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Badilla P, Abad S, Smith C, Tsui B, Cardenas-Iniguez C, Herting MM. Lifetime residential data collection protocol for the Adolescent Brain Cognitive Development (ABCD) Study. MethodsX 2024; 12:102673. [PMID: 38623304 PMCID: PMC11017270 DOI: 10.1016/j.mex.2024.102673] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
Understanding the impacts of environmental exposures on health outcomes during development is an important area of research for plenty of reasons. Collecting retrospective and prospective residential history can enrich observational studies through eventual linkages to external sources. Augmenting participant health outcome data with environmental data can better inform on the role of the environment, thereby enhancing prevention and intervention efforts. However, collecting the geospatial information needed for this type of research can be difficult, especially when data are collected directly from participants. Participants' residential histories are unique and often complex. Collecting residential history data often involves capturing precise spatial locations along specific timeframes as well as contending with recall bias and unique, complex living arrangements. When trying to assess lifetime environmental exposures, researchers must consider the many changes in location a person goes through and the timeframes in which these changes occur, ultimately creating a multidimensional and dynamic dataset. Creating data collection protocols that are feasible to administer, result in accurate data, and minimize data missingness is a major challenge to undertake. Here, we provide an overview of the protocol developed to collect the lifetime residential address information of participants in the Adolescent Brain Cognitive Development (ABCD) Study.
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Affiliation(s)
- Paola Badilla
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, USA
| | - Shermaine Abad
- Department of Radiology, University of California, San Diego, CA, USA
| | - Calen Smith
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Brandon Tsui
- Department of Radiology, University of California, San Diego, CA, USA
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Megan M. Herting
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
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Jia Q, Lou Y, Chen D, Li X, Liu Y, Chu R, Wang T, Zhou Z, Li D, Wan W, Huang Q, Yang X, Wang T, Wu Z, Xiao J. Long-term postoperative outcomes of spinal cellular schwannoma: study of 93 consecutive cases. Spine J 2024; 24:858-866. [PMID: 38272127 DOI: 10.1016/j.spinee.2024.01.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/03/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND CONTEXT Cellular schwannoma (CS) is a rare tumor that accounts for 2.8%-5.2% of all benign schwannomas. There is a dearth of up-to-date information on spinal CS in the literature. PURPOSE The aims of this study were to identify the proportion of CS cases amongst spinal benign schwannoma, describe the clinical features of spinal CS, and identify prognostic factors for local recurrence by analyzing data from 93 consecutive CS cases. STUDY DESIGN Retrospective review. PATIENT SAMPLE We analyzed 93 PSGCT screened from 1,706 patients with spine CS who were treated at our institute between 2008 and 2021. OUTCOME MEASURES Demographic, radiographic, operative and postoperative data were recorded and analyzed. METHODS We compared the clinical features of spinal CS from the cervical, thoracic, lumbar and sacral segments. Prognostic factors for local recurrence-free survival (RFS) were identified by the Kaplan-Meier method. Factors with p≤.05 in univariate analysis were subjected to multivariate analysis by Cox regression analysis. RESULTS The proportion of spinal CS in all benign schwannomas was 6.7%. The mean and median follow-up times for the 93 patients in this study were 92.2 and 91.0 months respectively (range 36-182 months). Local recurrence was detected in 11 cases, giving an overall recurrence rate of 11.7%, with one patient death. Statistical analysis revealed that tumor size ≥5 cm, intralesional resection, and Ki-67 ≥5% were independent negative prognostic factors for RFS in spinal CS. CONCLUSIONS Whenever possible, en bloc resection is recommended for spinal CS. Long-term follow-up should be carried out for patients with tumor size ≥5 cm and postoperative pathological Ki-67 ≥5%.
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Affiliation(s)
- Qi Jia
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yan Lou
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Dingbang Chen
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xiaolin Li
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yiqian Liu
- Department of Medical Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Ruitong Chu
- Department of Anesthesiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Ting Wang
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Zhenhua Zhou
- Department of Medical Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Dong Li
- Department of General Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Wei Wan
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Quan Huang
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xinghai Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Tao Wang
- Department of Orthopedics, The second affiliated hospital of Anhui Medical University, No.678 Furong Road, Jingkai district, Hefei, Anhui provice, China
| | - Zhipeng Wu
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China.
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Pereto C, Baudrimont M, Coynel A. Global natural concentrations of Rare Earth Elements in aquatic organisms: Progress and lessons from fifty years of studies. Sci Total Environ 2024; 922:171241. [PMID: 38417499 DOI: 10.1016/j.scitotenv.2024.171241] [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: 09/27/2023] [Revised: 01/26/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Rare Earth Elements (REEs) consist of a coherent group of elements with similar physicochemical properties and exhibit comparable geochemical behaviors in the environment, making them excellent tracers of environmental processes. For the past 50 years, scientific communities investigated the REE concentrations in biota through various types of research (e.g. exploratory studies, environmental proxies). The extensive development of new technologies over the past two decades has led to the increased exploitation and use of REEs, resulting in their release into aquatic ecosystems. The bioaccumulation of these emerging contaminants has prompted scientific communities to explore the fate of anthropogenic REEs within aquatic ecosystems. To achieve this, it is necessary to determine the natural concentration levels of REEs in aquatic organisms and the factors controlling REE dynamics. However, knowledge gaps still exist, and no comprehensive approach currently exists to assess the REE concentrations at the ecosystem scale or the factors controlling these concentrations in aquatic organisms. Based on a database comprising 102 articles, this study aimed to: i) provide a retrospective analysis of research topics over a 50-year period; ii) establish reference REE concentrations in several representative phyla of aquatic ecosystems; and iii) examine the global-scale influences of habitat and trophic position as controlling factors of REE concentrations in organisms. This study provides reference concentrations for 16 phyla of freshwater or marine organisms. An influence of habitat REE concentrations on organisms has been observed on a global scale. A trophic dilution of REE concentrations was highlighted, indicating the absence of biomagnification. Lastly, the retrospective approach of this study revealed several research gaps and proposed corresponding perspectives to address them. Embracing these perspectives in the coming years will lead to a better understanding of the risks of anthropogenic REE exposure for aquatic organisms.
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Affiliation(s)
- Clément Pereto
- Univ. Bordeaux, CNRS, Bordeaux INP, EPOC, UMR 5805, F-33600 Pessac, France.
| | - Magalie Baudrimont
- Univ. Bordeaux, CNRS, Bordeaux INP, EPOC, UMR 5805, F-33600 Pessac, France.
| | - Alexandra Coynel
- Univ. Bordeaux, CNRS, Bordeaux INP, EPOC, UMR 5805, F-33600 Pessac, France.
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Gang S, Kwon H, Song IH, Namgoong JM. Clinical implications of pediatric biliary intraepithelial neoplasia diagnosed from a choledochal cyst specimen. World J Surg Oncol 2024; 22:105. [PMID: 38643155 PMCID: PMC11031949 DOI: 10.1186/s12957-024-03384-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/06/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Biliary intraepithelial neoplasia (BilIN), a noninvasive precursor of cholangiocarcinoma, can manifest malignant transformation. Since cholangiocarcinoma (CCA) may progress due to chronic inflammation in the bile ducts and gallbladder, choledochal cysts are considered a precursor to CCA. However, BilIN has rarely been reported in children, to date. METHODS We reviewed medical records of patients (< 18 years of age, n = 329) who underwent choledochal cyst excision at Asan Medical Center from 2008 to 2022. BilIN was diagnosed in 15 patients. Subsequent analyses were performed of the demographics, surgical procedures, clinical course, and outcomes in these patients. Subgroup analysis and multivariate logistic regression test were performed to identify factors influencing BilIN occurrence. RESULTS The mean age of the patients included in our study was 40.1 ± 47.6 months. In 15 patients, BilIN of various grades was diagnosed. Todani type I was prevalent in 80% of the patients. The median age at surgery was 17 months. During a mean follow-up of 63.3 ± 94.0 months, no adverse events such as stone formation in the remnant intrapancreatic common bile duct and intrahepatic duct or cholangiocarcinoma were observed, indicating a favorable outcome until now. CONCLUSIONS The potential progression of choledochal cysts to BilIN in children was demonstrated. These results could underscore the importance of early and comprehensive excision of choledochal cysts, including resection margins for associated lesions and more thorough postoperative surveillance in patients with or at risk of BilIN.
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Affiliation(s)
- Sujin Gang
- Department of Pediatric Surgery, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu Seoul, 05505, Republic of Korea
| | - Hyunhee Kwon
- Department of Pediatric Surgery, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu Seoul, 05505, Republic of Korea
| | - In Hye Song
- Department of Pathology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu Seoul, 05505, Republic of Korea.
| | - Jung-Man Namgoong
- Department of Pathology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu Seoul, 05505, Republic of Korea.
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Kelkar SS, Prabhu VS, Zhang J, Ogando YM, Roney K, Verma RP, Miles N, Marth C. Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe. Arch Gynecol Obstet 2024:10.1007/s00404-024-07504-3. [PMID: 38634898 DOI: 10.1007/s00404-024-07504-3] [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: 12/01/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To assess the real-world prevalence of microsatellite instability (MSI)/mismatch repair (MMR) testing and related tumor status in recurrent/advanced endometrial cancer patients in Europe. METHODS Data were from two multi-center, retrospective patient chart review studies conducted in the United Kingdom, Germany, Italy, France and Spain: The Endometrial Cancer Health Outcomes-Europe-First-Line (ECHO-EU-1L) study and the ECHO-EU-Second-Line (ECHO-EU-2L) study. ECHO-EU-1L included recurrent/advanced endometrial cancer patients who received first-line systemic therapy between 1/JUN/2016 and 31/MAR/2020 after recurrent/advanced diagnosis. ECHO-EU-2L included patients with recurrent/advanced endometrial cancer who progressed between 1/JUN/2016 and 30/JUN/2019 following prior first-line systemic therapy. Data collected included patient demographics, MSI/MMR tumor testing and results, and clinical/treatment characteristics. RESULTS ECHO-EU-1L included 242 first-line patients and ECHO-EU-2L included 475 s-line patients. For all patients, median age at recurrent/advanced diagnosis was 69 years, roughly half had endometrioid carcinoma histology and over 75% had Stage IIIB-IV disease at initial diagnosis. The prevalence of MSI/MMR testing in the first-line and second-line cohorts was similar (36.4 and 34.9%, respectively). Among those tested, a majority had non-MSI-high/MMR proficient tumors (80.7 and 74.7% among first- and second-line patients, respectively). About 15% had MSI-high/MMR deficient tumors in both cohorts, and a few patients had discordant results (3.4 and 10.8% among first- and second-line patients, respectively). CONCLUSION Prior to the approvals of biomarker-directed therapies for recurrent/advanced endometrial cancer patients in Europe, there were low MSI/MMR testing rates for these patients of just over one-third. Given the availability of biomarker-directed therapies, increased MSI/MMR testing may help inform treatment decisions for recurrent/advanced endometrial cancer patients in Europe.
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Affiliation(s)
| | - Vimalanand S Prabhu
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA.
| | | | | | | | | | | | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
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Zhang ZM, Zhang N, Wang XF. Prognostic model on pregnancy outcomes for women with recurrent spontaneous abortions treated with cyclosporin A: A single-institution experience. Clinics (Sao Paulo) 2024; 79:100349. [PMID: 38613917 PMCID: PMC11033085 DOI: 10.1016/j.clinsp.2024.100349] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A. METHODS A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC. RESULTS After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; p < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; p = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; p = 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880). CONCLUSIONS This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.
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Affiliation(s)
- Ze-Ming Zhang
- Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Zhang
- Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Fei Wang
- Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, China.
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Leppanen MT, Sourisseau S, Burgess RM, Simpson SL, Sibley P, Jonker MTO. Sediment Toxicity Tests: A Critical Review of Their use in Environmental Regulations. Environ Toxicol Chem 2024. [PMID: 38597781 DOI: 10.1002/etc.5861] [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] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024]
Abstract
Sediments are an integral component of aquatic systems, linking multiple water uses, functions, and services. Contamination of sediments by chemicals is a worldwide problem, with many jurisdictions trying to prevent future pollution (prospective) and manage existing contamination (retrospective). The present review assesses the implementation of sediment toxicity testing in environmental regulations globally. Currently, the incorporation of sediment toxicity testing in regulations is most common in the European Union (EU), North America, and Australasian regions, with some expansion in Asia and non-EU Europe. Employing sediment toxicity testing in prospective assessments (i.e., before chemicals are allowed on the market) is most advanced and harmonized with pesticides. In the retrospective assessment of environmental risks (i.e., chemicals already contaminating sediments), regulatory sediment toxicity testing practices are applied inconsistently on the global scale. International harmonization of sediment toxicity tests is considered an asset and has been successful through the widespread adoption and deployment of Organisation for Economic Co-operation and Development guidelines. On the other hand, retrospective sediment assessments benefit from incorporating regional species and protocols. Currently used toxicity testing species are diverse, with temperate species being applied most often, whereas test protocols are insufficiently flexible to appropriately address the range of environmental contaminants, including nanomaterials, highly hydrophobic contaminants, and ionized chemicals. The ever-increasing and -changing pressures placed on aquatic resources are a challenge for protection and management efforts, calling for continuous sediment toxicity test method improvement to insure effective use in regulatory frameworks. Future developments should focus on including more subtle and specific toxicity endpoints (e.g., incorporating bioavailability-based in vitro tests) and genomic techniques, extending sediment toxicity testing from single to multispecies approaches, and providing a better link with ecological protection goals. Environ Toxicol Chem 2024;00:1-20. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
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Affiliation(s)
| | | | - Robert M Burgess
- Atlantic Coastal Environmental Science Division, Office of Research and Development, US Environmental Protection Agency, Narragansett, Rhode Island
| | | | - Paul Sibley
- School of Environmental Sciences, Ontario Agricultural College, University of Guelph, Guelph, Ontario, Canada
| | - Michiel T O Jonker
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Liu J, Lin A, Xiu W, Duan G. Can external application of Chinese medicine to treat children's periappendicular abscesses accelerate the child's recovery? Asian J Surg 2024:S1015-9584(24)00611-0. [PMID: 38604863 DOI: 10.1016/j.asjsur.2024.03.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/16/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Jie Liu
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China; Department of Medical Biology of Wannan Medical College, Wannan Medical College, Wuhu, China.
| | - Aiqin Lin
- Department of Medical Biology of Wannan Medical College, Wannan Medical College, Wuhu, China
| | - Wenli Xiu
- Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Guangqi Duan
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China.
