PubMed · 11608256
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W Kaiser. 1977. [Not Available].. https://pubmed.ncbi.nlm.nih.gov/11608256/
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BACKGROUND/AIMS: Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct diseases, yet many glaucoma cases in population-based datasets lack subtype specification. We assessed incidence patterns of glaucoma subtypes in China and the UK and used genetic evidence to infer the likely subtype composition of cases recorded as unspecified glaucoma. METHODS: Incident primary glaucoma was identified from linked inpatient records in the prospective China Kadoorie Biobank (CKB; n=512 504) and UK Biobank (UKB; n=492 329) studies. Cohort-specific phenotyping algorithms defined POAG, PACG and unspecified glaucoma. Adjusted incidence rates were estimated by direct standardisation. To support subtype inference, polygenic risk scores (PRSs) were constructed using ancestry-specific genome-wide association studies, including a new East Asian PACG meta-analysis, and tested for association with glaucoma phenotypes using multivariable logistic regression. RESULTS: Over 12 years of follow-up, 1658 primary glaucoma cases were identified in CKB and 7643 in UKB. Most (>68%) cases lacked subtype specification. Incidence increased with age and was twofold higher among women for PACG in both cohorts and for unspecified glaucoma in CKB. In UKB, POAG incidence was fivefold higher among Black than White participants, with a similar but attenuated pattern for unspecified glaucoma. PRS analyses indicated that unspecified glaucoma closely aligned with PACG in CKB but was more heterogeneous in UKB. CONCLUSION: Healthcare-recorded incidence patterns for POAG and PACG were consistent with established demographic risk factors, whereas unspecified glaucoma showed differences in subtype composition between populations. Integrating epidemiological and genetic evidence improves interpretation of glaucoma phenotypes when detailed clinical information is unavailable.
OBJECTIVE: To investigate the benefits and harms associated with antenatal corticosteroids (ACS) prior to planned caesarean birth at late preterm or early term. DESIGN: Retrospective cohort study. SETTING: South Australia, Australia, 2005-2018. PATIENTS: Women with singleton pregnancies undergoing planned caesarean birth between 36+0 and 38+6 weeks' gestation. METHODS: We used routinely collected electronic maternity and neonatal data. Adjusted risk differences (aRD) with 95% CIs were calculated for neonatal and maternal outcomes. OUTCOME MEASURES: Neonatal outcomes included respiratory distress requiring oxygen, hypoglycaemia requiring glucose, neonatal unit (NNU) admission and prolonged NNU admission (≥48 hours). RESULTS: Among the cohort of 4049 women, the proportion receiving ACS was 54.8%, 48.4% and 5.6% at 36, 37 and 38 completed weeks' gestation, respectively. ACS administration was associated with a significant reduction in respiratory distress across all gestations, with the greatest reduction seen at 36 weeks' gestation (aRD -12.5%; 95% CI -21.4% to -3.6%). At 38 weeks' gestation, ACS administration was associated with an increased risk of neonatal hypoglycaemia (aRD 5.7%; 95% CI 1.1% to 10.2%), NNU admission (aRD 5.4%; 95% CI 0.1% to 10.7%) and prolonged NNU admission (aRD 4.6%; 95% CI 0.2% to 8.9%). CONCLUSIONS: ACS administration prior to late preterm and early term planned caesarean birth was associated with reduced risk of respiratory distress. The net benefit of ACS administration before planned caesarean birth remains unclear; however, there was evidence of potential neonatal harm when birth occurred after 37 weeks' gestation.
There is marked variation in the frequency of focal segmental glomerulosclerosis (FSGS) around the world. Recent studies of renal biopsy specimen archives from several institutions in the United States suggest that the incidence of FSGS has increased over the past 20 years. Indeed, FSGS has become the leading cause of idiopathic nephrotic syndrome in adults and has become increasingly common in children as well. Further, the data indicate that black individuals are at increased risk for developing idiopathic FSGS as well as FSGS in the setting of human immunodeficiency virus (HIV)-1 infection. Data from around the world suggest great variability in the proportion of glomerular disease that is attributed to FSGS, with recent increases seen in some countries and not in others. Epidemiologic data from the United States Renal Data Systems (USRDS) show that the incidence of end-stage renal disease (ESRD) owing to idiopathic FSGS has increased considerably, both as absolute numbers and as a fraction of the total ESRD incident population, with FSGS now accounting for 3.3% of incident ESRD cases. In the United States, the annual rate of incident FSGS ESRD cases is 7 per million for the general population, 20 per million for black individuals, and 5 per million for white individuals. The numbers of acquired immune deficiency syndrome (AIDS) nephropathy incident ESRD cases increased rapidly until reaching a plateau after 1995. The reasons for the recent increase in idiopathic FSGS and FSGS incident ESRD cases are complex, but these trends are likely caused, at least in part, by a real increase in the incidence of FSGS over the past 10 to 20 years.