Odds Ratio (odds + ratio)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Odds Ratio

  • adjusted odds ratio
  • age-adjusted odds ratio
  • allelic odds ratio
  • common odds ratio
  • crude odds ratio
  • diagnostic odds ratio
  • estimated odds ratio
  • increased odds ratio
  • mortality odds ratio
  • pooled odds ratio
  • prevalence odds ratio
  • significant odds ratio
  • summary odds ratio

  • Terms modified by Odds Ratio

  • odds ratio estimate

  • Selected Abstracts

    Inflammatory events as detected in cervical smears and squamous intraepithelial lesions

    Anne M. E. Roeters M.D.
    Abstract The Dutch cytological coding system, KOPAC, enables to code for eight inflammatory events, that is koilocytosis (related to human papillomavirus (HPV)), Trichomonas, dysbacteriosis [related to bacterial vaginosis (BV)], Candida, Gardnerella, Actinomyces, Chlamydia, and non-specific inflammation (leucocytosis). This study presents an analysis of 1,008,879 smears. Of each smear, the age of the woman and the reason for smear taking (screening or indication) was available. The cytoscores (per mille) for these codes were calculated. For the screening smears, the cytoscores were for koilocytosis (HPV) 2.6, for Trichomonas vaginalis 1.9, for dysbacteriosis 31.4, for Candida albicans 9.8, for Gardnerella vaginalis 0.7, for Actinomyces 6.9, for Chlamydia 0.8, and for non-specific inflammatory changes 66.4. For the calculation of the Odds Ratio (OR), normal smears were used as a reference. The cytoscores for Chlamydia and Gardnerella covaried with high grade SIL (HSIL), with an OR of 7 and 12, respectively. In addition, the OR for Trichomonas vaginalis, for dysbacteriosis, and for leucocytosis proved to be significantly high in the indication smears. This study provides an oversight of HSIL and the full range of cervical infections as detected by cytology, proving that this infectious byproduct of screening can be very valuable. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source]

    Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma

    P. J. Veugelers
    SUMMARY., The aim of this study was to examine the association of obesity with esophageal adenocarcinoma, and with the precursor lesions Barrett esophagus and gastroesophageal reflux disease (GERD). This case-control study included cases with GERD (n = 142), Barrett esophagus (n = 130), and esophageal adenocarcinoma (n = 57). Controls comprised 102 asymptomatic individuals. Using logistic regression methods, we compared obesity rates between cases and controls adjusting for differences in age, gender, and lifestyle risk factors. Relative to normal weight, obese individuals were at increased risk for esophageal adenocarcinoma (Odds Ratio [OR] 4.67, 95% Confidence Interval [CI] 1.27,17.9). Diets high in vitamin C were associated with a lower risk for GERD (OR 0.40, 95% CI 0.19,0.87), Barrett esophagus (OR 0.44, 95% CI 0.20,0.98), and esophageal adenocarcinoma (OR 0.21, 95% CI 0.06,0.77). For the more established risk factors, we confirmed that smoking was a significant risk factor for esophageal adenocarcinoma, and that increased liquor consumption was associated with GERD and Barrett esophagus. In light of the current obesity epidemic, esophageal adenocarcinoma incidence rates are expected to continue to increase. Successful promotion of healthy body weight and diets high in vitamin C may substantially reduce the incidence of this disease. [source]

    Genomic convergence to identify candidate genes for Alzheimer Disease on chromosome 10

    HUMAN MUTATION, Issue 3 2009
    Xueying Liang
    Abstract A broad region of chromosome 10 (chr10) has engendered continued interest in the etiology of late-onset Alzheimer Disease (LOAD) from both linkage and candidate gene studies. However, there is a very extensive heterogeneity on chr10. We converged linkage analysis and gene expression data using the concept of genomic convergence that suggests that genes showing positive results across multiple different data types are more likely to be involved in AD. We identified and examined 28 genes on chr10 for association with AD in a Caucasian case-control dataset of 506 cases and 558 controls with substantial clinical information. The cases were all LOAD (minimum age at onset ,60 years). Both single marker and haplotypic associations were tested in the overall dataset and 8 subsets defined by age, gender, ApoE and clinical status. PTPLA showed allelic, genotypic and haplotypic association in the overall dataset. SORCS1 was significant in the overall data sets (p=0.0025) and most significant in the female subset (allelic association p=0.00002, a 3-locus haplotype had p=0.0005). Odds Ratio of SORCS1 in the female subset was 1.7 (p<0.0001). SORCS1 is an interesting candidate gene involved in the A, pathway. Therefore, genetic variations in PTPLA and SORCS1 may be associated and have modest effect to the risk of AD by affecting A, pathway. The replication of the effect of these genes in different study populations and search for susceptible variants and functional studies of these genes are necessary to get a better understanding of the roles of the genes in Alzheimer disease. 30, 463,471, 2009. © 2008 Wiley-Liss, Inc. [source]

    Defining complex contributions of NOD2/CARD15 gene mutations, age at onset, and tobacco use on Crohn's disease phenotypes

