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Artikel ; Online: Increased risk of type 3c diabetes mellitus after acute pancreatitis warrants a personalized approach including diabetes screening.

Walker, Alexander / O'Kelly, James / Graham, Catriona / Nowell, Sian / Kidd, Doug / Mole, Damian J

BJS open

2022 Band 6, Heft 6

Abstract: Background: Acute pancreatitis (AP) is a frequent cause of hospitalization with long-term health consequences, including type 3c diabetes mellitus (DM). The incidence and risk factors for new-onset morbidities after AP need to be clarified to inform a ... ...

Abstract	Background: Acute pancreatitis (AP) is a frequent cause of hospitalization with long-term health consequences, including type 3c diabetes mellitus (DM). The incidence and risk factors for new-onset morbidities after AP need to be clarified to inform a personalized medicine approach. Methods: Using a longitudinal electronic healthcare record-linkage analysis, all patients admitted to hospital in Scotland with a first episode of AP between 1 April 2009 and 31 March 2012 and followed for a minimum of 5 years after their index AP admission were identified. All new-onset morbidity with specific focus on type 3c DM were analysed and, using time-split multiple regression. Results: A total of 2047 patients were included. AP requiring critical care was followed by 2 years of heightened risk (HR 5.24) of developing type 3c DM, increased risk of new-onset cardiac disease (HR 1.61), and renal disease (HR 2.96). The additional risk conferred by critical care AP had a negative interaction with time, whereas additional risk associated with male sex and a non-gallstone aetiology was long lasting. Conclusion: Based on these findings, a personalized approach to include type 3c DM screening for a minimum of 2 years for individuals who required critical care when hospitalized with AP is recommended.
Mesh-Begriff(e)	Humans ; Male ; Pancreatitis/diagnosis ; Pancreatitis/etiology ; Pancreatitis/therapy ; Acute Disease ; Risk Factors ; Incidence ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/etiology
Sprache	Englisch
Erscheinungsdatum	2022-12-13
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac148
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: INCREASED MORTALITY IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM: DOES SURGERY MAKE A DIFFERENCE?

Collier, Andrew / Ghosh, Sujoy / Nowell, Sian / Clark, David

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2019 Band 25, Heft 4, Seite(n) 335–339

Abstract: Objective: ...

Abstract	Objective:
Mesh-Begriff(e)	Calcium ; Cohort Studies ; Female ; Humans ; Hyperparathyroidism, Primary ; Male ; Parathyroid Hormone ; Parathyroidectomy ; Retrospective Studies
Chemische Substanzen	Parathyroid Hormone ; Calcium (SY7Q814VUP)
Sprache	Englisch
Erscheinungsdatum	2019-04-16
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.4158/EP-2018-0407
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Primary hyperparathyroidism: Increasing prevalence, social deprivation, and surgery.

Collier, Andrew / Portelli, Mark / Ghosh, Sujoy / Nowell, Sian / Clark, David

Endocrine research

2017 Band 42, Heft 1, Seite(n) 31–35

Abstract: Objective: To measure the increasing incidence of primary hyperparathyroidism (PHPT) in Scotland, to determine the relationship between PHPT and deprivation, and to investigate the relationship between parathyroidectomy (PTX) and social deprivation.: ... ...

Abstract	Objective: To measure the increasing incidence of primary hyperparathyroidism (PHPT) in Scotland, to determine the relationship between PHPT and deprivation, and to investigate the relationship between parathyroidectomy (PTX) and social deprivation. Methods: We retrospectively identified a cohort of patients diagnosed with PHPT between 1986 and 2013 from the Scottish Morbidity Records (SMR01) database. The diagnosis of PHPT was made in accordance with the International Classification of Diseases code. Results: Between the years 1986 and 2013, 4002 patients were diagnosed with PHPT. There was a significant increase in the incidence of PHPT in this period (p < 0.0001), an association between the incidence of PHPT and deprivation (p < 0.0001) plus an association between a lower rate of PTX and deprivation (p < 0.001). Conclusion: The increase in incidence of PHPT may be due to a combination of increased awareness of PHPT, easier diagnosis, and an ageing population. The lower rate of PTX in relation to deprivation may reflect comorbidities, age, and uncertainty about the long-term benefits of PTX in asymptomatic patients.
Mesh-Begriff(e)	Adult ; Aged ; Aged, 80 and over ; Female ; Health Status Disparities ; Humans ; Hyperparathyroidism, Primary/epidemiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Scotland/epidemiology ; Social Class
Sprache	Englisch
Erscheinungsdatum	2017-02
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	605823-1
ISSN	1532-4206 ; 0743-5800
ISSN (online)	1532-4206
ISSN	0743-5800
DOI	10.3109/07435800.2016.1169545
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Risk of oesophageal cancer among patients previously hospitalised with eating disorder.

