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Torabi F, Lee-Lane E, Lacey A, Fonferko-Shadrach B, Harris D, Akbari A, Lyons RA, Rees M, Sawhney I, Halcox J, Powell R, Pickrell WO. A National Level Case-Control Study for Determining Risk of Major Cardiovascular Events in People with Epilepsy. Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionThe risk of cardiovascular events amongst people with epilepsy who are receiving enzyme-inducing anti-epileptic drugs (EIAEDs) seems to be higher than those on other medications and the general population. National-level record linkage enables development of case-control studies at a wider scope accounting for multiple factors.
Objectives and ApproachPeople with epilepsy were identified between 2003-01-01 and 2017-12-31 and were matched to a control group on: age, gender, deprivation quintile and year of diagnosis, accounting for any changes in clinical therapeutic guidelines. Primary and secondary care population records were linked to capture relevant comorbidities and major cardiovascular events. Annual district birth and death extract were used in combination with the Welsh Demographic Service (WDS) dataset to capture demographic and cardiovascular related death records. The WDS dataset was used to identify eligible control groups for each case and a linkage approach between the control and case database was developed for matching cases and controls with replacement and randomization. Survival analysis was conducted to evaluate the difference in time to first major cardiovascular event in patients receiving EIAED versus Non-EIAEDs and controls.
Results10,241 cases (mean age 49.6 years, 52.2% male) with diagnosis of epilepsy were matched to 35,145 controls. 3,180 (31.1%) cases received EIAEDs and 7,061 (68.9%) received non-EIAEDs. The risk of experiencing a major cardiovascular event was higher in cases compared to controls (adjusted hazard ratio 1.52,95%CI[1.50–1.55];p<0.001). There was no significant difference in cardiovascular events between those treated with non-EIAEDs and EIAEDs (adjusted hazard ratio 1.04,95%CI[0.95-1.12];p=0.407).
Conclusion / ImplicationsData linkage provides a unique opportunity and insight into studying disease risk factors. We have shown that individuals with epilepsy prescribed antiepileptic drugs, re at an increased risk of a major cardiovascular events regardless of treatment type (EIAED,NEIAED) compared with a matched control population.
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Harris D, Ellis DY, Gorman D, Foo N, Haustead D. Impact of COVID-19 social restrictions on trauma presentations in South Australia. Emerg Med Australas 2020; 33:152-154. [PMID: 33124718 DOI: 10.1111/1742-6723.13680] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review the impact of COVID-19 social restrictions on trauma presentations in South Australia. METHODS Retrospective database review. RESULTS During the period of social restrictions, there was a reduction in presentations of trauma and major trauma by 17% and 33%, respectively. The reduction in presentation rates was due to a large decrease in those aged over 40, with an increase in presentations in those younger than 40. Review by mechanism and location of injury revealed a reduction in road trauma, yet an increase in pedestrian trauma and trauma at home. CONCLUSION Social restrictions alter the characteristics of trauma presentations.
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Torabi F, Harris D, Akbari A, Bodger O, Lyons R, Gravenor M, Halcox J. Longitudinal study of adherence to anticoagulation guidelines in patients with atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Anticoagulation (AC) reduces the risk of stroke and systemic embolism (SSE) in patients with Atrial Fibrillation (AF). However, the association between changes in AF prevalence, risk factors for SSE, uptake of AC and incidence of SSE has not been documented specifically in these patients within a national population.
Purpose
Identifying antithrombotic prescribing and evaluating associations between changes in AF prevalence, SSE risk factors (CHA2DS2-VASC score) and uptake of AC. Evaluating relationships between changes in proportion of AF patients treated with AC and SSE rate at a population level. Developing a modelling tool which estimates rates of SSE (past and future) based on these factors, which can be used to drive improvements in health care.
Method
AF patients were identified in the population of Wales (SAIL databank) between 2012–2018. Temporal trends of AF, CHA2DS2-VASC scores, anti-thrombotic prescriptions and SSE events were evaluated. Multi-state Markov models were used to estimate SSE rates adjusted for AC and CHA2DS2-VASC scores. Simulation methods modelled SSE outcomes for the subsequent 7-years based on differing proportional population AC coverage.
