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Li D, Singh S, Zhang CD, Kaur RJ, Ebbehoj A, Atkinson EJ, Achenbach SJ, Stricker NH, Mielke MM, Rocca W, Bancos I. Risk of dementia and psychiatric or sleep disorders after diagnosis of adrenal adenomas: a population-based cohort study. Eur J Endocrinol 2023; 189:429-437. [PMID: 37801659 PMCID: PMC10581402 DOI: 10.1093/ejendo/lvad135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/25/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE Adrenal adenomas are commonly encountered in clinical practice. To date, population-based data on their impact on cognition, mental health, and sleep are lacking. We aimed to study possible associations between adrenal adenomas and dementia, psychiatric or sleep disorders. DESIGN Population-based cohort study, Olmsted County, MN, 1995-2017. METHODS Patients with adrenal adenoma and absent overt hormone excess were age- and sex-matched 1:1 to a referent person without adrenal adenoma. Outcomes were baseline and incident diagnoses of dementia, psychiatric or sleep disorders, assessed using ICD codes. RESULTS Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years. At baseline, and after adjusting for age, sex, education, BMI, and tobacco use, patients with adenoma had higher odds of depression (adjusted odds ratio, aOR: 1.3, 95% CI, 1.1-1.6), anxiety (aOR: 1.4, 95% CI, 1.1-1.8), and substance abuse (aOR: 2.4, 95% CI, 1.7-3.4) compared to referents. During a median follow-up of 6.8 years, and after adjusting for age, sex, socioeconomic status, BMI, tobacco, and substance abuse, patients demonstrated a higher risk of psychiatric and sleep disorders [adjusted hazard ratio (95% CI)]: depression [1.7 (1.3-2.2)], anxiety [1.4, CI (1.1-1.7)], insomnia [1.4 (1.0-1.9)], sleep-related breathing disorders [1.5 (1.1-1.9)], hypersomnias [2.1 (1.0-4.2)], parasomnias [2.1 (1.0-4.2)], and sleep-related movement disorders [1.5 (1.0-2.1)], but not dementia. CONCLUSIONS Patients with adenomas demonstrate a higher incidence of psychiatric and sleep disorders, possibly due to the underlying subtle increase in cortisol secretion.
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Affiliation(s)
- Dingfeng Li
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
- Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
| | - Sumitabh Singh
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Catherine D Zhang
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
- Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Ravinder Jeet Kaur
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
| | - Andreas Ebbehoj
- Department of Clinical Medicine, Department of Endocrinology and Diabetes, Aarhus University, Aarhus 8200, Denmark
| | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States
| | - Sara J Achenbach
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States
| | - Nikki H Stricker
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, United States
| | - Michelle M Mielke
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States
| | - Walter Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States
- Women’s Health Research Center, Mayo Clinic, Rochester, MN 55905, United States
| | - Irina Bancos
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
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St. Sauver J, Fu S, Sohn S, Weston S, Fan C, Olson J, Thorsteinsdottir B, LeBrasseur N, Pagali S, Rocca W, Liu H. Identification of delirium from real-world electronic health record clinical notes. J Clin Transl Sci 2023; 7:e187. [PMID: 37745932 PMCID: PMC10514685 DOI: 10.1017/cts.2023.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction We tested the ability of our natural language processing (NLP) algorithm to identify delirium episodes in a large-scale study using real-world clinical notes. Methods We used the Rochester Epidemiology Project to identify persons ≥ 65 years who were hospitalized between 2011 and 2017. We identified all persons with an International Classification of Diseases code for delirium within ±14 days of a hospitalization. We independently applied our NLP algorithm to all clinical notes for this same population. We calculated rates using number of delirium episodes as the numerator and number of hospitalizations as the denominator. Rates were estimated overall, by demographic characteristics, and by year of episode, and differences were tested using Poisson regression. Results In total, 14,255 persons had 37,554 hospitalizations between 2011 and 2017. The code-based delirium rate was 3.02 per 100 hospitalizations (95% CI: 2.85, 3.20). The NLP-based rate was 7.36 per 100 (95% CI: 7.09, 7.64). Rates increased with age (both p < 0.0001). Code-based rates were higher in men compared to women (p = 0.03), but NLP-based rates were similar by sex (p = 0.89). Code-based rates were similar by race and ethnicity, but NLP-based rates were higher in the White population compared to the Black and Asian populations (p = 0.001). Both types of rates increased significantly over time (both p values < 0.001). Conclusions The NLP algorithm identified more delirium episodes compared to the ICD code method. However, NLP may still underestimate delirium cases because of limitations in real-world clinical notes, including incomplete documentation, practice changes over time, and missing clinical notes in some time periods.
