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30-year mortality after venous thromboembolism: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature257922
Source
Circulation. 2014 Sep 2;130(10):829-36
Publication Type
Article
Date
Sep-2-2014
Author
Kirstine Kobberøe Søgaard
Morten Schmidt
Lars Pedersen
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Author Affiliation
From the Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. kks@clin.au.dk.
Source
Circulation. 2014 Sep 2;130(10):829-36
Date
Sep-2-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Databases as Topic - statistics & numerical data
Denmark - epidemiology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Regression Analysis
Retrospective Studies
Risk factors
Survival Rate
Venous Thromboembolism - epidemiology - mortality
Abstract
Studies on long-term mortality after venous thromboembolism (VTE) are sparse.
Using Danish medical databases, we conducted a 30-year nationwide population-based cohort study of 128 223 patients with first-time VTE (1980-2011) and a comparison cohort of 640 760 people from the general population (without VTE) randomly matched by sex, year of birth, and calendar period. The mortality risks for patients with deep venous thrombosis (DVT) and pulmonary embolism (PE) were markedly higher than for the comparison cohort during the first year, especially within the first 30 days (3.0% and 31% versus 0.4%). Using Cox regression, we assessed mortality rate ratios (MRRs) with 95% confidence intervals (CIs). The overall 30-year MRR was 1.55 (95% CI, 1.53-1.57) for DVT and 2.77 (95% CI, 2.74-2.81) for PE. The 30-day MRR was 5.38 (95% CI, 5.00-5.80) for DVT and 80.87 (95% CI, 76.02-86.02) for PE. Over time, the 30-day MRR was consistently 5- to 6-fold increased for DVT, whereas it improved for PE from 138 (95% CI, 125-153) in 1980 to 1989 to 36.08 (95% CI, 32.65-39.87) in 2000 to 2011. The 1- to 10-year and 11- to 30-year MRRs remained 25% to 40% increased after both DVT and PE but were 3- to 5-fold increased after DVT and 6- to 11-fold increased after PE when VTE was considered the immediate cause of death.
Patients with VTE are at increased risk of dying, especially within the first year after diagnosis, but also during the entire 30 years of follow-up, with VTE as an important cause of death. Although 30-day mortality after DVT remained fairly constant over the last 3 decades, it improved markedly for PE.
Notes
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49625027484
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49725027486
PubMed ID
24970783 View in PubMed
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Comparison of outcomes of patients = 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction).

https://arctichealth.org/en/permalink/ahliterature131661
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Publication Type
Article
Date
Nov-15-2011
Author
Lisbeth Antonsen
Lisette Okkels Jensen
Per Thayssen
Evald Høj Christiansen
Anders Junker
Hans-Henrik Tilsted
Christian Juhl Terkelsen
Anne Kaltoft
Michael Maeng
Knud Noerregaard Hansen
Jan Ravkilde
Jens Flensted Lassen
Morten Madsen
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. dr_lissie@hotmail.com
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Date
Nov-15-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Angina, Stable - mortality - therapy
Angina, Unstable - mortality - therapy
Angioplasty, Balloon, Coronary - statistics & numerical data - trends
Arrhythmias, Cardiac - mortality
Cohort Studies
Comorbidity
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - mortality
Humans
Male
Myocardial Infarction - mortality - therapy
Registries
Regression Analysis
Abstract
Patients = 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients = 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (= 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients = 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.
PubMed ID
21890087 View in PubMed
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Concomitant use of clopidogrel and statins and risk of major adverse cardiovascular events following coronary stent implantation.

https://arctichealth.org/en/permalink/ahliterature128016
Source
Br J Clin Pharmacol. 2012 Jul;74(1):161-70
Publication Type
Article
Date
Jul-2012
Author
Morten Schmidt
Martin B Johansen
Michael Maeng
Anne Kaltoft
Lisette O Jensen
Hans-Henrik Tilsted
Hans E Bøtker
John A Baron
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus Department of Cardiology, Aarhus, Denmark. morten.schmidt@dce.au.dk
Source
Br J Clin Pharmacol. 2012 Jul;74(1):161-70
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - prevention & control
Cohort Studies
Cytochrome P-450 CYP3A - antagonists & inhibitors
Denmark
Drug Interactions
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects - therapeutic use
Male
Middle Aged
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Regression Analysis
Risk factors
Stents
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Time Factors
Abstract
• The CYP3A4 inhibition by lipophilic statins may attenuate the effectiveness of clopidogrel. • No studies have measured drug exposure in a time-varying manner that detects discontinuation and restart of clopidogrel and statin therapy, allowing clinical quantification of the interaction effect.
