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Kinds of Registry Terms modified by Registry Selected AbstractsLIPID REGISTRY: Intravenous lipid emulsion as antidoteEMERGENCY MEDICINE AUSTRALASIA, Issue 6 2009Martyn Harvey No abstract is available for this article. [source] Phytotherapeutics: an evaluation of the potential of 1000 plantsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2010G. Cravotto MD Summary Objective:, The aim of this review is to evaluate and summarize the available scientific information on the commonest plant extracts marketed in Western countries. In view of the intense, ongoing search for new plant extracts with powerful anti-inflammatory activity, we paid particular attention to this topic. The aim is to provide broad coverage of as many potentially useful plants as possible and then to focus on those with the greatest therapeutic potential. Methods:, Our bibliographic sources were the SciFinder databases: CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS (update to October 2007). In order to assess the value of clinical trials, we focused a specific search on clinical investigations concerning nine plants with the most trial data, viz., Althaea officinalis, Calendula officinalis, Centella asiatica, Echinacea purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. This was carried out in several databases (update to June 2008): ISI Web of KnowledgeSM (ISI WoK), SciFinder (CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS) and PubMed (indexed for MEDLINE). Results:, Our survey covers roughly a 1000 plants, although clinical trials have been published only for 156 plants supporting specific pharmacological activities and therapeutic applications. However, for about half of the plants, in vitro and in vivo studies provide some support for therapeutic use. For one-fifth of the plants included in our search, only phytochemical studies were found. Their properties and indications were often attributed to the presence of certain compounds, but no evidence concerning the activities of the whole extracts was presented. We found that for about 12% of the plants, currently available on the Western market, no substantial studies on their properties had been published, while there was strong evidence that 1 in 200 were toxic or allergenic, so that their use ought to be discouraged or forbidden. Nine plants had considerable evidence of therapeutic effect, viz., A. officinalis, Calendula officinalis, Centella asiatica, E. purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. Conclusion:, The present review provides a baseline on the level of evidence available on many herbal preparations and should be of help to those intending to research further on these topics. [source] Body mass index, alcohol, tobacco and symptomatic gallstone disease: a Swedish twin studyJOURNAL OF INTERNAL MEDICINE, Issue 5 2007D. Katsika Abstract. Background/Aims., Both genetic and environmental factors are involved in the pathogenesis of gallstone disease (GD). We aimed to examine the association between symptomatic GD and overweight (body mass index, BMI, 25,30 kg m,2), obesity (BMI > 30 kg m,2), alcohol, smoking and smoke-free tobacco by analysing a large twin population. Methods., The Swedish Twin Registry (STR) was linked to the Swedish Hospital Discharge and Causes of Death Registries for GD and GD-surgery related diagnoses. Weight, height, use of alcohol, smoking and smoke-free tobacco were provided by STR and analysed for possible associations by conditional logistic regression. Results., Overweight and obesity were associated with a significantly higher risk for symptomatic GD in the whole study population (OR 1.86 and OR 3.38; CI: 1.52,2.28 and 2.28,5.02 respectively). High alcohol consumption was associated with a lower risk for GD in the whole population (OR 0.62; CI: 0.51,0.74) with no difference between discordant monozygotic and dizygotic twins (OR 1.08 and OR 0.96; CI: 0.82,1.42 and 0.79,1.16). Smoking or smoke-free tobacco was not correlated with GD. Conclusion., Consistent with epidemiological studies, we found positive associations between BMI and the development of symptomatic GD. High alcohol consumption was associated with a decreased risk against GD. Tobacco use has no impact on GD. [source] Mesothelioma in blood related subjects: Report of 11 clusters among 1954 Italy cases and review of the literatureAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2007Valeria Ascoli Abstract Background Malignant mesothelioma is a sporadic tumor related to asbestos. Its occurrence in blood relatives raises the question of potential contribution of predisposing factors. Methods The study analyses the features of mesothelioma in blood relatives that might explain the disease clustering. Data sources of familial clusters were three population-based Mesothelioma Registries in Italy (Veneto and Apulia Regions, Brescia province; 1978,2005) and Medline, Toxline, and Oshline/Hseline databases for a review of the literature (1968,2006). Results Eleven clusters (22 cases) were identified among 1954 Italy mesothelioma cases, and 51 clusters (120 cases) were extracted from 33 studies. The proportion of Italy familial cases was 1.4 per 100 mesothelioma cases; the ratio between the number of familial clusters and the number of non-familial mesothelioma cases was 1:148. The mesothelioma profile in consanguineous is the same as in non-consanguineous subjects (male prevalence; pleural site; age at diagnosis >50 years; asbestos exposure). Most clusters occurred in asbestos workers (shipyard, asbestos-cement