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PubMed2003

Reduced left hemispheric white matter volume in twins with bipolar I disorder.

BACKGROUND: Although the heritability of bipolar I disorder (BPI) is high, few magnetic resonance imaging (MRI) studies of siblings of bipolar patients exist. We performed MRI brain scans on a nationwide sample of twins with BPI, as well as on their co-twins and a demographically balanced sample of control twin subjects, to detect any structural alterations related to the disorder and to the increased genetic risk. METHODS: The National Hospital Discharge Register, National Population Register, and Finnish Twin Cohorts were used to identify bipolar twins. Structured diagnostic interviews and MRI scans were obtained for 24 twins with BPI, 15 healthy co-twins, and 27 control twin subjects. RESULTS: Patients and co-twins showed a significant decrease in left hemispheric white matter volume. The disparity in patients was -16.1 cm(3) (95% confidence interval [CI] -26.6, -5.6) and in co-twins -11.3 cm(3) (95% CI -22.1, -0.4) compared with control twin subjects. No gray matter decrease was seen in patients or co-twins. CONCLUSIONS: The results of this first large-scale MRI study of twins with BPI, their co-twins, and appropriate control twin subjects, suggest that alterations of the left hemisphere white matter in BPI may reflect genetic factors predisposing to the disorder.

Adult↗
PubMed2005

The effect of hospitalization with medical illnesses on the suicide risk in the oldest old: a population-based register study.

OBJECTIVES: To compare the effect of hospitalization with medical illnesses on the suicide risk in the oldest old (> or = 80) with that in the old (65-79) and middle-aged (52-64) using nationwide data. DESIGN: Event-history analysis using time-varying covariates based on prospective individual-level register data. SETTING: Population-based record linkage. PARTICIPANTS: All persons aged 52 and older living in Denmark during 1996 to 1998 (N=1,684,205). MEASUREMENTS: The studied event is completed suicide. The following time-varying variables are included in the analysis: current age, hospitalization with medical illnesses within previous 2 years, and number of different medical diagnoses given at hospitalizations within previous 2 years. Relative suicide risks were calculated using event-history analysis. The proportional attributable risk was calculated to assess to which extent hospitalization can explain the increased suicide risk in the oldest old. RESULTS: During the 3-year study period, 1,184 persons committed suicide. Hospitalization with medical illnesses was associated with an increased suicide risk in the study population. The highest suicide rates were found in the oldest-old men who had been hospitalized during the previous 2 years: 113 per 100,000 versus 80 per 100,000 in the general population of men aged 80 and older. Also, the oldest-old women with a history of hospitalization had a higher suicide rate than their peer group. Nevertheless, the oldest old experienced a lower increase in risk after hospitalization than the middle-aged. Experiencing three or more different diagnoses increased the risk further. Almost two-thirds of the oldest old who committed suicide had experienced a medical hospitalization during a 2-year period preceding the suicide. A substantial part of the greater suicide rate in the oldest old than in the middle-aged can be attributed to the increased prevalence of medical hospitalization. CONCLUSION: The oldest old who have been hospitalized with medical illnesses have a significantly higher suicide risk than people in the same age range with no hospitalization, although they experience a lower increase in risk after hospitalization than the middle-aged. The increased prevalence of medical illnesses explains a part of the greater suicide risk with age, especially for the oldest old women. Considering that hospitalization with medical illness often precedes suicide in the oldest old, hospitalization may play an important role in identification of suicidal ideation in older people.

Aged↗
PubMed1997

Patient-related risk factors for early revision of total hip replacements. A population register-based case-control study of 674 revised hips.

In this population register-based, matched case-control study, we assessed patient-related factors and early risk of revision after total hip replacement (THR). Information was obtained via a mall survey among patients reported to the Norwegian Arthroplasty Register during the period 1987-1993. The study included 674 revised hips, as cases, and 1,343 hips with a primary operation only, as controls. Completed questionnaires were received from 81% of the 2,017 individual cases and controls. We identified a set of patient-related factors associated with poor THR prognosis. Increasing weight was a risk factor among male patients older than 67 years who were more than 1.77 m tall (p = 0.01). Smoking had no overall effect, but former heavy smokers had an increased risk of 2.8 compared to never-smokers. Alcohol intake was associated with an increased risk of dislocation. Revision due to infection was commoner among patients taking anti-diabetic drugs (OR = 14) than among patients taking no medication. An increased overall revision risk was found among patients using systemic steroids (OR = 2.8) or local pulmonary steroids (OR = 6.0). The risk also increased in male patients performing regular exercise before the primary operation (OR = 2.6), and in female patients of working-age doing heavy work (OR = 1.9).