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Wang Z, Chen H, Chen Q, Zhu Y, Li M, Zhou J, Shi L. Outcomes of 2-SSRS plus bevacizumab therapy strategy for brainstem metastases (BSM) over 2 cm 3: a multi-center study. Neurosurg Rev 2024; 47:137. [PMID: 38564039 DOI: 10.1007/s10143-024-02369-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/17/2024] [Accepted: 03/24/2024] [Indexed: 04/04/2024]
Abstract
Despite 2-staged stereotactic radiosurgery (2-SSRS) has been reported to provide patients with improved survival and limited toxicity, 2-SSRS for brainstem metastases (BSM) larger than 2 cm3 remains challenging. We tried to find out the effectiveness and safety of 2-SSRS plus bevacizumab therapy for BSMs over 2 cm3 and prognostic factors that related to the tumor local control. Patients that received 2-SSRS plus bevacizumab therapy from four gamma knife center were retrospectively studied from Jan 2014 to December 2023. Patients' domestic characteristics and the tumor features were evaluated before and after the treatment. Cox regression model was used to find out prognostic factors for tumor local control. 53 patients with 63 lesions received the therapy. The median peri-tumor edema volume greatly reduced at the end of therapy (P < 0.01), the median tumor volume dramatically reduced (P < 0.01) and patients' KPS score improved significantly (P < 0.05) 3 months after the therapy. Patients' median OS was 12.8 months. The tumor local control rate at 3, 6, and 12 months was 98.4%, 93.4%, and 85.2%. The incidence side effects were mainly oral and nasal hemorrhage (5.7%, 3/53), and radiation necrosis (13.2%, 7/53). Patients with primary lung adenocarcinoma, therapeutic dose over 12 Gy at second-stage SRS, primary peri-tumor edema volume less than 2.3 cm³, primary tumor volume less than 3.7 cm³ would enjoy longer tumor local control. These results suggested that 2-SSRS plus bevacizumab therapy was effective and safe for BSMs over 2 cm3. However, it is important for patients with BSM to receive early diagnosis and treatment to achieve good tumor local control.
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Affiliation(s)
- Zheng Wang
- Cancer center, Gamma Knife Treatment Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Haining Chen
- Gamma Knife Treatment Center, Anhui Provincial Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, China
| | - Qun Chen
- Gamma Knife Treatment Center, Jiangsu province hospital, The First affiliated Hospital of Nanjing Medical University, Nanjing, 210001, China
| | - Yucun Zhu
- Gamma Knife Treatment Center, Ming ji Hospital, Affiliated to Nanjing Medical University, Nanjing, 210001, China
| | - Min Li
- Cancer center, Gamma Knife Treatment Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Jia Zhou
- Cancer center, Gamma Knife Treatment Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Lingfei Shi
- Geriatric Medicine Center, Department of Geriatric medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
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Meyr AJ. A Study Never Proves Anything: Contemporary Interpretation of the Levels of Clinical Evidence and Statistical Significance. Clin Podiatr Med Surg 2024; 41:215-222. [PMID: 38388117 DOI: 10.1016/j.cpm.2023.07.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Critical analysis of the medical literature and an evidence-based approach to clinical practice and medical decision-making is of vital importance in contemporary podiatric practice. This article reviews the levels of clinical evidence and their application within this paradigm. This includes determining which level of evidence is most appropriate for a given methodology, as well as an appreciation of inherent limitations within each level of evidence. The article concludes with a discussion on the difference between statistical significance and clinical significance.
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Affiliation(s)
- Andrew J Meyr
- Department of Surgery, Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA.
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Guo L, Zhu XY, Xue J, Sun JX, Yuan SX, Yi B, Huang L, Shi J, Cheng SQ, Guo WX. An inferior vena cava-priority approach in laparoscopic isolated hepatic caudate lobectomy. Langenbecks Arch Surg 2024; 409:106. [PMID: 38556526 DOI: 10.1007/s00423-024-03299-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Laparoscopic isolated caudate lobectomy is still a challenging operation for surgeons. The access route of the operation plays a vital role during laparoscopic caudate lobectomy. There are few references regarding this technique. Here, we introduce a preferred inferior vena cava (IVC) approach in laparoscopic caudate lobectomy. METHODS Twenty-one consecutive patients with caudate hepatic tumours between June 2016 and December 2021 were included in this study. All of them received laparoscopic caudate lobectomy involving an IVC priority approach. The IVC priority approach refers to prioritizing the dissection of the IVC from the liver parenchyma before proceeding with the conventional left or right approach. It emphasizes the importance of the IVC dissection during process. Clinical data, intraoperative parameters and postoperative results were evaluated. Sixteen patients were performed pure IVC priority approach, while 5 patients underwent a combined approach. We subsequently compared the intraoperative and postoperative between the two groups. RESULTS All 21 patients were treated with laparoscopic technology. The operative time was 190.95 ± 92.65 min. The average estimated blood loss was 251.43 ± 247.45 ml, and four patients needed blood transfusions during the perioperative period. The average duration of hospital stay was 8.43 ± 2.64 (range from 6.0 to 16.0) days. Patients who underwent the pure inferior vena cava (IVC) approach required a shorter hepatic pedicle clamping time (26 vs. 55 min, respectively; P < 0.001) and operation time (150 vs. 380 min, respectively; P = 0.002) than those who underwent the combined approach. Hospitalization (7.0 vs. 9.0 days, respectively; P = 0.006) was shorter in the pure IVC group than in the combined group. CONCLUSIONS Laparoscopic caudate lobectomy with an IVC priority approach is safe and feasible for patients with caudate hepatic tumours.
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Affiliation(s)
- Lei Guo
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Xiao-Ying Zhu
- Department of Operation Room, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Jie Xue
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Ju-Xian Sun
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Sheng-Xian Yuan
- Department of Hepatic Surgery III, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Bin Yi
- Department of Organ Transplantation, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Liang Huang
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Jie Shi
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China
| | - Shu-Qun Cheng
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China.
| | - Wei-Xing Guo
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China.
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Chen D, Xu D, Wu X, Wang J, Sheng S, Yu X, Lin X, Liu L, Ge X, Zhao H, Xu W. The efficacy of bandage contact lens in relieving the aggravation of dry eye disease after complicated cataract or/and IOL surgery. BMC Ophthalmol 2024; 24:141. [PMID: 38549070 PMCID: PMC10976755 DOI: 10.1186/s12886-024-03385-x] [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] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
PURPOSE In the present study, we aimed to evaluate the efficacy of the bandage contact lens (BCLs) in the treatment of dry eye disease (DED) after complicated cataract or/and intraocular lens (IOL) surgery. METHODS In this retrospective, single-centered, observational study, we collected data from 69 patients who underwent complicated cataract or/and IOL surgery. Of these, 35 cases wore their own BCLs immediately after the operation, while the other 34 cases did not have their own BCLs and were instead covered with gauze. The Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp microscope examination, keratograph analysis, and Schirmer I test were measured at baseline, 1 week and 1 month postoperatively. RESULTS In the BCL group, the score of the OSDI questionnaire was significantly decreased at 1 week and 1 month postoperatively compared with baseline levels (P = 0.000, collectively). Moreover, the fluorescein staining score of the BCL group was remarkably decreased 1-week and 1-month postoperatively compared with the non-BCL group (P = 0.000 and P = 0.000, respectively). Furthermore, the redness score of the BCL group was also better compared with the non-BCL group at 1 week and 1 month postoperatively (P = 0.014 and P = 0.004, respectively). CONCLUSIONS Complicated cataract or/and IOL surgery would intensify the DED. Early application of BCLs postoperatively improved patients' comfort and alleviated dry eye-related symptoms and signs. Furthermore, this mechanism might involve the acceleration of corneal epithelial healing, the alleviation of ocular stress response and the stabilization of the tear film. TRIAL REGISTRATION Trial registration ClinicalTrials, NCT04120389. Registered 10 October 2019-retrospectively registered.
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Affiliation(s)
- Dan Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Dejian Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Lemolight Ophthalmology Hospital, Hangzhou, Zhejiang, China
| | - Xingdi Wu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Jingwen Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Siting Sheng
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xuewen Yu
- Department of Ophthalmology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Xueqi Lin
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lirui Liu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xian Ge
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Jianyang Eye Hospital of Jianhu County, Jiangsu, China
| | - Huiling Zhao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Wen Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China.
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Zhu X, Liu S, Yuan Y, Gu N, Sha J, Guo Y, Deng Y. Clinical features and treatment options for pediatric adrenal incidentalomas: a retrospective single center study. BMC Pediatr 2024; 24:186. [PMID: 38491421 PMCID: PMC10943841 DOI: 10.1186/s12887-024-04673-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the clinical features and treatment options for pediatric adrenal incidentalomas(AIs) to guide the diagnosis and treatment of these tumors. METHODS The clinical data of AI patients admitted to our hospital between December 2016 and December 2022 were collected and retrospectively analyzed. All patients were divided into neonatal and nonneonatal groups according to their age at the time of the initial consultation. RESULTS In the neonatal group, 13 patients were observed and followed up, and the masses completely disappeared in 8 patients and were significantly reduced in size in 5 patients compared with the previous findings. Four patients ultimately underwent surgery, and the postoperative pathological diagnosis was neuroblastoma in three patients and teratoma in one patient. In the nonneonatal group, there were 18 cases of benign tumors, including 9 cases of ganglioneuroma, 2 cases of adrenocortical adenoma, 2 cases of adrenal cyst, 2 cases of teratoma, 1 case of pheochromocytoma, 1 case of nerve sheath tumor, and 1 case of adrenal hemorrhage; and 20 cases of malignant tumors, including 10 cases of neuroblastoma, 9 cases of ganglioneuroblastoma, and 1 case of adrenocortical carcinoma. CONCLUSIONS Neuroblastoma is the most common type of nonneonatal AI, and detailed laboratory investigations and imaging studies are recommended for aggressive evaluation and treatment in this population. The rate of spontaneous regression of AI is high in neonates, and close observation is feasible if the tumor is small, confined to the adrenal gland and has no distant metastasis.
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Affiliation(s)
- Xiaojiang Zhu
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Saisai Liu
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Yimin Yuan
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Nannan Gu
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Jintong Sha
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Yunfei Guo
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Yongji Deng
- Department of Urology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China.
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Abuharb MYI, Kaiwen L, Zhuhui H, Kui Z, Jubing Z, Yue S, Yang L, Taoshuai L, Ran D. Prognostic factors of surgical management for heart failure patients with reduced left ventricular ejection fraction. Heliyon 2024; 10:e26552. [PMID: 38434403 PMCID: PMC10907661 DOI: 10.1016/j.heliyon.2024.e26552] [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: 03/16/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Objectives There are many available pharmaceutical and surgical management for Coronary artery disease (CAD) patients. However, coronary artery bypass grafting (CABG) is the preferred treatment modality for CAD patients with low ejection fraction (EF) in view of the more favorable outcomes. This study aimed to determine the associated factors of poor outcomes post-CABG for heart failure patients with reduced left ventricular ejection fraction who underwent on-pump and off-pump CABG. Methods A retrospective review of CAD patients who underwent isolated on-pump CABG (ONCAB) or off-pump CABG (OPCAB) in Beijing Anzhen Hospital Affiliated with Capital Medical University from January 2013 to March 2021. Only those with confirmed reduced left ventricular ejection fraction (LVEF) ≤40% on preoperative echocardiography were included. By analyzing the clinical and surgical data, postoperative mortality and morbidity, as well as major cardiovascular and cerebrovascular adverse events (MACCE) as endpoints, certain risk factors of the postoperative complications were identified. Results Out of the 500 patients, 64 developed MACCE, of which 14 (13.6%) occurred in the ONCAB group and 50 (14.0%) in the OPCAB group. Univariate COX regression analysis showed that age ≥65 years, history of diabetes, and preoperative renal insufficiency were independent risk factors for postoperative primary endpoint events in CAD patients with heart failure with reduced ejection fraction (HFrEF). Following the multivariate COX regression analysis, in addition to the above three risk factors, a history of previous percutaneous coronary angiography (PCI) intervention was also a risk factor for the occurrence of the primary endpoints post-CABG. Conclusion Based on the analysis, significant predictors of post-CABG MACCE in patients with HFrEF included being older than 65 years old, having diabetes, preoperative renal insufficiency, and having previous PCI.
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Affiliation(s)
| | - Liu Kaiwen
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Huang Zhuhui
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Zhang Kui
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Zheng Jubing
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Song Yue
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Li Yang
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Liu Taoshuai
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
| | - Dong Ran
- Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing
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Balcom EF, Smyth P, Kate M, Vu K, Martins KJB, Aponte-Hao S, Luu H, Richer L, Williamson T, Klarenbach SW, McCombe JA. Disease-modifying therapy use and health resource utilisation associated with multiple sclerosis over time: A retrospective cohort study from Alberta, Canada. J Neurol Sci 2024; 458:122913. [PMID: 38335712 DOI: 10.1016/j.jns.2024.122913] [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: 10/12/2023] [Revised: 12/21/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Estimating multiple sclerosis (MS) prevalence and incidence, and assessing the utilisation of disease-modifying therapies (DMTs) and healthcare resources over time is critical to understanding the evolution of disease burden and impacts of therapies upon the healthcare system. METHODS A retrospective population-based study was used to determine MS prevalence and incidence (2003-2019), and describe utilisation of DMTs (2009-2019) and healthcare resources (1998-2019) among people living with MS (pwMS) using administrative data in Alberta. RESULTS Prevalence increased from 259 (95% confidence interval [CI]: 253-265) to 310 (95% CI: 304, 315) cases per 100,000 population, and incidence decreased from 21.2 (95% CI: 19.6-22.8) to 12.7 (95% CI: 11.7-13.8) cases per 100,000 population. The proportion of pwMS who received ≥1 DMT dispensation increased (24% to 31% annually); use of older platform injection therapies decreased, and newer oral-based, induction, and highly-effective therapies increased. The proportion of pwMS who had at least one MS-related physician, ambulatory, or tertiary clinic visits increased, and emergency department visits and hospitalizations decreased. CONCLUSIONS Alberta has one of the highest rates of MS globally. The proportion of pwMS who received DMTs and had outpatient visits increased, while acute care visits decreased over time. The landscape of MS care appears to be rapidly evolving in response to changes in disease burden and new highly-effective therapies.
