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Rząd M, Kanecki K, Lewtak K, Tyszko P, Gorynski P, Nitsch-Osuch A. Hospitalizations of patients with herpes zoster in Poland during 2012-2021: A population-based study. Vaccine 2024; 42:1928-1933. [PMID: 38368221 DOI: 10.1016/j.vaccine.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION The varicella-zoster virus (VZV) is an infectious agent that causes both chickenpox and herpes zoster/shingles (HZ). This infection can take various clinical forms, result in permanent complications, and be a marker of immunosuppression, e.g. in the course of a neoplastic disease. The aim of this study is to analyze epidemiological trends in hospitalization and hospital mortality rate among HZ patients in Poland (2012-2021). METHODS Our study is a population-based, retrospective analysis of hospital discharge records of patients with HZ. Data were obtained from the National Institute of Public Health in Poland, and they covered the period from 2012 to 2021. All hospitalization records with primary or secondary ICD-10 B02 code diagnosis were included in the study. RESULTS We analyzed the total number of 23,432 hospital discharge records of HZ patients in 2012-2021. The study group consisted of 22,169 (94.6 %) hospitalization records of first-time diagnosis of HZ in hospitalized patients: 9,309 males (42 %) and 12,860 females (58 %). In this group, 70.3 % were patients over 60 years old. The mean and median age was 64 and 69 years, respectively. The mean annual first-time hospitalization rate for HZ was estimated to be 5.8 per 100,000 person-years (95 % CI: 4.8-6.7 per 100,000 person-years). The hospitalization rate for HZ was similar during 2012-2019. There was a significant decrease in hospitalizations in 2020-2021 in comparison with the previous years (R2 = 0.42, p < 0.05). Women showed a higher hospitalization rate than men (p < 0.001). Urban residents had a higher hospitalization rate than rural residents (p < 0.001). In the analyzed period, 246 deaths were recorded (1.1 % of all hospitalized HZ patients) -119 males and 127 females. CONCLUSIONS The HZ-related number of hospitalizations and mortality in Poland are relatively low, but HZ is still a significant health problem. Risk factors include female gender, older age and residence in urban areas.
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Affiliation(s)
- Michał Rząd
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091Warsaw, 3 Oczki Street, Poland
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091Warsaw, 3 Oczki Street, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091Warsaw, 3 Oczki Street, Poland.
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091Warsaw, 3 Oczki Street, Poland; Institute of Rural Health in Lublin, 2 Jaczewskiego Street, 20-090 Lublin, Poland
| | - Paweł Gorynski
- National Institute of Public Health NIH - National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091Warsaw, 3 Oczki Street, Poland
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Kazemian SV, Shakeri M, Nazar E, Nasehi M, Sharafi S, Dadgarmoghaddam M. Prevalence, treatment outcomes and determinants of TB/HIV coinfection: A 4-year retrospective review of national tuberculosis registry in a country in a MENA region. Heliyon 2024; 10:e26615. [PMID: 38434388 PMCID: PMC10904239 DOI: 10.1016/j.heliyon.2024.e26615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/04/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
Background The co-occurrence of tuberculosis (TB) and AIDS (HIV) has emerged as a significant public health challenge. This study investigated the epidemiological factors and treatment outcomes of TB in individuals based on their HIV status in Iran. Methods The current study was a descriptive-analytical cross-sectional study that focused on new patients diagnosed with TB in Iran between 2018 and 2021. Patients' data were sourced from the National Tuberculosis Registry database of Iran. A multiple logistic regression model was used to investigate the relationship between the most important influencing factors and TB/HIV coinfection. Results Over a 4-year period, a study was conducted on 25,011 new TB patients out of 30,762 registered in the national database. TB and HIV were coinfected in 672 cases (2.68%). The highest number of coinfection cases were found in patients with smear-negative pulmonary tuberculosis (249 patients, 37.05%) and extrapulmonary tuberculosis (123 patients, 18.19%). TB patients with coinfection had a median TB treatment duration of three months longer than others. The success rate of TB treatment was lower in patients with coinfection (437 patients, 65.02%) than in non-coinfection patients (20,302 patients, 83.41%). Treatment success probability in smear-positive pulmonary tuberculosis patients with and without coinfection was lower than other types of TB. Logistic regression analysis showed that having a TB risk factor was the strongest predictor of coinfection, with an odds ratio of 29.73 (95% CI: 22.05-40.07), followed by having an HIV risk factor with an odds ratio of 17.52 (95% CI: 13.68-22.45). Conclusions The findings of this research offer significant insights into the potential causes of HIV coinfection in individuals with TB, which could be used to inform the development of policies and strategies aimed at enhancing the identification and treatment of TB patients who are at risk of TB/HIV coinfection and to promote optimal health status for patients with TB.
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Affiliation(s)
- Seyedeh Vajiheh Kazemian
- Community and Family Medicine Department, Resident of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadtaghi Shakeri
- Department of Biostatistics, School of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Eisa Nazar
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahshid Nasehi
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Saeid Sharafi
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Maliheh Dadgarmoghaddam
- Community and Family Medicine Department, Associate Professor of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Bemtgen X, Kaier K, Rilinger J, Rottmann F, Supady A, von Zur Mühlen C, Westermann D, Wengenmayer T, Staudacher DL. Myocarditis mortality with and without COVID-19: insights from a national registry. Clin Res Cardiol 2024; 113:216-222. [PMID: 36565377 PMCID: PMC9789728 DOI: 10.1007/s00392-022-02141-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Myocarditis in context of a SARS-CoV-2 infection is vividly discussed in the literature. Real-world data however are sparse, and relevance of the myocarditis diagnosis to outcome in coronavirus disease (COVID-19) is unclear. PATIENTS AND METHODS Retrospective analysis of 75,304 patients hospitalized in Germany with myocarditis between 2007 and 2020 is reported by DESTATIS. Patients hospitalized between 01/2016 and 12/2019 served as reference cohort for the COVID-19 patients hospitalized in 2020. RESULTS A total of 75,304 patients were hospitalized between 2007 and 2020 (age 42.5 years, 30.1% female, hospital mortality 2.4%). In the reference cohort, 24,474 patients (age 42.8 years, 29.5% female, hospital mortality 2.2%) were registered. In 2020, annual myocarditis hospitalizations dropped by 19.6% compared to reference (4921 vs. 6119 annual hospitalization), of which 443/4921 (9.0%) were connected to COVID-19. In 2020, hospital mortality of myocarditis in non-COVID-19 patients increased significantly compared to reference (2.9% vs. 2.2%, p = 0.008, OR 1.31, 95% CI 1.08-1.60). In COVID-19 myocarditis, hospital mortality was even higher compared to reference (13.5% vs. 2.2%, p < 0.001, OR 6.93, 95% CI 5.18-9.18). CONCLUSION The burden of patients with myocarditis and COVID-19 in 2020 was low. Hospital mortality was more than sixfold higher in patients with myocarditis and COVID-19 compared to those with myocarditis but without COVID-19.
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Affiliation(s)
- Xavier Bemtgen
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Klaus Kaier
- Faculty of Medicine, Institute for Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | - Jonathan Rilinger
- Department of Cardiology and Angiology, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Felix Rottmann
- Department of Medicine IV - Nephrology and Primary Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Supady
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Constantin von Zur Mühlen
- Department of Cardiology and Angiology, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Wengenmayer
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dawid L Staudacher
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Romero Pisonero E, Mora-Fernández J, Queipo Matas R, González Montalvo JI, Neira Álvarez M, Ojeda Thies C, Sáez López P, Malafarina V. Demographic, functional and clinical characteristics in hip fracture patients according to mental status of Spanish National Hip Fracture Registry. Rev Esp Geriatr Gerontol 2023; 59:101450. [PMID: 38159499 DOI: 10.1016/j.regg.2023.101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To describe the differences according to mental status at admission on the care process and 30-day outcomes in hip fracture patients, mainly regarding the use of rehabilitation resources and anti-osteoporotic medication, by analysing data from the Spanish National Hip Fracture Registry (RNFC, "Registro Nacional de Fracturas de Cadera" in Spanish). METHODS We analysed prospectively collected data from a cohort of patients admitted participating in the Spanish National Hip Fracture Registry (RNFC) in 76 Spanish hospitals between 2017 and 2019. We classified participants using Short Portable Mental Status Questionnaire (SPMSQ), defining two groups: patients with ≤2 SPMSQ score and patients with >2 SPMSQ score. RESULTS Of 21,254 patients was recorded SPMSQ in 17,242 patients, 9052 were >2 SPMSQ score (52.6%). These were older (87.7 vs. 85.3 years; p<0.001), had worse mobility (no-independent walking ability 26.0% vs. 4.5%; p<0.001) and were more likely to be living in nursing homes (35.3% vs. 9.6%; p<0.001). They were more likely to be treated nonoperatively (3.8% vs. 1.5%; p>0.001), less early mobilisation (57.5% vs. 68.9%; p<0.001) and suffered higher in-hospital mortality (5.2% vs. 2.7%; p<0.001). At discharge, they received less anti-osteoporotic medication (37.9% vs. 48.9%; p<0.001) and returned home less often (29.8%% vs. 51.2%; p<0.001). One month after fracture, patients with >2 SPMSQ score had poorer mobility (no-independent walking ability 44.4% vs. 24.9%; p<0.001) and were newly institutionalised in a nursing home more (12.6% vs. 12.0%; p<0.001) and were more likely to die by one-month post-fracture (9.5% vs. 4.6%; p<0.001). CONCLUSION RNFC patients with >2 SPMSQ score were more vulnerable and had poorer outcomes than patients with ≤2 SPMSQ score, suggesting that they need specialised care in-hospital and in the recovery phase.
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Affiliation(s)
| | - Jesús Mora-Fernández
- Department of Geriatrics, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University, Madrid, Spain
| | - Rocío Queipo Matas
- Europea University, Madrid, Spain; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
| | - Juan Ignacio González Montalvo
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain; Department of Geriatrics, La Paz University Hospital, Madrid, Spain; Department of Medicine, Faculty of Medicine, Autonoma University, Madrid, Spain
| | | | - Cristina Ojeda Thies
- Department of Traumatology and Orthopaedic Surgery, 12 de Octubre University Hospital, Madrid, Spain
| | - Pilar Sáez López
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain; Geriatrics Unit, Fundación Alcorcón University Hospital, Alcorcón, Madrid, Spain
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 19th official report of Heart Rhythm Association of the Spanish Society of Cardiology (2022). Rev Esp Cardiol (Engl Ed) 2023; 76:922-935. [PMID: 37774946 DOI: 10.1016/j.rec.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents data on implantable cardioverter-defibrillator implants in Spain in 2022. METHODS The data were collected from implantation centers, which voluntarily completed a data collection sheet during the implantation process, either manually or through a web page. RESULTS In 2022, 170 hospitals participated in the registry. A total of 7693 forms were received compared with the 7970 reported by Eucomed (European Confederation of Medical Suppliers Associations), representing 96.5% of the devices. The total rate of registered implants was 162/million inhabitants (168 according to Eucomed), showing a slight increase compared with previous years. Disparities persisted among autonomous communities and Spain continued to have the lowest implantation rate among countries participating in Eucomed. CONCLUSIONS The data from the registry for 2022 reflect the complete recovery of activity after the impact of the COVID-19 pandemic in 2020. Despite a slight improvement, there was no significant change in our position in Europe or in the substantial differences among autonomous communities.
