Clozapine and long-acting injectable antipsychotic medications were the pharmacologic treatments with the highest rates of prevention of relapse in schizophrenia. The risk of rehospitalization is about 20% to 30% lower during long-acting injectable treatments compared with equivalent oral formulations.
Among patients with schizophrenia, LAI use is associated with an approximately 30% lower risk of death compared with oral agents. SG LAIs and oral aripiprazole are associated with the lowest mortality.
Objectives
To compare the use of hormone therapy between Finnish postmenopausal women with and without a diagnosis for Alzheimer’s disease.
Design
Nationwide case-control study.
Setting
Finnish national population and drug register, between 1999 and 2013.
Participants
All postmenopausal women (n=84 739) in Finland who, between 1999 and 2013, received a diagnosis of Alzheimer’s disease from a neurologist or geriatrician, and who were identified from a national drug register. Control women without a diagnosis (n=84 739), matched by age and hospital district, were traced from the Finnish national population register.
Interventions
Data on hormone therapy use were obtained from the Finnish national drug reimbursement register.
Main outcome measures
Odds ratios and 95% confidence intervals for Alzheimer’s disease, calculated with conditional logistic regression analysis.
Results
In 83 688 (98.8%) women, a diagnosis for Alzheimer’s disease was made at the age of 60 years or older, and 47 239 (55.7%) women had been over 80 years of age at diagnosis. Use of systemic hormone therapy was associated with a 9-17% increased risk of Alzheimer’s disease. The risk of the disease did not differ significantly between users of estradiol only (odds ratio 1.09, 95% confidence interval 1.05 to 1.14) and those of oestrogen-progestogen (1.17, 1.13 to 1.21). The risk increases in users of oestrogen-progestogen therapy were not related to different progestogens (norethisterone acetate, medroxyprogesterone acetate, or other progestogens); but in women younger than 60 at hormone therapy initiation, these risk increases were associated with hormone therapy exposure over 10 years. Furthermore, the age at initiation of systemic hormone therapy was not a decisive determinant for the increase in risk of Alzheimer’s disease. The exclusive use of vaginal estradiol did not affect the risk of the disease (0.99, 0.96 to 1.01).
Conclusions
Long term use of systemic hormone therapy might be accompanied with an overall increased risk of Alzheimer’s disease, which is not related to the type of progestogen or the age at initiation of systemic hormone therapy. By contrast, use of vaginal estradiol shows no such risk. Even though the absolute risk increase for Alzheimer’s disease is small, our data should be implemented into information for present and future users of hormone therapy.
Lithium was the most effective mood stabilizer, and long-acting injections the most effective antipsychotics, in preventing hospitalization due to mental or physical illness.
A novel Bayesian gene mapping method, which can simultaneously utilize both molecular marker and gene expression data, is introduced. The approach enables a quantitative or qualitative phenotype to be expressed as a linear combination of the marker genotypes, gene expression levels, and possible genotype  gene expression interactions. The interaction data, given as marker-gene pairs, contains possible in cis and in trans effects obtained from earlier allelic expression studies, genetical genomics studies, biological hypotheses, or known pathways. The method is presented for an inbred line cross design and can be easily generalized to handle other types of populations and designs. The model selection is based on the use of effectspecific variance components combined with Jeffreys' noninformative prior -the method operates by adaptively shrinking marker, expression, and interaction effects toward zero so that non-negligible effects are expected to occur only at very few positions. The estimation of the model parameters and the handling of missing genotype or expression data is performed via Markov chain Monte Carlo sampling. The potential of the method including heritability estimation is presented using simulated examples and novel summary statistics. The method is also applied to a real yeast data set with known pathways.
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