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Colburn ME, Delaney MA, Anchor GC, Terio KA. Effect of formalin-fixation and paraffin-embedded tissue storage times on RNAscope in situ hybridization signal amplification. J Vet Diagn Invest 2024:10406387241245777. [PMID: 38650110 DOI: 10.1177/10406387241245777] [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] [Indexed: 04/25/2024] Open
Abstract
RNAscope in situ hybridization (ISH) detects target RNA in formalin-fixed, paraffin-embedded (FFPE) tissues. Protocols suggest that prolonged FFPE storage and formalin fixation may impact signal detection, potentially limiting the utility of RNAscope ISH in retrospective studies. To develop parameters for RNAscope use with archived specimens, we evaluated the effect of formalin-fixation time by measuring the signal of a reference gene (16srRNA) in selected tissues fixed in 10% neutral-buffered formalin for 1, 2, 3, 5, 7, 10, 14, 21, 28, 60, 90, 180, and 270 d. The signal intensity and percent area of signal decreased after 180 d. Tissues had detectable signal at 180 d but not at 270 d of formalin fixation. To assess target detection in paraffin blocks, we qualitatively compared the signal of canine distemper virus (CDV) antigen via immunohistochemistry and CDV RNA via RNAscope ISH in replicate sections from blocks stored at room temperature for 6 mo, 1, 3, 6, 8, 11, 13, and 15 y; RNA was detected in FFPE tissues stored for up to 15 y. Our results demonstrate that RNAscope ISH can detect targets in tissues with prolonged paraffin storage intervals and formalin-fixation times.
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Affiliation(s)
- Megan E Colburn
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, IL, USA
| | - Martha A Delaney
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, IL, USA
| | - Gretchen C Anchor
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, IL, USA
| | - Karen A Terio
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, IL, USA
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Brezan F, Meyer M, Vogel M, Heimer J, Falcato L, Montagna J, Bruggmann P. Prolonged diacetylmorphine take-home during the COVID-19 pandemic-Results of a retrospective cohort study. Addiction 2024. [PMID: 38644677 DOI: 10.1111/add.16503] [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: 06/29/2023] [Accepted: 03/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND AIMS Legal regulations for dispensing in Swiss heroin-assisted treatment were relaxed during the COVID-19 pandemic, allowing prolonged take-home of up to 7 days instead of two to reduce patient contact and the risk of infection. Our study aimed to measure the consequences of this new practice. DESIGN, SETTING AND PARTICIPANTS This was a retrospective cohort study set in Switzerland's largest outpatient centre for opioid agonist therapy. One hundred and thirty-four (72.4%) of the 185 patients receiving oral diacetylmorphine (DAM) participated in the study. MEASUREMENTS Through the utilization of electronic medication prescription and dispensing software, as well as the electronic medical record, the following data were extracted to explore the potential consequences: dose of DAM, the number of antibiotic therapies, emergency hospitalizations and incarcerations. Age, gender, prescriptions for psychotrophic drugs and additional prescription for injectable DAM were tested to assess an increased risk of losing prolonged take-home privileges. Data in the year since prolonged take-home (period 2) were compared with data from the equivalent prior year (period 1). FINDINGS DAM take-home was not associated with a change in DAM dose (P = 0.548), the number of emergency hospitalizations (P = 0.186) or the number of incarcerations (P = 0.215); 79.1% of all patients were able to maintain their extended take-home privileges. However, patients who had injectable DAM experienced significant reductions in their prolonged take-home privileges. CONCLUSION Allowing patients to take home oral diacetylmorphine for up to 7 days as treatment for opioid use disorder does not appear to pose any demonstrable health risk. It is generally manageable for the large majority of patients. However, careful consideration of prolonged take-home for patients with additional injectable diacetylmorphine is recommended, as these patients are more likely to lose take-home privileges.
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Affiliation(s)
| | - Maximilian Meyer
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marc Vogel
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - Jakob Heimer
- Department of Mathematics, Seminar for Statistics, ETH Zurich, Zurich, Switzerland
| | - Luis Falcato
- Arud Centre for Addiction Medicine, Zurich, Switzerland
| | | | - Philip Bruggmann
- Arud Centre for Addiction Medicine, Zurich, Switzerland
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Kegne TW, Anteneh ZA, Bayeh TL, Shiferaw BM, Tamiru DH. Survival Rate and Predictors of Mortality Among TB-HIV Co-Infected Patients During Tuberculosis Treatment at Public Health Facilities in Bahir Dar City, Northwest Ethiopia. Infect Drug Resist 2024; 17:1385-1395. [PMID: 38618582 PMCID: PMC11015844 DOI: 10.2147/idr.s446020] [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: 12/28/2023] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
Background Tuberculosis and human immunodeficiency virus co-infection pose a major public health concern, particularly in developing countries. The survival and predictors of mortality were not sufficiently studied among TB-HIV co-infected patients in Ethiopia. Objective This study aimed to investigate the survival rate and predictors of mortality among TB-HIV co-infected patients during TB treatment at public health facilities in Bahir Dar, Northwest Ethiopia. Methods A retrospective follow-up study was conducted among 401 TB-HIV co-infected patients who were treated for tuberculosis between July 2018 and June 2022 at public health facilities in Bahir Dar city, Ethiopia. Data were collected using a structured checklist from patient charts. Data entry and analysis were done using EpiData 3.1 and Stata version 15, respectively. A Cox proportional Hazard regression model was used to identify predictors of mortality. Predictors with P < 0.05 in the multivariable regression were considered statistically significant. Results Among the 401 TB-HIV co-infected patients, 59 (14.7%) died during the follow-up period. Predictors like lower BMI (AHR = 3.00, 95% CI = 1.44, 6.28), extrapulmonary TB infection (AHR = 3.30, 95% CI = 1.50, 7.29), presence of opportunistic infection (AHR = 5.07, 95% CI = 2.55, 10.08), functional status (bedridden: AHR = 4.49, 95% CI = 1.63, 12.33), and adherence to TB treatment (fair = AHR = 2.74, 95% CI = 1.41, 7.20, and poor = AHR = 3.75, 95% CI = 1.52, 9.23) were associated with mortality. Conclusion Mortality among TB and HIV coinfected people was high at public health facilities in Bahir Dar city. This result suggested that in order to increase patient survival, it would be necessary to enhance nutritional status, increase adherence to TB treatment, and prevent opportunistic infections.
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Affiliation(s)
- Teshager Worku Kegne
- Department of Health Services, Management Sciences for Health, Addis Ababa, Ethiopia
| | - Zelalem Alamrew Anteneh
- Department of Epidemiology and Biostatistics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadios Lidetu Bayeh
- Department of Epidemiology and Biostatistics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Desiyalew Habtamu Tamiru
- Department of Public Health Emergency, Humedica e.V International Aid Organization, Addis Ababa, Ethiopia
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Eriksson M, Bartonek Å. Orthosis use and ambulation in adults with myelomeningocele after orthotic management from childhood. Prosthet Orthot Int 2024; 48:196-203. [PMID: 37725508 PMCID: PMC11005670 DOI: 10.1097/pxr.0000000000000279] [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: 09/01/2022] [Revised: 02/08/2023] [Accepted: 07/20/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Orthotic devices are required for walking in many individuals with myelomeningocele. Evidence concerning orthosis use is sparse, partly because of heterogeneity among groups and different definitions of the neurological level. OBJECTIVES The objective of this study was to investigate ambulation regarding orthosis use and satisfaction with orthoses after intense orthotic management during childhood. STUDY DESIGN The study design is a retrospective follow-up with a cross-sectional study at adult age. METHODS Participants comprised 59 persons born in 1985 or later. Ambulation was categorized as community (Ca), household (Ha), nonfunctional (N-f), and nonambulation (N-a) groups. Orthosis use was registered at approximately 5 (Age5) and 12 (Age12) years of age and in adulthood (AdultAge). Satisfaction with orthoses was evaluated at AdultAge. RESULTS At Age5, Age12, and AdultAge, orthoses were used by 100%, 98%, and 78% of participants, respectively. Ambulation deteriorated between Age5 and Age12 in 17% of participants and between Age12 and AdultAge in 46%. At AdultAge, 63% maintained their ambulatory function; and muscle function and hip and knee flexion contractures were strongly correlated with ambulation. The ambulation groups did not differ regarding satisfaction with device or services, except in 2 single items where the Ha group differed in ratings from the N-f and N-a groups. CONCLUSION The high frequency of orthosis use and similar satisfaction in all ambulation groups emphasize that early planning and follow-up of orthosis treatment during growth are important for mobility in adulthood. Our results also underline the importance of a close assessment of each individual's condition.
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Affiliation(s)
- Marie Eriksson
- Division of Paediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Bartonek
- Division of Paediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Wyrwicz L, Rodríguez Sánchez CA, Sánchez-Rovira P, Lewis S, Sandschafer D, San T. Real-world clinical scenarios during introduction of trastuzumab biosimilar for HER2-positive breast cancer in the European Union. Future Oncol 2024; 20:821-832. [PMID: 38305004 DOI: 10.2217/fon-2023-0421] [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] [Indexed: 02/03/2024] Open
Abstract
Aim: Trastuzumab-anns is an intravenously administered biosimilar to trastuzumab approved by the EMA and US FDA for treatment of HER2+ early and metastatic breast cancer as well as metastatic gastric cancer. Lack of real-world characterization of biosimilar use has hindered uptake. Methods: This observational chart review characterizes 488 patients who received trastuzumab-anns in EU clinical practice settings. Results: Approximately 2/3rds of patients initiated trastuzumab-anns in adjuvant and neoadjuvant settings and most were naive new starters (70%). 30% were switchers from another trastuzumab, among whom 48% switched from trastuzumab iv. reference product. Common reasons for trastuzumab-anns discontinuation were a switch to another biosimilar product (34.8%, n = 85) or to trastuzumab reference product (15.6%, n = 38). Conclusion: Trastuzumab-anns was widely used in various treatment settings for HER2+ breast cancer.
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Affiliation(s)
- Lucjan Wyrwicz
- Department of Oncology & Radiotherapy, Maria Sklodowska Curie National Cancer Research Institute, Warsaw, Poland
| | | | | | - Sandra Lewis
- Global Medical Affairs, Amgen Inc., Thousand Oaks, CA 91320, USA
| | | | - Tevy San
- Centre Oncologie et Radiothérapie, Chambray-lès-Tours, Centre-Val de Loire, France
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Yeshurun S, Cramer T, Souroujon D, Mor M. The Association of Macronutrient Consumption and BMI to Exhaled Carbon Dioxide in Lumen Users: Retrospective Real-World Study. JMIR Mhealth Uhealth 2024; 12:e56083. [PMID: 38439744 PMCID: PMC11019421 DOI: 10.2196/56083] [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: 01/09/2024] [Revised: 02/21/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Metabolic flexibility is the ability of the body to rapidly switch between fuel sources based on their accessibility and metabolic requirements. High metabolic flexibility is associated with improved health outcomes and a reduced risk of several metabolic disorders. Metabolic flexibility can be improved through lifestyle changes, such as increasing physical activity and eating a balanced macronutrient diet. Lumen is a small handheld device that measures metabolic fuel usage through exhaled carbon dioxide (CO2), which allows individuals to monitor their metabolic flexibility and make lifestyle changes to enhance it. OBJECTIVE This retrospective study aims to examine the postprandial CO2 response to meals logged by Lumen users and its relationship with macronutrient intake and BMI. METHODS We analyzed deidentified data from 2607 Lumen users who logged their meals and measured their exhaled CO2 before and after those meals between May 1, 2023, and October 18, 2023. A linear mixed model was fitted to test the association between macronutrient consumption, BMI, age, and gender to the postprandial CO2 response, followed by a 2-way ANOVA. RESULTS The model demonstrated significant associations (P<.001) between CO2 response after meals and both BMI and carbohydrate intake (BMI: β=-0.112, 95% CI -0.156 to -0.069; carbohydrates: β=0.046, 95% CI 0.034-0.058). In addition, a 2-way ANOVA revealed that higher carbohydrate intake resulted in a higher CO2 response compared to low carbohydrate intake (F2,2569=24.23; P<.001), and users with high BMI showed modest responses to meals compared with low BMI (F2,2569=5.88; P=.003). CONCLUSIONS In this study, we show that Lumen's CO2 response is influenced both by macronutrient consumption and BMI. The results of this study highlight a distinct pattern of reduced metabolic flexibility in users with obesity, indicating the value of Lumen for assessing postprandial metabolic flexibility.
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Affiliation(s)
| | | | - Daniel Souroujon
- Metaflow Ltd, Tel-Aviv, Israel
- School of Public Health, Tel Aviv University, Tel-Aviv, Israel
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Huang V, Ciciriello S, Nikpour M, Oon S, Day J. Diagnosing and characterizing inflammatory myopathies at an Australian tertiary public hospital: Resource utilization and direct healthcare costs. Int J Rheum Dis 2024; 27:e15153. [PMID: 38661316 DOI: 10.1111/1756-185x.15153] [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: 09/29/2023] [Revised: 01/19/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
AIM To determine the direct health service costs and resource utilization associated with diagnosing and characterizing idiopathic inflammatory myopathies (IIMs), and to assess for limitations and diagnostic delay in current practice. METHODS A retrospective, single-center cohort analysis of all patients diagnosed with IIMs between January 2012 and December 2021 in a large tertiary public hospital was conducted. Demographics, resource utilization and costs associated with diagnosing IIM and characterizing disease manifestations were identified using the hospital's electronic medical record and Health Intelligence Unit, and the Medicare Benefits Schedule. RESULTS Thirty-eight IIM patients were identified. IIM subtypes included dermatomyositis (34.2%), inclusion body myositis (18.4%), immune-mediated necrotizing myopathy (18.4%), polymyositis (15.8%), and anti-synthetase syndrome (13.2%). The median time from symptom onset to diagnosis was 212 days (IQR: 118-722), while the median time from hospital presentation to diagnosis was 30 days (8-120). Seventy-six percent of patients required emergent hospitalization during their diagnosis, with a median length of stay of 8 days (4-15). The average total cost of diagnosing IIM was $15 618 AUD (STD: 11331) per patient. Fifty percent of patients underwent both MRI and EMG to identify affected muscles, 10% underwent both pan-CT and PET-CT for malignancy detection, and 5% underwent both open surgical and percutaneous muscle biopsies. Autoimmune serology was unnecessarily repeated in 37% of patients. CONCLUSION The diagnosis of IIMs requires substantial and costly resource use; however, our study has identified potential limitations in current practice and highlighted the need for streamlined diagnostic algorithms to improve patient outcomes and reduce healthcare-related economic burden.
