The Experts below are selected from a list of 115434 Experts worldwide ranked by ideXlab platform
Harold B Weiss - One of the best experts on this subject based on the ideXlab platform.
-
the epidemiology of Traumatic Injury related fetal mortality in pennsylvania 1995 1997 the role of motor vehicle crashes
Accident Analysis & Prevention, 2001Co-Authors: Harold B WeissAbstract:Methods: Rates and causes of Traumatic Injury-related fetal deaths in Pennsylvania were determined from a manual review of all fetal death certificates filed from 1995 to 1997 (7131 cases). Results: Thirty one Traumatic Injury cases were identified (6.5/100 000 live births). Most cases (94%) could be identified from the diagnosis code of 760.5 (maternal Injury) and 87% contained narratives indicating specific Injury mechanisms. Motor vehicles were the leading cause of Injury (81%). Placental separation was the leading diagnosis (42%). Conclusions: The ICD-9-CM code 760.5 appears to be a specific indicator of Traumatic fetal death, though it is not known how sensitive an indicator it is. Though not usually E-coded, the death certificates contained enough information to allow ascertainment of Injury mechanism. These are very conservative estimates of the burden of the problem. The major role that motor vehicle injuries have on reported Traumatic fetal Injury deaths was shown and a significant new challenge for child passenger safety advocates is indicated.
-
the epidemiology of Traumatic Injury related fetal mortality in pennsylvania 1995 1997 the role of motor vehicle crashes
Annual proceedings Association for the Advancement of Automotive Medicine. Association for the Advancement of Automotive Medicine, 1999Co-Authors: Harold B WeissAbstract:This paper explores rates and causes of Traumatic Injury-related fetal deaths in Pennsylvania and the role of motor vehicle crashes. Data were determined from a manual review of fetal death certificates filed from 1995-1997 (7,131 cases). 31 Traumatic Injury cases were identified (6.5/100,000 live births). Most cases (94%) could be identified from the ICD-9 diagnosis code of 760.5 (maternal Injury) and 87% contained narratives indicating specific Injury mechanisms. Motor vehicles were the leading cause of Injury (81%). Placental separation was the leading diagnosis (42%). The ICD-9-CM code 760.5 appears to be a specific indicator of Traumatic fetal death, though it is not known how sensitive an indicator it is. Though not E-coded, the death certificates contained enough information to allow ascertainment of Injury mechanism. Motor vehicle crashes play a predominant role in reported fetal Traumatic Injury-related deaths.
Sascha Dublin - One of the best experts on this subject based on the ideXlab platform.
-
population based signals of antidepressant drug interactions associated with unintentional Traumatic Injury
Clinical Pharmacology & Therapeutics, 2021Co-Authors: Charles E Leonard, Colleen M Brensinger, John R Horn, Sophie Chung, Warren B Bilker, Ghadeer K Dawwas, Emily K Acton, Todd A Miano, Sascha DublinAbstract:Antidepressants are very widely used and associated with Traumatic Injury, yet little is known about their potential for harmful drug interactions. We aimed to identify potential drug interaction signals by assessing concomitant medications (precipitant drugs) taken with individual antidepressants (object drugs) that were associated with unintentional Traumatic Injury. We conducted pharmacoepidemiologic screening of 2000-2015 Optum Clinformatics data, identifying drug interaction signals by performing self-controlled case series studies for antidepressant + precipitant pairs and Injury. We included persons aged 16-90 years codispensed an antidepressant and ≥ 1 precipitant drug(s), with an Injury during antidepressant therapy. We classified antidepressant person-days as either precipitant-exposed or precipitant-unexposed. The outcome was an emergency department or inpatient discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to calculate confounder adjusted rate ratios (RRs) and accounted for multiple estimation via semi-Bayes shrinkage. We identified 330,884 new users of antidepressants who experienced an Injury. Among such persons, we studied concomitant use of 7,953 antidepressant + precipitant pairs. Two hundred fifty-six (3.2%) pairs were positively associated with Injury and deemed potential drug interaction signals; 22 of these signals had adjusted RRs > 2.00. Adjusted RRs ranged from 1.06 (95% confidence interval: 1.00-1.12, P = 0.04) for citalopram + gabapentin to 3.06 (1.42-6.60) for nefazodone + levonorgestrel. Sixty-five (25.4%) signals are currently reported in a seminal drug interaction knowledgebase. We identified numerous new population-based signals of antidepressant drug interactions associated with unintentional Traumatic Injury. Future studies, intended to test hypotheses, should confirm or refute these potential interactions.
