Now showing items 1-20 of 6582

    • Use of venous-thrombotic-embolic prophylaxis in patients undergoing surgery for renal tumors: a questionnaire survey in the Nordic countries (The NORENCA-2 study)

      Lund, Lars; Nisen, Harry; Jarvinen, Petrus; Fovaeus, Magnus; Gudmundson, Eirikur; Kromann-Andersen, Bjarne; Ljungberg, Borje; Nilsen, Frode; Sundqvist, Pernilla; Clark, Peter E; Beisland, Christian; [ 1 ] Odense Univ Hosp, Dept Urol, JB Winsloew Vej 4,Entrance 20,Penthouse,2 Floor, DK-5000 Odense C, Denmark [ 2 ] Southern Univ Denmark, Clin Inst, Odense, Denmark Show more [ 3 ] Helsinki Univ Hosp, Dept Urol, Helsinki, Finland Show more [ 4 ] Sahlgrens Univ Hosp, Dept Urol, Gothenburg, Sweden Show more [ 5 ] Landspitali Univ Hosp, Dept Urol, Reykjavik, Iceland Show more [ 6 ] Herlev Univ Hosp, Dept Urol, Copenhagen, Denmark Show more [ 7 ] Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden Show more [ 8 ] Akershus Univ Hosp, Dept Urol, Lorenskog, Norway Show more [ 9 ] Orebro Univ, Fac Med & Hlth, Dept Urol, Orebro, Sweden [ 10 ] Atrium Hlth, Dept Urol, Charlotte, NC USA Show more [ 11 ] Haukeland Hosp, Dept Urol, Bergen, Norway Show more [ 12 ] Univ Bergen, Dept Clin Med, Bergen, Norway (Dove Medical Press, 2018-10-25)
      Purpose: To examine the variation in venous thromboembolism prophylactic treatment (VTEP) among renal cancer patients undergoing surgery. Materials and methods: An Internet-based questionnaire on renal tumor management before and after surgery was mailed to all Nordic departments of urology. The questions focused on the use of VTEP and were subdivided into different surgical modalities. Results: Questionnaires were mailed to 91 institutions (response rate 53%). None of the centers used VTEP before surgery, unless the patient had a vena caval tumor thrombus. Overall, the VTEP utilized during hospitalization for patients undergoing renal surgery included early mobilization (45%), compression stockings (52%) and low-molecular-weight heparin (89%). In patients undergoing open radical Nx, 80% of institutions used VTEP during their hospitalization (23% compression stockings and 94% low-molecular-weight heparin). After leaving the hospital, the proportion and type of VTEP received varied considerably across institutions. The most common interval, used in 60% of the institutions, was for a period of 4 weeks. The restriction to the Nordic countries was a limitation and, therefore, may not reflect the practice patterns elsewhere. It is a survey study and, therefore, cannot measure the behaviors of those institutions that did not participate. Conclusion: We found variation in the type and duration of VTEP use for each type of local intervention for renal cancer. These widely disparate variations in care strongly argue for the establishment of national and international guidelines regarding VTEP in renal surgery.
    • Lækningar í Íslendingasögum

      Óttar Guðmundsson; Formaður Félags áhugamanna um sögu læknisfræðinnar (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-11)
    • Risafituæxli á kvið - sjúkratilfelli

      Bryndís Ester Ólafsdóttir; Halla Fróðadóttir; Rebekka Guðrún Rúnarsdóttir; Elsa Björk Valsdóttir; 1) 2) Skurðsviði Landspítala 3) meinafræðideild Landspítala 4) Skurðsviði Landspítala‚ læknadeild Háskóla Íslands (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-11)
      Fituæxli eru algeng góðkynja mjúkvefjaæxli, oftast lítil, hægvaxandi og einkennalaus. Hér er lýst tilfelli 52 ára konu í mikilli yfirþyngd sem leitaði læknis vegna stækkandi æxlis ofan við lífbein sem var á stærð við fótbolta. Æxlið hafði farið vaxandi síðustu 8 mánuði. Uppvinnsla gaf vísbendingu að um fituæxli væri að ræða. Sjúklingurinn undirgekkst aðgerð þar sem æxlið var fjarlægt. Vefjagreiningin sýndi fituæxli án illkynja vaxtar. Fituæxli eru fjarlægð þegar stærð þeirra er farin að valda einkennum eða útiloka þarf illkynja mein. Risafituæxli eru skilgreind sem fituæxli yfir 10 cm í þvermál eða sem vega meira en 1000 grömm.
    • Langtímahorfur sjúklinga með bráða kransæðastíflu