    Dr. Steven R. Brant
    Abstract Background Multiple factors, particularly IBD family history, tobacco use, age at diagnosis and recently, NOD2 mutant genotypes may influence Crohn's disease (CD) heterogeneity. Methods We performed a multicenter retrospective record analysis of 275 unrelated patients with CD. Age at diagnosis, IBD family history, Jewish ethnicity, tobacco use at diagnosis, surgical history, disease site and clinical behavior were correlated with genotypes for NOD2 mutations, and all risk factors were assessed for independent influence on outcomes of disease site, behavior and surgery free survival. Results Risk of ileal disease was increased for CD patients with two NOD2 mutations (Odds Ratio, O.R. 10.1), a smoking history (O.R. 2.25 per pack per day at diagnosis) or a younger age at diagnosis (O.R. 0.97 per each increased year). Presence of ileal disease (O.R. 4.8) and carrying one or two NOD2 mutations (O.R. 1.9 and 3.5, respectively) were independent risk factors for stricturing or non-perianal fistulizing behavior. Ileal disease, youthful onset and smoking at diagnosis (but not NOD2 mutations) were risk factors for early surgery. Conclusions Carrying two NOD2 mutations predicts youthful onset, ileal disease involvement, and development of stricturing or non-perianal fistulizing complications. Smoking and early onset independently influence ileal site and time to surgery. [source]

    The role of patient personality in the identification of depression in older primary care patients

    Laura W. McCray
    Abstract Background Our aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms. Methods We examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study. Results High neuroticism (unadjusted Odds Ratio (OR) 2.36, 95% Confidence Interval (CI) [1.42, 3.93]) and low extraversion (adjusted OR 2.24, CI [1.26, 4.00]) were associated with physician identification of depression. Persons with high conscientiousness were less likely to be identified as depressed by the doctor (adjusted OR 0.45, CI [0.22, 0.91]). Conclusion Personality factors influence the identification of depression among older persons in primary care over and above the relationship of depressive symptoms with physician identification. Knowledge of personality may influence the diagnosis and treatment of depression in primary care. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Gender in elderly suicide: analysis of coroners inquests of 200 cases of elderly suicide in Cheshire 1989,2001

    Emad Salib
    Abstract Objectives The aim of this study is to review gender differences in elderly suicide in relation to specific social aspects of the suicidal process and health care contact before death. Such information may have practical value in identifying and targeting vulnerable elderly in whom suicide may be potentially preventable. Methods Data were extracted from the records of coroner's inquests into all reported suicide of persons aged 60 and over, in Cheshire over a period of 13 years 1989,2001. The Coroner's office covers the whole county of Cheshire (population 1,000,000). Results Men were less likely to have been known to psychiatric services (Odds Ratio [OR] 0.4 95% 0.2,0.6) and with less frequently reported history of previous attempted suicide compared to women (OR 0.5 95% Confidence Intervals [CI] 0.2,1). All deceased from ethnic minorities were men, none of whom had been known to psychiatric services. There was no significant difference between women and men in relation to, physical or psychiatric morbidity, GP contact prior to suicide, intimation of intent or living alone. Of suicide victims not known to services a surprisingly high proportion of 38% and 16% were found to have psychiatric morbidity in men and women respectively. Conclusion Suicide is an important problem in the elderly with gender playing an important part in their social behaviour but a high proportion of the deceased were not known to local services. Primary Care professionals have an important role to play in reducing elderly suicide as most contact with the health service in elderly suicide seem to be with GPs. Copyright © 2003 John Wiley & Sons, Ltd. [source]

    Basal ganglia calcification and psychotic symptoms in the very old

    Svante Östling
    Abstract Background Basal ganglia calcification (BGC) is associated with psychotic symptoms in young and middle-aged patient samples. Methods We studied the cross-sectional relationship between psychotic symptoms and BGC in a population sample of non-demented 85-year-olds, of whom 86 were mentally healthy, 11 had hallucinations or delusions, 21 had mood disorders and 20 had anxiety disorders. BGC was measured using computerized tomography (CT). Mental disorders were diagnosed using DSM-III-R criteria and psychotic symptoms were evaluated using information from psychiatric examinations, key-informant interviews and review medical records. Results BGC on CT was observed in 19% of mentally healthy and 64% of non-demented individuals with hallucinations or delusions [Odds Ratio (OR) 7.7, 95% Confidence Intervals (CI) 2.9,29.7, p=0.003]. There were no associations between BGC and mood or anxiety disorders. Conclusions BGC is strongly associated with psychotic symptoms in very old age, possibly due to a disturbance in the basal ganglia dopaminergic system. Copyright © 2003 John Wiley & Sons, Ltd. [source]

    Consumption of psychotropic medication in the elderly: a re-evaluation of its effect on cognitive performance

    Jacques Allard
    Abstract Background There have been few general population studies of the effects of psychotropic treatment on cognitive functioning in the elderly. Current evidence based on studies with numerous procedural shortenings supports the notion of the detrimental effect. Objectives To examine changes in a wide range of specific cognitive abilities across time in a general population sample in order to establish a relationship between psychotropic drug use and cognitive performance, and to estimate to what extent such cognitive changes may be attributable to psychotropic use or other factors, notably age and co-morbidity. Method We analysed the data from the Eugeria longitudinal study of cerebral ageing. Three hundred and seventy two subjects (263 female and 109 male) were visited at their place of residence and given a computerized cognitive examination. Depressive symptomatology and depressive episodes were defined according to ICD-9 criterias and medication use were established. Four categories of psychotropic consumers was differentiated. Using a logistic regression model, comparisons were made between consumers and non-consumers. Results A significant positive effect in chronic consumers was found on tests of secondary memory (delayed verbal recall: Odds Ratio (OR),=,1.22; 95% Confidence Intervals (CI) [1.04,1.43]; p,=,0.013) and this effect is principally attributable to antidepressants with significant effects being shown for both verbal (OR,=,1.59; 95%CI [1.18,2.14]; p,=,0.002) and visual recall (OR,=,1.51; 95%CI [1.05,2.16]; p,=,0.025). No effect is found for benzodiazepines. Conclusions Contrary to the common belief that psychotropic drug use has a detrimental effect on cognitive function of elderly people, even long term use is seen to be benign. We attest to the positive effects of antidepressant therapy on secondary memory. Copyright © 2003 John Wiley & Sons, Ltd. [source]