-
screening to identify signals of opioid drug interactions leading to unintentional Traumatic Injury
Biomedicine & Pharmacotherapy, 2020Co-Authors: Charles E Leonard, Colleen M Brensinger, Thanh Phuong Pham Nguyen, John R Horn, Sophie Chung, Warren B Bilker, Sascha Dublin, Samantha E Soprano, Ghadeer K Dawwas, David W OslinAbstract:Abstract Background Efforts to minimize harms from opioid drug interactions may be hampered by limited evidence on which drugs, when taken concomitantly with opioids, result in adverse clinical outcomes. Objective To identify signals of opioid drug interactions by identifying concomitant medications (precipitant drugs) taken with individual opioids (object drugs) that are associated with unintentional Traumatic Injury Design We conducted pharmacoepidemiologic screening of Optum Clinformatics Data Mart, identifying drug interaction signals by performing confounder-adjusted self-controlled case series studies for opioid + precipitant pairs and Injury. Setting Beneficiaries of a major United States-based commercial health insurer during 2000–2015 Patients Persons aged 16–90 years co-dispensed an opioid and ≥1 precipitant drug(s), with an unintentional Traumatic Injury event during opioid therapy, as dictated by the case-only design Exposure Precipitant-exposed (vs. precipitant-unexposed) person-days during opioid therapy. Outcome: Emergency department or inpatient International Classification of Diseases discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to generate confounder adjusted rate ratios. We accounted for multiple estimation via semi-Bayes shrinkage. Results We identified 25,019, 12,650, and 10,826 new users of hydrocodone, tramadol, and oxycodone who experienced an unintentional Traumatic Injury. Among 464, 376, and 389 hydrocodone-, tramadol-, and oxycodone-precipitant pairs examined, 20, 17, and 16 (i.e., 53 pairs, 34 unique precipitants) were positively associated with unintentional Traumatic Injury and deemed potential drug interaction signals. Adjusted rate ratios ranged from 1.23 (95 % confidence interval: 1.05–1.44) for hydrocodone + amoxicillin-clavulanate to 4.21 (1.88–9.42) for oxycodone + telmisartan. Twenty (37.7 %) of 53 signals are currently reported in a major drug interaction knowledgebase. Limitations Potential for reverse causation, confounding by indication, and chance Conclusions We identified previously undescribed and/or unappreciated signals of opioid drug interactions associated with unintentional Traumatic Injury. Subsequent etiologic studies should confirm (or refute) and elucidate these potential drug interactions.
Ghadeer K Dawwas - One of the best experts on this subject based on the ideXlab platform.