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Farhan M, Fazal F, Dave T, Butt A, Basit J, Maqbool S. National hepatitis registry in Pakistan: a dire need for hepatitis surveillance and control. Trop Med Health 2023; 51:41. [PMID: 37542354 PMCID: PMC10401767 DOI: 10.1186/s41182-023-00534-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/31/2023] [Indexed: 08/06/2023] Open
Abstract
Hepatitis is a major public health issue in Pakistan, with an estimated 11.55% prevalence of HCV infection in the adult population. The country ranks second globally in terms of hepatitis C virus (HCV) infections, with approximately one in every 20 Pakistanis already infected. The mortality rates due to HBV and HCV stand at 563,000 and 366,000 annually, respectively. However, the absence of a national registry or database system and the lack of coordination among provinces pose significant obstacles in combating this disease effectively. To address this issue, the establishment of a centralized national database registry is crucial, allowing comprehensive analysis, tracking of hepatitis prevalence, and identification of high-risk areas for targeted interventions. By fostering collaboration among provinces, the government, and non-governmental organizations, the registry would facilitate joint decision-making, minimize duplication of efforts, and address inconsistencies in diagnosis and treatment. Collaborating with student-run organizations and leveraging enhanced laboratory capacities post-COVID era can strengthen the hepatitis control program. The centralized approach and unified efforts are necessary to achieve the goal of a hepatitis-free Pakistan, where a healthier future can be realized.
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Affiliation(s)
| | - Faizan Fazal
- Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Tirth Dave
- Bukovinian State Medical University, Chernivtsi, Ukraine.
| | - Armeen Butt
- Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Jawad Basit
- Rawalpindi Medical University, Rawalpindi, Pakistan
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Nasibi S, Mojarrab S, Lashkarizadeh MR, Shafiei M, Saedi Dezaki E, Mahmoudvand H, Alizadeh A, Mohammadzadeh A, Adnani Sadati SJ, Mirbadie SR, Keighobadi M, Gholami S, Raeghi S, Abbasi M, Mohtasham F, Ravari MS, Dabirzadeh M, Mosavi Anari SA, Mirjalali H, Aliakbarian M, Abbasifard M, Fasihi Harandi M. Iranian Hydatid Disease Registry: Establishment and Implementation of a Neglected Tropical Disease Registry. Arch Iran Med 2023; 26:358-364. [PMID: 38301093 PMCID: PMC10685822 DOI: 10.34172/aim.2023.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2024]
Abstract
BACKGROUND Cystic echinococcosis (CE) or hydatid disease is a global public health concern which imposes considerable economic costs on the communities in endemic regions. CE surveillance data are not adequately reliable. The present study reports the development and outcomes of a CE registry in Iran. METHODS Hydatid Registry (HydatidReg) was initially established as a single-center registry in 2014 after the ethical approval of KMU. Following a call from MoHME to promote registry of different diseases and health outcomes, a call for participation was announced and all the Iranian Universities of Medical Sciences were requested to contribute to the registry. Subsequently, a nation-wide registry of hydatid disease was established in 2016. With a global perspective, HydatidReg joined the European Register of Cystic Echinococcosis (ERCE). A data collection form based on minimum dataset was designed and standard operating procedures (SOPs) were prepared to ensure standardized patient enrolment in the registry. A biobank system with two-dimensional barcoding was established along with HydatidReg for management and organization of biological specimens. RESULTS As of March 2021, a total of 690 patients were enrolled in the registry. HydatidReg registered 362 (17.3%) out of the total 2097 patients enrolled in ERCE. Quality control (QC) of the data demonstrated 91.2% completeness and 80% timeliness. In the biobank, 322 biological specimens from 184 CE patients have been deposited including 70 blood, 96 sera and 156 parasite materials. CONCLUSION High-quality data in the HydatidReg registry provided opportunities for health professionals to improve quality of care and organize meaningful research.
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Affiliation(s)
- Saeid Nasibi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahnaz Mojarrab
- Deputy of Research, Ministry of Health and Medical Education, Tehran. Iran
| | | | - Mohammad Shafiei
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Ebrahim Saedi Dezaki
- Department of Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hossein Mahmoudvand
- Department of Laboratory Sciences, School of Allied Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ardeshir Alizadeh
- Disease and Health Outcomes Registry Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Alireza Mohammadzadeh
- Disease and Health Outcomes Registry Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Seyed Jafar Adnani Sadati
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran
| | | | - Masoud Keighobadi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Toxoplasmosis (INRCT), Mazandaran University of Medical Sciences, Sari, Iran
| | - Shirzad Gholami
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saber Raeghi
- Department of Laboratory Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Masoumeh Abbasi
- Department of Health Information Technology, Kermanshah University of Medical Sciences, Kermanshah, Kermanshah, Iran
| | - Fatemeh Mohtasham
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrnaz Sadat Ravari
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansour Dabirzadeh
- Department of Parasitology and Mycology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Seyed Alireza Mosavi Anari
- Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Aliakbarian
- Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mitra Abbasifard
- Department of Internal Medicine, Ali-Ibn-Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
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Taneichi H, Kanemura T, Inoue G, Iwase Y, Ueda H, Kuzuhara A, Kurozumi T, Takahashi E, Takahashi H, Nakamae A, Hashiguchi H, Hiraizumi Y, Mae T, Morioka H, Yagi M, Sairenchi T, Nishiwaki Y, Inagaki T, Akiyama H, Nakashima Y. Current status and future prospects of the Japanese orthopaedic association national registry (JOANR), Japan's first national registry of orthopaedic surgery. J Orthop Sci 2023; 28:683-692. [PMID: 36775784 DOI: 10.1016/j.jos.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/14/2023]
Abstract
The Japanese Orthopaedic Association National Registry (JOANR) is Japan's first national registry of orthopaedic surgery, which has been developed after having been selected for the Project for Developing a Database of Clinical Outcome approved by the Health Policy Bureau of the Ministry of Health, Labour and Welfare. Its architecture has two levels of registration, one being the basic items of surgical procedure, disease, information on surgeons, surgery-related information, and outcome, and the other being detailed items in the affiliated registries of partner medical associations. It has a number of features, including the facts that, because it handles medical data, which constitute special care-required personal information, data processing is conducted entirely in a cloud environment with the imposition of high-level data security measures; registration of the implant data required to assess implant performance has been automated via a bar code reader app; and the system structure enables flexible collaboration with the registries of partner associations. JOANR registration is a requirement for accreditation as a core institution or partner institution under the board certification system, and the total number of cases registered during the first year of operation (2020) was 899,421 registered by 2,247 institutions, providing real-world evidence concerning orthopaedic surgery.
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Affiliation(s)
- Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Japan.
| | - Tokumi Kanemura
- Department of Orthopaedic Surgery, Konan Kosei Hospital, Japan
| | - Gen Inoue
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Japan
| | - Yoshiyuki Iwase
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Japan
| | - Haruki Ueda
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Japan
| | | | | | - Eiji Takahashi
- Department of Orthopaedic Surgery, Kanazawa Medical University, Japan
| | - Hiroshi Takahashi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Atsuo Nakamae
- Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Japan
| | - Hiroshi Hashiguchi
- Department of Orthopaedic Surgery, Yonekura Spine & Joint Hospital, Japan
| | - Yutaka Hiraizumi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Japan
| | - Tatsuo Mae
- Department of Physical Therapy, Osaka Yukioka Medical College, Japan
| | - Hideo Morioka
- Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Japan
| | - Mitsuru Yagi
- Department of Orthopedic Surgery, Keio University School of Medicine, Japan
| | - Toshimi Sairenchi
- Department of Medical Science of Nursing, Dokkyo Medical University School of Nursing, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, Toho University, Japan
| | - Tokiko Inagaki
- Medical Support Section, Medical Information Management Office, Public Noto General Hospital, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Gifu University, School of Medicine, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan
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Ga R, Muvvala SPR. Access to infertility care and ART treatment in India: A clinician's perspective. Best Pract Res Clin Obstet Gynaecol 2023; 86:102302. [PMID: 36646566 DOI: 10.1016/j.bpobgyn.2022.102302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/15/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
Infertility is a worldwide problem that is increasing with time. The cause of infertility can be due to either male or female factors or both. The food, environmental, occupational and psychological factors do contribute to infertility. The infertility and the present scenario of assisted reproductive technology (ART) in India with regard to the clinics, clinicians and regulatory mechanisms in vogue are discussed. The potential of India as a reproductive tourist destination and surrogacy issues is included. The social, economic, and family problems arising as a consequence of infertility are discussed. The status of ART in India is getting improved and the gap between the West and India is expected to be minimized with the influence of regulatory mechanisms introduced through ART Act in India. The salient features that have a bearing on the infertility treatment outcomes, which are being neglected, or recent findings of research are included with special reference to possible future developments in the field of ART.
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Affiliation(s)
- Ramaraju Ga
- Center for Assisted Reproduction, Krishna IVF Clinic, Maharanipeta, Visakhapatnam 530002, Andhra Pradesh, India.
| | - Sanni Prasada Rao Muvvala
- Center for Assisted Reproduction, Krishna IVF Clinic, Maharanipeta, Visakhapatnam 530002, Andhra Pradesh, India.
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Hultgren R, Fattahi N, Nilsson O, Svensjö S, Roy J, Linne A. Evaluating feasibility of using national registries for identification, invitation, and ultrasound examination of persons with hereditary risk for aneurysm disease-detecting abdominal aortic aneurysms in first degree relatives (adult offspring) to AAA patients (DAAAD). Pilot Feasibility Stud 2022; 8:252. [PMID: 36503690 PMCID: PMC9742022 DOI: 10.1186/s40814-022-01196-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sweden and the UK invite all 65-year-old men to a population-based ultrasound-based screening program to detect abdominal aortic aneurysms (AAA). First-degree relatives of patients with AAA are reported to have an increased risk to develop AAA, both women and men, but are not invited to screening. The "Detecting AAA in First Degree Relatives to AAA patients" (DAAAD) was designed to detect the true prevalence in adult offspring to AAA patients and to evaluate if national registries could be used for identification of index persons and their adult children with a high risk for the disease. The aim of this study is to summarize the design and methodology for this registry-based study. METHODS The study is based on a registry-based extraction and identification of a risk group in the population with a subsequent identification of their adult offspring. The targeted risk group suffers a heredity for a potentially lethal disease, AAA (n = 750) and matched control group without heredity for AAA is also identified and invited (n = 750). The participation rate in the population-based AAA screening program for men is 75% regionally. This population is younger and have a lower prevalence. A participation rate of 65% is considered clinically adequate. For the DAAAD study, a stratified analysis of the primary outcome, prevalence, will be performed for women and men separately. Two other planned projects are based on the material: firstly, evaluation of the anxiety for disease and health-related quality of life (HRQoL) and, secondly, the cost-effectiveness of the study. DISCUSSION In conclusion, this feasibility study will be instrumental in supporting the development of a possible new model to invite persons with high risk to develop hereditary rare diseases. To our knowledge, this is a unique, safe, and most likely to be a cost-efficient model to invite targeted risk groups for selected screening. If the study design and the results are shown to be cost-effective at the detected participation rate and prevalence, it should be further evaluated and adopted to a national screening program. The model also invites both women and men, which is unique for this specific patient group, considering that all population-based screening programs only include men. TRIAL REGISTRATION This trial is registered at the website of Clinical Trials. CLINICALTRIALS gov identifier, NCT4623268.