    Applying the Liu-Agresti Estimator of the Cumulative Common Odds Ratio to DIF Detection in Polytomous Items

    Randall D. Penfield
    Liu and Agresti (1996) proposed a Mantel and Haenszel-type (1959) estimator of a common odds ratio for several 2 × J tables, where the J columns are ordinal levels of a response variable. This article applies the Liu-Agresti estimator to the case of assessing differential item functioning (DIF) in items having an ordinal response variable. A simulation study was conducted to investigate the accuracy of the Liu-Agresti estimator in relation to other statistical DIF detection procedures. The results of the simulation study indicate that the Liu-Agresti estimator is a viable alternative to other DIF detection statistics. [source]

    Assessment of Dental Caries Predictors in a Seven-year Longitudinal Study

    Elaine Pereira da Silva Tagliaferro DDS
    Abstract Objective: To identify, in a group of 6,8-year-old schoolchildren, risk factors for dental caries increment in permanent dentition. Methods: Two hundred and six children from three different schools in Piracicaba, Brazil, were examined at baseline and after 7 years by the same two calibrated dentists. Data on dental caries (dmfs, DMFS, presence of initial lesions), fluorosis, oral hygiene and presence of sealant were collected at the clinical examination that was performed in an outdoor setting, under natural light, using a dental mirror and probe following the WHO recommendations. Information on socioeconomic level, fluoride usage, dental service utilization, dietary and oral hygiene habits was also obtained at baseline in a semi-structured questionnaire sent to the parents. The dependent variable was the 7-year DMFS increment. A univariate analysis was performed to test the association of independent variables in caries increment. Then a logistic regression model was used to estimate the adjusted Odds Ratio for caries increment. Results: Clinical (dmfs, DMFS) and non-clinical variables (daily toothbrushing, use of preventive topical methods, parents' educational level) were entered in the multiple logistic regression analysis. The prediction model included the clinical and socioeconomic variables, DMFS, dmfs and mother's educational level. The best caries predictor was the dmfs variable. Conclusion: Caries experience and mother's educational level were predictors of caries increment in permanent dentition. [source]

    Meta-analysis: levamisole improves the immune response to hepatitis B vaccine in dialysis patients

    F. Fabrizi
    Summary Background, Patients undergoing maintenance dialysis often fail to mount protective antibodies to hepatitis B virus surface antigen (HBsAg) following vaccination against hepatitis B virus (HBV). Some authors have suggested that levamisole improves immune response to HBV vaccine in dialysis population. However, consistent information on this issue does not exist. Aim, To evaluate efficacy and safety of levamisole as adjuvant to hepatitis B virus (HBV) vaccine in dialysis patients by performing a systematic review of the literature with a meta-analysis of clinical trials. Methods, We used the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. Only trials comparing the seroresponse rate in study subjects (levamisole plus HBV vaccine) vs. controls (HBV vaccine alone) were included. The end point of interest was the rate of patients showing seroprotective anti-hepatitis B titres at completion of HBV vaccine schedule in study vs. control groups. Results, We identified four studies involving 328 unique patients on regular dialysis. Only prospective, randomized clinical trials (RCTs) were included. Pooling of study results showed a significant increase in response rates among study (levamisole plus HBV vaccine) vs. control (HBV vaccine alone) patients; the pooled Odds Ratio was 2.432 (95% Confidence Intervals, 1.34; 4.403), P = 0.002. No study heterogeneity was found. These results did not change in various subgroups of interest. Conclusions, Our meta-analysis showed that levamisole significantly improves immune response to hepatitis B vaccine in dialysis population. The limited number of patients precluded more conclusions. [source]

    Consequences of childhood abuse among male psychiatric inpatients: Dual roles as victims and perpetrators

    Marylene Cloitre
    Abstract The relationship between retrospective self-reports of childhood abuse and subsequent interpersonal violence was assessed among 354 consecutive male inpatient admissions. Three logistic regressions revealed that, controlling for sociodemo-graphic and diagnostic variables, the association between childhood abuse and three mutually exclusive adult negative outcomes were as follows: (1) being a perpetrator of violence (Odds Ratio [OR] = ns), (2) being a victim of violence (OR = 2.5), and (3) being a perpetrator and victim (OR = 4.9). The results suggest that, among men with significant psychiatric impairments and childhood abuse, rates of adult victimization are high, and the most frequent negative outcome reflects involvement in dual roles of perpetrator and victim. The possible dynamics of this relationship are discussed. [source]

    Dyspeptic symptoms associated with Helicobacter pylori infection are influenced by strain and host specific factors

