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Association Between Life Events and Rheumatoid Arthritis: Results From a Population‐Based Case–Control Study 下载免费PDF全文
Annmarie Wesley Camilla Bengtsson Eva Skillgate Saedis Saevarsdottir Töres Theorell Marie Holmqvist Lars Klareskog Lars Alfredsson Sara Wedrén for the EIRA Study Group 《Arthritis care & research》2014,66(6):844-851
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Occupation and Risk of Developing Rheumatoid Arthritis: Results From a Population‐Based Case–Control Study 下载免费PDF全文
Anna Ilar Lars Alfredsson Pernilla Wiebert Lars Klareskog Camilla Bengtsson 《Arthritis care & research》2018,70(4):499-509
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Environmental factors are of importance for the etiology of rheumatoid arthritis (RA), but much remains unknown concerning the contributions from distinct occupational hazards. We explored the association between occupation and the risk of anti–citrullinated protein antibody (ACPA)+ RA or ACPA? RA.Methods
We analyzed 3,522 cases and 5,580 controls from the Swedish population–based Epidemiological Investigation of Rheumatoid Arthritis case–control study. A questionnaire was used to obtain information on work history and lifestyle factors. Blood samples were drawn for serologic analyses. Unconditional logistic regression was used to calculate the odds ratio (OR) of RA associated with the last occupation before study inclusion. Analyses were performed with adjustments for known environmental exposures and lifestyle factors, including pack‐years of cigarette smoking, alcohol use, body mass index, and education.Results
Among men, bricklayers and concrete workers (OR 2.9, 95% confidence interval [95% CI] 1.4–5.7), material handling operators (OR 2.4, 95% CI 1.3–4.4), and electrical and electronics workers (OR 2.1, 95% CI 1.1–3.8) had an increased risk of ACPA+ RA. For ACPA? RA, bricklayers and concrete workers (OR 2.4, 95% CI 1.0–5.7) and electrical and electronics workers (OR 2.6, 95% CI 1.3–5.0) had an increased risk. Among women, assistant nurses and attendants had a moderately increased risk of ACPA+ RA (OR 1.3, 95% CI 1.1–1.6). No occupations were significantly associated with ACPA? RA among women.Conclusion
Mainly occupations related to potential noxious airborne agents were associated with an increased risk of ACPA+ or ACPA? RA, after adjustments for previously known confounders.5.
Caroline Kronisch David J. McLernon James Dale Caron Paterson Stuart H. Ralston David M. Reid Ann Tierney John Harvie Neil McKay Hilary E. Wilson Robin Munro Sarah Saunders Ruth Richmond Derek Baxter Mike McMahon Vinod Kumar John McLaren Stefan Siebert Iain B. McInnes Duncan Porter Gary J. Macfarlane Neil Basu 《Arthritis \u0026amp; Rheumatology》2016,68(7):1596-1602
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ObjectivesTo examine time trends in glucocorticoid (GC) use among patients diagnosed with rheumatoid arthritis (RA) during the biologic era.MethodsA population-based inception cohort of RA patients diagnosed during 1999 – 2018 was followed longitudinally through their medical records until death, migration or 12/31/2020. All patients fulfilled 1987 American College of Rheumatology classification criteria for RA. GC start and stop dates were collected along with dosages in prednisone equivalents. The cumulative incidence of GC initiation and discontinuation adjusted for the competing risk of death was estimated. Cox models adjusted for age and sex were used to compare trends between time periods.ResultsThe study population included 399 patients (71% female) diagnosed in 1999 – 2008 and 430 patients (67% female) diagnosed in 2009 – 2018. GC use was initiated within 6 months of meeting RA criteria in 67% of patients in 1999-2008 and 71% of patients in 2009-2018, corresponding to a 29% increase in hazard for initiation of GC in 2009-2018 (adjusted hazard ratio [HR]: 1.29; 95% confidence interval [CI]: 1.09-1.53). Among GC users, similar rates of GC discontinuation within 6 months after GC initiation were observed in patients with RA incidence in 1999 – 2008 and 2009 – 2018 (39.1% versus 42.9%, respectively), with no significant association in adjusted Cox models (HR: 1.11; 95% CI: 0.93-1.31).ConclusionMore patients are initiating GCs early in their disease course now compared to previously. The rates of GC discontinuation were similar, despite the availability of biologics. 相似文献
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Convective Dialysis Reduces Mortality Risk: Results From a Large Observational,Population‐Based Analysis 下载免费PDF全文
Valeria Cernaro Giovanni Tripepi Luca Visconti Antonio Lacquaniti Gaetano Montalto Adolfo Romeo Domenica Cimadoro Giuseppe Costantino Francesco Torre Domenico Santoro Michele Buemi 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2018,22(5):457-468
According to many studies, extracorporeal dialysis with convective methods is associated with better clinical outcomes and a survival benefit compared to diffusive techniques. However, there is no full agreement on the actual superiority of this kind of renal replacement therapy on hard end‐points such as mortality. We performed a retrospective epidemiological cohort study to provide “real‐world” evidence on the impact of convective and non‐convective dialysis techniques on all‐cause and cardiac mortality and biochemical outcomes among dialysis patients in Sicily, the southernmost region of Italy. Data of all incident adult patients (N = 6529) who have started chronic extracorporeal dialysis over the period 2009–2015 were retrieved from the Sicilian Registry of Nephrology, Dialysis and Transplantation. There were 1558 patients receiving convective techniques (23.86%). Overall mortality rate was 45.21% with a significant difference between convective (31.39%) and non‐convective (49.55%) groups (P < 0.0001). After adjustment for potential confounders in multiple Cox regression models of increasing complexity, the mortality risk remained significantly lower for patients treated with convective methods (HR, 0.581; 95%CI, 0.525 to 0.643; P < 0.0001). Moreover, the convective group had a better blood chemistry profile, improved dialysis efficacy, and reduced mortality rate from cardiac diseases compared to the non‐convective group. As a sensitivity analysis, patients were categorized according to propensity score quartiles and the hazard ratio for both all‐cause and cardiac mortality was significantly lower for the convective group in each quartile. In conclusion, despite the observational and retrospective design, the results of the present study further support the use of convective therapies for the treatment of end‐stage renal disease. 相似文献