Results
AF prevalence increased from 51,492 to 64,852 from 2012–18, with mean CHA2DS2-VASC score increasing from 3.0 to 3.9. AC prescription coverage increased (24,892 [48.3%] to 44,195 [68.1%]), whilst antiplatelet therapy alone or no antithrombotic therapy decreased (14,532 [28.0%] to 5,385 [8.3%] and 26,602 [52.0%] to 21,164 [33.0%] respectively). Hospitalisation rate for SSE in AF population decreased by over 20%, from 1,039 per 100,000 patients/quarter in 2012 to 809 per 100,000 patients/quarter in 2018.
Markov modelling demonstrated a 39% lower SSE rate with AC compared to no AC over time, after adjustment for individual CHA2DS2-VASC (HR=0.61, 95% CI [0.58, 0.63]). Using the estimated progression rates, simulation models shown that an expected 3,574 SSE events per 100,000 per year could have been reduced to 2,956 (17% reduction rate) if AC adherence had been at the now recommended 90% rate from 2012. This model also predicts that improving AC coverage to 90% of patients over the next 7-years would reduce SSE rates by 12% per year (assuming no further increase in mean CHA2DS2-VASC score).
Conclusion
Despite the increase in both prevalence of AF and CHA2DS2-VASC between 2012–18, we observed a progressive decrease in SSE events along with increasing AC prescribing. Our study suggests not only that improved AC coverage is associated with better clinical outcomes, but also that the rate of therapeutic implementation is likely a crucial factor. Reducing transition time between evidence-based guideline publication and widespread clinical uptake of the recommendations appears to be an important opportunity to improve clinical outcomes at a population level and should inform healthcare policy development and implementation.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Funded by research grant
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Riedl MA, Maurer M, Bernstein JA, Banerji A, Longhurst HJ, Li HH, Lu P, Hao J, Juethner S, Lumry WR, Hébert J, Ritchie B, Sussman G, Yang WH, Escuriola Ettingshausen C, Magerl M, Martinez‐Saguer I, Maurer M, Staubach P, Zimmer S, Cicardi M, Perego F, Wu MA, Zanichelli A, Al‐Ghazawi A, Shennak M, Zaragoza‐Urdaz RH, Ghurye R, Longhurst HJ, Zinser E, Anderson J, Banerji A, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Christiansen S, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Levitch ES, Li HH, Lockey RF, Lugar P, Lumry WR, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Poarch K, Radojicic C, Rehman SM, Riedl MA, Schwartz LB, Shapiro R, Sher E, Smith AM, Smith TD, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H, Zuraw BL. Lanadelumab demonstrates rapid and sustained prevention of hereditary angioedema attacks. Allergy 2020; 75:2879-2887. [PMID: 32452549 PMCID: PMC7689768 DOI: 10.1111/all.14416] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
Background Lanadelumab demonstrated efficacy in preventing hereditary angioedema (HAE) attacks in the phase 3 HELP Study. Objective To assess time to onset of effect and long‐term efficacy of lanadelumab, based on exploratory findings from the HELP Study. Methods Eligible patients with HAE type I/II received lanadelumab 150 mg every 4 weeks (q4wks), 300 mg q4wks, 300 mg q2wks, or placebo. Ad hoc analyses evaluated day 0‐69 findings using a Poisson regression model accounting for overdispersion. Least‐squares mean monthly HAE attack rate for lanadelumab was compared with placebo. Intrapatient comparisons for days 0‐69 versus steady state (days 70‐182) used a paired t test for continuous endpoints or Kappa statistics for categorical endpoints. Results One hundred twenty‐five patients were randomized and treated. During days 0‐69, mean monthly attack rate was significantly lower with lanadelumab (0.41‐0.76) vs placebo (2.04), including attacks requiring acute treatment (0.33‐0.61 vs 1.66) and moderate/severe attacks (0.31‐0.48 vs 1.33, all P ≤ .001). More patients receiving lanadelumab vs placebo were attack free (37.9%‐48.1% vs 7.3%) and responders (85.7%‐100% vs 26.8%). During steady state, the efficacy of lanadelumab vs placebo was similar or improved vs days 0‐69. Intrapatient differences were significant with lanadelumab 300 mg q4wks for select outcomes. Lanadelumab efficacy was durable—HAE attack rate was consistently lower vs placebo, from the first 2 weeks of treatment through study end. Treatment emergent adverse events were comparable during days 0‐69 and 70‐182. Conclusion Protection with lanadelumab started from the first dose and continued throughout the entire study period.