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Affiliation(s)
- Jennifer St. Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Sunyang Fu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Susan Weston
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Chun Fan
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Janet Olson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Nathan LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Walter Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Women’s Health Research Center, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
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St Sauver J, Rocca W, LeBrasseur N, Chamberlain A, Olson J, Jacobson D, McGree M, Mielke M. Inflammatory biomarkers, multi-morbidity, and biologic aging. J Int Med Res 2022; 50:3000605221109393. [PMID: 35796512 PMCID: PMC9274410 DOI: 10.1177/03000605221109393] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives To study the association between multi-morbidity percentiles, which is a
measure of clinical aging, and interleukin (IL)-6, IL-10, and tumor necrosis
factor (TNF)-α. Methods Participants 50 to 95 years of age from the Mayo Clinic Study of Aging were
assigned age- and sex-specific multi-morbidity percentiles using look-up
tables that were reported previously (n = 1646). Percentiles were divided
into quintiles for analysis. Plasma IL-6, IL-10, and TNF-α levels were
measured in 1595 participants. Median inflammatory marker levels were
compared across multi-morbidity quintiles using nonparametric tests. Results People with higher multi-morbidity percentiles had significantly higher IL-6
and TNF-α levels compared with those with lower multi-morbidity percentiles.
Tests for trend across five multi-morbidity quintiles were significant among
women for IL-6 and among participants 70 years of age or older for IL-6 and
TNF-α. IL-10 was not associated with multi-morbidity percentiles. Conclusions Multi-morbidity percentiles may be a useful clinical index of biological age
for future studies, particularly in women and people 70 years of age and
older.
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Affiliation(s)
- Jennifer St Sauver
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Walter Rocca
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Nathan LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota.,Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Alanna Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Janet Olson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Debra Jacobson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Michaela McGree
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Michelle Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.,Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Rocca W. Neurological disorders, sex and gender: Effects of biological and socio-cultural differences. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li D, Kaur RJ, Zhang CD, Ebbehoj A, Singh S, Atkinson EJ, Achenbach SJ, Rocca W, Khosla S, Bancos I. Risk of bone fractures after the diagnosis of adrenal adenomas: a population-based cohort study. Eur J Endocrinol 2021; 184:597-606. [PMID: 33606665 PMCID: PMC7974392 DOI: 10.1530/eje-20-1396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/19/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Several small studies reported increased prevalence and incidence of asymptomatic vertebral fractures in patients with non-functioning adrenal adenomas and adenomas with mild autonomous cortisol secretion. However, the risk of symptomatic fractures at vertebrae, and at other sites remains unknown. Our objective was to determine the prevalence and incidence of symptomatic site-specific fractures in patients with adrenal adenomas. DESIGN Population-based cohort study, Olmsted County, Minnesota, USA, 1995-2017. METHODS Participants were the patients with adrenal adenoma and age/sex-matched referent subjects. Patients with overt hormone excess were excluded. Main outcomes measures were prevalence and incidence of bone fractures. RESULTS Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years (20-96). At the time of diagnosis, patients had a higher prevalence of previous fractures than referent subjects (any fracture: 47.9% vs 41.3%, P = 0.003, vertebral fracture: 6.4% vs 3.6%, P = 0.004, combined osteoporotic sites: 16.6% vs 13.3%, P = 0.04). Median duration of follow-up was 6.8 years (range: 0-21.9 years). After adjusting for age, sex, BMI, tobacco use, prior history of fracture, and common causes of secondary osteoporosis, patients with adenoma had hazard ratio of 1.27 (95% CI: 1.07-1.52) for developing a new fracture during follow up when compared to referent subjects. CONCLUSIONS Patients with adrenal adenomas have higher prevalence of fractures at the time of diagnosis and increased risk to develop new fractures when compared to referent subjects.