• Clopidogrel and CYP3A4-metabolizing statin use were each associated with a substantially reduced rate of major adverse cardiovascular events within 12 months after coronary stent implantation. • Although we observed an interaction between use of clopidogrel and statins, statin use vs. non-use was not associated with an increased rate of major adverse cardiovascular events in patients using clopidogrel after coronary stent implantation.
To examine whether CYP3A4-metabolizing statin use modified the association between clopidogrel use and major adverse cardiovascular events (MACE) after coronary stent implantation, using time-varying drug exposure ascertainment.
We conducted this population-based cohort study in Western Denmark (population: 3 million) using medical databases. We identified all 13 001 patients with coronary stent implantation between 2002 and 2005 and their comorbidities. During 12 months of follow-up, we tracked the use of clopidogrel and CYP3A4-metabolizing statins and the rate of MACE. We used Cox regression to compute hazard ratios (HRs) controlling for potential confounders.
The rate of MACE per 1000 person years was 104 for concomitant clopidogrel and statin use, 130 for clopidogrel without statin use, 108 for statin without clopidogrel use and 446 for no use of either drug. The adjusted HR comparing clopidogrel use with non-use was 0.68 (95% confidence interval (CI) 0.58, 0.79) among statin users and 0.34 (95% CI 0.29, 0.40) among statin non-users, yielding an interaction effect (i.e. relative rate increase) of 1.97 (95% CI 1.59, 2.44). The adjusted HR for MACE comparing statin use with non-use was 0.97 (95% CI 0.83, 1.13) among clopidogrel users and 0.49 (95% CI 0.42, 0.57) among clopidogrel non-users.
Clopidogrel and CYP3A4-metabolizing statin use were each associated with a substantially reduced rate of MACE within 12 months after coronary stent implantation. Although we observed an interaction between use of clopidogrel and statins, statin use vs. non-use was not associated with an increased rate of MACE in patients using clopidogrel after coronary stent implantation.
Notes
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PubMed ID
22243420 View in PubMed
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Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease.

https://arctichealth.org/en/permalink/ahliterature121329
Source
EuroIntervention. 2012 Aug;8(4):456-64
Publication Type
Article
Date
Aug-2012
Author
Lisette Okkels Jensen
Per Thayssen
Dóra Körmendiné Farkas
Mikkel Hougaard
Christian Juhl Terkelsen
Hans-Henrik Tilsted
Michael Maeng
Anders Junker
Jens Flensted Lassen
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk
Source
EuroIntervention. 2012 Aug;8(4):456-64
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Denmark
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Percutaneous Coronary Intervention - methods
Registries
Regression Analysis
Retrospective Studies
Time Factors
Treatment Outcome
Vascular Diseases - mortality - therapy
Abstract
In patients with ST-segment elevation myocardial infarction (STEMI), timely reperfusion with primary percutaneous coronary intervention (PPCI) is the preferred treatment. However, it remains unclear whether the optimal strategy is complete revascularisation or culprit vessel PPCI only.
From January 2002 to June 2009 all patients treated with PPCI were identified from the Western Denmark Heart Registry. We examined mortality according to timing of multivessel PCI: acute procedure, staged procedure during the index hospitalisation, or staged procedure performed within 60 days. The hazard ratio (HR) for death was estimated using a time-dependent Cox regression model, with time of PCI for the non-culprit lesion as the time-dependent variable. The study cohort consisted of 5,944 patients, of whom 4,770 (80%) had single-vessel disease and 1,174 (20%) had multivessel PCI within 60 days. Among 354 (30.2%) patients with acute multivessel PCI, 194 (16.5%) patients with multivessel PCI during the index hospitalisation, and 626 (53.3%) patients with multivessel PCI within 60 days after the index hospitalisation, the adjusted HRs for one-year mortality were 1.53 (95% confidence interval (CI): 1.07-2.18), 0.60 (95% CI: 0.28-1.26), and 0.28 (95% CI: 0.14-0.54), respectively, compared to patients with single vessel disease.
