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Cancer is an important risk factor for stroke, but the relationship between cancer and stroke is not well understood. Cancer patients with stroke often do not receive guideline-based treatments due to perceived higher risks, and experience worse outcomes than patients without cancer, including more recurrent strokes. The aim of this thesis is to expand our knowledge of the relationship between cancer and stroke by addressing five major objectives: 1) calculate the pooled one-year incidence of stroke after a new diagnosis of cancer by performing a systematic review and meta-analysis, 2) investigate if the risk for future stroke varies by a history of stroke prior to cancer diagnosis, 3) compare differences in treatment and outcomes between cancer patients with stroke and the general stroke population, 4) identify predictors for recurrent stroke in cancer patients, and 5) evaluate the utility of synthetic data for the purpose of cancer and stroke research.

Recognizing that Salmonella is a leading cause of bacterial foodborne illness in the United States (US), the US government established disease reduction goals for salmonellosis incidence. Surveillance data are used to monitor progress toward these goals, and to characterize salmonellosis epidemiology (e.g., specific serotype causing disease, model national and regional trends in incidence). This study used data from 11,411 culture-confirmed salmonellosis cases among Virginia residents reported to Virginia Department of Health during 2012-2022 to characterize salmonellosis epidemiology in Virginia using incidence rate ratios (IRRs) and a negative binomial Bayesian splines model. Trends were modelled separately for salmonellosis overall and for individual sub-types at the state level. State-level modelled incidence ranged between 10.9-12.9 (per 100,000 people); the lowest and highest reported incidence occurred in 2020 and 2019, respectively. During the COVID-19 pandemic, incidence appears to have decreased; incidence has not returned to pre-pandemic levels. According to the splines model, there was a substantial decrease in state-level culture-confirmed salmonellosis incidence in 2021 compared to 2018, which is consistent with trends nationally. Of the187 total Salmonella serotypes reported in Virginia during 2012-2022, 64% of culture-confirmed cases were attributable to six serotypes: Typhimurium/I 4,[5],12:i:- (20%), Enteritidis (18%), Newport (11%), and Javiana (8%), Bareilly (4%), and Braenderup (4%). The incidence of illnesses to specific attributable serotypes appeared to change between 2012 and 2022 with some serotypes decreasing in incidence (e.g., the incidence of S. Typhimurium/I 4,[5],12:i:-) and others increasing (e.g., S. Braenderup). Opposing serotype-specific trends may be contributing to the apparent stability in overall salmonellosis incidence in Virginia during 2012 through 2022. Some serotypes had an overall high reported incidence across all months, while others had distinct peaks in incidence during summer months (June-August). Similar to national trends, children <4 years old had the highest reported incidence of all age groups across all serotypes, indicating that reducing incidence in this population should be prioritized for achieving the desired reduction in salmonellosis incidence. Analyses using whole genome sequencing data indicated that within each of the 6 most common serotypes, most isolates represented 1-3 subtypes. Overall, our analyses indicate that trends in reported culture-confirmed salmonellosis incidence in Virginia are largely consistent with national trends and support the use of analyses of salmonellosis incidence at the subtype level to inform intervention efforts to address incidence of infections caused by specific serotypes. / Master of Science in Life Sciences / Salmonellosis is a foodborne disease caused by infection with the bacteria Salmonella. Salmonellosis cases reported to health departments are used to monitor the levels of disease that are occurring in the population at state and national levels. However, barriers to reporting, such as limited access to health care or a patient specimen not being collected, mean that not all cases that occur within the population are reported. While reported cases do not represent all cases occurring, they can provide important information about the types of Salmonella infecting people in a specific population, such as people residing in a state. Among reported cases, those that have a Salmonella isolate obtained from a patient sample are considered culture-confirmed and can be used to study the reported levels of disease with additional insights provided about the type of Salmonella causing infection. Our study analyzed data from 11,411 culture-confirmed reported cases of salmonellosis to identify trends in the levels, or incidence, of salmonellosis in Virginia between 2012-2022. Incidence of reported culture-confirmed salmonellosis cases occurring in the population were calculated to identify the number of cases occurring per 100,000 persons in Virginia. Temporal analyses were also conducted to identify trends in salmonellosis incidence in Virginia. The reported incidence of the most common subtypes of Salmonella causing infection varied over time by year and month. Children under 4 years old were found to have the highest reported incidence, suggesting that reducing salmonellosis incidence in young children should be prioritized. Overall, the patterns in reported incidence from culture-confirmed salmonellosis cases in Virginia largely reflected those seen nationally, indicating that the same strategies for reducing the incidence of reported salmonellosis will be beneficial at regional and national levels.

