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At least 55 records · Page 3Linked to original sources
PubMed1997

Long-term results of growth hormone treatment in France in children of short stature: population, register based study.

OBJECTIVES: To describe the growth of children treated with growth hormone and to evaluate the prognostic factors for height at the end of treatment. DESIGN: Register based cohort study. SETTING: French national register of all children treated with growth hormone. SUBJECTS: 3233 short stature children (3165 of whom were deficient in growth hormone) who were treated with growth hormone (excluding children with Turner's syndrome) and whose treatment started between 1973 and 1989, last data being recorded in December 1993. MAIN OUTCOME MEASURES: Annual changes in height, and height at the end of treatment. RESULTS: Mean height SD score at the end of treatment, after a mean of 4.3 years, was -2, corresponding to gain in mean height SD score of 1 and to a height SD score of 1.1 below target height. In all, 923 children prematurely stopped taking growth hormone treatment, mainly because of insufficient response (insufficient growth) or tiredness. Variables that predicted height at the end of treatment were age, target height, aetiology of short stature, use of puberty inhibitors, and type of growth hormone. CONCLUSIONS: The outcome of children of short stature with growth hormone deficiency who were treated with growth hormone has been less favourable than initially assumed. Growth hormone treatment has not restored normal growth to these children. The highly demanding nature and high costs of this treatment require an optimised prescription, and this remains to be determined.

Adolescent↗
PubMed2001

Matching dental practice board data to the health authority population register.

OBJECTIVE: To evaluate the process of matching Dental Practice Board (DPB) registration data to the health authority (HA) register for a defined locality. This included testing for the presence of socio-economic bias in the postcodes held in the DPB data sets and to determine if patients travelling to obtain primary dental care would have an effect on the matching process at health authority level. BASIC RESEARCH DESIGN: All 21 general dental practitioners in Ellesmere Port, South Cheshire gave written consent for the DPB to provide files of their registered patients to the health authority. The registered patients were electronically matched against residents in the HA register in a four stage process. Testing for the presence of a socio-economic bias in the postcodes included in the DPB data set was undertaken by constructing frequency distributions of the proportions of postcoded, and non or partially postcoded DPB records by Super Profiles Lifestyle group. A chi square test was used to test for significant differences. The extent of patients travelling to access primary dental care was assessed by comparing the proportions of registered patients of under 6 years, 25-60 years and those aged 65+ who lived outside South Cheshire Health Authority yet obtained their GDS care within Ellesmere Port. MAIN OUTCOME MEASURES: Out of a total of 39,474 records, 458 (1.2%) were duplicates. Some 35,447 (90.9%) of DPB records could be matched to those contained in the HA register. No significant (chi2 =10.85, df=9, P=0.27) socio-economic difference was found in the proportions of DPB records originally with, and without postcodes by Super Profiles Lifestyle group. Some 1,688 (47.3%) of the unmatched subjects were resident in health authorities other than South Cheshire and therefore could not be expected to be found in the HA register. Nearly 90% of children under 6 years registered with an Ellesmere Port GDP were South Cheshire residents, compared to approximately 85% of adults of working age and older adults. CONCLUSIONS: In this locality DPB data could be matched to the HA register with a reasonable degree of success. However, because of the time taken to clean and make the data sets compatible, the methodology used is inappropriate for routine use. In this locality no socio-economic bias could be found in the records with missing postcodes in the DPB data set. Patients travelling to access dental care would have little influence on the matching process at health authority level in this locality, irrespective of the age group under study.

Adult↗
PubMed1991

[Prognostic factors in hemorrhagic cerebrovascular accidents in a population register].

Since 1985, cases of acute vascular cerebral diseases observed among the inhabitants of the city of Dijon have been systematically recorded: 88 cerebral haemorrhages were reported from 1985 to 1988. Twenty-five variables have been defined from antecedents, clinical and para-clinical data. Seven variables, were statistically associated with death at the end of the first month: age, severity of neurological palsy, meningeal syndrome, coma or comatose state, hyperglycemia and mass effect on CAT-scan. Using a step-down variable selection procedure, two prognostic factors were found: loss of consciousness and advanced age.

Adult↗
PubMed1988

[Evaluation of health expenditures in the first 6 months after the diagnosis of cancer using a population register].

It is currently estimated in France, that the cost of cancer is rising to 25 billion francs, which represents approximately 6% of all health expenditure with an annual growth of 5-10%. The data from the Register of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the social security system, and its distribution in relationship with the different posts (assessment, type of treatment, supervision, transport) according to the cancer site. The average cost per patient within the first 6 months of the illness has been evaluated at 26,000 F (1984). The results show major differences for the cancer sites, care facilities and posts which are budgeted for.

Cancer Care Facilities↗
PubMed1994

Incidence of ectopic pregnancy. First results of a population-based register in France.

