Skip header and navigation

Refine By

449 records – page 1 of 45.

Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors-data from a large national quality register.

https://arctichealth.org/en/permalink/ahliterature307208
Source
Arthritis Res Ther. 2020 01 22; 22(1):15
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
01-22-2020
Author
Giovanni Cagnotto
Minna Willim
Jan-Åke Nilsson
Michele Compagno
Lennart T H Jacobsson
Saedis Saevarsdottir
Carl Turesson
Author Affiliation
Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden. giovanni.cagnotto@med.lu.se.
Source
Arthritis Res Ther. 2020 01 22; 22(1):15
Date
01-22-2020
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Abatacept - therapeutic use
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Female
Humans
Male
Middle Aged
Registries
Sweden
Treatment Outcome
Abstract
There are limited data regarding efficacy of abatacept treatment for rheumatoid arthritis (RA) outside clinical trials. Quality registers have been useful for observational studies on tumor necrosis factor inhibition in clinical practice. The aim of this study was to investigate clinical efficacy and tolerability of abatacept in RA, using a national register.
RA patients that started abatacept between 2006 and 2017 and were included in the Swedish Rheumatology Quality register (N?=?2716) were investigated. Survival on drug was estimated using Kaplan-Meier analysis. The European League Against Rheumatism (EULAR) good response and Health Assessment Questionnaire (HAQ) response (improvement of =?0.3) rates (LUNDEX corrected for drug survival) at 6 and at 12?months were assessed. Predictors of discontinuation were investigated by Cox regression analyses, and predictors of clinical response by logistic regression. Significance-based backward stepwise selection of variables was used for the final multivariate models.
There was a significant difference in drug survival by previous biologic disease-modifying antirheumatic drug (bDMARD) exposure (p?
PubMed ID
31969172 View in PubMed
Less detail

Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

https://arctichealth.org/en/permalink/ahliterature298110
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Author
Satu Mäkelä
Markku Asola
Henrik Hadimeri
James Heaf
Maija Heiro
Leena Kauppila
Susanne Ljungman
Mai Ots-Rosenberg
Johan V Povlsen
Björn Rogland
Petra Roessel
Jana Uhlinova
Maarit Vainiotalo
Maria K Svensson
Heini Huhtala
Heikki Saha
Author Affiliation
Tampere University Hospital, Tampere, Finland satu.m.makela@pshp.fi.
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Ankle Brachial Index
Aorta, Abdominal - diagnostic imaging
Aortic Diseases - diagnosis - epidemiology - etiology
Cause of Death - trends
Critical Illness - mortality - therapy
Denmark - epidemiology
Estonia - epidemiology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Peritoneal Dialysis - adverse effects - mortality
Prognosis
Prospective Studies
Renal Dialysis
Risk factors
Survival Rate - trends
Sweden - epidemiology
Ultrasonography, Doppler
Vascular Calcification - diagnosis - epidemiology - etiology
Abstract
Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.
We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.
The median AACS was 11 (range 0 - 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low ( 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS = 7 (p
PubMed ID
29386304 View in PubMed
Less detail

Accuracy of surgical complication rate estimation using ICD-10 codes.

https://arctichealth.org/en/permalink/ahliterature302167
Source
Br J Surg. 2019 02; 106(3):236-244
Publication Type
Journal Article
Multicenter Study
Observational Study
Date
02-2019
Author
A Storesund
A S Haugen
M Hjortås
M W Nortvedt
H Flaatten
G E Eide
M A Boermeester
N Sevdalis
E Søfteland
Author Affiliation
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Source
Br J Surg. 2019 02; 106(3):236-244
Date
02-2019
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Clinical Coding
Female
Humans
International Classification of Diseases
Length of Stay - statistics & numerical data
Male
Middle Aged
Norway - epidemiology
Operative Time
Postoperative Complications - epidemiology
Prospective Studies
Sensitivity and specificity
Young Adult
Abstract
The ICD-10 codes are used globally for comparison of diagnoses and complications, and are an important tool for the development of patient safety, healthcare policies and the health economy. The aim of this study was to investigate the accuracy of verified complication rates in surgical admissions identified by ICD-10 codes and to validate these estimates against complications identified using the established Global Trigger Tool (GTT) methodology.
This was a prospective observational study of a sample of surgical admissions in two Norwegian hospitals. Complications were identified and classified by two expert GTT teams who reviewed patients' medical records. Three trained reviewers verified ICD-10 codes indicating a complication present on admission or emerging in hospital.
A total of 700 admissions were drawn randomly from 12 966 procedures. Some 519 possible complications were identified in 332 of 700 admissions (47·4 per cent) from ICD-10 codes. Verification of the ICD-10 codes against information from patients' medical records confirmed 298 as in-hospital complications in 141 of 700 admissions (20·1 per cent). Using GTT methodology, 331 complications were found in 212 of 700 admissions (30·3 per cent). Agreement between the two methods reached 83·3 per cent after verification of ICD-10 codes. The odds ratio for identifying complications using the GTT increased from 5·85 (95 per cent c.i. 4·06 to 8·44) to 25·38 (15·41 to 41·79) when ICD-10 complication codes were verified against patients' medical records.
Verified ICD-10 codes strengthen the accuracy of complication rates. Use of non-verified complication codes from administrative systems significantly overestimates in-hospital surgical complication rates.
PubMed ID
30229870 View in PubMed
Less detail