      Einar Logi Snorrason; Bergrós Kristín Jóhannesdóttir; Thor Aspelund; Vilmundur Guðnason; Karl Andersen; 1 Læknadeild Háskóla Íslands, 2 Haukeland Universitetssjukehus, Bergen, 3 Hjartavernd, 4 hjartadeild 14EG Landspítala (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-11)
      Inngangur: Hratt lækkandi dánartíðni vegna kransæðasjúkdóma á Íslandi helst í hendur við samsvarandi lækkandi nýgengi kransæðastíflu á undanförnum þremur áratugum. Markmið þessarrar rannsóknar var að bera saman langtímalifun einstaklinga með NSTEMI (Non-ST elevation myocardial infarction) og STEMI (ST elevation myocardial infarction) og kanna áhrif áhættuþátta á lifun. Efniviður og aðferðir: Rannsóknin náði til allra sjúklinga sem greindust með bráða kransæðastíflu á Landspítala árið 2006. Upplýsingar um áhættuþætti hjarta- og æðasjúkdóma og greiningar voru fengnar úr Sögukerfi spítalans. Sjúklingum var fylgt eftir fram til 1. janúar 2015. Endapunktur rannsóknarinnar var andlát af hvaða orsök sem er. Samsettur endapunktur var dauðsfall eða endurinnlögn vegna kransæðastíflu. Niðurstöður: Á árinu 2006 greindust 447 einstaklingar með bráða kransæðastíflu á Landspítala, þar af voru 280 með NSTEMI (I21.4) og 167 með STEMI (I21 - I21.9). Nýgengi NSTEMI árið 2006 var 91,3 á hverja 100.000 íbúa. Nýgengi STEMI árið 2006 var 55,9 á hverja 100.000 íbúa. Meðalaldur NSTEMI-sjúklinga var 73,0 ár. Konur með NSTEMI voru að meðaltali 8,4 árum eldri en karlar með NSTEMI (konur 78,3 ár og karlar 69,9 ár). Meðalaldur STEMI-sjúklinga var 65,3 ár. Konur með STEMI voru að meðaltali 7,3 árum eldri en karlar með STEMI (konur 70,4 ár og karlar 63 ár). Fimm ára lifun NSTEMI-sjúklinga var 51%, 42% meðal kvenna og 57% meðal karla. Fimm ára lifun STEMI sjúklinga var 77%, 68% meðal kvenna og 80% meðal karla (logrank: p<0,01). Eftir aldursleiðréttingu var marktækt verri langtímalifun eftir NSTEMI samanborið við STEMI. Ályktanir: Nýgengi NSTEMI var hærra en STEMI á Íslandi árið 2006. Konur höfðu verri langtímahorfur en karlar, sem skýrist af hærri meðal­aldri þeirra. Langtímalifun NSTEMI-sjúklinga var verri en lifun STEMI sjúklinga þrátt fyrir aldursleiðréttingu.
    • Nóbelsverðlaunin í læknisfræði 2018 – bylting í meðferð krabbameina

      Örvar Gunnarsson; Landspítala (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-11)
    • Fjölmiðlar og heilbrigðiskerfið

      Magnús Haraldsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-11)
    • Framhaldsmenntun lækna á Íslandi

      Tómas Þór Ágústsson; Landspítala (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • Af læknanámi

      Kristján Erlendsson; Kennslustjóri læknadeildar HÍ (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • ÚR LÆKNABLAÐINU 1919: Inflúensan fyrrum og nú