A population-based register of ectopic pregnancy was established in 1992 for two French departments, with the primary aim of monitoring the trend in ectopic pregnancy over a prolonged period. In this paper, data collected during the first year of registration (1992) are analysed. The rate of ectopic pregnancy was 20.2 per 1000 live births, 15.8 per 1000 reported pregnancies and 9.5 per 10,000 women aged 15-44 years. The ectopic pregnancy rate per 1000 live births increased steeply after the age of 30 years and especially after the age of 35 years, whereas rates per 10,000 women of reproductive age steadily increased until the age of 35 years and decreased thereafter. The rates of ectopic pregnancy were lower in spring and summer than autumn and winter. These results are discussed and comparisons with similar studies conducted in the USA and Scandinavia are attempted.

Adolescent↗
PubMed2005

The impact of reproductive factors on breast cancer risk--the feasibility of using Swedish population-based registers to account for the effect of confounding in cohort studies.

OBJECTIVE: The aim of this study was to analyze the impact of reproductive factors on breast cancer risk among Swedish women by using nationwide population registers. METHODS: A cohort including all Swedish women born between 1920 and 1959 was followed up to 1997 by record linkage to different population-based registers. More than 4 million children were linked to the women in the cohort and 60,328 women were diagnosed with breast cancer. Poisson regression was used to model the breast cancer incidence by risk groups. In a sub-cohort of 18,164 women irradiated for skin hemangioma in infancy, the breast cancer risk was analyzed in relation to radiation dose and accounting for reproductive factors. RESULTS: The relative breast cancer risk (RR) for the reproductive factors was 0.35 [ 95% confidence interval (CI) 0.30--0.42] for women with 6 or more children and the first child before the age of 20 years, and RR was 1.11 (95% CI 1.06--1.18) for uniparous women with the first child at age 35 years or older, compared to nulliparous women. The discrepancies of reproductive factors in the hemangioma cohort compared to Swedish women had a minor effect on RR, with a reduction from 1.13 (95%CI 1.00--1.26) to 1.11 (95% CI 0.99--1.25). CONCLUSIONS: This study shows the feasibility of using population-based registers to retrieve reliable information on reproductive factors to eliminate its confounding effect when analyzing other risk factors.

Age Factors↗
PubMed2003

Coronary and cerebrovascular population-based registers in Europe: are morbidity indicators comparable? Results from the EUROCISS Project.

BACKGROUND: The EUROCISS Project (European Cardiovascular Indicators Surveillance Set), as part of the Health Monitoring Programme financed by the European Commission, has been implemented to develop health indicators and recommendations for the monitoring of cardiovascular diseases (CVDs). Morbidity data are rarely available in the different countries and when available, they are very rarely comparable. The aims of this paper are to list the existing population-based registers of acute myocardial infarction (AMI) and stroke in Europe, describe their methodology, and discuss their comparability. METHODS: using a questionnaire a comprehensive and updated picture on available sources of information, data, indicators, and methods were collected for population-based registers. The information requested generally included: the studied disease; the scope of the study (geographical area, temporal duration, age range, population); adopted methodologies (case definition, ICD coding for mortality and hospital discharge records, linkage and validation methods); morbidity indicators (attack rate, incidence, prevalence, case fatality rate). RESULTS: Belgium, Denmark, Finland, France, Germany, Italy, Norway, Spain, and Sweden have ongoing population-based registers for AMI. Denmark, Finland, France, Germany, Italy, Norway, and Sweden have ongoing population-based registers for stroke. Selection procedures of events, differences in age range, different validation procedures and methods make the results from these registers difficult to compare. CONCLUSIONS: Population-based registers provide the best indicators for AMI and stroke, such as attack rate and case fatality. Registers cover large samples of the population, usually regions or large municipalities. The comparability of data across countries depends on standardization, case definition, completeness, proper linkage, common diagnostic criteria and validation procedures. Given the high burden of AMI and stroke, efforts are needed in implementing registers in all European countries.

Cerebrovascular Disorders↗
PubMed2003

Worse survival in breast cancer among women with recent childbirth: results from a Swedish population-based register study.

