scholarly journals Trimethoprim Use prior to Pregnancy and the Risk of Congenital Malformation: A Register-Based Nationwide Cohort Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Jon Trærup Andersen ◽  
Morten Petersen ◽  
Espen Jimenez-Solem ◽  
Jeppe Nørgaard Rasmussen ◽  
Nadia Lyhne Andersen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Congenital Malformation ◽  
Odds Ratio ◽  
Congenital Malformations ◽  
Adjusted Odds Ratio ◽  
Limb Defects ◽  
Major Congenital Malformation ◽  
Increased Risk

Objectives. The aim of the study was to investigate whether the use of the antifolate antibiotic trimethoprim during the 12 weeks before conception was associated with congenital malformations.Methods. We conducted a nationwide register-based cohort study including all Danish women giving birth from 1997 to 2004. All women with at least one prescription of trimethoprim dispensed during the 12 weeks before conception were identified.Results. There was a doubling of congenital malformations in offspring to women exposed to trimethoprim in the 12 weeks before conception. The adjusted odds ratio (OR) of major congenital malformation was 1.87, 95% confidence interval (CI) 1.25–2.81. There was a significant increase in major malformations of the heart (OR=2.49; 1.18–5.26) and limbs (OR=2.18; 1.13–4.23).Conclusions. In this study, we found an association between exposure to trimethoprim during the 12 weeks before conception and an increased risk of heart and limb defects.

scholarly journals The association of gout with an increased risk of hypertension and diabetes mellitus among stroke survivors in New Zealand: A cross-sectional study using routinely collected electronic health data

2019 ◽  
Vol 8 ◽  
pp. 204800401986323 ◽  
Author(s):  
Dina Eufemia D San Gabriel ◽  
Julia Slark
Keyword(s):  
Diabetes Mellitus ◽  
New Zealand ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Cross Sectional Study ◽  
Stroke Survivors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk

Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.

scholarly journals Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
François Dépret ◽  
Clément Hoffmann ◽  
Laura Daoud ◽  
Camille Thieffry ◽  
Laure Monplaisir ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Kidney Injury ◽  
Smoke Inhalation ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
The Impact

Abstract Background The use of hydroxocobalamin has long been advocated for treating suspected cyanide poisoning after smoke inhalation. Intravenous hydroxocobalamin has however been shown to cause oxalate nephropathy in a single-center study. The impact of hydroxocobalamin on the risk of acute kidney injury (AKI) and survival after smoke inhalation in a multicenter setting remains unexplored. Methods We conducted a multicenter retrospective study in 21 intensive care units (ICUs) in France. We included patients admitted to an ICU for smoke inhalation between January 2011 and December 2017. We excluded patients discharged at home alive within 24 h of admission. We assessed the risk of AKI (primary endpoint), severe AKI, major adverse kidney (MAKE) events, and survival (secondary endpoints) after administration of hydroxocobalamin using logistic regression models. Results Among 854 patients screened, 739 patients were included. Three hundred six and 386 (55.2%) patients received hydroxocobalamin. Mortality in ICU was 32.9% (n = 243). Two hundred eighty-eight (39%) patients developed AKI, including 186 (25.2%) who developed severe AKI during the first week. Patients who received hydroxocobalamin were more severe and had higher mortality (38.1% vs 27.2%, p = 0.0022). The adjusted odds ratio (95% confidence interval) of AKI after intravenous hydroxocobalamin was 1.597 (1.055, 2.419) and 1.772 (1.137, 2.762) for severe AKI; intravenous hydroxocobalamin was not associated with survival or MAKE with an adjusted odds ratio (95% confidence interval) of 1.114 (0.691, 1.797) and 0.784 (0.456, 1.349) respectively. Conclusion Hydroxocobalamin was associated with an increased risk of AKI and severe AKI but was not associated with survival after smoke inhalation. Trial registration ClinicalTrials.gov, NCT03558646

scholarly journals P07 Roxithromycin in early pregnancy and the risk of major congenital malformation: a register based nationwide cohort study