production/processing, and insulation) and household-exposed blood relatives. Others were related to asbestos-cement factory pollution, asbestos-in-place, and handling asbestos-contaminated textiles. Two clusters were without any known exposure. Cancer family history revealed lung cancer cases in eight clusters. Conclusions Available data support asbestos exposure as the main risk factor in mesothelioma cases among blood relatives. Our finding of a low proportion of familial cases would not suggest the influence of a large genetic component for mesothelioma in blood relatives. Am. J. Ind. Med. 50:357,369, 2007. © 2007 Wiley-Liss, Inc. [source] Evaluation of prenatal diagnosis of associated congenital heart diseases by fetal ultrasonographic examination in EuropePRENATAL DIAGNOSIS, Issue 4 2001C. Stoll Abstract Ultrasound scans in the mid trimester of pregnancy are now a routine part of antenatal care in most European countries. With the assistance of Registries of Congenital Anomalies a study was undertaken in Europe. The objective of the study was to evaluate prenatal detection of congenital heart defects (CHD) by routine ultrasonographic examination of the fetus. All congenital malformations suspected prenatally and all congenital malformations, including chromosome anomalies, confirmed at birth were identified from the Congenital Malformation Registers, including 20 registers from the following European countries: Austria, Croatia, Denmark, France, Germany, Italy, Lithuania, Spain, Switzerland, The Netherlands, UK and Ukrainia. These registries follow the same methodology. The study period was 1996,1998, 709,030 births were covered, and 8126 cases with congenital malformations were registered. If more than one cardiac malformation was present the case was coded as complex cardiac malformation. CHD were subdivided into ,isolated' when only a cardiac malformation was present and ,associated' when at least one other major extra cardiac malformation was present. The associated CHD were subdivided into chromosomal, syndromic non-chromosomal and multiple. The study comprised 761 associated CHD including 282 cases with multiple malformations, 375 cases with chromosomal anomalies and 104 cases with non-chromosomal syndromes. The proportion of prenatal diagnosis of associated CHD varied in relation to the ultrasound screening policies from 17.9% in countries without routine screening (The Netherlands and Denmark) to 46.0% in countries with only one routine fetal scan and 55.6% in countries with two or three routine fetal scans. The prenatal detection rate of chromosomal anomalies was 40.3% (151/375 cases). This rate for recognized syndromes and multiply malformed with CHD was 51.9% (54/104 cases) and 48.6% (137/282 cases), respectively; 150/229 Down syndrome (65.8%) were livebirths. Concerning the syndromic cases, the detection rate of deletion 22q11, situs anomalies and VATER association was 44.4%, 64.7% and 46.6%, respectively. In conclusion, the present study shows large regional variations in the prenatal detection rate of CHD with the highest rates in European regions with three screening scans. Prenatal diagnosis of CHD is significantly higher if associated malformations are present. Cardiac defects affecting the size of the ventricles have the highest detection rate. Mean gestational age at discovery was 20,24 weeks for the majority of associated cardiac defects. Copyright © 2001 John Wiley & Sons, Ltd. [source] Breast cancer incidence among American Indian and Alaska Native women: US, 1999,2004,,§CANCER, Issue S5 2008Phyllis A. Wingo PhD Abstract BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race. METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region. RESULTS. Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease. CONCLUSIONS. To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening. Cancer 2008;113(5 suppl):1191,202. Published 2008 by the American Cancer Society. [source] Colorectal cancer in U.S. adults younger than 50 years of age, 1998,2001,CANCER, Issue S5 2006Temeika L. Fairley PhD Abstract BACKGROUND. Colorectal cancer (CRC) incidence rates are increasing among persons younger than 50 years of age, a population routinely not screened unless an individual has a high risk of CRC. This population-based study focuses primarily on describing the CRC burden for persons in this age group. METHODS. The data used for this study were derived from the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) surveillance systems. Age-adjusted incidence rates, rate ratios, and their corresponding 95% confidence intervals were calculated. RESULTS. CRC is ranked among the top 10 cancers occurring in males and females aged 20,49 years regardless of race. Persons younger than 50 years were more likely to present with less localized and more distant disease than do older adults. Among younger adults, age-adjusted incidence rates for poorly differentiated cancers were twice as high as rates for well-differentiated cancers. Incidence rates for poorly differentiated cancers were 60% higher than that for well-differentiated cancers diagnosed in older adults. Rates were significantly higher for blacks and significantly lower for Asians/Pacific Islanders when compared with that for whites for the most demographic and tumor characteristics examined. CONCLUSIONS. This study confirms the findings of previous population-based studies suggesting that younger patients present with more advanced disease than do older patients. This study also identifies racial and ethnic disparities in CRC incidence in this