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Molnar K, Walczynski T, Harris D. Clinical reasoning in resource limited settings: The realities of a remote medical retrieval service. Emerg Med Australas 2020; 32:893-896. [DOI: 10.1111/1742-6723.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 12/22/2019] [Accepted: 05/27/2020] [Indexed: 11/29/2022]
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Lewis C, Zwetchkenbaum SR, Baier RR, Harris D, Gardner RL. Dental and Oral Health Care in Nursing Homes: Results from Two Multi-Stakeholder Surveys. RHODE ISLAND MEDICAL JOURNAL (2013) 2020; 103:62-68. [PMID: 33003683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
STUDY OBJECTIVE To characterize oral health practices using data from statewide, multi-stakeholder surveys. STUDY DESIGN AND METHODS We analyzed data from two Rhode Island surveys. Together, the surveys targeted all nursing homes, residents, and resident representatives in Rhode Island, and asked about staff training on mouth care, frequency of dental provider visits, enrollment in nursing home dental programs, and barriers to oral health. Primary Results: Responding nursing home administrators reported high levels of commitment to oral health. Among residents enrolled in a nursing home dental care program, 76.1% had a preventive visit in the prior six months, compared to 31.0% of residents not enrolled. The majority of facilities (71.8%) reported that staff received training on routine mouth care at the time of hire. CONCLUSIONS Our findings highlight opportunities to better support nursing homes in providing residents with high-quality oral health, including acquiring staff skills to manage care-resistant behaviors, and routinely assessing residents' ability to provide their own mouth care.
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Wenger AS, Harris D, Weber S, Vaghi F, Nand Y, Naisilisili W, Hughes A, Delevaux J, Klein CJ, Watson J, Mumby PJ, Jupiter SD. Best‐practice forestry management delivers diminishing returns for coral reefs with increased land‐clearing. J Appl Ecol 2020. [DOI: 10.1111/1365-2664.13743] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rowse J, Harris D, Hardy D, Kirksey L, Smolock C, Lyden S, Caputo F. Optimal Timing of Surveillance Ultrasound in Small Aortic Aneurysms. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.06.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mansikka H, Virtanen K, Harris D, Jalava M. Measurement of team performance in air combat – have we been underperforming? THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2020. [DOI: 10.1080/1463922x.2020.1779382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ionescu A, Harris D, Selvaganapathy PR, Kishen A. Electrokinetic transport and distribution of antibacterial nanoparticles for endodontic disinfection. Int Endod J 2020; 53:1120-1130. [PMID: 32383495 DOI: 10.1111/iej.13321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/14/2022]
Abstract
AIM To assess a novel, noninvasive intervention capable of mobilizing charged antibacterial nanoparticles to the apical portions of the root canal system, utilizing the principles of electrokinetics. METHODS Experiments were conducted in three stages. Stage-1: A computer model was generated to predict and visualize the electric field and current density distribution generated by the proposed intervention. Stage-2: Transport of chitosan nanoparticles (CSnp) was evaluated qualitatively using a transparent microfluidic model with fluorescent-labelled CSnp. Stage-3: An ex vivo model was utilized to study the antimicrobial efficacy of the proposed treatment against 3-week-old monospecies E. faecalis biofilms. Scanning electron microscopy (SEM) was also utilized in this stage to confirm the deposition of CSnp. RESULTS The results of the computer simulations predicted an electric field and current density that reach their maxima at the apical constriction of the root canal. Correspondingly, the microfluidic experiments demonstrated rapid, controlled CSnp transport throughout the simulated root canal anatomy with subsequent distribution and deposition in the apical constriction as well as periapical regions. Infected root canals when subjected to the novel treatment method resulted in a mean bacterial reduction of 2.1 log CFU. SEM analysis revealed electrophoretic deposition of chitosan nanoparticles onto the root canal dentine walls in the apical region. CONCLUSION The findings from this study demonstrate that the combination of cationic antibacterial nanoparticles with a low-intensity electric field results in particle transportation (electrophoresis) and deposition within the root canal. This results in a synergistic antibiofilm efficacy and has the potential to enhance root canal disinfection.