Acute versus chronic myocardial injury and long-term outcomes.

https://arctichealth.org/en/permalink/ahliterature309340
Source
Heart. 2019 12; 105(24):1905-1912
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
12-2019
Author
Erik Kadesjö
Andreas Roos
Anwar Siddiqui
Liyew Desta
Magnus Lundbäck
Martin J Holzmann
Author Affiliation
Functional Area of Emergency Medicine, Karolinska University Hospital, 14184, Stockholm.
Source
Heart. 2019 12; 105(24):1905-1912
Date
12-2019
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Acute Disease
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Chronic Disease
Female
Follow-Up Studies
Heart Failure - etiology - mortality
Humans
Male
Middle Aged
Myocardial Infarction - complications - diagnosis - mortality - therapy
Myocardial Revascularization - methods
Prognosis
Sweden - epidemiology
Troponin T - blood
Abstract
There is a paucity of data regarding prognosis in patients with acute versus chronic myocardial injury for long-term outcomes. We hypothesised that patients with chronic myocardial injury have a similar long-term prognosis as patients with acute myocardial injury.
In an observational cohort study of 22?589 patients who had high-sensitivity cardiac troponin T (hs-cTnT) measured in the emergency department during 2011-2014, we identified all patients with level >14?ng/L and categorised them as acute myocardial injury, type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI) or chronic myocardial injury through adjudication. We estimated adjusted HRs with 95% CIs for the primary outcome all-cause mortality and secondary outcomes MI, and heart failure in patients with acute myocardial injury, T1MI and T2MI compared with chronic myocardial injury.
In total, 3853 patients were included. During 3.9 (±2) years of follow-up, 48%, 24%, 44% and 49% of patients with acute myocardial injury, T1MI, T2MI and chronic myocardial injury died, respectively. Patients with acute myocardial injury had higher adjusted risks of death (1.21, 95% CI 1.08 to 1.36) and heart failure (1.24, 95% CI 1.07 to 1.43), but a similar risk for myocardial infarction (MI) compared with the reference group. Patients with T1MI had a lower adjusted risk of death (0.86, 95% CI 0.74 to 1.00) and higher risk of MI (2.09, 95% CI 1.62 to 2.68), but a similar risk of heart failure. Patients with T2MI had a higher adjusted risk of death (1.46, 95% CI 1.18 to 1.80) and heart failure (1.30, 95% CI 1.00 to 1.69) compared with patients with chronic myocardial injury.
Absolute long-term risks for death are similar, and adjusted risks are slightly higher, among patients with acute myocardial injury and T2MI, respectively, compared with chronic myocardial injury. The lowest risk of long-term mortality was found in patients with T1MI. Both acute and chronic myocardial injury are associated with very high risks of adverse outcomes.
PubMed ID
31337668 View in PubMed
Less detail

Adherence to guidelines for androgen deprivation therapy after radical prostatectomy: Swedish population-based study.

