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Bacterial meningitis in Finland, 1995-2014: a population-based observational study.

https://arctichealth.org/en/permalink/ahliterature291171
Source
BMJ Open. 2017 Jun 06; 7(5):e015080
Publication Type
Journal Article
Observational Study
Date
Jun-06-2017
Author
Aleksandra Polkowska
Maija Toropainen
Jukka Ollgren
Outi Lyytikäinen
J Pekka Nuorti
Author Affiliation
School of Health Sciences, University of Tampere, Lääkärinkatu, Tampere, Finland.
Source
BMJ Open. 2017 Jun 06; 7(5):e015080
Date
Jun-06-2017
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Age Distribution
Aged
Bacteria - isolation & purification
Bacterial Vaccines - therapeutic use
Child
Child, Preschool
Female
Finland - epidemiology
Humans
Incidence
Infant
Male
Meningitis, Bacterial - epidemiology
Middle Aged
Regression Analysis
Sex Distribution
Vaccines, Conjugate - therapeutic use
Young Adult
Abstract
Bacterial meningitis remains an important cause of morbidity and mortality worldwide. Its epidemiological characteristics, however, are changing due to new vaccines and secular trends. Conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae (10-valent) were introduced in 1986 and 2010 in Finland. We assessed the disease burden and long-term trends of five common causes of bacterial meningitis in a population-based observational study.
A case was defined as isolation of S. pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, Listeria monocytogenes or H. influenzae from cerebrospinal fluid and reported to national, population-based laboratory surveillance system during 1995-2014. We evaluated changes in incidence rates (Poisson or negative binomial regression), case fatality proportions (?2) and age distribution of cases (Wilcoxon rank-sum).
During 1995-2014, S. pneumoniae and N. meningitidis accounted for 78% of the total 1361 reported bacterial meningitis cases. H. influenzae accounted for 4% of cases (92% of isolates were non-type b). During the study period, the overall rate of bacterial meningitis per 1?00?000 person-years decreased from 1.88 cases in 1995 to 0.70 cases in 2014 (4% annual decline (95% CI 3% to 5%). This was primarily due to a 9% annual reduction in rates of N. meningitidis (95%?CI 7% to 10%) and 2% decrease in S. pneumoniae (95%?CI 1% to 4%). The median age of cases increased from 31 years in 1995-2004 to 43 years in 2005-2014 (p=0.0004). Overall case fatality proportion (10%) did not change from 2004 to 2009 to 2010-2014.
Substantial decreases in bacterial meningitis were associated with infant conjugate vaccination against pneumococcal meningitis and secular trend in meningococcal meningitis in the absence of vaccination programme. Ongoing epidemiological surveillance is needed to identify trends, evaluate serotype distribution, assess vaccine impact and develop future vaccination strategies.
Notes
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PubMed ID
28592578 View in PubMed
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Prevalence of cervical, oral, and anal human papillomavirus infection in women living with HIV in Denmark - The SHADE cohort study.

https://arctichealth.org/en/permalink/ahliterature299750
Source
J Clin Virol. 2018 08; 105:64-71
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Date
08-2018
Author
Kristina Thorsteinsson
Merete Storgaard
Terese L Katzenstein
Steen Ladelund
Frederikke F Rönsholt
Isik Somuncu Johansen
Gitte Pedersen
Anne Gaardsting
Lars Nørregård Nielsen
Jesper Bonde
Anne-Mette Lebech
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. Electronic address: Kristina.thorsteinsson@regionh.dk.
Source
J Clin Virol. 2018 08; 105:64-71
Date
08-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Adult
Anal Canal - virology
Cervix Uteri - virology
Cohort Studies
Denmark - epidemiology
Epidemiological Monitoring
Female
Genotype
HIV Infections - complications - epidemiology - virology
Humans
Middle Aged
Mouth - virology
Papillomaviridae - genetics - isolation & purification
Papillomavirus Infections - epidemiology
Prevalence
Regression Analysis
Risk factors
Abstract
Women living with HIV (WLWH) have elevated risk of human papillomavirus (HPV) related cancers.
To assess prevalence, distribution and concordance of cervical, oral, and anal HPV infection, and predictors of oral and anal HPV in WLWH in Denmark.
WLWH followed in the Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) were enrolled and examined for cervical, oral, and anal HPV infection. Logistic regression models were used to identify predictors of anal and oral HPV.
A total of 214 of 334 WLWH had sufficient DNA for analysis at all three anatomical sites and were included in analyses. Cervical, oral, and anal high-risk (hr) HPV prevalence were 28.0%, 3.7% and 39.3%. Most frequent i) cervical, ii) oral and iii) anal hrHPV genotypes were i) hrHPV58 (8.4%), 52 (5.1%), 16 (5.1%) and 51 (5.1%); ii) 52 (1.4%) and iii) 51 (9.3%), 58 (8.9%), 16 (7.0%) and 18 (7.0%). Among present cervical, oral, and anal hrHPV genotypes, 6.7%, 12.5% and 17.9% were targeted by the 2-or 4-valent HPV vaccines, whereas 50.0%, 50.0% and 42.9% of hrHPV genotypes were covered by the 9-valent HPV vaccine. Anal HPV infection was predicted by cervical HPV infection (adjusted OR 4.47 (95%CI 2.25-8.89)).
Cervical and anal HPV infection were highly prevalent in WLWH. Non-16/18 hrHPV genotypes were predominant at all anatomical sites. Almost half of all hrHPV infections at the three anatomical sites could have been prevented by childhood/adolescent vaccination with the 9-valent HPV vaccine.
PubMed ID
29906660 View in PubMed
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Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014: a population-based cohort study from the North Denmark Region.