2019 ◽  
Vol 104 (6) ◽  
pp. e20.1-e20
Author(s):  
RH Olsen ◽  
HE Poulsen ◽  
JT Andersen
Keyword(s):  
Cohort Study ◽  
Congenital Malformation ◽  
Congenital Malformations ◽  
Safety Data ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Sensitivity Analyses ◽  
Multiple Birth ◽  
Major Congenital Malformation ◽  
Major Congenital Malformations

BackgroundMedicine use during pregnancy often causes concern for fetal harm. Roxithromycin, a macrolide antibiotic, is regarded as inadvisable to use during pregnancy due to lack of safety data. However, alternative macrolides have been associated with adverse outcomes in pregnancy. We conducted a register-based nationwide cohort study testing the hypothesis that use of roxithromycin in the first trimester is associated with major congenital malformations.MethodsWe included all Danish women giving live birth from 1997 to 2012. Women with at least one redeemed receipt of roxithromycin during first trimester were regarded as exposed. Multivariable logistic regression adjusting for maternal age, multiple birth, parity, year of conception, smoking, educational length, and household income was performed, supplemented by sensitivity analyses comparing unexposed with exposure to increasing accumulated doses of roxithromycin.ResultsThe study included 966,372 pregnancies of which 2,430 children were born to an exposed mother, 78 (3.34%) of the exposed children were diagnosed with a major congenital malformation compared with 33,609 (3.49%) among children born to unexposed mothers. The odds ratio for the occurrence of a major congenital malformation after exposure to roxithromycin was 0.96 (95% CI 0.76–1.20) and multifactorially adjusted 0.94 (0.74–1.18). Sensitivity analyses comparing unexposed with exposure to increasing accumulated doses of roxithromycin showed no dose response relationship. Further, no differences in the type of major malformation according to the EUROCAT subgrouping system were seen.ConclusionsWe found no association between exposure to roxithromycin in the first trimester of pregnancy and major congenital malformations.Disclosure(s)Nothing to disclose

scholarly journals Association of dietary patterns and endoscopic gastric mucosal atrophy in an adult Chinese population

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Song Lin ◽  
Tao Gao ◽  
Chongxiu Sun ◽  
Mengru Jia ◽  
Chengxia Liu ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Dietary Patterns ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Dietary Intakes ◽  
Mucosal Atrophy ◽  
Gastric Mucosal Atrophy ◽  
Increased Risk ◽  
Group Frequency ◽  
H Pylori

Abstract Atrophy gastritis harbor a high risk for the development of dysplasia and gastric cancer. The study investigated the relationships of specific dietary patterns and endoscopic gastric mucosal atrophy. In this cross-sectional study, we enrolled 574 consecutive outpatients who were diagnosed as chronic gastritis according to endoscopic examination. Dietary intakes of study individuals was assessed using the semi-quantitative food group frequency questionnaire. Logistic regression analyses were used to evaluate the relationship between dietary patterns and endoscopic gastric mucosal atrophy adjusted for potential confounders. A total of 574 participants were included, 286 with endoscopic gastric mucosal atrophy. Three dietary patterns were identified by factor analysis. “Alcohol and fish” (tertile 1 vs. tertile 3: adjusted odds ratio = 1.85, 95% confidence interval: 1.06–3.22) and “coarse cereals” (tertile 1 vs. tertile 3: adjusted odds ratio = 2.05, 95% confidence interval: 1.24–3.39) were associated with an increased risk for endoscopic gastric mucosal atrophy but a “traditional” pattern was not. Dietary pattern was not associated with gastric mucosal atrophy in women or in participants with H. pylori infection. A high adherence to both “Alcohol and Fish” and “Coarse cereals” dietary patterns seem to be associated with higher odds of endoscopic gastric mucosal atrophy in men and in patients without H. pylori infection. Further prospective cohort studies needed to confirm these findings.

