Population-based incidence of food allergies in Olmsted County over 17 years

Background: There is growing concern about the rising incidence and prevalence of food allergy globally. We previously reported the incidence of food allergy in Olmsted County, Minnesota, between 2002 and 2011. We sought to update the incidence and temporal trends of food allergies in our region through 2018. Methods: By using the Rochester Epidemiology Project, all Olmsted County residents, with an incident diagnosis of food allergy between January 2, 2012, and December 31, 2018, were identified and their medical records were reviewed. These cases were combined with the previously collected incidence cases from January 2, 2002, and December 31, 2011, to understand longitudinal trends in food allergy incidence rates. Results: Over the 17-year study period, 1076 patients (58.0% male patients, 72.1% white) were diagnosed with an incident food allergy. The median (interquartile range) age at first diagnosis was 2.0 years (1.1-8.4 years). The overall annual incidence rate for all ages was 3.9 (95% confidence interval [CI], 3.6‐4.1) per 10,000 person-years and was significantly higher in male than in female patients (4.4 [95% CI, 4.0‐4.7] and 3.3 [95% CI, 3.0‐3.6], respectively; p < 0.001). The most common food allergen was egg in infancy (57.7%), peanuts in ages 1‐4 years (58.3%), tree nuts in ages 5‐18 years (57.4%), and seafood in adults (≥19 years) (45.3%). Conclusion: The incidence of food allergy in Olmsted County steadily increased from 2002 to 2008, then remained relatively stable between the years 2008 and 2013, and again presented a rising trend over the next 5 years until 2018. This warrants further investigations into the effects of changes in guidelines for early introductions of allergenic foods and other factors that affect causality.

Association of Common Medications and the Risk of Early-Onset Gastric Cancer: A Population-Based Matched Study

Background. Early-onset gastric cancer (EOGC, age ≤ 60 years at diagnosis) now comprises >30% of new gastric cancers in the United States. It is hypothesized that chronic acid suppression with proton-pump inhibitors (PPIs) may promote tumorigenesis, while other medications including statins, nonsteroidal anti-inflammatory drugs (NSAIDs), metformin, and cyclooxygenase-2 (COX-2) inhibitors have been proposed as protective. We aimed to assess for an association between use of the aforementioned commonly prescribed medications and EOGC development. Methods. We used a population-based medical record linkage system, to identify cases of EOGC in Olmsted County, Minnesota, between January 1, 1995, and December 31, 2020. Patients were matched 1 : 1 with controls based on age at diagnosis, sex, smoking status, and body mass index (BMI). Conditional logistic regression was used to examine associations with the odds of EOGC development. Results. Ninety-six cases of EOGC were identified during the study period. On both univariate and multivariate regression analysis, there was no significant association between use of PPIs, statins, NSAIDs, or metformin and EOGC development. In a final multivariable model, there was a significant reduction in odds of EOGC with COX-2 inhibitor use for six months or more prior to cancer diagnosis ( OR = 0.39 , 95% CI 0.16-0.94). Conclusion. In this retrospective, population-based study of individuals in Olmsted County, MN, we found significantly reduced odds of EOGC development associated with COX-2 inhibitor use for six months or more prior to diagnosis, but no association between EOGC development and use of PPIs and other commonly prescribed medications.

Excessive Body Weight and Diverticular Disease

<b><i>Background:</i></b> The worldwide proportion of overweight adults almost doubled from 22% in 1975 to 39% in 2016. Comparably, for the USA and Germany in 2016, the proportion was 68 and 56.8%, respectively. In Olmsted County, Minnesota, the prevalence of diverticulitis also doubled between 1980 and 2007, from 19 to 40%. Obesity substantially increases the risk of multiple gastrointestinal (GI) diseases and non-GI diseases. In a narrative review, we examined the evidence on whether obesity also increases the risk for the development of diverticulosis or diverticular disease and its outcome. <b><i>Summary:</i></b> Evidence suggests that being overweight (body mass index ≥25 kg/m²) or obese (≥30 kg/m²), especially viscerally obese, is a risk factor for diverticulosis, diverticular disease and diverticulitis, diverticular bleeding, more severe or complicated disease, recurrent disease, and for worse outcomes after surgery. <b><i>Key Messages:</i></b> There is a well-founded association between overweight and diverticular disease as well as diverticulosis. It is not clear whether overweight per se or confounders linked with it are responsible for the association. However, means to fight the overweight and obesity epidemic might also help to reduce the prevalence of morbidity and mortality from diverticular disease.

Mioklonus pada Kehamilan dan Pasca Persalinan : Laporan Kasus

Pendahuluan: Mioklonus didefinisikan sebagai gerakan involunter yang mendadak dan singkat akibat kontraksi otot aktif atau hambatan aktivitas otot. Letak kelainan bisa berasal dari kortikal, subkortikal, atau spinal. Prevalensi mioklonus berdasarkan penelitian di Olmsted County, Minnesota, Amerika Serikat sejumlah 8,6 kasus dalam 100.000 populasi. Di Indonesia masih sedikit laporan mengenai kasus mioklonus terutama pada wanita hamil dan pasca persalinan. Perlu dilakukan pemeriksaan klinis dan pemeriksaan penunjang yang tepat untuk mengetahui klasifikasi dan etiologi mioklonus. Hal tersebut akan menentukan pemilihan terapi simptomatis dan terapi penyebab yang tepat. Perlu pengkajian lebih dalam mengenai standar diagnosis dan terapi khususnya pada pasien mioklonus dengan kehamilan dan pasca persalinan. Kasus: Dilaporkan dua kasus mioklonus pada otot abdomen pada pasien wanita dengan investigasi dan penatalaksanaan yang berbeda. Kasus pertama, wanita usia 25 tahun dengan usia kehamilan 20 minggu didiagnosis mioklonus pada abdomen tanpa pemberian terapi medikamentosa. Pada kasus kedua, wanita usia 24 tahun dengan 8 hari pasca persalinan didiagnosis mioklonus pada abdomen dengan pemberian terapi medikamentosa, yaitu fenitoin, triheksifenidil, dan diazepam. Kesimpulan: Pasien wanita usia 25 tahun, usia kehamilan 20 minggu dengan mioklonus pada abdomen mengalami perbaikan klinis setelah 3 bulan dengan tanpa pemberian terapi medikamentosa, sedangkan kasus lainnya, wanita usia 24 tahun, 8 hari pasca persalinan dengan mioklonus pada abdomen mengalami perbaikan klinis setelah 2 hari dengan pemberian terapi medikamentosa.

COVID-19 Outbreak Associated with a Fitness Center — Minnesota, September–November 2020

The Minnesota Department of Health investigated a COVID-19 outbreak at a fitness center in Olmsted County, Minnesota. Twenty-three SARS-CoV-2 infections (five employees and 18 members) were identified. An epidemiological investigation supported by whole genome sequencing demonstrated that transmission of SARS-CoV-2 occurred at the fitness center despite following recommended prevention strategies.