Adolescent↗
PubMed1995

Insulin treated diabetes mellitus: causes of death determined from record linkage of population based registers in Leicestershire, UK.

STUDY OBJECTIVE: Analyses of causes of mortality in people with diabetes using data form death certificates mentioning diabetes provide unreliable estimates of mortality. Under-recording of diabetes as a cause on death certificates has been widely reported, ranging from 15-60%. Using a population based register on people with diabetes and linking data from another source is a viable alternative. Data from the Office of Population Censuses and Surveys (OPCS) are the most acceptable mortality data available for such an exercise, as direct comparison with other published mortality rates is then possible. DESIGN: A locally maintained population-based mortality register and all insulin-treated diabetes mellitus cases notified to the Leicestershire diabetes register (n = 4680) were linked using record linkage software developed in-house (Lynx). This software has been extensively used in a maintenance and update cycle designed to maximise accuracy and minimise duplication and false registration on the diabetes register. Deaths identified were initially coded locally to the International Classification of Diseases, 9th revision (ICD9), and later a linkage was performed to use official OPCS coding. Mortality data identified by the linkage was indirectly standardised using population data for Leicestershire for 1991. Standardised mortality ratios (SMR) were estimated, with 95% confidence intervals. Insulin dependent diabetes (IDDM) was defined as diabetes diagnosed before age 30 years with insulin therapy begun within one year of diagnosis. All other types were considered non-insulin dependent diabetes (NIDDM). Analyses were performed for the whole sample and then for the NIDDM subgroup. Results from these analyses were similar and therefore only whole group analyses are presented. MAIN RESULTS: A total of 370 deaths were identified for the period of 1990-92 inclusive - 56% were in men and 44% in women, median age (range) 71 years (12-94). Approximately 90% of deaths were subjects with NIDDM. Diabetes was mentioned on 215 (58%) death certificates. The all causes SMRs were significantly raised for men and women for all ages less than 75 years. Ischaemic heart disease (ICD9) rubrics 410-414) accounted for 146 (40%) deaths - 41% of male and 38% of female deaths. Male and female SMRs were significantly raised for the age groups 45-64, 65-74, and 75-84 years. Cerebrovascular disease (ICD9 rubrics 430-438) accounted for 39 (10%) deaths and the SMR for women the external causes of death (ICD9 rubrics E800-E999) were also significantly raised overall and in age groups 15-44 and 45-64 years. This was not true for men, although numbers of deaths in this category were small for both men (4) and women (9). CONCLUSION: Record linkage has been used successfully to link two local, population based registers. This has enabled an analysis of mortality in people with diabetes to be performed which overcomes the problems associated with using as a sample, death certificates where diabetes is mentioned. The mortality rates and SMRs estimated should more accurately reflect the true rates than would be possible using other methods. The persisting excess mortality identified for people with diabetes is of a similar magnitude and attributable to similar causes as has been reported elsewhere in population based studies.

Adolescent↗
PubMed2002

Sociodemographic predictors of non-attendance at invitational mammography screening--a population-based register study (Sweden).

OBJECTIVE: To investigate the role of sociodemographic factors in predicting mammography uptake in an outreach screening program. METHODS: Linkage of data from a regional population-based mammography program with four Swedish nationwide registers: the Population and Housing Census of 1990, the Fertility Register, the Cancer Register, and the Cause of Death Register. We computed odds ratios (OR) and 95% confidence intervals (CI) for non-attendance by sociodemographic factors. Non-attendance was defined as failure to attend in response to the two most recent invitations. RESULTS: Multivariate analyses among 4198 non-attenders and 38,972 attenders revealed that both childless and high-parity women were more likely to be non-attenders (OR = 1.8, 95% CI: 1.6-2.0 and OR = 2.2, 95% CI: 1.8-2.7, respectively). Women living without a partner were less likely to attend (OR = 1.7, 95% CI: 1.5-1.9), as were non-employed women (OR = 2.1, 95% CI: 1.9-2.3). Those renting an apartment were more likely to be non-attenders compared with home-owners (OR = 1.8, 95% CI: 1.6-2.0), and immigrants from non-Nordic countries were more than twice as likely to be non-attenders compared with Swedish-born women (OR = 2.4, 95% CI: 2.0-2.8). CONCLUSIONS: There are identifiable subgroups in which mammography utilization can be increased. Special attention should be paid to women who have never attended, childless women, and non-Nordic immigrants.