      Þórður Thoroddsen (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • Sérnám í forgrunni

      Reynir Tómas Geirsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • Aldarafmæli spænsku veikinnar og viðbrögð við skæðum farsóttum á 21. öld

      Magnús Gottfreðsson; Ritstjóri Læknablaðsins (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • Peutz-Jeghers-heilkenni með garnasmokkun

      Gísli Gunnar Jónsson; Jórunn Atladóttir; Skurðlækningasviði Landspítala Hringbraut
      Hér er lýst tilfelli sjúklings með staðfest Peutz-Jeghers-heilkenni á grundvelli jákvæðrar vefjagreiningar samhliða litabreytingum á vörum. Þessi sjúklingur greindist ekki fyrr en hann fékk innsmokkun á mjógirni. Hægt hefði verið að greina hann fyrr á ævinni vegna fyrrgreindra litabreytinga og sögu um tíð kviðverkjaköst
    • Body mass index standard deviation score and obesity in children with type 1 diabetes in the Nordic countries. HbA and other predictors of increasing BMISDS.

      Birkebaek, N H; Kahlert, J; Bjarnason, R; Drivvoll, A K; Johansen, A; Konradsdottir, E; Pundziute-Lyckå, A; Samuelsson, U; Skrivarhaug, T; Svensson, J; [ 1 ] Aarhus Univ, Aarhus Univ Hosp, Dept Paediat, Aarhus, Denmark Show more [ 2 ] Aarhus Univ Hosp, Dept Clin Epidemiol, Aarhus, Denmark Show more [ 3 ] Landspitali Univ Hosp, Reykjavik, Iceland Show more [ 4 ] Univ Iceland, Fac Med, Reykjavik, Iceland Show more [ 5 ] Oslo Univ Hosp, Div Paediat & Adolescent Med, Oslo, Norway Show more [ 6 ] Rigshosp, Dept Growth & Reprod, Copenhagen, Denmark Show more [ 7 ] Univ Iceland, Sch Hlth Sci, Reykjavik, Iceland Show more [ 8 ] Queen Silvia Childrens Hosp, Gothenburg, Sweden [ 9 ] Linkobing Univ Hosp, Dept Pediat, Linkoping, Sweden Show more [ 10 ] Univ Copenhagen, Herlev Hosp, Dept Paediat, Copenhagen, Denmark (Wiley, 2018-11-01)
      Intensified insulin therapy may increase body weight and cause obesity. This study compared body mass index standard deviation score (BMISDS) and obesity rate in children with type 1 diabetes (T1D) in Denmark, Iceland, Norway and Sweden, and uncovered predictors for increasing BMISDS. Data registered in the Nordic national childhood diabetes databases during the period 2008-2012 on children below 15 years with T1D for more than 3 months were compiled, including information on gender, age, diabetes duration, hemoglobin A Totally, 11 025 children (48% females) (30 994 registrations) were included. Medians by the last recorded examination were: age, 13.5 years; diabetes duration, 4.3 years; HbA Obesity rate in children with T1D in the Nordic countries is high, however, with country differences. Low HbA
    • The Effect of Maternal Age on Obstetric Interventions in a Low-Risk Population.