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Affiliation(s)
- Rebecka Hultgren
- grid.24381.3c0000 0000 9241 5705Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Stockholm Aneurysm Research group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Nina Fattahi
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden ,grid.416648.90000 0000 8986 2221Section of Vascular Surgery, Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Olga Nilsson
- grid.24381.3c0000 0000 9241 5705Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Stockholm Aneurysm Research group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Sverker Svensjö
- grid.8993.b0000 0004 1936 9457Department of Surgical Sciences, Uppsala University, Uppsala, Sweden ,Centre for Clinical Research, Falun, Sweden
| | - Joy Roy
- grid.24381.3c0000 0000 9241 5705Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Stockholm Aneurysm Research group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Linne
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden ,grid.416648.90000 0000 8986 2221Section of Vascular Surgery, Department of Surgery, Södersjukhuset, Stockholm, Sweden
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Dutra M, da Silva SC, Beggiora PDS, Santos MV, Machado HR, Lopes LDS. Epidemiology of hydrocephalus in Brazil. J Pediatr (Rio J) 2022; 99:228-234. [PMID: 36493803 DOI: 10.1016/j.jped.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS). METHODS This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs. RESULTS In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars. CONCLUSIONS Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.
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Affiliation(s)
- Maurício Dutra
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brazil
| | - Stephanya Covas da Silva
- Universidade Federal de São Carlos, Centro de Ciências Biológicas e da Saúde, Departamento de Morfologia e Patologia, São Carlos, SP, Brazil.
| | - Pâmella da S Beggiora
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brazil
| | - Marcelo V Santos
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brazil
| | - Hélio R Machado
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brazil
| | - Luiza da S Lopes
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia e Anatomia, Ribeirão Preto, SP, Brazil
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 18th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021). Rev Esp Cardiol (Engl Ed) 2022; 75:933-945. [PMID: 36155845 DOI: 10.1016/j.rec.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents the data corresponding to implantable cardioverter-defibrillator (ICD) implantations in Spain in 2021. METHODS The data were drawn from implanting centers, which voluntarily completed a data collection sheet during the procedure. RESULTS In 2021, 7496 implant data sheets were received, compared with 7743 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 96.8% of the devices implanted in Spain. Data completion ranged from 99.9% for "name of implanting hospital" to 8.9% for "implanting hospital". In 2021, 199 hospitals participated in the registry, exceeding the figures of previous years, with around 170 participating hospitals. The total rate of registered implants was 158/million inhabitants (163 according to Eucomed), making 2021 the year with the highest activity. However, the registry continues to show significant differences among the various autonomous communities and the lowest implantation rate of all the European countries participating in Eucomed. CONCLUSIONS The Spanish implantable cardioverter-defibrillator registry for 2021 recorded an increase in the number of ICD implantations, reflecting the recovery of hospital activity after the initial impact of the COVID-19 pandemic in 2020. Although the total number of implants has increased in Spain, figures are still much lower than the European Union average, with differences persisting among Spanish autonomous communities.
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Melbye P, Gundtoft P, Lien-Iversen T, Barklin Morgan D, Pörneki JC, Viberg B. Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study. Knee 2022; 35:1-7. [PMID: 35144195 DOI: 10.1016/j.knee.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies with less than 10 years of follow-up have demonstrated no difference between surgical and non-surgical treatment after an anterior cruciate ligament (ACL) rupture; however, long-term effects remain unclear. The aim of this study was to compare the risk of long-term secondary surgical procedures after primary surgical and non-surgical treatment for ACL ruptures. METHODS Patients aged 18-35, registered in the Danish National Patient Registry with an ACL rupture between January 1, 1996 and December 31, 2000 with a minimum of 20 years follow-up were included. The surgically treated group was defined as receiving an ACL reconstruction within 1 year after diagnosis. Major secondary surgical procedures were defined as subsequent ACL surgeries (reconstruction/revision), arthroplasty, deep infection, arthrodesis, or amputation. Minor secondary surgical procedures were defined as meniscal surgery, synovectomy, and manipulation under anesthesia (MUA). Multivariate regression analysis was performed to assess relative risk (RR), adjusted for age and sex. The results are reported with 95% confidence intervals. RESULTS 7,539 patients had an ACL rupture; 1,970 patients were surgically treated. In the surgically treated group, 5.9% of patients underwent major secondary surgeries; this was 6.1% in the non-surgically treated group, yielding an adjusted RR of 1.05 (0.85;1.30). There were 43.9% minor secondary surgeries in the surgically treated group and 49.1% in the non-surgically treated group, yielding an adjusted RR of 1.29 (1.20;1.39). CONCLUSIONS No significant differences in the rate of major secondary surgical procedures between the groups, the non-surgical group was associated with a higher risk of minor secondary surgeries.
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Affiliation(s)
- Pernille Melbye
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark.
| | - Per Gundtoft
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Teodor Lien-Iversen
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Daniel Barklin Morgan
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Jens Christian Pörneki
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Bjarke Viberg
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
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Lindqvist L, Andersson A, Österberg J, Sandblom G, Hemmingsson O, Nordin P, Enochsson L. The Impact of Hospital Level of Care on the Management of Acute Cholecystitis: a Population-Based Study. J Gastrointest Surg 2022; 26:2551-2558. [PMID: 36253502 PMCID: PMC9674723 DOI: 10.1007/s11605-022-05471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The organization of healthcare could have an impact on the outcome of patients treated for acute cholecystitis (AC). The aim of this study was to analyze the way in which patients with AC are managed relative to the level of care by the treating hospital. METHODS Data were collected from the Swedish Register for Gallstone Surgery and ERCP (GallRiks). Cholecystectomies between 2010 and 2019 were included. The inclusion criterion was acute cholecystectomy in patients with AC operated at either tertiary referral centers (TRCs) or regional hospitals. RESULTS A total of 24,194 cholecystectomies with AC met the inclusion criterion. The time between admission and acute surgery was significantly elongated at TRCs compared with regional hospitals (2.2 ± 1.7 days vs. 1.6 ± 1.4 days, mean ± SD; p < 0.0001). Patients with a history of AC were more frequent at TRC (10.1% vs. 8.9%, p < 0.0056) and had a higher adverse event rate compared with those at regional hospitals (OR 1.61; CI 1.40-1.84, p < 0.0001). Surprisingly, an increased number of hospital beds correlated slightly with an increased number of days between admission and surgery (R2 = 0.132; p = 0.0075). CONCLUSION Compared with regional hospitals, patients with AC had to wait longer at TRCs before surgery. A history of AC significantly increased the risk of adverse events. These findings indicate that logistic and organizational aspects of hospital care may affect the management of patients with AC. However, whether these findings can be generalized to healthcare organizations outside Sweden requires further investigation.
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Affiliation(s)
- Lisa Lindqvist
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87, Umea, Sweden.
| | - Andreas Andersson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87, Umea, Sweden
| | - Johanna Österberg
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - Gabriel Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Oskar Hemmingsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87, Umea, Sweden
| | - Pär Nordin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87, Umea, Sweden
| | - Lars Enochsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87, Umea, Sweden
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Sunderby Hospital, Lulea, Sweden
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15
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 17th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020). Rev Esp Cardiol (Engl Ed) 2021; 74:971-982. [PMID: 34583912 DOI: 10.1016/j.rec.2021.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/13/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES We present the data corresponding to implantable cardioverter-defibrillator (ICD) implants in Spain in 2020. METHODS The data in this registry were drawn from implantation centers, which voluntarily completed a data collection sheet. RESULTS In 2020, 7056 implant sheets were received compared with 7106 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 99% of the devices implanted in Spain. Completion of the implant sheet ranged from 99.8% for the field "name of the implanting hospital" to 2.6% for the variable "referral hospital". A total of 173 hospitals performed ICD implants and participated in the registry, which is a similar figure to that in 2019 (n=172). The total rate of registered implants was 149/million inhabitants (150 according to Eucomed), revealing a slight reduction in implants in Spain in 2020 as a result of the impact of the COVID-19 pandemic. This reduction was uneven among the autonomous communities. CONCLUSIONS The Spanish Implantable Cardioverter Defibrillator Registry for 2020 shows an improvement in the rate of implants reported and a reduction in the number of ICD implants, which likely reflects the decrease in hospital activity not related to the treatment of COVID-19 infection. Similar to previous years, the total number of implants in Spain is still much lower than the average for the European Union, with an increase in the differences between Spanish autonomous communities.
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Dainty JR, Smith TO, Clark EM, Whitehouse MR, Price AJ, MacGregor AJ. Trajectories of pain and function in the first five years after total hip and knee arthroplasty : an analysis of patient reported outcome data from the National Joint Registry. Bone Joint J 2021; 103-B:1111-1118. [PMID: 34058866 DOI: 10.1302/0301-620x.103b6.bjj-2020-1437.r1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To determine the trajectories of patient reported pain and functional disability over five years following total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS A prospective, longitudinal cohort sub-study within the National Joint Registry (NJR) was undertaken. In all, 20,089 patients who underwent primary THA and 22,489 who underwent primary TKA between 2009 and 2010 were sent Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires at six months, and one, three, and five years postoperatively. OHS and OKS were disaggregated into pain and function subscales. A k-means clustering procedure assigned each patient to a longitudinal trajectory group for pain and function. Ordinal regression was used to predict trajectory group membership using baseline OHS and OKS score, age, BMI, index of multiple deprivation, sex, ethnicity, geographical location, and American Society of Anesthesiologists grade. RESULTS Data described two discrete trajectories for pain and function: 'level 1' responders (around 70% of cases) in whom a high level of improvement is sustained over five years, and 'level 2' responders who had sustained improvement, but at a lower level. Baseline patient variables were only weak predictors of pain trajectory and modest predictors of function trajectory. Those with worse baseline pain and function tended to show a greater likelihood of following a 'level 2' trajectory. Six-month patient-reported outcome measures data reliably predicted the class of five-year outcome trajectory for both pain and function. CONCLUSION The available preoperative patient variables were not reliable predictors of postoperative pain and function after THA and TKA. Reviewing patient outcomes at six months postoperatively is a reliable indicator of outcome at five years. Cite this article: Bone Joint J 2021;103-B(6):1111-1118.
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Affiliation(s)
- Jack R Dainty
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Emma M Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew J Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Busch M, Klein C, Uhl A, Haltmayer H, Cabanis M, Westenberg JN, Vogel M, Krausz RM. Retention in the Austrian opioid agonist treatment system: a national prospective cohort study. Harm Reduct J 2021; 18:25. [PMID: 33627159 PMCID: PMC7903033 DOI: 10.1186/s12954-021-00473-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/11/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Retention in care is a prerequisite for successful recovery, especially for a chronic condition like opioid dependence. Though retention varies greatly depending on the different substitution medication and treatment model, treatment retention is used as an indicator of treatment quality and effectiveness of care on a system and individual level. To monitor the overall quality of the Austrian opioid agonist treatment (OAT) system and to monitor patient satisfaction within the system, a new online-based registry called "eSuchmittel" was introduced in Austria at the beginning of 2011. The objective of this study is to analyze retention rates within the Austrian treatment system and to identify patient characteristics associated with retention, using data collected by the substitution registry. METHODS The complete Austrian sample of 4778 registered patients starting treatment between 1.1.2011 to 31.12.2012 were included in the prospective cohort study using data from the Austrian substitution registry. For the statistical analysis, multivariate Cox Regression and Kaplan-Meier survival analysis were used to evaluate retention in treatment. RESULTS The retention rate of the total cohort after two years was around 61%. Retention rates were significantly lower for men (exp(B) = .806, 95% CI 0.714-0.908) and significantly higher for patients aged 30 and older (exp(B) = 1.155, 95% CI 1.044-1.279), among patients located in Vienna (exp(B) = 1.439, 95% CI 1.273-1.626) and among patients prescribed oral slow-release morphine (SROM) (exp(B) = 2.141, 95% CI 1.885-2.430). CONCLUSIONS Average retention in the Austrian system is high in comparison to international retention rates. Nationally, SROM demonstrates higher treatment retention when compared to other available substitution medications. Sociodemographic and regional indicators also contribute to higher retention in care. A systematic monitoring of retention rates within a national registry is an important tool helping to evaluate the quality of care. In this study, the Austrian OAT system proves very high retention in care, an important success criterion.