Adult↗
PubMed1986

Use of registers and population censuses as sampling frames in Great Britain.

The use of official data sources as sampling frames for numerous government surveys in the United Kingdom is described. "The great majority of these surveys use registers of various kinds as sampling frames. Some of these registers are intended to cover all addresses in the country in which there are private households. Other registers relate to specific sub-groups of the population. Each of the general registers has advantages and disadvantages but none is ideal for sampling purposes. In recent years nearly all samples required of the general population have been drawn, by automated means, from the Postcode Address File, although the balance of advantages of this system need to be continually monitored and evaluated." Reasons why the census is not often used as a sampling frame are considered.

Censuses↗
PubMed1985

Multiple tumor incidence in patients with rheumatoid arthritis or allied disorders.

The incidence of multiple malignant neoplasms in 55,279 patients with rheumatoid arthritis (RA) or allied disorders was studied by linking two separate nationwide data registers covering the whole Finnish population. The linking of the Social Insurance Institution's Population Register and the Finnish Cancer Registry resulted in 2106 cancer patients in whom both cancer (diagnosed in 1967-1978) and rheumatoid arthritis or allied disorders (diagnosed before cancer) were diagnosed. In 1974, the allied disorders (ankylosing spondylitis or systemic connective tissue diseases) accounted for 3.9% of all the diagnoses in the Social Insurance Institution's Population Register. The incidence of multiple neoplasms was slightly but not significantly higher in cancer patients with RA or allied disorders than in the general population or in all cancer patients taken together. The risk of leukemia was four times higher in the rheumatoid or allied disease cancer patients than in all the cancer patients. The results are consistent with previous results showing that the leukemia incidence in RA patients is higher than expected.

Adult↗
PubMed2006

Representativity of a postal public health questionnaire survey in Sweden, with special reference to ethnic differences in participation.

AIM: Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000. The survey, which was based on an 18- to 80-year-old population sample, had a 58% response rate (n = 13 604). METHODS: For some variables, the information obtained using the questionnaire was compared with information obtained from a population register that covers all the population in the county (for the 18- to 80-year-old group, n = 850 476). The population register includes, among other data, information on age, gender, educational level, country of birth, and healthcare expenditure. RESULTS: Men, individuals with a low level of education, and immigrants were under-represented in the survey. However, except for immigrants, the under-representation was not large. Among immigrants, particularly those born in former Yugoslavia, the Arabic-speaking countries, and Poland were very significantly under-represented in the study. By contrast, immigrants born in other Nordic countries had responded to almost the same extent as respondents born in Sweden. The survey sample had about the same healthcare utilization costs as did the general population. CONCLUSIONS: In summary, the "Health Survey for Scania, 2000" seems largely representative of the total Scanian population. A major concern, however, is the under-representation of the immigrant population.

Adolescent↗
PubMedDate not supplied

Feasibility of population based screening in Ireland.

Population registers have formed the basis for computerised call/recall registers for screening programmes in many countries and have been important in achieving high uptakes in targeted populations. The absence of a population register for the ECCLES (European Campaign against Cancer, Localisation, Evaluation & Screening) Breast Screening Project necessitated the development of a special register of women in the target age group. The data sources used to build the project register were the Eastern Health Board and North Eastern Health Board General Medical Services database, Voluntary Health Insurance data and self-registration with the project. The register captured 86.3 per cent of the target population. A debate on the merits and difficulties associated with the setting up of a population register in Ireland is now timely.

Breast Neoplasms↗
PubMed1995

Evaluation of the results of the register-based population and housing census 1990 in Finland.

"The 1990 population and housing census was the first one in Finland to be conducted entirely on the basis of registers, without any questionnaires. The Finnish population census system draws on the basic administrative registers of the society giving data on the population census target units and the links between them. These units comprise individuals, families, households, buildings, dwellings, enterprises and establishments. Transferring from one data collection method to another inevitably causes some kind of break in the time series. Because of these breaks it was decided in Statistics Finland to carry out an extensive evaluation study to analyse the differences between questionnaire-based and register-based census data."