scholarly journals Thyroid Function Within the Normal Range and the Risk of Depression: A Population-Based Cohort Study

2014 ◽  
Vol 99 (4) ◽  
pp. 1213-1219 ◽  
Author(s):  
Marco Medici ◽  
Nese Direk ◽  
W. Edward Visser ◽  
Tim I. M. Korevaar ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Depressive Symptoms ◽  
Confidence Interval ◽  
Thyroid Function ◽  
Odds Ratio ◽  
Elderly Persons ◽  
Normal Range ◽  
Baseline Serum ◽  
Increased Risk ◽  
Depressive Syndromes

Context: Overt hypo- and hyperthyroidism are associated with an increased risk of depression. Little is known about the effects of variation in thyroid function within the normal range on the risk of depression. Objective: The objective of the study was to examine the association between normal-range thyroid function and the risk of depression. Design, Setting, and Participants: This was a cohort study in 1503 Dutch men and women, aged 70.6 (7.3) (mean [SD]) years. At baseline, serum TSH, thyroperoxidase antibody levels, and depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D)] were assessed. A CES-D of 16 or greater is indicative of a depressive disorder. During follow-up (mean 8.0 y), participants were continuously monitored for the occurrence of incident depressive syndromes (n = 156). Results: Cross-sectionally, persons in the lowest TSH tertile (0.3–1.0 mU/L) had more depressive symptoms [CES-D score (mean): 7.95 vs 6.63, P = .014] as well as an increased risk of a CES-D of 16 or greater [10.7% vs 5.0%, odds ratio (95% confidence interval) 2.22 (1.18–4.17)], compared with persons in the highest normal range TSH tertile (1.6–4.0 mU/L). In the prospective analyses, persons in the lowest TSH tertile who were depression free at baseline had a higher risk of incident depressive syndromes [12.3% vs 7.6%, odds ratio (95% confidence interval) 1.85 (1.10–3.11)]. Thyroid autoimmunity (thyroperoxidase antibody positivity) was not associated with CES-D scores or incident depressive syndromes. Conclusions: Elderly persons with low-normal TSH levels have more concurrent depressive symptoms as well as a substantially increased risk of developing a depressive syndrome in the subsequent years. This study identifies low-normal TSH as an important risk factor for depression in the elderly.

scholarly journals HHV-6 reactivation and its effect on delirium and cognitive functioning in hematopoietic cell transplantation recipients

Blood ◽  
2011 ◽  
Vol 117 (19) ◽  
pp. 5243-5249 ◽  
Author(s):  
Danielle M. Zerr ◽  
Jesse R. Fann ◽  
David Breiger ◽  
Michael Boeckh ◽  
Amanda L. Adler ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Confidence Interval ◽  
Cell Transplantation ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Central Nervous System Dysfunction ◽  
Increased Risk

AbstractHuman herpesvirus 6 (HHV-6) is detected in the plasma of approximately 40% of patients undergoing hematopoietic cell transplantation (HCT) and sporadically causes encephalitis in this population. The effect of HHV-6 reactivation on central nervous system function has not been fully characterized. This prospective study aimed to evaluate associations between HHV-6 reactivation and central nervous system dysfunction after allogeneic HCT. Patients were enrolled before HCT. Plasma samples were tested for HHV-6 at baseline and twice weekly after transplantation until day 84. Delirium was assessed at baseline, 3 times weekly until day 56, and weekly on days 56 to 84 using a validated instrument. Neurocognitive testing was performed at baseline and at approximately day 84. HHV-6 was detected in 111 (35%) of the 315 included patients. Patients with HHV-6 were more likely to develop delirium (adjusted odds ratio = 2.5; 95% confidence interval, 1.2-5.3) and demonstrate neurocognitive decline (adjusted odds ratio = 2.6; 95% confidence interval, 1.1-6.2) in the first 84 days after HCT. Cord blood and unrelated transplantation increased risk of HHV-6 reactivation. These data provide the basis to conduct a randomized clinical trial to determine whether prevention of HHV-6 reactivation will reduce neurocognitive morbidity in HCT recipients.