    G. Treiber
    Summary Background :,Dyspepsia can be associated with H. pylori infection. Aim :,To assess dyspeptic symptoms and potentially influencing factors before and up to 6 months following successful H. pylori eradication therapy. Methods :,Prospective cohort study involving H. pylori positive subjects from ambulatory or hospitalized care. Main outcome measures were symptoms during baseline and follow-up, the proportion of symptom-free patients, and symptom scores. Results :,After successful eradication, the summary score of all dyspeptic symptoms decreased and during follow-up, the proportion of symptom-free patients was higher in the group with peptic ulcers (69.4% vs. 40.9%, P < 0.0001) than with functional dyspepsia (FD). Regardless of diagnosis, virulent strains of H. pylori were associated with a higher prevalence of epigastric pain before treatment: absolute risk-difference (ARD) with Oip-A: 18.2%, Odds Ratio (OR) 2.35 [1.3,4.2, 95%-CI], P = 0.01; with Cag-A: 24.6%, OR 2.81 [1.6,5], P = 0.01. Low-dose aspirin in part was a major risk factor in FD for previous weight loss bdfore study entry. Post-treatment, non-ulcer patients were more likely to suffer from distention/bloating. Likewise, alcohol induced persistence of nausea and vomiting in this population. Conclusions :,Dyspeptic symptoms in H. pylori infected patients are more common with virulent strains. Symptoms are more likely to persist despite successful eradication if patients initially harboured virulent strains or concomitant aspirin or alcohol intake are present. In one-third of peptic ulcer patients, symptoms will not be cured 3 months after therapy. [source]

    Gender differences in the association of overweight and asthma morbidity among urban adolescents with asthma

    C. L. M. Joseph
    Asthma and obesity disproportionately affect US African-American youth. Among youth with asthma, obesity has been associated with poor control. The impact of gender on this association is unclear. We examined these relationships in a sample of urban, African-American adolescents with asthma. Questionnaires were used to identify high school students with asthma, and to examine the association of body mass index (BMI) to asthma morbidity, by gender. Of 5967 students completing questionnaires, 599 (10%) met criteria for asthma and 507 had data sufficient for inclusion in further analyses (46% male, mean age = 15.1 yr). Univariately, BMI > 85th percentile was significantly related only to reported emergency department visits (ED) and school days missed for any reason, Odds Ratio (95%Confidence Interval) = 1.7(1.1,2.7), p = 0.01 and 1.8(1.1,3.0), p = 0.01, respectively. A significant gender-BMI interaction (p < 0.05) was observed in multivariate models for ED visits, hospitalizations and school days missed for asthma. In gender-specific models, adjusted Risk Ratios for BMI > 85th and ED visits, hospitalizations, and school days missed because of asthma were 1.7(0.9,3.2), 6.6(3.1,14.6) and 3.6(1.8,7.2) in males. These associations were not observed in females. Gender modifies the association between BMI and asthma-related morbidity among adolescents with asthma. Results have implications for clinical management as well as future research. [source]

    The effect of parental mental health on proxy reports of health-related quality of life in children with sickle cell disease,

    PEDIATRIC BLOOD & CANCER, Issue 4 2010
    Julie A. Panepinto MD, MSPH
    Abstract Background The objectives of this study were to evaluate factors that influence agreement between parent-proxy and child self-report of health-related quality of life (HRQL) in sickle cell disease. We hypothesized that the mental health of the parent, parental HRQL and child characteristics would affect agreement. Procedure In a cross-sectional study of children with sickle cell disease, HRQL of the child and the parent's HRQL and mental health were assessed. The effect of parent and child characteristics on agreement between parent-proxy and child self-report of HRQL were determined. Results Rates of agreement between parent-proxy and child self-report of HRQL ranged between 42% and 49%. Parents with increased symptoms of distress had an increased odds of reporting a worse physical (Odds Ratio (OR) 1.12) and psychosocial HRQL (OR 1.10) compared to the child's self-report. Severe sickle cell disease was associated with an increased odds of the parent reporting the child's physical HRQL was worse, (OR 4.68) compared to the child's self-report. Conclusions Greater symptoms of distress in the parent are associated with worse parent-proxy report of the child's HRQL. Severe sickle cell disease is associated with greater disagreement between parent-proxy and child self-report of HRQL. These findings broaden our understanding of factors that influence proxy-reporting of a child's HRQL. Pediatr Blood Cancer. 2010;55:714,721. © 2010 Wiley-Liss, Inc. [source]

    Dupuytren's disease: Personal factors and occupational exposure

    Gérard Lucas
    Abstract Background The etiology of Dupuytren's disease is unknown, and the role of occupational exposure is still debated. Our objective was to study the association between occupational exposures, personal risk factors and Dupuytren's disease. Methods In this cross-sectional survey, nine occupational physicians performed clinical examinations, focused on Dupuytren's disease, of 2,406 French male civil servants employed at the Equipment Ministry in 1998 and interviewed them about medical history, leisure manual exposure and occupational biomechanical exposure to vibrations and manual work. A cumulative occupational exposure score was defined, with three levels of exposure. Results Dupuytren's disease was diagnosed in 212 men (8.8%). The occupational exposure score was significantly higher in this group of cases than in the rest of the sample (377 (SD280) vs. 223 (SD250), respectively; P,<,0.0001). Occupational exposure was associated with Dupuytren's disease (adjusted Odds Ratio,=,2.20 [1.39,3.45] for the intermediate and 3.10 [1.99,4.84] for the high exposure groups), with adjustment for age, leisure physical activities, alcohol consumption (,5 servings per day), history of diabetes, epilepsy, hand trauma, and familial history of Dupuytren's disease. Conclusion Manual work exposure was associated with Dupuytren's disease after adjustment for personal risk factors. Longitudinal studies are needed to confirm these results. Am. J. Ind. Med. 51:9,15, 2008. © 2007 Wiley-Liss, Inc. [source]