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Affiliation(s)
- Dingfeng Li
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Ravinder Jeet Kaur
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Catherine D. Zhang
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Andreas Ebbehoj
- Department of Clinical Medicine, Department of Endocrinology and Diabetes, Aarhus University, Aarhus, Denmark
| | - Sumitabh Singh
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth J. Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Sara J. Achenbach
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter Rocca
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Women’s Health Research Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Sundeep Khosla
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Irina Bancos
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
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Coon EA, Rocca W, Melson CS, Ahlskog JE, Matsumoto JY, Low PA, Singer W. Conjugal multiple system atrophy: Chance, shared risk factors, or evidence of transmissibility? Parkinsonism Relat Disord 2019; 67:10-13. [PMID: 31621598 PMCID: PMC6858521 DOI: 10.1016/j.parkreldis.2019.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/28/2019] [Accepted: 09/12/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe conjugal multiple system atrophy (MSA) in a couple married for 44 years, and to report environmental risk factors possibly contributing to the occurrence. METHODS Case description of conjugal MSA with report of shared environmental risk factors and retrospective review of consecutively diagnosed MSA patients between 1998 and 2012 with autonomic reflex screen at Mayo Clinic, Rochester (clinical series). Probability calculation was based on the age-specific point prevalence of MSA. RESULTS A husband and wife both developed MSA symptoms at age 63. The husband's onset was of imbalance, followed by falls and genitourinary failure; parkinsonism and antecollis was evident on examination. Autonomic testing showed widespread autonomic failure. The patient died 2.25 years after onset. The wife initially developed urinary symptoms progressing to incontinence. Parkinsonism, dysphonia, and falls began within 1 year. Autonomic testing revealed severe autonomic failure. Interview with the surviving wife and son revealed substantial chemical exposure, in particular pesticides. In our clinical series, there were no other cases of conjugal MSA. Assuming an age-specific point prevalence of MSA based on population studies and independence of the two events, the probability of both individuals developing MSA by chance is 6.08 e-9. CONCLUSION Based on the population point prevalence of MSA, conjugal MSA is rare but possible. We conclude that this case of conjugal MSA likely occurred by chance; however, exposure to shared risk factors (pesticides) may be contributory. Because this is the first reported case of conjugal MSA, to our best knowledge, evidence for transmissibility between spouses is lacking.
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Affiliation(s)
| | - Walter Rocca
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - J Eric Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Philip A Low
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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Rocca W. MULTIMORBIDITY IN POPULATION STUDIES: THE ROCHESTER EPIDEMIOLOGY PROJECT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W Rocca
- Mayo Clinic, Rochester, Minnesota, United States
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Lowe VJ, Tosakulwong N, Lesnick TG, Gunter JL, Senjem ML, Shuster LT, Mielke MM, Bailey KR, Jack CR, Rocca W, Miller VM, Kantarci K. IC‐P‐033: Treatment with 17β‐estradiol in postmenopausal women is associated with lower PiB‐PET retention. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lowe VJ, Tosakulwong N, Lesnick TG, Gunter JL, Senjem ML, Shuster LT, Mielke MM, Bailey KR, Jack CR, Rocca W, Miller VM, Kantarci K. O3‐01‐02: Treatment with 17β‐estradiol in postmenopausal women is associated with lower PiB‐PET retention. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rocca W. FTS‐03‐02: Half a century of medical records linkage in the rochester epidemiology project. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rocca W. Neurological consequences of premature ovarian failure. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rocca W. Prophylactic ophorectomy: primum non nocere. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Roberts R, Przybelski S, Weigand S, Kantarci K, Preboske G, Senjem M, Murphy M, Geda Y, Knopman D, Mielke M, Rocca W, Jack C, Petersen R. O1‐03‐03: Vascular risk factors in mid‐life increase structural MRI abnormalities in late life: The Mayo Clinic Study of Aging. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Yonas Geda