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Affiliation(s)
- Martin Busch
- Gesundheit Österreich GmbH (GÖG), Vienna, Austria
| | | | - Alfred Uhl
- Gesundheit Österreich GmbH (GÖG), Vienna, Austria
- Sigmund Freud University, Vienna, Austria
| | | | - Maurice Cabanis
- Zentrum Für Seelische Gesundheit, Klinikum Stuttgart, Stuttgart, Germany
| | - Jean Nicolas Westenberg
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
- Addictions and Concurrent Disorders Research Group, Institute of Mental Health, University of British Columbia, David Strangway Building, 5950 University Boulevard, Vancouver, BC V6T 1Z3 Canada
| | - Marc Vogel
- Psychiatrische Klinik Münsterlingen, Münsterlingen, Switzerland
| | - R. Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 16th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2019). Rev Esp Cardiol (Engl Ed) 2020; 73:1026-37. [PMID: 33039380 DOI: 10.1016/j.rec.2020.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/29/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES We present the data corresponding to implantable cardioverter-defibrillator (ICD) implants in Spain in 2019. METHODS The data were drawn from implant centers voluntarily completing a data collection sheet. RESULTS In 2019, 7003 implant sheets were received compared with the 7389 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 94.8% of the devices implanted in Spain. Completion of the implant sheet ranged from 99.7% in the field "name of the implanting hospital" to 17.8% in the variable "reference hospital". In 2019, 172 hospitals performed ICD implants and participated in the registry, a figure similar to that of 2018 (173). The total rate of registered implants was 149/million inhabitants; the rate reported by Eucomed was 157. Although this value represents the highest in the historical series, it is still much lower than the average rate of ICD implants in Europe (303). CONCLUSIONS The Spanish Implantable Cardioverter-Defibrillator Registry for 2019 reflects a growth in the number of ICD implants and is the year with the highest number of ICD implants in Spain. However, similar to previous years, the total number of implants in Spain is still much lower than the European Union average, with substantial differences between Spanish autonomous communities.
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19
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Masui T, Ito T, Komoto I, Uemoto S. Recent epidemiology of patients with gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) in Japan: a population-based study. BMC Cancer 2020; 20:1104. [PMID: 33189127 PMCID: PMC7666508 DOI: 10.1186/s12885-020-07581-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022] Open
Abstract
Background The worldwide prevalence and incidence of neuroendocrine neoplasms (NEN) have been increasing recently, although few studies have analyzed data on the current situation of NENs in Japan. Here, the Japan Neuroendocrine Tumor Society (JNETS) planned to investigate the recent incidence and distribution of these tumors using data from the national cancer registry started in 2016. This study examined the incidence and distribution of primary sites as well as rate of advanced disease from this population-based registry. Methods A retrospective, population-based study using data from the national cancer registry in Japan (NCR) was conducted to evaluate patients with gastro-entero-pancreatic NEN (GEP-NEN) in 2016. Associated population data were used to determine annual age-adjusted incidences. Results A total of 6735 individuals were diagnosed with GEP-NEN in Japan in 2016. Annual onset incidence was 0.70/100,000 for pancreatic NEN and 2.84/100,000 for gastrointestinal NEN. NEN in the ileum accounted for only 1% of total GEP-NENs in Japan. Most NENs in the esophagus or lungs were neuroendocrine carcinomas (NECs), while the majority of those in the duodenum, ileum, appendix and rectum were grade 1 neuroendocrine tumors (NETs). Median age at initial diagnosis was in between 60 to 65. Tumors in the duodenum, appendix and rectum were mostly limited to local, while those in the esophagus, stomach and colon tended to show distant metastasis. In Japan, initial treatment for GEP-NENs was resection even if the tumor was NEC. Conclusions This is the first report of a national registry-based incidence and distribution of GEP-NEN in Japan. These data will serve as an important first step to determining the exact etiology and trends for this pathology in Japan.
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Affiliation(s)
- Toshihiko Masui
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, 54 Shogoin Kawaracho, Sakyo, Kyoto, Japan.,Japan Neuroendocrine Tumor Society, Kyoto, Japan
| | - Tetsuhide Ito
- Japan Neuroendocrine Tumor Society, Kyoto, Japan.,School of Nursing at Fukuoka, International University of Health and Welfare, Fukuoka, Japan.,Hepato-Biliary-Pancreatic-Neuroendocrine-Tumor Center, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Izumi Komoto
- Japan Neuroendocrine Tumor Society, Kyoto, Japan.,Department of Surgery, Kansai Electric Power Hospital, Osaka, Japan.,Division of Neuroendocrine Tumor Science, Kansai Electric Power Medical Research Institute, Osaka, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, 54 Shogoin Kawaracho, Sakyo, Kyoto, Japan. .,Japan Neuroendocrine Tumor Society, Kyoto, Japan.
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Oshiro T, Kasama K, Nabekura T, Sato Y, Kitahara T, Matsunaga R, Arai M, Kadoya K, Nagashima M, Okazumi S. Current Status and Issues Associated with Bariatric and Metabolic Surgeries in Japan. Obes Surg 2020; 31:343-349. [PMID: 33170443 PMCID: PMC7808999 DOI: 10.1007/s11695-020-05056-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022]
Abstract
Among Asian countries, laparotomic and laparoscopic bariatric surgeries were introduced in Japan after its establishment in Taiwan. However, despite high prevalence of potential patients with obesity and diabetes, the wider incorporation of surgery into treatment regimen has been stalling for decades in Japan. While the unique Japanese national health insurance system has guaranteed fair healthcare delivery, it might have worked as a barrier to the development of bariatric and metabolic surgeries (BMS). The present article reviews the status of BMS in Japan and discusses recent issues related to its use. To focus on and identify the major obstacles inhibiting the widespread use of BMS, we have comprehensively covered some major areas including the insurance system, surgical indication, accreditation and training system, original research, and national registry.
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Affiliation(s)
- Takashi Oshiro
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan.
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Taiki Nabekura
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Yu Sato
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Tomoaki Kitahara
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Rie Matsunaga
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Motoaki Arai
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Kengo Kadoya
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Shinichi Okazumi
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
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Driessen MLS, Sturms LM, Bloemers FW, Ten Duis HJ, Edwards MJR, den Hartog D, de Jongh MAC, Leenhouts PA, Poeze M, Schipper IB, Spanjersberg WR, Wendt KW, de Wit RJ, van Zutphen S, Leenen LPH. The Dutch nationwide trauma registry: The value of capturing all acute trauma admissions. Injury 2020; 51:2553-2559. [PMID: 32792157 DOI: 10.1016/j.injury.2020.08.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/22/2020] [Accepted: 08/07/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Twenty years ago the Dutch trauma care system was reformed by the designating 11 level one Regional trauma centres (RTCs) to organise trauma care. The RTCs set up the Dutch National Trauma Registry (DNTR) to evaluate epidemiology, patient distribution, resource use and quality of care. In this study we describe the DNTR, the incidence and main characteristics of Dutch acutely admitted trauma patients, and evaluate the value of including all acute trauma admissions compared to more stringent criteria applied by the national trauma registries of the United Kingdom and Germany. METHODS The DNTR includes all injured patients treated at the ED within 48 hours after trauma and consecutively followed by direct admission, transfers to another hospital or death at the ED. DNTR data on admission years 2007-2018 were extracted to describe the maturation of the registry. Data from 2018 was used to describe the incidence rate and patient characteristics. Inclusion criteria of the Trauma Audit and Research (TARN) and the Deutsche Gesellschaft für Unfallchirurgie (DGU) were applied on 2018 DNTR data. RESULTS Since its start in 2007 a total of 865,460 trauma cases have been registered in the DNTR. Hospital participation increased from 64% to 98%. In 2018, a total of 77,529 patients were included, the median age was 64 years, 50% males. Severely injured patients with an ISS≥16, accounted for 6% of all admissions, of which 70% was treated at designated RTCs. Patients with an ISS≤ 15were treated at non-RTCs in 80% of cases. Application of DGU or TARN inclusion criteria, resulted in inclusion of respectively 5% and 32% of the DNTR patients. Particularly children, elderly and patients admitted at non-RTCs are left out. Moreover, 50% of ISS≥16 and 68% of the fatal cases did not meet DGU inclusion criteria CONCLUSION: The DNTR has evolved into a comprehensive well-structured nationwide population-based trauma register. With 80,000 inclusions annually, the DNTR has become one of the largest trauma databases in Europe The registries strength lies in the broad inclusion criteria which enables studies on the burden of injury and the quality and efficiency of the entire trauma care system, encompassing all trauma-receiving hospitals.
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Affiliation(s)
- M L S Driessen
- Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands.
| | - L M Sturms
- Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands
| | - F W Bloemers
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | | | - M J R Edwards
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D den Hartog
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M A C de Jongh
- Brabant Trauma Registry, Network Emergency Care Brabant, Tilburg, the Netherlands
| | - P A Leenhouts
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - M Poeze
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - I B Schipper
- Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - W R Spanjersberg
- Department of Trauma Surgery, Isala Klinieken, Zwolle, The Netherlands
| | - K W Wendt
- Department of Trauma Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - R J de Wit
- Department of Trauma Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - S van Zutphen
- Department of Surgery Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands
| | - L P H Leenen
- Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands; Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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Fosså SD, Aas K, Müller C, Jerm MB, Tandstad T, Lilleby W, Kvåle R, Gulbrandsen J, Haug E, Myklebust TA. Definitive radiotherapy for prostate cancer in Norway 2006-2015: Temporal trends, performance and survival. Radiother Oncol 2021; 155:33-41. [PMID: 33096165 DOI: 10.1016/j.radonc.2020.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND More studies are needed to document nation-wide use and effectiveness of curative definitive radiotherapy (Def-RT) in the treatment of prostate cancer (PCa). PATIENTS AND METHODS For 38,960 men diagnosed with PCa without distant metastases from 2006 to 2015 data from the Norwegian Prostate Cancer Registry and a national radiotherapy database (NoRadBase) was analyzed. Overall survival and PCa-specific mortality were described comparing EQD-2 < 74 Gy ("low-dose") with EQD-2 ≥ 74 Gy ("escalated dose"). RESULTS Use of Def-RT decreased (27-24%) whereas the proportion of radical prostatectomies (RPs) increased (31-38%). In high-risk patients the use of RP doubled (18-36%), while the proportion of Def-RT remained stable (about 35%). Before 2010, almost a quarter of patients received low-dose Def-RT with gradual increase of escalated Def-RT thereafter. Escalated Def-RT was associated with significantly more favorable 10-year PCa-specific mortality (4.4% [95% CI: 2.7-10.7%]) than observed after low-dose Def- RT (8.8% [95% CI: 6.2-9.8%), with the most beneficial effects in high-risk patients. Our analyses indicated the need to expand the NoRadBase by consensus-based quality measures. CONCLUSION In this nationwide cohort, the overall use of Def-RT decreased slightly. In high-risk patients the provision of Def-RT remained stable and was accompanied by doubling of patients with RP and reduction of a "no curative treatment" strategy. Escalated dose Def-RT significantly reduced 10-year PCa-specific mortality compared to low-dose Def-RT. Aiming for cancer care equity national radiotherapy registries for PCa should regularly monitor data based on consensus-based quality measures enabling feedback to the responsible hospitals.
