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2.
Artigo em Inglês | MEDLINE | ID: mdl-35006073

RESUMO

AIM: The aim of this study was to analyze the association between widely used contraceptive methods and the manifestation of lower urinary tract infections (LUTI) in patients treated in gynecological practices in Germany. MATERIALS AND METHODS: This study was based on IQVIA Disease Analyzer database and includes a total of 133,638 females aged between 16 and 50 years who received an initial diagnosis of LUTI including cystitis (ICD-10: N39.0, N30.0) between January 2011 and December 2020 (index date). 1 : 1 matching of LUTI cases to non-LUTI controls was used to investigate the association between predefined criteria and LUTI. A greedy nearest neighbor propensity score method was used to balance cases and controls with respect to age, pregnancy, visit frequency during the observation period, and comorbidities including cancer, diabetes mellitus, and urolithiasis. Univariate logistic regression models were used to assess the association between contraceptive prescriptions and LUTI. RESULTS: The general use of any contraceptive method was negatively associated with subsequent LUTI. Injectable contraceptives and pills were negatively associated with LUTI manifestation. There was a significant negative association between monophasic preparations containing < 50 µg estrogen, triphasic preparations, and progestogen-only preparations and LUTI. By contrast, we found a significant positive association between emergency contraceptives and LUTI. CONCLUSION: The general application of birth control methods as well as the use of injectable contraceptives and oral contraceptives were negatively associated with LUTI manifestation. In contrast to other birth control methods, the intake of emergency contraception was positively associated with a manifestation of LUTI.

3.
Artigo em Inglês | MEDLINE | ID: mdl-35006074

RESUMO

AIM: The aim of this study was to examine the age distribution and comorbidities of individuals vaccinated in primary care practices in April and May 2021. MATERIALS AND METHODS: The analysis was based on data from the IQVIA Disease Analyzer database and included 245,948 patients who received their first COVID-19 vaccination from one of 820 family medicine practices in April or May 2021. RESULTS: 93.6% of individuals received a vaccination based on general indication, 6.2% based on occupational indication, and 0.2% were nursing home residents. Men were 3.5 years younger on average than women (59.2 vs. 62.7 years). 54% of women and 52% of men younger than 60 years had at least one diagnosis from the priority list. Hypertension was the most common diagnosis (23.6% of men and 20.7% of women). In men, chronic respiratory diseases such as COPD or asthma were the second most common diagnosis (11.0%), while in women, depression (17.0%) was the second most common diagnosis. CONCLUSION: In the first 2 months of vaccination in general practices, most patients vaccinated were either elderly or chronically ill. Further studies comparing the characteristics of vaccinated and unvaccinated individuals would also be of great epidemiological relevance.

4.
Artigo em Inglês | MEDLINE | ID: mdl-35041059

RESUMO

PURPOSE: Little is known on how coronavirus disease 2019 (COVID-19) has impacted cancer diagnosis in Germany since the first lockdown in March 2020. Therefore, this retrospective study aimed to compare the number of patients newly diagnosed with cancer in general and specialized practices in Germany between April 2020-March 2021 and April 2019-March 2020. METHODS: Patients aged ≥ 18 years with at least 1 visit to 1 of 1403 general and specialized practices in Germany in April 2020-March 2021 (n = 3,804,596) and April 2019-March 2020 (n = 3,913,386) were included in this retrospective study. Specialized practices were composed of gynecology, dermatology and urology practices. Cancer diagnoses included all types of cancer documented using the International Classification of Diseases, 10th revision (ICD-10 codes: C00-C97). The number of patients newly diagnosed with cancer per practice was compared between April 2020-March 2021 and April 2019-March 2020 using Wilcoxon tests. RESULTS: There were 126,379 and 138,996 patients diagnosed with cancer in April 2020-March 2021 and April 2019-March 2020, respectively. The number of patients diagnosed with cancer decreased in all types of practice, and this decrease was significant in general practices (- 7.1%, p value = 0.038). In terms of cancer type, this decrease was particularly pronounced for skin cancers (- 12.8%, p value = 0.025). CONCLUSION: The COVID-19 pandemic has been associated with a decrease in the number of patients newly diagnosed with cancer in general and specialized practices in Germany. Public health interventions are urgently warranted to mitigate the deleterious effects of this health crisis on cancer diagnosis.