population. These findings suggest the need for additional studies to understand the behavior and etiology of CRC in blacks. Cancer 2006. © 2006 American Cancer Society. [source] Primary prevention of neural tube defects with folate in Western Australia: the value of the Western Australian Birth Defects RegistryCONGENITAL ANOMALIES, Issue 2 2006Carol Bower ABSTRACT This paper reviews the role of the Western Australian Birth Defects Registry in the primary prevention of neural tube defects. The Registry provides complete and up-to-date information on all neural tube defects (NTD), including terminations of pregnancy. These data have been used to determine a baseline rate of NTD and to monitor trends in NTD over time, when health promotion of folic acid supplement use and voluntary fortification of food with folate were introduced. The register has also been used to investigate NTD in special populations (Indigenous infants in Australia) and as a sampling frame for case control studies. The data derived from these studies have been used to assist in assessing whether mandatory food fortification in Australia is indicated to prevent NTD. [source] Early Vasoactive Drugs Improve Heart Failure OutcomesCONGESTIVE HEART FAILURE, Issue 6 2009William Frank Peacock MD Vasoactive therapy is often used to treat acute decompensated heart failure (ADHF). The authors sought to determine whether clinical outcomes are temporally associated with time to vasoactive therapy (vasoactive time) in ADHF. Using the Acute Decompensated Heart Failure (ADHERE) Registry, the authors examined the relationship between vasoactive time and inpatient mortality within 48 hours of hospitalization. Vasoactive agents were used early (defined as <6 hours) in 22,788 (63.8%) patients and late in 12,912 (36.2%). Median vasoactive time was 1.7 and 14.7 hours in the early and late groups, respectively. In-hospital mortality was significantly lower in the early group (odds ratio, 0.87; 95% confidence interval, 0.79,0.96; P=.006), and the adjusted odds of death increased 6.8% for every 6 hours of treatment delay (95% confidence interval, 4.2,9.6; P<.0001). Early vasoactive initiation is associated with improved outcomes in patients hospitalized for ADHF. [source] Comparison of the Effects of Cardiac Resynchronization Therapy in Patients With Class II vs Class III and IV Heart Failure (From the InSync/InSync ICD Italian Registry)CONGESTIVE HEART FAILURE, Issue 2 2008Scott Harris DO No abstract is available for this article. [source] Elevated Serum Cardiac Markers Predict Coronary Artery Disease in Patients With a History of Heart Failure Who Present With Chest Pain: Insights From the i*trACS RegistryCONGESTIVE HEART FAILURE, Issue 3 2007Jonathan Glauser MD The significance of a history of heart failure (HF) in patients presenting with acute coronary syndromes and elevated cardiac markers is unclear. The authors performed an analysis of patients enrolled in the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS). Cardiac marker measurement and cardiac catheterization were performed in 1174 patients. Of these, 116 (9.9%) had heart failure (HF). Coronary artery disease (CAD) was found in 61 (52.6%) patients in the HF group and 581 (54.9%) in the group without HF. In the non-HF cohort, positive markers occurred in 306 patients, in whom 217 (70.9%) had CAD at catheterization. In the HF subset, 24 patients had positive biomarkers and 15 (62.5%) had CAD. A history of HF did not lessen the likelihood of CAD as evidenced by angiography and does not diminish the utility of cardiac markers in diagnosing acute coronary syndromes. [source] Tolerability, Safety, and Efficacy of ,-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective ,-Blocker RegistryCONGESTIVE HEART FAILURE, Issue 1 2007William T. Abraham MD Heart failure (HF) clinical trials suggest different responses of blacks and whites to ,-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (,58% vs ,56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials. [source] The validity of the Violence Risk Appraisal Guide (VRAG) in predicting criminal recidivismCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2007Carolin Kröner Introduction,The VRAG is an actuarial risk assessment instrument, developed in Canada as an aid to estimating the probability of reoffending by mentally ill offenders. Aim,To test the predictive validity of the VRAG with a German sample. Method,The predictive validity of the VRAG was tested on a sample of 136 people charged with a criminal offence and under evaluation for criminal responsibility in the forensic psychiatry department at the University of Munich in 1994,95. The predicted outcome was tested by means of ROC analysis for correlation with the observed rate of recidivism between discharge after the 1994,95 assessment and the census date of 31 March 2003. Recidivism rate was calculated from the official records of the National Conviction Registry. Results,Just over 38% of the sample had reoffended by 2003. Their mean time-at-risk was 58 months (SD 3.391; range 0,115 months). The VRAG yielded a high predictive accuracy in the ROC analysis with an AUC of 0.703. For a constant time-at-risk < = 7 years, the predicted probability and observed rates of recidivism correlated significantly with Pearson's r = 0.941. Conclusions,The validity of the VRAG was replicated with a German sample. The VRAG yielded good predictive accuracy, despite differences in sample and outcome variables compared with its original sample. Copyright © 2007 John Wiley & Sons, Ltd. [source] Dento-alveolar and maxillofacial