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Price G, Peek N, Eleftheriou I, Spencer K, Paley L, Hogenboom J, van Soest J, Dekker A, van Herk M, Faivre-Finn C. An Overview of Real-World Data Infrastructure for Cancer Research. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00108-0. [PMID: 38631976 DOI: 10.1016/j.clon.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024]
Abstract
AIMS There is increasing interest in the opportunities offered by Real World Data (RWD) to provide evidence where clinical trial data does not exist, but access to appropriate data sources is frequently cited as a barrier to RWD research. This paper discusses current RWD resources and how they can be accessed for cancer research. MATERIALS AND METHODS There has been significant progress on facilitating RWD access in the last few years across a range of scales, from local hospital research databases, through regional care records and national repositories, to the impact of federated learning approaches on internationally collaborative studies. We use a series of case studies, principally from the UK, to illustrate how RWD can be accessed for research and healthcare improvement at each of these scales. RESULTS For each example we discuss infrastructure and governance requirements with the aim of encouraging further work in this space that will help to fill evidence gaps in oncology. CONCLUSION There are challenges, but real-world data research across a range of scales is already a reality. Taking advantage of the current generation of data sources requires researchers to carefully define their research question and the scale at which it would be best addressed.
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Affiliation(s)
- G Price
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
| | - N Peek
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK; The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge, Cambridge, UK
| | - I Eleftheriou
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
| | - K Spencer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK; National Disease Registration Service, NHS England, UK
| | - L Paley
- National Disease Registration Service, NHS England, UK
| | - J Hogenboom
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - J van Soest
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands; Brightlands Institute for Smart Society (BISS), Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands
| | - A Dekker
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - M van Herk
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Faivre-Finn
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
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Prunas O, Shioda K, Toscano CM, Bastias M, Valenzuela-Bravo MT, Diaz Tito J, Warren JL, Weinberger DM, de Oliveira LH. Estimated population-level impact of pneumococcal conjugate vaccines against all-cause pneumonia mortality among unvaccinated age groups in five Latin American countries. J Infect Dis 2024:jiae144. [PMID: 38502711 DOI: 10.1093/infdis/jiae144] [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: 08/08/2023] [Revised: 02/14/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Pneumococcal conjugate vaccines (PCVs) provide strong direct protection in children, while limited data are available on their indirect effect on mortality among older age groups. This multi-country study aimed to assess the population-level impact of pediatric PCVs on all-cause pneumonia mortality among ≥5 years of age, and invasive pneumococcal disease (IPD) cases in Chile. METHODS Demographic and mortality data from Argentina, Brazil, Chile, Colombia, and Mexico were collected considering the ≥ 5-year-old population, from 2000-2019, with 1,795,789 deaths due to all-cause pneumonia. IPD cases in Chile were also evaluated. Time series models were employed to evaluate changes in all-cause pneumonia deaths during the post-vaccination period, with other causes of death used as synthetic controls for unrelated temporal trends. RESULTS No significant change in death rates due to all-cause pneumonia was detected following PCV introduction among most age groups and countries. The proportion of IPD cases caused by vaccine serotypes decreased from 29% (2012) to 6% (2022) among ≥65 years in Chile. DISCUSSION While an effect of PCV against pneumonia deaths (a broad clinical definition that may not be specific enough to measure indirect effects) was not detected, evidence of indirect PCV impact was observed among vaccine-type-specific IPD cases.
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Affiliation(s)
- Ottavia Prunas
- Swiss Tropical and Public Health Institute; Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kayoko Shioda
- Boston University, School of Public Health; Boston, MA USA
| | - Cristiana M Toscano
- Federal University of Goias, Institute of Tropical Pathology and Public Health; Goiania, GO Brazil
| | - Magdalena Bastias
- Immunization consultant, Pan-American Health Organization (PAHO); Santiago, Chile
| | | | | | - Joshua L Warren
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT USA
- Department of Biostatistics, Yale School of Public Health, Yale University; New Haven, CT USA
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT USA
| | - Lucia H de Oliveira
- Comprehensive Immunization Program, Pan-American Health Organization (PAHO); Washington, DC USA
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Gingold JA, Wu H, Lieman H, Singh M, Jindal S. Comparing reproductive outcomes between conventional in vitro fertilization and nonindicated intracytoplasmic sperm injection in autologous embryo transfer cycles: a Society for Assisted Reproductive Technology Clinic Outcome Reporting System Study. F S Rep 2024; 5:23-32. [PMID: 38524206 PMCID: PMC10958644 DOI: 10.1016/j.xfre.2023.10.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 03/26/2024] Open
Abstract
Objective To compare clinical outcomes between nonindicated intracytoplasmic sperm injection (ICSI) and conventional insemination. Design Autologous cycles performed from 2014-2017 were identified, excluding frozen oocyte cycles. Outcomes were compared between conventional insemination (in vitro fertilization [IVF]) and nonindiated ICSI and analyzed separately for fresh, frozen-thawed preimplantation genetic testing (PGT) and frozen-thawed non-PGT cycles. Setting US-based fertility clinics reporting to the Society for Assisted Reproductive Technology. Participants A total of 187,520 patients underwent 318,930 cycles, 57,516 (18.0%) using conventional IVF and 261,414 ICSI (82.0%). Interventions Intracytoplasmic sperm injection, with or without indications (male factor, prior fertilization failure or any PGT [2012 recommendations]/single-gene PGT [2020 recommendations]). Main Outcome Measures Odds ratios (ORs) for live birth rates and clinical pregnancy rates were calculated after multivariable adjustment for maternal age, body mass index, infertility etiologies, prior IVF births, and number oocytes retrieved. Results Intracytoplasmic sperm injection was indicated in 151,627 (58.0%) of cycles according to 2012 American Society for Reproductive Medicine Practice Committee recommendations, and 108,895 (41.7%) according to 2020 recommendations. In multivariable models, nonindicated ICSI among fresh cycles was associated with reduced odds of completing a blastocyst-stage transfer (OR, 0.72; 95% confidence interval [CI] [0.7, 0.75]; P<.001), resulting in reduced odds of live birth (OR, 0.80; 95% CI [0.78, 0.83]; P<.001). Among completed fresh transfers, clinical pregnancy and live birth rates were comparable between nonindicated ICSI and IVF. Nonindicated ICSI in frozen-thawed cycles with PGT and without PGT was associated with comparable live birth and clinical pregnancy rates with IVF in multivariable models. Conclusion Nonindicated ICSI was associated with reduced blastocyst availability in fresh cycles compared with IVF, leading to lower live birth rates. Outcomes from completed transfers were clinically comparable.
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Affiliation(s)
- Julian A. Gingold
- Montefiore Institute for Reproductive Medicine and Health, OB/GYN & Women's Health, Hartsdale, New York
| | - Haotian Wu
- Mailman School of Public Health, Columbia University, New York, New York
| | - Harry Lieman
- Montefiore Institute for Reproductive Medicine and Health, OB/GYN & Women's Health, Hartsdale, New York
| | - Manvinder Singh
- Montefiore Institute for Reproductive Medicine and Health, OB/GYN & Women's Health, Hartsdale, New York
| | - Sangita Jindal
- Montefiore Institute for Reproductive Medicine and Health, OB/GYN & Women's Health, Hartsdale, New York
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Jankowski M, Bochenek B, Wieczorek J, Figurski M, Gruszczyńska M, Goryński P, Pinkas J. Epidemiological Characteristics of 101,471 Patients Hospitalized with Chronic Obstructive Pulmonary Disease (COPD) in Poland in 2019: Multimorbidity, Duration of Hospitalization, In-Hospital Mortality. Adv Respir Med 2023; 91:368-382. [PMID: 37736975 PMCID: PMC10514800 DOI: 10.3390/arm91050029] [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: 08/03/2023] [Revised: 08/28/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a common lung disease. There is a limited amount of nationwide data on COPD patients in Poland. This study aimed to characterize patients hospitalized with COPD in Poland in 2019 as well as to identify factors associated with the risk of in-hospital death and prolonged hospitalization among patients with COPD. This study is a retrospective database analysis. Data on patients hospitalized with COPD in Poland were obtained from the Nationwide General Hospital Morbidity Dataset. Data on all adults aged ≥40 years with a diagnosis of COPD from a physician (J44 code) were included in the analysis. Data were analyzed separately for patients hospitalized due to COPD (primary diagnosis) and patients with COPD as a comorbidity (secondary diagnosis). Completed medical records were available for 101,471 patients hospitalized with COPD (36.9% were females). Of those, 32% were hospitalized due to COPD. The mean age was 71.4 ± 9.7 years. The mean duration of hospitalization was 9.4 ± 11.4 days (median 7 days). Most of the COPD patients (89.3%) had at least one comorbidity. The in-hospital mortality rate was 6.8%. Older age, presence of cardiovascular diseases, and diseases of the genitourinary system (p < 0.05) were the most important factors associated with the risk of in-hospital death among patients hospitalized due to COPD.
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Affiliation(s)
- Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Bogdan Bochenek
- Institute of Meteorology and Water Management-National Research Institute, 01-673 Warsaw, Poland
| | - Joanna Wieczorek
- Institute of Meteorology and Water Management-National Research Institute, 01-673 Warsaw, Poland
| | - Mariusz Figurski
- Institute of Meteorology and Water Management-National Research Institute, 01-673 Warsaw, Poland
| | - Marta Gruszczyńska
- Institute of Meteorology and Water Management-National Research Institute, 01-673 Warsaw, Poland
| | - Paweł Goryński
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
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Li M, Zeng N, Liu Y, Sun X, Yang W, Liu Y, Mao Z, Yao Q, Zhao X, Liang H, Lou W, Ma C, Song J, Wu J, Yang W, Zhang P, Zhu L, Tian P, Zhang P, Zhang Z. Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010-2020 national registry. Chin Med J (Engl) 2023; 136:1967-1976. [PMID: 37525550 PMCID: PMC10431592 DOI: 10.1097/cm9.0000000000002499] [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: 11/10/2022] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor. CONCLUSIONS Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.
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Affiliation(s)
- Mengyi Li
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Na Zeng
- School of Public Health, Peking University, Beijing 100191, China
| | - Yang Liu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Xitai Sun
- Department of General Surgery, Nanjing Drum Tower Hospital, Nanjing, Jiangsu 210008, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China
| | - Yanjun Liu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan 610014, China
| | - Zhongqi Mao
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Qiyuan Yao
- Center for Obesity and Metabolic Surgery, Huashan Hospital, Fudan University, Shanghai 200030, China
| | - Xiangwen Zhao
- Department of Metabolic and Bariatric Surgery, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, China
| | - Hui Liang
- Department of General Surgery, First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 226399, China
| | - Wenhui Lou
- Department of General Surgery, Zhongshan Hospital, Shanghai 200032, China
| | - Chiye Ma
- Department of Gastrointestinal Surgery, Dongfang Hospital of Shaghai, Shanghai 200120, China
| | - Jinghai Song
- Department of General Surgery, Beijng Hospital, Beijing 100730, China
| | - Jianlin Wu
- Department of Gastrointestinal Surgery, Zibo Central Hospital, Zibo, Shandong 255020, China
| | - Wei Yang
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Pin Zhang
- Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Liyong Zhu
- Department of Gastrointestinal Surgery,The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, China
| | - Peirong Tian
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Peng Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
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Kauliņš R, Rudzītis A, Lejnieks A, Kigitoviča D, Skride A. Baseline Clinical Characteristics and Incidence of Chronic Thromboembolic Pulmonary Hypertension Patients in Latvia, 2019-2020. Medicina (Kaunas) 2023; 59:1426. [PMID: 37629717 PMCID: PMC10456735 DOI: 10.3390/medicina59081426] [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: 07/05/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023]
Abstract
Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and progressive condition; however, the true characteristics of CTEPH are still unknown, as notable regional variations exist in terms of patients' age, baseline hemodynamic data, and management choices. This report aims to investigate the baseline clinical characteristics, incidence, and risk factors associated with CTEPH patients in Latvia from 2019 to 2020. Methods: The data were analyzed from a prospective, nationwide, Latvian pulmonary hypertension registry for incident CTEPH cases. The patients' clinical characteristics were assessed at the time of diagnosis. Results: During the course of this study, a cohort of 13 patients with CTEPH were included for analysis. Among the enrolled CTEPH patients, most exhibited low exercise and functional capacity, with a median (±IQR) 6 min walk distance of 300.0 (±150.0) m. The median values (±IQR) for mean pulmonary artery pressure and pulmonary vascular resistance were 40.0 ± 13.0 mmHg and 7.35 ± 2.82 Wood units, respectively. The most common risk factors for CTEPH were a history of acute pulmonary embolism and a blood group other than O. Conclusions: The findings of this report revealed the characteristics of the Latvian CTEPH population, indicating that a significant proportion of patients are elderly individuals with multiple comorbidities.