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Affiliation(s)
- Erin F Balcom
- University of Alberta, Faculty of Medicine and Dentistry, Department of Medicine, Edmonton, Alberta T6G 2R3, Canada
| | - Penelope Smyth
- University of Alberta, Faculty of Medicine and Dentistry, Department of Medicine, Edmonton, Alberta T6G 2R3, Canada
| | - Mahesh Kate
- University of Alberta, Faculty of Medicine and Dentistry, Department of Medicine, Edmonton, Alberta T6G 2R3, Canada
| | - Khanh Vu
- University of Alberta, Faculty of Medicine and Dentistry, Real World Evidence Unit, Edmonton, Alberta T6G 2R3, Canada
| | - Karen J B Martins
- University of Alberta, Faculty of Medicine and Dentistry, Real World Evidence Unit, Edmonton, Alberta T6G 2R3, Canada
| | - Sylvia Aponte-Hao
- University of Calgary, Department of Community Health Sciences and the Centre for Health Informatics, Calgary, Alberta T2N 1N4, Canada
| | - Huong Luu
- University of Alberta, Faculty of Medicine and Dentistry, Real World Evidence Unit, Edmonton, Alberta T6G 2R3, Canada
| | - Lawrence Richer
- University of Alberta, Faculty of Medicine and Dentistry, Real World Evidence Unit, Edmonton, Alberta T6G 2R3, Canada; University of Alberta, Faculty of Medicine and Dentistry, Department of Pediatrics, Edmonton, Alberta T6G 2R3, Canada
| | - Tyler Williamson
- University of Calgary, Department of Community Health Sciences and the Centre for Health Informatics, Calgary, Alberta T2N 1N4, Canada
| | - Scott W Klarenbach
- University of Alberta, Faculty of Medicine and Dentistry, Department of Medicine, Edmonton, Alberta T6G 2R3, Canada; University of Alberta, Faculty of Medicine and Dentistry, Real World Evidence Unit, Edmonton, Alberta T6G 2R3, Canada.
| | - Jennifer A McCombe
- University of Alberta, Faculty of Medicine and Dentistry, Department of Medicine, Edmonton, Alberta T6G 2R3, Canada
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Haran A, Even-Zohar NG, Haran M, Lebel E, Aumann S, Shaulov A, Gatt M, Nachmias B. Impact of Folinic Acid Dosing on Efficacy and Toxicity of High-Dose Methotrexate in Central Nervous System Lymphoma. Clin Lymphoma Myeloma Leuk 2024; 24:187-193.e1. [PMID: 38008594 DOI: 10.1016/j.clml.2023.10.012] [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: 07/30/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 11/28/2023]
Abstract
INTRODUCTION High-dose methotrexate (HDMTX)-based regimens are the treatment of choice in primary central nervous system lymphoma (PCNSL). Folinic acid (FA) rescue is used to mitigate the toxic effects of MTX on normal cells. However, the optimal dosing of FA in PCNSL remains uncertain. METHODS We analyzed the relationship between FA dosing and treatment efficacy and toxicity in a cohort of 36 PCNSL patients treated at our institute between the years 2014 and 2022. A combination of univariate and multivariate analyses using known prognostic factors were used to determine the association between FA dosing and treatment outcomes. RESULTS We found that higher per-treatment cumulative FA doses were associated with inferior progression-free survival (PFS), with a hazard ratio (HR) of 2.2 for each 100 mg/m2 increase in FA dose. We identified a threshold of 350 mg/m2/treatment, above which there was a significant reduction in PFS. Notably, lower FA doses did not result in increased toxicity. CONCLUSION Our findings suggest that optimizing FA dosing to avoid very high rescue doses may improve treatment outcomes in PCNSL patients receiving HDMTX. Further prospective studies are warranted to validate these findings.
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Affiliation(s)
- Arnon Haran
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel.
| | - Noa Gross Even-Zohar
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
| | - Michal Haran
- Department of Hematology, Kaplan Medical Center, Rehovot, Israel
| | - Eyal Lebel
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
| | - Shlomzion Aumann
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
| | - Adir Shaulov
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
| | - Moshe Gatt
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
| | - Boaz Nachmias
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel
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Ip A, Mutebi A, Wang T, Jun M, Kalsekar A, Navarro FR, Wang A, Kamalakar R, Sacchi M, Elliott B. Treatment Outcomes with Standard of Care in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Real-World Data Analysis. Adv Ther 2024; 41:1226-1244. [PMID: 38302846 PMCID: PMC10879405 DOI: 10.1007/s12325-023-02775-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/15/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Despite new therapies for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL), treatments with chemotherapy, single-agent rituximab/obinutuzumab, single-agent lenalidomide, or combinations of these agents continue to be commonly used. METHODS This retrospective study utilized longitudinal data from 4226 real-world electronic health records to characterize outcomes in patients with R/R DLBCL. Eligible patients were diagnosed with DLBCL between January 2010 and March 2022 and had R/R disease treated with ≥ 1 prior systemic line of therapy (LOT), including ≥ 1 anti-CD20-containing regimen. RESULTS A total of 573 patients treated with ≥ 1 prior LOT were included (31.2% and 13.4% with ≥ 2 and ≥ 3 prior LOTs, respectively). Median duration of follow-up was 7.7 months. Most patients (57.1%) were male; mean standard deviation (SD) age was 63 (14.7) years. Overall and complete response rates (95% confidence interval (CI) were 52% (48-56) and 23% (19-27). Median duration of response and duration of complete response were 3.5 and 18.4 months. Median progression-free and overall survival (95% CI) was 3.0 (2.8-3.3) and 12.9 (10.1-16.9) months, respectively. Patients with a higher number of prior LOTs, primary refractoriness, refractoriness to last LOT, refractoriness to last anti-CD20-containing regimen, and prior CAR T exposure had worse outcomes (i.e., challenging-to-treat R/R DLBCL) compared with those without these characteristics. CONCLUSIONS Outcomes in patients with R/R DLBCL treated with chemotherapy, single-agent rituximab/obinutuzumab, single-agent lenalidomide, or combinations of these agents remain poor, especially for those with challenging-to-treat R/R DLBCL. These findings underscore the unmet need for new, safe, and effective therapies, especially for challenging-to-treat R/R DLBCL populations.
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Affiliation(s)
- Andrew Ip
- Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Alex Mutebi
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA.
| | - Tongsheng Wang
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA
| | - Monika Jun
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA
| | - Anupama Kalsekar
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA
| | | | | | | | - Mariana Sacchi
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA
| | - Brian Elliott
- Genmab US, Inc., 777 Scudders Mill Road, Plainsboro, NJ, 08536, USA
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Jourdes A, Cellerin E, Touzeau C, Harel S, Denis B, Escure G, Faure E, Jamard S, Danion F, Sonntag C, Ader F, Karlin L, Soueges S, Cazelles C, de La Porte des Vaux C, Frenzel L, Lanternier F, Brousse X, Cazaubiel T, Berger P, Collignon A, Blot M, Pieragostini A, Charles M, Chaleteix C, Redor A, Roland V, Cartau T, Macro M, Chalopin T, Vallet N, Perrot A, Martin-Blondel G. Characteristics and incidence of infections in patients with multiple myeloma treated by bispecific antibodies: a national retrospective study on the behalf of G2I and Intergroupe Francophone du Myélome. Clin Microbiol Infect 2024:S1198-743X(24)00098-3. [PMID: 38432433 DOI: 10.1016/j.cmi.2024.02.023] [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: 11/21/2023] [Revised: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Bispecific antibodies (BsAbs) are an effective treatment used in relapsed or refractory multiple myeloma. Despite a well-tolerated safety profile, infectious events appear to be frequent in clinical trials. Real-world data on epidemiology, characteristics, risk factors, and outcomes of infections in patients treated with BsAb are still needed. METHODS A retrospective, multicentre study in BsAb-treated patients with multiple myeloma was performed in 14 French centres from December 2020 to February 2023. The primary objective was to describe the incidence of infections that required hospitalization, specific treatment, or adaptation in BsAb administration. RESULTS Among 229 patients with multiple myeloma treated with BsAb, 153 (67%) received teclistamab, 47 (20%) received elranatamab, and 29 (13%) talquetamab. We reported a total of 234 infections, including 123 (53%) of grade of ≥3. Predominant infections affected the respiratory tract (n = 116, 50%) followed by bacteraemias (n = 36, 15%). The hospitalization rate was 56% (n = 131), and 20 (9%) infections resulted in death. Global cumulative incidence of the first infection was 70% in all patients, 73% in patients treated with B-cell maturation antigen-targeting, and 51% with GPRC5D-targeting BsAb. In univariate analyses, corticosteroids for cytokine release syndrome (CRS)/immune effector cell-associated neurotoxicity syndrome (ICANS) were associated with a higher risk of first infection (HR = 2.13; 95% CI, 1.38-3.28), whereas GPRC5D-targeting BsAb and anti-bacterial prophylaxis were associated with a lower risk (HR = 0.53; 95% CI, 0.3-0.94 and HR = 0.65; 95% CI, 0.46-0.9). Fine and Gray multivariate model found that only corticosteroids for CRS/ICANS were correlated with a higher risk of first infection (HR = 2.01; 95% CI, 1.27-3.19). DISCUSSIONS The implementation of preventive measures that aim to mitigate the risk of infection under BsAb is pivotal, notably in patients who received corticosteroids for CRS/ICANS.
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Affiliation(s)
- Aurélie Jourdes
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Toulouse, France
| | - Elise Cellerin
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France
| | - Cyrille Touzeau
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) Hôtel Dieu, Nantes, France
| | - Stéphanie Harel
- Service d'immuno-hématologie, Hôpital St-Louis, AP-HP, Paris, France
| | - Blandine Denis
- Service de Maladies Infectieuses et Tropicales, Hôpital St-Louis, AP-HP, Paris, France
| | - Guillaume Escure
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Lille, France
| | - Emmanuel Faure
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Lille, France; U1019-UMR 9017-Centre d'Infection et d'Immunité de Lille, INSERM, Centre National de la Recherche Scientifique, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Simon Jamard
- Service de Médecine Infectieuse et Tropicale, Centre Hospitalo-Universitaire (CHU) de Tours, France
| | - Francois Danion
- Service de Maladies Infectieuses et Tropicales, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France; Laboratoire d'Immuno-rhumatologie Moléculaire UMR_S 1109, INSERM, Strasbourg, Grand Est, France
| | - Cécile Sonntag
- Service d'hématologie, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Florence Ader
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM 1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Lionel Karlin
- Service d'hématologie, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Sarah Soueges
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
| | - Clarisse Cazelles
- Service d'hématologie, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; Institut Cochin, Université de Paris, CNRS UMR8104, INSERM U1016, Paris, France
| | | | - Laurent Frenzel
- Service d'hématologie, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; CEREMAST, Institut Imagine, INSERM U1163, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Centre, Paris, France
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, Centre National de Référence Mycoses Invasives et Antifongiques, Groupe de Recherche Translationnelle en Mycologie, Département de Mycologie, Paris, Île-de-France, France
| | - Xavier Brousse
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Bordeaux, France
| | - Titouan Cazaubiel
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Bordeaux, France; Equipe Génomique et Immunologie du Myélome Multiple, Centre de Recherche en Cancérologie de Toulouse INSERM U1037, Université Paul Sabatier, Toulouse, France
| | - Pierre Berger
- Infectiologie Transversale, Institut Paoli-Calmettes, Marseille, France
| | - Aude Collignon
- Service d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Mathieu Blot
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Dijon-Bourgogne, France; INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France; Equipe Lipness, INSERM LNC-UMR1231 et LabEx LipSTIC, Université de Burgundy, Dijon, France
| | - Andrea Pieragostini
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Dijon-Bourgogne, France
| | - Morgane Charles
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) d'Estaing, Clermont-Ferrand, France
| | - Carine Chaleteix
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) d'Estaing, Clermont-Ferrand, France
| | - Alexis Redor
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Perpignan, France
| | - Virginie Roland
- Service d'hématologie, Centre Hospitalier de Perpignan, France
| | - Tom Cartau
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) Côte de Nacre, Caen, France
| | - Margaret Macro
- Service d'hématologie, Institut bas Normand d'Hématologie, CHU Caen Normandie, Caen, France
| | - Thomas Chalopin
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France
| | - Nicolas Vallet
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France; Equipe INSERM U1069 N2COx, Groupe LNOx, Université de Tours, France
| | - Aurore Perrot
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Bordeaux, France; Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O), Toulouse, France
| | - Guillaume Martin-Blondel
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM, Université Toulouse III, Toulouse, France.