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Loundon N, Simon F, Aubry K, Bordure P, Bozorg-Grayeli A, Deguine O, Eyermann C, Franco-Vidal V, Godey B, Guevara N, Karkas A, Klopp N, Labrousse M, Lebreton JP, Lerosey Y, Lescanne E, Marianowski R, Merklen F, Mezouaghi K, Mom T, Moreau S, Mosnier I, Noël-Petroff N, Parietti-Winkler C, Piller P, Poncet C, Radafy E, Roman S, Roux-Vaillard S, Schmerber S, Tavernier L, Truy E, Vincent C, De Lamaze A. The French Cochlear Implant Registry (EPIIC): Perception and language results in infants with cochlear implantation under the age of 24 months. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137 Suppl 1:S11-S18. [PMID: 32863156 DOI: 10.1016/j.anorl.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Multi-centre study of the National French Registry (EPIIC) of patients with cochlear implants, focusing on infants who were operated-on under the age of 24 months between 2012 and 2016. PATIENTS AND METHODS A total of 615 profoundly deaf infants, who received cochlear implants (CIs) before their second birthday, were included in the registry by different CI centers. Epidemiological, surgical, speech therapy and school, follow-up data were included in the registry, 12, 24, 36 and 48 months thereafter. The following parameters were studied: type of implantation (uni- or bilateral), complications, cause of deafness, category of auditory perception (CAP), Open-set word recognition score (OSW), speech intelligibility rating, lexical comprehension with EVIP (Peabody), communication mode and type of schooling. Bilateral simultaneous CI (BiCI) and unilateral CI (UniCI) groups were compared. RESULTS There were 744 implantations. The explantation-reimplantation rate, within the four-year follow-up, was just 3.6%. Mean implantation age was 16.0 months, and similar in the two groups (BiCI/UniCI). A total of 51% of children had their first implant between 12 and 18 months, and 15% before 12 months. Implantation was unilateral in 52% of cases. Fifty-six percent of the bilateral procedures were sequential, with a mean delay of 16.8 months for the second implantation. The cause of deafness was unknown in 52% of cases. Of the 48% (297/615) of attributed cases, 32% had clear genetic causes. The remaining deafness was due to cytomegalovirus (CMV, 8%), inner-ear malformation (5%) and meningitis (3%). The main complications were from infections (47%) and internal device failure (25%). Four years post-operation, 84% of the UniCI and 75% of BiCl groups had a CAP≥5, and 83% of UniCl and 100% BiCI had OSW≥80%. Furthermore 74% of UniCI and 77% of BiCI communicated orally and 85% of UniCI and 90% of BiCI integrated into mainstream schooling. CONCLUSION The French Registry of cochlear implants (EPIIC) is the only such national registry in the world. Our analysis illustrates the immediate benefits of, either single or double, cochlear implantation for language, perception skills and schooling.
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Affiliation(s)
- N Loundon
- Department of Pediatric Otolaryngology, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
| | - F Simon
- Department of Pediatric Otolaryngology, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - K Aubry
- CHU de Limoges, Limoges, France
| | | | | | | | | | | | - B Godey
- CHU de Rennes, Rennes, France
| | | | - A Karkas
- CHU de St Etienne, Saint-Etienne, France
| | - N Klopp
- CHU d'Amiens, Amiens, France
| | | | | | | | | | | | - F Merklen
- CHU de Montpellier, Montpellier, France
| | | | - T Mom
- CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - I Mosnier
- Hôpital Pitié-Salpétrière, Paris, France
| | | | | | - P Piller
- CH de Nouméa, Nouméa, Nouvelle-Calédonie
| | - C Poncet
- Hôpital Rothschild, Paris, France
| | - E Radafy
- CH du Lamentin, Martinique, France
| | - S Roman
- CHU de Marseille, Marseille, France
| | | | | | | | - E Truy
- CHU de Lyon, Lyon, France
| | | | - A De Lamaze
- Department of Pediatric Otolaryngology, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
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Sood A, Kaur K, Mahajan R, Midha V, Singh A, Sharma S, Puri AS, Goswami B, Desai D, Pai CG, Peddi K, Philip M, Kochhar R, Nijhawan S, Bhatia S, Rao NS. Colitis and Crohn's Foundation (India): a first nationwide inflammatory bowel disease registry. Intest Res 2020; 19:206-216. [PMID: 32646197 PMCID: PMC8100380 DOI: 10.5217/ir.2019.09169] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/29/2020] [Indexed: 12/30/2022] Open
Abstract
Background/Aims The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India. Methods A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed. Results A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south. Conclusions The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.
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Affiliation(s)
- Ajit Sood
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Kirandeep Kaur
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ramit Mahajan
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Vandana Midha
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Arshdeep Singh
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Sarit Sharma
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | | | - Bhabhadev Goswami
- Department of Gastroenterology, Gauhati Medical College, Guwahati, India
| | - Devendra Desai
- P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - C Ganesh Pai
- Department of Gastroenterology, Kasturba Medical College, Manipal, India
| | - Kiran Peddi
- Citizens Centre for Digestive Disorders, Hyderabad, India
| | | | - Rakesh Kochhar
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Nijhawan
- Department of Gastroenterology, Sawai Man Singh Medical College, Jaipur, India
| | - Shobna Bhatia
- Department of Gastroenterology, King Edward Memorial Hospital, Mumbai, India
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Rahardja R, Zhu M, Love H, Clatworthy MG, Monk AP, Young SW. Rates of revision and surgeon-reported graft rupture following ACL reconstruction: early results from the New Zealand ACL Registry. Knee Surg Sports Traumatol Arthrosc 2020; 28:2194-2202. [PMID: 31679071 DOI: 10.1007/s00167-019-05773-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/23/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE There remains a lack of consensus on the patient factors associated with graft rupture following anterior cruciate ligament (ACL) reconstruction. This study aimed to identify the rate of revision and surgeon-reported graft rupture and clarify the patient risk factors for failure. METHODS Analysis was conducted on prospective data captured by the New Zealand ACL registry. All primary isolated ACL reconstructions recorded between April 2014 and December 2018 were reviewed to identify the rate of revision and surgeon-reported graft rupture. Univariate and multivariate survival analysis was performed to identify patient factors associated with revision and graft rupture. RESULTS A total of 7402 primary isolated ACL reconstructions were reviewed and had a mean follow-up time of 23.1 (SD ± 13.9) months. There were 258 surgeon-reported graft ruptures (3.5%) of which 175 patients underwent subsequent revision ACL reconstruction (2.4%). Patients younger than 18 years had the highest risk of revision (adjusted HR = 7.29, p < 0.001) and graft rupture (adjusted HR = 4.26, p < 0.001) when compared to patients aged over 36 years. Male patients had a higher risk of revision (adjusted HR = 2.00, p < 0.001) and graft rupture (adjusted HR = 1.70, p < 0.001) when compared to their female counterparts. Patients who underwent ACL reconstruction within 6 months of their injury had a two times increased risk of revision compared to patients who had surgery after 12 months (adjusted HR = 2.15, p = 0.016). CONCLUSION Younger age, male sex and a shorter injury-to-surgery time interval increased the risk of revision, while younger age and male sex increased the risk of surgeon-reported graft rupture. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Richard Rahardja
- University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.
| | - Mark Zhu
- University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.,Department of Orthopaedic Surgery, Auckland Hospital, Auckland, New Zealand
| | | | - Mark G Clatworthy
- Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand
| | - Andrew Paul Monk
- University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.,Department of Orthopaedic Surgery, Auckland Hospital, Auckland, New Zealand
| | - Simon W Young
- University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.,Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand
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Kane RL, Nasser JS, Chung KC. Establishment of a National Hand Surgery Data Registry: An Avenue for Quality Improvement. Hand Clin 2020; 36:221-229. [PMID: 32307053 DOI: 10.1016/j.hcl.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Considerable variation exists in the practice of hand surgery that may lead to wasteful spending and less than optimal quality of care. Hand surgeons can benefit from a centralized system that tracks process and outcome measures, delivers national benchmarking, and encourages the sharing of knowledge. A national registry can fulfill these needs for hand surgeons and incorporate quality improvement into their daily routine. Leaders in hand surgery should convene to appraise the organization of a national registry for their field and reach consensus on how the registry can be designed and funded.
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Affiliation(s)
- Robert L Kane
- Michigan Center for Hand Outcomes and Innovation Research, 2800 Plymouth Road, Building 14, Suite G200, Ann Arbor, MI 48109, USA
| | - Jacob S Nasser
- George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Kevin C Chung
- Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
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Alkatiri AA, Firman D, Haryono N, Yonas E, Pranata R, Fahri I, Artha IMJR, Pratama V, Widodo WA, Taufiq N, Alkatiri AH, Ng S, Sulastomo H, Soerianata S. Comparison between radial versus femoral percutaneous coronary intervention access in Indonesian hospitals, 2017-2018: A prospective observational study of a national registry. Int J Cardiol Heart Vasc 2020; 27:100488. [PMID: 32154360 DOI: 10.1016/j.ijcha.2020.100488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/13/2020] [Accepted: 02/19/2020] [Indexed: 11/23/2022]
Abstract
Background Coronary heart disease is a leading cause of death in Indonesia and percutaneous coronary intervention (PCI) is a routinely performed procedure. The aim of this study is to provide real-world insight on the demographics of coronary artery disease and comparison between radial compared to femoral PCI in Indonesia, which performed radial access whenever possible. Methods This is a prospective cohort study involving 5420 patients with coronary artery disease who underwent PCI at 9 participating centers in the period of January 2017–December 2018. Results Radial access rate was performed in 4038 (74.5%) patients. Patients receiving femoral access has a higher rate of comorbidities and complex lesions compared to radial access. The incidence of in-hospital mortality, cardiogenic shock, major arrhythmia, and tamponade were higher in femoral group. The incidence of in-hospital mortality was 114 (2.1%). New-onset angina (OR 3.412), chronic renal failure (OR 3.47), RBBB (OR 4.26), LBBB (OR 6.26), left main stenosis PCI (OR 3.58), cardiogenic shock (OR 4.9), and arrhythmia (OR 15.59) were found to be independent predictors of in-hospital mortality. Radial access did not independently affect in-hospital mortality. In propensity-matched cohort, radial access was not associated with lower in-hospital mortality in both bivariable and multivariable model. However, radial access was associated with reduced in-hospital mortality in STEMI subgroup (OR 0.31). Conclusion Higher rate of adverse events was noted on the femoral access group. However, it might stem from the fact that patients with more comorbidities and complex lesions are more likely to be assigned to femoral access-group. Neither radial or femoral access is superior in terms of in-hospital mortality upon propensity-score matching/multivariable analysis.
