Clozapine is uncommonly but importantly related to myocarditis, often fatal or near fatal and sometimes in relatively young patients with early onset after treatment initiation. The most striking feature about this condition is the wide diversity of nonspecific symptoms that occur in afflicted patients. Additional pharmacovigilance, improved reporting systems and further investigation of mechanisms of drug-induced myocarditis and related cardiovascular conditions (such as heart failure) are clearly warranted. A case-control study would be suitable for investigation of baseline predictors.

SummaryBackgroundInformation is needed regarding risk factors associated with injury. In middle- and lower-income countries, injury studies have focused on road traffic injuries and less attention has been given to other types of injuries.MethodsThis study is part of overarching health–risk transition research in Thailand with a large national cohort study that began in 2005 (n = 87,134). Associations between potential determinants and overall injury were measured, as well as injury by location (transport, home, work and sport), using data gathered from the baseline questionnaire.ResultsIn total, 21.5% of the cohort reported at least one incidence of injury over the last 12 months. Risk factors associated with injury were being male [odds ratio (OR) 1.20], having lower income (OR 1.70), having problems with vision (OR 1.46), having epilepsy (OR 3.02), having depression/anxiety (OR 1.62), poor self-assessed health (OR 1.68), being obese (OR 1.24) and death of father due to injury (OR 1.59). Analysis of injury by location provided more specific information on risk factors. For example, females were more likely to report injuries at home, while males, urban residents and regular alcohol drinkers were more likely to report transport injuries.ConclusionsThe risk of injury in Thailand varies considerably by location, sociodemographic group and several categories of co-existing morbidities. Such epidemiological information identifying risk factors for injury is useful for designing targeted injury prevention programmes in Thailand and other middle-income countries.

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Availability of ICD-10 cause of death codes in the National Coroners Information System (NCIS) strengthens its value as a public health surveillance tool. This study quantified the completeness of external cause ICD-10 codes in the NCIS for Victorian deaths (as assigned by the Australian Bureau of Statistics (ABS) in the yearly Cause of Death data). It also examined the concordance between external cause ICD-10 codes contained in the NCIS and a re-code of the same deaths conducted by an independent coder. Of 7,400 NCIS external cause deaths included in this study, 961 (13.0%) did not contain an ABS assigned ICD-10 code and 225 (3.0%) contained only a natural cause code. Where an ABS assigned external cause ICD-10 code was present (n=6,214), 4,397 (70.8%) matched exactly with the independently assigned ICD-10 code. Coding disparity primarily related to differences in assignment of intent and specificity. However, in a small number of deaths (n=49, 0.8%) there was coding disparity for both intent and external cause category. NCIS users should be aware of the limitations of relying only on ICD-10 codes contained within the NCIS for deaths prior to 2007 and consider using these in combination with the other NCIS data fields and code sets to ensure optimum case identification.

The practical implication of this study is that auditory icons having either direct or strong, indirect associations with warning events should be preferred.