This study was designed to investigate how time since childbirth affects breast cancer survival using unselected population-based data linking data from the Swedish Cancer Registry, fertility register, and population census registers. A total of 14,693 parous women < or =45 years of age with breast cancer were identified. Information on deaths was collected, and 5- and 10-year survival rates were calculated according to time since most recent childbirth. Mortality during the first 10 years of follow-up was further investigated in a Cox analysis, with adjustments for age at diagnosis, time period during which the diagnosis was made, number of children, and age at the time of the first child's birth. Women with diagnosis during pregnancy had a 5-year survival rate of 52.1% (95% CI, 41.2%-61.9%) and a 10-year survival rate of 43.9% (95% CI, 33.1%-54.2%), compared with survival rates of 80.0% (95% CI, 79.6%-81.4%) and 68.6% (95% CI, 67.5%-69.7%), respectively, in women diagnosed >10 years since childbirth. In the multivariate model, we found that time since childbirth was associated with inferior survival rates in cases of diagnosis <8 years after childbirth, in which the lowest survival rates were seen in women with diagnosis during pregnancy in the first 5 years of follow-up (adjusted relative risk compared with women with >10 years since last childbirth, 2.6; 95% CI, 1.8-3.4). The adjusted hazard ratios could be described by a decreasing function of a logarithmic transformation of years since childbirth. We found that the time of follow-up was of importance, in that women with a recent pregnancy had particularly lower survival rates during the first 5 years after diagnosis. The mechanisms behind the poor survival in breast cancer for women with recent childbirth are not known, but we suggest that one explanation might be a lower proportion of hormone receptor-positive tumors.

Adult↗
PubMed1994

[Care of the population not registered at an urban health center].

OBJECTIVE: To find the work-load involved in caring for a displaced part of the population and its social/health characteristics. DESIGN: Descriptive study lasting a year. SETTING: General medical clinics at an urban Primary Care Centre in Alcorcón (Madrid). PATIENTS: Those users over 14 not registered at the Centre who were attended by the General Practitioners and nursing staff during the study period. MEASUREMENTS AND MAIN RESULTS: During the sampling days 263 non-registered patients were attended in on-demand medical consultations, this being 5.58% of the total. 301 home notices were sent out during the year, of which 12.95% were generated by displaced patients. The medical consultations by appointment for this group were 2.3% of the total within the Centre and 15.3% at home. There were no significant differences between the registered and displaced populations regarding the number of referrals to laboratory, radiology or specialists. 21.86% of nurses' pre-arranged home visits were due to the follow-up of displaced patients. The patients in our sample were mostly elderly (82.4%), women (68.6%) and staying for extended periods within our catchment area. A third of them attended for bureaucratic reasons (prescriptions). 58.23% of the remaining consultations were due to chronic pathologies. 18.07% brought with them medical reports or long-treatment booklets. CONCLUSIONS: Caring for the non-registered population causes a considerable work-load for the Primary Care team, both because of the number of people and their social/health characteristics. It should be made a requirement that the patient brings medical reports when he/she moves from their customary residence.

Adolescent↗
PubMed2006

Temporal changes in the incidence of epilepsy in Finland: nationwide study.

PURPOSE: To examine possible changes over time in the incidence of epilepsy in different age groups. METHODS: Based on the nationwide full-refundable antiepileptic drug register and population register, incidence of newly diagnosed epilepsy was measured by granted full-refundable antiepileptic drugs for epilepsy. RESULTS: The incidence was throughout all age groups higher in men than in women. The incidence in the total population had significantly declined in 1986-2002, from 71.6/100,000 to 52.9/100,000. The incidence significantly decreased in children (0.77; 0.71-0.84, p<0.0001) and adults (0.83; 0.77-0.89, p<0.0001) but increased in the elderly (1.18; 1.10-1.26, p<0.0001). The increased incidence in the elderly over the time period was primarily seen in women. CONCLUSION: The incidence of epilepsy has significantly declined in both children and adults with a concurrent increase in the incidence among the elderly. Further studies are needed to elucidate the precise cause of these temporal changes.

Adult↗
PubMed1998

The East Flanders Prospective Twin Survey (Belgium): a population-based register.

The East Flanders Prospective Twin Survey (EFPTS), started in 1964, is unique among the 17 major European twin registers because it is population based, the twins (and higher order births) are ascertained at birth, basic perinatal data are collected, chorion type is established and, when appropriate, genetic markers including DNA fingerprints, are determined. The total number of sets is 5089 twin, 158 triplet and 14 of higher order. Zygosity has been diagnosed on the basis of sex, placental structure and genetic markers in more than 95% of pairs. The EFPTS is the only large register that includes placental data and allows differentiation of three subtypes of monozygotic twins based on the time of the initial zygotic division: the dichorionic-diamnionic pairs (early), the monochorionic-diamnionic pairs (intermediate), and the monochorionic-monoamnionic pairs (late). Methodology and basic results in twins are considered in this article; detailed studies will be reported later. The sex proportion in dizygotic (DZ) twins is the same as in singletons, whereas monozygotic (MZ) twins number more girls than boys. The difference in perinatal mortality between DZ and MZ twins is limited to the monochorionic MZ subgroup. Birth weight is highest in DZ twins and diminishes stepwise in MZ dichorionic and MZ monochorionic twins. Duration of pregnancy follows the same trend but is limited to a few days. Iatrogenic pregnancies are increasing to the point of representing almost 50% of the twin births in 1997.

Amnion↗