injuries: a 5-year multi-center study.DENTAL TRAUMATOLOGY, Issue 1 2008Part 2: Severity, location These injuries may cause morbidity and demand meticulously planned treatment. Part 1 of this study focused on the incidence of general trauma injuries, as well as facial or dental trauma. The aim of part 2 is to evaluate the severity and location of the dento-alveolar and maxillofacial injuries over 5 years. A retrospective cohort study was conducted based on data from the Israel National Trauma Registry. Patients admitted and hospitalized due to trauma injuries during the years 2000,2004, totaled 111 010 in which 5886 (5.3%) were maxillofacial or dental injuries. Most of these injuries were traffic-related (54.5%), followed by events at home (18.7%). Facial injuries combined with injuries to other organs involved occurred in 3721 (63.2%) of the patients. Most minor injuries were noted when no other organs were involved, while severe injuries were more common when multiple organs were involved. More than 25% of facial injuries required surgery. Meticulous epidemiologic studies are needed to support the leading role, extent, and severity of maxillofacial trauma. [source] Depression and obesity: do shared genes explain the relationship?DEPRESSION AND ANXIETY, Issue 9 2010Niloofar Afari Ph.D. Abstract Background: Studies have found a modest association between depression and obesity, especially in women. Given the substantial genetic contribution to both depression and obesity, we sought to determine whether shared genetic influences are responsible for the association between these two conditions. Methods: Data were obtained from 712 monozygotic and 281 dizygotic female twin pairs who are members of the community-based University of Washington Twin Registry. The presence of depression was determined by self-report of doctor-diagnosed depression. Obesity was defined as body mass index of ,30,kg/m2, based on self-reported height and weight. Generalized estimating regression models were used to assess the age-adjusted association between depression and obesity. Univariate and bivariate structural equation models estimated the components of variance attributable to genetic and environmental influences. Results: We found a modest phenotypic association between depression and obesity (odds ratio=1.6, 95% confidence interval=1.2,2.1). Additive genetic effects contributed substantially to depression (57%) and obesity (81%). The best-fitting bivariate model indicated that 12% of the genetic component of depression is shared with obesity. Conclusions: The association between depression and obesity in women may be in part due to shared genetic risk for both conditions. Future studies should examine the genetic, environmental, social, and cultural mechanisms underlying the relationship between this association. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Immediate and Midterm Complications of Sclerotherapy: Report of a Prospective Multicenter Registry of 12,173 Sclerotherapy SessionsDERMATOLOGIC SURGERY, Issue 2 2005FACPH, Jean-Jérôme Guex MD Background Growing interest in sclerotherapy has emphasized the need for complete knowledge of all aspects of this method. Objective To precisely delineate the actual incidence of immediate and delayed untoward events of daily sclerotherapy. Methods A multicenter prospective registry was established in 22 phlebology clinics to report their activity and complications. Results During the study period, 12,173 sessions of sclerotherapy were carried out, 5,434 with liquid, 6,395 with foam, and 344 using both. Four thousand eighty-eight (33.9%) sessions were carried out with ultrasound guidance. Forty-nine incidents or accidents (0.4%) occurred, of which 12 were with liquid and 37 with foam. These were reported during the time of the study and an additional 1-month follow-up. Most numerous were 20 cases of visual disturbances (in 19 cases, foam or air block was used); all resolved shortly, without any after-effects. A femoral vein thrombosis was the only severe adverse event in this study. Conclusions This study demonstrates that sclerotherapy is a safe technique. FUNDING FOR RESEARCH WAS PROVIDED BY THE FRENCH SOCIETY OF PHLEBOLOGY, A NONPROFIT ORGANIZATION. [source] Excess use of coercive measures in psychiatry among migrants compared with native DanesACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010M. Norredam Norredam M, Garcia-Lopez A, Keiding N, Krasnik A. Excess use of coercive measures in psychiatry among migrants compared with native Danes. Objective:, To investigate differences in risk of compulsory admission and other coercive measures in psychiatric emergencies among refugees and immigrants compared with that among native Danes. Method:, A register-based retrospective cohort design. All refugees (n = 29 174) and immigrants (n = 33 287) who received residence permission in Denmark from 1.1.1993 to 31.12.1999 were included and matched 1 : 4 on age and sex with native Danes. Civil registration numbers were cross-linked to the Danish Psychiatric Central Register and the Registry of Coercive Measures in Psychiatric Treatment. Results:, Refugees (RR = 1.82; 95%CI: 1.45; 2.29) and immigrants (RR = 1.14; 95%CI: 0.83; 1.56) experienced higher rates of compulsory admissions than did native Danes. This was most striking for refugee men (RR = 2.00; 95%CI: 1.53; 2.61) and immigrant women (RR = 1.73; 95%CI: 1.45; 2.60). Moreover, refugees and immigrants experienced higher frequencies of other coercive measures during hospitalisation compared with native Danes. Conclusion:, Coercive