Censuses↗
PubMed2000

Familial breast and ovarian cancer: a Swedish population-based register study.

A cohort of offspring of mothers with breast or ovarian cancer diagnosed in 1958-1993 was established using Swedish population-based registers. The children (n = 158,041) were born between 1941 and 1993, and their cancer incidence was followed between 1961 and 1993. A total of 3,257 tumors in 3,102 children were found. Observed numbers of cases were compared with expected numbers based on national calendar year-, age-, and sex-specific incidences. For daughters of women with breast cancer, the standardized morbidity ratios for being diagnosed with breast cancer and ovarian cancer before age 50 years were 1.99 (95% confidence interval (CI): 1.86, 2.14) and 1.28 (95% CI: 1.05, 1.54), respectively. The corresponding figures for daughters of women with ovarian cancer were 1.79 (95% CI: 1.55, 2.07) and 2.38 (95% CI: 1.77, 3.12). The risks were raised if the mother's cancer was diagnosed at a young age, the mother had multiple breast/ovarian diagnoses, or there was a sister with breast/ovarian cancer. Among all offspring, increased risks were found for thyroid cancer, testicular cancer, and malignant melanoma, while lung cancer risk was decreased if the mother had had breast cancer. The authors developed a variance estimator for the standardized morbidity ratio to cope with overdispersion due to dependency within families.

Adult↗
PubMed2006

Cancer risk among patients with multiple sclerosis: a population-based register study.

Cancer occurrence in patients with multiple sclerosis (MS) has been little studied, but associations with brain tumours, breast cancer, Hodgkin lymphoma and nasopharyngeal carcinoma have been suggested. We took advantage of population-based registers of MS and cancer to assess the risk of cancer following diagnosis of MS. Patients registered in the Danish Multiple Sclerosis Register were linked with the Danish Cancer Register to obtain information on cancer occurrence. The ratio of the observed to the number of expected cancers based on population-based incidence rates, i.e., the standardised incidence ratio (SIR), served as measure of the relative cancer risk. A database comprising all Danish women born after April 1, 1935, with information on all live-born children, was used in the analyses of breast cancer to adjust for reproductive factors. Overall 1,037 cancers were observed in 11,817 MS patients during 153,875 person-years of follow-up vs. an expected number of 1,098 (SIR = 0.94 [95% confidence interval CI: (0.89-1.00)]. The risk of brain tumours and Hodgkin lymphoma was not increased. A 16% overall reduced cancer risk in men with MS was explained by reduced numbers of cancers of the digestive, respiratory and genital organs. Though the overall cancer risk was not increased [SIR = 1.01(0.94-1.09), n = 676], female MS patients had an increased risk of breast cancer [SIR = 1.21 (1.05-1.39), n = 193]. Adjusting for parity and age at first child delivery did not change this risk estimate materially. In general MS patients are not at increased risk of cancer. Women with MS, however, seem to have a small excess risk of breast cancer, which cannot be attributed to reduced parity or delayed first child birth.

Adult↗
PubMed1987

Municipal records in nineteenth century Dutch emigration research.

Dutch emigrant registration records for the nineteenth century are examined in an effort to shed light on the local circumstances of the Dutch emigration movement. "Since nineteenth century emigration took place mostly through primary contacts this article will examine the newly established immigrant settlements as 'communities transplanted'...which directs our research to include local municipal records such as population censuses, population registers (which were supplemented after 1861 with registers of in- and out-migration), tax records, and records of vital events like marriage, birth and death registers. The quality and availability of these records vary from place to place, but generally speaking, in the case of the Netherlands, they are of high quality since population registration at the municipal level was required by law. The source of information for the local records are the population registers (Bevolkings Registers) which were originally constructed on the basis of information obtained from the 1850 population census...."

Birth Certificates↗
PubMed2005

Spatial distribution and registry-based case-control analysis of Campylobacter infections in Denmark, 1991-2001.