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Key Words
- ACE, Angiotensin Converting Enzyme
- AF, Atrial Fibrillation
- ARB, Angiotensin Receptor Blocker
- AVB, Atrioventricular Block
- CAD, Coronary Artery Disease
- CKD, Chronic Kidney Disease
- CTO, Chronic Total Occlusion
- CVD, Cerebrovascular Disease
- HF, Heart Failure
- Indonesia
- LAD, Left Anterior Descending
- LBBB, Left-bundle Branch Block
- LCX, Left Circumflex Artery
- LM, Left Main
- MI, Myocardial Infarction
- NOAC, Non-vitamin K Antagonist Oral Anticoagulant
- NSTEACS, Non-ST segment Elevation Acute Coronary Syndrome
- National registry
- PCI, Percutaneous Coronary Intervention
- PVD, Peripheral Vascular Disease
- Percutaneous coronary intervention
- RBBB, Right-bundle Branch Block
- RCA, Right Coronary Artery
- Radial access
- TIA, Transient Ischemic Attack
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 15th Official Report of the Spanish Society of Cardiology Electrophysiology and Arrhythmias Section (2018). ACTA ACUST UNITED AC 2019; 72:1054-64. [PMID: 31727564 DOI: 10.1016/j.rec.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 09/06/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents the data corresponding to automated implantable cardioverter-defibrillator (ICD) implants in Spain reported to the Spanish Registry in 2018. METHODS The data in this registry include both primary implants and generator replacements and were gathered from a data collection sheet voluntarily completed by implantation centers. RESULTS In 2018, 6421 implant sheets were received compared with 7077 reported by Eucomed (European Confederation of Medical Suppliers Associations). This represents data on 90.7% of the devices implanted in Spain. Compliance ranged between 99.6% for the field "name of the implanting hospital" and 12.4% for "population of residence". A total of 173 hospitals reported their data to the registry, representing a slight decrease compared with hospitals participating in 2017 (n=181). CONCLUSIONS After the reduction in ICD implants in 2017, the number of implants increased in 2018, with the highest number of ICDs implanted in Spain. The total number of implants remains much lower than the European Union average, with substantial differences between autonomous communities.
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Broch A, Trang H, Montalva L, Berrebi D, Dauger S, Bonnard A. Congenital central hypoventilation syndrome and Hirschsprung disease: A retrospective review of the French National Registry Center on 33 cases. J Pediatr Surg 2019; 54:2325-30. [PMID: 30879749 DOI: 10.1016/j.jpedsurg.2019.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/06/2019] [Accepted: 02/08/2019] [Indexed: 01/29/2023]
Abstract
AIM OF THE STUDY Congenital Central Hypoventilation Syndrome (CCHS) is a rare affection associated to Hirschsprung disease (HD) in 20% of the cases. Using the French CCHS registry, we described the population of patients suffering from both CCHS and HD reporting the outcome on these patients. METHODS Medical records were reviewed. Epidemiological, clinical, histological and genetic data were analyzed and extracted from the national French registry data. RESULTS 33 patients had CCHS and HD. Thirty percent had a severe form of CCHS (Death owing to CCHS or 24/24 ventilation beyond 1 year old). Fifty four percent required tracheotomy. HD's pathologic segment was classic (Rectosigmoid and left colic form) in 20% and long (Above the splenic flexure) in 80%. Twenty four percent were treated with daily irrigation, 21% had colostomy without undergoing pullthrough, and 55% underwent optimal treatment (pull through). We failed to demonstrate a correlation between severity of CCHS and HD's length. The rate of mortality was 57% and was higher in the long HD group (p = 0.0005). Fourteen patients were still alive, aged 1 to 31 years old. Ninety two percent were weaned off the 24/24 ventilation. Regarding the intestinal function, 38% presented with soiling and 30% with chronic diarrhea. Hundred percent had CCHS follow-up while only 35% had no surgical follow-up in regard to the HD. CONCLUSIONS This is the largest study regarding the CCHS / HD association and its long-term followup. Mortality is high demonstrating that a multidisciplinary follow-up on respiratory and intestinal function is necessary to improve outcome. Level III study.
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Irie H, Okamoto H, Uchino S, Endo H, Uchida M, Kawasaki T, Kumasawa J, Tagami T, Shigemitsu H, Hashiba E, Aoki Y, Kurosawa H, Hatakeyama J, Ichihara N, Hashimoto S, Nishimura M. The Japanese Intensive care PAtient Database (JIPAD): A national intensive care unit registry in Japan. J Crit Care 2019; 55:86-94. [PMID: 31715536 DOI: 10.1016/j.jcrc.2019.09.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The Japanese Intensive care PAtient Database (JIPAD) was established to construct a high-quality Japanese intensive care unit (ICU) database. MATERIALS AND METHODS A data collection structure for consecutive ICU admissions in adults (≥16 years) and children (≤15 years) has been established in Japan since 2014. We herein report a current summary of the data in JIPAD for admissions between April 2015 and March 2017. RESULTS There were 21,617 ICU admissions from 21 ICUs (217 beds) including 8416 (38.9%) for postoperative or procedural monitoring, defined as adult admissions following elective surgery or for procedures and discharged alive within 24 h, 11,755 (54.4%) critically ill adults other than monitoring, and 1446 (6.7%) children. The standardized mortality ratios (SMRs) based on the Acute Physiology and Chronic Health Evaluation (APACHE) III-j, APACHE II, and Simplified Acute Physiology Score II scores in adults ranged from 0.387 to 0.534, whereas the SMR based on the Paediatric Index of Mortality 2 in children was 0.867. CONCLUSION The data revealed that the SMRs based on general severity scores in adults were low because of high proportions of elective and monitoring admission. The development of a new mortality prediction model for Japanese ICU patients is needed.
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Affiliation(s)
- Hiromasa Irie
- Department of Anesthesiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
| | - Hiroshi Okamoto
- Department of Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Shigehiko Uchino
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo 105-8471, Japan
| | - Hideki Endo
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masatoshi Uchida
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Tatsuya Kawasaki
- Department of Pediatric Critical Care, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, Shizuoka 420-8660, Japan
| | - Junji Kumasawa
- Department of Critical Care Medicine, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai, Osaka 593-8304, Japan
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
| | - Hidenobu Shigemitsu
- Department of Intensive Care Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Eiji Hashiba
- Division of Intensive Care, Hirosaki University Hospital, 53 Honcho, Hirosaki, Aomori 036-8203, Japan
| | - Yoshitaka Aoki
- Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3125, Japan
| | - Hiroshi Kurosawa
- Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama, Kanagawa 231-8682, Japan
| | - Nao Ichihara
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Satoru Hashimoto
- Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masaji Nishimura
- The President of the Japanese Society of Intensive Care Medicine, 3-32-7 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Yamauchi T, Suka M, Nishigori C, Yanagisawa H. Evaluation of neurofibromatosis type 1 progression using a nationwide registry of patients who submitted claims for medical expense subsidies in Japan between 2008 and 2012. Orphanet J Rare Dis 2019; 14:166. [PMID: 31277677 PMCID: PMC6612089 DOI: 10.1186/s13023-019-1148-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No study to date has followed disease progression in patients with neurofibromatosis type 1 (NF1), including the incidence of various manifestations, using a national registry. Here we examined the state of NF1 progression using a nationwide registry of patients who submitted claims to receive medical expense subsidies for NF1 in Japan over a five-year period. A total of 342 eligible patients (194 females and 148 males) with NF1 who newly submitted claims for medical expense subsidies in Japan in 2008 were followed until 2012. RESULTS More than half of the patients were classified as Stage 5 in 2008. Of the eligible patients, 205 (60%) submitted claims to renew the subsidies between 2009 and 2012. During the study period, NF1 stage progressed in 30 patients, yielding an overall stage progression rate of 19% and progression incidence rate per 100 person-years of 12.2. Both stage progression rate and progression incidence rate were the highest in the 0-19 year age group at the time of registration and, as compared to other age groups, progression of neurological and bone manifestations was more prevalent in this age group. CONCLUSIONS The progression of neurological and bone manifestations was more prevalent in the 0-19 year age group compared to other age groups. The registry we used in the present study is useful for understanding the characteristics of patients with uncommon conditions, such as NF1. Our findings also highlight the feasibility of conducting quality research using registries of patients with rare diseases, such as NF1, that were not designed specifically for scientific research.
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Affiliation(s)
- Takashi Yamauchi
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | | | - Hiroyuki Yanagisawa
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Baig MA, Alzahrani SJ, Almuhaizea MA, Al-Shagathrh F. Fundamentals of Implementing a National Clinical Registries Program. Stud Health Technol Inform 2019; 262:384-387. [PMID: 31349248 DOI: 10.3233/shti190099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A National registry program is a resource intensive initiative involving multiple stakeholders, multi-institutional/multi-role/multi-users collaborative effort, where various aspects starting from work culture, research culture, registry conceptualization, resource availability, data format, data storage/retrieval techniques, data sharing protocols, data/dataset standards, data quality etc. vary drastically between different institutions. The biggest challenge for a national program will be to map these aspects under a common umbrella to establish standards for operations/execution, policies and procedures, which means aligning the registry operations with the operative process of each institution at first, due to this only a handful initiatives are implemented with limited success, hence it is advisable to study such implementations in great details as a guideline to build a solid foundation for future national initiatives[1][2]. The idea goes around building a solid database for holding all clinical registries under a single repository, along with streamlining and generalizing the policies and procedures for any disease or medical device registry, in order to save infrastructure spending, streamlining, saving on management and operational costs and overheads.
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Affiliation(s)
- Mansoor Ali Baig
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Department of Biostatistics Epidemiology & Scientific Computing, KFSHRC, KSA
| | - Somayah J Alzahrani
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Department of Biostatistics Epidemiology & Scientific Computing, KFSHRC, KSA
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Ro DH, Jin H, Park JY, Lee MC, Won S, Han HS. The use of bisphosphonates after joint arthroplasty is associated with lower implant revision rate. Knee Surg Sports Traumatol Arthrosc 2019; 27:2082-2089. [PMID: 30547306 DOI: 10.1007/s00167-018-5333-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE This study hypothesized that the use of bisphosphonates (BPs) after total joint arthroplasty (TJA) is associated with a lower implant revision rate. This study aimed (1) to investigate the association between BP use and the revision rate of TJA and (2) to determine the relationship between the medication period and the revision rate of TJA. METHODS National Health Insurance Service data on surgeries, medications, diagnoses, and screenings of 50 million Koreans were reviewed. People who underwent TJA in the period from 2002 to 2012 were identified and followed until 2016. During that period, 331,660 patients underwent total knee arthroplasty (TKA), and 56,043 patients underwent total hip arthroplasty (THA). Among them, 8447 knee patients (2.5%) and 2851 hip patients (5.0%) required revision surgery due to aseptic loosening. Demographic data, the duration of BP medication, and comorbidities were identified. The rate of revision surgery according to BP medication was investigated. The extended Cox proportional hazard model was used to evaluate the effect of the medication period. RESULTS The rate of TKA revision was 1.4% for BP users and 2.9% for BP non-users (p < 0.001). The THA revision rate was 2.8% and 5.3% for BP users and non-users, respectively (p < 0.001). The hazard ratio (HR) of revision was significantly lower in patients who took BP medication for more than one year (TKA HR = 0.472, 95% CI [0.350-0.637]; THA HR = 0.490, 95% CI [0.247-0.972]) compared to that in short-term users (less than 1 year). CONCLUSIONS The use of BPs after TJA was associated with a lower revision rate. The use of BPs for more than one year further reduced the risk of revision. Bisphosphonate use can be highly recommended to reduce the revision rate of TJA. LEVEL OF EVIDENCE Retrospective cohort study, Level III.