measures in psychiatry are more likely to be experienced by migrants than by native Danes. [source] Increased number of offspring in first degree relatives of psychotic individuals: a partial explanation for the persistence of psychotic illnessesACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009M. Weiser Objective:, As patients with psychotic illness have fewer offspring than controls, the persistence of psychotic illness is puzzling. We hypothesized that unaffected first-degree relatives of patients have more offspring than controls. Method:, Probands were 4904, individuals with non-affective psychotic disorders identified from a hospitalization registry. Unaffected first degree relatives and matched controls were identified from the Israeli Population Registry. The number of offspring of unaffected parents, biological siblings and controls was ascertained. Results:, Unaffected parents of psychotic patients had more offspring/person than controls; 4.5 ± 2.7 vs. 3.4 ± 2.2, P = 0.000. Unaffected parents from familial psychosis families (more than one affected family member) had 1.83 more offspring than controls; unaffected parents from non-familial psychosis families had 0.97 more offspring than controls (both P < 0.001). Conclusion:, These findings might imply that genes which increase susceptibility for schizophrenia may be associated with increased number of offspring, perhaps supplying a partial explanation for the persistence of psychosis. [source] Intrapartum fever and chorioamnionitis as risks for encephalopathy in term newborns: a case,control studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2008Heidi K Blume MD MPH In this study we examined the relationship between diagnoses of isolated intrapartum fever or chorioamnionitis and the risk of encephalopathy in term newborns. We conducted a population-based, case,control study in Washington State using 1994 to 2002 linked data from the Washington State Birth Registry and the Comprehensive Hospital Abstract Reporting System (CHARS). We identified 1060 singleton, term newborns (602 males, 458 females) with International Classification of Diseases (ICD-9) diagnoses consistent with encephalopathy, and 5330 unaffected control newborns (2756 males, 2574 females). Intrapartum fever was defined by a diagnosis of intrapartum temperature of >38°C in the birth registry or CHARS databases. Chorioamnionitis was defined using ICD-9 diagnoses recorded in CHARS. We identified 2.2 cases of encephalopathy per 1000 births. Isolated intrapartum fever was associated with a 3.1-fold (95% confidence interval [CI] 2.3-4.2) increased risk of newborn encephalopathy. Chorioamnionitis was associated with a 5.4-fold (95% CI 3.6-7.8) increased risk of encephalopathy. We found that isolated intrapartum fever and chorioamnionitis were independently associated with an increased risk of encephalopathy in term infants. Our data also indicate that there is a spectrum of risk for encephalopathy in term infants exposed to intrapartum fever. Infants born to women with signs of chorioamnionitis other than isolated intrapartum fever may be at higher risk of encephalopathy than those exposed only to isolated intrapartum fever. [source] Cancer risk among patients hospitalized for Type 1 diabetes mellitus: a population-based cohort study in SwedenDIABETIC MEDICINE, Issue 7 2010X. Shu Diabet. Med. 27, 791,797 (2010) Abstract Aims, Type 1 diabetes mellitus (T1DM) is an autoimmune disease with potential mechanistic links to immune-related cancers. We aimed at examining the overall and specific cancer risks among hospitalized T1DM patients from the national registers in Sweden. Methods, A T1DM research cohort was created by identifying T1DM patients from the Hospital Discharge Register and linking them with the Cancer Registry. Standardized incidence ratios (SIRs) for subsequent cancers were calculated among patients with T1DM compared with those without T1DM. Results, Two hundred and fifty-eight cases were ascertained with subsequent cancers during the follow-up duration from 1964 to 2006, with an increased overall SIR of 1.17 (95% CI 1.04,1.33) among 24 052 T1DM patients identified at baseline. Significant excess was noted for gastric and skin (squamous cell carcinoma) cancers and for leukaemia. Increased risk of acute lymphatic leukaemia accounted for most of the variation of leukaemia risk (SIR = 5.31, 95% CI 3.32,8.05). Cancer risk varied with sex, age at first hospitalization and numbers of hospitalizations. The risk was higher in women compared with men and in those hospitalized for T1DM at age over 10 years compared with the younger patients. Higher risks were also found among those with more hospital visits. Conclusion, By quantifying the variations of overall and site-specific cancer risks after T1DM, the current study provides novel associations between T1DM and subsequent cancers, the mechanisms of which remain to be established. [source] Childhood growth and age at diagnosis with Type 1 diabetes in Colorado young peopleDIABETIC MEDICINE, Issue 10 2009K. Vehik Abstract Objective, Studies have suggested that the age at diagnosis of Type 1 diabetes (T1D) is decreasing over time. The overload hypothesis postulates that risk factors, such as accelerated growth, may be responsible for this decrease. We assessed changes in age, body mass index (BMI), weight and height at diagnosis with T1D in non-Hispanic white (NHW) and Hispanic (HISP) young people from Colorado, using data from the IDDM Registry and SEARCH Study. Methods, In three time periods, 656 (1978,1983), 562 (1984,1988) and 712 (2002,2004) young people aged 2,17 years were newly diagnosed with T1D. Age, weight, height and presence of diabetic ketoacidosis (DKA) at diagnosis with T1D were obtained from medical records. Trends over the three time periods were assessed with regression analyses. Results, Age at diagnosis decreased by 9.6 months over time (P = 0.0002). Mean BMI standard deviation score (SDS), weight SDS and height SDS increased over time (P < 0.0001), while prevalence of DKA decreased (P < 0.0001). Increasing height over time accounted for 15% (P = 0.04) of the decreasing age at diagnosis with T1D. Conclusions, Our study provides evidence that increased linear growth, but not increased BMI or weight over time, may account, at least in part, for the younger age at diagnosis of T1D in Colorado children. This finding supports the hypothesis that increasing environmental pressure resulting from changes in potentially preventable risk factors may accelerate the onset of T1D in children. [source] Human islet cell transplantation , future prospectsDIABETIC MEDICINE, Issue 2 2001S. A. White Summary Background Islet transplantation has the potential to cure diabetes mellitus. Nevertheless despite successful reversal of diabetes in many small animal models, the clinical situation has been far more challenging. The aim of this review is to discuss why insulin-independence after islet allotransplantation has been so difficult to achieve. Methods A literature review was undertaken using Medline from 1975 to July 2000. Results reported to the International Islet Transplant Registry (ITR) up to December 1998 were also analysed. Results Up to December 1998, 405 islet allotransplants have been reported the ITR. Of those accurately documented between 1990 and 1998 (n = 267) only 12% have achieved insulin-independence (greater than 7 days). However with refined peri-transplant protocols insulin indepedence at 1 year can reach 20%. Conclusions There are many factors which can explain the failure of achieving insulin-independence after islet allotransplantation. These include the use of diabetogenic immunosuppressive agents to abrogate both islet allo-immunity and auto-immunity, the critical islet mass to achieve insulin-independence and the detrimental effects of transplanting islets in an ectopic site. However recent evidence most notably from the Edmonton group demonstrates that islet allotransplantation still has great potential to become an established treatment option for diabetic patients. [source] The Validity of Using Multiple Imputation for Missing Out-of-hospital Data in a State Trauma RegistryACADEMIC EMERGENCY MEDICINE, Issue 3 2006Craig D. Newgard MD Objectives: To assess 1) the agreement of multiply imputed out-of-hospital values previously missing in a state trauma registry compared with known ambulance values and 2) the potential impact of using multiple imputation versus a commonly used method for handling missing data (i.e., complete case analysis) in a typical multivariable injury analysis. Methods: This was a retrospective cohort analysis. Multiply imputed out-of-hospital data from 1998 to 2003 for four variables (intubation attempt, Glasgow Coma Scale score, systolic blood pressure, and respiratory rate) were compared with known values from probabilistically linked ambulance records using measures of agreement (,, weighted ,, and Bland,Altman plots). Ambulance values were assumed to represent the "true" values for all analyses. A hypothetical multivariable regression model was used to demonstrate the impact (i.e., bias and precision of model results) of handling missing out-of-hospital data with multiple imputation versus complete case analysis. Results: A total of 6,150 matched ambulance and trauma registry records were available for comparison. Multiply imputed values for the four out-of-hospital variables demonstrated fair to good agreement with known ambulance values. When included in typical multivariable analyses, multiple imputation increased precision and reduced bias compared with using complete case analysis for the same data set. Conclusions: Multiply imputed out-of-hospital values for intubation attempt, Glasgow Coma Scale score, systolic blood pressure, and respiratory rate have fair to good agreement with known ambulance values. Multiple imputation also increased precision and reduced bias compared with complete case analysis in a typical multivariable injury model, and it should be considered for studies using out-of-hospital data from a trauma registry, particularly when substantial portions of data are missing. [source] Dysthymia in male adolescents is associated with increased risk of later hospitalization for psychotic disorders: a historical-prospective cohort studyEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2008Mark Weiser Abstract Aim: Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia. Methods: The Israeli Draft Board screens the entire, unselected population of 16,17 years old male adolescents for psychiatric disorders. These adolescents were followed for hospitalization for psychotic disorders and schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Of 275 705 male adolescents screened, 1267 (0.5%) were hospitalized for psychotic disorders (International Classification of Diseases [ICD]-10 20.0,29.9), and 757 (0.3%) were hospitalized for schizophrenia (ICD-10 20.0,20.9) over the next 1,10 years. Results: Of 275 705 male adolescents screened, 513 (0.2%) were diagnosed as suffering from dysthymia by the Draft Board. Of these adolescents, 10/513 (2.0%) were later hospitalized for psychotic