Brewster, David H / Nowell, Siân L / Clark, David N

Cancer epidemiology

2015 Band 39, Heft 3, Seite(n) 313–320

Abstract: Background: It has been suggested that the risk of oesophageal adenocarcinoma might be increased in patients with a history of eating disorders due to acidic damage to oesophageal mucosa caused by self-induced vomiting practiced as a method of weight ... ...

Abstract	Background: It has been suggested that the risk of oesophageal adenocarcinoma might be increased in patients with a history of eating disorders due to acidic damage to oesophageal mucosa caused by self-induced vomiting practiced as a method of weight control. Eating disorders have also been associated with risk factors for squamous cell carcinoma of the oesophagus, including alcohol use disorders, as well as smoking and nutritional deficiencies, which have been associated with both main sub-types of oesophageal cancer. There have been several case reports of oesophageal cancer (both main sub-types) arising in patients with a history of eating disorders. Methods: We used linked records of hospitalisation, cancer registration and mortality in Scotland spanning 1981-2012 to investigate the risk of oesophageal cancer among patients with a prior history of hospitalisation with eating disorder. The cohort was restricted to patients aged ≥10 years and <60 years at the date of first admission with eating disorder. Disregarding the first year of follow-up, we calculated indirectly standardised incidence ratios using the general population as the reference group to generate expected numbers of cases (based on age-, sex-, socio-economic deprivation category-, and calendar period-specific rates of disease). Results: After exclusions, the cohort consisted of 3617 individuals contributing 52,455 person-years at risk. The median duration of follow-up was 13.9 years. Seven oesophageal cancers were identified, as compared with 1.14 expected, yielding a standardised incidence ratio of 6.1 (95% confidence interval: 2.5-12.6). All were squamous cell carcinomas arising in females with a prior history of anorexia nervosa. Conclusions: Patients hospitalised previously with eating disorders are at increased risk of developing oesophageal cancer. Confounding by established risk factors (alcohol, smoking, and nutritional deficiency) seems a more likely explanation than acidic damage through self-induced vomiting because none of the incident cases of oesophageal cancer were adenocarcinomas, and because the study cohort had higher than background rates of hospitalisation with alcohol-related conditions and chronic obstructive pulmonary disease.
Mesh-Begriff(e)	Adult ; Aged ; Carcinoma, Squamous Cell/epidemiology ; Cohort Studies ; Esophageal Neoplasms/epidemiology ; Feeding and Eating Disorders/complications ; Female ; Humans ; Incidence ; Middle Aged ; Risk Factors
Sprache	Englisch
Erscheinungsdatum	2015-03-11
Erscheinungsland	Netherlands
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2508729-0
ISSN	1877-783X ; 1877-7821
ISSN (online)	1877-783X
ISSN	1877-7821
DOI	10.1016/j.canep.2015.02.009
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Survival and new-onset morbidity after critical care admission for acute pancreatitis in Scotland: a national electronic healthcare record linkage cohort study.

Ventre, Chiara / Nowell, Sian / Graham, Catriona / Kidd, Doug / Skouras, Christos / Mole, Damian J

BMJ open

2018 Band 8, Heft 12, Seite(n) e023853

Abstract: Introduction: Severe acute pancreatitis (AP) requiring critical care admission (ccAP) impacts negatively on long-term survival.: Objective: To document organ-specific new morbidity and identify risk factors associated with premature mortality after ... ...