Introduction: The Mortality–Incidence Ratio complement [1 – MIR] is an indicator validated in various populations to estimate five-year cancer survival, but its validity remains unreported in Peru. This study aims to determine if the MIR correlates directly with five-year survival in patients diagnosed with the ten most common types of cancer in metropolitan Lima. Materials and methods: The Metropolitan Lima Cancer Registry (RCLM in Spanish) for 2004–2005 was used to determine the number of new cases and the number of deaths of the following cancers: breast, stomach, prostate, thyroid, lung, colon, cervical, and liver cancers, as well as non-Hodgkin’s lymphoma and leukaemia. To determine the five-year survival, the five-year vital status of cases recorded was verified in the National Registry of Identification and Civil Status (RENIEC in Spanish). A linear regression model was used to assess the correlation between [1 – MIR] and total observed five-year survival for the selected cancers. Results: Observed and estimated five-year survival determined by [1 – MIR] for each neoplasia were thyroid (66.7%, 86.7%), breast (69.6%; 68%), prostate (64.3%, 63.8%) and cervical (50.1%, 58.5%), respectively. Pearson’s r coefficient for the correlation between [MIR – 1] and observed survival was = 0.9839. Using the coefficient of determination, it was found that [1 – MIR] (X) captures the 96.82% of observed survival (Y). Conclusion: The Mortality–Incidence Ratio complement [1 – MIR] is an appropriate tool for approximating observed five-year survival for the ten types of cancers studied. This study demonstrates the validity of this model for predicting five-year survival in cancer patients in metropolitan Lima.

Le sport est largement conseillé chez les enfants et les adolescents mais a pour inconvénient le développement de blessures musculosquelettiques au niveau des membres et du rachis. Les blessures de surutilisation des membres représentent une part importante des blessures musculo-squelettiques.Cette thèse avait pour but de déterminer s’il existait des différences entre les sports en ce qui concerne l’incidence, la localisation et le diagnostic de blessures de surutilisation des membres chez les enfants et si certains sports étaient des facteurs de risques pour le développement de ces blessures. De plus, elle avait pour but de comparer les résultats obtenus à ceux des adultes.Pour ce faire, deux revues systématiques ont été réalisées, la première pour les enfants et adolescents et la seconde pour les adultes. De plus, une étude prospective réalisée dans une population générale d’enfants a été analysée.Il existence peu d’évidences scientifiques sur l’incidence, les localisations et les diagnostics des blessures de surutilisation dans la littérature. Pour ces deux populations, et pour tous les sports étudiés les blessures de surutilisation affectent plus fréquemment les membres inférieurs. Chez les enfants/adolescents, les blessures affectent en particulier les genoux et la jambe, sans grande différence entre les sports. Alors que chez les adultes des différences apparaissent entre les sports et les zones les plus souvent touchées sont différentes des enfants. Concernant les diagnostics, il n’y a pas de différence entre les sports chez les enfants ; et il n’est pas possible de se prononcer chez les adultes. On note des différences entre les diagnostics retrouvés chez les enfants/adolescents et les adultes.L’étude prospective permet d’obtenir l’incidence des blessures pour neuf sports, et identifie parmi ceux-ci deux sports à risque : le football et le handball. / In youngsters, physical activity has many direct health benefits but can also cause musculoskeletal injuries. Overuse injuries of the extremities represent an important part of all the musculoskeletal injuries that can occur in childhood.The aim of this thesis is to determine if some sports are more likely to expose children and adolescents to a greater risk of developing overuse injuries of the extremities and to investigate if there is difference regarding the diagnosis and the localisation of these injuries between different types of sports. Another aim was to compare these findings with those relating to adults.To achieve this, two systematic reviews have been done, one for youngsters and one for adults, and data from a large prospective study of schoolchildren were analysed.Paucity of relevant information in the literature made it difficult to obtain clear answers to our questions. However, we noticed that, for both population and all sports, overuse injuries more often affected the lower limb. In youngsters, the sites most often affected are the knee, the lower limb and the foot, and this is almost the same for all sports that were studied. In adults the localisation varies for the different sports and is not the same between youngsters and adults. Also the diagnoses do not vary between sports in youngsters ; whereas it was not possible to study this in adults. The diagnoses were different between the two populations studied. The prospective study of the schoolchildren permitted to determine the incidence of overuse injuries reported in children participating in nine different sports and to relate these results to their exposure to these sports (dose-response). Two sports were identified as risk factors: football and handball.