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Affiliation(s)
- Ričards Kauliņš
- Department of Internal Diseases, Riga Stradiņš University, LV-1079 Riga, Latvia
| | - Ainārs Rudzītis
- Department of Internal Diseases, Riga Stradiņš University, LV-1079 Riga, Latvia
- Department of Rare Diseases, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia
| | - Aivars Lejnieks
- Department of Internal Diseases, Riga Stradiņš University, LV-1079 Riga, Latvia
- Department of Internal Diseases, Riga East Clinical University Hospital, LV-1079 Riga, Latvia
| | - Dana Kigitoviča
- Department of Internal Diseases, Riga Stradiņš University, LV-1079 Riga, Latvia
| | - Andris Skride
- Department of Internal Diseases, Riga Stradiņš University, LV-1079 Riga, Latvia
- Department of Rare Diseases, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia
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Lee DO, Jeon YJ, Park GY, Lee DY. Does Perioperative Use of Bisphosphonate Affect the Implant Revision Rate of Total Ankle Arthroplasty? Foot Ankle Int 2023; 44:656-664. [PMID: 37102369 DOI: 10.1177/10711007231166926] [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] [Indexed: 04/28/2023]
Abstract
BACKGROUND It is unknown whether perioperative bisphosphonate (BP) use reduces revision rates in total ankle replacement arthroplasty (TAR) although its effect has been demonstrated to be effective in reducing revision rates in total knee or hip replacement arthroplasty. METHODS We reviewed National Health Insurance Service data based on national health insurance service claims data and health care utilization, health screening, sociodemographic variables, medication history, operation codes, and mortality data for 50 million Koreans. From 2002 to 2014, 6391 of 7300 patients who underwent TAR were BP nonusers, whereas 909 patients were BP users. The revision rate according to BP medication and comorbidities was investigated. The Kaplan-Meier estimate and extended Cox proportional hazard model were also used. RESULTS The revision rate of TAR was 7.9% for BP users and 9.5% for BP nonusers, which showed no significant difference (P = .251). Implant survival over time decreased constantly. Adjusted hazard ratio for hypertension was 1.242 (P = .017), whereas other comorbidities such as diabetes had no effect on the revision rate of TAR. CONCLUSION We found that the perioperative BP use did not reduce the revision rate of TAR. Comorbidities (except hypertension) did not affect the revision rate of TAR. More research regarding various factors affecting the revision of TAR could be warranted. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
| | - Ye Jin Jeon
- RexSoft Inc, Seoul, South Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | | | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea
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Okazumi S, Oshiro T, Sasaki A, Matsubara H, Tatsuno I. Verification of Safety and Efficacy of Sleeve Gastrectomy Based on National Registry by Japanese Society for Treatment of Obesity. J Clin Med 2023; 12:4303. [PMID: 37445338 DOI: 10.3390/jcm12134303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/17/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
In Japan, bariatric surgical treatment was started in 1982. The Japanese Society for Treatment of Obesity (JSTO) was established in 2007, and then, JSTO started the national registry of bariatric surgery cases and multidisciplinary educational program. A total of 44 facilities registered 4055 bariatric surgical cases until 2021. In this study, the purpose is to clarify the indication, the safety and the effectiveness of the sleeve gastrectomy using national registry database compiled by JSTO. Preoperative BMI ranged from 27.6 to 90.7 kg/m2, and the mean value was 42.7. With regard to gender, men/women was 1/1.3. Age was 42.2 as mean. As preoperative comorbidities, DM ratio was 54.4% of the patients, hypertension 64.5%, dyslipidemia 65.1%, and sleep apnea syndrome 69.8%. As an operation method, laparoscopic method was conducted in 99.7% of the cases. The intraoperative incidence rate was 0.9%. Conversion rate to open method was 1.1%. Postoperative morbidity ratio was 5.6%, and mortality was 0%. Reoperations were performed in 1.5% of the cases. Postoperative hospital stay was 5 days in median value. Body weight loss was 27.6 kg in the mean value after follow-up days of 279 ± 245. As the effect on the preoperative metabolic comorbidities, DM has improved in 82.9% of the cases, hypertension 67.9% and dyslipidemia 66.6%. In conclusion, using JSTO database, we evaluated the indication, postoperative complications and weight loss effect of sleeve gastrectomy in Japan. Regarding the evaluation of the effect on preoperative comorbidities, future follow-up based on more detailed criteria was considered to be necessary.
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Affiliation(s)
- Shinichi Okazumi
- Japanese Society for Treatment of Obesity, Tokyo 113-0033, Japan
- Department of Surgery, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura 285-8741, Japan
| | - Takashi Oshiro
- Japanese Society for Treatment of Obesity, Tokyo 113-0033, Japan
- Department of Surgery, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura 285-8741, Japan
| | - Akira Sasaki
- Japanese Society for Treatment of Obesity, Tokyo 113-0033, Japan
| | | | - Ichiro Tatsuno
- Japanese Society for Treatment of Obesity, Tokyo 113-0033, Japan
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Stonebraker JS, Iorio A, Lavin M, Rezende SM, Srivastava A, Pierce GF, Coffin D, Tootoonchian E, Makris M. Reported prevalence of von Willebrand disease worldwide in relation to income classification. Haemophilia 2023. [PMID: 37276350 DOI: 10.1111/hae.14810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The diagnosis of von Willebrand disease (VWD) is complex and challenging, especially when diagnostic resources are limited. This results in a lack of consistency in identifying and reporting the number of people with VWD and variations in the VWD prevalence worldwide. AIM To analyze the reported prevalence of VWD worldwide in relation to income classification. METHODS Data on the VWD prevalence from the World Federation of Hemophilia Annual Global Survey, national registries of Australia, Canada, and the United Kingdom, and the literature were analysed. The income level of each country was classified according to the World Bank. RESULTS The mean VWD prevalence worldwide was 25.6 per million people. The VWD prevalence for high-income countries (HIC) of 60.3 per million people was significantly greater (p < .01) than upper middle (12.6), lower middle (2.5) and low (1.1) income countries. The type 3 VWD prevalence for HIC of 3.3 per million people was significantly greater (p < .01) than lower middle (1.3) and low income (0.7) countries. The reported VWD prevalence was greater among females than males. CONCLUSION The reported VWD prevalence varied considerably across and within income classifications. The variability of type 3 VWD prevalence was less than the VWD prevalence (all types). The variability in detection and diagnosis of type 1 VWD presents a challenge in forming a consistent prevalence value across countries and income classifications.
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Affiliation(s)
- Jeffrey S Stonebraker
- Department of Business Management, Poole College of Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Alfonso Iorio
- Mike Gent Chair in Health Care Research, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Lavin
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland, Dublin, Ireland
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland
| | - Suely M Rezende
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alok Srivastava
- Department of Hematology, Christian Medical College, Vellore, India
| | - Glenn F Pierce
- World Federation of Hemophilia, Montréal, Québec, Canada
| | - Donna Coffin
- World Federation of Hemophilia, Montréal, Québec, Canada
| | | | - Michael Makris
- Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
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Kjellström B, Runheim H, Beaudet A, Husberg M, Ivarsson B, Pillai N, Levin LÅ, Bernfort L. Societal costs associated to chronic thromboembolic pulmonary hypertension: A study utilizing linked national registries. Pulm Circ 2023; 13:e12254. [PMID: 37362560 PMCID: PMC10286567 DOI: 10.1002/pul2.12254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but serious complication after a pulmonary embolism. Healthcare resource utilization (HCRU; hospitalization, outpatient visits, and drug utilization) as well as productivity loss (sick leave and disability pension) before and after the CTEPH diagnosis is sparsely studied. By linking several Swedish national databases, this study estimated the societal costs in a national CTEPH cohort (n = 369, diagnosed with CTEPH in 2008-2019) 5 years before and 5 years after diagnosis (index date) and compared to an age, sex, and geographically matched control group (n = 1845, 1:5 match). HCRU and productivity loss were estimated per patient per year. Patients were stratified as operated with pulmonary endarterectomy (PEA group) or not operated (non-PEA group). Direct and indirect societal costs were 2.1 times higher before, and 8.1 times higher after the index date for patients with CTEPH compared to the matched control groups. The higher costs were evident already several years preceding the index date. The main cost driver before the index date in both the PEA and the non-PEA groups was productivity loss. The productivity loss remained high for both groups in the 5-year period following the index date, but the main cost drivers were prescribed drugs and hospitalizations for patients that underwent PEA and prescribed drugs in the non-PEA group. In conclusion, CTEPH was associated with large societal costs related to healthcare consumption and productivity loss, both before and after diagnosis.
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Affiliation(s)
- Barbro Kjellström
- Department of Clinical Sciences Lund, Clinical Physiology and Skåne University Hospital Lund University Lund Sweden
| | - Hannes Runheim
- Department of Health, Medicine and Caring Sciences, Unit of Health Care Analysis Linköping University Linköping Sweden
| | | | - Magnus Husberg
- Department of Health, Medicine and Caring Sciences, Unit of Health Care Analysis Linköping University Linköping Sweden
| | - Bodil Ivarsson
- Department of Clinical Sciences Lund, Cardiothoracic Surgery and Medicine Services University Trust Lund University Lund Sweden
| | - Nadia Pillai
- Actelion Pharmaceuticals Ltd. Allschwil Switzerland
| | - Lars-Åke Levin
- Department of Health, Medicine and Caring Sciences, Unit of Health Care Analysis Linköping University Linköping Sweden
| | - Lars Bernfort
- Department of Health, Medicine and Caring Sciences, Unit of Health Care Analysis Linköping University Linköping Sweden
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Schölin JS, Rizell S, Paganini A, Mark H. A national registry-based study of surgery and demography comparing internationally adopted and children born in Sweden with cleft lip and/or palate. J Plast Surg Hand Surg 2023; 57:354-359. [PMID: 35801393 DOI: 10.1080/2000656x.2022.2097252] [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: 10/17/2022]
Abstract
This national registry-based study compares surgical procedures, demography, and concurrent medical conditions, in internationally adopted and Swedish-born children with cleft lip and/or palate until the age of five years. Data on the cleft type and gender for 331 internationally adopted children and 2064 Swedish-born children born from 2007 to 2018, were extracted from the registry and analyzed. Data on surgical procedures performed in Sweden and concurrent medical conditions and were collected for internationally adopted children and Swedish-born children with unilateral or bilateral cleft, born 2007-2013. A higher prevalence of unilateral and bilateral clefts (p < 0.0001), as well as a predominance of male patients with unilateral clefts (p = 0.0025), were identified among the internationally adopted children compared with children born in Sweden. Differences in the concurrence of other medical conditions in internationally adopted children versus Swedish-born infants were non-significant. Primary palatal surgeries performed in Sweden were significantly delayed for the adopted group. More secondary palatal surgeries such as speech improving surgery and palatal re-repair were needed for internationally adopted children (p < 0.0001) until age five.Conclusions: The Swedish CLP Registry provided national coverage of the CL/P cohort. Internationally adopted children exhibited a predominance of more severe cleft types, a predominance of males, delayed primary palatal surgery and increased need for secondary surgeries before age five.