Using data from an 11-year period (1991-2001), the authors analyzed available information on location of residence for all registered, laboratory-confirmed, domestically acquired cases of campylobacteriosis in Denmark. Patient data were merged with data from a national register on housing and addresses, and a population density index was constructed using the Danish population register. The study was performed as a register-based case-control study; 15 age-matched controls for each case were selected from the national population register. A total of 22,066 cases were compared with 318,958 controls in logistic regression analysis. Living in types of housing found in rural areas and living in areas with a low population density were both associated with an increased risk of infection. This relation concerned children in particular and explained one third of cases among children in the countryside. Furthermore, in some counties there was an association between infection and type of drinking-water company serving the home. This study indicated that contact with animals or the environment is the source of a substantial proportion of sporadic Campylobacter infections in the Danish countryside, particularly among children.

Adolescent↗
PubMed2002

[Fertility after ectopic pregnancy: the population-based register of the urban area around Lille, Northern France].

The aims of this work were the evaluation of the reproductive outcome after ectopic pregnancy, and the assessment of the role of infertility risk factors and treatment's strategy. All patients in the population-based register of the urban area around Lille, Northern France, were followed-up. 345 women treated between April 1994 and March 1997, who were trying to become pregnant were interviewed by telephone every 6 months and then every year. The cumulative pregnancy rates were calculated by the Kaplan-Meier estimation. Associations between infertility risk factors and intrauterine pregnancy were tested by the logrank test, and by a Cox model for multivariate analysis. The mean duration of follow-up was 22 months, and 228 (66%) women had obtained a new pregnancy at the time of the analysis. 23 (10%) of the first pregnancies were recurrences. For women for whom EP occurred with an IUCD (17 patients), the 1 year intrauterine pregnancy (IUP) reached 67%. For the others, the 1 year IUP rate was 56%, and reached 67% after 2 years. After adjusting factors associated with fertility with a Cox regression, 3 factors seemed to lower reproductive performances: age > 35 years, previous history of infertility, and anterior tubal damage. More than half the women treated for EP obtained spontaneously a normally progressive pregnancy after 1 year. Reproductive performances are associated with characteristics of the patients, but do not depend on radical or conservative treatment.

Adult↗
PubMed2001

Health status and quality of life of people with multiple sclerosis.

PURPOSE: The aim of this study was to ascertain the health status and quality of life of a community based cohort of people with multiple sclerosis. METHOD: A postal questionnaire with self-completed measures of impairment, disability, physical dependency and quality of life was sent to a random sample of 203 people with multiple sclerosis from a population register. The sample was stratified according to five disease courses. The population register is of the prevalent population of 760 people with multiple sclerosis resident in the Leeds Health Authority. The register used multiple sources of ascertainment and is prospectively maintained with new incident cases. RESULTS: The estimated mean age of people with multiple sclerosis is 46 years (SE: 0.85), and mean duration of disease is 14.4 years (SE: 0.69). Almost four in five (78 %) are female, and one in six (17%) live alone. Impairments of balance, vision and memory are common and in all cases there is little difference in the frequency between disease course groups. In contrast, impairments of bladder and bowel are more common in those with a progressive disease course. Disability is more common in those with a progressive disease course but all scores on the SF36 Physical Function scale are low and demonstrate the disabling consequences of the disease, irrespective of disease course. These consequences must contribute to the fact that over two-thirds (68 %) were not employed at the time of the survey. Quality of life does not differ across disease course groups, but rather varies by age and duration. CONCLUSIONS: People with multiple sclerosis experience a range of impairments and disabilities. Those with progressive disease courses experience greater levels of impairment and disability than other groups. There is not a straightforward exchange between health status and quality of life. A measure of subjective quality of life may reflect adjustment to disease, such that, for example, the longer the duration, the older the individual, the more likely the person will report a relatively good quality of life.

Female↗
PubMed2006

[Informative value of the specialized registers in research of leukemia in Chernobyl accident liquidators in Ukraine].

The article considers the possibility of the use of current infrastructure of specialized population registers of Ukraine to study leukemia and other systemic blood diseases revealed in Chernobyl accident liquidators. Advantage and limitation of such registers in the use are discussed in the article. Ukrainian state register of people who suffered from Chernobyl accident and Ukrainian national cancer registers are the largest population registers in the country, which cover all the territory of Ukraine and contain information on each individual and may serve as source base for epidemiological studies. To solve issues on leukemia and other oncological diseases is recommended to use in complex data of specialized registers of Ukraine. It should be also taken into account necessity of using late registered cases and verifying registered diagnoses.

Chernobyl Nuclear Accident↗