5.
J Psychiatr Res ; 147: 79-84, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35026596

RESUMO

Little is known about the effects of coronavirus disease 2019 (COVID-19) on mental health compared with other respiratory infections. Thus, the aim of this retrospective cohort study was to investigate whether COVID-19 diagnosis is associated with a significant increase in the incidence of depression and anxiety disorder in patients followed in general practices in Germany compared with acute upper respiratory infection diagnosis. This study included all patients diagnosed with symptomatic or asymptomatic COVID-19 for the first time in 1198 general practices in Germany between March 2020 and May 2021. Patients diagnosed with acute upper respiratory infection were matched to those with COVID-19 using propensity scores based on sex, age, index month, and Charlson Comorbidity Index. The index date corresponded to the date on which either COVID-19 or acute upper respiratory infection was diagnosed. Differences in the incidence of depression and anxiety disorder between the COVID-19 and the acute upper respiratory infection group were studied using conditional Poisson regression models. This study included 56,350 patients diagnosed with COVID-19 and 56,350 patients diagnosed with acute upper respiratory infection (52.3% women; mean [SD] age 43.6 [19.2] years). The incidence of depression (IRR = 1.02, 95% CI = 0.95-1.10) and anxiety disorder (IRR = 0.94, 95% CI = 0.83-1.07) was not significantly higher in the COVID-19 group than in the upper respiratory infection group. Compared with acute upper respiratory infection diagnosis, COVID-19 diagnosis was not associated with a significant increase in the incidence of depression and anxiety disorder in patients treated in general practices in Germany.

7.
J Psychiatr Res ; 146: 87-91, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34959163

RESUMO

There is limited literature on the long-term relationship between the diagnosis of factor V Leiden (FVL) and depression. Therefore, the aim of this retrospective cohort study was to investigate the association between FVL and the 10-year incidence of depression in Germany. Patients diagnosed with FVL for the first time in one of 1,274 general practices in Germany between 2000 and 2019 were included in this study (index date). Patients without FVL were matched (1:5) to those with FVL by sex, age, index year, and the average number of consultations per year. In individuals without FVL, index date corresponded to a randomly selected visit date between 2000 and 2019. The association between the diagnosis of FVL and the 10-year incidence of depression was analyzed using Kaplan-Meier curves and Cox regression models. This study included 1,070 patients with and 5,350 patients without FVL (64.9% women; 46.0 [16.5] years). Ten years after the index date, 21.4% and 14.1% of individuals with and without FVL were diagnosed with depression, respectively (log-rank p-value<0.001). After adjusting for thromboembolic events, the Cox regression analysis further showed that FVL was associated with a significant increase in the incidence of depression (HR = 1.61, 95% CI = 1.33-1.95). In this study conducted in Germany, FVL was identified as a long-term risk factor for depression. More research is needed to confirm or refute the present findings in other settings.