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Rao V, Burket N, Christodoulides A, Wilson C, Flores CA, Kwon JH, Miller J, Bradbury J. Lowering Cranioplasty Infection Incidence with Novel Bone Flap Storage Protocol: A Retrospective Cohort Study. World Neurosurg 2024; 183:e454-e461. [PMID: 38157984 DOI: 10.1016/j.wneu.2023.12.120] [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: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND After craniectomy, autologous bone flaps may be stored using wet or dry cryopreservation. After brain edema subsides, they are replaced during an operation termed cranioplasty. Cranioplasty is associated with 15% infection incidence. METHODS We conducted a retrospective comparison of infection outcomes between wet and dry cryopreservation of cranioplasty bone flaps. Historically, bone flaps were stored utilizing wet cryopreservation-bone flap storage in 1 L of lactated Ringer's solution containing 80 mg gentamicin and 2 g nafcillin in a sterile plastic container secured in an unsterile plastic bag. Our newer dry cryopreservation protocol involved storage in gauze soaked in 80 mg gentamicin and 2 g nafcillin within a 3-layer sterile bag system. RESULTS A total of 119 autologous bone flaps were included, with median follow-up of 3.9 months from cranioplasty. Overall, 10.9% became infected, requiring subsequent surgery; 18.4% of 49 bone flaps stored using wet cryopreservation became infected compared with only 5.7% of 70 dry cryopreservation bone flaps (P = 0.038; relative risk [RR] 0.311; absolute risk reduction 12.7%). Tobacco use (P = 0.076; RR 3.17) was not associated with increased infection risk. Infection incidence was similar for traumatic craniectomy indications compared to the other indications (12.0% trauma vs. 10.1% other; P = 0.750). On average, infected cranioplasty patients spent 8.5 more days hospitalized and faced increased risk of additional complications. CONCLUSIONS Dry cryopreservation significantly decreases infection after cranioplasty when compared with wet cryopreservation, and this mitigates additional morbidity, mortality, and costs attributable to cranioplasty infection. Other nonmodifiable risk factors for cranioplasty infection were identified.
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Affiliation(s)
- Varun Rao
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Noah Burket
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alexei Christodoulides
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
| | | | - Chiara A Flores
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jae Hyun Kwon
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - James Miller
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jamie Bradbury
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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20
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Considine EG, Sherr JL. Real-World Evidence of Automated Insulin Delivery System Use. Diabetes Technol Ther 2024; 26:53-65. [PMID: 38377315 PMCID: PMC10890954 DOI: 10.1089/dia.2023.0442] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: Pivotal trials of automated insulin delivery (AID) closed-loop systems have demonstrated a consistent picture of glycemic benefit, supporting approval of multiple systems by the Food and Drug Administration or Conformité Européenne mark receipt. To assess how pivotal trial findings translate to commercial AID use, a systematic review of retrospective real-world studies was conducted. Methods: PubMed and EMBASE were searched for articles published after 2018 with more than five nonpregnant individuals with type 1 diabetes (T1D). Data were screened/extracted in duplicate for sample size, AID system, glycemic outcomes, and time in automation. Results: Of 80 studies identified, 20 met inclusion criteria representing 171,209 individuals. Time in target range 70-180 mg/dL (3.9-10.0 mmol/L) was the primary outcome in 65% of studies, with the majority of reports (71%) demonstrating a >10% change with AID use. Change in hemoglobin A1c (HbA1c) was reported in nine studies (range 0.1%-0.9%), whereas four reported changes in glucose management indicator (GMI) with a 0.1%-0.4% reduction noted. A decrease in HbA1c or GMI of >0.2% was achieved in two-thirds of the studies describing change in HbA1c and 80% of articles where GMI was described. Time below range <70 mg/dL (<3.9 mmol/L) was reported in 16 studies, with all but 1 study showing stable or reduced levels. Most systems had >90% time in automation. Conclusion: With larger and more diverse populations, and follow-up periods of longer duration (∼9 months vs. 3-6 months for pivotal trials), real-world retrospective analyses confirm pivotal trial findings. Given the glycemic benefits demonstrated, AID is rapidly becoming the standard of care for all people living with T1D. Individuals should be informed of these systems and differences between them, have access to and coverage for these technologies, and receive support as they integrate this mode of insulin delivery into their lives.
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Affiliation(s)
| | - Jennifer L. Sherr
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
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21
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Van Hise NW, Petrak RM, Shah K, Diaz M, Chundi V, Redell M. Oritavancin Versus Daptomycin for Osteomyelitis Treatment After Surgical Debridement. Infect Dis Ther 2024; 13:535-547. [PMID: 38421519 DOI: 10.1007/s40121-024-00925-2] [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: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Weekly intravenous (IV) oritavancin and daily daptomycin were compared in an outpatient setting following extensive surgical debridement for treating patients with osteomyelitis. METHODS This was a retrospective, observational study of patients diagnosed with acute osteomyelitis. Exclusion criteria were the use of Gram-negative antibiotic therapy, use of antibiotics for more than 48 h prior to oritavancin or daptomycin or prior use of > 2 doses of oritavancin or more than 4 weeks of daptomycin. Clinical success was resolution or improvement of symptoms and no further treatment. Data were analyzed with Chi-square test or Fisher's exact test. RESULTS Consecutive outpatients (n = 150) with acute osteomyelitis who were treated with oritavancin or daptomycin (1:1) following extensive surgical debridement were identified. Staphylococcus aureus was the most common pathogen (n = 117). No patient in either group received prior antibiotic therapy (previous 30 days) or was hospitalized within 90 days prior to surgical debridement. Twenty-one (28%) patients prescribed oritavancin had chronic kidney disease, seven of whom were receiving hemodialysis or peritoneal dialysis. Compared to oritavancin, patients prescribed daptomycin had higher rates of all-cause readmission [odds ratio (OR) 2.89; p < 0.001], more infection-related readmission (OR 3.19; p < 0.001), and greater likelihood of receiving antibiotics post-discontinuation of initial therapy (OR 2.13; p < 0.001). Repeat surgical debridement was required for 68.0% with daptomycin vs. 23.1% with oritavancin (p < 0.001). CONCLUSIONS Oritavancin demonstrated a significantly higher rate of clinical success compared to daptomycin, with lower all-cause and infection-related readmissions, reduced need for repeat surgical debridement, and fewer additional antibiotic requirements.
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Affiliation(s)
| | - Russell M Petrak
- Metro Infectious Disease Consultants (MIDC), Burr Ridge, IL, 60527, USA
| | - Kairav Shah
- Metro Infectious Disease Consultants (MIDC), Stockbridge, GA, 30281, USA
| | - Melina Diaz
- Metro Infectious Disease Consultants (MIDC), Stockbridge, GA, 30281, USA
| | - Vishnu Chundi
- Metro Infectious Disease Consultants (MIDC), Chicago, IL, 60618, USA
| | - Mark Redell
- Melinta Therapeutics, Medical Affairs, Parsippany-Troy Hills, USA
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22
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Migliorini E, van Dijk B, Philips B, Mylanus E, Huinck W. The relation between cochlear implant programming levels and speech perception performance in post-lingually deafened adults: a data-driven approach. Eur Arch Otorhinolaryngol 2024; 281:1163-1173. [PMID: 37665345 PMCID: PMC10858098 DOI: 10.1007/s00405-023-08195-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE Programming a cochlear implant (fitting) is an essential part of a user's post-implantation journey, defining how sound will be translated into electrical stimulation and aiming to provide optimal speech perception outcomes. Currently, there are no established, evidence-based guidelines for fitting cochlear implant users, leading to a high degree of variability in fitting practices, users' parameters, and probably outcomes. In this study a data-driven approach is used to retrospectively investigate the relation between cochlear implant fitting parameters and speech perception outcomes in post-lingually deafened adults. METHODS 298 data points corresponding to fitting parameters and speech audiometry test results for the same number of adult, post-lingually deafened, experienced CI users were analyzed. Correlation analysis was performed, after which parameters from the top-scoring and bottom-scoring tertiles were compared via the Mann-Whitney-Wilcoxon u test. RESULTS Weak correlations between dynamic range and speech audiometry outcomes were identified, having p values lower than (albeit close to) 0.05. A significant (p < 0.05) difference in electrical dynamic range (the difference between the minimum and maximum amount of current which may be delivered by each electrode) was found, with top-scoring subjects having on average a wider dynamic range. CONCLUSION The association between dynamic range and speech perception outcomes shown in this retrospective study highlights the need for deeper investigation into evidence-driven fitting. It might be a first step in the direction of evidence-based fitting, minimizing variability in outcomes for cochlear implant users and helping mitigate the issue of unexplained low performance.
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Affiliation(s)
- Enrico Migliorini
- Cochlear Technology Centre Belgium, Mechelen, Belgium.
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
| | | | | | - Emmanuel Mylanus
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Wendy Huinck
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
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D'Souza S, Milne BJ, Li C, Anns F, Gardner A, Lumley T, Morton SMB, Murphy IR, Verhagen E, Wright C, Quarrie K. Kumanu Tāngata: the aftermatch study - protocol to examine the health outcomes of high-level male rugby union players using linked administrative data. BMJ Open Sport Exerc Med 2024; 10:e001795. [PMID: 38362564 PMCID: PMC10868174 DOI: 10.1136/bmjsem-2023-001795] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tāngata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.
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Affiliation(s)
- Stephanie D'Souza
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J Milne
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Chao Li
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
| | - Francesca Anns
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrew Gardner
- Sydney School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Research Institute for Innovative Solutions for Well-being and Health (INSIGHT), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ian R Murphy
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Evert Verhagen
- Department of Public and Occupational Health, EMGO, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Craig Wright
- Social Wellbeing Agency, Wellington, New Zealand
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Vishak MS, Haritha GH, Raja K. Assessing the Efficacy of Steroids as a Single Modality Treatment for Kimura Disease: A Retrospective Analysis. Indian J Otolaryngol Head Neck Surg 2024; 76:683-686. [PMID: 38440515 PMCID: PMC10909021 DOI: 10.1007/s12070-023-04250-x] [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: 09/02/2023] [Accepted: 09/21/2023] [Indexed: 03/06/2024] Open
Abstract
Kimura disease is an idiopathic chronic inflammatory disorder, that usually affects the head and neck sites. The use of steroid for its management has been long reviewed in literature alongside immune suppression, but there are only few studies that compare the efficacy of steroid as a single modality treatment for the same. A middle-aged patient, hailing from southern state of India, presented to our outpatient clinic with right sided facial swelling for 2 years. Patient was diagnosed as a case of kimura disease of head and neck with cytological analysis and other investigations. Patient was managed medically with low dose oral corticosteroids and followed up for 6 months. This is a retrospective analysis of the efficacy of this single modality treatment. Patients with Kimura disease with no renal involvement, low dose oral corticosteroids can be tried as a single modality treatment, provided there are no contra indications for the same. Although long term follow up is essential to look for recurrence rates and associated long term benefits for the same.
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Affiliation(s)
- M. S. Vishak
- Department of Otorhinolaryngology, JIPMER, Puducherry, India
| | - G. H. Haritha
- Department of Otorhinolaryngology, JIPMER, Puducherry, India
| | - Kalaiarasi Raja
- Department of Otorhinolaryngology, JIPMER, Puducherry, India
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25
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Brasfield MB, Bui C, Patihis L, Crowther MR, Allen RS, McDonough IM. Self-Reported Chronic Stress Is Unique Across Lifetime Periods: A Test of Competing Structural Equation Models. The Gerontologist 2024; 64:gnad042. [PMID: 37029789 PMCID: PMC10825840 DOI: 10.1093/geront/gnad042] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic stress can have deleterious effects on physical and mental health. However, self-report measures of chronic stress typically only assess stress recently, ignoring ongoing or repeated stress throughout the life span. The present study tested whether retrospective judgments of stress across different lifetime periods offer unique information that cannot be ascertained by measures of recent chronic stress. RESEARCH DESIGN AND METHODS A survey was given to 271 adults aged 46-81 using Amazon's Mechanical Turk. The questions assessed self-reported stress across multiple domains (e.g., general stress, financial stress, interpersonal stress) from well-known and validated surveys. Also, items were added to assess different lifetime periods of self-reported stress, including one's childhood, 20s/30s, and 50s/60s. Using structural equation modeling, we tested competing models for how lifetime periods and stress domains might relate to one another. RESULTS The best fitting model revealed that different domains of stress (discrimination, loneliness, personal, and general stress) were highly correlated with one another within a given lifetime period but that the different lifetime periods (childhood, 20s/30s, 50s/60s, and current) were relatively independent. DISCUSSION AND IMPLICATIONS Current measures assessing the frequency or strength of "chronic stress" are misleading because they do not capture ongoing or repeated stress throughout the life span. Past experiences convey unique information about one's chronic stress, offering a new perspective on the meaning of "chronic stress" from a life-course perspective, consistent with previous stress accumulation models.
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Affiliation(s)
- Mikenzi B Brasfield
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Chuong Bui
- Alabama Life Research Institute, University of Alabama, Tuscaloosa, Alabama, USA
| | - Lawrence Patihis
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Martha R Crowther
- Institute for Rural Health Research, College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
- Alabama Research Institute on Aging, College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Rebecca S Allen
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
- Alabama Research Institute on Aging, College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Ian M McDonough
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
- Alabama Research Institute on Aging, College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
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Boye KS, Bae JP, Thieu VT, Lage MJ. An Economic Evaluation of the Relationship Between Glycemic Control and Total Healthcare Costs for Adults with Type 2 Diabetes: Retrospective Cohort Study. Diabetes Ther 2024; 15:395-407. [PMID: 38038897 PMCID: PMC10838884 DOI: 10.1007/s13300-023-01507-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Glycemic control is associated with better outcomes among individuals with type 2 diabetes (T2D). This research examines total US all-cause medical costs for adults with T2D with recommended glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%). METHODS The study used administrative claims data linked to HbA1c laboratory test results from January 1, 2015 through June 30, 2021 to identify adults with T2D with a recorded HbA1c test. Patients with recommended glycemic control at index date were propensity score matched to patients with poor glycemic control. General linear models and two-part models were used to compare all-cause outpatient, drug, acute care and total costs for 1 year post index date. RESULTS The study included 59,830 propensity-matched individuals. Results indicate that recommended glycemic control, compared to poor glycemic control, was associated with statistically significantly lower all-cause acute care ($23,868 ± $21,776 vs. $24,352 ± $22,223), drug ($10,277 ± $14,671 vs. $10,540 ± $14,928), and total medical costs ($41,381 ± $42,757 vs. $42,054 ± $43,422) but significantly higher outpatient costs ($7290 ± $12,028 vs. $7026 ± $11,587) (all p < 0.0001). Sensitivity analyses examined results based upon alternative HbA1c thresholds of ≤ 6.5% and < 8%. Results were generally robust to alternative HbA1c thresholds, with higher HbA1c thresholds associated with higher all-cause total costs as well as increased savings for having HbA1c below threshold. CONCLUSIONS Glycemic control was associated with significantly lower all-cause total, drug, and acute care medical costs. Given the high prevalence of T2D in the USA, our results suggest potential economic benefits associated with glycemic control for healthcare providers.