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Weinberger KR, Harris D, Spangler KR, Zanobetti A, Wellenius GA. Estimating the number of excess deaths attributable to heat in 297 United States counties. Environ Epidemiol 2020; 4:e096. [PMID: 32613153 PMCID: PMC7289128 DOI: 10.1097/ee9.0000000000000096] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/30/2020] [Indexed: 11/25/2022] Open
Abstract
There is a well-established relationship between high ambient temperature and risk of death. However, the number of deaths attributable to heat each year in the United States remains incompletely quantified. METHODS We replicated the approach from a large, international study to estimate temperature-mortality associations in 297 United States counties and additionally calculated the number of deaths attributable to heat, a quantity of likely interest to policymakers and the public. RESULTS Across 297 counties representing 61.9% of the United States population in 2000, we estimate that an average of 5,608 (95% empirical confidence interval = 4,748, 6,291) deaths were attributable to heat annually, 1997-2006. CONCLUSIONS Our results suggest that the number of deaths related to heat in the United States is substantially larger than previously reported.
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Lightfoot J, Harris D, Haustead D. Challenge of managing patients with COVID-19 and acute behavioural disturbances. Emerg Med Australas 2020; 32:714-715. [PMID: 32319209 PMCID: PMC7264723 DOI: 10.1111/1742-6723.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
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Rocco M, Evans R, Sharma S, Claure-Del Granado R, Cullis B, Burdmann E, Hendricks K, Harris D. SUN-013 CAPACITY BUILDING FOR INTEGRATED CARE IN LOW RESOURCE SETTINGS: ISN KIDNEY CARE NETWORK PROJECT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Walton MK, Cappelleri JC, Byrom B, Goldsack JC, Eremenco S, Harris D, Potero E, Patel N, Flood E, Daumer M. Considerations for development of an evidence dossier to support the use of mobile sensor technology for clinical outcome assessments in clinical trials. Contemp Clin Trials 2020; 91:105962. [PMID: 32087341 DOI: 10.1016/j.cct.2020.105962] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/05/2020] [Accepted: 02/17/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mobile sensors offer enormous potential for the collection of informative clinical endpoints in clinical trials to support regulatory decision making and product labelling. There are currently no specific guidelines on the information needed to enable regulators to review and accept proposed endpoints derived from mobile sensors for use in drug development trials. OBJECTIVE The purpose of this working group report is to recommend the structure and content of an evidence dossier intended to support whether a clinical endpoint derived from mobile sensor data is fit-for-purpose for use in regulatory submissions for drug approvals. EVIDENCE DOSSIER The structure and content of a dossier to provide evidence supporting the use of a sensor-derived clinical endpoint is described. Sections include clinical endpoint definition and positioning, the concept of interest, the context of use, clinical validation and interpretation, study implementation, and analytical validity with sensor performance verification in support of the selected sensor. CONCLUSIONS In the absence of definitive regulatory guidance, this report provides a considered approach to compiling a comprehensive body of evidence to justify acceptance of mobile sensors for support of new drug applications.