Acute multivessel PCI in patients with STEMI was associated with increased mortality.
Notes
Comment In: EuroIntervention. 2012 Aug;8(4):423-522917723
PubMed ID
22917729 View in PubMed
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Declining risk of triple-class antiretroviral drug failure in Danish HIV-infected individuals.

https://arctichealth.org/en/permalink/ahliterature7161
Source
AIDS. 2005 May 20;19(8):815-22
Publication Type
Article
Date
May-20-2005
Author
Nicolai Lohse
Niels Obel
Gitte Kronborg
Alex Laursen
Court Pedersen
Carsten S Larsen
Birgit Kvinesdal
Henrik Toft Sørensen
Jan Gerstoft
Author Affiliation
Odense University Hospital, and University of Southern Denmark, Odense, Denmark. nicolai.lohse@ouh.fyns-amt.dk
Source
AIDS. 2005 May 20;19(8):815-22
Date
May-20-2005
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Anti-HIV Agents - therapeutic use
Anti-Retroviral Agents - therapeutic use
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Cohort Studies
Denmark
Female
HIV Infections - drug therapy - mortality - virology
HIV-1
Humans
Male
Middle Aged
Regression Analysis
Research Support, Non-U.S. Gov't
Risk
Survival Rate
Treatment Failure
Viral Load
Abstract
OBJECTIVES: To analyse the incidence, prevalence, and predictors for development of triple-class antiretroviral drug failure (TCF) in individuals infected with HIV. DESIGN: Population-based observational cohort study from 1 January 1995 to 31 December 2003, focusing on all 2722 recipients of highly active antiretroviral therapy (HAART) in Denmark. METHODS: We used person-years analysis, Kaplan-Meier survival curves and Cox regression analysis. TCF was defined as a minimum of 120 days with viral load > 1000 copies/ml on treatment with each of the three major drug classes. RESULTS: We observed 177 TCFs, yielding a crude incidence rate (IR) of 1.8 per 100 person-years [95% confidence interval (CI), 1.6-2.1]. Seven years after initiation of HAART, 17.2% (95% CI, 14.5-20.5) of antiretroviral (ART)-experienced patients, but only 7.0% (95% CI, 4.3-11.2) of ART-naive patients were estimated to have failed. After an initial rise, the IR from the third to the sixth year of HAART declined significantly for ART-experienced patients [incidence rate ratio (IRR), 0.80 per year (95% CI, 0.66-0.97); P = 0.022], and non-significantly for ART-naive patients [IRR, 0.79 per year (95% CI, 0.53-1.18); P = 0.255]. The IR for all patients being followed each year declined from 1997 to 2003 [IRR, 0.88 (95% CI, 0.81-0.96); P = 0.002]. The prevalence of TCF remained stable at less than 7% after 2000. Predictors of TCF at commencement of HAART were a CD4 cell count below 200, a previous AIDS-defining event, previous antiretroviral exposure, earlier year of HAART initiation, and young age. CONCLUSIONS: The risk of TCF is declining in Denmark and the prevalence remains stable.
PubMed ID
15867496 View in PubMed
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The impact of exacerbation frequency on mortality following acute exacerbations of COPD: a registry-based cohort study.

https://arctichealth.org/en/permalink/ahliterature264806
Source
BMJ Open. 2014;4(12):e006720
Publication Type
Article
Date
2014
Author
Sigrun Alba Johannesdottir Schmidt
Martin Berg Johansen
Morten Olsen
Xiao Xu
Joseph M Parker
Nestor A Molfino
Timothy L Lash
Henrik Toft Sørensen
Christian Fynbo Christiansen
Source
BMJ Open. 2014;4(12):e006720
Date
2014
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Disease Progression
Female
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - mortality
Registries - statistics & numerical data
Regression Analysis
Abstract
To examine the association between exacerbation frequency and mortality following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Cohort study using medical databases.