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Affiliation(s)
- Victoria Huang
- Department of Rheumatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sabina Ciciriello
- Department of Rheumatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Mandana Nikpour
- The University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia
- The University of Sydney, Camperdown, New South Wales, Australia
- Royal Prince Alfred Hospital Sydney, Camperdown, New South Wales, Australia
| | - Shereen Oon
- Department of Rheumatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- The University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Jessica Day
- Department of Rheumatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Victoria, Australia
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Roels J, Genevois JP, Fostier-Humbert M, Porsmoguer C, Blondel M, Chanoit G, Fau D, Cachon T. Prevalence of elbow dysplasia in 13 dog breeds in France: a retrospective radiographic study (2002-2022). Am J Vet Res 2024:1-8. [PMID: 38518402 DOI: 10.2460/ajvr.23.12.0290] [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: 12/22/2023] [Accepted: 03/05/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE To describe the prevalence of elbow dysplasia (ED) in 13 dog breeds in France. ANIMALS A total of 18,870 elbow radiographs taken from 2002 to 2022 were evaluated by 2 independent examiners. METHODS For each breed, the incidence of each of the 4 International Elbow Working Group scoring classes was extracted from the database. Breeds were excluded if fewer than 150 radiographs had been read for that breed. RESULTS This study included 17,861 records for 13 dog breeds: American Akita, Alaskan Malamute, Old German Shepherd (Altdeutscher Schäferhund), American Staffordshire Terrier, Australian Shepherd, Belgian Shepherd, White Swiss Shepherd, Bernese Mountain Dog, Cane Corso, Czechoslovakian Wolfdog, Rhodesian Ridgeback, Rottweiler, and Dogue de Bordeaux. The overall prevalence of ED was 11.4%, ranging from 1.1% in the Czechoslovakian Wolfdog to 32.2% in the Dogue de Bordeaux. The Dogue de Bordeaux, Rottweiler, Bernese Mountain Dog, and Cane Corso breeds were most commonly affected by ED. The prevalence of ED was significantly higher in male dogs than in female dogs (17.5% vs 10.5%, P < .05). Joint incongruity and fragmented coronoid process were the 2 most common primary ED lesions identified. The prevalence of ED among the dogs evaluated decreased over the timeframe of the study. CLINICAL RELEVANCE The results of this study help to clarify the prevalence of ED in different breeds in France. These data should be interpreted with caution as this study included a small percentage of the total number of dogs born for each breed in France over the study period.
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Affiliation(s)
- Joséphine Roels
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Jean-Pierre Genevois
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Mathilde Fostier-Humbert
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Charles Porsmoguer
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Margaux Blondel
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Guillaume Chanoit
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Didier Fau
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Thibaut Cachon
- Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
- Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
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Öztekin S, Hooning MJ, van Deurzen CHM, Dietvorst AMHP, Drooger JC, Kitzen JJEM, Martens JWM, van der Padt-Pruijsten A, Vastbinder MB, Zuetenhorst H, Heemskerk-Gerritsen BAM, Jager A. The effect of (neo)adjuvant chemotherapy on long-term survival outcomes in patients with invasive lobular breast cancer treated with endocrine therapy: A retrospective cohort study. Cancer 2024; 130:927-935. [PMID: 37985357 DOI: 10.1002/cncr.35125] [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: 08/16/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Despite histological and molecular differences between invasive lobular carcinoma (ILC) and invasive carcinoma of no special type, according to national treatment guidelines no distinction is made regarding the use of (neo)adjuvant chemotherapy. Studies on the long-term outcome of chemotherapy in patients with ILC are scarce and show inconclusive results. METHODS All patients with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative ILC with an indication for chemotherapy treated with adjuvant endocrine therapy were selected from the Erasmus Medical Center Breast Cancer database. Cox proportional hazards models were used to estimate the effect of chemotherapy on recurrence-free survival (RFS), breast cancer-specific survival (BCSS), and overall survival (OS). RESULTS A total of 520 patients were selected, of whom 379 were treated with chemotherapy and 141 were not. Patients in the chemotherapy group were younger (51 vs. 61 years old; p < .001), had a higher T status (T3+, 33% vs. 14%; p < .001), and more often had lymph node involvement (80% vs. 49%; p < .001) in comparison to the no-chemotherapy group. After adjusting for confounders, chemotherapy treatment was not associated with better RFS (hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.63-2.31), BCSS (HR, 1.24; 95% CI, 0.60-2.58), or OS (HR, 0.97; 95% CI, 0.56-1.66). This was also reflected by adjusted Cox survival curves in the chemotherapy versus no-chemotherapy group for RFS (75% vs. 79%), BCSS (80% vs. 84%), and OS (72% vs. 71%). CONCLUSIONS Chemotherapy is not associated with improved RFS, BCSS, or OS for patients with ER+/HER2- ILC treated with adjuvant endocrine therapy and with an indication for chemotherapy.
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Affiliation(s)
- Selin Öztekin
- Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands
| | | | - Anne-Marie H P Dietvorst
- Department of Medical Oncology, Breast Cancer Center South Holland South, Van Weel Bethesda Hospital, Dirksland, the Netherlands
| | - Jan C Drooger
- Department of Medical Oncology, Breast Cancer Center South Holland South, Ikazia Hospital, Rotterdam, the Netherlands
| | - Jos J E M Kitzen
- Department of Medical Oncology, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - John W M Martens
- Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands
| | | | - Mijntje B Vastbinder
- Department of Medical Oncology, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - Hanneke Zuetenhorst
- Department of Medical Oncology, Franciscus Gasthuis en Vlietland, Rotterdam, the Netherlands
| | | | - Agnes Jager
- Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands
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Hofner M, Hurnaus P, DiStefano D, Philip S, Kim S, Shaw J, Waring AC. Outcomes of an Asynchronous Care Model for Chronic Conditions in a Diverse Population: 12-Month Retrospective Chart Review Study. JMIR Diabetes 2024; 9:e53835. [PMID: 38363585 DOI: 10.2196/53835] [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: 10/20/2023] [Revised: 12/06/2023] [Accepted: 02/16/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Diabetes and hypertension are some of the most prevalent and costly chronic conditions in the United States. However, outcomes continue to lag behind targets, creating further risk of long-term complications, morbidity, and mortality for people living with these conditions. Furthermore, racial and ethnic disparities in glycemic and hypertension control persist. Flexible telehealth programs leveraging asynchronous care allow for increased provider access and more convenient follow-up, ultimately improving critical health outcomes across demographic groups. OBJECTIVE We aim to evaluate the 12-month clinical outcomes of participants in the 9amHealth web-based clinic for diabetes and hypertension. We hypothesized that participation in the 9amHealth program would be associated with significant improvements in glycemic and blood pressure (BP) control across a diverse group of individuals. METHODS We enrolled 95 patients in a completely web-based care clinic for diabetes and hypertension who received nutrition counseling, health coaching, and asynchronous physician consultations for medication prescribing. Patients received standard or cellular-connected glucose meters and BP cuffs in order to share data. Laboratory tests were completed either with at-home phlebotomy draws or a self-administered test kit. Patients' first and last hemoglobin A1c (HbA1c) and BP results over the 12-month period were compared, and analyses were repeated across race and ethnicity groups. RESULTS Among all 95 patients, the average HbA1c decreased by -1.0 (from 8.2% to 7.2%; P<.001) over 12 months of program participation. In those with a baseline HbA1c >8%, the average HbA1c decreased by -2.1 (from 10.2% to 8.1%; P<.001), and in those with a baseline HbA1c >9%, the average HbA1c decreased by -2.8 (from 11% to 8.2%; P<.001). Among participants who identified as a race or ethnicity other than White, the HbA1c decreased by -1.2 (from 8.6% to 7.4%, P=.001). Further examination of subgroups confirmed HbA1c lowering within each race or ethnicity group. In the overall population, the average systolic BP decreased by 17.7 mm Hg (P=.006) and the average diastolic BP decreased by 14.3 mm Hg (P=.002). Among participants self-identifying as a race or ethnicity other than White, the results similarly showed a decrease in BP (average reduction in systolic BP of 10 mm Hg and in diastolic BP of 9 mm Hg). CONCLUSIONS A fully web-based model leveraging all-asynchronous physician review and prescribing, combined with synchronous and asynchronous coaching and nutrition support, was associated with clinically meaningful improvement in HbA1c and BP control over a 12-month period among a diverse group of individuals. Further studies should prospectively evaluate the effectiveness of such models among larger populations, assess the longer-term sustainability of these outcomes, and explore financial models to make these types of programs broadly accessible.
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Affiliation(s)
| | | | | | - Shaji Philip
- Washington Permanente Medical Group, Seattle, WA, United States
| | - Sarah Kim
- Zuckerberg San Francisco General Hospital, Division of Endocrinology, Diabetes and Metabolism, University of California, San Francisco, San Francisco, CA, United States
| | - Julie Shaw
- The Ottawa Hospital and EORLA, University of Ottawa, Ottowa, ON, Canada
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Yamakawa N, Umeda M, Yoshii Y, Mitsudo K, Noguchi M, Kusukawa J, Katakura A, Nakayama H, Sasaki M, Noguchi T, Ueda M, Bukawa H, Yagihara K, Horie A, Miyazaki A, Chikazu D, Tomihara K, Mishima K, Otsuru M, Asoda S, Fujiwara S, Ohyama Y, Kurita H, Kawamata H, Fukuda M, Shintani Y, Kobayashi T, Kanno T, Oh-Iwa I, Kawano K, Yamashita Y, Kobayashi W, Ohiro Y, Uzawa K, Ota Y, Kirita T. Multicenter retrospective study of nivolumab for recurrent/metastatic oral squamous cell carcinoma. Oral Dis 2024; 30:247-258. [PMID: 36519515 DOI: 10.1111/odi.14471] [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: 09/13/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Immunotherapy with nivolumab for patients with recurrent/metastatic oral squamous cell carcinoma has not been evaluated. Here, we aimed to examine the efficacy, safety, and prognostic factors of nivolumab in these patients. MATERIALS AND METHODS This multicenter retrospective observational study involved patients who received nivolumab between April 2017 and June 2019. The patient characteristics were evaluated for association with progression-free and overall survival. Progression-free and overall survival rates were calculated; parameters that were significant in the univariate analysis were used as explanatory variables. Independent factors for progression-free and overall survival were identified using multivariate analysis. RESULTS Totally, 143 patients were included. The overall response and disease control rates were 27.3% and 46.2%, respectively. The median, 1- and 2-year progression-free survival rates were 2.7 months, 25.4%, and 19.2%, respectively; those for overall survival were 11.2 months, 47.3%, and 33.6%, respectively. The independent factors affecting progression-free survival were performance status and immune-related adverse event occurrence, whereas those affecting overall survival were performance status, target disease, and number of previous lines of systemic cancer therapy. Eight patients reported grade ≥3 immune-related adverse events. CONCLUSION Nivolumab was effective for recurrent/metastatic oral squamous cell carcinoma treatment and was well tolerated by patients.