Abstract	Introduction: Severe acute pancreatitis (AP) requiring critical care admission (ccAP) impacts negatively on long-term survival. Objective: To document organ-specific new morbidity and identify risk factors associated with premature mortality after an episode of ccAP. Design: Cohort study. Setting: Electronic healthcare registries in Scotland. Participants: The ccAP cohort included 1471 patients admitted to critical care with AP between 1 January 2008 and 31 December 2010 followed up until 31 December 2014. The population cohort included 3450 individuals from the general population of Scotland frequency-matched for age, sex and social deprivation. Methods: Record linkage of routinely collected electronic health data with population matching. Primary and secondary outcome measures: Patient demographics, comorbidity (Charlson Comorbidity Index), acute physiology, organ support and other critical care data were linked to records of mortality (death certificate data) and new-onset morbidity. Kaplan-Meier and Cox regression analyses were used to identify risk factors associated with mortality. Results: 310 patients with AP died during the index admission. Outcomes were not ascertained for five patients, and the deprivation quintile was not known for six patients. 340 of 1150 patients in the resulting postdischarge ccAP cohort died during the follow-up period. Greater comorbidity measured by the Charlson score, prior to ccAP, negatively influenced survival in the hospital and after discharge. The odds of developing new-onset diabetes mellitus after ccAP compared with the general population were 10.70 (95% CI 5.74 to 19.94). A new diagnosis of myocardial infarction, stroke, heart failure, liver disease, peptic ulcer, renal failure, cancer, peripheral vascular disease and lung disease was more frequent in the ccAP cohort than in the general population. Conclusions: The persistent deleterious impact of severe AP on long-term outcome and survival is multifactorial in origin, influenced by pre-existing patient characteristics and acute episode features. Further mechanistic and epidemiological investigation is warranted.
Mesh-Begriff(e)	Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Cohort Studies ; Critical Care/methods ; Databases, Factual ; Female ; Hospital Mortality/trends ; Humans ; Intensive Care Units/statistics & numerical data ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Morbidity/trends ; Pancreatitis/diagnosis ; Pancreatitis/mortality ; Pancreatitis/therapy ; Patient Admission/statistics & numerical data ; Prognosis ; Proportional Hazards Models ; Recurrence ; Registries ; Retrospective Studies ; Scotland/epidemiology ; Survival Analysis
Sprache	Englisch
Erscheinungsdatum	2018-12-14
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2018-023853
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The impact of cancer on subsequent chance of pregnancy: a population-based analysis.

Anderson, Richard A / Brewster, David H / Wood, Rachael / Nowell, Sian / Fischbacher, Colin / Kelsey, Tom W / Wallace, W Hamish B

Human reproduction (Oxford, England)

2018 Band 33, Heft 7, Seite(n) 1281–1290

Abstract: Study question: What is the impact of cancer in females aged ≤39 years on subsequent chance of pregnancy?: Summary answer: Cancer survivors achieved fewer pregnancies across all cancer types, and the chance of achieving a first pregnancy was also ... ...