8.
J Med Virol ; 94(1): 298-302, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491581

RESUMO

For preventing the spread of the coronavirus disease 2019 (COVID-19) pandemic, measures like wearing masks, social distancing, and hand hygiene played crucial roles. These measures may also have affected the expansion of other infectious diseases like respiratory tract infections (RTI) and gastro-intestinal infections (GII). Therefore, we aimed to investigate non-COVID-19 related RTI and GII during the COVID-19 pandemic. Patients with a diagnosis of an acute RTI (different locations) or acute GII documented anonymously in 994 general practitioner (GP) or 192 pediatrician practices in Germany were included. We compared the prevalence of acute RTI and GII between April 2019-March 2020 and April 2020-March 2021. In GP practices, 715,440 patients were diagnosed with RTI or GII in the nonpandemic period versus 468,753 in the pandemic period; the same trend was observed by pediatricians (275,033 vs. 165,127). By GPs, the strongest decrease was observed for the diagnosis of influenza (-71%, p < 0.001), followed by acute laryngitis (-64%, p < 0.001), acute lower respiratory infections (bronchitis) (-62%, p < 0.001), and intestinal infections (-40%, p < 0.001). In contrast, the relatively rare viral pneumonia strongly increased by 229% (p < 0.001). In pediatrician practices, there was a strong decrease in infection diagnoses, especially influenza (-90%, p < 0.001), pneumonia (-73%, p < 0.001 viral; -76%, p < 0.001 other pneumonias), and acute sinusitis (-66%, p < 0.001). No increase was observed for viral pneumonia in children. The considerable limitations concerning social life implemented during the COVID-19 pandemic to combat the spread of SARS-CoV-2 also resulted in an inadvertent but welcome reduction in other non-Covid-19 respiratory tract and gastro-intestinal infections.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Gastroenteropatias/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Higiene das Mãos/métodos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Distanciamento Físico , Prevalência , Adulto Jovem
9.
J Clin Med ; 10(23)2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34884391

RESUMO

Portal vein thrombosis (PVT) is a severe disease that adversely affects patients' well-being. Data on the influence of PVT on the occurrence of depression or anxiety disorders are lacking. This study aimed to explore the impact of PVT on the incidence of depression and anxiety disorders diagnoses in a large German primary care cohort over a ten-year period. Patients with PVT were matched to non-PVT individuals by age, sex, yearly consultation frequency, index year and comorbidities in a 1:5 ratio. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between PVT and both depression and anxiety disorders was investigated using Cox regression models. We compared 547 patients with PVT with 2735 matched individuals without PVT. Within 5 years of the index date, 17.4% of patients with PVT and 9.3% of non-PVT individuals were diagnosed with depression (p < 0.001). Anxiety disorders were diagnosed in 5.5% and 3.0% of patients with PVT and non-PVT individuals, respectively (p = 0.002). On regression analyses, PVT was positively associated with incident depression (HR 2.01, 95% CI 1.53-2.64, p < 0.001) as well as anxiety disorders (HR 2.16, 95% CI 1.35-3.46, p = 0.001). Regarding depression, this association remained significant in women as well as in men. There was no association between PVT and the incidence of anxiety disorders in women. In conclusion, PVT is associated with the development of depression and anxiety disorders. However, further prospective studies are needed to confirm our findings before definitive recommendations can be made.

11.
Postgrad Med ; 2021 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-34872427

RESUMO

OBJECTIVES: The present study aimed to analyze the association between the prescription of ivy leaves dry extract EA 575 (licensed under the trade name Prospan® in Germany) and the incidence of antibiotic use, incident bacterial complications, and days of sick leave in adult patients with cold diseases. METHODS: This retrospective cohort study was based on the IQVIA Disease Analyzer database and included adult patients from 1,032 general practices in Germany with a documentation of common cold between 2017 and 2020 (index date) and prescription of either EA 575 or an antibiotic drug within three days after index date. 1:1 propensity score matching based on age, sex, index month, physician, health insurance status, and the Charlson Comorbidity Index was carried out. Univariable regression models were used to investigate the association between EA 575 prescription and defined outcomes. RESULTS: Data of 7,034 patients treated with EA 575 and 7,034 matched patients receiving an antibiotic were available. EA 575 prescription was associated with significantly lower odds of an antibiotic prescription in the time periods of 4-30 days (OR: 0.83; 95% CI: 0.72-0.96) and 31-365 days (OR: 0.44; 95% CI: 0.40-0.48) after the index date. EA 575 prescription was significantly associated with a lower rate of sick leave of more than 7 days (33.0% vs. 37.7%, OR: 0.81; 95% CI: 0.73-0.90) in patients with any sick leave, as well as with lower odds of a new cough diagnosis (OR: 0.91, 95% CI: 0.85-0.98) when compared to antibiotic prescription. CONCLUSION: Our study provides further evidence that the use of phytopharmaceuticals, in particular ivy leaves dry extract EA 575, could contribute to a reduction in the number of inappropriate antibiotic prescriptions for respiratory infection with cough symptoms.