    Diet and prostate cancer risk with specific focus on dairy products and dietary calcium: A case,control study

    THE PROSTATE, Issue 10 2010
    Sara Raimondi
    Abstract BACKGROUND Despite the prevalence of prostate cancer worldwide, only a few risk factors have been well-established. The role of diet, especially of dairy products, in the etiology of prostate cancer is still controversial. METHODS This study assessed the association of dietary components, particularly dairy products and dietary calcium, on prostate cancer risk in a case,control study of 197 cases and an equal number of individually matched controls recruited in Montreal, Canada. A semi-quantitative food frequency questionnaire was administered in which the usual consumption frequency and amounts consumed of more than 200 food items were recorded. RESULTS We found a twofold increased risk of prostate cancer associated with an increased intake of dairy products {Odds Ratio (OR),=,2.19; 95% Confidence Intervals (CI) 1.22,3.94}. A significant trend of decreasing prostate cancer risk with higher intake was found for legumes, nuts, finfish/shellfish and for ,-tocopherol after adjustment for calcium intake. Milk was the only dairy product significantly associated with prostate cancer risk, with OR,=,2.27; 95% CI (1.25,4.09) for the highest versus lowest quartiles of consumption. Calcium, the main micronutrient contained in dairy products, showed only a borderline association with prostate cancer risk (P,=,0.09), with slightly higher risk for higher calcium intake. In conclusion, this study supports the hypothesis that dairy products, especially milk, are involved in the etiology of prostate cancer. However, the mechanisms by which the various nutrients in dairy products and total diet may interact to influence this risk remain unknown. Prostate 70: 1054,1065, 2010. © 2010 Wiley-Liss, Inc. [source]

    An ,Unconditional-like' Structure for the Conditional Estimator of Odds Ratio from 2 × 2 Tables

    James A. Hanley
    Abstract In the estimation of the odds ratio (OR ), the conditional maximum-likelihood estimate (cMLE ) is preferred to the more readily computed unconditional one (uMLE ). However, the exact cMLE does not have a closed form to help divine it from the uMLE or to understand in what circumstances the difference between the two is appreciable. Here, the cMLE is shown to have the same ,ratio of cross-products' structure as its unconditional counterpart, but with two of the cell frequencies augmented, so as to shrink the unconditional estimator towards unity. The augmentation involves a factor, similar to the finite population correction, derived from the minimum of the marginal totals. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    The influence of polymorphisms of VKORC1 and CYP2C9 on major gastrointestinal bleeding risk in anticoagulated patients

    Ramón Montes
    Summary The VKORC1 c.,1639G>A and CYP2C9 c.430C>T and c.1075A>C polymorphisms have been associated with increased sensitivity to oral anticoagulants. However, their role in gastrointestinal bleeding is unknown. We studied the risk of gastrointestinal bleeding associated with these polymorphisms, and how this risk was influenced by the anticoagulant dose and the use of common drugs. Eighty-nine patients with gastrointestinal bleeding during acenocoumarol therapy and 177 patients free of bleeding during acenocoumarol therapy were studied. None of the three polymorphisms constituted a serious gastrointestinal bleeding risk factor. However, patients bearing at least one of these polymorphisms were at high risk, when they simultaneously met one of the following conditions: a weekly dose of acenocoumarol higher than 15 mg [adjusted Odds Ratio (OR) (95% confidence interval (CI) = 4·19 (1·59,11·04)]; amiodarone use [adjusted OR (95% CI) = 9·97 (1·75,56·89)]; or aspirin use [adjusted OR (95% CI) = 8·97 (1·66,48·34)]. The consumption of statins was associated with a lower risk of gastrointestinal bleeding [adjusted OR = 0·50 (0·26,0·99)]. The risk of gastrointestinal bleeding during acenocoumarol therapy in carriers of any of the studied polymorphisms is severely increased with exposure to weekly doses of acenocoumarol higher than 15 mg or the use of amiodarone or aspirin. [source]

    Increased prevalence of iron-overload associated endocrinopathy in thalassaemia versus sickle-cell disease

    Ellen B. Fung
    Summary Iron-overload associated endocrinopathy is the most frequently reported complication of chronic transfusion therapy in patients with thalassaemia (Thal). This study compared iron-overloaded subjects with Thal (n = 142; 54%M; age 25·8 ± 8·1 years) and transfused sickle-cell disease (Tx-SCD; n = 199; 43%M, 24·9 ± 13·2 years) to non-transfused SCD subjects (non-Tx-SCD; n = 64, 50%M, 25·3 ± 11·3 years), to explore whether the underlying haemoglobinopathy influences the development of endocrinopathy. Subjects were recruited from 31 centres in the USA, Canada and the UK. Subjects with Thal had more evidence of diabetes (13% vs. 2%, P < 0·001), hypogonadism (40% vs. 4%, P < 0·001), hypothyroidism (10% vs. 2%, P = <0·001) and growth failure (33% vs. 7%, P < 0·001), versus Tx-SCD. Fifty-six per cent of Thal had more than one endocrinopathy compared with only 13% of Tx-SCD (P < 0·001). In contrast, Tx-SCD was not different from non-Tx-SCD. Multivariate analysis indicated that endocrinopathy was more likely in Thal than SCD [Odds Ratio (OR) = 9·4, P < 0·001], with duration of chronic transfusion a significant predictor (OR = 1·4 per 10 years of transfusion, P = 0·04). Despite iron overload, endocrinopathy was not increased in Tx-SCD versus non-Tx-SCD, suggesting that the underlying disease may modulate iron-related endocrine injury. However, because transfusion duration remained a significant predictor of endocrinopathy, these data should be confirmed in SCD subjects that have been chronically transfused for longer periods of time. [source]