Abstract	Study question: What is the impact of cancer in females aged ≤39 years on subsequent chance of pregnancy? Summary answer: Cancer survivors achieved fewer pregnancies across all cancer types, and the chance of achieving a first pregnancy was also lower. What is known already: The diagnosis and treatment of cancer in young females may be associated with reduced fertility but the true pregnancy deficit in a population is unknown. Study design, size, duration: We performed a retrospective cohort study relating first incident cancer diagnosed between 1981 and 2012 to subsequent pregnancy in all female patients in Scotland aged 39 years or less at cancer diagnosis (n = 23 201). Pregnancies were included up to end of 2014. Females from the exposed group not pregnant before cancer diagnosis (n = 10 271) were compared with general population controls matched for age, deprivation quintile and year of diagnosis. Participants/materials, setting, methods: Scottish Cancer Registry records were linked to hospital discharge records to calculate standardized incidence ratios (SIR) for pregnancy, standardized for age and year of diagnosis. Linkage to death records was also performed. We also selected women from the exposed group who had not been pregnant prior to their cancer diagnosis who were compared with a matched control group from the general population. Additional analyses were performed for breast cancer, Hodgkin lymphoma, leukaemia, cervical cancer and brain/CNS cancers. Main results and the role of chance: Cancer survivors achieved fewer pregnancies: SIR 0.62 (95% CI: 0.60, 0.63). Reduced SIR was observed for all cancer types. The chance of achieving a first pregnancy was also lower, adjusted hazard ratio = 0.57 (95% CI: 0.53, 0.61) for women >5 years after diagnosis, with marked reductions in women with breast, cervical and brain/CNS tumours, and leukaemia. The effect was reduced with more recent treatment period overall and in cervical cancer, breast cancer and Hodgkin lymphoma, but was unchanged for leukaemia or brain/CNS cancers. The proportion of pregnancies that ended in termination was lower after a cancer diagnosis, and the proportion ending in live birth was higher (78.7 vs 75.6%, CI of difference: 1.1, 5.0). Limitations, reasons for caution: Details of treatments received were not available, so the impact of specific treatment regimens on fertility could not be assessed. Limited duration of follow-up was available for women diagnosed in the most recent time period. Wider implications of the findings: This analysis provides population-based quantification by cancer type of the effect of cancer and its treatment on subsequent pregnancy across the reproductive age range, and how this has changed in recent decades. The demonstration of a reduced chance of pregnancy across all cancer types and the changing impact in some but not other common cancers highlights the need for appropriate fertility counselling of all females of reproductive age at diagnosis. Study funding/competing interest(s): This study was funded by NHS Lothian Cancer and Leukaemia Endowments Fund. Part of this work was undertaken in the MRC Centre for Reproductive Health which is funded by the MRC Centre grant MR/N022556/1. RAA has participated in Advisory Boards and/or received speaker's fees from Beckman Coulter, IBSA, Merck and Roche Diagnostics. He has received research support from Roche Diagnostics, Ansh labs and Ferring. The other authors have no conflicts to declare.
Mesh-Begriff(e)	Adult ; Birth Rate ; Cancer Survivors ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female/etiology ; Live Birth ; Neoplasms/complications ; Pregnancy ; Pregnancy Rate ; Registries ; Retrospective Studies ; Scotland
Sprache	Englisch
Erscheinungsdatum	2018-06-18
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/dey216
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Mode of birth and risk of infection-related hospitalisation in childhood: A population cohort study of 7.17 million births from 4 high-income countries.

Miller, Jessica E / Goldacre, Raphael / Moore, Hannah C / Zeltzer, Justin / Knight, Marian / Morris, Carole / Nowell, Sian / Wood, Rachael / Carter, Kim W / Fathima, Parveen / de Klerk, Nicholas / Strunk, Tobias / Li, Jiong / Nassar, Natasha / Pedersen, Lars H / Burgner, David P

PLoS medicine

2020 Band 17, Heft 11, Seite(n) e1003429

Abstract: Background: The proportion of births via cesarean section (CS) varies worldwide and in many countries exceeds WHO-recommended rates. Long-term health outcomes for children born by CS are poorly understood, but limited data suggest that CS is associated ... ...

