36 research outputs found
Impact du diabÚte sur la mortalité à la suite d'une hospitalisation pour un premier infarctus aigu du myocarde au Québec
L'objectif de la prĂ©sente thĂšse Ă©tait d'examiner dans une large population non sĂ©lectionnĂ©e au QuĂ©bec, l'impact du diabĂšte sur la mortalitĂ© suite Ă une hospitalisation pour un premier infarctus aigu du myocarde (IAM) survenue dans des centres hospitaliers de la province de QuĂ©bec entre 1995 et 2001. La rĂ©alisation de ce projet de thĂšse s'est basĂ©e sur le jumelage de trois bases de donnĂ©es mĂ©dico-administratives, soit 1) le fichier quĂ©bĂ©cois des hospitalisations, 2) le registre des dĂ©cĂšs et 3) la base de donnĂ©es du Programme quĂ©bĂ©cois de surveillance du diabĂšte. L'analyse des donnĂ©es a permis dans un premier temps de mettre en Ă©vidence l'influence du diabĂšte dans l'augmentation de la mortalitĂ© Ă long terme chez les groupes les plus Ă risque, en l'occurrence les jeunes femmes ĂągĂ©es de moins de 65 ans, chez qui, le risque de mortalitĂ© Ă cinq ans Ă©tait 1,5 fois plus Ă©levĂ© que chez les hommes diabĂ©tiques et 3 fois plus Ă©levĂ© que chez les femmes non diabĂ©tiques de mĂȘme tranche d'Ăąge, et ce, indĂ©pendamment des facteurs sociodĂ©mographiques, des co-morbiditĂ©s, des complications hospitaliĂšres et du traitement invasif par revascularisation reçu pendant le sĂ©jour hospitalier. Dans un deuxiĂšme temps, nous avons examinĂ© l'Ă©volution temporelle dans la lĂ©talitĂ© hospitaliĂšre et Ă 1 an suite Ă l'admission pour IAM et dans le recours Ă la revascularisation (pontage coronarien et angioplastie) chez les patients diabĂ©tiques et non diabĂ©tiques. Les rĂ©sultats de cette Ă©tude descriptive ont dĂ©montrĂ© une augmentation significative dans le recours Ă la revascularisation chez les patients diabĂ©tiques durant la pĂ©riode de l'Ă©tude. Cette amĂ©lioration Ă©tait accompagnĂ©e d'un dĂ©clin significatif dans la lĂ©talitĂ©, similaire Ă la population non diabĂ©tique. Par ailleurs, malgrĂ© cette baisse significative de la lĂ©talitĂ©, le risque de mortalitĂ© Ă 1 an demeure toutefois 1,21 fois plus Ă©levĂ© chez les diabĂ©tiques que chez les non diabĂ©tiques, et ce mĂȘme aprĂšs ajustement pour les caractĂ©ristiques des patients et les co-morbiditĂ©s. Par la suite, nous avons dĂ©montrĂ© que cette baisse de mortalitĂ© chez la population diabĂ©tique Ă©tait restreinte aux groupes appartenant Ă une classe socio-Ă©conomique favorisĂ©e. Chez les plus dĂ©munis, matĂ©riellement et socialement, la lĂ©talitĂ© est demeurĂ©e relativement stable dans le temps. Enfin, les rĂ©sultats de l'Ă©tude de validation de la dĂ©finition de cas de diabĂšte utilisĂ©e dans la prĂ©sente thĂšse ont dĂ©montrĂ© que la dĂ©finition de cas de diabĂšte est associĂ©e Ă une sensibilitĂ© de 94,6% et Ă une valeur prĂ©dictive positive de 87,9%. Ces rĂ©sultats indiquent que les bases de donnĂ©es administratives constituent une source valide et fiable pour identifier l'ensemble de la population diagnostiquĂ©e diabĂ©tique au QuĂ©bec
Population based absolute and relative survival to 1 year of people with diabetes following a myocardial infarction: A cohort study using hospital admissions data
<p>Abstract</p> <p>Background</p> <p>People with diabetes who experience an acute myocardial infarction (AMI) have a higher risk of death and recurrence of AMI. This study was commissioned by the Department for Transport to develop survival tables for people with diabetes following an AMI in order to inform vehicle licensing.</p> <p>Methods</p> <p>A cohort study using data obtained from national hospital admission datasets for England and Wales was carried out selecting all patients attending hospital with an MI for 2003-2006 (inclusion criteria: aged 30+ years, hospital admission for MI (defined using ICD 10 code I21-I22). STATA was used to create survival tables and factors associated with survival were examined using Cox regression.</p> <p>Results</p> <p>Of 157,142 people with an MI in England and Wales between 2003-2006, the relative risk of death or recurrence of MI for those with diabetes (n = 30,407) in the first 90 days was 1.3 (95%CI: 1.26-1.33) crude rates and 1.16 (95%CI: 1.1-1.2) when controlling for age, gender, heart failure and surgery for MI) compared with those without diabetes (n = 129,960). At 91-365 days post AMI the risk was 1.7 (95% CI 1.6-1.8) crude and 1.50 (95%CI: 1.4-1.6) adjusted. The relative risk of death or re-infarction was higher at younger ages for those with diabetes and directly after the AMI (Relative risk; RR: 62.1 for those with diabetes and 28.2 for those without diabetes aged 40-49 [compared with population risk]).</p> <p>Conclusions</p> <p>This is the first study to provide population based tables of age stratified risk of re-infarction or death for people with diabetes compared with those without diabetes. These tables can be used for giving advice to patients, developing a baseline to compare intervention studies or developing license or health insurance guidelines.</p
Association between the 2008â09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during SpringâSummer 2009: Four Observational Studies from Canada
In three case-control studies and a household transmission cohort, Danuta Skowronski and colleagues find an association between prior seasonal flu vaccination and increased risk of 2009 pandemic H1N1 flu
Chlorate and Other Oxychlorine Contaminants Within the Dairy Supply Chain
The presence of chlorate in milk and dairy products can arise from the use of chlorinated water and chlorinated detergents for cleaning and sanitation of process equipment at both farm and food processor level. Chlorate and other oxychlorine species have been associated with inhibition of iodine uptake in humans and the formation of methemoglobin, with infants and young children being a highârisk demographic. This comprehensive review of chlorate and chlorine derivatives in dairy, highlights areas of concern relative to the origin and/or introduction of chlorate within the dairy supply chain. This review also discusses the associated health concerns, regulations, and chemical behavior of chlorate and chlorineâderived byâproducts, and provides a summary of mechanisms for their detection and removal
Specific gene patterns and molecular pathways related to human carcinogenesis in different populations among various geographic locations.
We read with great interest the article by Beg et al,1 which was recently published in Cancer. Colorectal cancers (CRCs) are the most commonly diagnosed malignancies, accounting for approximately 1.36 million new cases worldwide every year.2 Colorectal carcinogenesis is a complex, multistep process involving environmental and lifestyle factors in addition to sequential genetic changes and possibly viral components. Currently, the majority of deaths from CRC occur in developing countries including the Middle East, in which the incidence of CRC is rising. CRCs are characterized by a marked propensity toward invasion and spread to local lymph nodes. The overall 5âyear survival rate for patients diagnosed with CRC is approximately 60% and to our knowledge this rate has not significantly improved over the past 2 decades.3 Therefore, new preventive and therapeutic strategies to circumvent various stages of carcinogenesis in CRC are becoming a major investigative focus. To achieve this goal, a comprehensive understanding of the genetic interactions associated with early events in colorectal carcinogenesis is an essential first step.College of Medicine at Qatar University