-
population based signals of antidepressant drug interactions associated with unintentional Traumatic Injury
Clinical Pharmacology & Therapeutics, 2021Co-Authors: Charles E Leonard, Colleen M Brensinger, John R Horn, Sophie Chung, Warren B Bilker, Ghadeer K Dawwas, Emily K Acton, Todd A Miano, Sascha DublinAbstract:Antidepressants are very widely used and associated with Traumatic Injury, yet little is known about their potential for harmful drug interactions. We aimed to identify potential drug interaction signals by assessing concomitant medications (precipitant drugs) taken with individual antidepressants (object drugs) that were associated with unintentional Traumatic Injury. We conducted pharmacoepidemiologic screening of 2000-2015 Optum Clinformatics data, identifying drug interaction signals by performing self-controlled case series studies for antidepressant + precipitant pairs and Injury. We included persons aged 16-90 years codispensed an antidepressant and ≥ 1 precipitant drug(s), with an Injury during antidepressant therapy. We classified antidepressant person-days as either precipitant-exposed or precipitant-unexposed. The outcome was an emergency department or inpatient discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to calculate confounder adjusted rate ratios (RRs) and accounted for multiple estimation via semi-Bayes shrinkage. We identified 330,884 new users of antidepressants who experienced an Injury. Among such persons, we studied concomitant use of 7,953 antidepressant + precipitant pairs. Two hundred fifty-six (3.2%) pairs were positively associated with Injury and deemed potential drug interaction signals; 22 of these signals had adjusted RRs > 2.00. Adjusted RRs ranged from 1.06 (95% confidence interval: 1.00-1.12, P = 0.04) for citalopram + gabapentin to 3.06 (1.42-6.60) for nefazodone + levonorgestrel. Sixty-five (25.4%) signals are currently reported in a seminal drug interaction knowledgebase. We identified numerous new population-based signals of antidepressant drug interactions associated with unintentional Traumatic Injury. Future studies, intended to test hypotheses, should confirm or refute these potential interactions.
-
screening to identify signals of opioid drug interactions leading to unintentional Traumatic Injury
Biomedicine & Pharmacotherapy, 2020Co-Authors: Charles E Leonard, Colleen M Brensinger, Thanh Phuong Pham Nguyen, John R Horn, Sophie Chung, Warren B Bilker, Sascha Dublin, Samantha E Soprano, Ghadeer K Dawwas, David W OslinAbstract:Abstract Background Efforts to minimize harms from opioid drug interactions may be hampered by limited evidence on which drugs, when taken concomitantly with opioids, result in adverse clinical outcomes. Objective To identify signals of opioid drug interactions by identifying concomitant medications (precipitant drugs) taken with individual opioids (object drugs) that are associated with unintentional Traumatic Injury Design We conducted pharmacoepidemiologic screening of Optum Clinformatics Data Mart, identifying drug interaction signals by performing confounder-adjusted self-controlled case series studies for opioid + precipitant pairs and Injury. Setting Beneficiaries of a major United States-based commercial health insurer during 2000–2015 Patients Persons aged 16–90 years co-dispensed an opioid and ≥1 precipitant drug(s), with an unintentional Traumatic Injury event during opioid therapy, as dictated by the case-only design Exposure Precipitant-exposed (vs. precipitant-unexposed) person-days during opioid therapy. Outcome: Emergency department or inpatient International Classification of Diseases discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to generate confounder adjusted rate ratios. We accounted for multiple estimation via semi-Bayes shrinkage. Results We identified 25,019, 12,650, and 10,826 new users of hydrocodone, tramadol, and oxycodone who experienced an unintentional Traumatic Injury. Among 464, 376, and 389 hydrocodone-, tramadol-, and oxycodone-precipitant pairs examined, 20, 17, and 16 (i.e., 53 pairs, 34 unique precipitants) were positively associated with unintentional Traumatic Injury and deemed potential drug interaction signals. Adjusted rate ratios ranged from 1.23 (95 % confidence interval: 1.05–1.44) for hydrocodone + amoxicillin-clavulanate to 4.21 (1.88–9.42) for oxycodone + telmisartan. Twenty (37.7 %) of 53 signals are currently reported in a major drug interaction knowledgebase. Limitations Potential for reverse causation, confounding by indication, and chance Conclusions We identified previously undescribed and/or unappreciated signals of opioid drug interactions associated with unintentional Traumatic Injury. Subsequent etiologic studies should confirm (or refute) and elucidate these potential drug interactions.
Charles E Leonard - One of the best experts on this subject based on the ideXlab platform.