    Non-therapeutic risk factors for onset of tardive dyskinesia in schizophrenia: A meta-analysis,,

    MOVEMENT DISORDERS, Issue 16 2009
    Diederik E. Tenback MD
    Abstract A meta-analysis of prospective studies with schizophrenia patients was conducted to examine whether the evidence exists for risk factors for the emergence of Tardive Dyskinesia (TD) in schizophrenia. A computer assisted Medline/PubMed and Embase search was conducted in January 2008 for the years 1985,2007. Selected were truly prospective studies of incident cases of TD in a population with at least 80% patients with schizophrenia. Measures of relative risk were collected from the individual studies, either directly or by calculating the relative risk from the cox- or logistic regression coefficient provided in the article. Hazard Ratio's and Odds Ratio's were pooled using fixed and random effect models in case of multiple studies using the same measure of risk and outcome. Only eight studies satisfied the inclusion criteria reporting on 25 different single estimate risk factors. Of 25 risk factors, six concerned replicated estimates suitable for meta-analysis. Of these, non-white ethnic group and early extrapyramidal symptoms qualified as risk factors for the emergence of TD in schizophrenia. The association with older age was suggestive but inconclusive. Despite many reported risk factors for TD in schizophrenia, little conclusive evidence exists to corroborate this. However, the fact that early EPS predicts onset of TD has important clinical and research implications. © 2009 Movement Disorder Society [source]

    Anxiety does not predict response to antidepressant treatment in late life depression: results of a meta-analysis

    J. Craig Nelson
    Abstract Objective Previous studies of mixed aged and older adult samples with major depressive disorder (MDD) reported reduced depression response in anxious patients, but a systematic review and analysis has not been performed. Our aim was to determine if anxiety predicts antidepressant response in previously identified placebo-controlled trials of second generation antidepressants for late-life depression. Method From a previous systematic review that identified ten randomized, placebo-controlled trials of community dwelling patients aged 60 or older with major depression, anxious patients were identified by a score ,7 on the anxiety/somatization factor of the Hamilton Depression Rating Scale (HDRS). Response was defined as 50% or greater improvement on the HDRS or the Montgomery Asberg Depression Rating Scale. A meta-analysis was performed using a random effects model to calculate Odds Ratios (OR). Results Data were available from eight trials having ten drug-placebo contrasts that included 2322 anxious and 1387 non-anxious patients. The odds ratio for response to drug compared to placebo in anxious patients was 1.57 (95% CI 1.15, 2.14; z,=,2.86, n,=,10, p,<,0.001), in non-anxious patients was 1.44 (95% CI 1.15, 1.80, z,=,3.21, n,=,10, p,<,0.001), and did not differ between groups. Pooled response rates to drug and placebo respectively were 49.4% vs 37.4% in anxious patients and 44.2 vs 35.5% in non-anxious patients. Conclusions In randomized, placebo-controlled trials, anxiety in late-life depression was not associated with decreased response to second generation antidepressants. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status

    Matthew Niti
    Abstract Objective Depression in elderly is reportedly associated with a number of specific chronic illnesses. Whether each of these co-morbid associations results uniquely from disease-specific psychobiological responses or is mediated by non-specific factors like subjective health and functional status is unclear. Method Analysis of data of 2,611 community-dwelling Chinese aged 55 and older, including depressive symptoms defined by Geriatric Depression Scale score,,,5 and self-reports of specific chronic illnesses. Results The prevalence of depressive symptoms was 13.3%, lower in those without chronic illness (7.5%), and higher in those with illnesses (13.2,24.2%). Crude Odds Ratios (OR) were significantly elevated for hypertension, eye disorders, diabetes, arthritis, ischemic heart disease, asthma/COPD, stroke, osteoporosis, heart failure, thyroid problem, and gastric problem. In multivariable analyses, only asthma/COPD [OR:2.85, 95% Confidence Intervals (CI): 1.36, 5.98], gastric problem (OR:2.64, 95% CI: 1.11, 6.29), arthritis (OR:1.87, 95% CI: 1.02, 3.42) and heart failure (OR:2.11, 95% CI: 0.98, 4.58) remained independently associated with depressive symptoms, after adjusting for comorbidities, subjective health and functional status, cognitive functioning, smoking, alcohol, psychosocial and demographic variables. Conclusion Most comorbid associations of depressive symptoms with specific chronic illnesses are explained by accompanying poor self-reported health and functional status, but some illnesses probably have a direct psychobiological basis. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Oral health and cardiovascular disease in Sweden

