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Registry Study (registry + study)
Selected AbstractsPreterm birth or foetal growth impairment and psychiatric hospitalization in adolescence and early adulthood in a Swedish population-based birth cohortACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009W. Monfils Gustafsson Objective:, Preterm birth and restricted foetal growth are related to symptoms of psychiatric disorder. Our aim was therefore to investigate possible relations between being born preterm and/or small for gestational age (SGA) and later psychiatric hospitalization. Method:, A population-based registry study of psychiatric hospitalization of in total 155 994 boys and 148 281 girls born in Sweden in 1973,1975. Results:, The risk of hospitalization for all mental disorders was increased for preterm SGA boys (OR 2.19, 95% CI 1.49,3.21); at-term SGA boys (OR 1.55, 95% CI 1.34,1.79); at-term SGA girls (OR 1.31, 95% CI 1.15,1.50). At-term SGA boys and girls suffered increased risk of anxiety and adjustment disorders (OR 1.70, 95% CI 1.18,2.45 and OR 1.49, 95% CI 1.14,1.94). Preterm SGA boys were at risk of personality disorders (OR 3.30, 95% CI 1.16,9.41) and psychotic disorders (OR 4.36, 95% CI 1.85,10.30). Conclusion:, The results show a relationship between being born SGA and later psychiatric hospitalization, where preterm birth and male gender seem to increase the risk. [source] The North American Immune Tolerance Registry: contributions to the thirty-year experience with immune tolerance therapyHAEMOPHILIA, Issue 1 2009D. DIMICHELE Summary., The North American Immune Tolerance Registry (NAITR) began in 1992 as a project of the ISTH Factor VIII/IX Subcommittee with the goal of further determining immune tolerance induction (ITI) practices in Canada and the United States. This retrospective registry study, published in 2002, was limited in its capacity to provide definitive answers to many unresolved ITI practice issues. Nonetheless, it played a role in developing guidelines for current ITI practice and in generating hypotheses that must now be examined through rigorous prospective data collection efforts. For haemophilia A, the logical next step has been the initiation of international prospective randomized studies of ITI outcome relative to factor VIII (FVIII) dose and purity for subjects with high titre inhibitors. Both trials will additionally provide platforms for translational study of the immunology of tolerance, a prelude to the next generation of safe and effective tolerizing strategies. For the less common problem of FIX inhibitor eradication, prospective randomized studies will not be a feasible way to confirm the NAITR observations. Coordinated international efforts will still be required to prospectively collect data on ITI outcome to document new potentially effective therapeutic strategies for inhibitor eradication. These registries will hopefully also serve to identify potential subjects for scientific studies of immunology of haemophilia B-related allergic phenomena, a devastating complication of FIX antibody development. [source] Changing GPs' prescription patterns through guidelines and feedback.PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2007Intervention study Abstract Purpose To investigate whether and how a multi-dimensional intervention including clinical guidelines on the choice of medical treatment in the primary and the secondary health care sector, and individual feedback to general practices about their own and other practices' prescription patterns in five Anatomical Therapeutic Chemical classification system (ATC)-groups was followed by changes in the practices' prescription pattern. Methods Prospective historical registry study and a questionnaire study of GPs' self-reported use of guidelines and feedback. Results In every ATC-group the number of prescribed defined daily doses (DDDs) kept growing after the intervention, while potential savings by DDD decreased. Individual practices' changes in the prescription pattern differed by ATC-group and practices with high potential savings/DDD before the intervention showed the greatest relative reduction in potential savings/DDD. The county's average cost/DDD for the five ATC-groups declined from above the Danish average before the intervention to a level below the average cost/DDD after the intervention. In the questionnaire study (response rate: 79%), 69% of respondents had read the guidelines and 78% reported that the feedback influenced their prescription of drugs. Conclusions The observed changes in drug costs and potential savings were not due to volume effects but a combination of price effects, including generic substitution and choice of less expensive analogues, demonstrating that it is possible to change GPs' prescription patterns without interfering with patients' access to treatment or with GPs' clinical freedom.' Copyright © 2007 John Wiley & Sons, Ltd. [source] Prevalence and risk factors of severe obstetric haemorrhageBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2008I Al-Zirqi Objective, To determine the prevalence, causes, risk factors and acute maternal complications of severe obstetric haemorrhage. Design, Population-based registry study. Population, All women giving birth (307 415) from 1 January 1999 to 30 April 2004 registered in the Medical Birth Registry of Norway. Information about socio-economic risk factors was obtained from Statistics Norway. Methods, Cross-tabulation was used to study prevalence, causes and acute maternal complications of severe obstetric haemorrhage. Associations of severe obstetric haemorrhage with demographic, medical and obstetric risk factors were estimated using multiple logistic regression models. Main outcome measure, Severe obstetric haemorrhage (blood