      Einarsdóttir, Kristjana; Bogadóttir, Hjördís Ýr; Bjarnadóttir, Ragnheiður Ingibjörg; Steingrímsdóttir, Þóra; [ 1 ] Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Sturlugata 8, IS-101 Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Fac Med, Reykjavik, Iceland Show more [ 3 ] Landspitali Univ Hosp, Ctr Dev Primary Hlth Care Capital Area, Reykjavik, Iceland Show more [ 4 ] Landspitali Univ Hosp, Dept Obstet & Gynaecol, Reykjavik, Iceland (Wiley, 2018-09-19)
      Obstetric interventions appear to increase with advancing maternal age, but limited supporting evidence exists, particularly for young women and specifically for prelabor and intrapartum cesarean birth. The aim of this study was to explore the association between obstetric interventions and maternal age in a low-risk population. The study was restricted to all low-risk, nulliparous women with singleton, vertex, term births who gave birth in Iceland from 1997 to 2015, identified in the Icelandic Medical Birth Registry. Logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% CIs for the risks of labor induction, instrumental birth, and cesarean birth (prelabor and intrapartum), according to maternal age group. All models were adjusted for gestational age, year of birth, and demographic factors, and the models for intrapartum cesarean birth were also adjusted for dystocia and fetal distress. For women aged more than 40 years, the aOR for induction of labor was 4.69 (95% CI, 3.2-6.8) compared with women aged between 25 and 29 years. In women aged more than 40 years, the increased risks for prelabor cesarean birth and intrapartum cesarean birth were 7.4 (95% CI, 3.0-18.0) and 3.6 (95% CI, 2.1-6.0), respectively. The risk of instrumental birth was slightly increased for women aged between 35 and 39 years (aOR, 1.6; 95% CI, 1.3-2.0), compared with women aged between 25 and 29 years, but not for women aged at least 40 years (aOR, 1.1; 95% CI, 0.7-1.9). For women aged less than 20 years, the risk of induction of labor (aOR, 0.8; 95% CI, 0.7-0.9) and instrumental births (aOR, 0.6; 95% CI, 0.5-0.7) was reduced compared with women aged between 25 and 29 years. The risk of interventions generally increased with increasing maternal age, but the risk of instrumental births was not increased for women aged over 40 years. Also, young women were at a decreased risk of induction of labor and instrumental births.
    • Impact of the 10-valent pneumococcal conjugate vaccine on antimicrobial prescriptions in young children: a whole population study.

      Eythorsson, Elias; Sigurdsson, Samuel; Hrafnkelsson, Birgir; Erlendsdóttir, Helga; Haraldsson, Ásgeir; Kristinsson, Karl G; 1 University of Iceland, Faculty of Medicine, 101, Reykjavík, Iceland. 2 Department of Mathematics, University of Iceland, Reykjavík, Iceland. 3 Department of Clinical Microbiology, Landspítali University Hospital, 101, Reykjavík, Iceland. 4 Children's Hospital Iceland, Landspítali University Hospital, Reykjavík, Iceland. 5 University of Iceland, Faculty of Medicine, 101, Reykjavík, Iceland. karl@landspitali.is. 6 Department of Clinical Microbiology, Landspítali University Hospital, 101, Reykjavík, Iceland. karl@landspitali.is. (BioMed Central, 2018-10-04)
      Antimicrobial resistance is a public-health threat and antimicrobial consumption is the main contributor. The ten-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced into the Icelandic vaccination program in 2011. The aim was to estimate the vaccine impact of PHiD-CV10 on outpatient antimicrobial prescriptions in children. Eleven Icelandic birth-cohorts (2005-2015) were followed from birth until three years of age or to the end of the study period (December 31, 2016). Birth-cohorts were grouped as vaccine non-eligible (VNEC, 2005-2010) or vaccine eligible (VEC, 2011-2015). Data on primary care visits for respiratory infections and antimicrobial prescriptions were extracted from two national registers. Using national identification numbers, prescriptions were linked to physician visits if filled within three days of the visit. Incidence rates and incidence rate ratios between VNEC and VEC were calculated. An Andersen-Gill model was used to model the individual level data, accounting for repeated events and censoring. Vaccine impact was calculated as (1 - Hazard Ratio) × 100%. Included were 53,510 children who contributed 151,992 person-years of follow-up and filled 231,660 antimicrobial prescriptions. The incidence rate was significantly lower in the VEC compared to the VNEC, 144.5 and 157.2 prescriptions per 100 person-years respectively (IRR 0.92, 95%CI 0.91-0.93). Children in VEC were more likely to have filled zero (IRR 1.16 (95%CI 1.10-1.23) and 1-4 (IRR 1.08 95%CI 1.06-1.11) prescriptions compared to children in VNEC. The vaccine impact of PHiD-CV10 against all-cause antimicrobial prescriptions was 5.8% (95%CI 1.6-9.8%).When only considering acute otitis media-associated prescriptions, the vaccine impact was 21.8% (95%CI 11.5-30.9%). The introduction of PHiD-CV10 lead to reduced antimicrobial use in children, mainly by reducing acute otitis media episodes. This intervention therefore reduces both disease burden and could slow the spread of antimicrobial resistance.
    • Acute kidney injury following coronary angiography: a nationwide study of incidence, risk factors and long-term outcomes.