    Results of a national questionnaire survey
    Abstract Objective: The purpose of the present study was to assess the relation between dental health and cardiovascular disease in an adult Swedish population. Material and method: A questionnaire was sent to 4811 randomly selected Swedes. It contained 52 questions about dental care habits, oral health, cardiovascular disease and their socio-economic situation. Odd ratios for all cardiovascular diseases (CVD) and the subgroup myocardial infarction, stroke and high blood pressure were calculated with a logistic regression model adjusted for age, gender, smoking, income, civil status and education. These ratios were calculated for subjects 41 years since few people suffer from CVD before this. Results: The national questionnaire was answered by 2839 (59%) people between 20,84 years of age and, of them, 1577 were 41 years of age or more. We found a significant association between self-reported bleeding gums (odds ratio 1.60, p=0.0017), presence of dentures (odds ratio 1.57, p=0.0076) and known CVD, which has also been reported in international studies. However, no association between loose teeth, deep pockets and known CVD was detected. Conclusion: The results indicate that oral health and, especially gingival inflammation is associated with CVD. Zusammenfassung Zielsetzung: Untersuchung des Zusammenhanges von oraler Gesundheit und kardiovaskulären Erkrankungen in einer Population schwedischer Erwachsener. Material und Methoden: Ein Fragebogen wurden an 4811 zufällig ausgewählten Schweden verschickt. Er enthielt 52 Fragen zu Zahnhygienegewohnheiten, Mundhygiene, Herz-Kreislauf-Erkrankungen und sozioökonomischem Status. Odds Ratios (OR) für alle kardiovaskulären Erkrankungen (KVE) und für die Untergruppen Myocardinfarkt, Schlaganfall sowie Bluthochdruck wurden mit einem logistischen Regressionsmodell berechnet, das für Alter, Geschlecht, Rauchen, Einkommen, sozialen Status und Ausbildung korrigiert war. Dies erfolgte für Personen 41 Jahre, da jüngere Individuen selten an KVE leiden. Ergebnisse: Der Fragebogen wurde von 2839 Personen (59%) im Alter zwischen 20 und 84 Jahren beantwortet, von denen 1577,41 Jahre oder älter waren. Es ergab sich eine signifikante Assoziation zwischen von den Patienten berichtetem Zahnfleischbluten (OR 1.60, p=0.0017) sowie Vorhandensein von Prothesen (OR 1.57, p=0.0076) und bekannter KVE. Allerdings konnte keine Assoziation zwischen lockeren Zähnen bzw tiefen Taschen und bekannter KVE gefunden werden. Schlussfolgerungen: Diese Ergebnisse zeigen, dass ein Zusammenhang zwischen oraler Gesundheit, speziell gingivaler Entzündung, und KVE besteht. Résumé But: Le but de cette étude était de mettre en évidence la relation entre la santé dentaire et la maladie cardiovasculaire dans une population suédoise adulte. Matériaux et méthodes: Un questionnaire fut adresséà 4811 suédois sélectionnés au hasard. Il contenait 52 questions sur les habitudes de soins dentaires, la santé orale, la maladie cadiovasculaire et leur situation socio-économique. L'odds-ratio pour toutes les maladies cardiovasculaires (CVD) et le sous-groupe d'infarctus du myocarde, d'attaque et d'hypertension, fut calculé par un modèle de régression logistique ajusté pour l'âge, le sexe, le tabagisme, le revenu, l'état civil et le niveau d'éductation. Ces odds-ratio furent calculés pour les sujets de plus de 41 ans, puisque peu de gens souffrent de CVD avant cet âge. Resultats: 2839 (59%) personnes entre 20 et 84 ans, parmi lesquelles 1577 étaient âges d'au moins 41 ans répondirent à ce questionnaire national. Nous avons trouvé une association significative entre les saignement gingivaux (décrits par les sondés euxmêmes) (odds-ratio 1.60, p<0.0017), la présence de prothèse amovible (odds ratio 1.57, p=0.0076) et une CVD reconnu, ce qui a étéégalement rapporté dans les études internationales. Cependant, aucune association entre les dents perdues, la profondeur de poche et une CVD connue ne fut détectée. Conclusion: Les résultats indiquent que la santé orale et particulièrement l'inflammation gingivale est associée avec les CVD. [source]

    Alternaria sensitization and allergic rhinitis with or without asthma in the French Six Cities study

    ALLERGY, Issue 3 2010
    Z. A. Randriamanantany
    To cite this article: Randriamanantany ZA, Annesi-Maesano I, Moreau D, Raherison C, Charpin D, Kopferschmitt C, Lavaud F, Taytard A, De Blay F, Caillaud D. Alternaria sensitization and allergic rhinitis with or without asthma in the French Six Cities study. Allergy 2010; 65: 368,375. Abstract Background:, Allergic sensitization to Alternaria has been related to asthma in various studies, but its association with allergic rhinitis is still controversial. Objectives:, The aim of this study was to assess at the population level the relationships in childhood between Alternaria sensitization and ,past-year rhinoconjunctivitis' (PYRC), ,ever hay fever' (EHF) and ,ever allergic rhinitis caused by allergens other than pollens' (EAR) according to the presence or the absence of asthma. Methods:, This study is part of the Six Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II. Children underwent skin prick test (SPT) to Alternaria and parents filled a standardized medical questionnaire. Results:, Some 6726 children with a mean age of 10 years were examined. The overall prevalence of Alternaria sensitization was 2.8%, 0.8% for monosensitization. Prevalences of symptoms in sensitized children were 27.7% for PYRC, 27.0% for EHF and 30.4% for EAR. Adjusted Odds Ratios (OR) between Alternaria sensitization and allergic rhinitis phenotypes were 2.34 (95% confidence interval: 1.51,3.63) for PYRC, 2.40 (1.65,3.50) for EHF and 2.95 (2.05,4.23) for EAR. The relationship still remained in the case of monosensitization to Alternaria for both PYRC and EAR when excluding the asthmatic children [OR = 3.87 (1.54,9.78) and 2.88 (1.10,7.55) respectively]. Conclusion:, In our population-based sample of children, we found a link between Alternaria sensitization and allergic rhinitis, independently of asthma, which is compatible with the mechanisms of deposition of Alternaria in the upper airways. [source]

