True Difference In Incidence Research Articles

Racial and ethnic differences in abdominal soft tissue sarcoma incidence in New Zealand: a retrospective audit.

Soft tissue sarcomas are a rare and heterogenous group of tumours. Anecdotally there seems to be an over representation of patients of Māori ethnicity presented at the Auckland Regional Sarcoma Multidisciplinary Meeting (MDM). To date no study has reported on ethnicity demographics of abdominal and retroperitoneal sarcoma in New Zealand. The aim of this study is to characterize the ethnicity distribution of patients discussed at the regional MDM. A retrospective audit was performed of patients presented at the Auckland Regional Sarcoma MDM between January 2015 and December 2020 with abdominal sarcoma. Ethnicity documentation for these patients was reviewed. One hundred and twenty-four patients with intra-abdominal and retroperitoneal tumours were discussed at MDM with 61 proceeding for resection, of those 43 (70.5%) were primary tumours, 10 (16.4%) were recurrent tumours and 8 (13.1%) had metastatic disease. Liposarcoma made up 56 (45.2%) cases, Leiomyosarcoma 33 (26.6%), Other 35 (28.2%). Ethnicities for this group specifically were European 64 (51.6%), Māori 31 (25.0%), Pacific Peoples 17 (13.7%), Asian 6 (4.8%) and Other/unknown 3(2.4%). This was found to be statistically significantly different to the expected ethnicity distribution based on 2018 census data from North Island DHBs (χ2 =19.55, p=0.00), with Māori and Pacific Peoples being over-represented and Asian patients being under-represented. Recommendation for surgery did not appear to be related to ethnicity. Our descriptive data shows a higher proportion of patients of Māori ethnicity discussed through the North Island regional sarcoma MDM than we would expect comparted to ethnicity distribution in the general population. It is unclear whether this represents a true difference in incidence based on ethnicity.

Giardiasis notifications are associated with socioeconomic status in Sydney, Australia: a spatial analysis

ObjectiveIn developed countries prolonged symptoms due to, or following, Giardia intestinalis infection can have a significant impact on the quality of life. In this research, we investigate the presence of a socioeconomic status (SES) gradient in the reporting of giardiasis in South West Sydney Local Health District (SWSLHD), New South Wales (NSW), Australia, across geographic scales. MethodsWe used a large database, spatial‐cluster analysis and a linear model. ResultsFirstly, we found one spatial cluster of giardiasis in one of the most advantaged neighbourhoods of SWSLHD. Secondly, rates of giardiasis notifications were significantly and consistently lower in SWSLHD compared to an unnamed advantaged Local Health District and NSW over multiple years. Finally, we found an overall significant positive dose–response relationship between counts of giardiasis and area‐level SES. ConclusionsLower reporting in disadvantaged areas may represent true differences in incidence across SES groups or may result from differential use of health services and reporting. Implications for public healthIf the disparities result from differential use of health services, research should be directed toward identifying barriers and facilitators of use. If disparities result from a true difference in incidence, then the behavioural mediators between SES and giardiasis should be identified and addressed.

Abstract WP181: Incidence of Transient Ischemic Attack in Auckland, New Zealand, in 2011-2012

Introduction: There have been few recent population studies reporting the burden of TIA. We aimed to determine the incidence (first ever in a lifetime) of TIA in an ethnically diverse population. Hypothesis: The incidence of TIA may vary by different ethnic group. Methods: The fourth Auckland Regional Community Stroke study (ARCOS IV) used multiple overlapping ascertainment methods to identify all hospitalized and non-hospitalized cases of definite TIA in people ≥16 years of age usually resident in Auckland (population ≥16 years was 1.12 million), over 12 months from March 2011. TIA was defined as an acute loss of focal cerebral or ocular function with symptoms lasting <24 hours, of presumed vascular cause. Patients with isolated vertigo, diplopia and non-focal symptoms were excluded. Results: There were 785 people with TIA [402 (51.2%) women, mean (SD) age 71.5 (13.8) years]. Of these, 614 (78%) were European, 32 (4.1%) Maori (indigenous people of New Zealand), 62 (8%) Pasifika (originating from the Pacific Islands) and 75 (10%) Asian/Others. Most (82%) TIA patients were seen in a hospital setting (emergency room, outpatient clinic or admitted). The annual age-standardized incidence of TIA was 40 (95% CI 36-43) per 100,000 people. The annual age-standardized incidence per 100,000 people of TIA was less in Maori (27; 95% CI 8-40) and Asian/Others (21; 95% CI 16-27) than in Europeans (45; 95% CI 41-50). Vascular risk factor profiles and treatment at presentation varied between the different ethnic groups. For example, non-Europeans were more likely to be diabetic (p<0.01), and Maori and Pasifika were less likely to be taking lipid-lowering therapy (p<0.01), than other groups. Conclusions: This study has demonstrated ethnic differences in the burden of TIA in an era of aggressive primary and secondary vascular risk factor management. We speculate that that the lower incidence of TIA seen in ethnic minorities may reflect a failure to seek medical attention as opposed to a true difference in incidence. If confirmed, programs targeting different ethnic groups, particularly those of lower socioeconomic status, and aimed at improving health literacy around vascular disease and reducing barriers to accessing health care, will be required.