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Affiliation(s)
- Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yumi Yoshii
- Department of Cancer Genomics and Medical Oncology, Nara Medical University, Kashihara, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Hideki Nakayama
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Sasaki
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Michihiro Ueda
- Department of Oral Oncology, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuhiro Yagihara
- Department of Oral Surgery, Saitama Cancer Center, Kitaadachi-gun, Japan
| | - Akihisa Horie
- Department of Oral and Maxillofacial Surgery, Kanto Rosai Hospital, Kawasaki, Japan
| | - Akihiro Miyazaki
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kei Tomihara
- Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Mitsunobu Otsuru
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Seiji Asoda
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shigeyoshi Fujiwara
- Department of Oral and Maxillofacial Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hitoshi Kawamata
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Japan
| | - Masayuki Fukuda
- Department of Dentistry and Oral Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukari Shintani
- Department of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takanori Kobayashi
- Department of Dentistry and Oral Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Ichiro Oh-Iwa
- Department of Oral and Maxillofacial Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Kenji Kawano
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoshio Yamashita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Wataru Kobayashi
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoichi Ohiro
- Oral and Maxillofacial Surgery, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuhiro Uzawa
- Department of Oral Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshihide Ota
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
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An Z, Nie J, Huang Y, Fang P, Meng X, Cai C, Yu L. Contribution of non-socioeconomic factors to healthy quality of life in socioeconomically deprived patients with advanced gastrointestinal cancer: Measuring attributable fraction. J Adv Nurs 2024; 80:1154-1165. [PMID: 37710401 DOI: 10.1111/jan.15862] [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: 04/20/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation. AIM This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors. DESIGN A retrospective study based on cross-sectional design. METHODS Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients. RESULTS The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors-gait, self-care ability, abdominal distension, nutritional status, weight loss and posture-has an independent positive impact on the development of a healthy quality of life for patients. CONCLUSIONS Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non-socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life. IMPLICATIONS FOR PRACTICE This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally. REPORTING METHOD This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Zifen An
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Jiaqi Nie
- School of Public Health, Wuhan University, Wuhan, China
| | - Yanfang Huang
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Pei Fang
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
- Medical Center for Gastrointestinal Surgery, Weifang People's Hospital, Weifang, Shandong, China
| | - Xianmei Meng
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Chunfeng Cai
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Liping Yu
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
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Kang YF, Ge YJ, Ding MK, Liu-Fu JF, Cai ZG, Shan XF. A comparison of accuracy among different approaches of static-guided implant placement in patients treated with mandibular reconstruction: A retrospective study. Clin Oral Implants Res 2024; 35:251-257. [PMID: 38031527 DOI: 10.1111/clr.14219] [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: 03/15/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE This study aimed to evaluate the differences in the accuracy of immediate intraoral, immediate extraoral, and delayed dental implant placement with surgical guides (static computer-aided implant surgery) in patients treated with mandibular reconstruction. METHODS This was a retrospective study. The patients were divided into three groups: immediate intraoral placement (IIO), immediate extraoral placement (IEO), and delayed placement (DEL). Four variables were used to compare the planned and actual implant positions: angular deviation, three-dimensional (3D) deviation at the entry point of the implant, 3D deviation at the apical point of the implant, and depth deviation. RESULTS The angular deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. The 3D deviation at the entry point was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .01) groups. The 3D deviation at the apical point was significantly higher in the IIO group than in the IEO (p < .01) and DEL (p < .01) groups. The depth deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. There was no statistical difference between the IEO and DEL group in angular and 3D deviation. CONCLUSION With surgical guides, among the different approaches for implant placement, delayed implant placement remains the most accurate approach for patients treated with mandibular reconstruction.
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Affiliation(s)
- Yi-Fan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Yan-Jun Ge
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Meng-Kun Ding
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Jian-Feng Liu-Fu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Zhi-Gang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Xiao-Feng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
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Alsoof D, Perry J, Yang DS, Zhang AS, McDonald CL, Kuris EO, Daniels AH. Risk of Dysphagia and Dysphonia in Patients With Prior Thyroidectomy Undergoing Anterior Cervical Discectomy and Fusion. Global Spine J 2024; 14:494-502. [PMID: 35835538 PMCID: PMC10802520 DOI: 10.1177/21925682221111095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study using PearlDiver database. OBJECTIVES To evaluate the effect of prior thyroidectomy on complications of Anterior Cervical Discectomy and Fusion (ACDF) surgery. METHODS PearlDiver was used to identify patients without prior dysphagia or dysphonia undergoing ACDF between the years 2010-2020Q1. Patients with and without prior thyroidectomy were matched by levels of fusion, alcohol use, and gastroesophageal reflux disease in a 1:5 ratio. Postoperative outcomes were assessed for each cohort with multivariable logistic regression, controlling for age, sex, and Elixhauser Comorbidity Index. RESULTS Between 2010 and 2019, matched cohorts of 792 ACDF patients with prior thyroidectomy and 3960 ACDF only patients were included in the study. Of patients with previous thyroidectomy undergoing ACDF, 16.3% experienced dysphagia at 1-year compared with 10.6% for patients undergoing ACDF only (aOR=1.39, P=.004). Patients with previous thyroidectomy also had higher odds of dysphonia at 1-year following ACDF, as compared to patients with ACDF alone (2.7% vs 1.2%, aOR=1.74, P= .048). Patients undergoing ACDF with prior thyroidectomy did not have increased risk of revision at 1 year (aOR=1.10, P=.698), 2 years (aOR=1.16, P=.457), or 5 years (aOR=1.20, P=.255) following surgery. There were no differences in postoperative opioid utilization rates at 1 month (aOR=2.07, P=.138), 3 months (aOR=2.45, P=.095), 6 months (aOR=1.34, P=.520), and 12 months (aOR=1.69, P=.202). Prior thyroidectomy was not associated with reintubation following ACDF (P=.995). CONCLUSIONS Patients with prior thyroidectomy undergoing ACDF surgery experience increased odds of dysphagia and dysphonia at 1-year follow-up compared to those without prior thyroidectomy.
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Affiliation(s)
- Daniel Alsoof
- Alpert Medical School of Brown University, Providence, RI, USA
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI, USA
| | - Justin Perry
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel S. Yang
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Andrew S. Zhang
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI, USA
| | - Christopher L. McDonald
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI, USA
| | - Eren O. Kuris
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI, USA
| | - Alan H. Daniels
- Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI, USA
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15
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Shih MC, Wang AL, Radosta S, Mushatt DM. Retrospective cohort study comparing two versus three blood culture sets in people who inject drugs. Infect Dis (Lond) 2024; 56:183-192. [PMID: 37991992 DOI: 10.1080/23744235.2023.2284884] [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: 06/19/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The current standard of drawing two vs three blood culture sets lacks adequate guidance. Because people who inject drugs are at higher risk for bacteraemia and life-threatening infection, consideration of a third blood culture becomes more important. AIM To investigate the risks and benefits of obtaining two versus three blood culture sets. METHODS Retrospective cohort study of adults who inject drugs at a multicentre catch-net hospital system from 2017-2022. FINDINGS 998 people who inject drugs and 2278 blood culture sets were analysed. There were 1618 episodes with two blood culture sets and 660 episodes with three. A potential benefit of adding a third blood culture was seen in 30 (4.5%) episodes. However, only 13 (2.0%) episodes showed pathogen-identifying benefit, as 17 (2.6%) involved known inadequately treated infections or the same pathogen in another culture. The number of blood culture sets needed to achieve diagnostic benefit was 51. There were more contaminants for three blood culture sets (65, 9.8%) than for two (114, 7.0%) (p < 0.00001). By adding a third blood culture, the risk of a contaminant increased by 39.7%; the number of blood culture sets needed to find a contaminant was 36. Of 122 episodes with only contaminants and available for analysis, 111 (91.0%) experienced at least one complication. 33 (27.0%) patients experienced either prolonged admission, readmission, or unnecessary antibiotic administration. CONCLUSIONS The benefits of possibly isolating a pathogen from a third blood culture set do not universally outweigh the risks for contaminant growth for people who inject drugs. A third blood culture should be considered in specific clinical scenarios (i.e. inadequately treated endocarditis and osteomyelitis).
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Affiliation(s)
- Michael C Shih
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Aprilgate L Wang
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Stella Radosta
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - David M Mushatt
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
- Section of Adult Infectious Diseases, Tulane University School of Medicine, New Orleans, LA, USA
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Lawrence-Sidebottom D, Huffman LG, Beam AB, Guerra R, Parikh A, Roots M, Huberty J. Rates of Trauma Exposure and Posttraumatic Stress in a Pediatric Digital Mental Health Intervention: Retrospective Analysis of Associations With Anxiety and Depressive Symptom Improvement Over Time. JMIR Pediatr Parent 2024; 7:e55560. [PMID: 38412001 PMCID: PMC10933721 DOI: 10.2196/55560] [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: 12/15/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND More than 2 out of 3 children and adolescents in the United States experience trauma by the age of 16 years. Exposure to trauma in early life is linked to a range of negative mental health outcomes throughout the lifespan, particularly co-occurring symptoms of posttraumatic stress (PTS), anxiety, and depression. There has been an increasing uptake of digital mental health interventions (DMHIs) among youths, particularly for anxiety and depression. However, little is known regarding the incidence of trauma exposure and PTS symptoms among youths participating in DMHIs and whether PTS symptoms impact anxiety and depressive symptom treatment response. Moreover, it is unclear whether participation in a DMHI for anxiety and depressive symptoms is associated with secondary effects on PTS symptoms among trauma-exposed youths. OBJECTIVE This study aims to use retrospective data from youths participating in a DMHI to (1) characterize rates of trauma, PTS, and comorbid anxiety and depressive symptoms; (2) determine whether trauma exposure and elevated PTS symptoms impact the improvement of comorbid anxiety and depressive symptoms throughout participation in care; and (3) determine whether participation in a non-posttraumatic DMHI is linked to reductions in PTS symptoms. METHODS This study was conducted using retrospective data from members (children ages 6 to 12 years) involved in a pediatric collaborative care DMHI. Participating caregivers reported their children's trauma exposure. PTS, anxiety, and depressive symptom severity were measured monthly using validated assessments. RESULTS Among eligible participants (n=966), 30.2% (n=292) reported at least 1 traumatic event. Of those with trauma exposure and elevated symptoms of PTS (n=119), 73% (n=87) exhibited elevated anxiety symptoms and 50% (n=59) exhibited elevated depressive symptoms. Compared to children with no trauma, children with elevated PTS symptoms showed smaller reductions per month in anxiety but not depressive symptoms (anxiety: F2,287=26.11; P<.001). PTS symptoms also decreased significantly throughout care, with 96% (n=79) of participants showing symptom reductions. CONCLUSIONS This study provides preliminary evidence for the frequency of trauma exposure and comorbid psychiatric symptoms, as well as variations in treatment response between trauma-exposed and nontrauma-exposed youths, among participants in a pediatric collaborative care DMHI. Youths with traumatic experiences may show increased psychiatric comorbidities and slower treatment responses than their peers with no history of trauma. These findings deliver compelling evidence that collaborative care DMHIs may be well-suited to address mental health symptoms in children with a history of trauma while also highlighting the critical need to assess symptoms of PTS in children seeking treatment.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc, Madison, WI, United States
- FitMinded Inc LLC, Phoenix, AZ, United States
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Ibrahim DR, Saadi AT, Yahya NB, Ibrahim MS, Saeed AY, Abdulaziz SS, Hasqyal RY, Alarsalani BK, Ibrahim KS. Retrospective analysis of pediatric sepsis and the burden of antimicrobial resistance in Duhok, Kurdistan Region of Iraq. Front Pharmacol 2024; 15:1347832. [PMID: 38469402 PMCID: PMC10925647 DOI: 10.3389/fphar.2024.1347832] [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: 12/01/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction: Sepsis is a life-threatening complication in pediatric patients. This study primarily aimed to investigate sepsis-causing bacteria and their antimicrobial resistance profile and check the change in the antimicrobial resistance trend for some selected bacteria. In addition, we evaluated the incidence of sepsis, the related mortality rate, and the effectiveness and outcome of the treatment regimes in sepsis pediatric patients. Methods: A retrospective analysis was conducted on 4-year data (2018-2021) collected from three intensive care units at the Hevi Pediatric Teaching Hospital. Sepsis screening involved clinical detection and confirmation by blood culture. Results: A total of 520 out of 1,098 (47.35%) blood samples showed positive microbial growth. A decrease in sepsis rate was observed during the COVID-19 pandemic. Coagulase-negative Staphylococci (CoNS) and Klebsiella pneumonia were the most commonly isolated bacteria. A notable variation in the antimicrobial resistance trend was observed among sepsis-causing bacteria. The empirical sepsis treatment recommended by the WHO was ineffective, as certain bacteria exhibited 100% resistance to every antibiotic tested. The mortality rate significantly increased from 1.3% in 2018 to 16.5% in 2021. Discussion: The antimicrobial resistance profile of sepsis causing bacteria is of concerns, indicating a potentially serious situation. Thus, to avoid treatment failure, the monitoring of antimicrobial resistance in pediatric patients is essential.
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Affiliation(s)
- Delveen R. Ibrahim
- Department of Biology, Collage of Science, University of Duhok, Duhok, Kurdistan Region, Iraq
| | - Abdulrhaman T. Saadi
- Medical Microbiology Department, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
- Heevi Pediatrics Teaching Hospital, Duhok Health Directorate, Duhok, Kurdistan Region, Iraq
| | - Nizar B. Yahya
- Heevi Pediatrics Teaching Hospital, Duhok Health Directorate, Duhok, Kurdistan Region, Iraq
- Pediatrics Department, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
| | - Marwa S. Ibrahim
- Department of Medical Laboratory Technology, College of Health and Medical Techniques-Shekhan, Duhok Polytechnic University, Duhok, Kurdistan Region, Iraq
| | - Ali Y. Saeed
- Department of Biology, Collage of Science, University of Duhok, Duhok, Kurdistan Region, Iraq
| | - Sawsan S. Abdulaziz
- Heevi Pediatrics Teaching Hospital, Duhok Health Directorate, Duhok, Kurdistan Region, Iraq
| | - Revan Y. Hasqyal
- Heevi Pediatrics Teaching Hospital, Duhok Health Directorate, Duhok, Kurdistan Region, Iraq
| | - Berivan K. Alarsalani
- Heevi Pediatrics Teaching Hospital, Duhok Health Directorate, Duhok, Kurdistan Region, Iraq
| | - Khalid S. Ibrahim
- Department of Biology, College of Sciences, University of Zakho, Zakho, Kurdistan Region, Iraq
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Ye Y, Murdock DJ, Chen C, Liedtke W, Knox CA. Epidemiology of myasthenia gravis in the United States. Front Neurol 2024; 15:1339167. [PMID: 38434198 PMCID: PMC10907989 DOI: 10.3389/fneur.2024.1339167] [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: 11/15/2023] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Global studies of epidemiology of myasthenia gravis (MG) have pointed to increasing prevalence of this rare autoimmune disorder affecting the neuromuscular synapse; however, no new data for the USA were available for decades. We aimed to estimate the incidence rate and prevalence of MG in a large-scale insured US population. Methods We conducted a population-based retrospective cohort study to estimate the annual incidence and prevalence of MG cases in the USA during 2017. Using a previously validated algorithm, we identified cases of MG in two Truven Health MarketScan databases, which during 2017 included a sample of approximately 20 million commercially insured and Medicare recipients, plus 10 million Medicaid recipients. We report crude incidence and prevalence and calculated age-and sex-standardized estimates for the USA based on the 2017 American Community Survey. We estimated the number of adult cases during 2021 by extrapolating from the stratified estimates to the population size from the 2021 American Community Survey. Results From the US commercially/Medicare-insured cohort, we calculated an age-and sex-standardized incidence of 68.5 new cases per million person-years with an adjusted prevalence of 316.4 per million. Within the Medicaid-insured population, similar yet slightly lower numbers emerged: the adjusted incidence was 49.7 new cases per million person-years, and the adjusted prevalence rate was 203.7 cases per million. Given our results, we were able to estimate that there were approximately 82,715 US adults living with MG in 2021 (or an estimated 320.2 cases per million adults in the USA). We observed a strong effect of age and sex when stratifying the identified incidence rate and prevalence, with a pattern of female preponderance among the younger age brackets, a male preponderance for older cases in the commercially/Medicare-insured cohort, and the disease incidence and prevalence steadily increasing with age. Discussion Our updated US population-based estimates of MG epidemiology demonstrate an increase in the previously reported incidence and prevalence from over 20 years ago, in keeping with developments in westernized, industrialized countries. Notable findings of steadily increasing prevalence with age, driven by robust increases in elderly males, prompts questions for basic-translational research, therapeutics, and public health.