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Affiliation(s)
- Du Hyun Ro
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Heejin Jin
- Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Jae-Young Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Sungho Won
- Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
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Fernández-Fabrellas E, Molina-Molina M, Soriano JB, Portal JAR, Ancochea J, Valenzuela C, Xaubet A; SEPAR-IPF National Registry. Demographic and clinical profile of idiopathic pulmonary fibrosis patients in Spain: the SEPAR National Registry. Respir Res 2019; 20:127. [PMID: 31208406 DOI: 10.1186/s12931-019-1084-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/24/2019] [Indexed: 12/13/2022] Open
Abstract
Background Little is known on the characteristics of patients diagnosed with idiopathic pulmonary fibrosis (IPF) in Spain. We aimed to characterize the demographic and clinical profile of IPF patients included in the IPF National Registry of the Spanish Respiratory Society (SEPAR). Methods This is a prospective, observational, multicentre and nationwide study that involved 608 IPF patients included in the SEPAR IPF Registry up to June 27th, 2017, and who received any treatment for their disease. IPF patients were predominantly males, ex-smokers, and aged in their 70s, similar to other registries. Results Upon inclusion, mean ± SD predicted forced vital capacity was 77.6% ± 19.4, diffusing capacity for carbon monoxide was 48.5% ± 17.7, and the 6-min walk distance was 423.5 m ± 110.4. The diagnosis was mainly established on results from the high-resolution computed tomography in the proper clinical context (55.0% of patients), while 21.2% of patients required invasive procedures (surgical lung biopsy) for definitive diagnosis. Anti-fibrotic treatment was prescribed in 69.4% of cases, 51.5% pirfenidone and 17.9% nintedanib, overall with a good safety profile. Conclusions The SEPAR IPF Registry should help to further characterize current characteristics and future trends of IPF patients in Spain and compare/pool them with other registries and cohorts.
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Asakai H, Shimizu A, Mitsuhashi T, Ueyama T, Yokoshiki H, Nishii N, Sekiguchi Y, Okamura H, Morita N, Nitta T, Hirao K. Current Trends in Implantable Cardioverter-Defibrillator Therapy in Children - Results From the JCDTR Database. Circ J 2018; 83:52-55. [PMID: 30344201 DOI: 10.1253/circj.cj-18-0712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implantable cardioverter defibrillators (ICDs) are being used with increasing frequency in children. Our aim was to examine the current trend of pediatric ICD implantation in Japan. Methods and Results: Data was extracted from the Japanese Cardiac Device Treatment Registry (JCDTR), a nation-wide registry started in 2006. All patients aged less than 18 years who had an ICD implantation registered between 2006 and 2016 were included in the analysis. A total of 201 patients were included, with a median age of 16 years (range 1-18). The underlying cardiac diagnosis was primary electrical disease (67%), cardiomyopathy (26%) and congenital heart disease (4%), with idiopathic ventricular fibrillation (29%) and long QT syndrome (21%) being the 2 most common diagnoses. Implantation indication was primary prevention in only 30 patients (15%). There were 27 patients (13%) aged ≤12 years, with a larger proportion of patients with cardiomyopathy (33%). The indication in younger children was secondary prevention in all cases. Younger children may be under-represented in our study given the nature of the database as it is a predominantly adult cardiology database. CONCLUSIONS In the past decade, ICD implantation has been performed in approximately 20 children per year in Japan, mostly for secondary prevention. There was no increase in the trend nor a change in age distribution.
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Affiliation(s)
- Hiroko Asakai
- Department of Pediatrics, The University of Tokyo Hospital
| | | | - Takeshi Mitsuhashi
- Department of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center
| | | | - Hisashi Yokoshiki
- Department of Cardiovascular Medicine, Sapporo City General Hospital
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Yukio Sekiguchi
- Cardiovascular Division, Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | | | - Kenzo Hirao
- Department of Cardiology, Tokyo Medical and Dental University
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Handa N, Kumamaru H, Torikai K, Kohsaka S, Takayama M, Kobayashi J, Ogawa H, Shirato H, Ishii K, Koike K, Yokoyama Y, Miyata H, Motomura N, Sawa Y. Learning Curve for Transcatheter Aortic Valve Implantation Under a Controlled Introduction System - Initial Analysis of a Japanese Nationwide Registry. Circ J 2018; 82:1951-1958. [PMID: 29794375 DOI: 10.1253/circj.cj-18-0211] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The introduction of transcatheter aortic valve implantation (TAVI) into Japan was strictly controlled to optimize patient outcomes. The goal of this study was to assess if increasing experience during the introduction of this procedure was associated with outcomes.Methods and Results:The initial 1,752 patients registered in the Japanese national TAVI registry were included in the study. The association between operator procedure number and incidence of the early safety endpoint at 30 days (ESE30) as defined in the Valve Academic Research Consortium-2 consensus document was evaluated. Patients were divided into 4 groups by quartiles of procedure count (Groups I-IV in order of increasing number of procedures). Median patient age was 85 years, and 30.5% were male. The 30-day mortality rate was 1.4% (n=24), and 78 patients (7.9%) experienced 95 ESE30. Among the variables included in the model, ESE30 was associated with non-transfemoral approach (P=0.004), renal dysfunction (Cr >2.0 mg/dL) (P=0.01) and NYHA class III/IV (P=0.04). ESE30 incidence was not significantly different between Groups I-III and Group IV. Spline plots demonstrated that experience of 15-20 cases in total was needed to achieve a consistent low risk of ESE30. CONCLUSIONS Increasing experience was associated with better outcomes, but to a lesser degree than in previous reports. Our findings suggested that the risks associated with the learning curve process were appropriately mitigated.
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Affiliation(s)
- Nobuhiro Handa
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency.,Office of Safety, Pharmaceuticals and Medical Devices Agency
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, Graduate School of Medicine, Faculty of Medicine, The University of Tokyo
| | - Kei Torikai
- Department of Cardiovascular Surgery, Osaka University Hospital
| | - Shun Kohsaka
- Department of Cardiology, School of Medicine, Keio University
| | | | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Hisao Ogawa
- Department of Cardiology, National Cerebral and Cardiovascular Center
| | - Haruki Shirato
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency
| | - Kensuke Ishii
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency
| | - Kazuhisa Koike
- Office of Safety, Pharmaceuticals and Medical Devices Agency
| | | | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, Faculty of Medicine, The University of Tokyo
| | - Noboru Motomura
- Department of Cardiovascular Surgery, School of Medicine, Toho University Sakura Hospital
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Hospital
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McWilliams DF, Walsh DA. Factors predicting pain and early discontinuation of tumour necrosis factor-α-inhibitors in people with rheumatoid arthritis: results from the British society for rheumatology biologics register. BMC Musculoskelet Disord 2016; 17:337. [PMID: 27515300 PMCID: PMC4982340 DOI: 10.1186/s12891-016-1192-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/29/2016] [Indexed: 11/10/2022] Open
Abstract
Background We examined pain levels in 2 cohorts assembled from the British Society for Rheumatology Biologics Register (BSRBR), and investigated which factors predicted Bodily Pain scores and discontinuation of TNFα-inhibitors. Method Data were retrieved from BSRBR-RA databases for up to 1 year after commencing TNFα-inhibitors (n = 11995) or being treated with non-biologic therapies (n = 3632). Bodily Pain scores were derived from the Short Form-36 (SF36) questionnaire and norm-transformed to allow comparison with UK population averages. Discontinuation data were from physician reports. Other data, including 28-joint disease activity score (DAS28) measurements, were from clinical examination, interview, medical records and self-report questionnaires. DAS28-P was derived as the proportion of DAS28 attributed to patient-reported factors (tender joint count and visual analogue score). Missing baseline variables from both cohorts were imputed into 20 replicate datasets. Odds ratios (OR) and adjusted OR were calculated for higher than median pain within each cohort. Results Participants reported moderate to severe pain at baseline, and pain scores remained >1SD worse than normal population standards at 1 year, even when disease activity responded to treatment. Baseline pain was associated with DAS28-P, worse physical function, worse mental health, and DAS28. After logistic regression, independent predictors of higher than median pain at follow up were baseline Bodily Pain score, higher DAS28-P, worse physical function or mental health and co-morbidities. Higher age, male gender, and higher BMI were additional independent predictors of higher pain in participants who received TNFα-inhibitors. Baseline pain was also one of the predictors of discontinuation of the first TNFα-inhibitor within 1 year, as were female gender, current smoking, co-morbidities, extra-articular manifestations and worse function. Conclusion Pain persists in people with treated RA, even in those for whom inflammation responds to treatment. Worse pain outcomes are predicted by factors different to those typically found to predict inflammatory disease activity in other studies. Worse pain at baseline also predicts discontinuation of TNFα-inhibitors. Improved pain management should complement inflammatory disease suppression in RA. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1192-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel F McWilliams
- Arthritis UK Pain Centre, Academic Rheumatology, University of Nottingham, Nottingham, UK. .,Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK.
| | - David A Walsh
- Arthritis UK Pain Centre, Academic Rheumatology, University of Nottingham, Nottingham, UK.,Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
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Orzalesi L, Casella D, Santi C, Cecconi L, Murgo R, Rinaldi S, Regolo L, Amanti C, Roncella M, Serra M, Meneghini G, Bortolini M, Altomare V, Cabula C, Catalano F, Cirilli A, Caruso F, Lazzaretti MG, Cataliotti L, Bernini M. Nipple sparing mastectomy: Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period. Breast 2015; 25:75-81. [PMID: 26612083 DOI: 10.1016/j.breast.2015.10.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/18/2015] [Accepted: 10/25/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nipple sparing mastectomy is deemed surgically and oncologically safe based on a long lasting literature data from reviews of single institution series. This study aims at evaluating surgical and oncological outcomes of NSM on a large multi-institutional scale, by means of the Italian National registry. METHODS In July 2011 a panel of Italian specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up schedule guidelines could participate inserting any NSM case performed, retrospectively and prospectively from that moment on. In March 2015 analysis of data was accomplished. Dataset for this study consists of cases performed in the period between January 1st 2009 and December 31st 2014. RESULTS 913 Women were included in the analysis, for a total of 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI utilization increased over time. NSM failure rate, with NAC removal for any reason was 11.5%. NAC necrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes were calculated among primitive EBC cases only: locoregional recurrences rate was 2.9%, NAC recurrence 0.7%. Systemic recurrence rate was 1.0%. Five deaths (0.7%) were registered. CONCLUSIONS More than 10% of NSM procedures are prophylactic mastectomies. MRI is gaining more importance over time. Surgical and oncological results show that NSM is effective. This National multicentric analysis enables a comparison of results with no geographical differences and a "safe" state of the art of NSM in Italy.