-
population based signals of antidepressant drug interactions associated with unintentional Traumatic Injury
Clinical Pharmacology & Therapeutics, 2021Co-Authors: Charles E Leonard, Colleen M Brensinger, John R Horn, Sophie Chung, Warren B Bilker, Ghadeer K Dawwas, Emily K Acton, Todd A Miano, Sascha DublinAbstract:Antidepressants are very widely used and associated with Traumatic Injury, yet little is known about their potential for harmful drug interactions. We aimed to identify potential drug interaction signals by assessing concomitant medications (precipitant drugs) taken with individual antidepressants (object drugs) that were associated with unintentional Traumatic Injury. We conducted pharmacoepidemiologic screening of 2000-2015 Optum Clinformatics data, identifying drug interaction signals by performing self-controlled case series studies for antidepressant + precipitant pairs and Injury. We included persons aged 16-90 years codispensed an antidepressant and ≥ 1 precipitant drug(s), with an Injury during antidepressant therapy. We classified antidepressant person-days as either precipitant-exposed or precipitant-unexposed. The outcome was an emergency department or inpatient discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to calculate confounder adjusted rate ratios (RRs) and accounted for multiple estimation via semi-Bayes shrinkage. We identified 330,884 new users of antidepressants who experienced an Injury. Among such persons, we studied concomitant use of 7,953 antidepressant + precipitant pairs. Two hundred fifty-six (3.2%) pairs were positively associated with Injury and deemed potential drug interaction signals; 22 of these signals had adjusted RRs > 2.00. Adjusted RRs ranged from 1.06 (95% confidence interval: 1.00-1.12, P = 0.04) for citalopram + gabapentin to 3.06 (1.42-6.60) for nefazodone + levonorgestrel. Sixty-five (25.4%) signals are currently reported in a seminal drug interaction knowledgebase. We identified numerous new population-based signals of antidepressant drug interactions associated with unintentional Traumatic Injury. Future studies, intended to test hypotheses, should confirm or refute these potential interactions.
-
screening to identify signals of opioid drug interactions leading to unintentional Traumatic Injury
Biomedicine & Pharmacotherapy, 2020Co-Authors: Charles E Leonard, Colleen M Brensinger, Thanh Phuong Pham Nguyen, John R Horn, Sophie Chung, Warren B Bilker, Sascha Dublin, Samantha E Soprano, Ghadeer K Dawwas, David W OslinAbstract:Abstract Background Efforts to minimize harms from opioid drug interactions may be hampered by limited evidence on which drugs, when taken concomitantly with opioids, result in adverse clinical outcomes. Objective To identify signals of opioid drug interactions by identifying concomitant medications (precipitant drugs) taken with individual opioids (object drugs) that are associated with unintentional Traumatic Injury Design We conducted pharmacoepidemiologic screening of Optum Clinformatics Data Mart, identifying drug interaction signals by performing confounder-adjusted self-controlled case series studies for opioid + precipitant pairs and Injury. Setting Beneficiaries of a major United States-based commercial health insurer during 2000–2015 Patients Persons aged 16–90 years co-dispensed an opioid and ≥1 precipitant drug(s), with an unintentional Traumatic Injury event during opioid therapy, as dictated by the case-only design Exposure Precipitant-exposed (vs. precipitant-unexposed) person-days during opioid therapy. Outcome: Emergency department or inpatient International Classification of Diseases discharge diagnosis for unintentional Traumatic Injury. We used conditional Poisson regression to generate confounder adjusted rate ratios. We accounted for multiple estimation via semi-Bayes shrinkage. Results We identified 25,019, 12,650, and 10,826 new users of hydrocodone, tramadol, and oxycodone who experienced an unintentional Traumatic Injury. Among 464, 376, and 389 hydrocodone-, tramadol-, and oxycodone-precipitant pairs examined, 20, 17, and 16 (i.e., 53 pairs, 34 unique precipitants) were positively associated with unintentional Traumatic Injury and deemed potential drug interaction signals. Adjusted rate ratios ranged from 1.23 (95 % confidence interval: 1.05–1.44) for hydrocodone + amoxicillin-clavulanate to 4.21 (1.88–9.42) for oxycodone + telmisartan. Twenty (37.7 %) of 53 signals are currently reported in a major drug interaction knowledgebase. Limitations Potential for reverse causation, confounding by indication, and chance Conclusions We identified previously undescribed and/or unappreciated signals of opioid drug interactions associated with unintentional Traumatic Injury. Subsequent etiologic studies should confirm (or refute) and elucidate these potential drug interactions.