P02-256 - Prevalence of mental disorders in late life

In late life patients considerably more seldom than patients of other age groups reach attention of psychiatrists due to obliteration of symptoms of mental suffering, their masked by somatic symptoms manifestation, not seldom - negative attitude of relatives toward psychiatric assistance etc.Study of patients of elder and older age at units of somatic hospital of another profile (therapeutic, cardiologic, neurological, traumatologic) has shown that mental disturbances are revealed in 74,4 % of them. Non-psychotic forms of disorders are basic (73,8 %), more seldom psychoses are found (18,6 %) and dementias of various nature (7,6 %). Of most prevalence in this contingent were disorders related with cerebral-vascular diseases (42,6 %), including those with acute disturbances of brain blood circulation (20,5 %). Somatogenic mental disorders occupy more modest place counting 8,8%. Neuroses including nosogenias are observed in 9,2 % of cases. Endogenous diseases are rarely found in patients of a somatic institution (6,7 %).In recent years significant growth of organic mental disorders in Russian Federation occurs predominantly at the expense of the elderly. In structure of this pathology as selective epidemiological investigations show the first place according to incidence rate is occupied by cerebral-vascular diseases (34,1 %); the second place is occupied by neurotic disturbances (26,0 %); the third one - affective disorders (15,4 %).Differences in sickness rate and morbidity in such conditions identified by researchers in different populations may reflect more particularly their diagnostic approaches than the true differences in incidence and prevalence.

Tolerability of Antiandrogens in the Treatment of Prostate Cancer

This article presents and discusses data on the tolerability of the antiandrogens, both steroidal (cyproterone acetate; CPA) and non-steroidal (bicalutamide, flutamide, nilutamide), across all stages of hormone-responsive prostate cancer. Steroidal and non-steroidal antiandrogens have different endocrine effects and therefore different pharmacological side effects during monotherapy, with CPA generally resulting in loss of sexual interest and erectile dysfunction, whereas the majority of men retain some sexual interest and function during non-steroidal antiandrogen monotherapy. The most common side effects of the non-steroidal agents are gynaecomastia and breast pain. Although the incidence of these events varies considerably between studies, there is no evidence that there is a true difference in incidence between the three non-steroidal agents. Important differences exist between the antiandrogens with respect to non-pharmacological side effects. CPA has been linked to adverse changes in serum lipids as well as significant, and in some cases fatal, cardiovascular events. CPA can also cause hepatotoxicity. Nilutamide is associated with delayed adaptation to darkness, alcohol intolerance and interstitial pneumonitis. Flutamide is associated with a greater risk of serious hepatotoxicity than bicalutamide or nilutamide. Diarrhoea is also more likely to occur during therapy with flutamide than the other antiandrogens. In contrast, no specific non-pharmacological complications have been linked to bicalutamide, while diarrhoea and abnormal liver function occur less frequently than with flutamide. Thus, when considering antiandrogen therapy at any stage of prostate cancer, bicalutamide appears to have advantages over the other antiandrogens.

Incidence studies of primary and secondary intracranial tumors: a systematic review of their methodology and results.

We reviewed the incidence studies of intracranial tumors to compare their methodology and identify whether there was evidence of true differences in incidence by time, place, age, or sex. Studies were identified from Medline (1966-95), bibliographies of relevant articles, and personal knowledge. For each study, various methodological details were recorded, along with the age-standardized incidence of all primary tumors and the crude and age/sex-specific incidences of different types of intracranial tumor. Methodological factors which significantly influenced the reported incidence were identified and the results of different studies were compared and combined in a meta-analysis if appropriate. Twenty studies (over 20,000 primary tumors) were included. Higher incidences of primary tumors were found in studies that: used many methods to identify cases (odds ratio [OR] 1.92); included a high percentage of asymptomatic patients (OR 2.03); did not require histologic confirmation of the diagnosis (OR 1.69). Studies from the 1980's reported higher incidences than in previous decades (OR 1.51), probably because of improved methodology. Comparable studies from the 1980's gave widely different incidence rates for all primary tumors (7.1-18.6 per 100,000 per year). In all studies, the incidence of neuroepithelial and meningeal tumors increased dramatically with age. Neuroepithelial tumors were 40% more common in men, whilst meningeal and cranial nerve tumors were about 80% and 40% more common in women, respectively. Further incidence studies are required to establish geographical and secular variations in the incidence of primary intracranial tumors but these must use comparable methodologies. Provisional guidelines for future studies are given.

Suspected poisoning in children. Study of the incidence of true poisoning and poisoning scare in a defined population in North East Bristol.

The distinction between true and suspected poisoning in children has not been made clear in previous work on childhood poisoning. A study of suspected poisoning in children under 15 years of age in a defined population of North East Bristol from November 1970 to July 1973 carried out by the Health Education Council Medical Research Division included 53,000 child-years at risk. The number of suspected poisonings was 3-4/1000 population aged under 15 years per year, with a higher incidence in younger age groups. Detailed investigation of the circumstances of the accidents carried out by a multidisciplinary team showed that at least 65%, and possibly as many as 78% were poisoning scares and not true poisoning. The evidence used by the casualty doctor and by the parents to diagnose poisoning was explored, and in many cases was circumstantial. Children with fathers in nonmanual occupations were over-represented. This may reflect differences in patterns of utilization behaviour rather than true differences in incidence.

Congenital heart disease in Taiwan, Republic of China.

A review of 5 years' experience with congenital heart disease in National Taiwan University Hospital, Taipei, Taiwan, Republic of China, shows that congenital aortic valvar and supravalvar stenosis are not seen and the incidence of coarctation is very low. Statistics on congenital heart disease as reported in studies on all groups of patients from several other Asian countries were collected and compared with those from European and North American countries. The low incidence for the two mentioned congenital cardiac defects in the reports from Asian countries is probably not due to chance, but may represent a true difference in incidence. In the discussion of etiological factors possibly responsible for the low incidence of coarctation and aortic stenosis, it is postulated that dietary factors may be responsible for the observed differences in incidence.