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Affiliation(s)
- Johnna Sahlsten Schölin
- Department of Plastic and Reconstructive Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Rizell
- Clinic of Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Sweden
| | - Anna Paganini
- Department of Plastic and Reconstructive Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans Mark
- Department of Plastic and Reconstructive Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Runheim H, Kjellström B, Beaudet A, Ivarsson B, Husberg M, Pillai N, Levin L, Bernfort L. Societal costs associated with pulmonary arterial hypertension: A study utilizing linked national registries. Pulm Circ 2023; 13:e12190. [PMID: 36704610 PMCID: PMC9868346 DOI: 10.1002/pul2.12190] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a progressive disease with no cure. Healthcare resource utilization (HCRU; hospitalization, outpatient visits, and drug utilization) before diagnosis and productivity loss (sick leave and disability pension) before and after PAH diagnosis are not well known. By linking several Swedish national databases, this study have estimated the societal costs in a national PAH cohort (n = 749, diagnosed with PAH in 2008-2019) 5 years before and 5 years after diagnosis and compared to an age, sex, and geographically matched control group (n = 3745, 1:5 match). HCRU and productivity loss were estimated per patient per year. The PAH group had significantly higher HCRU and productivity loss compared to the control group starting already 3 and 5 years before diagnosis, respectively. HCRU peaked the year after diagnosis in the PAH group with hospitalizations (mean ± standard deviation; 2.0 ± 0.1 vs. 0.2 ± 0.0), outpatient visits (5.3 ± 0.3 vs. 0.9 ± 0.1), and days on sick leave (130 ± 10 vs. 13 ± 1) significantly higher compared to controls. Total costs during the entire 10-year period were six times higher for the PAH group than the control group. In the 5 years before diagnosis the higher costs were driven by productivity loss (76%) and hospitalizations (15%), while the 5 years after diagnosis the main cost drivers were drugs (63%), hospitalizations (16%), and productivity loss (16%). In conclusion, PAH was associated with large societal costs due to high HCRU and productivity loss, starting several years before diagnosis. The economic and clinical burden of PAH suggests that strategies for earlier diagnosis and more effective treatments are warranted.
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Affiliation(s)
- Hannes Runheim
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Barbro Kjellström
- Department of Clinical Sciences Lund, Clinical Physiology and Skåne University HospitalLund UniversityLundSweden
| | | | - Bodil Ivarsson
- Department of Clinical Sciences Lund, Cardiothoracic Surgery and Medicine Services University Trust, Region SkåneLund UniversityLundSweden
| | - Magnus Husberg
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Nadia Pillai
- Actelion Pharmaceuticals Ltd.AllschwilSwitzerland
| | - Lars‐Åke Levin
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Lars Bernfort
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
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Popescu CC, Mogoșan CD, Enache L, Codreanu C. Comparison of Efficacy and Safety of Original and Biosimilar Adalimumab in Active Rheumatoid Arthritis in a Real-World National Cohort. Medicina (Kaunas) 2022; 58. [PMID: 36557052 DOI: 10.3390/medicina58121851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Background and Objectives: Real-world evidence should reflect the evidence obtained from controlled trials; therefore, the study aimed to compare biosimilar adalimumab (bADA) to original adalimumab (oADA) in terms of efficacy and safety in a real-life national cohort of rheumatoid arthritis (RA) patients. Materials and Methods: The following study is a prospective observational study in which we analyzed patients treated with reimbursed biologics from the Romanian Registry of Rheumatic Diseases (RRBR). RA cases must fulfill the 2010 classification criteria, as well as specific inclusion and exclusion criteria. The RRBR database was queried for all RA patients starting oADA or bADA (FKB327, GP2017, MSB11022, SB5 available) from 2 May 2019 (the first bADA initiation) until 26 March 2022 (study search date). Results: The study included 441 patients who started oADA (48.3%) or bADA (51.7%) in the same time period. At baseline, patients starting bADA had a significantly higher mean age and lower prevalence of women. After the first six months of treatment, there were no significant differences between the oADA and bADA regarding rates of Boolean (15.0% vs. 12.3%, p = 0.401), DAS28-CRP (32.4% vs. 34.2%, p = 0.686) and SDAI (16.4% vs. 14.0%, p = 0.483) remission rates. There were 107 cases of adverse events (AE): 81.3% on oADA and 18.7% on bADA. Notably, 51.4% of AE were infections. Regarding severity, 49.5% of AEs were mild, 34.6% were moderate, and 15.9% were severe. Conclusion: Biosimilar adalimumab showed similar efficacy and safety to original adalimumab after the first six months of treatment in RA patients from a national registry.
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Mallebranche C, Reguerre Y, Fresneau B, Andre N, Berger C, Briandet C, Castex MP, Defachelles AS, Faure-Conter C, Lejeune J, Klein S, Leverger G, Marie-Cardine A, Oudot C, Freycon C, Proust S, Roumy M, Thebaud E, Verite C, Lacour B, Orbach D. The French FRACTURE database: A way to improve knowledge on management of children with very rare tumors. Pediatr Blood Cancer 2022; 69:e30003. [PMID: 36156381 DOI: 10.1002/pbc.30003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Very rare pediatric tumors (VRTs), defined by an annual incidence ≤2 per million inhabitants, represent a heterogeneous group of cancers. Due to their extremely low incidence, knowledge on these tumors is scant. Since 2012, the French Very Rare Tumors Committee (FRACTURE) database has recorded clinical data about VRTs in France. This study aims: (a) to describe the tumors registered in the FRACTURE database; and (b) to compare these data with those registered in the French National Registry of Childhood Cancer (RNCE). METHODS Data recorded in the FRACTURE database between January 1, 2012 and December 31, 2018 were analyzed. In addition, these data were compared with those of the RNCE database between 2012 and 2015 to evaluate the completeness of the documentation and understand any discrepancies. RESULTS A total of 477 patients with VRTs were registered in the FRACTURE database, representing 97 histological types. Of the 14 most common tumors registered in the RNCE (772 patients), only 19% were also registered in the FRACTURE database. Total 39% of children and adolescent VRTs registered in the RNCE and/or FRACTURE database (323 of a total of 828 patients) were not treated in or linked to a specialized pediatric oncology unit. CONCLUSION VRTs represent many different heterogenous entities, which nevertheless account for 10% of all pediatric cancers diagnosed each year. Sustainability in the collection of these rare tumor cases is therefore important, and a regular systematic collaboration between the FRACTURE database and the RNCE register helps to provide a more exhaustive picture of these VRTs and allow research completeness for some peculiar groups of patients.
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Affiliation(s)
| | - Yves Reguerre
- Pediatric Oncology and Hematology Unit, CHU Saint Denis de la Réunion, Bellepierre, France
| | - Brice Fresneau
- Department of Child and Adolescent Cancer, Gustave Roussy Institute, Villejuif, France
| | - Nicolas Andre
- Pediatric Oncology, La Timone Hospital, Marseille, France
| | - Claire Berger
- Lyon University, Jean Monnet University, INSERM, U1059, Sainbiose, University Hospital, Pediatric Hematology-Oncology Department, Saint-Etienne, France
| | | | | | | | - Cécile Faure-Conter
- Pediatric Oncology, Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France
| | - Julien Lejeune
- Pediatric Oncology and Hematology, CHRU Tours, Tours, France
| | - Sébastien Klein
- Pediatric Oncology and Hematology, CHU Jean-Minjoz, Besançon, France
| | - Guy Leverger
- Hemato-Immuno-Oncology, Trousseau Hospital, APHP, Paris, France
| | | | | | - Claire Freycon
- Pediatric Onco-Hematology, CHU Grenoble - Hôpital Couple-Enfant, La Tronche, France
| | - Stéphanie Proust
- Pediatric Immuno-Hemato-Oncology Unit, CHU Angers, Angers, France
| | - Marianne Roumy
- Pediatric Clinical Research Platform, CHU Angers, Angers, France
| | - Estelle Thebaud
- Pediatric Immuno-Hemato-Oncology Unit, CHU Nantes, Nantes, France
| | - Cécile Verite
- Pediatric Hematology and Oncology, CHU Bordeaux, Bordeaux, France
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHU Nancy, Nancy, France.,Inserm UMR 1153, Centre of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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15
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Rousset-Jablonski C, Dalon F, Reynaud Q, Lemonnier L, Dehillotte C, Jacoud F, Berard M, Viprey M, Van Ganse E, Durieu I, Belhassen M. Cancer incidence and prevalence in cystic fibrosis patients with and without a lung transplant in France. Front Public Health 2022; 10:1043691. [PMID: 36483264 PMCID: PMC9723348 DOI: 10.3389/fpubh.2022.1043691] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cystic fibrosis (CF) care and the life expectancy of affected patients have substantially improved in recent decades, leading to an increased number of patients being diagnosed with comorbidities, including cancers. Our objective was to characterize the epidemiology of cancers between 2006 and 2017 in CF patients with and without a lung transplant. Methods Medical records of CF patients from 2006 to 2016 in the French CF Registry were linked to their corresponding claims data (SNDS). The annual prevalence and incidence rates of cancers were estimated from 2006 to 2017 in CF patients without lung transplant and in those with lung transplant after transplantation. Results Of the 7,671 patients included in the French CF Registry, 6,187 patients (80.7%) were linked to the SNDS; among them, 1,006 (16.3%) received a lung transplant. The prevalence of any cancer increased between 2006 and 2017, from 0.3 to 1.0% and from 1.3 to 6.3% in non-transplanted and transplanted patients, respectively. When compared to the general population, the incidence of cancer was significantly higher in both non-transplanted [Standardized Incidence Ratio (SIR) = 2.57, 95%CI 2.05 to 3.17] and transplanted (SIR = 19.76, 95%CI 16.45 to 23.55) patients. The median time between transplant and the first cancer was 3.9 years. Among the 211 incident cancer cases, the most frequent malignant neoplasms were skin neoplasm (48 cases), lung cancers (31 cases), gastro-intestinal (24 cases), and hematologic cancers (17 cases). Conclusion The overall burden of cancer in CF patients is high, particularly following lung transplantation. Therefore, specific follow-up, screening and cancer prevention for CF patients with transplants are necessary.
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Affiliation(s)
- Christine Rousset-Jablonski
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France,Département de chirurgie, Centre Léon Bérard, Lyon, France,*Correspondence: Christine Rousset-Jablonski
| | | | - Quitterie Reynaud
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France
| | | | | | - Flore Jacoud
- PELyon, PharmacoEpidemiologie Lyon, Lyon, France
| | | | - Marie Viprey
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Health Data Department, Hospices Civils de Lyon, Lyon, France
| | - Eric Van Ganse
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,PELyon, PharmacoEpidemiologie Lyon, Lyon, France,Respiratory Medicine, Croix-Rousse University Hospital, Lyon, France
| | - Isabelle Durieu
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France
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Búřilová P, Pokorná A, Benešová K, Mužík J, Klugar M, Krupová L, Dolanová D, Saibertová S, Beeckman D. A ten-year follow-up of the prevalence of pressure injuries in the Czech Republic: Analysis of the National Registry. Int Wound J 2022; 19:1870-1877. [PMID: 35352481 PMCID: PMC9615265 DOI: 10.1111/iwj.13793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/02/2023] Open
Abstract
The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs were used in the period 2010-2019. A total of 264 442 records of patients with diagnoses of L89.0-L89.9 were identified from 2010 to 2019 (26 444 patients per year on average). The numbers are increasing every year, and there is a 40% increase between 2010 and 2019. When comparing recorded PIs, the percentage of PIs occurrence in category I decreased, and the number of PIs in category IV increased in the second analysed period. Still, in absolute numbers, there is an increase across all categories. The age of patients with recorded PIs also rose slightly in the second analysed period. We have proven the PIs prevalence increase in an ageing population.