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Affiliation(s)
- Yun Ye
- The Division of Epidemiology, The Ohio State University, Columbus, OH, United States
| | | | - Chao Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, United States
| | | | - Caitlin A. Knox
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, United States
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Zhao HN, Yin H, Liu JY, Song LL, Peng YL, Ma BY. Deep learning-assisted ultrasonic diagnosis of cervical lymph node metastasis of thyroid cancer: a retrospective study of 3059 patients. Front Oncol 2024; 14:1204987. [PMID: 38390270 PMCID: PMC10881794 DOI: 10.3389/fonc.2024.1204987] [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: 04/13/2023] [Accepted: 01/09/2024] [Indexed: 02/24/2024] Open
Abstract
Objective This study aimed to develop a deep learning system to identify and differentiate the metastatic cervical lymph nodes (CLNs) of thyroid cancer. Methods From January 2014 to December 2020, 3059 consecutive patients with suspected with metastatic CLNs of thyroid cancer were retrospectively enrolled in this study. All CLNs were confirmed by fine needle aspiration. The patients were randomly divided into the training (1228 benign and 1284 metastatic CLNs) and test (307 benign and 240 metastatic CLNs) groups. Grayscale ultrasonic images were used to develop and test the performance of the Y-Net deep learning model. We used the Y-Net network model to segment and differentiate the lymph nodes. The Dice coefficient was used to evaluate the segmentation efficiency. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were used to evaluate the classification efficiency. Results In the test set, the median Dice coefficient was 0.832. The sensitivity, specificity, accuracy, PPV, and NPV were 57.25%, 87.08%, 72.03%, 81.87%, and 66.67%, respectively. We also used the Y-Net classified branch to evaluate the classification efficiency of the LNs ultrasonic images. The classification branch model had sensitivity, specificity, accuracy, PPV, and NPV of 84.78%, 80.23%, 82.45%, 79.35%, and 85.61%, respectively. For the original ultrasonic reports, the sensitivity, specificity, accuracy, PPV, and NPV were 95.14%, 34.3%, 64.66%, 59.02%, 87.71%, respectively. The Y-Net model yielded better accuracy than the original ultrasonic reports. Conclusion The Y-Net model can be useful in assisting sonographers to improve the accuracy of the classification of ultrasound images of metastatic CLNs.
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Affiliation(s)
- Hai Na Zhao
- Department of Ultrasonography, West China hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hao Yin
- Computer science of Sichuan University, Chengdu, Sichuan, China
| | - Jing Yan Liu
- Department of Ultrasonography, West China hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lin Lin Song
- Department of Ultrasonography, West China hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yu Lan Peng
- Department of Ultrasonography, West China hospital of Sichuan University, Chengdu, Sichuan, China
| | - Bu Yun Ma
- Department of Ultrasonography, West China hospital of Sichuan University, Chengdu, Sichuan, China
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Liu Y, Zhang N, Yang Q. Predicting the recurrence of usual-type cervical adenocarcinoma using a nomogram based on clinical and pathological factors: a retrospective observational study. Front Oncol 2024; 14:1320265. [PMID: 38384815 PMCID: PMC10879399 DOI: 10.3389/fonc.2024.1320265] [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: 10/12/2023] [Accepted: 01/16/2024] [Indexed: 02/23/2024] Open
Abstract
Background Usual-type cervical adenocarcinoma is the most frequent type of adenocarcinoma, and its prevalence is increasing worldwide. Tumor recurrence is the leading cause of mortality; therefore, recognizing the risk factors for cervical cancer recurrence and providing effective therapy for recurrent cervical cancer are critical steps in increasing patient survival rates. This study aimed to retrospectively analyze the clinicopathological data of patients with usual-type cervical adenocarcinoma by combining the diagnosis and treatment records after the initial treatment and recurrence. Methods We retrospectively analyzed patients diagnosed with usual-type cervical adenocarcinoma who underwent radical hysterectomy and pelvic lymph node dissection at Shengjing Hospital of China Medical University between June 2013 and June 2022. We constructed a nomogram-based postoperative recurrence prediction model, internally evaluated its efficacy, and performed internal validation. Results This study included 395 participants, including 87 individuals with recurrence. At a 7:3 ratio, the 395 patients were divided into two groups: a training set (n = 276) and a validation set (n = 119). The training set was subjected to univariate analysis, and the risk variables for recurrence included smoking, ovarian metastasis, International Federation of Gynaecology and Obstetrics (FIGO) staging, lymphovascular space invasion, perineural invasion, depth of muscular invasion, tumor size, lymph node metastasis, and postoperative HPV infection months. The aforementioned components were analyzed using logistic regression analysis, and the results showed that the postoperative HPV infection month, tumor size, perineural invasion, and FIGO stage were independent risk factors for postoperative recurrence (p<0.05). The aforementioned model was represented as a nomogram. The training and validation set consistency indices, calculated using the bootstrap method of internal validation, were 0.88 and 0.86, respectively. The model constructed in this study predicted the postoperative recurrence of usual-type cervical cancer, as indicated by the receiver operating characteristic curve. The model demonstrated good performance, as evidenced by the area under the curve, sensitivity, and specificity values of 0.90, 0.859, and 0.844, respectively. Conclusion Based on the FIGO staging, peripheral nerve invasion, tumor size, and months of postoperative HPV infection, the predictive model and nomogram for postoperative recurrence of usual-type cervical adenocarcinoma are precise and effective. More extensive stratified evaluations of the risk of cervical adenocarcinoma recurrence are still required, as is a thorough assessment of postoperative recurrence in the future.
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Affiliation(s)
| | | | - Qing Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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21
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Marshalek JP, Epistola R, Tomassetti S. Real-world treatment outcomes from a retrospective cohort of patients with acute myeloid leukemia from an urban safety net hospital. J Oncol Pharm Pract 2024:10781552231225398. [PMID: 38321873 DOI: 10.1177/10781552231225398] [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] [Indexed: 02/08/2024]
Abstract
INTRODUCTION While continual advancements in acute myeloid leukemia have augmented response rates and survival, outcomes in clinical trials may not correlate with real-world practice as trials may underrepresent individuals with comorbidities, decreased performance status, and older age. Additionally, clinical trials may underrepresent certain ethnicities, and disparities based on ethnicity, socioeconomic status, and insurance have been demonstrated in acute myeloid leukemia. METHODS We performed a retrospective chart review of adult patients with acute myeloid leukemia who were treated at Harbor-UCLA from 2014 to 2022 to examine patient characteristics, management patterns, and outcomes in a safety net hospital setting. RESULTS The median age was 56 years old (range 18-84). In regards to risk stratification, 22%, 33%, and 41% had favorable, intermediate, and adverse risk acute myeloid leukemia, respectively. The most common induction regimens included 7 + 3 (55%), azacitidine (10%), azacitidine + venetoclax (7%), and 7 + 3 + midostaurin (7%). The complete remission rate was 51%. Among patients who received intensive induction chemotherapy, 15% underwent re-induction with a second cycle, 51% received consolidation therapy, and 5% received maintenance therapy with a targeted agent. Overall, 12% of patients received allogeneic stem cell transplant. Median overall survival was 12.2 months, and 5-year overall survival was 18%. CONCLUSIONS Suboptimal response rates and survival in this population may be related to low rates of re-induction and allogeneic transplant in addition to high rates of adverse cytogenetics, secondary acute myeloid leukemia, and supportive care only. Efforts to increase access to clinical trials, novel therapies, and transplants for diverse and underinsured populations are essential.
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Affiliation(s)
- Joseph P Marshalek
- Division of Hematology/Oncology, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Raisa Epistola
- Division of Hematology/Oncology, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Sarah Tomassetti
- Division of Hematology/Oncology, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
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Walia A, Ani F, Maglaras C, Raman T, Fischer C. Resolution of Radiculopathy Following Indirect Versus Direct Decompression in Single Level Lumbar Fusion. Global Spine J 2024:21925682241230926. [PMID: 38315111 DOI: 10.1177/21925682241230926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
STUDY DESIGN Retrospective analysis. OBJECTIVES To evaluate resolution of radiculopathy in one-level lumbar fusion with indirect or direct decompression techniques. METHODS Patients ≥18 years of age with preoperative radiculopathy undergoing single-level lumbar fusion with up to 2-year follow-up were grouped by indirect and direct decompression. Direct decompression (DD) group included ALIF and LLIF with posterior DD procedure as well as all TLIF. Indirect decompression (ID) group included ALIF and LLIF without posterior DD procedure. Propensity score matching was used to control for intergroup differences in age. Intergroup outcomes were compared using means comparison tests. Logistic regressions were used to correlate decompression type with symptom resolution over time. Significance set at P < .05. RESULTS 116 patients were included: 58 direct decompression (DD) (mean 53.9y, 67.2% female) and 58 indirect decompression (ID) (mean 54.6y, 61.4% female). DD patients experienced greater blood loss than ID. Additionally, DD patients were 4.7 times more likely than ID patients to experience full resolution of radiculopathy at 3 months post-op. By 6 months, DD patients demonstrated larger reductions in VAS score. With regard to motor function, DD patients had improved motor score associated with the L5 dermatome at 6 months relative to ID patients. CONCLUSIONS Direct decompression was associated with greater resolution of radiculopathy in the near post-operative term, with no differences at long term follow-up when compared with indirect decompression. In particularly debilitated patients, these findings may influence surgeons to perform a direct decompression to achieve more rapid resolution of radiculopathy symptoms.
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Affiliation(s)
- Arnaav Walia
- NYU Langone Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Fares Ani
- NYU Langone Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Constance Maglaras
- NYU Langone Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Tina Raman
- NYU Langone Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Charla Fischer
- NYU Langone Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
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Bilello D, Townsend E, Broome MR, Burnett Heyes S. Friendship and self-harm: a retrospective qualitative study of young adults' experiences of supporting a friend who self-harmed during adolescence. Front Psychol 2024; 14:1221661. [PMID: 38370107 PMCID: PMC10869467 DOI: 10.3389/fpsyg.2023.1221661] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/11/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Self-harm amongst young people is becoming increasingly prevalent. Understanding, responding to, and supporting young people who self-harm is vital. Friends are typically the first and sometimes the only source of support sought by adolescents who self-harm. Despite their important role as confidants, friends' perspectives and experiences remain poorly understood. Methods We conducted retrospective qualitative semi-structured interviews, prompted by an adapted version of the Card Sort Task for Self-Harm (CaTS-FF), about the experiences of nine female young adults (18-20 years old) who supported a friend who self-harmed during adolescence. Data were analyzed using thematic analysis. Results Four themes were developed: (1) "I did not realize my friend was on the road to self-harm": Friends' reactions to self-harm; (2) "That's what friends do": the role of friends; (3) The impact of supporting a friend who self-harms; and (4) "They were quite formative years": reflecting on growth through the experience. Discussion The present findings highlight the complex experiences of young people supporting a friend who self-harms. Despite being willing to take on the role of a supporter, participants experienced a range of difficult emotions and consequences. The temporal transition running through the four themes reflects the evolving nature of participants' attitudes, knowledge, and friendships. Overall, results highlight the unmet needs of adolescents supporting young people who self-harm, as well as identifying potential pathways to "support the supporters" toward resilience.