- Mayo Clinic College of MedicineRochesterMinnesotaUnited States
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Savica R, Grossardt B, Ahlskog J, Bower J, Rocca W. Incidence and Distribution of Parkinsonism in Olmsted County Minnesota, 1991-2005 (S42.007). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s42.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Roberts R, Geda Y, Knopman D, Cha R, Pankratz V, Mielke M, Boeve B, Tangalos E, Ivnik R, Rocca W, Petersen R. Does Progression and Mortality in Mild Cognitive Impairment Vary in Men and Women? The Mayo Clinic Study of Aging (P07.155). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Knopman D, Roberts R, Pankratz V, Geda Y, Mielke M, Cha R, Boeve B, Tangalos E, Rocca W, Petersen R. Risk of Dementia in Persons Who Refused To Participate in a Longitudinal Study of Cognitive Aging (P01.083). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Roberts R, Knopman D, Boeve B, Geda Y, Pankratz V, Cha R, Rocca W. P3‐116: Outcomes of MCI: The Mayo Clinic study of aging. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Yonas Geda
- Mayo ClinicRochesterMinnesotaUnited States
| | | | - Ruth Cha
- Mayo ClinicRochesterMinnesotaUnited States
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Rocca W. Mayo Clinic office visit. Prophylactic oophorectomy. An interview with Walter Rocca, M.D. Mayo Clin Womens Healthsource 2011; 15:6. [PMID: 21540789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Abstract
Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced in order to prevent the subsequent development of ovarian cancer or other ovarian pathology that might require additional surgery. At present, bilateral oophorectomy is performed in 78% of women aged between 45 and 64 years having a hysterectomy, and a total of approximately 300,000 prophylactic oophorectomies are performed in the USA every year. Estrogen deficiency resulting from pre- and post-menopausal oophorectomies has been associated with higher risks of coronary heart disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression and anxiety in many studies. While ovarian cancer accounts for 14,800 deaths per year in the USA, coronary heart disease accounts for 350,000 deaths per year. In addition, 100,000 cases of dementia may be attributable annually to prior bilateral oophorectomy. At present, observational studies suggest that bilateral oophorectomy may do more harm than good. In women who are not at high risk of developing ovarian or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution.
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Affiliation(s)
- William H Parker
- John Wayne Cancer Institute at Saint John's Medical Center, 2200 Santa Monica Blvd., Santa Monica, CA 90404, USA.
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Bronstein J, Carvey P, Chen H, Cory-Slechta D, DiMonte D, Duda J, English P, Goldman S, Grate S, Hansen J, Hoppin J, Jewell S, Kamel F, Koroshetz W, Langston JW, Logroscino G, Nelson L, Ravina B, Rocca W, Ross GW, Schettler T, Schwarzschild M, Scott B, Seegal R, Singleton A, Steenland K, Tanner CM, Van Den Eeden S, Weisskopf M. Meeting report: consensus statement-Parkinson's disease and the environment: collaborative on health and the environment and Parkinson's Action Network (CHE PAN) conference 26-28 June 2007. Environ Health Perspect 2009; 117:117-121. [PMID: 19165397 PMCID: PMC2627854 DOI: 10.1289/ehp.11702] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 08/25/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder. People with PD, their families, scientists, health care providers, and the general public are increasingly interested in identifying environmental contributors to PD risk. METHODS In June 2007, a multidisciplinary group of experts gathered in Sunnyvale, California, USA, to assess what is known about the contribution of environmental factors to PD. RESULTS We describe the conclusions around which they came to consensus with respect to environmental contributors to PD risk. We conclude with a brief summary of research needs. CONCLUSIONS PD is a complex disorder, and multiple different pathogenic pathways and mechanisms can ultimately lead to PD. Within the individual there are many determinants of PD risk, and within populations, the causes of PD are heterogeneous. Although rare recognized genetic mutations are sufficient to cause PD, these account for < 10% of PD in the U.S. population, and incomplete penetrance suggests that environmental factors may be involved. Indeed, interplay among environmental factors and genetic makeup likely influences the risk of developing PD. There is a need for further understanding of how risk factors interact, and studying PD is likely to increase understanding of other neurodegenerative disorders.