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Affiliation(s)
- Petra Búřilová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Department of Public HealthMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Andrea Pokorná
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Klára Benešová
- Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Jan Mužík
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Miloslav Klugar
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Czech National Centre for Evidence‐Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of ExcellenceMasaryk University GRADE Centre, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | - Lenka Krupová
- Department of DermatologyUniversity Hospital OstravaOstravaCzech Republic
| | - Dana Dolanová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Simona Saibertová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium,School of Health SciencesÖrebro UniversityÖrebroSweden,School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI)University of Medicine and Health SciencesDublinIreland,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark,School of Nursing and MidwiferyMonash UniversityClaytonAustralia
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Köbe J, Willy K, Senges J, Hochadel M, Kleemann T, Spitzer SG, Andresen D, Jehle J, Steinbeck G, Szendey I, Butter C, Brachmann J, Hoffmann E, Eckardt L. Selection and outcome of ICD and CRT-D patients - Comparison of 4384 patients from the German Device Registry to randomized controlled trials. J Cardiovasc Electrophysiol 2022; 33:483-492. [PMID: 35028995 DOI: 10.1111/jce.15365] [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: 09/28/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Registry data adds important information to randomized controlled trials (RCT) on real-life aspects of implantable cardioverter-defibrillator (ICD) patients with and without cardiac resynchronization therapy (CRT-D). This analysis of the prospectively conducted German Device Registry aims at comparing mortality rates, comorbidities, complication rates to results from RCT. METHODS The German Device registry (DEVICE) prospectively collected data on ICD and CRT-D first implantations from 50 German centres. Demographic data, details on cardiac disease, electrocardiogram (ECG), medication, and data about procedure, complications and hospital stay were stored in electronic case report forms. One year after device implantation patients were contacted for follow-up. RESULTS DEVICE included n=4384 first ICD/CRT-D implantations (29.3% CRT-D devices). We found a strong adherence to guidelines with over 90% of patients being on ß-blocker and ACE-inhibitor medication and adequate QRS width in the majority of CRT-D patients. Patients receiving a CRT-D were older (67.6±11.0 years vs. 63.9±13.4 years, p<0.001) and had lower ejection fractions (mean 25% vs. 30%, p<0.001) compared to ICD patients. Dilated cardiomyopathy was the predominant underlying heart disease in CRT-D (53.3%), coronary artery disease in ICD patients (64.7%). Compared to RCT our DEVICE patients had more comorbidities (17.9% chronic kidney disease (CKD)) and higher one-year mortality rates (10.7% ICD group, 12.3% CRT group). In multivariate analysis, CKD patients had an almost 2-fold higher risk of 1-year mortality. CONCLUSION Despite relevant limitations of registry data, DEVICE highlights important differences between RCT and real-world registry data and the impact of comorbidities on mortality of ICD and CRT-D recipients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Julia Köbe
- Division of Electrophysiology, Department of Cardiology and Angiology, Münster, Germany
| | - Kevin Willy
- Division of Electrophysiology, Department of Cardiology and Angiology, Münster, Germany
| | - Jochen Senges
- Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
| | - Matthias Hochadel
- Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
| | | | | | | | | | - Gerhard Steinbeck
- Medical Hospital I, Ludwig-Maximilians-University of Munich, Großhadern
| | | | | | | | | | - Lars Eckardt
- Division of Electrophysiology, Department of Cardiology and Angiology, Münster, Germany
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Maděrková Tozzi M, Dvořák Jr. V, Klásková E, Šuláková S, Wita M, Hálek J, Vrtěl R, Curtisová V, Pilka R, Dušek L, Ľubušký M. Screening for congenital defects and genetic diseases of the fetus at University Hospital in Olomouc and sending/ reporting to the National register of reproductive health in the Czech Republic. Ceska Gynekol 2022; 87:162-172. [PMID: 35896393 DOI: 10.48095/cccg2022162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of the study was to analyze the results of the screening for congenital defects (CD) and genetic diseases (GD) of the fetus in the Fetal Medicine Centre at the Department of Obstetrics and Gynecology, University Hospital in Olomouc. MATERIALS AND METHODS Prospective cohort study. In the period from 1 January 2020 to 31 December 2021, a total of 14,460 health services were performed on 4,916 pregnant women. Within the screening of CD and GD of the fetus, 501 pregnant women were found to have an abnormality requiring further clinical management, 170 of them were diagnosed with a CD of the fetus and in 20 cases a GD of the fetus was diagnosed by a laboratory genetic examination. All diagnosed fetal CD and GD were sent/ reported according to the valid methodology of the National health information system (NHIS) to the National register of reproductive health (NRRH) to the CD Module. RESULTS An increased calculated individual risk of genetic fetal disease was diagnosed in the first trimester of pregnancy in 10.7% of fetuses (319/ 2,968), and in the second trimester in 0.9% of fetuses (27/ 2,948). Nuchal translucency (NT) > 3.5 mm was diagnosed in 0.9% of fetuses by ultrasound examination in the first trimester of pregnancy (26/ 2,968). In fetal CD and GD screening, 501 pregnant women were found to have an abnormality requiring further clinical management, 72.1% of women (361/ 501) had an increased risk of genetic fetal disease, and diagnostic examination of the fetal genetic material obtained by invasive procedure (chorionic villus sampling or amniocentesis) was indicated. A total of 31.3% of them (113/ 361) refused the invasive procedure and 2.5% (9/ 361) did not attend the planned procedure; the invasive procedure was performed in 66.2% (239/ 361). CONCLUSION Comparing the results of CD and GD fetal screening in our medical facility with other specialized medical facilities in the Czech Republic is currently difficult to do, but information from the NRRH could allow objective and transparent comparisons in the future.
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Fujimori T, Nakajima N, Sugiura T, Ikegami D, Sakaura H, Kaito T, Iwasaki M. Epidemiology of symptomatic ossification of the posterior longitudinal ligament: a nationwide registry survey. J Spine Surg 2021; 7:485-494. [PMID: 35128122 DOI: 10.21037/jss-21-78] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ossification of the posterior longitudinal ligament (OPLL) is radiographically detectable in 3-6% of Asian individuals, although not all detectable OPLL cases lead to myelopathy. To date, it is unknown how many patients suffer from neurological symptoms due to OPLL. The purpose of this study was to investigate the epidemiology of symptomatic OPLL using Japan's national registry database. METHODS We examined the registry data of patients with OPLL who held a certificate of medical subsidy from the Japanese Ministry of Health, Labor and Welfare. The study period was from January 1, 2011 to December 31, 2012. RESULTS Registry data revealed that the incidence and the period prevalence of symptomatic OPLL were 0.005% (5 per 100,000 population) and 0.027% (27 per 100,000 population), respectively. OPLL occurred twice as often in men as in women. The peak age for onset of symptoms was 60-69 years. The mean Japanese Orthopedic Association (JOA) score was 9 points. Ninety percent of OPLL patients underwent surgery, and 90% of these surgeries were performed with a posterior approach. The most common indication for surgery was a JOA score of 11 points. CONCLUSIONS According to registry data, the prevalence of symptomatic OPLL was less than one-hundredth of that of radiographically detected OPLL. This indicates that most cases of radiographically detectable OPLL may be asymptomatic.
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Affiliation(s)
- Takahito Fujimori
- Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan.,Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Nozomu Nakajima
- Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Tsuyoshi Sugiura
- Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Daisuke Ikegami
- Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Hironobu Sakaura
- Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Motoki Iwasaki
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan
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20
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Molitor N, Yalcinkaya E, Auricchio A, Burri H, Delacretaz E, Kühne M, Menafoglio A, Reek S, Reichlin T, Herrera-Siklody C, Zimmerli M, Sticherling C, Duru F. Swiss National Registry on Catheter Ablation Procedures: Changing Trends over the Last 20 Years. J Clin Med 2021; 10:jcm10143021. [PMID: 34300187 PMCID: PMC8304673 DOI: 10.3390/jcm10143021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/01/2021] [Revised: 06/25/2021] [Accepted: 07/01/2021] [Indexed: 11/16/2022] Open
Abstract
The Swiss Ablation Registry provides a national database for electrophysiologic studies and catheter ablations. We analyzed the database to provide an in-depth look at changing trends over the last 20 years. During the study period a total of 78622 catheter ablations (age 61.0 ± 1.2 years; 63.7% male) were performed in 29 centers. The number of ablations increased by approximately ten-fold in 20 years. Ablation for atrial fibrillation (AF) was the main driver behind this increase, with more than hundred-fold (39.7% of all ablations in 2019). Atrioventricular-nodal-reentrant-tachycardia (AVNRT) and accessory pathways, being the main indications for ablation in 2000 (44.1%/25.1%, respectively), made up of only a small proportion (15.2%/3.5%,) respectively in 2019. Fluoroscopy, ablation, and procedure durations were reduced for all ablations over time. The highest repeat ablations were performed for ventricular tachycardia and AF (24.4%/24.3%). The majority of ablations (63.0%) are currently performed in private hospitals and non-university public hospitals whereas university hospitals had dominated (82.4%) at the turn of the century. A pronounced increase in the number of catheter ablations in Switzerland was accompanied by a marked decrease in fluoroscopy, ablation, and procedure durations. We observed a shift toward more complex procedures in older patients with comorbidities.
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Affiliation(s)
- Nadine Molitor
- Department of Cardiology, University Heart Center Zurich, 8091 Zurich, Switzerland; (N.M.); (E.Y.)
| | - Emre Yalcinkaya
- Department of Cardiology, University Heart Center Zurich, 8091 Zurich, Switzerland; (N.M.); (E.Y.)
| | - Angelo Auricchio
- Department of Cardiology, Istituto Cardiocentro Ticino, 6900 Lugano, Switzerland;
| | - Haran Burri
- Department of Cardiology, University Hospital Geneva, 1205 Geneva, Switzerland;
| | - Etienne Delacretaz
- Department of Cardiology, Hirslanden Clinique Cecil, 1011 Lausanne, Switzerland;
| | - Michael Kühne
- Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (M.K.); (C.S.)
| | - Andrea Menafoglio
- Department of Cardiology, Hospital of Bellinzona and Valli, 6500 Bellinzona, Switzerland;
| | - Sven Reek
- Department of Cardiology, Hirslanden Clinica Aarau, 5001 Aarau, Switzerland;
| | - Tobias Reichlin
- Department of Cardiology, Inselspital University Hospital Bern, University of Bern, 3010 Bern, Switzerland;
| | | | | | - Christian Sticherling
- Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (M.K.); (C.S.)
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, 8091 Zurich, Switzerland; (N.M.); (E.Y.)
- Center for Integrative Human Physiology, University of Zurich, 8091 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-2553565
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21
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Mercadal L, Lambert O, Couchoud C, Metzger M, Edet S, Merle S, Jacquelinet C, Stengel B. Prescription patterns of dialysate potassium and potassium binders and survival on haemodialysis-the French Renal Epidemiology and Information Network registry. Nephrol Dial Transplant 2021; 36:151-159. [PMID: 32582941 DOI: 10.1093/ndt/gfaa077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Management of potassium disorders in patients on haemodialysis (HD) is complex. We studied prescription patterns of dialysate potassium and potassium binders, and their associations with patient survival. METHODS This national registry-based study included 25 629 incident adult patients alive after 3 months of HD from 2010 through 2013 and followed-up through 31 December 2014. We used Cox proportional hazard models to estimate multiadjusted mortality hazard ratios (HRs) associated with time-dependent exposure to facility-level dialysate potassium concentrations and patient-level potassium binder exposure. RESULTS Almost all dialysis units used, and generally most often, dialysate potassium concentrations of 2 mmol/L. During this period, use of concentrations <2 mmol/L tended to decrease and those ≥3 mmol/L to increase. In 2014, 9% of units used a single dialysate formula, 41% used two and 50% three or more. The most frequent combinations were 2 and 3 mmol/L (40%), and <2, 2 and 3 mmol/L (37%). Compared with patients on HD in units using only one dialysate formula, those in units using two or three had adjusted mortality HRs of 0.91 [95% confidence interval (CI) 0.82-1.01] and 0.84 (0.75-0.93), respectively. Potassium binders were prescribed for 37% of all patients at baseline. Adjusted mortality HRs associated with doses <4, 4-8 and ≥8 g/day versus none were 1.22 (95% CI 1.04-1.51), 0.6 (0.54-0.66) and 0.25 (0.24-0.33), respectively. CONCLUSIONS Diversity in facility-level use of dialysate potassium concentrations and potassium binder use at an appropriate dose appear to be associated with better survival in HD patients.