https://arctichealth.org/en/permalink/ahliterature291867
Source
BMJ Open. 2017 Aug 21; 7(8):e014508
Publication Type
Journal Article
Observational Study
Date
Aug-21-2017
Author
Erika Frischknecht Christensen
Mette Dahl Bendtsen
Thomas Mulvad Larsen
Flemming Bøgh Jensen
Tim Alex Lindskou
Hans Ole Holdgaard
Poul Anders Hansen
Søren Paaske Johnsen
Christian Fynbo Christiansen
Author Affiliation
Department of Clinical Medicine, Prehospital and Emergency Research,Aalborg University, Aalborg, Denmark.
Source
BMJ Open. 2017 Aug 21; 7(8):e014508
Date
Aug-21-2017
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Ambulances
Child
Child, Preschool
Cohort Studies
Comorbidity - trends
Denmark - epidemiology
Emergency Medical Services - statistics & numerical data
Female
Hospital Mortality - trends
Humans
Infant
Infant, Newborn
Male
Middle Aged
Prevalence
Registries
Regression Analysis
Sex Distribution
Time Factors
Young Adult
Abstract
Demand for ambulances is growing. Nevertheless, knowledge is limited regarding diagnoses and outcomes in patients receiving emergency ambulances. This study aims to examine time trends in diagnoses and mortality among patients transported with emergency ambulance to hospital.
Population-based cohort study with linkage of Danish national registries.
The North Denmark Region in 2007-2014.
Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services.
The number of emergency ambulance service patients, distribution of their age, sex, hospital diagnoses, comorbidity, and 1-day and 30-day mortality were assessed by calendar year. Poisson regression with robust variance estimation was used to estimate both age-and sex-adjusted relative risk of death and prevalence ratios for Charlson Comorbidity Index (CCI) to allow comparison by year, with 2007 as reference year.
The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4%?and of patients aged 60+ years from 39.9% to 48.6%, respectively. The proportion of injuries gradually declined, non-specific diagnoses increased, especially the last year. Proportion of patients with high comorbidity (CCI=3) increased from 6.4% in 2007 to 9.4% in 2014, corresponding to an age- and sex-adjusted prevalence ratio of 1.27 (95% CI 1.16 to 1.39). The 1-day and 30?day mortality decreased from 2.40% to 1.21%?and from 5.01% to 4.36%, respectively, from 2007 to 2014, corresponding to age-adjusted and sex-adjusted relative risk of 0.43 (95% CI 0.37 to 0.50) and 0.72 (95% CI 0.66 to 0.79), respectively.
During the 8-year period, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased.
Notes
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PubMed ID
28827233 View in PubMed
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Trends in place of death: The role of demographic and epidemiological shifts in end-of-life care policy.

https://arctichealth.org/en/permalink/ahliterature293080
Source
Palliat Med. 2017 Dec; 31(10):964-974
Publication Type
Journal Article
Observational Study
Date
Dec-2017
Author
Jorid Kalseth
Ole Magnus Theisen
Author Affiliation
1 Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.
Source
Palliat Med. 2017 Dec; 31(10):964-974
Date
Dec-2017
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Attitude to Death
Cause of Death
Child
Child, Preschool
Female
Home Care Services - statistics & numerical data
Hospital Mortality - trends
Hospitals - statistics & numerical data
Humans
Infant
Male
Middle Aged
Norway
Nursing Homes - statistics & numerical data
Palliative Care - trends
Patient Preference
Regression Analysis
Sex Factors
Terminal Care - trends
Young Adult
Abstract
Surveys suggest that most people prefer to die at home. Trends in causes of mortality and age composition could limit the feasibility of home deaths.
To examine the effect of changes in decedents' age, gender and cause of death on the pattern of place of death using data on all deaths in Norway for the period 1987-2011.
Population-based observation study comparing raw, predicted, as well as standardised shares of place of death isolating the effect of demographic and epidemiological changes. The analysis was bolstered with joinpoint regression to detect shifts in trends in standardised shares.
All deaths (1,091,303) in Norway 1987-2011 by age, gender and cause of death. Place of death at home, hospital, nursing home and other.
Fewer people died in hospitals (34.1% vs 46.2%) or at home (14.2% vs 18.3%), and more in nursing homes (45.5% vs 29.5%) in 2011 than in 1987. Much of the trend can be explained by demographic and epidemiological changes. Ageing of the population and the epidemiological shift represented by the declining share of deaths from circulatory diseases (31.4% vs 48.4%) compared to the increase in deaths from neoplasms (26.9% vs 21.8%) and mental/behavioural diseases (4.4% vs 1.2%) are the strongest drivers in the shift in place of death. Joinpoint regression shows important differences between categories.
Demographic and epidemiological changes go a long way in explaining shifts in place of death. The analyses reveal substantial differences in trends between different decedent groups.
PubMed ID
28190375 View in PubMed
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