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Affiliation(s)
- Delfina Bilello
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University Park, The University of Nottingham, Nottingham, United Kingdom
| | - Matthew R. Broome
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stephanie Burnett Heyes
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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24
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Schalleij JMCJ, van Schaardenburgh FE, Wörner E, Koenraadt-van Oost I, van Es EM, van Oirschot BAJA, Eygendaal D, The B. Smaller radioulnar window is associated with a distal biceps tendon rupture in patients with limited forearm rotation: a 3-dimensional computed tomography comparison study of proximal impingement caused by radial tuberosity hypertrophy-a single-center case series. J Shoulder Elbow Surg 2024; 33:373-380. [PMID: 37879599 DOI: 10.1016/j.jse.2023.09.020] [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: 02/28/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND It has been suggested that hypertrophy of the radial tuberosity may result in impingement leading to either a lesion of the distal biceps tendon or rotational impairment. Two previous studies on hypertrophy of the radial tuberosity had contradictory results and did not examine the distance between the radius and ulna: the radioulnar window. Therefore, this comparative cohort study aimed to investigate the radioulnar window in healthy subjects and compare it with that in subjects with either nontraumatic-onset rotational impairment of the forearm or nontraumatic-onset distal biceps tendon ruptures with rotational impairment of the forearm by use of dynamic 3-dimensional computed tomography measurements to attain a comprehensive understanding of the underlying etiology of distal biceps tendon ruptures. We hypothesized that a smaller radioulnar window would increase the risk of having a nontraumatic-onset distal biceps tendon rupture and/or rotational impairment compared with healthy individuals. METHODS This study measured the distance between the radius and ulna at the level of the radial tuberosity using entire-forearm computed tomography scans of 15 patients at the Amphia Hospital between 2019 and 2022. Measurements of healthy subjects were compared with those of subjects who had nontraumatic-onset rotational impairment of the forearm and subjects who had a nontraumatic-onset distal biceps tendon rupture with rotational impairment of the forearm. The Wilcoxon signed rank test was used for individual comparisons, and the Mann-Whitney U test was used for group comparisons. RESULTS A significant difference was found between the radioulnar window in the forearms of the subjects with a distal biceps tendon rupture (mean, 1.6 mm; standard deviation 0.2 mm) and the radioulnar window in the forearms of the healthy subjects (mean, 4.8 mm; standard deviation, 1.4 mm; P = .018). A trend toward smaller radioulnar windows in the rotational impairment groups was also observed, although it was not significant (P > .05). CONCLUSIONS The radioulnar window in the forearms of the subjects with a distal biceps tendon rupture with rotational impairment was significantly smaller than that in the forearms of the healthy subjects. Therefore, patients with a smaller radioulnar window have a higher risk of rupturing the distal biceps tendon. Nontraumatic-onset rotational impairment of the forearm may also be caused by a similar mechanism. Future studies are needed to further evaluate these findings.
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Affiliation(s)
- Jill M C J Schalleij
- Faculty of Health, Medicine and Lifestyle, Maastricht University, Maastricht, The Netherlands.
| | | | - Elisabeth Wörner
- Department of Orthopaedics, Reinier de Graaf Hospital, Delft, The Netherlands
| | | | - Eline M van Es
- Department of Orthopaedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Denise Eygendaal
- Department of Orthopaedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Bertram The
- Department of Orthopaedics, Amphia Hospital, Breda, The Netherlands
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Tsur N, Yosefof E, Dudkiewicz D, Edri N, Stern S, Shpitzer T, Mizrachi A, Najjar E. Foregoing elective neck dissection for elderly patients with oral cavity squamous cell carcinoma. ANZ J Surg 2024; 94:128-139. [PMID: 37811844 DOI: 10.1111/ans.18711] [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: 04/01/2023] [Revised: 08/29/2023] [Accepted: 09/16/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Elective neck dissection (END) improves outcomes among clinically node-negative patients with oral cavity squamous cell carcinoma (OCSCC). However, END is of questionable value, considering the potentially higher comorbidities and operative risks in elderly patients. METHODS A retrospective review of all patients older than 65 years of age who were treated for OCSCC at a tertiary care centre between 2005 and 2020 was conducted. RESULTS Fifty-three patients underwent primary tumour resection alone, and 71 had simultaneous END. Most primary tumours were located on the mobile tongue. The patients who did not undergo END had a higher mean age (81.2 vs. 75.1 years, P < 0.00001), significantly shorter surgeries, and shorter hospitalizations. Occult cervical metastases were found in 24% of the patients who underwent END. The two groups showed no significant differences in overall survival or recurrence rates. Similar results were shown in a subpopulation analysis of patients older than 75 years. CONCLUSION Foregoing END in elderly patients with no clinical evidence of neck metastases did not result in lower survival rates or higher recurrence rates.
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Affiliation(s)
- Nir Tsur
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Yosefof
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dean Dudkiewicz
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nofar Edri
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sagit Stern
- Hadassah University Hospital, Otolaryngology / Head & Neck Surgery, Jerusalem, Israel
| | - Thomas Shpitzer
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Esmat Najjar
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Timm MJ, Robertson CL, Zhand N. Mortality Rate and Causes of Death in a Canadian Tertiary Schizophrenia Program. Can J Psychiatry 2024; 69:138-139. [PMID: 37537872 PMCID: PMC10789225 DOI: 10.1177/07067437231193887] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Makenna J. Timm
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Carrie L. Robertson
- Schizophrenia Recovery Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Naista Zhand
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Schizophrenia Recovery Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
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Knapp B, Govindan A, Patel SS, Pepin K, Wu N, Devarakonda S, Buchowski JM. Outcomes in Patients with Spinal Metastases Managed with Surgical Intervention. Cancers (Basel) 2024; 16:438. [PMID: 38275879 PMCID: PMC10813971 DOI: 10.3390/cancers16020438] [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] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Spinal metastases are a significant cause of morbidity in patients with advanced cancer, and management often requires surgical intervention. Although prior studies have identified factors that influence outcomes with surgery, the ability of these factors to predict outcomes remains unclear in the era of contemporary therapies, and there is a need to better identify patients who are likely to benefit from surgery. METHODS We performed a single-center, retrospective analysis to evaluate risk factors for poor outcomes in patients with spinal metastases treated with surgery. The primary outcome was mortality at 180 days. RESULTS A total of 128 patients were identified. Age ≥ 65 years at surgery (p = 0.0316), presence of extraspinal metastases (p = 0.0110), and ECOG performance scores >1 (p = 0.0397) were associated with mortality at 180 days on multivariate analysis. These factors and BMI ≤ 30 mg/kg2 (p = 0.0008) were also associated with worse overall survival. CONCLUSIONS Age > 65, extraspinal metastases, and performance status scores >1 are factors associated with mortality at 180 days in patients with spinal metastases treated with surgery. Patients with these factors and BMI ≤ 30 mg/kg2 had worse overall survival. Our results support multidisciplinary discussions regarding the benefits and risks associated with surgery in patients with these risk factors.
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Affiliation(s)
- Brendan Knapp
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA; (B.K.)
| | - Ashwin Govindan
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA; (B.K.)
| | - Shalin S. Patel
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kymberlie Pepin
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA; (B.K.)
| | - Ningying Wu
- Biostatistics Shared Resource, Division of Public Health Sciences, Department of Surgery, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Siddhartha Devarakonda
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA; (B.K.)
| | - Jacob M. Buchowski
- Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
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Fuster-Casanovas A, Miró Catalina Q, Vidal-Alaball J, Escalé-Besa A, Carrión C. eHealth in the Management of Depressive Episodes in Catalonia's Primary Care From 2017 to 2022: Retrospective Observational Study. JMIR Ment Health 2024; 11:e52816. [PMID: 38236631 PMCID: PMC10835588 DOI: 10.2196/52816] [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: 09/16/2023] [Revised: 12/12/2023] [Accepted: 12/28/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The reasons for mental health consultations are becoming increasingly relevant in primary care. The Catalan health care system is undergoing a process of digital transformation, where eHealth is becoming increasingly relevant in routine clinical practice. OBJECTIVE This study aimed to analyze the approach to depressive episodes and the role of eHealth in the Catalan health care system from 2017 to 2022. METHODS A retrospective observational study was conducted on diagnostic codes related to depressive episodes and mood disorders between 2017 and 2022 using data from the Catalan Institute of Health. The sociodemographic evolution and prevalence of depression and mood disorders in Catalonia were analyzed between 2017 and 2022. Sociodemographic variables were analyzed using absolute frequency and percentage. The prevalence of depressive episodes was calculated, highlighting the year-to-year changes. The use of eHealth for related consultations was assessed by comparing the percentages of eHealth and face-to-face consultations. A comparison of sociodemographic variables based on attendance type was conducted. Additionally, a logistic regression model was used to explore factors influencing face-to-face attendance. The analysis used R software (version 4.2.1), with all differences examined using 95% CIs. RESULTS From 2017 to 2022, there was an 86.6% increase in the prevalence of depression and mood disorders, with women consistently more affected (20,950/31,197, 67.2% in 2017 and 22,078/33,169, 66.6% in 2022). In 2022, a significant rise in depression diagnoses was observed in rural areas (difference 0.71%, 95% CI 0.04%-1.43%), contrasting with a significant decrease in urban settings (difference -0.7%, 95% CI -1.35% to -0.05%). There was a significant increase in antidepressant use in 2022 compared to 2017 (difference 2.4%, 95% CI 1.87%-3.06%) and the proportion of eHealth visits rose from 4.34% (1240/28,561) in 2017 to 26.3% (8501/32,267) in 2022. Logistic regression analysis indicated that men (odds ratio [OR] 1.06, 95% CI 1.04-1.09) and younger individuals had a higher likelihood of eHealth consultations in 2022. Furthermore, individuals using eHealth consultations were more likely to use antidepressants (OR 1.54, 95% CI 1.50-1.57) and anxiolytics (OR 1.06, 95% CI 1.03-1.09). CONCLUSIONS The prevalence of depression in Catalonia has significantly increased in the last 6 years, likely influenced by the COVID-19 pandemic. Despite ongoing digital transformation since 2011, eHealth usage remained limited as of 2017. During the lockdown period, eHealth accounted for nearly half of all health care consultations, representing a quarter of consultations by 2022. In the immediate aftermath of the COVID-19 pandemic, emerging evidence suggests a significant role of eHealth in managing depression-related consultations, along with an apparent likelihood of patients being prescribed antidepressants and anxiolytics. Further research is needed to understand the long-term impact of eHealth on diagnostic practices and medication use.
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Affiliation(s)
- Aïna Fuster-Casanovas
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya, Barcelona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Faculty of Medicine, University of Vic-Central, University of Catalonia, Vic, Spain
| | - Anna Escalé-Besa
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Faculty of Medicine, University of Vic-Central, University of Catalonia, Vic, Spain
| | - Carme Carrión
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya, Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion, Barcelona, Spain
- School of Medicine, Universitat de Girona, Girona, Spain
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Patel P, Richard I, Filice G, Nikiforov I, Kata P, Kanukuntla AK, Okere A, Hollenbeak CS, Cheriyath P. Cardiac Catheterization and Outcomes for Elderly Patients Hospitalized With Heart Failure. Health Serv Insights 2024; 17:11786329231224616. [PMID: 38250651 PMCID: PMC10798072 DOI: 10.1177/11786329231224616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/28/2023] [Indexed: 01/23/2024] Open
Abstract
Background Heart failure affects over 6 million people in the United States (US) with limited evidence to support the use of cardiac catheterization. The benefit of its use remains mostly as expert opinion. This study intends to assess the benefits and risks of cardiac catheterization in elderly patients admitted for heart failure. Methods This was a retrospective study using data from the National Inpatient Sample, including admissions 65 years and older hospitalized for heart failure, between 2008 and 2016. The outcomes analyzed were in-hospital mortality, total hospital costs, and length of stay. Results After controlling for covariates, cardiac catheterization was found to have a protective association with mortality (OR 0.87, 95% CI 0.833-0.912, P < .0001), an increased hospital length of stay by 2.88 days (95% CI: 2.84-2.92 days, P < .0001) and approximately $16 255 increase in cost. Conclusions Cardiac catheterization was associated with decreased in-hospital mortality, longer length of stay and higher total costs in admissions with heart failure aged 65 years or older.
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Affiliation(s)
- Palak Patel
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | - Ivan Richard
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | - Giuseppe Filice
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | - Ivan Nikiforov
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | - Priyaranjan Kata
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | | | - Arthur Okere
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
| | - Christopher S Hollenbeak
- Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Pramil Cheriyath
- Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA
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30
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Pedersen J, Jarløv AE, Rasmussen ÅK, Stochholm K. Incidence, Treatment, and Survival of Adrenocortical Carcinoma in Denmark 2003-2019. J Endocr Soc 2024; 8:bvae012. [PMID: 38370442 PMCID: PMC10872687 DOI: 10.1210/jendso/bvae012] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Indexed: 02/20/2024] Open
Abstract
Objectives Adrenocortical carcinoma (ACC) is a malignant tumor originating from the adrenal cortex. The aim of the study was to report the incidence of ACC and survival of ACC in Denmark. The secondary objective was to describe the impact of treatment with mitotane on survival. Design Retrospective population study of patients diagnosed with ACC between 2003 and 2019 in Denmark. Methods Individuals at risk for ACC were identified in the national Danish Health registries, and diagnosis of ACC was confirmed by review of the health records. Data on demographics, presentation, treatment, recurrence, and death was evaluated. Results 138 patients were included in the study with more females (59.4%) than males (40.6%). Incidence rate was 1.4 per million per year. The incidence rate ratio significantly increased only in females by 1.06 [95% confidence interval (CI): 1.02-1.12] per year. Overall median survival was 1.93 (95% CI: 1.24-3.00) years with no differences between males and females. The proportion of patients treated with mitotane (either as adjuvant treatment or as part of a chemotherapeutic regime) was 72.3%. Survival was significantly decreased in women not treated with mitotane compared to women treated with mitotane (either as adjuvant or as part of a chemotherapeutic regime) hazards ratio .30 (95% CI: .10-.89), adjusted for European Network for the Study of Adrenal Tumours score, age at diagnosis, and year of diagnosis, but survival was unaffected by mitotane treatment in men. Conclusion Incidence of ACC in Denmark was 1.4 per million per year and increased in women but not in males during the study period 2003-2019.