disorders (including schizophrenia, HR = 3.967, 95%CI (confidence intervals): 2.129,7.390), and 4/513 (0.8%) were later hospitalized for schizophrenia (HR = 2.664, 95%CI: 0.997,7.116). Conclusions: In this population-based cohort of male adolescents, dysthymia was associated with increased risk for future psychotic disorders. Dysthymia in some adolescents might be a prodromal symptom, while in others it might be a risk factor for later psychosis. Clinicians assessing dysthymic adolescents should be aware that these symptoms might be part of the prodrome. [source] Ventricular Mechanical Asynchrony in Patients with Different Degrees of Systolic Dysfunction: Results from AVE Registry by the Italian Society of Cardiovascular Echography (SIEC)ECHOCARDIOGRAPHY, Issue 2 2010Scipione Carerj M.D. Objective: The aim of the study was to compare the prevalence of interventricular and intraventricular asynchrony in patients with different degrees of left ventricular (LV) dysfunction. Methods: We enrolled 182 patients (male 79%, mean age 64 ± 11 years) with LV ejection fraction (EF) < 50% and identified two groups: Group A (n = 79) with mild-to-moderate LV dysfunction (EF between 36% and 49%) and Group B (n = 103) with severe dysfunction (EF , 35%). An echocardiogram was performed in all patients and a delay longer than 40 msec in the time difference between the aortic and pulmonary preejection intervals was considered as an index of interventricular asynchrony. The electromechanical delays were assessed by pulsed tissue Doppler technique. A time difference between the earliest and the latest segment greater than 40 msec was considered the cutoff for intraventricular asynchrony. The sum of asynchrony was calculated by adding to the LV intraventricular delay the delay between the lateral basal right ventricular segment and the most delayed LV basal segment. Results: The prevalence of interventricular asynchrony was lower among Group A patients (19.8% vs. 37.9%; P = 0.007) while the prevalence of intraventricular asynchrony did not differ between groups (32.9% vs. 44% in Group A and Group B respectively; P = 0.18). The sum of asynchrony (cutoff >102 msec) did not differ between groups either (29.9% vs. 35.9%; P = 0.39). Conclusions: The prevalence of intraventricular asynchrony is independent of the LV systolic dysfunction severity. This could indicate the potential role of cardiac resynchronization therapy in patients with mild-moderate systolic dysfunction. (ECHOCARDIOGRAPHY 2010;27:110-116) [source] Genetic aspects of pathological gambling: a complex disorder with shared genetic vulnerabilitiesADDICTION, Issue 9 2009Daniela S. S. Lobo ABSTRACT Aims To summarize and discuss findings from genetic studies conducted on pathological gambling (PG). Methods Searches were conducted on PubMed and PsychInfo databases using the keywords: ,gambling and genes', ,gambling and family' and ,gambling and genetics', yielding 18 original research articles investigating the genetics of PG. Results Twin studies using the Vietnam Era Twin Registry have found that: (i) the heritability of PG is estimated to be 50,60%; (ii) PG and subclinical PG are a continuum of the same disorder; (iii) PG shares genetic vulnerability factors with antisocial behaviours, alcohol dependence and major depressive disorder; (iv) genetic factors underlie the association between exposure to traumatic life-events and PG. Molecular genetic investigations on PG are at an early stage and published studies have reported associations with genes involved in the brain's reward and impulse control systems. Conclusions Despite the paucity of studies in this area, published studies have provided considerable evidence of the influence of genetic factors on PG and its complex interaction with other psychiatric disorders and environmental factors. The next step would be to investigate the association and interaction of these variables in larger molecular genetic studies with subphenotypes that underlie PG. Results from family and genetic investigations corroborate further the importance of understanding the biological underpinnings of PG in the development of more specific treatment and prevention strategies. [source] Timing of first alcohol use and alcohol dependence: evidence of common genetic influencesADDICTION, Issue 9 2009Carolyn E. Sartor ABSTRACT Aims To estimate the magnitude of genetic and environmental influences on timing of first alcohol use and alcohol dependence (AD) and to quantify the overlap in these influences across the two alcohol-related outcomes. Participants The sample consisted of 5382 twins (2691 complete pairs), aged 24,36 years, from the Australian Twin Registry. Measurements History of alcohol use and DSM-IV alcohol dependence were assessed by structured telephone interview. Findings In both sexes, the relationship between age at first alcohol use and risk for AD followed a linear trend, such that the highest rates of AD were observed in individuals who began drinking at an earlier than average age (14 years or younger). Heritability estimates for timing of first alcohol use and AD were 36% and 53%, respectively. Shared environmental factors accounted for 15% of variance in initiation. There was no evidence of shared environmental influences on AD. The genetic correlation between timing of first alcohol use and AD was 0.59. Conclusions Findings highlight the substantial role of genetics in the development of AD and the early manifestation of that genetic risk in the timing of alcohol use initiation which, unlike AD, is also influenced to a modest degree by