scholarly journals Seven-day services in surgery and weekend effect at a Japanese teaching hospital: a retrospective cohort study

2019 ◽  
Author(s):  
Masaaki Matoba ◽  
Takashi Suzuki ◽  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Weekend Effect ◽  
Emergency Setting ◽  
Academic Medical Centre ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background Hospitals deliver 24-hour, 7-day care on a 5-day workweek model, as fewer resources are available on weekends. In prior studies, poorer outcome with weekend admission or surgery was observed. The purpose of this study was to investigate if 7-day service at a hospital affects the likelihood of the “weekend effect” in surgery. The 7-day service included outpatient consultations, diagnostic examinations, and elective surgeries. Methods This was a retrospective cohort study of patients who underwent surgery between April 2014 and October 2016 at an academic medical centre in Tokyo, Japan. The main outcome measure was thirty-day in-hospital mortality from the index surgery. The characteristics of the participants were compared using the Mann–Whitney U test or the chi-squared test as appropriate. Logistic regression was used to test for differences in the mortality rate between the two groups, and propensity score adjustments were made. Results A total of 7442 surgeries were identified, of which, 1386 (19%) took place on the weekend. Of the 947 emergency surgeries, 25% (235) were performed on the weekend. The mortality following emergency weekday surgery was 21‰ (15/712), compared with 55‰ (13/235) following weekend surgery. Of the 6495 elective surgeries, 18% (1151) were performed on the weekend. The mortality following elective weekday surgery was 2.3‰ (12/5344), compared with 0.87‰ (1/1151) following weekend surgery. After adjustment, weekend surgeries were associated with an increased risk of death, especially in the emergency setting (emergency odds ratio: 2.7, 95% confidence interval: 1.2–6.5 vs. elective odds ratio: 0.4, 95% confidence interval: 0.05–3.2). Conclusions Patients undergoing surgery on weekends had higher 30-day mortality than did those undergoing surgery on weekdays, especially in the emergency setting. These findings have potential implications for health administrators and policy makers who may try to restructure the hospital workweek or consider weekend elective surgery.

scholarly journals The association between migraine and hospital readmission due to pain after surgery: A hospital registry study

Cephalalgia ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 286-295 ◽  
Author(s):  
Katharina Platzbecker ◽  
Megan Behua Zhang ◽  
Tobias Kurth ◽  
Maira Isabella Rudolph ◽  
Katharina Eikermann-Haerter ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hospital Readmission ◽  
Odds Ratio ◽  
Migraine Without Aura ◽  
Adjusted Odds Ratio ◽  
Surgical Patients ◽  
Day Hospital ◽  
Registry Study ◽  
Increased Risk ◽  
Hospital Registry

Background Migraine has been identified as a risk factor of 30-day hospital readmission after surgery. We aimed to further characterize this association examining pain as a potentially migraine-associated, preventable reason for readmission. Hypothesis Compared to patients with no migraine, surgical patients with migraine are at increased risk of 30-day hospital readmission with an admitting diagnosis specifying pain. Methods This hospital registry study examined 150,710 patients aged 18 years and above, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and two affiliated community hospitals in Massachusetts, USA. Results Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio 1.42 [95% confidence interval 1.15–1.75]). The association was stronger for migraine with aura (compared to migraine without aura: Adjusted odds ratio 1.69 [95% confidence interval 1.06–2.70]; compared to no migraine: Adjusted odds ratio 2.20 [95% confidence interval 1.44–3.37]). The predicted adjusted risk of pain-related 30-day readmissions was 9.1 [95% confidence interval 5.3–13.0] in 1000 surgical patients with migraine with aura and 5.4 [95% confidence interval 4.2–6.6] in 1000 patients with migraine without aura, compared to 4.2 [95% confidence interval 3.8–4.5] in 1000 patients with no migraine. Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted odds ratio 1.55 [95% confidence interval 1.20–2.00]). Conclusion Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain.