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Affiliation(s)
- Jens Pedersen
- Department of Medicine, Division of Endocrinology, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Anne Elisabeth Jarløv
- Department of Endocrinology and Metabolism, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Åse Krogh Rasmussen
- Department of Endocrinology and Metabolism, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, 8200 Aarhus, Denmark
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31
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Kerman IA, Glover ME, Lin Y, West JL, Hanlon AL, Kablinger AS, Clinton SM. Antibiotic exposure is associated with decreased risk of psychiatric disorders. Front Pharmacol 2024; 14:1290052. [PMID: 38259293 PMCID: PMC10801048 DOI: 10.3389/fphar.2023.1290052] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/01/2023] [Indexed: 01/24/2024] Open
Abstract
Objective: This study sought to investigate the relationship between antibiotic exposure and subsequent risk of psychiatric disorders. Methods: This retrospective cohort study used a national database of 69 million patients from 54 large healthcare organizations. We identified a cohort of 20,214 (42.5% male; 57.9 ± 15.1 years old [mean ± SD]) adults without prior neuropsychiatric diagnoses who received antibiotics during hospitalization. Matched controls included 41,555 (39.6% male; 57.3 ± 15.5 years old) hospitalized adults without antibiotic exposure. The two cohorts were balanced for potential confounders, including demographics and variables with potential to affect: the microbiome, mental health, medical comorbidity, and overall health status. Data were stratified by age and by sex, and outcome measures were assessed starting 6 months after hospital discharge. Results: Antibiotic exposure was consistently associated with a significant decrease in the risk of novel mood disorders and anxiety and stressor-related disorders in: men (mood (OR 0.84, 95% CI 0.77, 0.91), anxiety (OR 0.88, 95% CI 0.82, 0.95), women (mood (OR 0.94, 95% CI 0.89,1.00), anxiety (OR 0.93, 95% CI 0.88, 0.98), those who are 26-49 years old (mood (OR 0.87, 95% CI 0.80, 0.94), anxiety (OR 0.90, 95% CI 0.84, 0.97)), and in those ≥50 years old (mood (OR 0.91, 95% CI 0.86, 0.97), anxiety (OR 0.92, 95% CI 0.87, 0.97). Risk of intentional harm and suicidality was decreased in men (OR 0.73, 95% CI 0.55, 0.98) and in those ≥50 years old (OR 0.67, 95% CI 0.49, 0.92). Risk of psychotic disorders was also decreased in subjects ≥50 years old (OR 0.83, 95 CI: 0.69, 0.99). Conclusion: Use of antibiotics in the inpatient setting is associated with protective effects against multiple psychiatric outcomes in an age- and sex-dependent manner.
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Affiliation(s)
- Ilan A. Kerman
- Mental Health Integrated Care Community, Minneapolis Veterans Administration Health Care System, Minneapolis, MN, United States
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Matthew E. Glover
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Yezhe Lin
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carillion School of Medicine, Roanoke, VA, United States
- Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, Tongji University, Shanghai, China
- Department of Psychiatry, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jennifer L. West
- Department of Statistics and Center for Biostatistics and Health Data Science, Virginia Tech, Blacksburg, VA, United States
| | - Alexandra L. Hanlon
- Department of Statistics and Center for Biostatistics and Health Data Science, Virginia Tech, Blacksburg, VA, United States
| | - Anita S. Kablinger
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carillion School of Medicine, Roanoke, VA, United States
| | - Sarah M. Clinton
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
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32
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Zhao J, Zeng L, Liang G, Luo M, Yang W, Liu J, Pan J. Risk factors for symptomatic rotator cuff tears: a retrospective case-control study. Front Med (Lausanne) 2024; 10:1321939. [PMID: 38239617 PMCID: PMC10794627 DOI: 10.3389/fmed.2023.1321939] [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: 10/17/2023] [Accepted: 12/14/2023] [Indexed: 01/22/2024] Open
Abstract
Background The incidence and diagnostic rate of rotator cuff tears (RCTs) have increased significantly. The purpose of this study was to investigate and analyze the risk factors for symptomatic RCTs to provide a basis for their prevention and treatment. Methods We retrospectively analyzed the relevant clinical indicators of 193 randomized clinical trial (RCT) patients and 161 non-RCT patients hospitalized with shoulder pain as the main complaint from January 1, 2017, to August 31, 2021. Univariate analysis and multivariate logistic regression analysis were used to analyze the differences in potential risk factors between the two groups. Results Univariate analysis revealed that age (p < 0.001), body mass index (BMI) (p = 0.036), hypertension (p < 0.001), coronary heart disease (p = 0.028), history of shoulder trauma (p < 0.001), hyperlipidemia (p = 0.025), type III acromion (p = 0.012) and critical shoulder angle (CSA) (p < 0.001) increased the risk of RCTs. Multivariate logistic regression analysis revealed that age ≥ 60 years (OR = 2.61, 95% CI = 1.23 to 5.12), CSA ≥ 35° (OR = 4.24, 95% CI = 1.60 to 11.22), hypertension (OR = 2.34, 95% CI = 1.33 to 4.11) and history of shoulder trauma (OR = 5.20, 95% CI = 2.87 to 9.45) were independent risk factors for symptomatic RCTs. Conclusion The results of this study showed that age ≥ 60 years, CSA ≥35°, hypertension and history of shoulder trauma are independent risk factors for symptomatic RCTs and can provide directions for further development of prevention and treatment strategies. Future studies need to clarify the mechanism underlying the association between these risk factors and symptomatic RCTs.
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Affiliation(s)
- Jinlong Zhao
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Lingfeng Zeng
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Guihong Liang
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Minghui Luo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Weiyi Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Jun Liu
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, China
| | - Jianke Pan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China
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Shah VK, English JC. Store-and-forward inpatient teledermatology improves care for hospitalized patients with bullous eruptions after a primary inpatient team consultation: A retrospective study. J Am Acad Dermatol 2024; 90:174-177. [PMID: 37714217 DOI: 10.1016/j.jaad.2023.08.090] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Vrusha K Shah
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Joseph C English
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Alkabbani SS, AlHalak RH, Al Smady MN, Alsaraj F. The epidemiology of acute pancreatitis in a tertiary care hospital in Dubai. Ann Afr Med 2024; 23:36-39. [PMID: 38358169 PMCID: PMC10922180 DOI: 10.4103/aam.aam_107_23] [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: 07/05/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 02/16/2024] Open
Abstract
Background The prevalence of acute pancreatitis is rising especially in the Western world, but the prevalence remains unknown in most Middle Eastern Countries. Acute pancreatitis has been attributed with multiple etiologies with the two most common being alcohol abuse disorder and gallstones. The incidence and prevalence of it in the United Arab Emirates are yet to be reported. Materials and Methods The Atlanta criteria were used for the diagnosis of acute pancreatitis and applied to patients that have been admitted to a single tertiary center in the year 2021. Several variables were investigated including gender, age, clinical presentation, etiology, radiological and laboratory results, complications, and outcome. Moreover, the Bedside Index for Severity in Acute Pancreatitis score was used to assess and determine the severity of acute pancreatitis in these patients. Results Nineteen patients were identified in our database with 52% being males. The mean age of patients was 41 years. The most frequent presentation was abdominal pain in 100% of our patients. Moreover, the most common etiology identified was idiopathic (52.63%), followed by biliary (21.05%). The mortality rate was 0%. Conclusion This is the first retrospective study in Dubai on acute pancreatitis. Pancreatitis is a life-threatening condition with multiple etiologies. Physicians should consider multifactorial acute pancreatitis in patients with different comorbidities.
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Affiliation(s)
- Sarah S. Alkabbani
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Rouzy H. AlHalak
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Montaser N. Al Smady
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Fuad Alsaraj
- Department of Endocrinology, Mediclinic Parkview Hospital, Dubai, UAE
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35
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Wu L, Zhang J, Zhang HM, Wang CY. Study on red blood cell distribution width in children with severe Mycoplasma pneumoniae pneumonia. Biomark Med 2024; 18:69-77. [PMID: 38440878 DOI: 10.2217/bmm-2023-0671] [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] [Indexed: 03/06/2024] Open
Abstract
Background: This study aimed to investigate the clinical value of the red blood cell distribution width (RDW) in severe Mycoplasma pneumoniae pneumonia (MPP). Methods: A total of 185 children with diagnosed severe MPP were included. The patients' case records and laboratory examination data were analyzed retrospectively. The children were grouped into quartiles based on RDW. Results: Univariate analysis revealed that RDW was significantly correlated with the Pediatric Risk of Mortality (PRISM) III score, Sepsis-Related Organ Failure Assessment score, incidence of invasive intubation and 30-day in-hospital mortality. After adjustment for the severity of illness, multivariate analysis revealed that the PRISM III score and RDW were factors independently associated with 30-day in-hospital mortality. Conclusion: This study revealed that RDW could be correlated with the long-term prognosis and severity of severe MPP.
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Affiliation(s)
- Lin Wu
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Jinyan Zhang
- College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Hui-Min Zhang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Cheng-Yi Wang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
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Hu Y, Zhang Z, Wang F, Qiu X. Comparison of modified tumescent and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective clinical study. J Int Med Res 2024; 52:3000605231220789. [PMID: 38242865 PMCID: PMC10799600 DOI: 10.1177/03000605231220789] [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: 08/27/2023] [Accepted: 11/23/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair poses certain challenges to less experienced surgeons. This study was performed to compare the clinical outcomes of modified tumescent laparoscopic TAPP (MT-TAPP) inguinal hernia repair versus conventional laparoscopic TAPP (CL-TAPP) inguinal hernia repair. METHODS We retrospectively analyzed the perioperative data of patients with inguinal hernias who underwent either MT-TAPP repair (n = 57) or CL-TAPP repair (n = 54) at the General Surgery Department of Nanjing Yimin Hospital from November 2019 to June 2023. RESULTS The durations of the total operation and the preperitoneal space dissection were shorter in the MT-TAPP than CL-TAPP group. The estimated blood loss volume was lower in the MT-TAPP than CL-TAPP group. The visual analogue scale scores recorded at the 12- and 24-hour postoperative time points showed significantly greater reductions in the MT-TAPP than CL-TAPP group. CONCLUSIONS Using liquid injection and gauze dissection is both safe and practical. This technique results in a shortened total operation time, less time spent on preperitoneal space dissection, decreased estimated blood loss, and less severe postoperative pain.
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Affiliation(s)
- Yilong Hu
- Department of General Surgery, Nanjing Yimin Hospital, Nanjing, China
| | - Zhengwei Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Xinghua People’s Hospital, Yangzhou University, Taizhou, China
| | - Feng Wang
- Department of General Surgery, Nanjing Yimin Hospital, Nanjing, China
| | - Xiewu Qiu
- Department of General Surgery, Nanjing Yimin Hospital, Nanjing, China
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De Braud F, Deschler-Baier B, Morris JC, Worden F, Han Y, Kiiskinen U, Jen MH, Barker SS, Szymczak S, Gilligan AM. Comparative Effectiveness of First-Line Selpercatinib versus Standard Therapies in Patients with RET-Activated Cancers: An Exploratory Interpatient Analysis of LIBRETTO-001. Cancers (Basel) 2023; 16:140. [PMID: 38201566 PMCID: PMC10778524 DOI: 10.3390/cancers16010140] [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: 12/02/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Selpercatinib is indicated for locally advanced/metastatic RET-activated solid tumors after progression or following prior systemic therapies. Until the recently published data from LIBRETTO-431 and LIBRETTO-531, there were limited effectiveness data comparing selpercatinib with other first-line treatments in RET-activated non-small cell lung cancer (NSCLC), medullary thyroid cancer (MTC), and thyroid cancer (TC). This study analyzed patient data from LIBRETTO-001 and compared the outcomes (time to treatment discontinuation {TTD}, time to next treatment or death {TTNT-D}, time to progression {TTP}, and the objective response rate {ORR}) of first-line selpercatinib (selpercatinib arm) use with the outcomes of first-line standard therapies in patients who then received selpercatinib in later lines of treatment (comparator arm). Overall, the first-line selpercatinib arm had a longer TTD, TTNT-D, and TTP versus the first-line comparator arm. The hazard ratios (HRs) for TTD were 0.29 (NSCLC), 0.15 (MTC), 0.08 (TC); for TTNT-D, the HRs were 0.48 (NSCLC), 0.11 (MTC), 0.09 (TC); and for TTP, the HRs were 0.54 (NSCLC), 0.15 (MTC), and 0.12 (TC). The ORR was higher for first-line selpercatinib versus the first-line comparator (NSCLC: 85.3% vs. 39.7%; MTC: 82.6% vs. 15.2%; and TC: 81.8% vs. 31.8%). First-line selpercatinib use is associated with improved outcomes compared to first-line comparator therapies for patients with advanced/metastatic RET-activated cancers.
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Affiliation(s)
- Filippo De Braud
- Department of Oncology and Hematology-Oncology, University of Milan, 20133 Milan, Italy;
| | | | - John C. Morris
- Department of Endocrinology, The Mayo Clinic, Rochester, MN 55905, USA;
| | - Francis Worden
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48105, USA;
| | - Yimei Han
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
| | - Urpo Kiiskinen
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
| | - Min-Hua Jen
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
| | - Scott S. Barker
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
| | - Sylwia Szymczak
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
| | - Adrienne M. Gilligan
- Value Evidence Outcomes, Eli Lilly and Company, Indianapolis, IN 46285, USA; (Y.H.); (U.K.); (M.-H.J.); (S.S.B.); (S.S.)