https://arctichealth.org/en/permalink/ahliterature311023
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Publication Type
Journal Article
Observational Study
Date
Jun-2020
Author
Magdalena Lycken
Linda Drevin
Hans Garmo
Anders Larsson
Ove Andrén
Lars Holmberg
Anna Bill-Axelson
Author Affiliation
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Date
Jun-2020
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Aged, 80 and over
Androgen Antagonists - therapeutic use
Combined Modality Therapy
Guideline Adherence - statistics & numerical data
Humans
Male
Middle Aged
Orchiectomy
Postoperative Period
Prostatectomy
Prostatic Neoplasms - drug therapy - surgery
Sweden
Abstract
Background: Androgen deprivation therapy (ADT) is a non-curative but essential treatment of prostate cancer with severe side effects. Therefore, both over- and underuse should be avoided. We investigated adherence to guidelines for ADT following radical prostatectomy through Swedish population-based data.Material and methods: We used the database Uppsala/Örebro PSA cohort (UPSAC) to study men with localised or locally advanced prostate cancer at diagnosis (clinical stage T1-T3, N0-NX, M0-MX, and prostate-specific antigen (PSA)
PubMed ID
32338176 View in PubMed
Less detail

Age-related change in peak oxygen uptake and change of cardiovascular risk factors. The HUNT Study.

https://arctichealth.org/en/permalink/ahliterature304656
Source
Prog Cardiovasc Dis. 2020 Nov - Dec; 63(6):730-737
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Author
Jon Magne Letnes
Håvard Dalen
Stian Thoresen Aspenes
Øyvind Salvesen
Ulrik Wisløff
Bjarne Martens Nes
Author Affiliation
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.
Source
Prog Cardiovasc Dis. 2020 Nov - Dec; 63(6):730-737
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Aged
Aging
Cardiovascular Diseases - diagnosis - epidemiology - prevention & control
Exercise
Female
Health status
Healthy Lifestyle
Heart Disease Risk Factors
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Oxygen consumption
Physical Fitness
Primary Prevention
Prognosis
Risk assessment
Risk Reduction Behavior
Time Factors
Young Adult
Abstract
Large longitudinal studies on change in directly measured peak oxygen uptake (VO2peak) is lacking, and its significance for change of cardiovascular risk factors is uncertain. We aimed to assess ten-year change in VO2peak and the influence of leisure-time physical activity (LTPA), and the association between change in VO2peak and change in cardiovascular risk factors.
A healthy general population sample had their VO2peak directly measured in two (n = 1431) surveys of the Nord-Trøndelag Health Study (HUNT3; 2006-2008 and HUNT4; 2017-19). Average ten-year decline in VO2peak was non-linear and progressed from 3% in the third to about 20% in the eight decade in life and was more pronounced in men. The fit linear mixed models including an additional 2,933 observations from subjects participating only in HUNT3 showed similar age-related decline. Self-reported adherence to LTPA recommendations was associated with better maintenance of VO2peak, with intensity seemingly more important than minutes of LTPA with higher age. Adjusted linear regression analyses showed that one mL/kg/min better maintenance of VO2peak was associated with favorable changes of individual cardiovascular risk factors (all p = 0.002). Using logistic regression one mL/kg/min better maintenance of VO2peak was associated with lower adjusted odds ratio of hypertension (0.95 95% CI 0.92 to 0.98), dyslipidemia (0.92 95% CI 0.89 to 0.94), and metabolic syndrome (0.86 95% CI 0.83 to 0.90) at follow-up.
Although VO2peak declines progressively with age, performing LTPA and especially high-intensity LTPA is associated with less decline. Maintaining VO2peak is associated with an improved cardiovascular risk profile.
PubMed ID
32971113 View in PubMed
Less detail

Age-related incidence of cervical cancer supports two aetiological components: a population-based register study.