12.
Clin Park Relat Disord ; 5: 100120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34888519

RESUMO

Background: Little is known on the potential relationship between osteoarthritis and Parkinson's disease. Objective: Therefore, the objective of this retrospective cohort study was to analyze the association between osteoarthritis and the incidence of Parkinson's disease in patients followed up for up to 10 years in general practices in the United Kingdom. Methods: This study included patients diagnosed for the first time with osteoarthritis in one of 256 general practices in the United Kingdom between 2000 and 2016 (index date). Patients without osteoarthritis were matched (1:1) to those with osteoarthritis using propensity scores based on sex, age and index year. In individuals without osteoarthritis, index date corresponded to a randomly selected visit date. The outcome of this study was the 10-year cumulative incidence of Parkinson's disease in patients with and without osteoarthritis. Cox regression analyses were adjusted for common comorbidities. Results: This study included 260,224 patients (62.0% women; mean [SD] age 66.4 [12.7] years). The 10-year cumulative incidence of Parkinson's disease was 1.2% in patients with osteoarthritis and 0.6% in their counterparts without osteoarthritis (log-rank p-value < 0.001). The adjusted Cox regression model further showed a positive and significant association between osteoarthritis and the incidence of Parkinson's disease (HR = 1.82, 95% CI: 1.63-2.02). Similar results were obtained in all sex and age subgroups. Conclusions: In this retrospective cohort study conducted in the United Kingdom, there was a positive association between osteoarthritis and the incidence of Parkinson's disease. More research is warranted to confirm or refute these findings in other settings and countries.

13.
J Clin Med ; 10(24)2021 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-34945206

RESUMO

(1) Background: Irritable bowel syndrome (IBS) represents one of the most common disorders of gut-brain interaction (DGBI). As recent data has suggested an increased cancer incidence for IBS patients, there is an ongoing debate whether IBS might be associated with a risk of cancer development. In the present study, we evaluated and compared incidence rates of different malignancies including gastrointestinal cancer in a large cohort of outpatients, with or without IBS, treated in general practices in Germany. (2) Methods: We matched a cohort of 21,731 IBS patients from the IQVIA Disease Analyzer database documented between 2000 and 2019 in 1284 general practices to a cohort of equal size without IBS. Incidence of cancer diagnoses were evaluated using Cox regression models during a 10-year follow-up period. (3) Results: In 11.9% of patients with IBS compared to 8.0% without IBS, cancer of any type was diagnosed within 10 years following the index date (p < 0.001). In a regression analysis, this association was confirmed in female (HR: 1.68, p < 0.001) and male (HR = 1.57, p < 0.001) patients as well as in patients of all age groups. In terms of cancer entity, 1.9% of patients with and 1.3% of patients without IBS were newly diagnosed with cancer of digestive organs (p < 0.001). Among non-digestive cancer entities, the strongest association was observed for skin cancer (HR = 1.87, p < 0.001), followed by prostate cancer in men (HR = 1.81, p < 0.001) and breast cancer in female patients (HR = 1.80, p < 0.001). (4) Conclusion: Our data suggest that IBS might be associated with cancer of the digestive organs as well as with non-digestive cancer entities. However, our findings do not prove causality and further research is warranted as the association could be attributed to life style factors that were not documented in the database.