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Affiliation(s)
| | - Paul Carvey
- Rush University Medical Center, Chicago, Illinois, USA
| | - Honglei Chen
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Deborah Cory-Slechta
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Donato DiMonte
- The Parkinson’s Institute and Clinical Center, Sunnyvale, California, USA
| | - John Duda
- Parkinson’s Disease Research, Education, and Clinical Center, Philadelphia, Pennsylvania, USA
| | - Paul English
- California Department of Health Services, Oakland, California, USA
| | - Samuel Goldman
- The Parkinson’s Institute and Clinical Center, Sunnyvale, California, USA
| | - Stephen Grate
- U.S. Army Medical Research and Material Command, Fort Detrick, Maryland, USA
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Jane Hoppin
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Sarah Jewell
- The Parkinson’s Institute and Clinical Center, Sunnyvale, California, USA
| | - Freya Kamel
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Walter Koroshetz
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - James W. Langston
- The Parkinson’s Institute and Clinical Center, Sunnyvale, California, USA
| | | | - Lorene Nelson
- Stanford University School of Medicine, Stanford, California, USA
| | - Bernard Ravina
- University of Rochester School of Medicine, Rochester, New York, USA
| | | | - George W. Ross
- Pacific Health Research Institute, Honolulu, Hawaii, USA
| | - Ted Schettler
- Science and Environmental Health Network, Ames, Iowa, USA
| | | | - Bill Scott
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Richard Seegal
- New York State Department of Health, Albany, New York, USA
| | | | | | - Caroline M. Tanner
- The Parkinson’s Institute and Clinical Center, Sunnyvale, California, USA
| | | | - Marc Weisskopf
- Harvard School of Public Health, Boston, Massachusetts, USA
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21
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Litvan I, Halliday G, Hallett M, Goetz CG, Rocca W, Duyckaerts C, Ben-Shlomo Y, Dickson DW, Lang AE, Chesselet MF, Langston WJ, Di Monte DA, Gasser T, Hagg T, Hardy J, Jenner P, Melamed E, Myers RH, Parker D, Price DL. The etiopathogenesis of Parkinson disease and suggestions for future research. Part I. J Neuropathol Exp Neurol 2007; 66:251-7. [PMID: 17413315 DOI: 10.1097/nen.0b013e3180415e42] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Irene Litvan
- University of Louisville School of Medicine, Louisville, Kentucky 40202, USA.
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22
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Litvan I, Chesselet MF, Gasser T, Di Monte DA, Parker D, Hagg T, Hardy J, Jenner P, Myers RH, Price D, Hallett M, Langston WJ, Lang AE, Halliday G, Rocca W, Duyckaerts C, Dickson DW, Ben-Shlomo Y, Goetz CG, Melamed E. The Etiopathogenesis of Parkinson Disease and Suggestions for Future Research. Part II. J Neuropathol Exp Neurol 2007; 66:329-36. [PMID: 17483689 DOI: 10.1097/nen.0b013e318053716a] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We are at a critical juncture in our knowledge of the etiology and pathogenesis of Parkinson disease (PD). It is clear that PD is not a single entity simply resulting from a dopaminergic deficit; rather it is most likely caused by a combination of genetic and environmental factors. Although there is extensive new information on the etiology and pathogenesis of PD, which may advance its treatment, new syntheses of this information are needed. The second part of this two-part, state-of-the-art review by leaders in PD research critically examines the research field to identify areas for which new knowledge and ideas might be helpful for treatment purposes. Topics reviewed in Part II are genetics, animal models, and oxidative stress.
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Affiliation(s)
- Irene Litvan
- University of Louisville School of Medicine, Louisville, Kentucky 40202, USA.
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23
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Beghi E, Azzoni A, Benedetti D, Bordo B, Bottacchi E, Monetti C, Rocca W. [Study group: "Evaluation of the efficacy of therapeutic treatments in epilepsy"]. Epidemiol Prev 1990; 12:21-7. [PMID: 2149105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- E Beghi
- Istituto di Ricerche Farmacologiche, Mario Negri, Milano
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