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Shenk CE, Shores KA, Ram N, Felt JM, Chimed-Ochir U, Olson AE, Fisher ZF. Contamination in Observational Research on Child Maltreatment: A Conceptual and Empirical Review With Implications for Future Research. Child Maltreat 2023:10775595231224472. [PMID: 38146950 DOI: 10.1177/10775595231224472] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Contamination is a methodological phenomenon occurring in child maltreatment research when individuals in an established comparison condition have, in reality, been exposed to maltreatment during childhood. The current paper: (1) provides a conceptual and methodological introduction to contamination in child maltreatment research, (2) reviews the empirical literature demonstrating that the presence of contamination biases causal estimates in both prospective and retrospective cohort studies of child maltreatment effects, (3) outlines a dual measurement strategy for how child maltreatment researchers can address contamination, and (4) describes modern statistical methods for generating causal estimates in child maltreatment research after contamination is controlled. Our goal is to introduce the issue of contamination to researchers examining the effects of child maltreatment in an effort to improve the precision and replication of causal estimates that ultimately inform scientific and clinical decision-making as well as public policy.
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Affiliation(s)
- Chad E Shenk
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Kenneth A Shores
- School of Education, The University of Delaware, Newark, DE, USA
| | - Nilam Ram
- Department of Communications, Stanford University, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - John M Felt
- The Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - Ulziimaa Chimed-Ochir
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Anneke E Olson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Zachary F Fisher
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Miranda KU, DeAntonio R, Norero X, Estripeaut D. The impact of varicella vaccination: A 2005-2019 interrupted time series analysis. Hum Vaccin Immunother 2023; 19:2278927. [PMID: 38175951 PMCID: PMC10760379 DOI: 10.1080/21645515.2023.2278927] [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: 07/21/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
Varicella is an acute, highly contagious disease in susceptible individuals and is preventable through vaccination. This study aimed to determine the impact of varicella vaccination on hospitalizations and complications at a pediatric reference hospital in Panama before and after the vaccine introduction. This descriptive ecological study analyzed clinical records of patients diagnosed with varicella through a retrospective and interrupted time series analysis. An autoregressive integrated moving average model was built to compare the incidence rates observed after vaccination with those expected rates derived from the model. A statistical model was fitted to the observed interrupted time series data by regression and used to predict future trends. The mean difference in varicella hospital discharges before and after the introduction of the varicella vaccine was 47%. The rate of hospitalizations for varicella decreased to 52.3%. A declining trend in varicella hospitalizations was observed from 2015 after vaccine introduction in 2014. Complications in vaccinated patients were secondary skin and soft tissue infection, possibly due to bacterial superinfection. The impact of varicella vaccination on reducing varicella hospital discharges reported at a pediatric reference hospital in Panama was confirmed.
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Affiliation(s)
- Katherina U. Miranda
- Pediatric Infectious Diseases, Hospital José Domingo de Obaldía, PanamaCity, Panama
| | - Rodrigo DeAntonio
- Epidemiology and Public Health, Centro de Investigación Cevaxin The Panama Clinic, PanamaCity, Panama
| | - Ximena Norero
- Pediatric Infectious Diseases, Hospital del Niño José Renán Esquivel, PanamaCity, Panama
| | - Dora Estripeaut
- Pediatric Infectious Diseases, Hospital del Niño José Renán Esquivel, PanamaCity, Panama
- Sistema Nacional de Investigación (SNI) SENACYT, Ciudad de Panamá, Panamá
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Abbott EE, Oh W, Dai Y, Feuer C, Chan L, Carr BG, Nadkarni GN. Joint Modeling of Social Determinants and Clinical Factors to Define Subphenotypes in Out-of-Hospital Cardiac Arrest Survival: Cluster Analysis. JMIR Aging 2023; 6:e51844. [PMID: 38059569 PMCID: PMC10721134 DOI: 10.2196/51844] [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] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 12/08/2023] Open
Abstract
Background Machine learning clustering offers an unbiased approach to better understand the interactions of complex social and clinical variables via integrative subphenotypes, an approach not studied in out-of-hospital cardiac arrest (OHCA). Objective We conducted a cluster analysis for a cohort of OHCA survivors to examine the association of clinical and social factors for mortality at 1 year. Methods We used a retrospective observational OHCA cohort identified from Medicare claims data, including area-level social determinants of health (SDOH) features and hospital-level data sets. We applied k-means clustering algorithms to identify subphenotypes of beneficiaries who had survived an OHCA and examined associations of outcomes by subphenotype. Results We identified 27,028 unique beneficiaries who survived to discharge after OHCA. We derived 4 distinct subphenotypes. Subphenotype 1 included a distribution of more urban, female, and Black beneficiaries with the least robust area-level SDOH measures and the highest 1-year mortality (2375/4417, 53.8%). Subphenotype 2 was characterized by a greater distribution of male, White beneficiaries and had the strongest zip code-level SDOH measures, with 1-year mortality at 49.9% (4577/9165). Subphenotype 3 had the highest rates of cardiac catheterization at 34.7% (1342/3866) and the greatest distribution with a driving distance to the index OHCA hospital from their primary residence >16.1 km at 85.4% (8179/9580); more were also discharged to a skilled nursing facility after index hospitalization. Subphenotype 4 had moderate median household income at US $51,659.50 (IQR US $41,295 to $67,081) and moderate to high median unemployment at 5.5% (IQR 4.2%-7.1%), with the lowest 1-year mortality (1207/3866, 31.2%). Joint modeling of these features demonstrated an increased hazard of death for subphenotypes 1 to 3 but not for subphenotype 4 when compared to reference. Conclusions We identified 4 distinct subphenotypes with differences in outcomes by clinical and area-level SDOH features for OHCA. Further work is needed to determine if individual or other SDOH domains are specifically tied to long-term survival after OHCA.
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Affiliation(s)
- Ethan E Abbott
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Division of Data-Driven and Digital Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Wonsuk Oh
- Division of Data-Driven and Digital Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Yang Dai
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Cole Feuer
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Lili Chan
- Division of Data-Driven and Digital Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Brendan G Carr
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
| | - Girish N Nadkarni
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Division of Data-Driven and Digital Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New YorkNY, United States
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Kribs CM, van den Driessche P. Honoring the life and legacy of Fred Brauer. J Biol Dyn 2023; 17:2285096. [PMID: 37988036 DOI: 10.1080/17513758.2023.2285096] [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: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
The work of Fred Brauer (1932-2021) broke new ground in several areas of mathematical population biology, especially mathematical epidemiology and population management. This special issue reflects his legacy: the lines of inquiry he opened, the impact of his research and his books, and his mentoring of generations of young researchers. This dedication highlights milestones in his career and connects his work to the contributions in this issue.
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Affiliation(s)
- Christopher M Kribs
- Departments of Mathematics and Curriculum & Instruction, University of Texas at Arlington, Arlington, TX, USA
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Hansen KH, Johansen JS, Urbanska EM, Meldgaard P, Hjorth-Hansen P, Kristiansen C, Stelmach M, Santoni-Rugiu E, Ulhøi MP, Dydensborg AB, Dünweber C, Andersen JL. Clinical outcomes of ALK+ non-small cell lung cancer in Denmark. Acta Oncol 2023; 62:1775-1783. [PMID: 37815923 DOI: 10.1080/0284186x.2023.2263153] [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: 07/19/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Real-world clinical outcomes of anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) patients vary. This study aimed to investigate the treatment and clinical outcomes of all ALK+ NSCLC patients in Denmark in the period 2011-2018, regardless of disease stage. MATERIALS AND METHODS A national pathology database with complete coverage was used to identify ALK+ NSCLC patients diagnosed between 2011 and 2018. Clinical data were obtained through retrospective chart reviews. Overall survival (OS) and duration of treatment (DOT) were analyzed using Kaplan-Meier methodologies. RESULTS A total of 209 ALK+ NSCLC patients were included. The cohort had a slight overrepresentation of female patients (56.5%) with a mean age of 61.6 years. Most patients were adenocarcinoma cases (97%) and presented with an ECOG performance status of 0-1 (79%). Stage IIIb-IVb patients comprised 70% of the cohort. The use of ALK-tyrosine kinase inhibitors (TKIs) as first-line treatment increased over time, with the 1st generation ALK-TKI crizotinib being the predominant treatment in the 1st line. In 1st line treatment, 2nd generation ALK-TKIs had a median DOT more than twice the median DOT of crizotinib (25.1 and 9.1 months, respectively). The median OS for the entire cohort was 44.0 months. Patients with stage I-IIIA disease had a median OS that had not been reached, while those with stage IIIb-IVb disease had a median OS of 31.8 months. Patients with stage IIIb-IVb disease receiving an ALK-TKI as 1st line treatment had a median OS of 42.5 months with immature follow-up. Brain metastases at diagnosis or choice of 1st line treatment did not statistically significantly impact OS. CONCLUSION This study gives insights into the treatment and outcome of ALK+ NSCLC patients in Denmark and provides a real-world confirmation of the superior disease control provided by 2nd generation ALK-TKIs as compared to the 1st generation ALK-TKI crizotinib.
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Affiliation(s)
| | | | - Edyta Maria Urbanska
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Meldgaard
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Charlotte Kristiansen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | | | - Eric Santoni-Rugiu
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Schmidl D, Hommer N, Hommer A. An Exploratory Retrospective Data Analysis Comparing the Outcomes of Selective Laser Trabeculoplasty and Argon Laser Trabeculoplasty in Patients with Open-Angle Glaucoma or Ocular Hypertension in Vienna, Austria, from the Year 2012 to 2022. Medicina (Kaunas) 2023; 59:2075. [PMID: 38138178 PMCID: PMC10744835 DOI: 10.3390/medicina59122075] [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] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The aim of the present study was to compare the short-term outcomes of selective laser trabeculoplasty (SLT) with argon laser trabeculoplasty (ALT) in patients with glaucoma in a real-world setting. Materials and Methods: The present study was conducted as a retrospective case-control study. The main outcome was the change in intraocular pressure (IOP) three months after laser surgery. In addition, the number of substances used for lowering of IOP and adverse events (AEs) were assessed. Results: Charts from 25 patients were included in the present study, of which 12 had received ALT and 13 SLT. In both groups, IOP significantly decreased from baseline values 6 weeks and 3 months after laser treatment (p < 0.01 vs. baseline at each timepoint for both groups). While after 6 weeks, no difference between groups was found, after 3 months, the decrease in IOP was significantly more pronounced in the SLT group (-26 ± 21% in the ALT group vs. -41 ± 14% in the SLT group, p = 0.018 between groups, ANOVA). Three months after laser treatment, the number of IOP-lowering substances used by each patient had decreased with no difference between groups (ALT: from 2.7 ± 0.8 to 2.3 ± 0.9 substances; SLT: from 1.8 ± 1.2 to 1.3 ± 1.1 substances, p = 0.386). Only a few AEs were observed. Two patients in the ALT and one patient in the SLT group required trabeculectomy within 1 year after laser treatment due to IOP decompensation. Conclusions: In the present study, SLT was at least as effective as ALT with fewer AEs and a similar reduction in concomitant IOP-lowering medication.
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Affiliation(s)
- Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (N.H.)
| | - Nikolaus Hommer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (N.H.)
- Hommer Ophthalmology Institute, Albertgasse 39, 1080 Vienna, Austria
- Department of Ophthalmology, Hanusch Hospital, 1140 Vienna, Austria
| | - Anton Hommer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (N.H.)
- Hommer Ophthalmology Institute, Albertgasse 39, 1080 Vienna, Austria
- Department of Ophthalmology, Hera Hospital, 1090 Vienna, Austria
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Gadelha M, Marques NV, Fialho C, Scaf C, Lamback E, Antunes X, Santos E, Magalhães J, Wildemberg LE. Long-term Efficacy and Safety of Pasireotide in Patients With Acromegaly: 14 Years of Single-Center Real-World Experience. J Clin Endocrinol Metab 2023; 108:e1571-e1579. [PMID: 37357993 PMCID: PMC10655523 DOI: 10.1210/clinem/dgad378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 04/26/2023] [Revised: 05/31/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023]
Abstract
CONTEXT Acromegaly is a rare, chronic, debilitating disorder caused by prolonged hypersecretion of growth hormone (GH) and overproduction of insulin-like growth factor I (IGF-I). Medical therapies, including the somatostatin receptor ligand (SRL) pasireotide, are frequently used to restore biochemical control. OBJECTIVE As patients often receive therapy over prolonged periods, long-term data from real-life settings are needed. METHODS A retrospective analysis was performed using a prospectively maintained database of all patients with acromegaly from our primary care center who were enrolled in clinical studies with pasireotide (first visit November 2008). The main outcome measures were safety and biochemical control (age-adjusted IGF-I ≤ upper limit of normal). RESULTS Patients (n = 50) entered 4 parental studies and 30 continued in the rollover; at data cutoff (June 2022), 27 were still receiving pasireotide. Overall, median (range) exposure was 58 (3-137) months. Normal IGF-I was achieved in 54%, and acromegaly symptoms and quality of life were improved with treatment. No predictors of pasireotide response were identified; however, controlled patients had smaller tumors and lower GH at baseline. Tumor volume reduction occurred in 63% of evaluable patients (n = 10/16). Most patients presented hyperglycemic events, including 63.2% of patients with normal glucose before treatment. Older patients and those with higher IGF-I, glucose, and HbA1c at baseline had higher glucose and HbA1c during pasireotide treatment. CONCLUSION Pasireotide provided clinical benefit and was well tolerated for more than 11 years of treatment in acromegaly patients, most of whom were resistant to first-generation SRLs.