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Gassner A, Harris D, Mausch K, Terheggen A, Lopes C, Finlayson RF, Dobie P. Poverty eradication and food security through agriculture in Africa: Rethinking objectives and entry points. OUTLOOK ON AGRICULTURE 2019; 48:309-315. [PMID: 33281227 PMCID: PMC7684531 DOI: 10.1177/0030727019888513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Agriculture in Africa is expected to meet the dual objectives of providing food and helping people to escape poverty. African agriculture is dominated by smallholdings and donors generally target their agricultural support at the smallholder sector. The expectation is that if the gap between actual and potential yields can be closed, smallholders will grow sufficient crops to feed their families, with a surplus to sell, thus meeting food security needs and bringing in an income to move them out of poverty. In practice, this is often not possible. While technologies already exist that can raise smallholder farmers' yields 3 or 4 times, even under rainfed conditions, the small size of land available to them limits how much can be grown and the per capita income from agriculture is insufficient to allow people to move above the current World Bank-defined poverty line of US$1.90 per day. We link this finding with farmer typologies to further explain that there are large differences between individual farming households themselves in terms of their investment incentives and capability to benefit from field-level technologies that are aimed at increasing farm productivity. We argue for more differentiated policies for agricultural development in Africa and suggest that policymakers should be much more aware of the heterogeneity of farms and target interventions accordingly. It is important to understand where and for whom agriculture will have the main purpose of ensuring food and nutritional security and where and for whom there is the potential for significant increases in incomes and a contribution to wider economic growth. Let us recognize the distinctiveness of these targets and underlying target groups and work towards solutions that address the underlying needs.
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Dansie K, Davies C, Hawley C, Johnson D, Craig J, Chapman J, Cooper B, Pollock C, Harris D, McDonald S. SAT-022 ASSOCIATION BETWEEN PUBLICATION OF THE INITIATING DIALYSIS EARLY AND LATE (IDEAL) STUDY AND CHANGE IN DIALYSIS INITIATION PRACTICE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pelland K, Morphis B, Harris D, Gardner R. Assessment of First-Year Use of Medicare's Advance Care Planning Billing Codes. JAMA Intern Med 2019; 179:827-829. [PMID: 30855643 PMCID: PMC6547145 DOI: 10.1001/jamainternmed.2018.8107] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This observational analysis characterizes the first year of use of the Medicare code for advance care planning and describes beneficiaries most likely to receive advance care planning.
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Harris D, Thomas K, Jutkowitz E. DOES TECHNOLOGY USE PROTECT AGAINST COGNITIVE DECLINE? RESULTS FROM A RETROSPECTIVE COHORT STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gilsenan A, Harding A, Kellier-Steele N, Harris D, Midkiff K, Andrews E. The Forteo Patient Registry linkage to multiple state cancer registries: study design and results from the first 8 years. Osteoporos Int 2018; 29:2335-2343. [PMID: 29978254 PMCID: PMC6154045 DOI: 10.1007/s00198-018-4604-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/13/2018] [Indexed: 11/05/2022]
Abstract
UNLABELLED The Forteo Patient Registry (FPR) aims to estimate the incidence of osteosarcoma in US patients treated with teriparatide. Enrollment began in 2009 and will continue through 2019, with linkage planned through 2024. To date, no incident cases of osteosarcoma have been identified among patients registered in the FPR. INTRODUCTION The Forteo Patient Registry (FPR) was established in 2009 to estimate the incidence of osteosarcoma in US patients treated with teriparatide. The objective of this paper is to describe study methods, challenges encountered, and progress to date. METHODS The FPR is a prospective US registry designed to link data from participants annually with state cancer registries. Patient enrollment is planned for 10 years (2009-2019) and annual linkage with US state cancer registries for 15 years (2010-2024). All US state cancer registries and DC were invited to participate. Patients are recruited using pre-enrollment materials included in teriparatide device packaging, kits, and brochures distributed by health-care providers; a toll-free number; and a study website. A linkage algorithm is used to match data from enrolled participants with cancer registry data. RESULTS For the eighth annual linkage in 2017, information necessary for linkage with 63,270 patients in the FPR was submitted to each of the 42 participating registries. These patients contributed approximately 242,782 person-years of follow-up. A total of 5268 adult osteosarcoma cases diagnosed since January 1, 2009, were available for linkage from participating state cancer registries. To date, no incident cases of osteosarcoma have been identified among patients registered in the FPR. CONCLUSIONS Based on the estimated 242,782 person-years of observation as of the eighth annual linkage and projecting current enrollment rate to study end in 2024, it is anticipated that the completed study will be able to detect a fourfold increase in the risk of osteosarcoma if one exists.