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Affiliation(s)
- Kristina S Boye
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Jay P Bae
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Vivian T Thieu
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Maureen J Lage
- HealthMetrics Outcomes Research, 28 Riverside Lane, Madison, CT, 06443, USA.
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Ma H, O'Brien S, Gupta P. Treatment Patterns and Outcomes in U.S. Military Veterans Diagnosed With Chronic Lymphocytic Leukemia (CLL). Clin Lymphoma Myeloma Leuk 2024; 24:77-82. [PMID: 37743181 DOI: 10.1016/j.clml.2023.09.001] [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: 08/10/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION U.S. veterans in the Veterans Affairs (VA) Healthcare System are managed in a national single-payer system with access to FDA-approved therapies. Prescribing patterns and outcomes of patients with CLL manage in the VA system are described. PATIENTS AND METHODS This is a retrospective analysis of adult patients diagnosed with CLL managed in the VA from January 1999 through December 2020. First line treatment patterns are trended over 20 years. Factors associated with survival were analyzed in both untreated and treated patients. RESULTS In the final analysis, 16,331 patients with CLL were included. The median overall survival (OS) for the whole cohort was 8.7 years (95% confidence interval [CI], 8.6-8.9). The median OS from diagnosis was 8.9 years (95% CI, 8.6-9.2 in untreated patients with CLL. In treated patients, the median time to first line treatment was 1.9 years (range, 0-21 years), and the median OS from initiation of treatment was 5.0 years (95% CI, 4.8-5.2). First line treatments varied over time, consistent with FDA approval of targeted therapies. Exposure to targeted therapies as either first line or in subsequent lines of therapy was associated longer survival: median OS of 8.5 years (95% CI, 8.0-9.1) compared to 3.5 years (95% CI, 3.5-3.9) in patients who never received targeted therapy (P < .0001). CONCLUSION Patients treated in the VA have received therapies in line with current evidence-based treatment practices over the past 20 years. Treatment with targeted therapies is associated with longer median OS both in the first line and relapsed/refractory setting.
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Affiliation(s)
- Helen Ma
- VA Long Beach Healthcare System, Long Beach, CA; University of California Irvine, Orange, CA.
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28
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Sun S, Chen C, Sheng Z, Wei M. The distal tibiofibular joint effusion may be a reliable index for diagnosing the distal tibiofibular syndesmosis instability in ankle. Skeletal Radiol 2024; 53:329-338. [PMID: 37466645 PMCID: PMC10730661 DOI: 10.1007/s00256-023-04395-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To analyze the accuracy of MRI in diagnosis of distal tibiofibular syndesmosis instability (DTSI) and construct new diagnostic parameters. MATERIALS AND METHODS This retrospective study evaluated 212 patients with history of ankle sprains and 3 T MRI and received a final diagnosis of distal tibiofibular syndesmosis instability by ankle arthroscopic surgery from October 2017 and December 2021. We compared the accuracy of syndesmotic injury, qualitative index of distal tibiofibular joint effusion (DTJE), and quantitative index of distal tibiofibular joint effusion (DTJE) in diagnosing distal tibiofibular syndesmosis instability. The criteria for syndesmotic injury were consistent with previous literature, and DTJE was grouped according to the pre-experimental results. RESULTS A total of 212 patients (mean age, 35.64 ± 11.79, 74 female and 138 male) were included. Independent predictive MRI features included syndesmotic injury, qualitative index of distal tibiofibular joint effusion, and quantitative index of DTJE including the height, projected area of equal-point method, and projected area of incremental-value method. The quantitative index of DTJE showed a higher area under the receiver operating characteristic curve (0.805/0.803/0.804/0.811/0.817/0.805 > 0.8, P < 0.05; in comparison with all other method). The height measurement method was simpler and easier to operate, that could be gotten only by measuring the DTJE distance of a MRI independent layer, and the cut-off value of the effusion height was 8.00 mm and the Youden index (0.56) was the best. CONCLUSIONS Our research translated a complicated string of MRI multi-dimensional spatial measurements into a simple measuring process, and established the significance of quantifying DTJE in the diagnosis of DTSI. We found that the 8-mm height of DTJE was a more specific indicator for DTSI and could serve as a novel MRI diagnostic cutoff in clinical practice.
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Affiliation(s)
- Shouqi Sun
- Medical School of Chinese PLA, Beijing, China
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Chinese PLA General Hospital, Beijing, China
| | - Chao Chen
- Medical School of Chinese PLA, Beijing, China
- Department of Rehabilitation Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | | | - Min Wei
- Medical School of Chinese PLA, Beijing, China.
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Chinese PLA General Hospital, Beijing, China.
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Zhang B, Liu H, Li H, Wang J, Zhu H, Yu P, Huang X, Wang W. Obstetric blood transfusion in placenta previa patients with prenatal anemia: a retrospective study. BMC Pregnancy Childbirth 2024; 24:92. [PMID: 38291360 PMCID: PMC10826213 DOI: 10.1186/s12884-024-06279-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The appropriate use of obstetric blood transfusion is crucial for patients with placenta previa and prenatal anemia. This retrospective study aims to explore the correlation between prenatal anemia and blood transfusion-related parameters in this population. METHODS We retrieved the medical records of consecutive participants who were diagnosed with placenta previa and underwent cesarean section in our hospital. We compared the baseline demographics and clinical characteristics of patients with and without anemia. The correlation between prenatal anemia and obstetric blood transfusion-related parameters was evaluated using multivariate regression analysis. RESULTS A total of 749 patients were enrolled, with a mean prenatal hemoglobin level of 10.87 ± 1.37 g/dL. Among them, 54.87% (391/749) were diagnosed with anemia. The rate of obstetric blood transfusion was significantly higher in the anemia group (79.54%) compared to the normal group (44.41%). The median allogeneic red blood cell transfusion volume in the anemia group was 4.00 U (IQR 2.00-6.00), while in the normal group, it was 0.00 U (IQR 0.00-4.00). The prenatal hemoglobin levels had a non-linear relationship with intraoperative allogeneic blood transfusion rate, massive blood transfusion rate, red blood cell transfusion units, and fresh plasma transfusion volume in patients with placenta previa, with a threshold of 12 g/dL. CONCLUSIONS Our findings suggest that prenatal anemia is associated with a higher rate of blood transfusion-related parameters in women with placenta previa when the hemoglobin level is < 12 g/dL. These results highlight the importance of promoting prenatal care in placenta previa patients with a high requirement for blood transfusion.
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Affiliation(s)
- Baolian Zhang
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hong Liu
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haiyan Li
- Department of Ultrasound in Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia Wang
- Department of Quality Control, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - He Zhu
- Department of Gynecology and Obstetrics, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Peijia Yu
- Department of Medical Record, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xianghua Huang
- Department of Gynecology and Obstetrics, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
| | - Wenli Wang
- Department of Gynecology and Obstetrics, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
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Mandefro A, Tadele G, Mekonen B, Golassa L. Analysing the six-year malaria trends at Metehara Health Centre in Central Ethiopia: the impact of resurgence on the 2030 elimination goals. Malar J 2024; 23:32. [PMID: 38263087 PMCID: PMC10804523 DOI: 10.1186/s12936-024-04854-w] [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: 12/14/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite Ethiopia's concerted efforts to eliminate malaria by 2030, the disease continues to pose a significant public health and socioeconomic challenge in the country. The year 2021 witnessed 2.78 million malaria cases and 8041 associated deaths, emphasizing the persistent threat. Monitoring the prevalence trend of malaria is crucial for devising effective control and elimination strategies. This study aims to assess the trend of malaria prevalence at the Metehara Health Centre in the East Shoa Zone, Ethiopia. METHODS A retrospective study, spanning from February to September 2023, utilized malaria registration laboratory logbooks at Metehara Health Centre to evaluate the prevalence of malaria from 2017/18 to 2022/23. Malaria and related data were collected using a pre-designed data collection sheet. Descriptive statistics were employed for data summarization, presented through graphs and tables. RESULTS Out of 59,250 examined blood films, 17.4% confirmed the presence of Plasmodium infections. Among the confirmed cases, 74.3%, 23.8%, and 1.84% were attributed to Plasmodium falciparum, Plasmodium vivax, and mixed infections, respectively. The trend of malaria exhibited a steady decline from 2017/18 to 2021/22, reaching 9.8% prevalence. However, an abrupt increase to 26.5% was observed in 2022/23. Males accounted for a higher proportion (66%) of cases compared to females (34%). The age group 15-24 years experienced the highest malaria incidence at 42%. Notably, malaria cases peaked during autumn (September to November) at 43% and reached the lowest percentage during spring (March to May) at 13%. CONCLUSION Malaria persists as a significant health challenge in and around Metehara, central Ethiopia, predominantly driven by Plasmodium falciparum. The five-year declining trend was interrupted by a notable upsurge in 2022/23, indicating a resurgence of malaria in the study area. It is imperative to adopt a reverse strategy to sustain the progress achieved by the national malaria control plan.
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Affiliation(s)
- Aynalem Mandefro
- Akililu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Geletta Tadele
- College of Medicine and Health Science, Wollega University, Nekemte, Ethiopia
| | - Bacha Mekonen
- Malaria and NTDs Research Team, Bacterial, Parasitic, and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lemu Golassa
- Akililu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Zhao J, Chen R, Zhang Y, Wang Y, Zhu H. Impact of Treatment Delay on the Prognosis of Patients with Ovarian Cancer: A Population-based Study Using the Surveillance, Epidemiology, and End Results Database. J Cancer 2024; 15:473-483. [PMID: 38169558 PMCID: PMC10758034 DOI: 10.7150/jca.87881] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/22/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose: This study aimed to assess the impact of treatment delay on prognosis in patients with ovarian cancer. Methods: A retrospective analysis of patients with ovarian cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 was performed. Chi-square tests were used to assess baseline differences. The Kaplan-Meier method was used to evaluate the effect of different treatment intervals on survival outcomes in patients. Cox regression analyses were used to identify independent factors associated with ovarian cancer prognosis. Results: Of the 21,590 patients included, 15,675 (72.6%), 5,582 (25.9%), and 333 (1.54%) were classified into the immediate-treatment (<1 month after diagnosis), intermediate-delay (1-2 month delayed), and long-delay groups (≥3 months delayed), respectively. The 5-year probability of overall survival (OS) was 61.4% in the immediate-treatment group, decreasing to 36.4% and 34.8% in the intermediate- and long-delay groups, respectively. Similar survival differences were also reflected in cancer-specific survival (CSS), with 5-year CSS probabilities of 66.7%, 42.6%, and 41.8% in the aforementioned groups, respectively. Patients in the intermediate-delay group showed poorer OS (adjusted hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02-1.11; p=0.006) and CSS (adjusted HR, 1.06; 95% CI, 1.01-1.11; p=0.012) than immediate-treatment group. Conclusions: Patients with delayed treatment had poorer OS and CSS. The patient's waiting time from diagnosis to initial treatment should be within 1 month.
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Affiliation(s)
| | | | | | - Yu Wang
- Department of Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haiyan Zhu
- Department of Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
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Grempler R, Ahlberg J, Germovsek E, Gupta P, Li H, Pilvankar M, Sharma A, Stopfer P, Hansel S. Human Dose and Pharmacokinetic Predictions for Biologics at Boehringer Ingelheim: A Retrospective Analysis. Adv Ther 2024; 41:364-378. [PMID: 37971653 DOI: 10.1007/s12325-023-02710-y] [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: 09/02/2023] [Accepted: 10/06/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Accurate predictions of pharmacokinetics and efficacious doses for biologics in humans are critical for selecting appropriate first-in-human starting doses and dose ranges and for estimating clinical material needs and cost of goods. This also impacts clinical feasibility, particularly for subcutaneously administered biologics. METHODS We performed a comprehensive comparison between predicted and observed clearances and doses in humans for a set of 22 biologic drugs developed at Boehringer Ingelheim (BI) over the last 2 decades. The analysis included biologics across three therapeutic areas comprising a wide variety of modalities: mono- and bispecific monoclonal antibodies (mAbs) and nanobodies and a Fab fragment. RESULTS Our analysis showed that observed clearances in humans were within twofold of predicted clearances for 17 out of 20 biologics (85%). Six biologics had uncharacteristically high observed human clearances (range 32-280 mL/h) for their respective molecular classes, impacting their clinical developability. For three molecules, molecular characteristics contributed to the high clearance. Clinically selected doses were within twofold of predicted for 58% of projects. With 42% and 25% of projects selecting clinical doses higher than two- or threefold the predicted value, respectively, the importance of better understanding not only the pharmacokinetic (PK) but also the predictivity of pharmacodynamic models is highlighted. CONCLUSIONS We provide a clinical pharmacology perspective on the commonly accepted twofold range of human clearance predictions as well as the implications of higher than predicted targeted efficacious plasma concentration on clinical development. Finally, an analysis of key success factors for biologics at BI was conducted, which may be relevant for the entire pharmaceutical industry. This is one of the largest retrospective analyses for biologics and provides further evidence that successful predictions of human PK and efficacious dose will be further facilitated by gathering key translational data early in research.