https://arctichealth.org/en/permalink/ahliterature293540
Source
BJOG. 2016 Apr; 123(5):772-8
Publication Type
Journal Article
Observational Study
Date
Apr-2016
Author
K Seppä
J Pitkäniemi
N Malila
M Hakama
Author Affiliation
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
Source
BJOG. 2016 Apr; 123(5):772-8
Date
Apr-2016
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Early Detection of Cancer
Female
Finland - epidemiology
Humans
Incidence
Middle Aged
Models, Statistical
Poisson Distribution
Registries
Risk factors
Uterine Cervical Neoplasms - diagnosis - epidemiology - etiology
Abstract
To assess whether age-related incidence of cervical cancer supports two aetiological components and to assess trends in these components due to risk factors and to organised screening in Finland.
Population-based register study.
Finnish Cancer Registry.
Cervical cancer cases and female population in Finland in 1953-2012.
Cervical cancer incidence was estimated using Poisson regression where age-specific incidence consists of two (early-age and late-age) normally distributed components.
Accumulated net risks (incidences) and numbers of cancer cases attributed to each age-related component by calendar time.
The accumulated cervical cancer incidence in 2008-2012 was only 30% of that in 1953-1962, before the screening started. The fit of the observed age-specific rates and the rates based on the two-component model was good. In 1953-62, the accumulated net risk ratio (RR; early-age versus late-age) was 0.42 (95% CI 0.29-0.61). The early-age component disappeared in 1973-77 (RR 0.00; 95% CI 0.00-0.08). Thereafter, the risk for the early-age component increased, whereas the risk for the late-age component decreased, and in 2008-2012 the RR was 0.55 (95% CI 0.24-0.89).
In Finland, cervical cancer incidence has two age-related components which are likely to indicate differences in risk factors of each component. The trend in risk of both components followed the effects of organised screening. Furthermore, the risk related to the early-age component followed changes in risk factors, such as oncogenic HPV infections and other sexually transmitted diseases and smoking habits.
Cervical cancer incidence has two age-related components which are likely to have differencies in their aetiology.
PubMed ID
26599730 View in PubMed
Less detail

Age-related variation in volume and content of restorative private dental care for adults in Finland in 2012-2017: A nationwide register-based observation.

https://arctichealth.org/en/permalink/ahliterature311762
Source
J Dent. 2021 01; 104:103537
Publication Type
Journal Article
Observational Study
Date
01-2021
Author
Miira M Vehkalahti
Ulla Palotie
Maria Valaste
Author Affiliation
Dept. of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. Electronic address: miira.vehkalahti@helsinki.fi.
Source
J Dent. 2021 01; 104:103537
Date
01-2021
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Aged, 80 and over
Child
Crowns
Dental Care
Dental caries
Dental Restoration Failure
Dental Restoration, Permanent
Finland
Humans
Retrospective Studies
Abstract
This study assessed age-related variation in the volume and content of restorative dental care performed by private dentists for adults in Finland in 2012-2017.
This retrospective register-based observational study utilized the Social Insurance database of private dental services in 2012 and 2017, including all patients. The data were aggregated into 5-year age groups for 20-89-year-olds; those aged 90+ formed one group. A patient was one who had received at least one treatment, and a restoration patient one who received at least one restoration (direct/indirect), excluding prosthetic crowns. Attendance rate was the proportion of the population treated. Volume of restorative treatment was the proportion of restoration patients among all patients using private dental services. Content of restorative treatment was described as the number of teeth receiving restoration and the size of restoration (number of surfaces restored). Correlation coefficient demonstrated associations between age groups and numbers of restorations.
Rate of restoration patients was 64.8 % in 2012 and 61.1 % in 2017, the rate for individuals aged under 80 years in each calendar year being smaller than in previous years. Mean number of restorations received per patient was 1.59 in 2012 and 1.42 in 2017, increasing with age (r?=?0.85 in 2012; r?=?0.95 in 2017). Small restorations dominated; one to two surfaces were covered in 72.3 % and 75.5 % of restorations in 2012 and 2017, respectively.
Volume and content of restorative dental care for adults vary by age and have decreased slightly over time.
Restorative treatments are a prominent part of dental care for adults. This paper sheds light on the entity of restorative dental care for adults visiting private dentists. Variation in restoration volume and content is shown according to patient's age group, and changes are assessed across six years.
PubMed ID
33232773 View in PubMed
Less detail

Anal incontinence after caesarean and vaginal delivery in Sweden: a national population-based study.