shared environmental factors. The considerable overlap in heritable influences,and the virtual absence of overlap in individual-specific environmental influences,on initiation of alcohol use and AD indicates that the association between age at first drink and AD is attributable in large part to common genetic sources of variance. [source] Motorcycle-related major trauma: On-road versus off-road incidence and profile of casesEMERGENCY MEDICINE AUSTRALASIA, Issue 5 2010Antonina Mikocka-Walus Abstract Objective: To describe and compare the incidence and profile of on- and off-road motorcycle-related major trauma (including death) cases across a statewide population. Methods: A review of prospectively collected data on adult, motorcycle-related major trauma cases from 2001 to 2008 was conducted. Major trauma survivors were identified from the population-based Victorian State Trauma Registry, and deaths were extracted from the National Coroners Information System. Poisson regression was used to test for increasing incidence using two measures of exposure: population of Victoria aged ,16 years, and registered motorcycles. Results: There were 1157 major trauma survivors and 344 deaths with motorcycle-related injuries over the study period. There was no change in the incidence of motorcycle-related major trauma (both survivors plus deaths) (Incident Rate ratio [IRR]= 1.14, 95% confidence interval [CI] 0.94,1.37) over the study period. Similarly, there was no change over time in the incidence of on-road motorcycle-related injury (survivors plus deaths) per 100 000 population (IRR = 1.03, 95% CI 0.84,1.27). However, the incidence of off-road motorcycle-related injury (survivors plus deaths) increased over the study period (IRR = 1.69, 95% CI 1.10,2.60). Among survivors and deaths, 882 (76%) and 301 (87.5%) cases, respectively, occurred on road. Conclusions: Off-road motorcycle-related major trauma has increased and this has not been targeted in injury prevention campaigns in Australia. The incidence of on-road motorcycle-related death in adults has decreased. Preventive strategies to address on-road injuries have been enforced and these are expected to lead to further reduction of on-road motorcycle crashes in the future. [source] Modeling the genetic and environmental association between peer group deviance and cannabis use in male twinsADDICTION, Issue 3 2009Nathan A. Gillespie ABSTRACT Background Peer group deviance (PGD) is linked strongly to liability to drug use, including cannabis. Our aim was to model the genetic and environmental association, including direction of causation, between PGD and cannabis use (CU). Method Results were based on 1736 to 1765 adult males from the Mid-Atlantic Twin Registry with complete CU and PGD data measured retrospectively at three time-intervals between 15 and 25 years using a life-history calendar. Results At all ages, multivariate modeling showed that familial aggregation in PGD was explained by a combination of additive genetic and shared environmental effects. Moreover, the significant PGD,CU association was best explained by a CU,PGD causal model in which large portions of the additive genetic (50,78%) and shared environmental variance (25,73%) in PGD were explained by CU. Conclusions Until recently PGD was assumed to be an environmental, upstream risk factor for CU. Our data are not consistent with this hypothesis. Rather, they suggest that the liability to affiliate with deviant peers is explained more clearly by a combination of genetic and environmental factors that are indexed by CU which sits as a ,risk indicator' in the causal pathway between genetic and environmental risks and the expression of PGD. This is consistent with a process of social selection by which the genetic and environmental risks in CU largely drive the propensity to affiliate with deviant peers. [source] Pathways to cannabis abuse: a multi-stage model from cannabis availability, cannabis initiation and progression to abuseADDICTION, Issue 3 2009Nathan A. Gillespie ABSTRACT Aims Although previous twin studies have modeled the association between drug initiation and abuse, none has included the obvious risk factor of drug availability. Our aim is to determine whether the genetic and environmental risk factors for cannabis availability also generate variation in cannabis initiation and/or progression to DSM-IV symptoms of abuse. Design We used multi-stage modeling, also known as causal-common-contingent (CCC) analysis, to partition the genetic and environmental factors into common and stage-specific components. Participants This report is based on data collected from 1772 adult males from the Mid Atlantic Twin Registry. Measurements The twins participated in two structured interviews which included clinical and non-clinical measures of cannabis abuse as well as retrospective assessments of perceived cannabis availability between ages 8 and 25 years. Findings Cannabis availability explained almost all the shared environmental risks in cannabis initiation and abuse. The influence of availability on the symptoms of abuse was indirect and mediated entirely by cannabis initiation. Conclusion These findings have begun to elucidate the causal processes underlying the liability to drug use and abuse in terms of putative risk factors. Specifically, our results show that the latent shared environmental factors in cannabis initiation and abuse can be explained by measured aspects of the shared environment,those responsible for variation in cannabis availability. [source] | ||||||||||||||||||||||||||||||||||||||||||||||