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Affiliation(s)
- Lucile Mercadal
- Nephrology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,CESP, Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Université Paris-Saclay, Villejuif, France
| | - Oriane Lambert
- CESP, Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Université Paris-Saclay, Villejuif, France
| | | | - Marie Metzger
- CESP, Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Université Paris-Saclay, Villejuif, France
| | - Stéphane Edet
- Nephrology Department, Rouen University Hospital, Rouen, France
| | - Sylvie Merle
- Regional Observatory on Health, University Hospital of Martinique, Le Lamentin, France
| | - Christian Jacquelinet
- CESP, Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Université Paris-Saclay, Villejuif, France
| | - Bénédicte Stengel
- CESP, Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Université Paris-Saclay, Villejuif, France
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22
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Yousef M, Showe LC, Ben Shlomo I. Clinical presentation of COVID-19 - a model derived by a machine learning algorithm. J Integr Bioinform 2021; 18:3-8. [PMID: 33675198 PMCID: PMC8035960 DOI: 10.1515/jib-2020-0050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 pandemic has flooded all triage stations, making it difficult to carefully select those most likely infected. Data on total patients tested, infected, and hospitalized is fragmentary making it difficult to easily select those most likely to be infected. The Israeli Ministry of Health made public its registry of immediate clinical data and the respective status of infected/not infected for all viral DNA tests performed up to Apr. 18th, 2020 including almost 120,000 tests. We used a machine-learning algorithm to find out which immediate clinical elements mattered the most in identifying the true status of the tested persons including age or gender matter, to enable future better allocation of surveillance policy for those belonging to high-risk groups. In addition to the analyses applied on the first batch of the available data (Apr. 11th), we further tested the algorithm on the independent second batch (Apr. 12th to 18th). Fever, cough and headache were the most diagnostic, differing in degree of importance in different subgroups. Higher percentage of men were found positive (9.3 vs. 7.3%), but gender did not matter for the clinical presentation. The prediction power of the model was high, with accuracy of 0.84 and area under the curve 0.92. We provide a hand-held short checklist with verbal description of importance for the leading symptoms, which should expedite the triage and enable proper selection of people for further follow-up.
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Affiliation(s)
- Malik Yousef
- Head of the Galilee Digital Health Research Center, Safed, 13206, Israel
- Zefat Academic College, Safed, 13206, Israel
| | - Louise C. Showe
- The Wistar Institute, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Izhar Ben Shlomo
- Zefat Academic College, Safed, 13206, Israel
- Head of the Program of Emergency Medicine, Safed, Israel
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23
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Marinaccio A, Consonni D, Mensi C, Mirabelli D, Migliore E, Magnani C, Di Marzio D, Gennaro V, Mazzoleni G, Girardi P, Negro C, Romanelli A, Chellini E, Grappasonni I, Madeo G, Romeo E, Ascoli V, Carrozza F, Angelillo IF, Cavone D, Tumino R, Melis M, Curti S, Brandi G, Mattioli S, Iavicoli S. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case-control study and epidemiological remarks. Scand J Work Environ Health 2020; 46:609-617. [PMID: 32253443 PMCID: PMC7737812 DOI: 10.5271/sjweh.3895] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993-2015, incidence rates, survival median period and prognostic factors have been evaluated. A case-control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85-7.31 and OR 3.42, 95% CI 1.93-6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.
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Affiliation(s)
- Alessandro Marinaccio
- Epidemiology Unit, Occupational and Environmental Medicine, Epidemiology and Hygiene Department, INAIL, Via Stefano Gradi 55, 00143 Rome, Italy.
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24
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Çobanoğlu N, Özçelik U, Çakır E, Şişmanlar Eyüboğlu T, Pekcan S, Cinel G, Yalçın E, Kiper N, Emiralioğlu N, Şen V, Şen HS, Ercan Ö, Çokuğraş H, Kılınç AA, Al Shadfan LM, Yazan H, Altıntaş DU, Karagöz D, Demir E, Kartal Öztürk G, Bingöl A, Başaran AE, Sapan N, Çekiç Ş, Çelebioğlu E, Aslan AT, Gürsoy TR, Tuğcu G, Özdemir A, Harmancı K, Yıldırım GK, Köse M, Hangül M, Tamay Z, Süleyman A, Yüksel H, Yılmaz Ö, Özcan G, Topal E, Can D, Korkmaz Ekren P, Çaltepe G, Kılıç M, Özdoğan Ş, Doğru D. Patients eligible for modulator drugs: Data from cystic fibrosis registry of Turkey. Pediatr Pulmonol 2020; 55:2302-2306. [PMID: 32453906 DOI: 10.1002/ppul.24854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/22/2020] [Accepted: 05/09/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND A better understanding of cystic fibrosis transmembrane conductance regulator biology has led to the development of modulator drugs such as ivacaftor, lumacaftor-ivacaftor, tezacaftor-ivacaftor, and elexacaftor-tezacaftor-ivacaftor. This cross-sectional study evaluated cystic fibrosis (CF) patients eligible for modulator drugs. METHODS Data for age and genetic mutations from the Cystic Fibrosis Registry of Turkey collected in 2018 were used to find out the number of patients who are eligible for modulator therapy. RESULTS Of registered 1488 CF patients, genetic analysis was done for 1351. The numbers and percentages of patients and names of the drugs, that the patients are eligible for, are as follows: 122 (9.03%) for ivacaftor, 156 (11.54%) for lumacaftor-ivacaftor, 163 (11.23%) for tezacaftor-ivacaftor, and 57 (4.21%) for elexacaftor-tezacaftor-ivacaftor. Among 1351 genotyped patients total of 313 (23.16%) patients are eligible for currently licensed modulator therapies (55 patients were shared by ivacaftor and tezacaftor-ivacaftor, 108 patients were shared by lumacaftor-ivacaftor and tezacaftor-ivacaftor, and 22 patients were shared by tezacaftor-ivacaftor and elexacaftor-tezacaftor-ivacaftor groups). CONCLUSIONS The present study shows that approximately one-fourth of the registered CF patients in Turkey are eligible for modulator drugs. As, frequent mutations that CF patients have in Turkey are different from North American and European CF patients, developing modulator drugs effective for those mutations is necessary. Furthermore, as modulator drugs are very expensive currently, financial support of the government in developing countries like Turkey is noteworthy.
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Affiliation(s)
- Nazan Çobanoğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Uğur Özçelik
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Çakır
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey
| | | | - Sevgi Pekcan
- Division of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ebru Yalçın
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nural Kiper
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hadice Selimoğlu Şen
- Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömür Ercan
- Division of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Haluk Çokuğraş
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ayşe Ayzıt Kılınç
- Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | | | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey
| | - Derya Ufuk Altıntaş
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Dilek Karagöz
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Esen Demir
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Gökçen Kartal Öztürk
- Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine Akdeniz University, Antalya, Turkey
| | - Abdurrahman Erdem Başaran
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine Akdeniz University, Antalya, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Şükrü Çekiç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Ebru Çelebioğlu
- Department of Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayşe Tana Aslan
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Tuğba Ramaslı Gürsoy
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gökçen Tuğcu
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Koray Harmancı
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Gonca Kılıç Yıldırım
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Mehmet Köse
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melih Hangül
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy and Pulmonology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ayşe Süleyman
- Division of Pediatric Allergy and Pulmonology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hasan Yüksel
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Özge Yılmaz
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Gizem Özcan
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erdem Topal
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Demet Can
- Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | | | - Gönül Çaltepe
- Division of Pediatric Gastroenterology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Mehmet Kılıç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Şebnem Özdoğan
- Division of Pediatric Pulmonology, Sarıyer Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Deniz Doğru
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Abstract
National registries provide useful information in understanding outcomes of surgeries that have late sequelae, especially for rare operations such as total elbow arthroplasty (TEA).A systematic search was performed and data were compiled from the registries to compare total elbow arthroplasty outcomes and evaluate trends. We included six registries from Australia, the Netherlands, New Zealand, Norway, the United Kingdom and Sweden.Inflammatory arthritis was the most common indication for total elbow arthroplasty, followed by acute fracture and osteoarthritis. When comparing 2000-2009 to 2010-2017 data, total elbow arthroplasty for inflammatory arthritis decreased and total elbow arthroplasty for fracture and osteoarthritis increased. There was an increase in the number of revision TEAs over this time period.The range of indications for total elbow arthroplasty is broadening; total elbow arthroplasty for acute trauma and osteoarthritis is becoming increasingly more common. However, inflammatory arthritis remains the most common indication in recent years. This change is accompanied by an increase in the incidence of revision surgery. Cite this article: EFORT Open Rev 2020;5:215-220. DOI: 10.1302/2058-5241.5.190036.
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Affiliation(s)
- Arno A Macken
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
| | - Ante Prkic
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
| | - Izaäk F Kodde
- Department of Orthopaedic Surgery, Amsterdam UMC, Amsterdam, Netherlands
| | - Jonathan Lans
- Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Neal C Chen
- Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amsterdam UMC, Amsterdam, Netherlands
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26
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Dogru D, Çakır E, Şişmanlar T, Çobanoğlu N, Pekcan S, Cinel G, Yalçın E, Kiper N, Şen V, S Şen H, Ercan Ö, Keskin Ö, B Eltan S, Al Shadfan LM, Yazan H, Altıntaş DU, Şaşihüseyinoğlu Ş, Sapan N, Çekiç Ş, Çokuğraş H, A Kılınç A, R Gürsoy T, Aslan AT, Bingöl A, Başaran AE, Özdemir A, Köse M, Hangül M, Emiralioğlu N, Tuğcu G, Yüksel H, Yılmaz Ö, Orhan F, Gayretli Aydın ZG, Topal E, Tamay Z, Süleyman A, Can D, Bal CM, Çaltepe G, Özçelik U. Cystic fibrosis in Turkey: First data from the national registry. Pediatr Pulmonol 2020; 55:541-548. [PMID: 31710166 DOI: 10.1002/ppul.24561] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/09/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) care has been implemented in Turkey for a long time; however, there had been no patient registry. For this purpose, the Turkish National CF Registry was established. We present the first results of registry using data collected in 2017. METHODS The data were collected using a data-entry software system, which was accessed from the internet. Demographic and annually recorded data consisted of 15 and 79 variables, respectively. RESULTS There were 1170 patients registered from 23 centers; the estimated coverage rate was 30%. The median age at diagnosis was 1.7 years (median current age: 7.3 years); 51 (4.6%) patients were aged over 18 years. Among 293 patients who were under 3 years of age, 240 patients (81.9%) were diagnosed through newborn screening. Meconium ileus was detected in 65 (5.5%) patients. Genotyping was performed in 978 (87.4%) patients and 246 (25.2%) patients' mutations were unidentified. The most common mutation was deltaF508 with an allelic frequency of 28%, followed by N1303K (4.9%). The median FEV1% predicted was 86. Chronic colonization with Pseudomonas aeruginosa was seen in 245 patients. The most common complication was pseudo-Bartter syndrome in 120 patients. The median age of death was 13.5 years in a total of 15 patients. CONCLUSIONS Low coverage rate, lack of genotyping, unidentified mutations, and missing data of lung functions are some of our greatest challenges. Including data of all centers and reducing missing data will provide more accurate data and help to improve the CF care in Turkey in the future.