Northern Denmark.
On 1 January 2005, we identified all patients with prevalent hospital-diagnosed chronic obstructive pulmonary disease (COPD) who had at least one AECOPD during 1 January 2005 to 31 December 2009. We followed patients from the first AECOPD during this period until death, emigration or 31 December 2009, whichever came first. We flagged all AECOPD events during follow-up and characterised each by the exacerbation frequency (0, 1, 2 or 3+) in the prior 12-month period.
Using Cox regression, we computed 0-30-day and 31-365-day age-adjusted, sex-adjusted, and comorbidity-adjusted mortality rate ratios (MRRs) with 95% CIs entering exacerbation frequency as a time-varying exposure.
We identified 16,647 eligible patients with prevalent COPD, of whom 6664 (40%) developed an AECOPD and were thus included in the study cohort. The 0-30-day MRRs were 0.97 (95% CI 0.80 to 1.18), 0.90 (95% CI 0.70 to 1.15) and 1.03 (95% CI 0.81 to 1.32) among patients with AECOPD with 1, 2 and 3+ AECOPDs versus no AECOPD within the past 12 months, respectively. The corresponding MRRs were 1.47 (95% CI 1.30 to 1.66), 1.89 (95% CI 1.59 to 2.25) and 1.59 (95% CI 1.23 to 2.05) for days 31-365.
Among patients with AECOPD, one or more exacerbations in the previous year were not associated with 30-day mortality but were associated with an increased 31-365-day mortality.
Notes
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PubMed ID
25526796 View in PubMed
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Maternal use of proton pump inhibitors during early pregnancy and the prevalence of hypospadias in male offspring.

https://arctichealth.org/en/permalink/ahliterature261003
Source
Am J Ther. 2014 Jul-Aug;21(4):254-9
Publication Type
Article
Author
Rune Erichsen
Ellen Mikkelsen
Lars Pedersen
Henrik Toft Sørensen
Source
Am J Ther. 2014 Jul-Aug;21(4):254-9
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Female
Humans
Hypospadias - epidemiology - etiology
Infant, Newborn
Male
Maternal Exposure - adverse effects
Pregnancy
Prevalence
Proportional Hazards Models
Proton Pump Inhibitors - administration & dosage - adverse effects
Registries
Regression Analysis
Time Factors
Young Adult
Abstract
Proton pump inhibitors (PPIs) are increasingly used in reflux disease treatment also among pregnant women. Hypospadias prevalence is increasing and the birth defect is diagnosed in 0.3%-0.8% of male births, but the association with maternal PPI use during pregnancy is virtually unknown. Therefore, we decided to estimate the hypospadias risk in male offspring after maternal PPI use during pregnancy. We used Danish nationwide registries to conduct a population-based prevalence study including all live-born boys from 1997 through 2009. Maternal PPI use was classified according to exposure time: early pregnancy (30 days before conception through the end of the first trimester) and entire pregnancy (30 days before and throughout pregnancy). Outcome was defined as a hospital hypospadias diagnosis recorded any time after delivery. We calculated prevalence ratios and 95% confidence intervals associating maternal PPI use with hypospadias in male offspring using Cox proportional hazard regression analysis and adjusted for confounding factors. We identified a total of 430,569 live-born boys of whom 2926 were exposed to maternal PPI use during early pregnancy. Among the exposed boys, 20 (0.7%) were diagnosed with hypospadias, whereas 2683 (0.6%) of the nonexposed had hypospadias (adjusted prevalence ratio = 1.1; 95% confidence interval, 0.7-1.7). A total of 5227 boys were exposed during the entire pregnancy, and 32 (0.6%) had hypospadias corresponding to a prevalence ratio of 1.0 (95% confidence interval, 0.7-1.4). The subanalysis restricted to omeprazole exposure showed similar results. We thus conclude that maternal PPI use during pregnancy was not associated with hypospadias in boy offspring.