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Affiliation(s)
- Rolf Grempler
- Department of Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma Inc, 900 Ridgebury Road, Ridgefield, CT, 06877, USA.
| | - Jennifer Ahlberg
- Department of Biotherapeutics Discovery, Boehringer Ingelheim Pharma Inc, Connecticut, USA
| | - Eva Germovsek
- Department of Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co.KG, Ingelheim am Rhein, Germany
| | - Priyanka Gupta
- Department of Biotherapeutics Discovery, Boehringer Ingelheim Pharma Inc, Connecticut, USA
| | - Hua Li
- Department of Biotherapeutics Discovery, Boehringer Ingelheim Pharma Inc, Connecticut, USA
| | - Minu Pilvankar
- Department of Biotherapeutics Discovery, Boehringer Ingelheim Pharma Inc, Connecticut, USA
| | - Ashish Sharma
- Department of Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma Inc, 900 Ridgebury Road, Ridgefield, CT, 06877, USA
| | - Peter Stopfer
- Department of Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co.KG, Biberach an der Riss, Germany
| | - Steven Hansel
- Department of Biotherapeutics Discovery, Boehringer Ingelheim Pharma Inc, Connecticut, USA
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Maráz A, Nagy B, Macher T, Jeskó J, Tischler E, Csongvai C, Kearney M. Nationwide Study of Real-World Treatment Patterns and Clinical Outcomes in Patients with Metastatic Urothelial Carcinoma in Hungary. Adv Ther 2023; 40:5475-5488. [PMID: 37831384 PMCID: PMC10611888 DOI: 10.1007/s12325-023-02694-9] [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: 08/05/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Data describing real-world treatment patterns in patients with metastatic urothelial carcinoma (mUC) in Central-Eastern Europe are scarce, and data from Hungary have not been published. This retrospective, nationwide, real-world study investigated patient characteristics, treatment patterns, comorbidities, and clinical outcomes in patients with mUC in Hungary. METHODS Adults diagnosed with mUC from January 2016 through June 2021 were identified using the National Health Insurance Fund Administration database. Overall survival (OS) was estimated using the Kaplan-Meier method. RESULTS In total, 2523 patients with mUC were identified. Median follow-up was 7.1 months. Overall, 50% of patients received an identified systemic anticancer treatment; within this subgroup, first-line treatment was platinum-based chemotherapy (PBC) in 86%, non-PBC in 8%, and immune checkpoint inhibitor (ICI) in 6%. The proportion of patients receiving treatment increased from 41% in 2016 to 59% in 2020, driven by increased use of first-line PBC or first-line ICI treatment. Comorbidities were more common in patients receiving first-line ICI treatment vs PBC or non-PBC and in patients receiving carboplatin + gemcitabine vs cisplatin + gemcitabine. Overall, only 24% received a second-line treatment. Unadjusted median OS from the start of first-line treatment in the PBC, non-PBC, and ICI subgroups was 12.8, 7.5, and 6.3 months, respectively. Median OS from date of diagnosis in untreated patients was 7.8 months. OS comparisons adjusted for differences in baseline characteristics between subgroups could not be performed. CONCLUSION To our knowledge, this is the first study to assess treatment patterns in patients with mUC in clinical practice in Hungary, using the national health insurance database. Rates of first- and second-line treatment were consistent with those observed in other countries. Avelumab first-line maintenance treatment became available for reimbursement in Hungary in late 2022, after the study period. Given the evolving landscape of reimbursed treatments in Hungary, further analyses are warranted.
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Affiliation(s)
- Anikó Maráz
- Department of Oncotherapy, University of Szeged, Korányi Fasor 12, 6720, Szeged, Hungary.
| | - Bence Nagy
- Healthware Consulting Ltd., Budapest, Hungary
| | | | | | - Erika Tischler
- Merck Kft., Budapest, Hungary
- Merck KGaA, Darmstadt, Germany
| | - Csaba Csongvai
- Merck Kft., Budapest, Hungary
- Merck KGaA, Darmstadt, Germany
| | - Mairead Kearney
- Global Value Demonstration, Market Access and Pricing (GVAP), The Healthcare Business of Merck KGaA, Darmstadt, Germany
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Herbold J, O'Brien T, Peters K, Sanichar A, Babyar S. Responsiveness of Section GG Scores in Tracking Post-Stroke Functional Recovery From Inpatient Rehabilitation Admission to 90-Day Follow-Up. Arch Phys Med Rehabil 2023; 104:2002-2010. [PMID: 37541360 DOI: 10.1016/j.apmr.2023.07.013] [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: 03/28/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To evaluate the responsiveness and scale-to-sample targeting of Section GG of the Inpatient Rehabilitation Facility-Patient Assessment Instrument in measuring the trajectory of functional recovery in patients with stroke from inpatient rehabilitation admission to 90 days after discharge. DESIGN Retrospective cohort study. SETTING 150-bed inpatient rehabilitation facility. PARTICIPANTS Patients with stroke (N=1087) discharged between December 2019 to April 2021. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Admission and discharge self-care and mobility scores from Section GG were analyzed for the Inpatient Only group (n= 817). Admission, discharge and 90-day post-discharge Section GG scores from telephone interviews with patients or caregivers were analyzed for the Follow-Up group (n=270). Standardized response means (SRM) determined responsiveness of the tool for each group and time interval. Score means, standard deviations, and floor/ceiling effects illustrated scale-to-sample targeting of the tool. RESULTS Self-care and mobility scores improved significantly from admission to discharge (P<.001) for both groups and from discharge to 90 days (P<.001) for the Follow-Up group. Large SRM existed from admission to discharge for self-care and mobility scores in both groups. A small-to-moderate SRM was seen from discharge to 90 days for self-care (0.46) and a moderate SRM was observed for mobility (0.68). Overall floor effects were minor at admission for self-care (9.8%) and mobility (7.2.%). Overall ceiling effects were minor at discharge for self-care (11.2%) and mobility (4.6%) and significant at follow-up for both self-care (45.2%) and mobility (32.2%). CONCLUSIONS Section GG is responsive to change and appropriately measures patients' functional ability during inpatient rehabilitation. More study is required for telephone follow-up after discharge from inpatient rehabilitation.
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Affiliation(s)
- Janet Herbold
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY
| | - Theodore O'Brien
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Karrah Peters
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Andrea Sanichar
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Suzanne Babyar
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY; Department of Physical Therapy, Hunter College, The City University of New York, New York, NY.
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Kowalkowski H, Austin G, Guo Y, Miller-Wilson LA, DaCosta Byfield S. Patterns of colorectal cancer screening and adherence rates among an average-risk population enrolled in a national health insurance provider during 2009-2018 in the United States. Prev Med Rep 2023; 36:102497. [PMID: 38116257 PMCID: PMC10728437 DOI: 10.1016/j.pmedr.2023.102497] [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: 03/30/2023] [Revised: 10/31/2023] [Accepted: 11/05/2023] [Indexed: 12/21/2023] Open
Abstract
While colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US), outcomes can be improved through timely screening. Despite the benefits and widespread availability of screening tests, adherence to recommended screening strategies is low. The study aimed to provide recent evidence regarding screening rates and adherence to screening recommendations among adults at average risk for CRC in a commercially insured and Medicare Advantage population. De-identified administrative data from a large US research database were examined to determine screening rates for the years 2009 through 2018. The study population included adults aged 50-75 years and annual study population counts ranged from 1,390,594 in 2009 to 1,654,544 in 2018. Incident screening rates were found to be relatively stable across the study years (approximately 15 %) with adherence lowest in the youngest age group (ages 50-54 years). Colonoscopies accounted for approximately 50 % of all screening tests performed, while there was a substantial increase in the use of home-based screening tests over the study timeframe. The use of the fecal immunochemical test increased from 17.2 % in 2009 to 28.9 % in 2018 and the multi-target stool DNA test increased from 0.4 % in 2015 to 9.0 % in 2018. Overall though, CRC screening and adherence rates remain relatively low among adults at average risk for CRC in the US. Improving adherence rates with CRC screening recommendations among individuals at average risk for CRC is required to improve health outcomes.
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Affiliation(s)
- Henrik Kowalkowski
- UnitedHealth Group, 9900 Bren Road East, Minnetonka, MN 55343, United States
| | - George Austin
- UnitedHealth Group, 9900 Bren Road East, Minnetonka, MN 55343, United States
| | - Yinglong Guo
- UnitedHealth Group, 9900 Bren Road East, Minnetonka, MN 55343, United States
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余 紫, 秦 云, 袁 进, 赵 晋, 孙 世. [ Retrospective Analysis of the Effect of Uric Acid on the Prognosis of Immunoglobulin A Nephropathy With Stage 3-4 Chronic Kidney Disease]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:1121-1127. [PMID: 38162075 PMCID: PMC10752786 DOI: 10.12182/20231160505] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Indexed: 01/03/2024]
Abstract
Objective To investigate the effect of uric acid on the clinicopathological characteristics and prognosis of immunoglobulin A nephropathy (IgAN) in patients with stage 3-4 chronic kidney disease (CKD). Methods The clinical and pathological data of 263 IgAN patients who had stage 3-4 CKD and who had confrimed diagosis through renal biopsy at the First Affiliated Hospital of Air Force Medical University between December 2008 and January 2020 were retrospectively collected. According to the levels of uric acid, the patients were divided into a hyperuricemia group (n=102) and a normal uric acid group (n=161), and the clinicopathological characteristics of the two groups were compared accordingly. With progression to end-stage renal disease or death as the endpoint event, the renal survival rate of the two groups was compared by the Kaplan-Meier method and the relationship between uric acid and the prognosis was analyzed by Cox regression and LASSO regression. Results Compared with the normal uric acid group, the hyperuricemia group had a significantly higher proportion of male patients and patients with a history of hypertension, a significantly higher level of blood urea nitrogen, and lower levels of estimated glomerular filtration rate and high-density lipoprotein. In terms of pathology, patients in the hyperuricemia group had significantly higher proportion of glomerulosclerosis, higher mesangial hypercellularity, and higher tubular atrophy/interstitial fibrosis (P<0.05). Kaplan-Meier curve showed that there was a significant difference in renal survival rate between the two groups (P<0.0001). LASSO regression showed that high uric acid was a risk factor for the prognosis of IgAN patients with stage 3-4 CKD. Further multivariate Cox analysis showed that, compared with the normal uric acid group, the hyperuricemia group had a higher risk of incurring composite outcomes (hazard ratio [HR]=1.61, 95% confidence interval [CI]: 1.10-2.34). When uric acid was used as a continuous variable, the increase of 1 mg/dL in uric acid concentration was associated with an increased HR of 1.18 (95% CI: 1.08-1.29) for the composite outcome. Conclusion High uric acid is a risk factor for poor renal prognosis in IgAN patients with stage 3-4 CKD and reducing uric acid levels may effectively improve the prognosis of high-risk IgAN patients.
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Affiliation(s)
- 紫娴 余
- 空军军医大学第一附属医院 肾脏内科 (西安 710032)Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - 云龙 秦
- 空军军医大学第一附属医院 肾脏内科 (西安 710032)Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - 进国 袁
- 空军军医大学第一附属医院 肾脏内科 (西安 710032)Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - 晋 赵
- 空军军医大学第一附属医院 肾脏内科 (西安 710032)Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - 世仁 孙
- 空军军医大学第一附属医院 肾脏内科 (西安 710032)Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
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Kaki R. A retrospective study of Aeromonas hydrophila infections at a university tertiary hospital in Saudi Arabia. BMC Infect Dis 2023; 23:671. [PMID: 37814215 PMCID: PMC10563259 DOI: 10.1186/s12879-023-08660-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/29/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Aeromonas hydrophila can cause a wide range of diseases and is mainly found in patients with underlying diseases. Globally the data on Aeromonas infections is limited, and no studies have been published about the situation in Saudi Arabia. The aim of this study was to investigate the risk factors, clinical presentation, treatment, and outcomes of Aeromonas infections in Saudi Arabia. METHODS A retrospective study was performed at a tertiary university hospital with 1000 beds in Jeddah, Saudi Arabia. All patients 14 years and older with Aeromonas-positive cultures between January 1, 2015, and December 31, 2022 were included. Patient information was extracted from the electronic health records, including patient demographics, comorbidities, presenting symptoms, source of infection, human immunodeficiency virus status, culture results and antimicrobial susceptibility, use of immunosuppressive medication, and 30-day mortality. RESULTS In total 24 patients were identified with Aeromonas hydrophila-positive cultures, 22 of which were males (91.7%), and most (75%) had hospital-acquired infections. The 30-day mortality was 20.8%. All Aeromonas cultures were susceptible to gentamicin, cefepime, and ciprofloxacin, while the majority were resistant to ceftazidime (83.3%) and meropenem (62.5%). The most common disease presentation was skin and soft tissue infection (33.3%), the most common clinical sign was fever (58.3%), and the most common symptom was abdominal pain (37.5%). Comorbidities were very common (median 3, range 1-7). Pitt bacteremia score (p < 0.001), Charlson weighted comorbidity index (p < 0.02), international normalized ratio (p < 0.005), and the number of comorbidity factors (p < 0.05) were all associated with 30-day mortality due to Aeromonas infection. The number of comorbidities had the best predictive value (83.3%) of 30-day mortality (p < 0.05, Odds ratio 3.253, 95% confidence interval: 1.088-9.729). CONCLUSIONS Aeromonas hydrophila is an important pathogen to consider in nosocomial infections. The number of comorbidities had the best predictive value of 30-day mortality. The susceptibility pattern of this organism indicates that, in Saudi Arabia, when an Aeromonas infection is suspected, treatment with quinolone along with other broad-spectrum antibiotics should be started until the culture and susceptibility results are known.
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Affiliation(s)
- Reham Kaki
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- Department of Infectious Disease & Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, 22252, Saudi Arabia.