    Public perceptions of the threat of terrorist attack in Australia and anticipated compliance behaviours

    Garry Stevens
    Abstract Objective: To determine the perceived threat of terrorist attack in Australia and preparedness to comply with public safety directives. Methods: A representative sample of 2,081 adults completed terrorism perception questions as part of the New South Wales Population Health Survey. Results: Overall, 30.3% thought a terrorist attack in Australia was highly likely, 42.5% were concerned that self or family would be directly affected and 26.4% had changed the way they lived due to potential terrorist attacks. Respondents who spoke a language other than English at home were 2.47 times (Odds Ratios (OR=2.47, 95% CI:1.58-3.64, p<0.001) more likely to be concerned self or family would be affected and 2.88 times (OR=2.88, 95% CI:1.95-4.25, p<0.001) more likely to have changed the way they lived due to the possibility of terrorism. Those with high psychological distress perceived higher terrorism likelihood and greater concern that self or family would be directly affected (OR=1.84, 95% CI:1.05-3.22, p=0.034). Evacuation willingness was high overall but those with poor self-rated health were significantly less willing to leave their homes during a terrorism emergency. Conclusion: Despite not having experienced recent terrorism within Australia, perceived likelihood of an attack was higher than in comparable western countries. Marginalisation of migrant groups associated with perceived terrorism threat may be evident in the current findings. Implications: This baseline data will be useful to monitor changes in population perceptions over time and determine the impact of education and other preparedness initiatives. [source]

    A Note on Estimating Crude Odds Ratios in Case,Control Studies with Differentially Misclassified Exposure

    BIOMETRICS, Issue 4 2002
    Robert H. Lyles
    Summary. Morrissey and Spiegelman (1999, Biometrics55, 338,344) provided a comparative study of adjustment methods for exposure misclassification in case-control studies equipped with an internal validation sample. In addition to the maximum likelihood (ML) approach, they considered two intuitive procedures based on proposals in the literature. Despite appealing ease of computation associated with the latter two methods, efficiency calculations suggested that ML was often to be recommended for the analyst with access to a numerical routine to facilitate it. Here, a reparameterization of the likelihood reveals that one of the intuitive approaches, the inverse matrix method, is in fact ML under differential misclassification. This correction is intended to alert readers to the existence of a simple closed-form ML estimator for the odds ratio in this setting so that they may avoid assuming that a commercially inaccessible optimization routine must be sought to implement ML. [source]

    Risk Ratios and Odds Ratios for Common Events in Cross-sectional and Cohort Studies

    Scott T. Wilber MD
    No abstract is available for this article. [source]

    Psychotic and behavioural symptoms in a population-based sample of the very elderly subjects

    S. Östling
    Objective:, The aim was to elucidate the relationship between psychotic and behavioural symptoms in the elderly. Method:, A representative sample of 85 year old subjects living in Gothenburg, Sweden (n = 451) was assessed with neuropsychiatric examinations, key informant interviews and record reviews. Results:, Fourteen percent of these very elderly subjects had paranoid symptoms with concomitant anxious agitation and/or irritability/anger. Hallucinations and paranoid symptoms were both associated with a pattern of behavioural symptoms including both anxious agitation and irritability/anger simultaneously in both demented [hallucinations, Odds ratio (OR) 2.8, Confidence interval (CI) 1.2,6.7, paranoid symptoms OR 5.6 CI 2.2,14.2] and non-demented (hallucinations OR 3.2 CI 1.2,8.3, paranoid symptoms OR 4.8 CI 2.0,11.8). Conclusion:, Psychotic symptoms are associated with behavioural symptoms regardless of dementia status. Since these symptoms lead to decreased ability to function in daily life and increased caregiver burden, it is important for health professionals to identify and treat these symptoms also in non-demented. [source]

    The fine needle aspiration biopsy diagnostic criteria of proliferative breast lesions: A retrospective statistical analysis of criteria for papillomas and radial scar lesions

    Andrew Field F.R.C.P.A.
    Abstract This study aimed to analyze statistically the accuracy of fine needle aspiration biopsy cytological criteria in diagnosing epithelial hyperplasia with atypia (EHA), papillary lesions (PAP), and radial scar/complex sclerosing lesions (RS/CSL). The 42 criteria studied were extracted from a literature review and those developed and used in our department. Cytological cases with diagnoses of EHA, PAP, and RS/CSL for the period of 1997,2001 were correlated with relevant histological follow-up and the positive predictive power of these diagnoses have been presented in an earlier publication. Some 77 cases with definite, specific histological diagnoses of atypia or a more severe lesion, PAP and RS/CSL, were reviewed and scored using 55 cytological criteria. As the group of EHA and RS/CSL yielded a smaller number of cases, these were grouped together in the statistical analysis and compared to PAP. The cytological features, which were most diagnostic for PAP, were stellate (Odds ratio 1.75) and meshwork (Odds ratio 3.29) tissue fragments, while the presence of tubular structures was inversely proportional to the histological outcome of PAP. True papillary fragments were uncommon and not statistically significant in diagnosing PAP of the breast. Diagn. Cytopathol. 2007;35:386,397. © 2007 Wiley-Liss, Inc. [source]