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Affiliation(s)
- Deniz Dogru
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Çakır
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Tuğba Şişmanlar
- Division of Pediatric Pulmonology, Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
| | - Nazan Çobanoğlu
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Sevgi Pekcan
- Division of Pediatric Pulmonology, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ebru Yalçın
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nural Kiper
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Velat Şen
- Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hadice S Şen
- Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömür Ercan
- Division of Pediatric Pulmonology, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Özlem Keskin
- Division of Pediatric Allergy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sevgi B Eltan
- Division of Pediatric Allergy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Lina M Al Shadfan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Derya U Altıntaş
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Şenay Şaşihüseyinoğlu
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Şükrü Çekiç
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Haluk Çokuğraş
- Division of Pediatric Allergy and Pulmonology, Cerrahpaşa Medicine Faculty, Istanbul University, Istanbul, Turkey
| | - Ayşe A Kılınç
- Division of Pediatric Allergy and Pulmonology, Cerrahpaşa Medicine Faculty, Istanbul University, Istanbul, Turkey
| | - Tuğba R Gürsoy
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşe T Aslan
- Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Abdurrahman E Başaran
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ali Özdemir
- Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Mehmet Köse
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melih Hangül
- Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Gaziantep Cengiz Gökçek Maternity and Children Hospital, Gaziantep, Turkey
| | - Gökçen Tuğcu
- Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Hasan Yüksel
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Özge Yılmaz
- Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Fazıl Orhan
- Division of Pediatric Allergy, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Zeynep G Gayretli Aydın
- Division of Pediatric Infectious Disease, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Erdem Topal
- Division of Pediatric Allergy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşe Süleyman
- Division of Pediatric Allergy, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Demet Can
- Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | - Cem M Bal
- Division of Pediatric Pulmonology, Atatürk Regional Training and Research Hospital, Erzurum, Turkey
| | - Gönül Çaltepe
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Uğur Özçelik
- Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Abstract
Hand surgery leadership in the United States must identify and define what quality care means for its patients. To achieve this, the surgical team needs a standardized framework to track and improve quality. This is necessary not only in our value-based health care system but also in light of considerable provider variation in the management of common hand conditions and the ongoing need for evidence-based guidelines to inform decision-making. Building a national registry for the field of hand surgery could be the solution and warrants serious consideration. A registry designed by hand surgery experts can collect data on process and outcome measures that are meaningful and specific to patients with hand conditions. These data inform the surgical team regarding where to focus their efforts for improvement. Existing methods of quality measurement are not compatible with hand surgery, a field with an ambulatory setting and rare incidence of mortality. Patient-reported outcomes, such as health-related quality of life, represent a more useful measure of quality for hand surgery and are just one example of the type of data that could be tracked using a national registry. An investment in a large-scale registry could seamlessly integrate patient preferences, values, and expectations into clinical practice so that desired outcomes can be delivered consistently across the nation.
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Affiliation(s)
- Robert L Kane
- Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
| | - Kevin C Chung
- Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI.
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Brenner MJ, Chang CWD, Boss EF, Goldman JL, Rosenfeld RM, Schmalbach CE. Patient Safety/Quality Improvement Primer, Part I: What PS/QI Means to Your Otolaryngology Practice. Otolaryngol Head Neck Surg 2019; 159:3-10. [PMID: 29968525 DOI: 10.1177/0194599818779547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/22/2023]
Abstract
Patient safety/quality improvement (PS/QI) is the cornerstone of 21st-century health care. Otolaryngology-Head and Neck Surgery is excited to provide a dedicated PS/QI primer. The overarching goal for this PS/QI series is to provide a comprehensive and practical resource that assists readers, authors, and peer reviewers in understanding PS/QI research, its unique methodology, and the associated reporting standards for trustworthy performance measures. The target audience includes resident and fellows, faculty from the private sector and academia, and allied health professionals. This inaugural primer reviews PS/QI background as it relates to otolaryngology practice. It explores the history, goals, and development of performance measurement. In addition, it highlights opportunities for integrating PS/QI into otolaryngology practice. Payers will drive patients to quality care based on outcomes. Otolaryngologists have a responsibility to embrace a culture of PS/QI. In doing so, we will define optimal, quality otolaryngology care through objective data and metrics.
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Affiliation(s)
- Michael J Brenner
- 1 School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Emily F Boss
- 3 School of Medicine Johns Hopkins University, Baltimore, Maryland, USA
| | - Julie L Goldman
- 4 School of Medicine, University of Louisville, Louisville, Kentucky, USA
| | | | - Cecelia E Schmalbach
- 6 Roudebush Veterans Medical Center, School of Medicine, Indiana University, Indianapolis, Indiana, USA
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Nicoloso G, Kürsteiner O, Bussmann F, Marbacher M, Tiercy JM. A study of selected hematopoietic stem cell donors provided by an intermediate size registry. Eur J Haematol 2019; 103:426-432. [PMID: 31385372 DOI: 10.1111/ejh.13307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Planning new hematopoietic stem cell (HSC) donor recruitment strategies requires a sound understanding of the factors underlying donor selection, especially considering HLA-matching criteria. METHOD A total of 182 consecutive workups of Swiss donors performed from 2014 to 2017 were analyzed for HLA match level, locus disparities, number of potentially 10/10 matched donors in the international database, donor ranking on the lists, donor date of registration, age, ABO, CMV, gender matching, patient genotype frequency, and country performing the search. RESULTS Matching status of the selected donors was 10/10 for 38.5%, 10-12/12 for 35.1%, and 8-9/10 for 26.4% donors, without differences in average donor age in the three categories. HLA-A and -C mismatches were most frequent and -DRB1 very rare. 8.2% patients were matched for HLA-DPB1 (12/12). ABO matching was 46.3%, and CMV matching was 59.1%. Based on "HaploStat"-derived genotype frequencies, 50.3% patients belonged to the "good," 38.5% to the "fair," and 11.2% to the "poor" search prognosis categories. 37.9% of transplants were gender-mismatched, and 42.3% of donors were female. CONCLUSION HLA typing quality (high resolution, all loci typed), great diversity of haplotypes and donor age are main factors impacting the selection of Swiss donors, while gender and ABO matching seem to be of secondary importance.
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Affiliation(s)
- Grazia Nicoloso
- Swiss Blood Stem Cells, Swiss Transfusion SRC Ltd, Bern, Switzerland
| | - Oliver Kürsteiner
- Swiss Blood Stem Cells, Swiss Transfusion SRC Ltd, Bern, Switzerland
| | - Felix Bussmann
- Swiss Blood Stem Cells, Swiss Transfusion SRC Ltd, Bern, Switzerland
| | - Monika Marbacher
- Swiss Blood Stem Cells, Swiss Transfusion SRC Ltd, Bern, Switzerland
| | - Jean-Marie Tiercy
- Swiss Blood Stem Cells, Swiss Transfusion SRC Ltd, Bern, Switzerland
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Longinetti E, Regodón Wallin A, Samuelsson K, Press R, Zachau A, Ronnevi LO, Kierkegaard M, Andersen PM, Hillert J, Fang F, Ingre C. The Swedish motor neuron disease quality registry. Amyotroph Lateral Scler Frontotemporal Degener 2018; 19:528-537. [PMID: 30296856 DOI: 10.1080/21678421.2018.1497065] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 10/28/2022]
Abstract
OBJECTIVE We set up the Swedish Motor Neuron Disease (MND) Quality Registry to assure early diagnosis and high-quality health care for all MND patients (mainly amyotrophic lateral sclerosis, ALS), and to create a research base by prospectively following the entire MND population in Sweden. METHODS Since 2015, the MND Quality Registry continuously collects information about a wide range of clinical measures, biological samples, and quality of life outcomes from all MND patients recruited at the time of MND diagnosis in Sweden and followed at each clinic visit approximately every 12 weeks. The Registry includes an Internet based patient own reporting portal that involves patients in the registration of their current symptoms and health status. RESULTS As of 20th January 2017, the MND Quality Registry included 99% of the MND patients of the Stockholm area (N = 194), consisting mostly of ALS patients (N = 153, 78.9%), followed by patients labeled as MND due to a neurophysiology finding but not fulfilling the criteria for ALS (N = 20, 10.3%), primary lateral sclerosis (N = 13, 6.7%), and progressive spinal muscular atrophy patients (N = 8, 4.1%). A higher proportion of these patients were women (N = 100, 52%), and women and men had a similar age at symptoms onset (59 years). CONCLUSIONS Main strengths of the MND Quality Registry are its clinical, quantitative, qualitative, and prospective nature, providing the researchers potential means of identifying appropriate candidates for clinical trials and other research projects, as well as assuring to the patients an effective and adequate time spent on-site with the healthcare professionals.
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Affiliation(s)
- Elisa Longinetti
- a Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden
| | - Amanda Regodón Wallin
- a Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden
| | - Kristin Samuelsson
- b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden.,c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Rayomand Press
- b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden.,c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Anne Zachau
- b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden
| | - Lars-Olof Ronnevi
- b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden.,c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Marie Kierkegaard
- d Function Area Occupational therapy and Physiotherapy , Karolinska University Hospital , Stockholm , Sweden.,e Department of Neurobiology Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden , and
| | - Peter M Andersen
- f Department of Clinical Neurosciences , Umeå University , Stockholm , Sweden
| | - Jan Hillert
- c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Fang Fang
- a Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden
| | - Caroline Ingre
- b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden.,c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
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Taruscio D, Vittozzi L, Rocchetti A, Torreri P, Ferrari L. The Occurrence of 275 Rare Diseases and 47 Rare Disease Groups in Italy. Results from the National Registry of Rare Diseases. Int J Environ Res Public Health 2018; 15:ijerph15071470. [PMID: 30002291 PMCID: PMC6068991 DOI: 10.3390/ijerph15071470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/30/2018] [Accepted: 07/09/2018] [Indexed: 01/29/2023]
Abstract
Knowledge of rare diseases (RD) is often scattered among many data collections and registries of patient cohorts. Therefore, assessing the burden of RD in the general population, developing appropriate policies and planning services for the care of RD patients is difficult. This study aimed at providing a systematic picture of RD occurrence in a population as big as 60 million. Data of diagnoses were certified and collected by a network of 247 specialized centres covering the whole Italian territory. Data received (about 200,000 records) were validated according to formal criteria and, where necessary, corrected by the data sources. Data of age at onset and sex distribution are given for about 400 diseases. Incidence and/or birth prevalence are given for 275 diseases and 47 disease groups, which, altogether, comprise a substantial part of the known rare diseases. Data quality, internal consistency, and external validity of the database have also been assessed and ways to limit the impact of some discrepancies were devised. The information provided by RNMR, cutting across such a wide range of RD, represents a unique coherent basis allowing the prioritization of relevant public health measures and research activities.
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Affiliation(s)
- Domenica Taruscio
- Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Luciano Vittozzi
- Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Adele Rocchetti
- Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Paola Torreri
- Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Luca Ferrari
- Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, 00161 Rome, Italy.