      Helgason, Dadi; Long, Thorir E; Helgadottir, Solveig; Palsson, Runolfur; Sigurdsson, Gisli H; Gudbjartsson, Tomas; Indridason, Olafur S; Gudmundsdottir, Ingibjorg J; Sigurdsson, Martin I; 1 Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 2 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3 Division of Anaesthesia and Intensive Care Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 4 Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 5 Division of Cardiothoracic Surgery, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 6 Division of Cardiology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 7 Division of Anaesthesia and Intensive Care Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. martiningi@gmail.com. 8 Department of Anesthesiology, Duke University Hospital, 2301 Erwin Road, Durham, NC, USA. martiningi@gmail.com. (Springer Heidelberg, 2018-10-01)
      We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD). This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria. Patients without post-procedural SCr were assumed to be free of AKI. Incident CKD was defined as 90-day sustained estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m AKI was detected in 231 of 13,561 cases (1.7%). There was an interaction between contrast dose and preexisting kidney function, where the risk for AKI was only significant at a dose > 150 mL in patients with baseline eGFR < 45 mL/min/1.73 m For iso-osmolar contrast, the risk of AKI related to contrast dose was evident for higher amount of contrast in patients with baseline eGFR < 45 mL/min/1.73 m
    • Mortality due to bleeding, myocardial infarction and stroke in dialysis patients.

      Ocak, G; Noordzij, M; Rookmaaker, M B; Cases, A; Couchoud, C; Heaf, J G; Jarraya, F; De Meester, J; Groothoff, J W; Waldum-Grevbo, B E; Palsson, R; Resic, H; Remón, C; Finne, P; Stendahl, M; Verhaar, M C; Massy, Z A; Dekker, F W; Jager, K J; 1 Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands. 2 ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. 3 Registre de Malalts Renals de Catalunya, Universitat de Barcelona, IDIBAPS, Barcelona, Spain. 4 REIN Registry, Agence de Biomedecine, Saint Denis La Plaine, France. 5 Department of Medicine, Zealand University Hospital, Roskilde, Denmark. 6 Department of Nephrology, Sfax University Hospital and Research Unit, Faculty of Medicine, Sfax University, Sfax, Tunisia. 7 Department of Nephrology, Dialysis and Hypertension, Dutch-Speaking Belgian Renal Registry, Sint-Niklaas, Belgium. 8 Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands. 9 Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway. 10 Division of Nephrology, Internal Medicine Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 11 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 12 Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina. 13 SICATA (The Information System of the Andalusian Transplant Autonomic Coordination Registry), Andalusia, Spain. 14 Finnish Registry for Kidney Diseases, Helsinki, Finland. 15 Swedish Renal Registry, Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden. 16 Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne Billancourt/Paris, France. 17 INSERM Unit 1018, CESP, Team 5, UVSQ, Villejuif, France. 18 Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. (Wiley, 2018-10-01)
      Essentials Mortality due to bleeding vs. arterial thrombosis in dialysis patients is unknown. We compared death causes of 201 918 dialysis patients with the general population. Dialysis was associated with increased mortality risks of bleeding and arterial thrombosis. Clinicians should be aware of the increased bleeding and thrombosis risks. Background Dialysis has been associated with both bleeding and thrombotic events. However, there is limited information on bleeding as a cause of death versus arterial thrombosis as a cause of death. Objectives To investigate the occurrence of bleeding, myocardial infarction and stroke as causes of death in the dialysis population as compared with the general population. Methods We included 201 918 patients from 11 countries providing data to the ERA-EDTA Registry who started dialysis treatment between 1994 and 2011, and followed them for 3 years. Age-standardized and sex-standardized mortality rate ratios for bleeding, myocardial infarction and stroke as causes of death were calculated in dialysis patients as compared with the European general population. Associations between potential risk factors and these causes of death in dialysis patients were investigated by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) by the use of Cox proportional-hazards regression. Results As compared with the general population, the age-standardized and sex-standardized mortality rate ratios in dialysis patients were 12.8 (95% CI 11.9-13.7) for bleeding as a cause of death (6.2 per 1000 person-years among dialysis patients versus 0.3 per 1000 person-years in the general population), 13.4 (95% CI 13.0-13.9) for myocardial infarction (22.5 versus 0.9 per 1000 person-years), and 12.4 (95% CI 11.9-12.9) for stroke (14.3 versus 0.7 per 1000 person-years). Conclusion Dialysis patients have highly increased risks of death caused by bleeding and arterial thrombosis as compared with the general population. Clinicians should be aware of the increased mortality risks caused by these conditions.
    • Second malignancies in patients with myeloproliferative neoplasms: a population-based cohort study of 9379 patients.