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Liu L, Liu S, Hao M, Hu S, Yu T, Yang Y, Liu Z. Sarcopenia as an important determinant for adverse outcomes in patients with pyogenic liver abscess. PeerJ 2023; 11:e16055. [PMID: 37810784 PMCID: PMC10559880 DOI: 10.7717/peerj.16055] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/17/2023] [Indexed: 10/10/2023] Open
Abstract
Background Low muscle mass/sarcopenia has been associated with poor prognosis in many diseases, but its clinical significance in pyogenic liver abscess (PLA) remains unclear. The purpose of this study is to investigate the relationship between muscle mass and prognosis of patients with PLA. Methods A total of 154 adult patients with PLA hospitalized at Tongji Hospital (Wuhan, Hubei, China) between October 2011 and June 2021 were included in this retrospective analysis. Muscle-fat related indicators were measured by computed tomography (CT) images at the third lumbar vertebra (L3) level. The data of patients between the sarcopenia group and non-sarcopenia group were compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results The skeletal muscle index (SMI) was independently associated with adverse outcomes (95% CI [0.649-0.954], P = 0.015) of PLA in multivariate logistic regression analysis. This conclusion held true in sex-specific subgroup analysis. ROC analysis indicated that SMI may predict adverse outcomes in both male (area under the ROC curve [AUC], 0.718; cut-off, 52.59; P < 0.001) and female (AUC, 0.714; cut-off, 38.39; P = 0.017) patient populations. Conclusions Sarcopenia serves as an independent risk factor for poor prognosis in PLA and patients with sarcopenia may be more prone to adverse outcomes.
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Affiliation(s)
- Li Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Shaohua Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Meng Hao
- Department of Gastroenterology, Zigui County People’s Hospital, Yichang, China
| | - Song Hu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Yu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Yunkai Yang
- Eight-year Program of Clinical Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhelong Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
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Ezzedine K, Soliman AM, Li C, Camp HS, Pandya AG. Comorbidity Burden Among Patients with Vitiligo in the United States: A Large-Scale Retrospective Claims Database Analysis. Dermatol Ther (Heidelb) 2023; 13:2265-2277. [PMID: 37668899 PMCID: PMC10539259 DOI: 10.1007/s13555-023-01001-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Vitiligo is often associated with comorbid conditions that may increase economic burden and affect patients' health-related quality of life. No large-scale study has been published to date using claims databases to evaluate the burden of comorbidities among patients with vitiligo. Herein, we evaluate the comorbidity burden among patients diagnosed with vitiligo from the US. METHODS This retrospective cohort analysis used the Merative MarketScan Commercial Database. Eligible patients were diagnosed with vitiligo between January 2008 and December 2020 and matched 1:4 (vitiligo:control) with control subjects with no diagnosis of vitiligo between January 2007 and December 2021. Study outcomes were the incidence of comorbidities after matching, adjusted hazard ratios of comorbidity incidence among patients with vitiligo relative to matched control subjects, and time to comorbidity diagnosis or incidence. RESULTS Baseline demographics were well balanced between matched vitiligo (n = 13,687) and control cohorts (n = 54,748). Incidence rates of comorbidities were higher among patients compared with control subjects (psychiatric, 28.4% vs 22.8%; autoimmune, 13.4% vs 5.1%; and non-autoimmune, 10.0% vs 7.0%). The most common psychiatric and autoimmune comorbidities in patients with vitiligo compared with control subjects included anxiety (14.3% vs 11.0%, respectively), sleep disturbance (9.1% vs 7.1%), depression (8.0% vs 6.3%), atopic dermatitis (3.1% vs 1.1%), psoriasis (2.7% vs 0.6%), and linear morphea (1.5% vs 0.1%). The risk of developing any psychiatric (hazard ratio 1.31; P < 0.01), autoimmune (hazard ratio 2.77; P < 0.01), or non-autoimmune (hazard ratio 1.45; P < 0.01) comorbidity was significantly higher among patients with vitiligo. Time to diagnosis of most vitiligo comorbidities was 1-3 years, although linear morphea was diagnosed at < 1 year. CONCLUSION Results of this retrospective analysis demonstrated that patients were much more likely to be diagnosed with autoimmune or psychiatric comorbidities following a vitiligo diagnosis, which likely contributed to increased economic burden and lower quality of life.
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Affiliation(s)
- Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, UPEC, 51 Avenue de Lattre de Tassignv, 94000, Créteil, France.
- EA 7379 EpiDermE, Université Paris-Est Créteil (UPEC), Créteil, France.
| | | | - Chao Li
- AbbVie Inc., North Chicago, IL, USA
| | | | - Amit G Pandya
- Palo Alto Foundation Medical Group, Sunnyvale, CA, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Lelisa K, Hailemeskel E, Bekele D, Dugassa S. Malaria positivity rate trend analysis at water resources development project of Wonji Sugar Estate Oromia, Ethiopia. Parasitol Res 2023; 122:2259-2266. [PMID: 37507541 DOI: 10.1007/s00436-023-07923-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
Evidence on the trends of the proportion of malaria infections detected by routine passive case detection at health facilities is important for public health decision making especially in areas moving towards elimination. The objective was to assess nine years of trends on clinical malaria infections detected at health facility and its associated climate factors, in the water resource development set up of Wonji sugar estate, Oromia, Ethiopia. Retrospective data were collected from malaria-suspected patient recording logbook at Wonji sugar factory's primary hospital. Monthly average meteorological data were obtained from the estate meteorological station. Data were collected from April through June 2018 and January 2022. The data were analyzed using Stata version 16.0 software for Chi-square and regression analysis. Over the last nine years, 34,388 cases were legible for analysis with complete data. Of these, 11.75% (4039/34388) were positive for clinical malaria. Plasmodium vivax test positivity was the highest proportion (8.2%, n = 2820) followed by Plasmodium falciparum (3.48%, n = 1197) and mixed infections (P. falciparum and P. vivax, 0.06%, n = 21). The odds of being positive for malaria was highest in males (AOR = 1.46; 95%CI = 1.36-1.52; P < 0.001) compared to females and in older individuals of above 15 years old (AOR = 4.55, 95%CI = 4.01-5.17, P < 0.001) followed by school-aged children (5-15 years old) (AOR = 2.16; 95%CI = 1.88-2.49, P < 0.001). There was no significant variation in the proportion of malaria-positive cases in the dry and wet seasons (P = 0.059). Malaria test positivity rates were associated with average monthly rainfall (AdjIRR = 1.00; 95%CI = 1.00-1.001, P < 0.001) while negatively associated with average monthly minim temperature (adjIRR = 0.94; 95%CI = 0.94-0.95; P < 0.001) and average monthly relative humidity (adjIRR = 0.99, 95%CI = 0.99-1.00, P = 0.023). There was year-round malaria transmission, adults especially males and school children frequently tested malaria positive. Hence, alternative vector management tools like larval source management have to be deployed besides ITNs and IRS in such water development areas to achieve the malaria elimination goal.
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Affiliation(s)
- Kidane Lelisa
- Vector Biology and Control Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia.
- Department of Biology, College of Natural and Computational Sciences, Dilla University, PO Box 419, Dilla, Ethiopia.
| | - Elifaged Hailemeskel
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
- Department of Biology, College of Natural and Computational Sciences, Wollo University, PO Box 1145, Dessie, Ethiopia.
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands.
| | - Damtew Bekele
- Department of Biology, College of Natural and Computational Sciences, Ambo University, PO Box 19, Ambo, Ethiopia
| | - Sisay Dugassa
- Vector Biology and Control Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
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Chae C, Kim RK, Jang EJ, Shim JA, Park E, Lee KH, Hong SL, Aziz AB, Tadesse BT, Marks F, Tak S, Lee S, Kwon D. Comparing the effectiveness of bivalent and monovalent COVID-19 vaccines against COVID-19 infection during the winter season of 2022-2023: A real-world retrospective observational matched cohort study in the Republic of Korea. Int J Infect Dis 2023; 135:95-100. [PMID: 37572956 DOI: 10.1016/j.ijid.2023.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES To compare the effectiveness of bivalent and monovalent COVID-19 vaccines throughout the 2022-2023 winter season based on real-world data. METHODS This retrospective observational matched cohort study used the national vaccination program and a surveillance dataset from the Republic of Korea, and included adults aged >18 years who received bivalent or monovalent COVID-19 vaccines between October 11, 2022, and December 17, 2022. Cox proportional hazard models were used to estimate the hazard ratio for COVID-19 infection between the groups. RESULTS We included 29,245 matched individuals in the bivalent and monovalent vaccine groups, respectively. The bivalent vaccine recipients showed 12.2% (95% confidence interval [CI] 6.5-17.7%) additional protection against COVID-19 infection compared with the monovalent vaccine recipients. The additional protection provided by bivalent vaccines was significantly higher among residents of long-term care facilities (39.4%, 95% CI 21.6-53.1%). Maximum additional protection was observed 3 to 4 months after completing the vaccination (17.6%, 95% CI 6.6-27.3%). CONCLUSION Bivalent COVID-19 vaccines showed significantly better protection against infection than monovalent vaccines among adults during the 2022-2023 winter season. Our results highlight that immunization programs with bivalent vaccines comprising recent variants can be an effective measure to prepare for seasonal COVID-19 circulation.
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Affiliation(s)
- Chungman Chae
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea.
| | - Ryu Kyung Kim
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Eun Jung Jang
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Ae Shim
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Eunkyung Park
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kil Hun Lee
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sye Lim Hong
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Sangwoo Tak
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sangwon Lee
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Donghyok Kwon
- Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Shimizu Y, Hayakawa H, Honda E, Sasaki N, Takada M, Okada T, Ohira T, Kiyama M. Association between serum albumin levels and height loss in Japanese workers: a retrospective study. J Physiol Anthropol 2023; 42:21. [PMID: 37700384 PMCID: PMC10498632 DOI: 10.1186/s40101-023-00338-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Height loss starting in middle age was previously shown to be associated with high cardiovascular mortality in later life. However, the factors associated with height loss remain unknown. Since low serum albumin levels are reported to be associated with high mortality caused by cardiovascular disease, they may also contribute to height loss. METHODS To clarify the association between serum albumin and height loss, we conducted a retrospective study of 7637 Japanese workers who participated in general health check-ups from 2008 to 2019. Height loss was defined as the highest quartile of height loss per year. RESULTS Individual with high serum concentration of albumin possess beneficial influence on preventing incidence of height loss. In both men and women, serum albumin level was significantly inversely associated with height loss. After adjustment for known cardiovascular risk factors, the adjusted odd ratio (OR) and 95% confidence interval (CI) for height loss per 1 standard deviation of albumin (0.2 g/dL for both men and women) were 0.92 (0.86, 0.98) in men and 0.86 (0.79, 0.95) in women. Even when the analysis was limited to participants without hypoalbuminemia, essentially same association was observed, with fully adjusted corresponding ORs (95%CI) of 0.92 (0.86, 0.98) in men and 0.86 (0.78, 0.94) in women. CONCLUSION Independent of known cardiovascular risk factors, higher serum albumin levels may prevent height loss among Japanese workers. While several different diseases cause hypoalbuminemia, they may not be the main reasons for the association between serum albumin and height loss. Though further research is necessary, this finding may help clarify the mechanisms underlying the association between height loss and higher mortality in later life.
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Affiliation(s)
- Yuji Shimizu
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan.
| | - Hidenobu Hayakawa
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka, Japan
| | - Eiko Honda
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Nagisa Sasaki
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Midori Takada
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Takeo Okada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masahiko Kiyama
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka, Japan
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Delport D, Sacks-Davis R, Abeysuriya RG, Hellard M, Scott N. Lives saved by public health restrictions over the Victorian COVID-19 Delta variant epidemic wave, Aug-Nov 2021. Epidemics 2023; 44:100702. [PMID: 37327657 PMCID: PMC10265399 DOI: 10.1016/j.epidem.2023.100702] [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: 10/12/2022] [Revised: 05/26/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Prior to mid-2021, Australia's approach to COVID-19 was to eliminate community transmission. However, between August-November 2021, the state of Victoria, Australia, experienced an outbreak of the Delta variant that continued to grow despite extensive lockdowns and public health measures in place. While these public health restrictions were ultimately unable to stop community transmission, they likely had a major impact reducing transmission and adverse health outcomes relative to voluntary risk-mitigation only (e.g., in response to rising cases and deaths, some people may avoid crowded settings, hospitality, retail, social occasions, or indoor settings). This study aims to estimate the impact of the August-November 2021 enforced public health restrictions in Victoria, compared to voluntary risk-mitigation only. METHODS An agent-based model was calibrated to Victorian epidemiological, health and behavioural data from 1 August to 30 November 2021, as well as policies that were implemented over that period. Two counter-factual scenarios were run for the same period with (a) no restrictions in place; or (b) voluntary risk-mitigation only, based on behaviour measured over the December-January Omicron BA.1 epidemic wave when restrictions were not in place. RESULTS Over August-November 2021, the baseline model scenario resulted in 97,000 (91,000-102,000) diagnoses, 9100 (8500-9700) hospital admissions, and 480 (430-530) deaths. Without any restrictions in place, there were 3,228,000 (3,200,000-3,253,000) diagnoses, 375,100 (370,200-380,900) hospital admissions, and 16,700 (16,000-17,500) deaths. With voluntary risk-mitigation equal to those observed during the Omicron BA.1 epidemic wave, there were 1,507,000 (1,469,000-1,549,000) diagnoses, 130,300 (124,500-136,000) hospital admissions, and 5500 (5000-6100) deaths. CONCLUSION Public health restrictions implemented in Victoria over August-November 2021 are likely to have averted more than 120,000 hospitalizations and 5000 deaths relative to voluntary risk-mitigation only. During a COVID-19 epidemic wave voluntary behaviour change can reduce transmission substantially, but not to the same extent as enforced restrictions.