Abstract	Background: The proportion of births via cesarean section (CS) varies worldwide and in many countries exceeds WHO-recommended rates. Long-term health outcomes for children born by CS are poorly understood, but limited data suggest that CS is associated with increased infection-related hospitalisation. We investigated the relationship between mode of birth and childhood infection-related hospitalisation in high-income countries with varying CS rates. Methods and findings: We conducted a multicountry population-based cohort study of all recorded singleton live births from January 1, 1996 to December 31, 2015 using record-linked birth and hospitalisation data from Denmark, Scotland, England, and Australia (New South Wales and Western Australia). Birth years within the date range varied by site, but data were available from at least 2001 to 2010 for each site. Mode of birth was categorised as vaginal or CS (emergency/elective). Infection-related hospitalisations (overall and by clinical type) occurring after the birth-related discharge date were identified in children until 5 years of age by primary/secondary International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes. Analysis used Cox regression models, adjusting for maternal factors, birth parameters, and socioeconomic status, with results pooled using meta-analysis. In total, 7,174,787 live recorded births were included. Of these, 1,681,966 (23%, range by jurisdiction 17%-29%) were by CS, of which 727,755 (43%, range 38%-57%) were elective. A total of 1,502,537 offspring (21%) had at least 1 infection-related hospitalisation. Compared to vaginally born children, risk of infection was greater among CS-born children (hazard ratio (HR) from random effects model, HR 1.10, 95% confidence interval (CI) 1.09-1.12, p < 0.001). The risk was higher following both elective (HR 1.13, 95% CI 1.12-1.13, p < 0.001) and emergency CS (HR 1.09, 95% CI 1.06-1.12, p < 0.001). Increased risks persisted to 5 years and were highest for respiratory, gastrointestinal, and viral infections. Findings were comparable in prespecified subanalyses of children born to mothers at low obstetric risk and unchanged in sensitivity analyses. Limitations include site-specific and longitudinal variations in clinical practice and in the definition and availability of some data. Data on postnatal factors were not available. Conclusions: In this study, we observed a consistent association between birth by CS and infection-related hospitalisation in early childhood. Notwithstanding the limitations of observational data, the associations may reflect differences in early microbial exposure by mode of birth, which should be investigated by mechanistic studies. If our findings are confirmed, they could inform efforts to reduce elective CS rates that are not clinically indicated.
Mesh-Begriff(e)	Adult ; Australia ; Cesarean Section/adverse effects ; Cesarean Section/statistics & numerical data ; Child ; Child, Preschool ; Cohort Studies ; Denmark ; Developed Countries ; England ; Female ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infections/complications ; Male ; Parturition ; Pregnancy ; Risk Factors ; Scotland
Sprache	Englisch
Erscheinungsdatum	2020-11-19
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2185925-5
ISSN	1549-1676 ; 1549-1277
ISSN (online)	1549-1676
ISSN	1549-1277
DOI	10.1371/journal.pmed.1003429
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Perinatal risks in female cancer survivors: A population-based analysis.

van der Kooi, Anne-Lotte L F / Brewster, David H / Wood, Rachael / Nowell, Sian / Fischbacher, Colin / van den Heuvel-Eibrink, Marry M / Laven, Joop S E / Wallace, W Hamish B / Anderson, Richard A

PloS one

2018 Band 13, Heft 8, Seite(n) e0202805

Abstract: Background/objectives: Advances in cancer management have resulted in improved survival rates, particularly in children and young adults. However, treatment may adversely affect reproductive outcomes among female cancer survivors. The objective of this ... ...

Abstract	Background/objectives: Advances in cancer management have resulted in improved survival rates, particularly in children and young adults. However, treatment may adversely affect reproductive outcomes among female cancer survivors. The objective of this study was to investigate their risk of adverse perinatal outcomes compared to the general population. Design/methods: We performed a population-based analysis, including all female cancer survivors diagnosed before the age of 40 years between 1981 and 2012. Pregnancy and perinatal complications were identified through linkage of the Scottish Cancer Registry with hospital discharge records based on the Community Health Index (CHI) database. We compared 1,629 female cancer survivors with a first ever singleton pregnancy after diagnosis, with controls matched on age, deprivation quintile, and year of cancer diagnosis selected from the general population (n = 8,899). Relative risks and 95%-confidence intervals of perinatal risks were calculated using log-binomial regression. Results: Survivors were more likely to give birth before 37 weeks of gestation (relative risk (RR]) 1.32, 95%-CI 1.10-1.59), but did not show an increased risk of low birth weight (<2.5kg: RR 1.15, 95%-CI 0.94-1.39), and were less likely to give birth to offspring small for gestational age (RR 0.81, 95%-CI 0.68-0.98). Operative delivery and postpartum haemorrhage were more common but approached rates in controls with more recent diagnosis. The risk of congenital abnormalities was not increased (RR 1.01, 95%-CI 0.85-1.20). Conclusion: Cancer survivors have an increased risk of premature delivery and postpartum haemorrhage, but their offspring are not at increased risk for low birth weight or congenital abnormalities. In recent decades there has been a normalisation of delivery method in cancer survivors, nevertheless careful management remains appropriate particularly for those diagnosed in childhood.
Mesh-Begriff(e)	Adult ; Cancer Survivors ; Cesarean Section/statistics & numerical data ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Small for Gestational Age ; Perinatal Care ; Postpartum Hemorrhage/epidemiology ; Pregnancy ; Pregnancy Complications/classification ; Pregnancy Complications/epidemiology ; Premature Birth/epidemiology
Sprache	Englisch
Erscheinungsdatum	2018-08-23
Erscheinungsland	United States
Dokumenttyp	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0202805
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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