scholarly journals Genetic variants of SULT1A1 and XRCC1 genes and risk of lung cancer in Bangladeshi population

Tumor Biology ◽  
2017 ◽  
Vol 39 (11) ◽  
pp. 101042831772927 ◽  
Author(s):  
Tasnova Tasnim ◽  
Mir Md Abdullah Al-Mamun ◽  
Noor Ahmed Nahid ◽  
Md Reazul Islam ◽  
Mohd Nazmul Hasan Apu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Lung Cancer Risk ◽  
Smoking Status ◽  
Functional Polymorphisms ◽  
Increased Risk ◽  
Bangladeshi Population

Lung cancer is one of the most frequently occurring cancers throughout the world as well as in Bangladesh. This study aimed to correlate the prognostic and/or predictive value of functional polymorphisms in SULT1A1 (rs9282861) and XRCC1 (rs25487) genes and lung cancer risk in Bangladeshi population. A case-control study was conducted which comprises 202 lung cancer patients and 242 healthy volunteers taking into account the age, sex, and smoking status. After isolation of genomic DNA, genotyping was done by polymerase chain reaction–restriction fragment length polymorphism method and the lung cancer risk was evaluated as odds ratio that was adjusted for age, sex, and smoking status. A significant association was found between SULT1A1 rs9282861 and XRCC1 rs25487 polymorphisms and lung cancer risk. In case of rs9282861 polymorphism, Arg/His (adjusted odds ratio = 5.06, 95% confidence interval = 3.05–8.41, p < 0.05) and His/His (adjusted odds ratio = 3.88, 95% confidence interval = 2.20–6.82, p < 0.05) genotypes were strongly associated with increased risk of lung cancer in comparison to the Arg/Arg genotype. In case of rs25487 polymorphism, Arg/Gln heterozygote (adjusted odds ratio = 4.57, 95% confidence interval = 2.79–7.46, p < 0.05) and Gln/Gln mutant homozygote (adjusted odds ratio = 4.99, 95% confidence interval = 2.66–9.36, p < 0.05) were also found to be significantly associated with increased risk of lung cancer. This study demonstrates that the presence of His allele and Gln allele in case of SULT1A1 rs9282861 and XRCC1 rs25487, respectively, involve in lung cancer prognosis in Bangladeshi population.

scholarly journals Association of abnormal placental perfusion with the risk of male hypospadias: a hospital-based retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chen Zhu ◽  
Bin Zhang ◽  
Ting Peng ◽  
Ming-Qing Li ◽  
Yun-Yun Ren ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cohort Study ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Cumulative Risk ◽  
Second Trimester ◽  
Singleton Pregnancy ◽  
Placental Perfusion ◽  
Increased Risk

Abstract Background The effect and extent of abnormal placental perfusion (APP) on the risk of male hypospadias are poorly understood. We compared the prevalence of male hypospadias in the offspring of women with APP and quantify the extent of the APP effect on the anomaly. Methods A hospital-based retrospective analysis of births from 2012 to 2016 was conducted in 2018. Women of singleton pregnancy and male infants born to them were included (N = 21,447). A multivariate analysis was performed to compare the prevalence of male hypospadias in infants exposed to APP with those that were not exposed to APP. Results Compared with the infants of women without APP, infants of women with APP showed an increased risk of male hypospadias (odds ratio, 2.40; 95% confidence interval, 1.09–5.29). The male hypospadias cumulative risk increased with the severity of APP. Infants exposed to severe APP had a significantly higher risk of male hypospadias than those without APP exposure (9.2 versus 1.7 per 1000 infants, P < 0.001). A path analysis indicated that 28.18–46.61% of the risk of hypospadias may be attributed to the effect of APP. Conclusions Male hypospadias risk was associated with APP and increased with APP severity, as measured in the second trimester. APP had an important role in the development of the anomaly.

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