14.
Curr Oncol ; 28(6): 5035-5040, 2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34940062

RESUMO

BACKGROUND: Colorectal cancer is one of the most common malignancies in the Western world, and is responsible for about 10% of annual cancer-related deaths. Especially for UICC stage IV, the probability of survival is significantly reduced. Little is known about risk factors for specific metastatic patterns of colorectal cancer that may also influence patients' overall survival. METHODS: We used data from the IQVIA oncology dynamics (OD) database to determine the prevalence of pulmonary metastases in 19,321 patients with UICC stage IV colorectal cancer in eight European and Asian countries. RESULTS: In total, 6132 of 19,321 (31.7%) study patients had lung metastases, with a higher prevalence among patients with rectal (37.5%) than colon (30.1%) cancer. When compared to China as the country with the lowest lung metastases prevalence, the odds for lung metastases were highest in UK (OR: 2.02, 95%CI: 1.80-2.28), followed by Italy (OR: 1.86, 95%CI: 1.52-2.27), Spain (OR: 1.85, 95%CI: 1.64-2.09), and Germany (OR: 1.47, 95%CI: 1.26-1.71). CONCLUSION: The prevalence of pulmonary metastases in UICC stage IV colorectal cancer varies widely among the different analyzed countries. Although the present data are purely descriptive, a possible combination of ethnic, environmental, and health care system-associated differences could be discussed as the underlying cause. Further studies are needed to investigate the reasons for differences in the prevalence of lung metastases.

15.
Artigo em Inglês | MEDLINE | ID: mdl-34897572

RESUMO

PURPOSE: There is a growing body of evidence suggesting a decisive involvement of the human lipid metabolism in cancer development. However, clinical data on the association between blood triglyceride or cholesterol levels including the cholesterol transporters high-density and low-density lipoproteins (LDL, HDL) and cancer incidence have remained inconclusive. Here, we investigated the association between blood triglyceride as well as total, LDL and HDL cholesterol levels and cancer among outpatients from Germany. METHODS: 61,936 patients with available blood lipid values were identified from the IQVIA Disease Analyzer database and followed up between 2005 and 2019. Multivariable logistic regression models were used to study the association between lipid values and cancer. RESULTS: The probability of cancer was significantly lower among patients with elevated total cholesterol concentrations and higher in patients with decreased HDL serum levels. In contrast, serum concentrations of LDL and triglycerides had no impact on cancer risk. In cancer site-stratified analyses, we observed a trend towards higher rates of cancers from digestive organs, breast, skin cancer, urinary tract and cancers from lymphoid and hematopoietic tissue in patients with HDL values < 35 mg/dl, while a negative association between total cholesterol > 250 mg/dl and respiratory organ as well as urinary tract cancers was observed. CONCLUSION: Our data strongly support the hypothesis that serum-specific lipid profiles are positively associated with cancer.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34897573

RESUMO

BACKGROUND: Diabetes mellitus (DM) has recently been associated with an increased incidence of such digestive tract malignancies as gastric or colorectal cancer. However, systematic data on the prevalence of DM among digestive tract cancer entities, especially in terms of geographic distributions, are lacking. METHODS: We used the Oncology Dynamics database (IQVIA) to identify a total of 80,193 patients with gastrointestinal (GI) cancer (5845 esophagus, 20,806 stomach, 38,138 colon, and 15,414 rectum cancer patients) from eight European and Asian countries. RESULTS: The overall prevalence of DM among all digestive tract cancer patients was 14.8% (11,866/80,193). In terms of cancer site, DM prevalence was highest in patients with colon (15.5%) or rectal (15.3%) cancer and lowest in patients with esophageal cancer (12.0%). Interestingly, we observed significant differences in DM prevalence between countries. Spain (27.8%, 31.3%) and South Korea (21.0%, 27.9%) had the highest prevalence of DM among gastric and colon cancer patients, while DM prevalence in esophageal (18.8%) and rectal (38.0%) cancer patients was highest in Germany. CONCLUSION: Our data revealed a high prevalence of DM among digestive tract cancer patients in Europe and Asia, and showed that DM prevalence varies among digestive tract cancer sites as well as countries.