loss of > 1500 ml or blood transfusion). Results, Severe obstetric haemorrhage was identified in 3501 women (1.1%). Uterine atony, retained placenta and trauma were identified causes in 30, 18 and 13.9% of women, respectively. The demographic factors of a maternal age of ,30 years and South-East Asian ethnicity were significantly associated with an increased risk of haemorrhage. The risk was lower in women of Middle Eastern ethnicity, more than three and two times higher for emergency caesarean delivery and elective caesarean than for vaginal birth, respectively, and substantially higher for multiple pregnancies, von Willebrand's disease and anaemia (haemoglobin <9 g/dl) during pregnancy. Admissions to an intensive care unit, postpartum sepsis, hysterectomy, acute renal failure and maternal deaths were significantly more common among women with severe haemorrhage. Conclusion, The high prevalence of severe obstetric haemorrhage indicates the need to review labour management procedures. Demographic and medical risk factors can be managed with extra vigilance. [source] The differential effect of foreign-born status on preterm birth: a Taiwan population-based birth registry studyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2007L-C See Whether foreign-born status confers a protective effect on preterm birth in Taiwan was investigated using singleton live birth data from the 2004 Taiwan Birth Registry (n= 211 946). Newborns of foreign-born mothers (FBMs) comprised 13.7% of the population. The preterm birth rate of newborns of FBMs (5.9%) was significantly lower than that of newborns of Taiwan-born mothers (TBMs) (8.0%) (P < 0.0001). After having adjusted for predisposing maternal factors or adverse pregnancy conditions, newborns of FBMs still had a lower risk in preterm birth than that of TBMs, with an odds ratio of 0.74 and 95% confidence interval between 0.71 and 0.79. Selection was hypothesised to explain the low preterm birth rate in FBMs. [source] Increase in basal cell carcinoma incidence steepest in individuals with high socioeconomic status: results of a cancer registry study in the NetherlandsBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2009S. Van Hattem Summary Background, Development of both basal cell carcinoma (BCC) and cutaneous malignant melanoma (MM) is associated with acute and intermittent sun exposure. In contrast to MM, the association between socioeconomic status (SES) and BCC is not well documented. Objectives, To investigate the incidence of BCC according to SES, stratifying by age and tumour localization in a large population-based cohort. To assess changes over time in the distribution of the patients with BCC across the SES categories. Methods, All patients with a histologically confirmed first primary BCC (n = 27,027) diagnosed between 1988 and 2005 in the Southeast of the Netherlands were stratified by sex, age (25,44, 45,64 and , 65 years), period of diagnosis, SES category (based on income and value of housing) and localization of the BCC. Age-standardized BCC incidence rates were calculated for the year 2004 by SES category and localization. Ordinal regression was used to assess changes over time in the proportion of patients with BCC by sex, age and SES. Results For men in all age groups higher BCC incidence in the highest SES category was observed, which remained significant after stratification for tumour localization. For women a consistent relationship was found only in younger women (< 65 years) for truncal BCCs, which occurred more frequently in high SES groups. Between 1990 and 2004, the proportion of BCC patients with high SES increased (+6%) and the proportion with low SES decreased (,7%). Conclusions, High SES is associated with increased incidence of BCC among men. Our data suggest that BCC is changing from a disease of the poor to a disease of the rich. [source] Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer,,CANCER, Issue 17 2010S. Revel-Vilk MD Abstract BACKGROUND: The use of central venous catheters (CVCs) has greatly improved the quality of care in children with cancer, yet these catheters may cause serious infectious and thrombotic complications. The aim of this prospective registry study was to assess the host and CVC-related risk factors for CVC-created thrombotic complications. METHODS: Patients undergoing CVC insertion for chemotherapy were followed prospectively for CVC complications. At the time of enrollment, demographic, clinical, and CVC-related data, and family history of thrombosis were collected. Survival and Cox regression analyses were performed. RESULTS: A total of 423 CVCs were inserted into 262 patients for a total of 76,540 catheter days. The incidence of CVC-related deep-vein thrombosis (DVT) was 0.13 per 1000 catheter-days (95% confidence interval [CI], 0.06-0.24). Insertion of peripherally inserted central catheters (PICCs) and insertion in an angiography suite significantly increased the risk of symptomatic CVC-related DVT. The incidence of CVC occlusion was 1.35 per 1000 catheter-days (95% CI, 1.1-1.63). Positive family history of thrombosis significantly increased the risk of CVC occlusion (hazard ratio [HR], 2.16; 95% CI, 1.2-3.8). The CVC-related risk factors were insertion of Hickman catheters, insertion in angiography suite, and proximal-tip location. Patients developing at least 1 episode of both CVC occlusion and infection had an increased risk for developing symptomatic CVC-related DVT (HR, 4.15; 95% CI, 1.2-14.4). CONCLUSIONS: Both patient-related and CVC-related factors are associated with higher risk of symptomatic thrombotic complications. These risk factors could be used in the clinical setting and in developing future studies for CVC thromboprophylaxis. Cancer 2010. © 2010 American Cancer Society. [source] | ||||||||||