L Staerk - One of the best experts on this subject based on the ideXlab platform.
-
resumption of oral anticoagulation following Traumatic Injury and risk of stroke and bleeding in patients with atrial fibrillation a nationwide cohort study
European Heart Journal, 2018Co-Authors: L Staerk, Ellen Holm, Kasper Gadsboll, Caroline Sindetpedersen, Brice Ozenne, Thomas Alexander Gerds, Anders Nissen Bonde, Emil L. Fosbøl, Morten Lamberts, Christian TorppedersenAbstract:Aims: We examined the risks of all-cause mortality, stroke, major bleeding, and recurrent Traumatic Injury associated with resumption of vitamin K antagonists (VKAs) and non-VKAs oral anticoagulants (NOACs) following Traumatic Injury in atrial fibrillation (AF) patients. Methods and results: This was a Danish nationwide registry-based study (2005-16), including 4541 oral anticoagulant (OAC)-treated AF patients experiencing Traumatic Injury (defined as Traumatic brain Injury, hip fracture, or Traumatic torso or abdominal Injury). Within 90 days following discharge from Traumatic Injury, 60.6% resumed VKA (median age = 80, CHA2DS2-VASc = 4, HAS-BLED = 2), 16.7% resumed NOAC (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 2), and 22.7% did not resume OAC treatment (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 3). Switch from VKA to NOAC occurred among 9.5%. Since 2009, the trend in OAC resumption increased (P-value <0.0001), in particular with NOACs (P-value <0.0001). Follow-up started 90 days after discharge, and time-varying multiple Cox regression analyses were used for comparisons. Compared with non-resumption, VKA and NOAC resumption were associated with lower hazard [95% confidence interval (CI)] of all-cause mortality [hazard ratio (HR) 0.48 (0.42-0.53) and HR 0.55 (0.47-0.66), respectively] and ischaemic stroke [HR 0.56 (0.43-0.72) and HR 0.54 (0.35-0.82), respectively], increased major bleeding hazard [HR 1.30 (1.03-1.64) and HR 1.15 (0.81-1.63), respectively], and similar hazard of recurrent Traumatic Injury [HR 0.93 (0.73-1.18) and HR 0.87 (0.60-1.27), respectively]. Conclusion: AF patients resuming VKA and NOAC treatment following Traumatic Injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent Traumatic Injury. Withholding OAC following a Traumatic Injury in AF patients may not be warranted.
-
resumption of oral anticoagulation following Traumatic Injury and risk of stroke and bleeding in patients with atrial fibrillation a nationwide cohort study
European Heart Journal, 2018Co-Authors: L Staerk, Ellen Holm, Kasper Gadsboll, Caroline Sindetpedersen, Brice Ozenne, Thomas Alexander Gerds, Anders Nissen Bonde, Emil L. Fosbøl, Morten Lamberts, Gregory Y H LipAbstract:Aims We examined the risks of all-cause mortality, stroke, major bleeding, and recurrent Traumatic Injury associated with resumption of vitamin K antagonists (VKAs) and non-VKAs oral anticoagulants (NOACs) following Traumatic Injury in atrial fibrillation (AF) patients. Methods and results This was a Danish nationwide registry-based study (2005-16), including 4541 oral anticoagulant (OAC)-treated AF patients experiencing Traumatic Injury (defined as Traumatic brain Injury, hip fracture, or Traumatic torso or abdominal Injury). Within 90 days following discharge from Traumatic Injury, 60.6% resumed VKA (median age = 80, CHA2DS2-VASc = 4, HAS-BLED = 2), 16.7% resumed NOAC (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 2), and 22.7% did not resume OAC treatment (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 3). Switch from VKA to NOAC occurred among 9.5%. Since 2009, the trend in OAC resumption increased (P-value Conclusion AF patients resuming VKA and NOAC treatment following Traumatic Injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent Traumatic Injury. Withholding OAC following a Traumatic Injury in AF patients may not be warranted.