      Landtblom, Anna Ravn; Bower, Hannah; Andersson, Therese M-L; Dickman, Paul W; Samuelsson, Jan; Björkholm, Magnus; Kristinsson, Sigurdur Yngvi; Hultcrantz, Malin; 1 Department of Medicine, Division of Hematology, Stockholm South Hospital and Karolinska Institutet, Stockholm, Sweden. anna.ravn-landtblom@sll.se. 2 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3 Department of Medicine, Division of Hematology, Stockholm South Hospital and Karolinska Institutet, Stockholm, Sweden. 4 Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 5 Faculty of Medicine, University of Iceland and Department of Hematology, Landspitali National University Hospital, Reykjavik, Iceland. 6 Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. (Nature Publishing Group, 2018-10-01)
      To determine the risk of a wide range of second malignancies in patients with myeloproliferative neoplasms (MPNs), we conducted a large population-based study and compared the results to matched controls. From national Swedish registers, 9379 patients with MPNs diagnosed between 1973 and 2009, and 35,682 matched controls were identified as well as information on second malignancies, with follow-up until 2010. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using Cox regression and a flexible parametric model. There was a significantly increased risk of any non-hematologic cancer with HR of 1.6 (95% CI: 1.5-1.7). The HRs for non-melanoma skin cancer was 2.8 (2.4-3.3), kidney cancer 2.8 (2.0-4.0), brain cancer 2.8 (1.9-4.2), endocrine cancers 2.5 (1.6-3.8), malignant melanoma 1.9 (1.4-2.7), pancreas cancer 1.8 (1.2-2.6), lung cancer 1.7 (1.4-2.2), and head and neck cancer 1.7 (1.2-2.6). The HR of second malignancies was similar across all MPN subtypes, sex, and calendar periods of MPN diagnosis. The risk of developing a hematologic malignancy was also significantly increased; the HR for acute myeloid leukemia was 46.0 (32.6-64.9) and for lymphoma 2.6 (2.0-3.3). In conclusion, our study provides robust population-based support of an increased cancer risk in MPN patients.
    • Sex-Based Differences in Incidence of Inflammatory Bowel Diseases-Pooled Analysis of Population-Based Studies From Western Countries.