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Jones HG, Qasem E, Dilaver N, Egan R, Bodger O, Kokelaar R, Evans MD, Davies M, Beynon J, Harris D. Inflammatory cell ratios predict major septic complications following rectal cancer surgery. Int J Colorectal Dis 2018; 33:857-862. [PMID: 29705942 DOI: 10.1007/s00384-018-3061-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The inflammatory response is known to have an important role in tumourigenesis and the response to treatment. Previous studies have demonstrated that inflammatory cell ratios such as the neutrophil-to-lymphocyte ratio (NLR) can predict survival and recurrence following surgery for various cancers. The objective of this study was to demonstrate if pre-operative NLR has a role in predicting post-operative septic complications in patients undergoing rectal cancer surgery. METHODOLOGY Consecutive patients undergoing scheduled resection for rectal cancer in a tertiary centre from July 2007 to Dec 2015 were included. Data was gathered from a prospectively held database of rectal cancer. Normally distributed data were compared with paired t tests (mean ± standard error in the mean (SEM)), and proportions were compared with Fisher's exact test. A p value of < 0.05 was considered statistically significant. RESULTS Three hundred fourteen patients were identified in this study. Sixty nine (22.0%) patients had a major septic complication following surgery for rectal cancer, which was associated with a poor survival outcome (p < 0.01) Both pre and post-operative NLR and PLR (platelet lymphocyte ratio) were associated with post-operative septic complications (both p < 0.01). A pre-operative NLR threshold level of 4 was chosen from ROC analysis, and this provided a relatively specific test to predict post-operative septic complications in these patients (specificity = 83.7%, negative predictive value (NPV) = 74.8%). DISCUSSION In this study, the pre-operative NLR and PLR were both predictive of major post-operative septic complications. A pre-operative NLR of less than 4 was strongly negative predictor of post-operative complications in rectal cancer surgery. It can be regarded as a predictive and prognostic factor for these patients.
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Harris D, Visser J, Hurwitz P, Dietze D. 253 Physician- and Patient-reported Outcomes Following Use of a Compounded Scar/Burn Gel: Results from a Prospective Observational Survey Study. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Harris D, Lacey A, Akbari A, Gravenor MB, Halcox J. EARLY DISCONTINUATION OF P2Y12 ANTAGONISTS AND ADVERSE CLINICAL OUTCOMES POST PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)30615-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harris D, McNicoll L, Epstein-Lubow G, Thomas KS. Association between anxious symptoms and sleeping medication use among US older adults. Int J Geriatr Psychiatry 2018; 33:e307-e313. [PMID: 28960462 PMCID: PMC5773373 DOI: 10.1002/gps.4795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/11/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the relationship between anxiety symptoms and sleeping medication use among a nationally representative sample of US older adults. DESIGN Cross-sectional design using data from the 2011 National Health and Aging Trends Study to examine the relationship between anxiety symptoms as rated by the Generalized Anxiety Disorder-2 and self-reported sleeping medication use. Survey weights were applied to account for complex survey design. Logistic regression was used to measure the association between anxiety symptoms and sleeping medication use after adjusting for sociodemographic factors, physical health, and other sleep-related issues. RESULTS In 2011, 13.1% of respondents experienced high anxiety symptoms and 29.0% reported taking a sleeping medication at least once a week during the last 30 days. Results estimate that approximately 4 million US older adults have clinically significant anxiety symptoms and approximately 10 million US older adults used a sleeping medication in the last 30 days. Adjusted results revealed that high anxiety symptoms are significantly associated with sleeping medication use compared to low anxiety symptoms (AOR = 1.57; 95% CI, 1.29-1.91). Depression symptoms were also associated with sleeping medication (AOR = 1.29; 95% CI, 1.08-1.55). CONCLUSIONS Results demonstrated that anxiety symptoms are significantly associated with sleeping medication use among US older adults. We also found that depressive symptoms, chronic conditions, and worse self-rated health are associated with sleeping medication use. As sleeping medications are associated with adverse health events, these results have clinical implications for treating anxiety symptoms among older patients.
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O'Dwyer D, Williams A, Khan U, Harris D, Evans M, Davies M. NELA - Identifying Factors to Improve Mortality Rates. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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