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Hallenstål N, Sunnergren O, Ericsson E, Hemlin C, Hessén Söderman AC, Nerfeldt P, Odhagen E, Ryding M, Stalfors J. Tonsil surgery in Sweden 2013-2015. Indications, surgical methods and patient-reported outcomes from the National Tonsil Surgery Register. Acta Otolaryngol 2017; 137:1096-1103. [PMID: 28598766 DOI: 10.1080/00016489.2017.1327122] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 10/19/2022]
Abstract
AIM To describes how tonsil surgery was performed in Sweden from 2013 to 2015 with data from the National Tonsil Surgery Registry in Sweden (NTSRS). METHOD The registry collects data from both professionals and patients through questionnaires. A total of 33,870 tonsil surgeries were analysed, comprising approximately 80% of all tonsil surgeries in Sweden from 2013 to 2015. RESULTS The two most common procedures were tonsillectomy (41%) and tonsillotomy with adenoidectomy (38%). Tonsillectomy was most commonly performed to treat frequent tonsillitis, while the main indication for tonsil surgery with combined adenoidectomy and for tonsillotomy alone was upper airway obstruction. The most commonly used techniques were cold steel (70%) for tonsillectomy/adenotonsillectomy and radiofrequency (79%) for tonsillotomy/adenotonsillotomy. Ninety-five percent of patients reported symptom relief after 180 d. Day surgery was utilised in 70% of the surgeries. The rate of readmission due to post-tonsillectomy haemorrhage was 5.1%. Male patients more often underwent tonsil surgery at preschool ages due to upper airway obstruction; in comparison, female patients to a larger extent underwent surgery in their early teens because of previous infections. CONCLUSIONS The NTSRS provides an opportunity to survey tonsil surgery in Sweden and to launch and follow up improvement programmes as desired.
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Affiliation(s)
- Niclas Hallenstål
- Department of Otorhinolaryngology, Östersund Hospital, Östersund, Sweden
| | - Ola Sunnergren
- Department of Otorhinolaryngology, Ryhov County Hospital and Futurum– the Academy for Health and Care, County Council, Jönköping, Sweden
| | - Elisabeth Ericsson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Anne-Charlotte Hessén Söderman
- Department of Otorhinolaryngology, Cityakuten, Stockholm, Sweden
- Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pia Nerfeldt
- Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Odhagen
- Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Borås, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Marie Ryding
- Department of Otorhinolaryngology, Östersund Hospital, Östersund, Sweden
- Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Joacim Stalfors
- Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Sheikh Khalifa Medical City, Ajman, United Arab Emirates
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Abstract
The absence of descriptive epidemiological data on the frequency and distribution of fractures in a population is serious and may underestimate the actual importance of this public health problem. In this study, we report the crude and standardized incidence rates of fractures in the population of Kuwait during the period 2009-2012. Using the Ministry of Public Health's national registry, demographic data of all fracture cases between 2009 and 2012 were retrieved. These were further categorized into fractures at the hip or any other sites. Average annual incidence rates were calculated and standardized using the world's population in 2010 as a reference. Thus, 18,119 fractures among males and 6,362 among females were recorded. The overall estimated annual incidence rates of fractures per 100,000 person-years were 207 for males and 111.8 for females. Moreover, 13.3% of all fractures were in the hip, with incidence rates of 24.8 for males and 18.9 for females; while 86.7% were in other sites, with corresponding incidence rates of 182.2 and 92.8, respectively. The age-specific fracture incidence rates in females remained below the corresponding rates of males until ≥50 years of age, after which the female age groups showed successively higher rates. The age-standardized incidence rates for all fractures (hip and other sites) were 247.4 for males, 175.4 for females, and 216.2 for both sexes. The burden of this major public health challenge is set to rise, and such population-based incidence data call for an urgent need for action to reduce the projected human impact and socioeconomic costs of fracture.
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Affiliation(s)
- Fawaz Y Azizieh
- Department of Mathematics and Natural Sciences, International Centre for Applied Mathematics and Computational Bioengineering, College of Arts and Sciences, Gulf University for Science and Technology, Mubarak Al-Abdullah, Hawally, State of Kuwait
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Tomassini F, Scuderi V, Berardi G, Dili A, D’Hondt M, Sergeant G, Hubert C, Huysentruyt F, Berrevoet F, Lucidi V, Troisi RI. The practice of laparoscopic liver surgery in Belgium: a national survey. Acta Chir Belg 2017; 117:15-20. [PMID: 27541973 DOI: 10.1080/00015458.2016.1202478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Laparoscopic liver surgery (LLS) gained popularity bringing several advantages including decreased morbidity and reduction of length of hospital stay compared to open. METHODS To understand practice and evolution of LLS in Belgium, a 20-questions survey was sent to all members of the Royal Belgian Society for Surgery, the Belgian Section of Hepato-Pancreatic and Biliary Surgery and the Belgian Group for Endoscopic Surgery. RESULTS Thirty-seven surgical units representing 61 surgeons performing LLS in Belgium responded: 50% from regional hospitals, 28% from university and 22% from peripheral hospitals. Replies from high volume centers (>50 liver-surgery/year) were 19%. More than 25% of liver procedures were performed laparoscopically in 35% of centers. LLS is adopted since more than 15-years in 14.5% of centers with an increasing rate reported in 59%. Low relevance of LLS in the hospital organization (26.5%) and lack of time in surgical schedules (12%) or of specific training (9%) are the main barriers for further diffusion. More than 80% of the responders agreed to participate to a national prospective registry. CONCLUSION LLS is mainly performed in experienced HPB units with an increasing interest in peripheral centers. A prospective national registry will be useful by providing real data in terms of indications, morbidity and overall evolution.
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Umeshita K, Inomata Y, Furukawa H, Kasahara M, Kawasaki S, Kobayashi E, Kokudo N, Sakisaka S, Shimada M, Tanaka E, Uemoto S. Liver transplantation in Japan: Registry by the Japanese Liver Transplantation Society. Hepatol Res 2016; 46:1171-1186. [PMID: 26887781 DOI: 10.1111/hepr.12676] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 12/20/2015] [Revised: 02/10/2016] [Accepted: 02/12/2016] [Indexed: 12/12/2022]
Abstract
As of December 31, 2013, a total of 7474 liver transplants have been carried out at 66 institutions in Japan. This total included 7255 living-donor transplants and 219 deceased-donor transplants (216 from heart-beating donors and 3 from non-heart-beating donors). The annual total of liver transplants in 2013 decreased to 408, from 422 in 2012. The number of liver transplants from living donors decreased to 369, from 381, whereas the number of liver transplants from heart-beating deceased donors did not change significantly. The most frequent indication was cholestatic disease, followed by neoplastic disease. In terms of graft liver in living-donor cases, right-lobe graft was the most popular (36%). Patient survival following transplantations from heart-beating donors (1 year, 85.9%; 3 years, 82.6%; 5 years, 81.3%; 10 years, 73.8%) was similar to those from living donors (1 year, 83.8%; 3 years, 79.6%; 5 years, 77.1%; 10 years, 71.9%; 15 years, 67.8%; 20 years, 66.1%). Graft survival was very much the same as patient survival. As for ABO-incompatible transplantation, transplant period affected the outcome significantly, probably due to local infusion therapy and rituximab prophylaxis, which were introduced in many transplant centers after 2000 and 2004, respectively.
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Affiliation(s)
- Koji Umeshita
- Department of Surgery, Graduate School of Medicine, Osaka University, Osaka
| | - Yukihiro Inomata
- Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto
| | - Hiroyuki Furukawa
- Department of Gastroentrologic and General Surgery, Asahikawa Medical University, Asahikawa
| | - Mureo Kasahara
- Transplantation Center, National Center for Child Health and Development
| | - Seiji Kawasaki
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine
| | - Eiji Kobayashi
- Department of Organ Fabrication, Keio University School of Medicine
| | - Norihiro Kokudo
- Hepatobiliary Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo
| | - Shotaro Sakisaka
- Department of Gastroenterology and Medicine, Fukuoka University School of Medicine, Fukuoka
| | | | - Eiji Tanaka
- Department of Medicine, Shinshu University School of Medicine, Matsumoto
| | - Shinji Uemoto
- Department of HPB Surgery and Transplantation, Kyoto University, Kyoto, Japan
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Abstract
Aim of database To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients. Main variables The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning. Descriptive data The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may obtain access to the data for use in specific research projects by applying to the steering committee. Conclusion The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time devoted is necessary to maintain the integrity of the registry and the validity of the data.
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Affiliation(s)
- Lone Baandrup
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup
| | - Charlotte Cerqueira
- Registry Support Centre (East) - Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen
| | - Lea Haller
- The Danish Clinical Registries, Registry Support Centre for Health Quality and Informatics (KCKS-West), Aarhus
| | - Lene Korshøj
- The Danish Clinical Registries, Registry Support Centre for Health Quality and Informatics (KCKS-West), Aarhus
| | - Inge Voldsgaard
- Psychosis Ward, Section P, Aarhus University Hospital, Risskov
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
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Abstract
Aim of the database The aim of the Danish Adult Diabetes Registry (DADR) is to provide data from both the primary health care sector (general practice [GP]) and the secondary sector (specialized outpatient clinics) to assess the quality of treatment given to patients with diabetes. The indicators represent process and outcome indicators selected from the literature. Study population The total diabetes population in Denmark is estimated to be ~300,000 adult diabetes patients. Approximately 10% have type 1 diabetes, which is managed mainly in the secondary sector, and 90% have type 2 diabetes with the majority (80%) being treated in primary health care. In 2014, DADR included data from a total of 70,826 patients. Main variables The following variables are assessed: date of analysis as well as the outcome for hemoglobin A1c, blood pressure, lipids, urinary albumin–creatinine ratio, smoking status, glucose-, blood pressure-, and lipid-lowering treatment (yes/no), insulin pump treatment (yes/no), and date of last eye and foot examination. Descriptive data In 2014, the annual report included data regarding over 38,000 patients from outpatient clinics, which is assumed to have included almost all patients in this setting, and >32,000 from GPs, reflecting improved but still limited coverage from this setting. The annual results are published in a compiled report of Danish Diabetes Care, which included DADR, data from the pediatric diabetes database, and the national ophthalmological diabetes database. The annual report is published, which included data on national, regional, and local level (individual outpatient clinics and corresponding GPs). This allows a comprehensive overview of diabetes care in Denmark. Conclusion The database covers an increasing fraction of patients with diabetes in Denmark, and the structure for full coverage is in place. Annual reporting has helped to ensure focus on the quality of diabetes treatment in the primary and secondary health care. Furthermore, it is an important resource for Danish register-based diabetes research.
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Affiliation(s)
- Marit Eika Jørgensen
- Steno Diabetes Center, Gentofte; National Institute of Public Health, University of Southern Denmark, Odense
| | | | | | - Charlotte Cerqueira
- Registry Support Centre (East) - Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark
| | - Peter Rossing
- Steno Diabetes Center, Gentofte; Aarhus University, Aarhus; University of Copenhagen, Copenhagen, Denmark
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Ahluwalia A, Gladwin M, Coleman GD, Hord N, Howard G, Kim-Shapiro DB, Lajous M, Larsen FJ, Lefer DJ, McClure LA, Nolan BT, Pluta R, Schechter A, Wang CY, Ward MH, Harman JL. Dietary Nitrate and the Epidemiology of Cardiovascular Disease: Report From a National Heart, Lung, and Blood Institute Workshop. J Am Heart Assoc 2016; 5:e003402. [PMID: 27385425 PMCID: PMC5015377 DOI: 10.1161/jaha.116.003402] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Amrita Ahluwalia
- The William Harvey Research Institute, Barts & The London Medical School, Queen Mary University of London, UK
| | - Mark Gladwin
- Vascular Medicine Institute, Pittsburgh University, Pittsburgh, PA
| | | | | | | | | | - Martin Lajous
- Nacional de Salud Pública de Mexico, Mexico, Albania
| | | | - David J Lefer
- Louisiana State University Health Sciences Center, New Orleans, LA
| | - Leslie A McClure
- Dornsife School of Public Health at Drexel University, Philadelphia, PA
| | | | - Ryszard Pluta
- National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Alan Schechter
- National Institute for Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Chia-Yih Wang
- National Center for Health Statistics, CDC, Hyattsville, MD
| | | | - Jane L Harman
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
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Abstract
The Swedish MS registry (SMSreg) is designed to assure quality health care for patients with multiple sclerosis (MS). It has been active since 2001 and web-based since 2004. It runs on government funding only and is used in all Swedish neurology departments. The SMSreg currently includes data on 14,500 of Sweden's estimated 17,500 prevalent patients with MS. One important function of SMSreg, to which participation is voluntary, is to serve as a tool for decision support and to provide an easy overview of the patient information needed at clinical visits. This is its core feature and explains why the majority of Swedish MS specialists contribute data. Another success factor for SMSreg is that entered data can be readily accessed, either through a query function into Excel format or through a set of predesigned tables and diagrams in which parameters can be selected. Recent development includes a portal allowing patients to view a summary of their registered data and to report a set of patient-reported outcomes. SMSreg data have been used in close to 100 published scientific reports. Current projects include an incidence cohort (EIMS), post-marketing cohorts of patients on novel disease-modifying drugs (IMSE), and a prevalence cohort (GEMS). As these studies combine physical sampling and questionnaire data with clinical documentation and possible linkage to other public registries, together they provide an excellent platform for integrated MS research.