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Affiliation(s)
- Mônica Gadelha
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Nelma Verônica Marques
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Christhiane Fialho
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Cristiane Scaf
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Elisa Lamback
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Ximene Antunes
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Erica Santos
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Jaqueline Magalhães
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Luiz Eduardo Wildemberg
- Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
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Tseng YW, Er TK. Retrospective Analysis of Allergen Distribution Dynamics in Central Taiwan. Br J Biomed Sci 2023; 80:12030. [PMID: 38034850 PMCID: PMC10683208 DOI: 10.3389/bjbs.2023.12030] [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: 09/11/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023]
Abstract
Introduction: Allergy is a type Ⅰ hypersensitivity reaction to certain substances (allergens) such as environmental factors, food and drugs. Allergies are a significant public health issue, and therefore, understanding the distribution patterns of allergens in specific regions is important. This study aimed to retrospectively analyse allergen distribution patterns in Central Taiwan over a 5 years period (2018-2022). Methods: Data of patients who had allergen sensitization testing using the OPTIGEN® Allergen-Specific IgE Assay from the 1st of January 2018 to the 31st of December 2022 were reviewed retrospectively. Statistical analyses were performed to determine the prevalence and distribution of allergens in our study population. Results: A total of 8,444 patients (3,784 males and 4,660 females) who attended the Asia University Hospital for allergen detection were enrolled in this study. Dermatophagoides farina (41.8%), Dermatophagoides pteronyssinus (37.9%), house dust (24.6%), cockroach mix (17.7%), crab (12.6%), clam (9.8%), shrimp (9.1%), cat dander (8.1%), pig weed (8%) and peanut (7.8%) were identified as the ten allergens that most commonly induced sensitization in our study population. Additionally, crab, clam, shrimp, peanut and beef were the five most common food allergens. Conclusion: In summary, our findings contribute significantly to the knowledge on allergen distribution in Central Taiwan. Our identification of prevalent allergens may contribute to an improved understanding of the epidemiology of allergies in this region.
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Affiliation(s)
- Yu-Wei Tseng
- Division of Laboratory Medicine, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Tze-Kiong Er
- Division of Laboratory Medicine, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Deparment of Nursing, Asia University, Taichung, Taiwan
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Saunders LM, Sandhu HS, McBride L, Maniarasu VS, Taylor S, Dhokia R. A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland. Cureus 2023; 15:e49513. [PMID: 38024056 PMCID: PMC10681795 DOI: 10.7759/cureus.49513] [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] [Accepted: 11/27/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Degenerative cervical myelopathy (DCM) is a condition of growing concern due to its increasing incidence among the ageing population. It involves age-associated pathological changes of the cervical spine that can result in spinal cord compression. This can lead to deficits in motor and sensory function of the upper and lower limbs, issues with balance and dexterity, as well as bladder and bowel disturbance. Patients can be categorised as having mild, moderate, or severe degenerative cervical myelopathy depending on their modified Japanese Orthopaedic Association (mJOA) score. This condition is generally managed surgically; however, patients with mild degenerative cervical myelopathy may be offered or opt for non-surgical treatment initially. AIMS The main aim of this study is to evaluate the surgical management of patients with DCM and to ascertain the degree of mJOA improvement from pre-surgery and one-year post-surgery follow-up. The second aim of the study is to explore the demographics within Northern Ireland who are diagnosed with DCM and who undergo surgery. This information could allow for better planning of services in the future for this patient cohort. METHODS This is a retrospective review of the surgical management of degenerative cervical myelopathy within the Regional Spinal Orthopaedic Unit in Northern Ireland over three years with one-year follow-up. The data was retrospectively collected from the Fracture Outcome Research Database. A total of 102 patients (10:7, male:female) with DCM were retrospectively evaluated. Exclusion criteria included all patients diagnosed with spinal tumour, fracture, central cord syndrome, and dislocation. Two patients were removed due to incorrect coding of DCM diagnosis and were not included. Key variables assessed were gender, age, symptoms, type of surgery, complications, and MRC score and mJOA score pre-surgery, 48 hours, six months, and one year post surgery. The choice of surgery was guided by the maximal angle of compression, the number of vertebral levels involved, patient comorbidities, and anesthetic risk. RESULTS The sample consisted of 60 men (58.82%) and 42 women (41.17%) with an average age of 57.17 ± 12.13 years ranging from 27 to 83 years old. Statistical analysis was conducted to explore the effect of time before and after surgery up to one year on the mJOA score. There was a significant difference in mJOA score pre-surgery and at six months and one year post surgery (R = 0.579053, p <0.001). Of the patients, 61.8% with a length of stay greater than three days and 71.4% of patients with a length of stay greater than seven days had a posterior approach surgery. A multiple linear regression analysis revealed that the mJOA score pre-surgery and the presence of complications significantly predicted the length of stay post-surgery (β -1.044, p = .011 and β -5.791, p = .028). CONCLUSION The first key finding of this study is that the mJOA score tends to improve after surgery for the majority of patients, particularly at six months, which is consistent with the literature. The second key finding is that anterior approach surgery is associated with a lower rate of complications and shorter post-surgery length of stay in hospital compared to posterior approach surgery. The third key finding is that the pre-surgery mJOA score and the presence of complications post surgery significantly predict the post-surgery length of stay.
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Affiliation(s)
- Laura M Saunders
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Hushil S Sandhu
- Department of Trauma and Orthopaedics, Royal Victoria Hospital, Belfast, GBR
| | - Lorcán McBride
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | | | - Samantha Taylor
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Rakesh Dhokia
- Department of Trauma and Orthopaedics, Royal Victoria Hospital, Belfast, GBR
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Nath LC, Elliott A, La Gerche A, Weir J, Forbes G, Thomas G, Franklin S. Associations between postrace atrial fibrillation and measures of performance, racing history and airway disease in horses. J Vet Intern Med 2023; 37:2573-2583. [PMID: 37740606 PMCID: PMC10658555 DOI: 10.1111/jvim.16878] [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: 11/27/2022] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common performance limiting arrhythmia in racehorses. High dose exercise and airway disease promote AF in humans. Few studies have investigated epidemiological factors associated with AF in horses. OBJECTIVES Explore variables relating to performance, exercise volume and postrace endoscopic findings in horses with AF. ANIMALS A total of 164 horses with poor race performance and postrace AF were compared to 321 horses with poor performance without AF (PP) and 314 horses performing to expectation (TE). METHODS Horse-level and race-level variables for horses racing in Australia and Hong Kong from 2009 to 2021 were compared using univariable and multivariable logistic regression. Postrace endoscopic exercise-induced pulmonary hemorrhage (EIPH) and tracheal mucus accumulation (TMA) grades for AF and PP horses were compared using chi-squared analysis. RESULTS Variables that were significant in the multivariable model of AF compared to TE were distance (lengths) behind the winner, (odds ratio [OR]; 95% confidence interval [95% CI], 1.41 [1.32-1.51], P < .0001), cumulative prize money per start before the event (OR [95% CI] 1.02 [1.01-1.03], P = .01) and age (OR [95% CI] 0.72 [0.55-0.92], P = .01). More AF horses had EIPH grade ≥ 3 (23/109; 21.1%) than PP horses (7/213; 3.3%; OR [95%CI] 7.9 [3.3-20.2], P < .0001). CONCLUSIONS AND CLINICAL IMPORTANCE Acute race performance was substantially impaired by AF but career earnings before the event were not inferior. Exercise volume did not promote AF. Higher grades of EIPH found in AF horses suggests a mechanistic relationship between these conditions.
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Şensöz E, Cecen G. Comparison of Intramedullary and Extramedullary Fixation Results in Subtrochanteric Femur Fractures. Cureus 2023; 15:e49258. [PMID: 38143672 PMCID: PMC10746348 DOI: 10.7759/cureus.49258] [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] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
OBJECTIVE The subtrochanteric femur is a load-bearing region where deforming forces are effective. These fractures are difficult to treat for orthopedic surgeons. In this article, we aimed to compare intramedullary (IM) and extramedullary (EM) fixation methods for these fractures that do not have gold standard treatment. METHODS Eighty-five patients were retrospectively evaluated. Patients with IM implants (IM femoral nail, proximal femoral nail) were grouped as Group 1, and patients with EM implants were grouped as Group 2 (95° condylar plate, locked anatomical proximal femoral plate). Patients' age, gender, fractured hip side, etiology, anesthesia type, preoperative waiting time, follow-up period, fracture type, Harris hip score (HHS), and mechanical complications were examined. RESULTS The mean age of the patients was 44.13 years. There was no difference between the groups in terms of age and gender. The mean follow-up period of the patients was 13.28 months. Falling from a height was the most common cause of subtrochanteric fracture. IM fixation was applied to 62 patients, and EM fixation was applied to 23 patients. No significant difference was found between Groups 1 and 2 in non-union, delayed union, implant failure, shortness rates, and HHS. CONCLUSION Both IM and EM fixation methods have advantages and disadvantages in treating subtrochanteric fractures. These methods yield similar results in both groups in our study. The issue of fixation methods remains controversial in the literature, and further studies are needed on this subject.
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Affiliation(s)
- Ersin Şensöz
- Orthopedics, Dr. Lutfi Kirdar Kartal City Hospital, Istanbul, TUR
| | - Gultekin Cecen
- Orthopedics and Traumatology, Bahçeşehir University Medical School, Istanbul, TUR
- Orthopedics and Traumatology, VM Medical Park Pendik Hospital, Istanbul, TUR
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Sebo P, Schwarz J, Achtari M, Clair C. Women Are Underrepresented Among Authors of Retracted Publications: Retrospective Study of 134 Medical Journals. J Med Internet Res 2023; 25:e48529. [PMID: 37801343 PMCID: PMC10589828 DOI: 10.2196/48529] [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: 04/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
We examined the gender distribution of authors of retracted articles in 134 medical journals across 10 disciplines, compared it with the gender distribution of authors of all published articles, and found that women were underrepresented among authors of retracted articles, and, in particular, of articles retracted for misconduct.
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Affiliation(s)
- Paul Sebo
- University Institute for Primary Care, University of Geneva, Geneva, Switzerland
| | - Joëlle Schwarz
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Margaux Achtari
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Carole Clair
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
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50
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Xu S, Hong V, Sy LS, Bruxvoort KJ, Lewin B, Han B, Holmquist KJ, Qian L. Risk Factors for Not Completing a 2-Dose Primary Series of Messenger RNA COVID-19 Vaccination in a Large Health Care System in Southern California: Retrospective Cohort Study. JMIR Public Health Surveill 2023; 9:e46318. [PMID: 37792452 PMCID: PMC10563864 DOI: 10.2196/46318] [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: 02/06/2023] [Revised: 07/22/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND COVID-19 vaccination is crucial in combating the COVID-19 pandemic. Messenger RNA COVID-19 vaccines were initially authorized as a 2-dose primary series and have been widely used in the United States; completing the 2-dose primary series offers protection against infection, severe illness, and death. Understanding the risk factors for not completing the 2-dose primary series is critical to evaluate COVID-19 vaccination programs and promote completion of the 2-dose primary series. OBJECTIVE This study examined potential risk factors for not completing a 2-dose primary series of mRNA COVID-19 vaccination. METHODS We conducted a retrospective cohort study among members aged ≥18 years from a large integrated health care system, Kaiser Permanente Southern California, from December 14, 2020, to June 30, 2022. Noncompletion of the 2-dose primary series was defined as not completing the second dose within 6 months after receipt of the first dose. Crude noncompletion rates were estimated overall and by demographic characteristics, health care use patterns, comorbidity, and community-level socioeconomic factors. A Poisson regression model was fit to examine associations of individual-level and community-level risk factors with noncompletion of the 2-dose primary series. RESULTS Among 2.5 million recipients of ≥1 dose of mRNA COVID-19 vaccines, 3.3% (n=81,202) did not complete the second dose within 6 months. Members aged 25-44 years, 65-74 years, and ≥75 years were less likely to not complete the 2-dose primary series than those aged 18-24 years, while members aged 45-64 years were more likely to not complete the 2-dose primary series (adjusted risk ratio [aRR] 1.13, 95% CI 1.10-1.15). Male sex was associated with a higher risk of noncompletion (aRR 1.17, 95% CI 1.15-1.19). Hispanic and non-Hispanic Black race/ethnicity were associated with a lower risk of noncompletion (range aRR 0.78-0.91). Having Medicaid and prior influenza vaccination were associated with a higher risk of noncompletion. Having SARS-CoV-2 infection, experiencing an adverse event, or having an inpatient and emergency department visit during the minimum recommended dose intervals were associated with a higher risk of not completing the 2-dose primary series (aRR 1.98, 95% CI 1.85-2.12; 1.99, 95% CI 1.43-2.76; and 1.85, 95% CI 1.77-1.93, respectively). Those who received the first dose after June 30, 2021, were more likely to not complete the 2-dose primary series within 6 months of receipt of the first dose. CONCLUSIONS Despite limitations such as being a single-site study and the inability to consider social factors such as employment and vaccine attitudes, our study identified several risk factors for not completing a 2-dose primary series of mRNA vaccination, including being male; having Medicaid coverage; and experiencing SARS-CoV-2 infection, adverse events, or inpatient and emergency department visits during the minimum recommended dose intervals. These findings can inform future efforts in developing effective strategies to enhance vaccination coverage and improve the completion rate of necessary doses.
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Affiliation(s)
- Stanley Xu
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Vennis Hong
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Lina S Sy
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Katia J Bruxvoort
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bruno Lewin
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Bing Han
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Kimberly J Holmquist
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
| | - Lei Qian
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, United States
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