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Tuberculosis is a major public health problem in Aboriginal populations. Studies are lacking to evaluate incidence of tuberculosis across residence status. The incidence of tuberculosis in Saskatchewans Aboriginal population was investigated to determine whether differences existed between off- and on-reserve groups. A retrospective cohort study was performed, using data from the Saskatchewan Tuberculosis Control Program database of on and off reserve residents diagnosed with pulmonary tuberculosis between January 1, 1986, and December 31, 2005. Age, sex and residence-specific incidence rates were calculated with the use of Census populations for 1986, 1991, 1996 and 2001. Multivariate analysis using poisson regression was completed.<p>There were 1750 cases during the study period; 710 occurred off reserve and 1040 on reserve. 1337 cases were diagnosed in Registered Aboriginals, with the remaining 413 in the non-registered population. The mean age of Aboriginal cases on reserve was 12.92 and 19.98 for off reserve cases. Females were more likely to have tuberculosis on reserve, while males were more likely off reserve. Overall, TB rates both on and off reserve decreased over the study period. The on reserve population maintains greater rates of tuberculosis compared to their off reserve counterparts, after adjustment for age.<p>Although there is a natural history to infectious disease epidemics such as tuberculosis, it should be a higher priority of government policies and services to further decrease rates. The collection of more accurate population statistics would allow for more in-depth surveillance of TB in Saskatchewan and would contribute to knowledge about how and where to best allocate future resources.

Tuberculosis is a major public health problem in Aboriginal populations. Studies are lacking to evaluate incidence of tuberculosis across residence status. The incidence of tuberculosis in Saskatchewans Aboriginal population was investigated to determine whether differences existed between off- and on-reserve groups. A retrospective cohort study was performed, using data from the Saskatchewan Tuberculosis Control Program database of on and off reserve residents diagnosed with pulmonary tuberculosis between January 1, 1986, and December 31, 2005. Age, sex and residence-specific incidence rates were calculated with the use of Census populations for 1986, 1991, 1996 and 2001. Multivariate analysis using poisson regression was completed.<p>There were 1750 cases during the study period; 710 occurred off reserve and 1040 on reserve. 1337 cases were diagnosed in Registered Aboriginals, with the remaining 413 in the non-registered population. The mean age of Aboriginal cases on reserve was 12.92 and 19.98 for off reserve cases. Females were more likely to have tuberculosis on reserve, while males were more likely off reserve. Overall, TB rates both on and off reserve decreased over the study period. The on reserve population maintains greater rates of tuberculosis compared to their off reserve counterparts, after adjustment for age.<p>Although there is a natural history to infectious disease epidemics such as tuberculosis, it should be a higher priority of government policies and services to further decrease rates. The collection of more accurate population statistics would allow for more in-depth surveillance of TB in Saskatchewan and would contribute to knowledge about how and where to best allocate future resources.

No description available.