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Affiliation(s)
- Lorenzo Orzalesi
- Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy.
| | - Donato Casella
- Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy.
| | - Caterina Santi
- Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy.
| | - Lorenzo Cecconi
- Statistics, Department of Statistics, Informatics and Application "G.Parenti", University of Florence, Viale Morgagni 59, 50134 Florence, Italy.
| | - Roberto Murgo
- Breast Unit Surgery, San Giovanni Rotondo Hospital, Viale Cappuccini 1, 71013 S.Giovanni Rotondo, Foggia, Italy.
| | - Stefano Rinaldi
- Breast Unit Surgery, San Paolo Hospital, Via Capo Scardicchio 92, 70123 Bari, Italy.
| | - Lea Regolo
- Breast Unit Surgery, Maugeri Hospital, Via Maugeri 10, 27100 Pavia, Italy.
| | - Claudio Amanti
- Breast Unit Surgery, Sant'Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy.
| | - Manuela Roncella
- Breast Unit Surgery, Cisanello Hospital, Via Roma 67, 56123 Pisa, Italy.
| | - Margherita Serra
- Breast Unit Surgery, Sant'Orsola Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | - Graziano Meneghini
- Breast Unit, Montecchio Maggiore Hospital, Via Ca' Rotte 7, 36075 Montecchio Maggiore, Vicenza, Italy.
| | | | - Vittorio Altomare
- Breast Unit, Campus Biomedico Hospital, Via Alvaro del Portillo 200, 00128 Rome, Italy.
| | - Carlo Cabula
- Breast Unit Surgery, Businco Hospital, Via Jenner 1, 09127 Cagliari, Italy.
| | - Francesca Catalano
- Breast Unit, Cannizzaro Hospital, Via Messina 829, 95126 Catania, Italy.
| | - Alfredo Cirilli
- Breast Unit Surgery, Policlinico Hospital, P.zza Giulio Cesare 11, Bari, Italy.
| | - Francesco Caruso
- Breast Unit Surgery, Humanitas Hospital, Via Vittorio Emanuele da Bormida 64, 95126 Catania, Italy.
| | | | - Luigi Cataliotti
- President European Breast Centres Certification, President Senonetwork Italia Onlus, Italy.
| | - Marco Bernini
- Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy.
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Abstract
UNLABELLED The crude and age-standardized rates of hip fractures in elderly Kuwaiti subpopulation were determined for the years 2009-2012. Both rates have increased and are further expected to rise substantially in the coming decades. INTRODUCTION It is projected that rates of hip fractures will increase in most of the Middle East countries. There are only few population-based studies investigating the incidence of hip fractures in the Arabian Gulf region. The objective of this study is to report the crude and age-standardized incidence rates of hip fracture in the Kuwaiti elderly population. METHODS Using the Ministry of Public Health's registry data, this population-based study evaluated the incidence of hip fractures in Kuwaiti subpopulation aged 50 and above for the years 2009, 2010, 2011, and 2012. Using the world population in 2010 as a reference, these incidence rates were age-standardized and compared to data from several regions. RESULTS Hip fracture crude incidence rates varied between 113.7 and 147.4/100,000 for males and between 135.3 and 148.1/100,000 for females, with a female/male ratio of 1.3-1.5. The combined (men and women) incidence rate of hip fractures increased by 17.1 % over the 4-year period of study (125.9/100,000 in 2009 to 147.8/100,000 in 2012). Using the world population in 2010 as a reference, the age-standardized rates were 129.5, 131.5, 154.6, and 169.8 for males and 189.6, 192.9, 197.2, and 214.4 for females, for the years 2009, 2010, 2011, and 2012, respectively. CONCLUSIONS The hip fracture age-standardized incidence rates in the Kuwaiti subpopulation aged 50 years and above are rising and expected to increase substantially in the coming decades.
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Affiliation(s)
- Piroze M Davierwala
- Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany
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Cervantes-Salazar J, Calderón-Colmenero J, Ramírez-Marroquín S, Palacios-Macedo A, Bolio Cerdán A, Vizcaíno Alarcón A, Curi-Curi P, de la Llata M, Erdmenger Orellana J, González J, García Soriano F, Calderón A, Casillas L, Villanueva F, Sánchez Ramírez R, Osnaya H, Necoechea JC, Alva Espinoza C, Prado Villegas G. Mexican registry of pediatric cardiac surgery. First report. Bol Med Hosp Infant Mex 2014; 71:286-291. [PMID: 29421617 DOI: 10.1016/j.bmhimx.2014.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 07/10/2014] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Currently, there is a spreading worldwide tendency to characterize health issues and to propose alternative solutions via the creation of computerized databases. The aim of this study was to present the results in a computerized database of pediatric cardiac surgeries developed under the auspices of the Mexican Association of Specialists in Congenital Heart Diseases (Asociación Mexicana de Especialistas en Cardiopatías Congénitas A.C) and coordinated by the collegiate group of Pediatric Cardiology and Surgery as petitioned by the National Institutes of Health and High Specialty Hospitals Coordinating Commission. METHODS We analyzed all cases registered in the database during a 1-year observation period (August 1, 2011 to July 31, 2012) by all major Health Ministry-dependent institutes and hospitals offering surgical services related to pediatric cardiopathies to the non-insured population. RESULTS Seven institutions participated voluntarily in completing the database. During the analyzed period, 943 surgeries in 880 patients with 7% reoperations (n=63) were registered. Thirty-eight percent of the surgeries were performed in children <1 year of age. The five most common cardiopathies were patent ductus arteriosus (n=96), ventricular septal defect (n=86), tetralogy of Fallot (n=72), atrial septal defect (n=68), and aortic coarctation (n=54). Ninety percent of surgeries were elective and extracorporeal circulation was used in 62% of surgeries. Global mortality rate was 7.5% with the following distribution in the RACHS-1 score categories: 1 (n=4, 2%), 2 (n=19, 6%), 3 (n=22, 8%), 4 (n=12, 19%), 5 (n=1, 25%), 6 (n=6, 44%), and non-classifiable (n=2, 9%). CONCLUSIONS This analysis provides a representative view of the surgical practices in cardiovascular diseases in the pediatric population at the national non-insured population level. However, incorporating other health institutions to the national registry database will render a more accurate panorama of the national reality in surgical practices in the population <18 years of age.
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Affiliation(s)
| | - Juan Calderón-Colmenero
- Asociación Mexicana de Especialistas en Cardiopatías Congénitas. A.C., México, D.F., México; Instituto Nacional de Cardiología Dr. Ignacio Chávez, México, D.F., México.
| | | | | | | | | | - Pedro Curi-Curi
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Estado de México, México
| | - Manuel de la Llata
- Comisión Coordinadora de los Institutos Nacionales de Salud, Dirección General de Coordinación de los Hospitales Regionales de Alta Especialidad, Secretaría de Salud, México, D.F., México
| | | | | | | | - Alejandro Calderón
- Centro Regional de Alta Especialidad de Chiapas, Tuxtla Gutiérrez, Chiapas, México
| | - Luis Casillas
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, México
| | - Filiberto Villanueva
- Hospital Regional de Alta Especialidad de Oaxaca, Hospital de la Niñez Oaxaqueña, San Bartolo Coyotepec, Oaxaca, México
| | - Roberto Sánchez Ramírez
- Comisión Coordinadora de los Institutos Nacionales de Salud, Dirección General de Coordinación de los Hospitales Regionales de Alta Especialidad, Secretaría de Salud, México, D.F., México
| | - Héctor Osnaya
- Instituto Nacional de Pediatría, México, D.F., México
| | | | - Carlos Alva Espinoza
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Estado de México, México
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Koton S, Telman G, Kimiagar I, Tanne D. Gender differences in characteristics, management and outcome at discharge and three months after stroke in a national acute stroke registry. Int J Cardiol 2013; 168:4081-4. [PMID: 23871354 DOI: 10.1016/j.ijcard.2013.07.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/29/2013] [Accepted: 07/03/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND The importance of gender as an independent risk factor for poor outcome is not clear. We examined gender differences in patients' characteristic, management and outcome at discharge and 3-months after acute stroke in a national hospital-based registry. METHODS Data were derived from the triennial two-month national Acute Stroke Israeli Registry (Feb-March 2004, March-April 2007, April-May 2010). Unselected patients in all Israeli hospitals (n = 28) were included. Outcome at 3-month was assessed in a sub-sample. Logistic regression models were used in the study of gender as an independent risk factor for poor outcome. RESULTS In total, 5034 patients (88.5% ischemic stroke, 9.6% ICH and 1.9% undetermined stroke) were included, of them 2285 (45.4%) women. Follow-up at 3-month was completed for 1040 patients, 41.9% women. Women showed higher rates of cardiovascular risk factors in-hospital death (p = 0.007) and poor functional outcome (p < 0.0001). Following adjustment for age, prior disability, NIHSS, prior stroke and risk factors, risk estimates (ORs, 95%CI) for women compared to men were 0.72 (0.55-0.96) for in-hospital death, 1.03 (0.83-1.29) for discharge to a nursing home or death, and 1.01 (0.86-1.20) for disability. Poor outcomes at 3-month were significantly more common in women; however, adjusted risk estimates were not significantly increased: OR 0.95 (95%CI 0.50-1.81) for death at 3-months, 1.41 (0.99-2.01) for Barthel Index ≤ 60, 1.24 (0.90-1.72) for dependency and 0.88 (0.55-1.39) for living in a nursing home or death. CONCLUSION Gender-differences in risk of death and poor functional outcome after stroke are mainly explained by dissimilarities in patients' characteristics and stroke severity.
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Affiliation(s)
- Silvia Koton
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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Mor Z, Weinstein R, Grotto I, Levin Y, Chemtob D. Thirty years of HIV in Israel: current epidemiology and future challenges. BMJ Open 2013; 3:e003078. [PMID: 23833144 PMCID: PMC3703582 DOI: 10.1136/bmjopen-2013-003078] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/25/2013] [Accepted: 06/12/2013] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The HIV/AIDS burden in Israel is increasing. This study aims to describe the nationwide-HIV epidemiology in the last 30 years and highlight areas of concern in HIV/AIDS control. DESIGN Descriptive study. SETTING The National HIV/AIDS Registry in Israel. PARTICIPANTS All individuals who were reported with HIV/AIDS in Israel. PRIMARY OUTCOME MEASURES Classification of HIV/AIDS cases by risk groups, calculation of annual trend analysis and estimation of HIV transmission rates by dividing the annual HIV/AIDS-incidence by the prevalence, while the number of newly diagnosed HIV/AIDS cases reported was a proxy of the incidence. RESULTS From 1981 to 2010, 6579 HIV/AIDS cases were reported in an upward trend from 3.6 new HIV diagnoses/100 000 population in 1986 to 5.6 in 2010. Immigrants from countries of generalised epidemic (ICGE) comprised 2717 (41.3%) of all cases: 2089 (76.9%) were Israeli citizens and 628 (23%) were non-Israeli citizens, mostly migrant workers. The majority (N=2040) of ICGE Israeli citizens were born in Ethiopia. Only 796 (12.1%) of all HIV/AIDS cases were heterosexuals who were non-ICGE and not injecting drug users (IDUs). IDU comprised 13.4% (N=882) of all cases. Men who have sex with men (MSM) accounted for 33.2% (N=1403) of all men reported, while the annual number of MSM reported with HIV/AIDS has quadrupled between 2000 and 2010. It is estimated that the HIV point prevalences in 2010 for Ethiopian-born Israeli citizens, IDU and MSM aged 16-45 were 1805, 1492 and 3150, respectively. The crude estimated transmission rates among Israeli citizens, excluding the Ethiopian-born, was 10.5, while among Ethiopian-born Israeli citizens, IDU and MSM the rates were 3.6, 6.3 and 13.2, respectively. CONCLUSIONS The HIV/AIDS burden in Israel is low among heterosexuals and higher in risk-groups. Among these risk groups, the highest HIV transmission rate was in MSM, followed by IDU and ICGE. Culturally sensitive and focused prevention interventions should be tailored exclusively for each of the vulnerable risk groups.
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Affiliation(s)
- Zohar Mor
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
- Ramla Department of Health, Ministry of Health, Ramla, Israel
| | - Ruth Weinstein
- Department of Health Education and Promòtion, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services, Ministry of Health, Jerusalem, Israel
- Faculty of Medicine, Ben Gurion University in the Negev, Beer Sheva, Israel
| | - Yana Levin
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
| | - Daniel Chemtob
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
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