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Affiliation(s)
- J. Hillert
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Department of Neurology Karolinska University Hospital Stockholm Sweden
| | - L. Stawiarz
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Department of Neurology Karolinska University Hospital Stockholm Sweden
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Abstract
STUDY DESIGN National registry cohort study. OBJECTIVE The aim of this study was to investigate the effect of surgical stabilization on survival of spinal fractures related to ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA Spinal fractures related to AS are associated with considerable morbidity and mortality. Multiple studies suggest a beneficial effect of surgical stabilization in these patients. METHODS In the Swedish patient registry, all patients treated in an inpatient facility are registered with diagnosis and treatment codes. The Swedish mortality registry collects date and cause of death for all fatalities. Registry extracts of all patients with AS and spinal fractures including date of death and treatment were prepared and analyzed for epidemiological purposes. RESULTS Seventeen thousand two hundred ninety-seven individual patients with AS were admitted to treatment facilities in Sweden between 1987 and 2011. Nine hundred ninety patients with AS (age 66 ± 14 years) had 1131 spinal fractures, of which 534 affected cervical, 352 thoracic, and 245 lumbar vertebrae. Thirteen percent had multiple levels of injuries during the observed period. Surgically treated patients had a greater survival than those treated nonsurgically [hazard ratio (HR) 0.79, P = 0.029]. Spinal cord injury was the major factor contributing to mortality in this cohort (HR 1.55, P < 0.001). The proportion of surgically treated spinal fractures increased linearly during the last decades (r = 0.92, P < 0.001) and was 64% throughout the observed years. CONCLUSIONS Spinal cord injury threatened the survival of patients with spinal fractures related to AS. Even though surgical treatment is associated with a considerable complication rate, it improved the survival of spinal fractures related to AS. LEVEL OF EVIDENCE 3.
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Abstract
There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier in life that may affect the risk of MS. This register has no systematic follow-up data except for survival. The DMSR has over the years published nationwide incidence- and prevalence data from Denmark and has been involved in a number of 'historical prospective' studies to elucidate the association between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have received disease-modifying treatments since 1996. It has, in particular, contributed to the knowledge of the role of antibodies against the biological drugs used for the treatment of MS.
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Affiliation(s)
- N. Koch-Henriksen
- Department of Clinical Epidemiology; University of Aarhus; Aarhus Denmark
- The Danish Multiple Sclerosis Registry; Rigshospitalet; Copenhagen Denmark
| | - M. Magyari
- The Danish Multiple Sclerosis Registry; Rigshospitalet; Copenhagen Denmark
- Danish Multiple Sclerosis Center; Department of Neurology; Righospitalet; Copenhagen Denmark
| | - B. Laursen
- The National Institute of Public Health; University of Southern Denmark; Copenhagen Denmark
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Bajraktari IH, Teuta BÇ, Vjollca SM, Bajraktari H, Saiti V, Krasniqi B, Muslimi F. Demographic features of patients with rheumatoid arthritis in kosovo. Med Arch 2015; 68:407-10. [PMID: 25649180 PMCID: PMC4314179 DOI: 10.5455/medarh.2014.68.407-410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/30/2014] [Indexed: 12/05/2022] Open
Abstract
Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory illness characterized by polyarthritis of small and large joints which in the course of time may progress to disability. Material and methods: In our prospective study were included 951 patients (females 730, and males 221 respectively) with an average age 51.3 year old, diagnosed with RA in accordance with ACR-EULAR/2010 criteria. The purpose of the paper is to investigate gender, age, group age by gender, level of education, residing place, nationality, religion, social condition, marital status, and vocation in our patients. Statistical processing has been carried out with program SPSS 20.0, SigmaStat 2.03, SigmaPlot 2000, MedCalc and Excel 2010. Most present group age was 40 – 49 year old with difference in distribution based on gender. Results: The largest number of them had completed secondary education, most of them originated from rural areas, were farmers by vocation and housewives. The database created by this survey can serve for building the RA patients’ national registry. This registry can serve for further researches and planning the management of RA as a systemic rheumatic disease that has an immense social, economic and health impact. Largest portion of RA patients were farmers and housewives respectively (38% and 32.2% respectively). Vocations such as: retail sellers, workers in administration, education, factory, maintenance, and artisan workers had similar incidence in both genders that ranged from 9.7% to 6.2%, whereas these vocations among males ranged from 11.3% to 2.7%.
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Affiliation(s)
- Ismet H Bajraktari
- Clinic for Rheumatology, University and Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Backa-Çiço Teuta
- Clinic for Rheumatology, University Hospital Centre "Mother Teresa", Tirana, Albania
| | | | - Halit Bajraktari
- Private internal medicine - rheumatology practice "Prorheuma", Prishtina, Kosovo
| | - Valton Saiti
- Clinic for Endocrinology, University and Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Blerim Krasniqi
- University of Medical Sciences "Rezonanca", Prishtina, Kosovo
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Faunø P, Rahr-Wagner L, Lind M. Risk for Revision After Anterior Cruciate Ligament Reconstruction Is Higher Among Adolescents: Results From the Danish Registry of Knee Ligament Reconstruction. Orthop J Sports Med 2014; 2:2325967114552405. [PMID: 26535272 PMCID: PMC4555549 DOI: 10.1177/2325967114552405] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: The number of children and adolescents with anterior cruciate ligament (ACL) reconstructions is increasing, and disturbing reports on high rerupture rates in this group have been noted. Purpose: To describe the outcome of ACL reconstruction in children and adolescents based on data from the Danish Knee Ligament Reconstruction Registry (DKRR). Study Design: Cohort study; Level of evidence, 3. Methods: Data were retrieved from the DKRR, a national population-based registry. The analysis was based on a population of 14,806 ACL-reconstructed patients. The outcome was evaluated using risk of ACL revision, subjective outcome score (Knee injury and Osteoarthritis Outcome Score [KOOS]), Tegner function score, and objective knee laxity. Three age groups were defined (A, <13 years; B, 13-15 years; and C, 15-20 years) and compared with D, patients ≥20 years (adults). There were 95 patients in group A, 327 in B, 2888 in C, and 11,496 in D. Results: There was a significantly increased risk of revision surgery in the age groups B (6.7%) and C (4.9%) compared with the adults in group D (2.0%). Objective knee laxity did not differ between the 4 groups. Groups A, B, and C had a higher score on the combined KOOS symptoms, pain, sport, and quality of life subscales (KOOS4; 79.6, 76.6, and 73.1, respectively) compared with the adults (69.7). Group B had higher KOOS quality of life (76.6) and sports (71.1) scores than did group C (73.1 and 66.4, respectively). The Tegner activity score did not differ between the 4 groups. No impact of the use of extracortical graft fixation was detected in the youngest age group. Conclusion: Study results indicated an increased risk of graft failure in patients between 13 and 20 years of age. This is in contrast to the better subjective and equal objective knee score found in the same age groups. Clinical Relevance: The new knowledge about the high revision rate among ACL-reconstructed teenagers is important for evidence-based preoperative information of ACL patients and their parents.
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Affiliation(s)
- Peter Faunø
- Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lene Rahr-Wagner
- Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Martin Lind
- Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark
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Koton S, Tsabari R, Molshazki N, Kushnir M, Shaien R, Eilam A, Tanne D. Burden and outcome of prevalent ischemic brain disease in a national acute stroke registry. Stroke 2013; 44:3293-7. [PMID: 24065711 DOI: 10.1161/strokeaha.113.002174] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Previous overt stroke and subclinical stroke are frequent in patients with stroke; yet, their clinical significance and effects on stroke outcome are not clear. We studied the burden and outcome after acute ischemic stroke by prevalent ischemic brain disease in a national registry of hospitalized patients with acute stroke. METHODS Patients with ischemic stroke in the National Acute Stroke Israeli prospective hospital-based registry (February to March 2004, March to April 2007, and April to May 2010) with information on previous overt stroke and subclinical stroke per computed tomography/MRI (n=3757) were included. Of them, a subsample (n=787) was followed up at 3 months. Logistic regression models were computed for outcomes in patients with prior overt stroke or subclinical stroke, compared with patients with first stroke, adjusting for age, sex, vascular risk factors, stroke severity, and clinical classification. RESULTS Two-thirds of patients had a prior overt stroke or subclinical stroke. Death rates were similar for patients with and without prior stroke. Adjusted odds ratios (OR; 95% confidence interval [CI]) for disability were increased for patients with prior overt stroke (OR, 1.31; 95% CI, 1.03-1.66) and subclinical stroke (OR, 1.45; 95% CI, 1.16-1.82). Relative odds of Barthel Index≤60 for patients with prior overt stroke (OR, 2.04; 95% CI, 1.14-3.68) and with prior subclinical stroke (OR, 2.04; 95% CI, 1.15-3.64) were twice higher than for patients with a first stroke. ORs for dependency were significantly increased for patients with prior overt stroke (OR, 1.95; 95% CI, 1.19-3.20) but not for those with subclinical stroke (OR, 1.36; 95% CI, 0.84-2.19). CONCLUSIONS In our national cohort of patients with acute ischemic stroke, nearly two thirds had a prior overt stroke or subclinical stroke. Risk of poor functional outcomes was increased for patients with prior stroke, both overt and subclinical.
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Affiliation(s)
- Silvia Koton
- From the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (S.K., D.T.); Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel (R.T., N.M., D.T.); Department of Neurology, Kaplan Medical Center, Rechovot, Israel (M.K., A.E.); and Department of Neurology, Rivka Ziv Medical Center, Zefat, Israel (R.S.)
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Voican I, Vladareanu AM, Bumbea H, Barsan L, Vasile D. CML patients in the molecular era - report of five years experience of diagnosis and treatment in a single center. J Med Life 2013; 6:319-26. [PMID: 24146695 PMCID: PMC3786495] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/25/2013] [Indexed: 11/15/2022] Open
Abstract
Chronic myeloid leukemia (CML) represents about 15% of all leukemia cases. Although the incidence of the disease is rather low, the therapeutic progress of the last decade has dramatically changed the evolution of this disease, whose survival considerably increased and in whom we now speak even about cure. The success of the therapy is strongly connected to the precocity of the diagnosis and molecular targeted therapy that implies a close monitoring of the patient. The specific molecular assay, that developed a lot in the last years, became an important tool in the management of these patients, providing the possibility of efficient changing in therapy. The purpose of our study was to identify the characteristics of our CML patients in terms of clinical and biological behavior. We analyzed 21 patients diagnosed between October 2007 and December 2010 and compared the data with a historical group of patients, also diagnosed in our department between March 2005 and September 2007. We found a better outcome and overall survival in the study group, due to improved diagnosis and monitoring techniques as well as to better access to therapy.
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Affiliation(s)
- I Voican
- Department of Hematology, University Hospital Bucharest, Romania
| | - AM Vladareanu
- Department of Hematology, University Hospital Bucharest, Romania
| | - H Bumbea
- Department of Hematology, University Hospital Bucharest, Romania
| | - L Barsan
- Department of Hematology, University Hospital Bucharest, Romania
| | - D Vasile
- Department of Hematology, University Hospital Bucharest, Romania
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