PubMed ID
22314213 View in PubMed
Less detail

Mortality after hospitalization for pneumonia among individuals with HIV, 1995-2008: a Danish cohort study.

https://arctichealth.org/en/permalink/ahliterature148585
Source
PLoS One. 2009;4(9):e7022
Publication Type
Article
Date
2009
Author
Ole S Søgaard
Nicolai Lohse
Jan Gerstoft
Gitte Kronborg
Lars Østergaard
Court Pedersen
Gitte Pedersen
Henrik Toft Sørensen
Niels Obel
Author Affiliation
Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark. olesoega@rm.dk
Source
PLoS One. 2009;4(9):e7022
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active
Cohort Studies
Denmark
Female
HIV Infections - complications - mortality
Hospitalization
Humans
Male
Middle Aged
Odds Ratio
Pneumonia - complications - mortality - virology
Prognosis
Registries
Regression Analysis
Abstract
HIV-infected persons are at increased risk of pneumonia, even with highly active antiretroviral treatment (HAART). We examined the impact of pneumonia on mortality and identified prognostic factors for death among HIV-infected.
In a nationwide, population-based cohort of individuals with HIV, we included persons hospitalized with pneumonia from the Danish National Hospital Registry and obtained mortality data from the Danish Civil Registration System. Comparing individuals with and without pneumonia, we used Poisson regression to estimate relative mortality and logistic regression to examine prognostic factors for death following pneumonia. From January 1, 1995, to July 1, 2008, we observed 699 episodes of first hospitalization for pneumonia among 4,352 HIV patients. Ninety-day mortality after pneumonia decreased from 22.4% (95% confidence interval [CI]: 16.5%-28.9%) in 1995-1996 to 8.4% (95% CI: 6.1%-11.6%) in 2000-2008. Mortality remained elevated for more than a year after hospitalization for pneumonia: adjusted mortality rate ratio 5.38 (95% CI: 4.27-6.78), 1.80 (95% CI: 1.36-2.37), and 1.62 (95% CI: 1.32-2.00) for days 0-90, 91-365, and 366+, respectively. The following variables predicted mortality within 90 days following hospitalization for pneumonia (adjusted Odds Ratios): male sex (3.77, 95% CI: 1.37-10.4), Charlson Comorbidity Index score > or = 2 (3.86, 95% CI: 2.19-6.78); no current HAART (3.58, 95% CI: 1.83-6.99); history of AIDS (2.46, 95% CI: 1.40-4.32); age per 10 year increase (1.43, 95% CI: 1.11-1.85); and CD4+ cell count
Notes
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PubMed ID
19750011 View in PubMed
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Pre-gravid oral contraceptive use and time to pregnancy: a Danish prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature116169
Source
Hum Reprod. 2013 May;28(5):1398-405
Publication Type
Article
Date
May-2013
Author
Ellen M Mikkelsen
Anders H Riis
Lauren A Wise
Elizabeth E Hatch
Kenneth J Rothman
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N 8200, Denmark. em@dce.au.dk
Source
Hum Reprod. 2013 May;28(5):1398-405
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Contraception Behavior
Contraceptives, Oral - therapeutic use
Denmark
Ethinyl Estradiol - therapeutic use
Female
Fertility - drug effects
Humans
Male
Pregnancy
Probability
Prospective Studies
Questionnaires
Regression Analysis
Time Factors
Time-to-Pregnancy - drug effects
Young Adult
Abstract
Is there an association between oral contraceptive (OC) use (age at the start of use, duration of use, ethinylestradiol dose and generation) and time to pregnancy (TTP)?
Although OC use was associated with a transient delay in the return of fertility, we found no evidence that long-term OC use deleteriously affects fecundability.
Studies using retrospective data on TTP have reported a short-term delay in the return of fertility after OC use. However, little is known about the long-term OC use and TTP.
Data were derived from 'Snart Gravid.dk', a prospective cohort study that enrolled participants from 1 June 2007 to 31 May 2010. The final study population consisted of 3727 women.