https://arctichealth.org/en/permalink/ahliterature299811
Source
Lancet. 2019 Mar 23; 393(10177):1233-1239
Publication Type
Comparative Study
Journal Article
Observational Study
Date
Mar-23-2019
Author
Charlotta Larsson
Charlotta Linder Hedberg
Ewa Lundgren
Lars Söderström
Katarina TunÓn
Pär Nordin
Author Affiliation
Department of Surgical and Perioperative Sciences, University of Umeå and Hospital of Östersund, Östersund, Sweden.
Source
Lancet. 2019 Mar 23; 393(10177):1233-1239
Date
Mar-23-2019
Language
English
Publication Type
Comparative Study
Journal Article
Observational Study
Keywords
Adult
Birth weight
Cesarean Section - adverse effects - methods
Delivery, Obstetric - adverse effects - methods
Fecal Incontinence - diagnosis - epidemiology - etiology
Female
Humans
Male
Maternal Age
Pelvic Floor Disorders - diagnosis - epidemiology - etiology
Pregnancy
Risk factors
Sweden - epidemiology
Abstract
Elective caesarean delivery is increasing rapidly in many countries, and one of the reasons might be that caesarean delivery is widely believed to protect against pelvic floor disorders, including anal incontinence. Previous studies on this issue have been small and with conflicting results. The aim of present study was to compare the risk of developing anal incontinence in women who had a caesarean delivery, in those who had a vaginal delivery, and in two age-matched control groups (nulliparous women and men).
In this observational population-based study, we included all women in the Swedish Medical Birth Register who gave birth by caesarean delivery or vaginal delivery during 1973-2015 in Sweden and were diagnosed with anal incontinence according to ICD 8-10 in the Swedish National Patient Register during 2001-15. Exclusion criteria were multiple birth delivery, mixed vaginal and caesarean delivery, and four or more deliveries. We compared the diagnosis of anal incontinence between women previously delivered solely by caesarean delivery and those who solely had delivered vaginally. We also compared it with two age-matched control groups of nulliparous women and men from the Swedish Total Population Register. Finally, we analysed risk factors for anal incontinence in the caesarean delivery and vaginal delivery groups.
3?755?110 individuals were included in the study. Between 1973 and 2015, 185?219 women had a caesarean delivery only and 1?400?935 delivered vaginally only. 416 (0·22 %) of the 185?219 women in the caesarean delivery group were diagnosed with anal incontinence compared with 5171 (0·37%) of 1?400?935 women in the vaginal delivery group. The odds ratio (OR) for being diagnosed with anal incontinence after vaginal delivery compared with caesarean delivery was 1·65 (95% CI 1·49-1·82; p
Notes
CommentIn: Lancet. 2019 Mar 23;393(10177):1183-1184 PMID 30799058
PubMed ID
30799061 View in PubMed
Less detail

Analysis of penetrating keratoplasty in Northern Alberta, Canada, from 2000 to 2015.

https://arctichealth.org/en/permalink/ahliterature301334
Source
Can J Ophthalmol. 2018 12; 53(6):568-573
Publication Type
Journal Article
Observational Study
Date
12-2018
Author
Matthew D Benson
Khaliq Kurji
Calvin Tseng
Bo Bao
Dean Mah
Author Affiliation
Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.
Source
Can J Ophthalmol. 2018 12; 53(6):568-573
Date
12-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alberta - epidemiology
Child
Child, Preschool
Corneal Diseases - epidemiology - surgery
Female
Follow-Up Studies
Forecasting
Humans
Incidence
Infant
Keratoplasty, Penetrating - methods
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Visual acuity
Young Adult
Abstract
To study indications for penetrating keratoplasty (PK) at a single site. The trends in the causative organisms for infectious keratitis requiring surgery were also evaluated.
Retrospective observational study.
A total of 1181 eyes of 935 patients undergoing PK between January 2000 and December 2015 in Northern Alberta, Canada.
Indications for PK were evaluated over the 16-year study period, and the trends in these indications were compared over 5-year intervals. The microbiology of infectious keratitis cases requiring surgery was similarly evaluated.
The most common indications for PK from 2000 to 2015 were keratoconus (23%), re-graft (22%), and corneal scar (12%). There was a decline in the percent of total surgeries done for Fuchs' dystrophy (p = 1.1 × 10-3) and pseudophakic bullous keratopathy (p = 5.6 × 10-5), whereas a corresponding increase in keratoconus (p = 3.2 × 10-5), trauma (p = 2.1 × 10-3), and infectious keratitis cases (p = 0.010) was observed. The most common causes for infectious keratitis cases were viral (45%), bacterial (18%), parasitic (11%), and fungal (9%). There was a significant increase in the percent of infectious keratitis cases due to a viral etiology from 2005 to 2010 (p = 6.4 × 10-3).
The indications for PK are comparable with other centres in North America. Nearly half of all infectious keratitis cases requiring surgery are viral. The increase in viral cases requiring surgery may reflect improved diagnostics or recurrent cases.
PubMed ID
30502979 View in PubMed
Less detail

449 records – page 1 of 45.