used. Results We included 107 patients (52 women, 40 with ulcerative colitis, 64 with Crohn disease, and 3 with unclassified IBD) in the study. The overall observation time was 388 patient-years with and 1445 patient-years without anticoagulation. In total, 23 MB events were registered in 21 patients, among whom 13 MB events occurred without anticoagulation and 10 occurred with anticoagulation. No fatal bleeding during anticoagulation was registered. The incidence rate for MB events was 2.6/100 patient-years during periods exposed to anticoagulation and 0.9/100 patient-years during the unexposed time. Exposure to anticoagulation (adjusted incidence rate ratio, 3.7; 95% confidence interval, 1.5-9.0; P = 0.003) and ulcerative colitis (adjusted incidence rate ratio, 3.5; 95% confidence interval, 1.5-8.1; P = 0.003) were independent risk factors for MB events. Conclusion The risk of major but not fatal bleeding is increased in patients with IBD during anticoagulation. Our findings indicate that this risk may be outweighed by the high VTE recurrence rate in patients with IBD.

Left Hemidiaphragm Rupture Following High-Speed Motor Vehicle Crash

2012 ◽  
Vol 41 (4) ◽  
pp. 130-132
Author(s):  
Michelle Bittle ◽  
Eric Hoffer ◽  
Jeffrey D. Robinson
Keyword(s):  
High Speed ◽  
Motor Vehicle ◽  
Motor Vehicle Crash ◽  
Vehicle Crash ◽  
Left Hemidiaphragm
Sign in / Sign up

Export Citation Format

Share Document