Eligible women were Danish pregnancy planners, aged 18-40 years, who completed a baseline questionnaire and bimonthly follow-up questionnaires until conception or for 12 months, whichever came first. Cohort retention was 80%. We used proportional probability regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), with adjustment for potential confounders.
Compared with barrier methods, the use of OCs as the last contraception method before attempting to conceive was associated with a short-term delay in return of fertility (FR = 0.87, 95% CI: 0.79-0.96). Longer term OC use was associated with higher fecundability: compared with OC use for less than 2 years; FRs were 0.98 (95% CI: 0.83-1.15) for 2-3 years, 1.16 (95% CI: 0.98-1.37) for 4-5 years, 1.10 (95% CI: 0.93-1.29) for 6-7 years, 1.17 (95% CI: 0.99-1.38) for 8-9 years, 1.23 (95% CI: 1.04-1.46) for 10-11 years and 1.28 (95% CI: 1.07-1.53) for =12 years of OC use.
Because this was a non-experimental study, where study volunteers provided information about their history of contraceptive use at baseline and were followed prospectively to assess their waiting times to pregnancy, there was some potential for error in the reporting of OC use and TTP. Nevertheless, participants reported data on OC use before the occurrence of pregnancy, thereby reducing the potential for systematic bias.
Women who have used OCs for many years should be reassured as there was no evidence that long-term OC use has a deleterious affects on fecundability. Both short- and long-term OC users are likely to experience a transient delay in conception compared with those discontinuing barrier methods.
This study was supported by the National Institute of Child Health and Human Development (R21050264) and the Danish Medical Research Council (271-07-0338). The authors declare that there are no conflicts of interest.
Notes
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PubMed ID
23427234 View in PubMed
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Prognosis of patients with liver cirrhosis and spontaneous bacterial peritonitis.

https://arctichealth.org/en/permalink/ahliterature9555
Source
Hepatogastroenterology. 2003 Nov-Dec;50(54):2133-6
Publication Type
Article
Author
Peter Jepsen
Hendrik Vilstrup
Jens Kjølseth Møller
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Denmark. pj@soci.au.dk
Source
Hepatogastroenterology. 2003 Nov-Dec;50(54):2133-6
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bacterial Infections - diagnosis - mortality
Cause of Death
Comorbidity
Denmark - epidemiology
Female
Humans
Leukocyte Count
Liver Cirrhosis - diagnosis - mortality
Male
Middle Aged
Paracentesis
Peritonitis - diagnosis - mortality
Prognosis
Proportional Hazards Models
Regression Analysis
Research Support, Non-U.S. Gov't
Survival Analysis
Abstract
BACKGROUND/AIMS: Patients with liver cirrhosis and ascites have a high risk of spontaneous bacterial peritonitis, but the prognostic impact of spontaneous bacterial peritonitis has not been well examined. METHODOLOGY: Patients with liver cirrhosis and ascites were included at the time of their first paracentesis during hospitalization in the Department of Hepatology, Aarhus University Hospital, Denmark, between September 1992 and September 2000. Cox regression was used to estimate the mortality of patients with spontaneous bacterial peritonitis (ascites leukocyte count > or = 250 per mm3) relative to controls without spontaneous bacterial peritonitis. Furthermore, we used Cox regression to estimate the change in mortality when controls developed spontaneous bacterial peritonitis during follow-up. RESULTS: Of 286 patients, 76 (27%) had spontaneous bacterial peritonitis at the first paracentesis. The mortality ratio of patients with spontaneous bacterial peritonitis relative to controls was 1.0 (95% confidence interval 0.7-1.5) after adjustment for age, gender, comorbidity, and alcohol abuse. Of the 210 controls, 42 (20%) were found to have spontaneous bacterial peritonitis at a later paracentesis. Their mortality rate more than doubled with the onset of spontaneous bacterial peritonitis. CONCLUSIONS: Spontaneous bacterial peritonitis at the first paracentesis did not affect the prognosis of patients with liver cirrhosis, whereas development of spontaneous bacterial peritonitis during follow-up doubled the mortality risk. This may be due to a longer diagnostic delay in those who developed spontaneous bacterial peritonitis during follow-up.
PubMed ID
14696480 View in PubMed
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