      Shah, Shailja C; Khalili, Hamed; Gower-Rousseau, Corinne; Olen, Ola; Benchimol, Eric I; Lynge, Elsebeth; Nielsen, Kári R; Brassard, Paul; Vutcovici, Maria; Bitton, Alain; Bernstein, Charles N; Leddin, Desmond; Tamim, Hala; Stefansson, Tryggvi; Loftus, Edward V; Moum, Bjørn; Tang, Whitney; Ng, Siew C; Gearry, Richard; Sincic, Brankica; Bell, Sally; Sands, Bruce E; Lakatos, Peter L; Végh, Zsuzsanna; Ott, Claudia; Kaplan, Gilaad G; Burisch, Johan; Colombel, Jean-Frederic; 1 Division of Gastroenterology, Mount Sinai Hospital, New York, New York; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: shailja.c.shah@vanderbilt.edu. 2 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 3 Public Health Unit, Epimad Registre, Lille University Hospital, France; INSERM LIRIC, UMR 995, Lille University, France. 4 Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 5 CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Department of Pediatrics and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. 6 Division of Gastroenterology, University of Copenhagen, Copenhagen, Denmark. 7 Division of Gastroenterology, National Hospital, Tórshavn, Faroe Islands. 8 Department of Medicine, McGill University, Montreal, Quebec, Canada. 9 Department of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada. 10 Division of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada. 11 Division of Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada. 12 Division of Gastroenterology, National University Hospital of Iceland, Reykjavík, Iceland. 13 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, New York. 14 Department of Gastroenterology, Oslo University Hospital and University of Oslo, Oslo, Norway. 15 Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. 16 Division of Gastroenterology, University of Otago, Christchurch, New Zealand. 17 Division of Gastroenterology, University of Rijeka, Rijeka, Croatia. 18 Division of Gastroenterology, St. Vincent's Hospital, Melbourne, Australia. 19 Division of Gastroenterology, Mount Sinai Hospital, New York, New York. 20 Division of Gastroenterology, Semmelweis University, Budapest, Hungary. 21 Division of Gastroenterology, University of Regensburg, Regensburg, Germany. 22 Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 23 Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark. (W.B. Saunders, 2018-01-01)
      Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. Female patients had a lower risk of CD during childhood, until the age range of 10-14 years (incidence rate ratio, 0.70; 95% CI, 0.53-0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25-29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5-9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.
    • Reduction in All-Cause Acute Otitis Media in Children <3 Years of Age in Primary Care Following Vaccination With 10-Valent Pneumococcal Haemophilus influenzae Protein-D Conjugate Vaccine: A Whole-Population Study.

      Sigurdsson, Samuel; Eythorsson, Elias; Hrafnkelsson, Birgir; Erlendsdóttir, Helga; Kristinsson, Karl G; Haraldsson, Ásgeir; 1 Faculty of Medicine, University of Iceland. 2 Department of Mathematics, University of Iceland. 3 Department of Clinical Microbiology, Reykjavík. 4 Children's Hospital Iceland, Landspítali University Hospital, Reykjavík. (Oxford University Press, 2018-09-28)
      The 10-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced in Iceland in 2011, without catch-up. The aim of this study was to estimate vaccine impact (VI) on acute otitis media (AOM). In this whole-population study, all primary care visits due to AOM from 2005 to 2015 in children <3 years of age were included. Birth cohorts were grouped as vaccine noneligible (VNEC) or vaccine eligible (VEC). Crude incidence rates (IRs) were compared between the VNEC and VEC. A Cox regression model for repeated events was used to model the individual-level data. VI was calculated as (hazard ratio [HR] - 1) × 100%. Included were 53150 children, with 140912 person-years of follow-up and 58794 AOM episodes. Both IR and the mean number of episodes differed significantly between VNEC and VEC; 43 compared to 38 episodes per 100 person-years and 1.61 episodes per child compared to 1.37. IR was significantly reduced in all age brackets, with the largest reduction in children <4 months of age (40% [95% confidence interval {CI}, 31%-49%). The VI on all-cause AOM was 22% (95% CI, 12%-31%). The impact was mediated through its effect on the first (HR, 0.84 [95% CI, .82-.86]) and second (HR, 0.95 [95% CI, .93-.98]) episodes. The impact of PHiD-CV10 on all-cause AOM was considerable, mediated mainly by preventing the first two episodes of AOM. A decrease in the IR of AOM in children too young to receive direct vaccine protection was demonstrated, suggesting herd effect.