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Affiliation(s)
- D Delport
- Disease Elimination Program, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - R Sacks-Davis
- Disease Elimination Program, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - R G Abeysuriya
- Disease Elimination Program, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - M Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population and Global Health, The University of Melbourne, Parkville, Australia; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases, The University of Melbourne and Victorian Infectious Diseases Reference Laboratory, Parkville, Australia
| | - N Scott
- Disease Elimination Program, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Butalia S, Luu H, Guigue A, Martins KJB, Williamson T, Klarenbach SW. Health care cost of severe obesity and obesity-related comorbidities: A retrospective cohort study from Alberta, Canada. Obes Res Clin Pract 2023; 17:421-427. [PMID: 37709630 DOI: 10.1016/j.orcp.2023.09.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/18/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Estimates of health care costs associated with severe obesity, and those attributable to specific health conditions among adults living with severe obesity are needed. METHODS Administrative data was used to identify adults who previously received a procedure, and had (investigational cohort) or did not have (control cohort) a body mass index ≥ 35 kg/m2. Two-part models were used to estimate the incremental health care cost of severe obesity and related health conditions during a 1-year observation period. RESULTS Adjusting for potential confounders, the total health care cost ratio was higher in the investigational (n = 220,190) versus control (n = 1,955,548) cohort (1.32 [95 % CI: 1.32, 1.33]) with a predicted incremental cost of $2221 (95 % CI $2184, $22,265) per person-year; costs were less when obesity-related health conditions were controlled for (1.13 [95 % CI: 1.13, 1.14]; $1097 [95 % CI: $1084, $1110] per person-year). Among those living with severe obesity, incremental costs associated with specific health conditions ranged from $737 (95 % CI: $747, $728) lower (dyslipidemia) to $12,996 (95 % CI: $12,512, $13,634) higher (peripheral vascular disease) per person-year. CONCLUSIONS Adults living with severe obesity had greater costs than those without, largely driven by obesity-related health conditions. For the Alberta adult population with a severe obesity prevalence of 11 %, severe obesity may account for an estimated additional $453-918 million in health care costs per year. Findings of this study provide rationale for resources and strategies to prevent and manage obesity and its complications.
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Affiliation(s)
- Sonia Butalia
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada T2N 1N4
| | - Huong Luu
- Faculty of Medicine and Dentistry, Real World Evidence Unit, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
| | - Alexis Guigue
- Department of Community Health Sciences and the Centre for Health Informatics, University of Calgary, Canada T2N 1N4
| | - Karen J B Martins
- Faculty of Medicine and Dentistry, Real World Evidence Unit, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
| | - Tyler Williamson
- Department of Community Health Sciences and the Centre for Health Informatics, University of Calgary, Canada T2N 1N4
| | - Scott W Klarenbach
- Faculty of Medicine and Dentistry, Real World Evidence Unit, University of Alberta, Edmonton, Alberta, Canada T6G 2R3; Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2R3.
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Chitty KM, Sperandei S, Carter GL, Ali Z, Raubenheimer JE, Schaffer AL, Page A, Buckley NA. Five healthcare trajectories in the year before suicide and what they tell us about opportunities for prevention: a population-level case series study. EClinicalMedicine 2023; 63:102165. [PMID: 37649805 PMCID: PMC10462847 DOI: 10.1016/j.eclinm.2023.102165] [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: 05/23/2023] [Revised: 07/16/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Background Suicide prevention requires a shift from relying on an at-risk individual to engage with the healthcare system. Understanding patterns of healthcare engagement by people who have died by suicide may provide alternative directions for suicide prevention. Methods This is a population-based case-series study of all suicide decedents (n = 3895) in New South Wales (NSW), Australia (2013-2019), with linked coronial, health services and medicine dispensing data. Healthcare trajectories were identified using a k-means longitudinal 3d analysis, based on the number and type of healthcare contacts in the year before death. Characteristics of each trajectory were described. Findings Five trajectories of healthcare utilisation were identified: (A) none or low (n = 2598, 66.7%), (B) moderate, predominantly for physical health (n = 601, 15.4%), (C) moderate, with high mental health medicine use (n = 397, 10.2%), (D) high, predominantly for physical health (n = 206, 5.3%) and E) high, predominantly for mental health (n = 93, 2.4%). Given that most decedents belonged to Trajectory A this suggests a great need for suicide preventive interventions delivered in the community, workplace, schools or online. Trajectories B and D might benefit from opioid dispensing limits and access to psychological pain management. Trajectory C had high mental health medicine use, indicating that the time that medicines are prescribed or dispensed are important touchpoints. Trajectory E had high mental health service predominantly delivered by psychiatrists and community mental health, but limited psychologist use. Interpretation Although most suicide decedents made at least one healthcare contact in the year before death, contact frequency was overall very low. Given the characteristics of this group, useful access points for such intervention could be delivered through schools and workplaces, with a focus on alcohol and drug intervention alongide suicide awareness. Funding Australia's National Health and Medical Research Council.
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Affiliation(s)
- Kate M. Chitty
- Discipline of Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- School of Population and Global Health, Faculty of Health and Medicine, University of Western Australia, WA, Australia
| | - Sandro Sperandei
- Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Gregory L. Carter
- College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University of Newcastle, NSW, Australia
| | - Zein Ali
- Discipline of Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Jacques E. Raubenheimer
- Discipline of Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Andrea L. Schaffer
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- School of Population Health, University of New South Wales, NSW, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Nicholas A. Buckley
- Discipline of Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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Mahdi Salehi M, Maragha T, Brondani M. Application of the Life Grid in Oral Health Research: A Scoping Review. Community Dent Health 2023; 40:187-194. [PMID: 37655484 DOI: 10.1922/cdh_00088salehi08] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
AIM The life grid is a retrospective interview-based tool used to enhance recall of past events. This scoping review examines the use of the life grid in oral health research and its applications. METHODS Using the Joanna Briggs Institute framework, Medline (Ovid), CINAHL, PsycInfo, ERIC, MedEdPortal, Web of Science Core Collection, ProQuest, and Google Scholar were searched with "life grid" and "oral" as initial keywords. Then, two reviewers screened the records independently. Studies published until April 21, 2022, were added, regardless of language. Data were summarised narratively and in a comprehensive table focused on seven main areas. RESULTS A total of 22 studies were included from 724 initially identified records. The life grid was used in different forms, in various qualitative, longitudinal, and cross-sectional studies with participants of different ages. Eight studies used the life grid at the beginning of the interview, four during the process, and one at the end. The ability to reduce recall bias, increase data reliability, establish rapport with participants, and ensure information accuracy were among the most commonly cited benefits of using the life grid in oral health research, particularly in oral cancer research. CONCLUSIONS The life grid is a flexible tool used in a variety of structures and applications in oral health research. Positive impacts have been reported by both researchers and participants. This review highlights the potential of the life grid as a data collection and interview tool in oral health research and dental education.
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Affiliation(s)
- M Mahdi Salehi
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - T Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - M Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
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Lawson AB. Evaluation of predictive capability of Bayesian spatio-temporal models for Covid-19 spread. BMC Med Res Methodol 2023; 23:182. [PMID: 37568119 PMCID: PMC10422743 DOI: 10.1186/s12874-023-01997-3] [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: 07/20/2022] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Bayesian models have been applied throughout the Covid-19 pandemic especially to model time series of case counts or deaths. Fewer examples exist of spatio-temporal modeling, even though the spatial spread of disease is a crucial factor in public health monitoring. The predictive capabilities of infectious disease models is also important. METHODS In this study, the ability of Bayesian hierarchical models to recover different parts of the variation in disease counts is the focus. It is clear that different measures provide different views of behavior when models are fitted prospectively. Over a series of time horizons one step predictions have been generated and compared for different models (for case counts and death counts). These Bayesian SIR models were fitted using MCMC at 28 time horizons to mimic prospective prediction. A range of goodness of prediction measures were analyzed across the different time horizons. RESULTS A particularly important result is that the peak intensity of case load is often under-estimated, while random spikes in case load can be mimicked using time dependent random effects. It is also clear that during the early wave of the pandemic simpler model forms are favored, but subsequently lagged spatial dependence models for cases are favored, even if the sophisticated models perform better overall. DISCUSSION The models fitted mimic the situation where at a given time the history of the process is known but the future must be predicted based on the current evolution which has been observed. Using an overall 'best' model for prediction based on retrospective fitting of the complete pandemic waves is an assumption. However it is also clear that this case count model is well favored over other forms. During the first wave a simpler time series model predicts case counts better for counties than a spatially dependent one. The picture is more varied for morality. CONCLUSIONS From a predictive point of view it is clear that spatio-temporal models applied to county level Covid-19 data within the US vary in how well they fit over time and also how well they predict future events. At different times, SIR case count models and also mortality models with cumulative counts perform better in terms of prediction. A fundamental result is that predictive capability of models varies over time and using the same model could lead to poor predictive performance. In addition it is clear that models addressing the spatial context for case counts (i.e. with lagged neighborhood terms) and cumulative case counts for mortality data are clearly better at modeling spatio-temporal data which is commonly available for the Covid-19 pandemic in different areas of the globe.
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Affiliation(s)
- Andrew B Lawson
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, 29425, USA.
- School of Medicine, Usher Institute, University of Edinburgh, Edinburgh, UK.
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Mac S, Shi S, Millson B, Tehrani A, Eberg M, Myageri V, Langley JM, Simpson S. Burden of illness associated with Respiratory Syncytial Virus (RSV)-related hospitalizations among adults in Ontario, Canada: A retrospective population-based study. Vaccine 2023; 41:5141-5149. [PMID: 37422377 DOI: 10.1016/j.vaccine.2023.06.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/28/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Globally, RSV is a common viral pathogen that causes 64 million acute respiratory infections annually. Our objective was to determine the incidence of hospitalization, healthcare resource use and associated costs of adults hospitalized with RSV in Ontario, Canada. METHODS To describe the epidemiology of adults hospitalized with RSV, we used a validated algorithm applied to a population-based healthcare utilization administrative dataset in Ontario, Canada. We created a retrospective cohort of incident hospitalized adults with RSV between September 2010 and August 2017 and followed each person for up to two years. To determine the burden of illness associated with hospitalization and post-discharge healthcare encounters each RSV-admitted patient was matched to two unexposed controls based on demographics and risk factors. Patient demographics were described and mean attributable 6-month and 2-year healthcare costs (2019 Canadian dollars) were estimated. RESULTS There were 7,091 adults with RSV-associated hospitalizations between 2010 and 2019 with a mean age of 74.6 years; 60.4 % were female. RSV-coded hospitalization rates increased from 1.4 to 14.6 per 100,000 adults between 2010-2011 and 2018-2019. The mean difference in healthcare costs between RSV-admitted patients and matched controls was $28,260 (95 % CI: $27,728 - $28,793) in the first 6 months and $43,721 over 2 years (95 % CI: $40,383 - $47,059) post-hospitalization. CONCLUSIONS RSV hospitalizations among adults increased in Ontario between 2010/11 to 2018/19 RSV seasons. RSV hospitalizations in adults were associated with increased attributable short-term and long-term healthcare costs compared to matched controls. Interventions that could prevent RSV in adults may reduce healthcare burden.
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Affiliation(s)
| | | | | | | | | | | | - Joanne M Langley
- Canadian Center for Vaccinology (Dalhousie University, IWK Health and Nova Scotia Health) Halifax, Nova Scotia, Canada
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Kribs C, Ruan S, Feng Z. A celebration of Fred Brauer's legacy in mathematical biology. J Math Biol 2023; 87:37. [PMID: 37537314 DOI: 10.1007/s00285-023-01971-z] [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: 06/13/2023] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023]
Abstract
Fred Brauer (1932-2021), one of the pioneers of mathematical population biology, shaped generations of researchers through his lines of research, his books which have become key references in the field, and his mentoring of junior researchers. This dedication reviews some of his work in population harvesting and epidemiological modeling, highlighting how this special collection reflects the impact of his legacy through both his research accomplishments and the formation of new researchers.
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Affiliation(s)
- Christopher Kribs
- Department of Mathematics, University of Texas at Arlington, Arlington, TX, USA.
| | - Shigui Ruan
- Department of Mathematics, University of Miami, Coral Gables, FL, USA
| | - Zhilan Feng
- Department of Mathematics, Purdue University, West Lafayette, IN, USA
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Ehrman JK, Keteyian SJ, Johansen MC, Blaha MJ, Al-Mallah MH, Brawner CA. Improved cardiorespiratory fitness is associated with lower incident ischemic stroke risk: Henry Ford FIT project. J Stroke Cerebrovasc Dis 2023; 32:107240. [PMID: 37393688 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107240] [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: 05/23/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Change in cardiorespiratory fitness (CRF) modulates vascular disease risk; however, it's unclear if this adds further prognostic information, particularly for ischemic stroke. The objective of this analysis is to describe the association between the change in CRF over time and subsequent incident ischemic stroke. METHODS This is a retrospective, longitudinal, observational cohort study of 9,646 patients (age=55±11 years; 41% women; 25% black) who completed 2 clinically indicated exercise tests (> 12 months apart) and were free of any stroke at the time of test 2. CRF was expressed as metabolic-equivalents-of-task (METs). Incident ischemic stroke was identified using ICD codes. The adjusted hazard ratio (aHR) was determined for risk of ischemic stroke associated with change in CRF. RESULTS Mean time between tests was 3.7 years (IQR, 2.2, 6.0). During a median of 5.0 years (IQR, 2.7, 7.6 y) of follow-up, there were 873 (9.1%) ischemic stroke events. Each 1 MET increase between tests was associated with a 9% lower ischemic stroke risk (aHR 0.91 [0.88-0.94]; n = 9.646). There was an interaction effect by baseline CRF category, but not for sex or race. A sensitivity analysis which removed those who experienced an incident diagnosis known to be associated with an increased risk of ischemic vascular disease, validated our primary findings (aHR 0.91 [0.88, 0.95]; n= 6,943). CONCLUSIONS Improvement in CRF over time is independently and inversely associated with a lower risk of ischemic stroke. Encouragement of regular exercise focused on improving CRF may reduce ischemic stroke risk.
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Affiliation(s)
- Jonathan K Ehrman
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.
| | - Steven J Keteyian
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Michelle C Johansen
- Cerebrovascular Division, Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medicine, Lutherville, MD, USA
| | | | - Clinton A Brawner
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA
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