17.
Neuroepidemiology ; 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724667

RESUMO

BACKGROUND: This study aimed to identify clinical features that predate the diagnosis of PD in a primary care setting. METHODS: This retrospective case-control study was based on data from the Disease Analyzer database (IQVIA) and included 17,702 patients with Parkinson's disease and 17,702 non-PD controls matched for age, sex, and index year. We analyzed the prevalence of 15 defined diagnoses and symptoms documented within 2 years, ≥2 to <5, and ≥5 to <10 years prior to the index date in patients with and without PD. Logistic regression analyses were conducted to assess the association between PD and the predefined diagnoses. RESULTS: The prevalence of motor, neuropsychiatric and autonomic features was higher in those with a later diagnosis of Parkinson's disease than controls for all three periods except for rigidity in the ≥2 to <5 and ≥5 to <10-year periods and erectile dysfunction in the most recent period before diagnosis. The clinical presentation recorded in the greatest percentage of patients was depression, followed by dizziness, insomnia, and constipation, but these were also common in the control population. The odds ratios were highest for increase in tremor, followed by balance impairment and memory problems, particularly in the latest period before diagnosis, and by constipation particularly in the earliest period examined. CONCLUSION: The prodromal features of PD could be identified in this large primary care database in Germany with similar results to those found in previous database studies despite differences in methodologies and systems.

19.
Epilepsy Behav ; 125: 108393, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34731722

RESUMO

OBJECTIVE: Epilepsy is a complex disease with serious consequences for the quality of life and prognosis of those affected. The importance of comorbidities in disease progression and prognosis has gained increasing recognition in recent years. In the present study, we investigated the potential association between epilepsy and heart failure in an outpatient cohort in Germany. METHODS: Using the IQVIA Disease Analyzer database, we identified a total of 9646 patients with late-onset epilepsy and a matched cohort of equal size without late-onset epilepsy who were followed up between 2005 and 2018. Cox regression models were used to evaluate the potential association between epilepsy and heart failure. RESULTS: Within 10 years of the index date, 28.6% of patients with epilepsy and 20.4% of patients without epilepsy had been diagnosed with HF (log-rank p < 0.001). The incidences were 36.3 cases per 1,000 patient years in the epilepsy cohort versus 23.1 cases in the non-epilepsy cohort. In regression analyses, epilepsy was significantly associated with the incidence of HF (Hazard Ratio (HR): 1.56, p < 0.001). The association was somewhat stronger in men (HR: 1.63, p < 0.001) than in women (HR: 1.49, p < 0.001). The HR in the epilepsy group decreased with increasing age. CONCLUSION: Our study provides strong evidence that epilepsy is associated with an increased incidence of heart failure. This finding should help raise awareness of this important comorbidity and could trigger specific cardiovascular screening programs in patients with epilepsy.

20.
Z Gastroenterol ; 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34820806

RESUMO

BACKGROUND: Adequate pharmacological treatment is of pivotal importance to improve prognosis in patients with decompensated liver cirrhosis. We studied the adherence to recommended pharmacological treatments as secondary prevention in cirrhotic patients following a first decompensation in German primary care. METHODS: Using the Disease Analyzer Database, the current study sample included patients with liver cirrhosis who had an initial diagnosis of a first decompensation event between 2015 and 2018 (index date) and a follow-up time of at least 6 months after the index date. Pharmacological treatments following the 6 months after the index date were studied. RESULTS: The study included 1538 patients with a first decompensation event. The frequency of first-time complications of cirrhosis was 60% new onset of ascites, 25% overt hepatic encephalopathy (HE), 3% spontaneous bacterial peritonitis (SBP), and 12% acute variceal bleeding. The adherence to guideline-recommended treatment following the initial decompensation was highest for ascites, with 91.3% of patients receiving diuretics. Non-selective beta-blockers following an event of variceal bleeding were prescribed in 69.1% and lactulose and/or rifaximin in 59.1% after a bout of HE. The frequency of prescriptions of antibiotics after SBP was 60.4%. Potenzially harmful prescribed medications included non-steroidal anti-inflammatory drugs in 15.5%, benzodiazepines in 12.8%, opioids in 9.5%, and proton pump inhibitors in 73.7%. CONCLUSION: Our findings underline the need for intensified efforts to distribute practice guidelines for liver cirrhosis and increase awareness of over-prescribing of potentially harmful medication.

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