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Whitaker HJ, Hassell K, Hoschler K, Power L, Stowe J, Boddington NL, Tsang C, Zhao H, Linley E, Button E, Okusi C, Aspden C, Byford R, deLusignan S, Amirthalingam G, Zambon M, Andrews NJ, Watson C. Influenza vaccination during the 2021/22 season: A data-linkage test-negative case-control study of effectiveness against influenza requiring emergency care in England and serological analysis of primary care patients. Vaccine 2024; 42:1656-1664. [PMID: 38342716 DOI: 10.1016/j.vaccine.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
We present England 2021/22 end-of-season adjusted vaccine effectiveness (aVE) against laboratory confirmed influenza related emergency care use in children aged 1-17 and in adults aged 50+, and serological findings in vaccinated vs unvaccinated adults by hemagglutination inhibition assay. Influenza vaccination has been routinely offered to all children aged 2-10 years and adults aged 65 years + in England. In 2021/22, the offer was extended to children to age 15 years, and adults aged 50-64 years. Influenza activity rose during the latter half of the 2021/22 season, while remaining comparatively low due to COVID-19 pandemic control measures. Influenza A(H3N2) strains predominated. A test negative design was used to estimate aVE by vaccine type. Cases and controls were identified within a sentinel laboratory surveillance system. Vaccine histories were obtained from the National Immunisation Management Service (NIMS), an influenza and COVID-19 vaccine registry. These were linked to emergency department presentations (excluding accidents) with respiratory swabbing ≤ 14 days before or ≤ 7 days after presentation. Amongst adults, 423 positive and 32,917 negative samples were eligible for inclusion, and 145 positive and 6,438 negative samples among children. Those admitted to hospital were further identified. In serology against the circulating A(H3N2) A/Bangladesh/4005/2020-like strain, 61 % of current season adult vaccinees had titres ≥ 1:40 compared to 17 % of those unvaccinated in 2020/21 or 2021/22 (p < 0.001). We found good protection from influenza vaccination against influenza requiring emergency care in children (72.7 % [95 % CI 52.7, 84.3 %]) and modest effectiveness in adults (26.1 % [95 % CI 4.5, 42.8 %]). Adult VE was higher for A(H1N1) (81 % [95 % CI 50, 93 %]) than A(H3N2) (33 % [95 % CI 6, 53 %]). Consistent protection was observable across preschool, primary and secondary school aged children. Imperfect test specificity combined with very low prevalence may have biased estimates towards null. With limited influenza circulation, the study could not determine differences by vaccine types.
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Affiliation(s)
- Heather J Whitaker
- Statistics, Modelling and Economics Department, UK Health Security Agency, Colindale, London, UK.
| | - Katie Hassell
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Katja Hoschler
- Virus Reference Unit, UK Health Security Agency, Colindale, London, UK
| | - Linda Power
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Julia Stowe
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Nicki L Boddington
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Camille Tsang
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Hongxin Zhao
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Ezra Linley
- Seroepidemiology Unit, UK Health Security Agency, Manchester, UK
| | - Elizabeth Button
- Nuffield Department of General Practitioners Research and Surveillance Centre, Oxford Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Cecilia Okusi
- Nuffield Department of General Practitioners Research and Surveillance Centre, Oxford Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carole Aspden
- Nuffield Department of General Practitioners Research and Surveillance Centre, Oxford Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Byford
- Nuffield Department of General Practitioners Research and Surveillance Centre, Oxford Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon deLusignan
- Nuffield Department of General Practitioners Research and Surveillance Centre, Oxford Primary Care Health Sciences, University of Oxford, Oxford, UK; Royal College of General Practitioners Research and Surveillance Centre, 30, Euston Square, London, UK
| | - Gayatri Amirthalingam
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Maria Zambon
- Virus Reference Unit, UK Health Security Agency, Colindale, London, UK
| | - Nick J Andrews
- Statistics, Modelling and Economics Department, UK Health Security Agency, Colindale, London, UK; Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
| | - Conall Watson
- Immunisation and Vaccine-preventable Diseases Division, UK Health Security Agency, Colindale, London, UK
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52
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Romo-Miguel P, Ballesteros-Peña S. Ultrasound-guided puncture vs conventional technique for arterial blood gas analysis sampling in adults: A systematic review. Enferm Intensiva (Engl Ed) 2024:S2529-9840(23)00071-X. [PMID: 38453623 DOI: 10.1016/j.enfie.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/14/2023] [Accepted: 10/02/2023] [Indexed: 03/09/2024]
Abstract
AIM To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults. METHOD A search protocol was developed and applied to three databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed. RESULTS Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of four studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success. CONCLUSIONS Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.
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Affiliation(s)
- P Romo-Miguel
- Unidad de Cuidados Intensivos, Osakidetza, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - S Ballesteros-Peña
- Biobizkaia Health Research Institute, Barakaldo, Vizcaya, Spain; Dirección de Enfermería, Osakidetza, Hospital Santa Marina, Bilbao, Vizcaya, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Leioa, Spain.
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53
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Dartigeas C, Quinquenel A, Ysebaert L, Dilhuydy MS, Anglaret B, Slama B, Le Du K, Tardy S, Tchernonog E, Orfeuvre H, Voillat L, Guidez S, Malfuson JV, Dupuis S, Deslandes M, Feugier P, Leblond V. Final results on effectiveness and safety of Ibrutinib in patients with chronic lymphocytic leukemia from the non-interventional FIRE study. Ann Hematol 2024:10.1007/s00277-024-05666-3. [PMID: 38443660 DOI: 10.1007/s00277-024-05666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/15/2024] [Indexed: 03/07/2024]
Abstract
We conducted an observational study (FIRE) to understand the effectiveness and safety outcomes of ibrutinib in patients with chronic lymphocytic leukemia (CLL) in France, after a maximum follow-up of five years. Patients were included according to the French marketing authorization in 2016 (i.e. patients with relapsed or refractory CLL or to previously untreated CLL patients with deletion 17p and/or tumor protein p53 mutations unsuitable for chemoimmunotherapy) and could have initiated ibrutinib more than 30 days prior their enrolment in the study (i.e. retrospective patients) or between 30 days before and 14 days after their enrolment (i.e. prospective patients). The results showed that in the effectiveness population (N = 388), the median progression-free survival (PFS) was 53.1 (95% CI: 44.5-60.5) months for retrospective patients and 52.9 (95% CI: 40.3-60.6) months for prospective patients and no difference was shown between the PFS of patients who had at least one dose reduction versus the PFS of patients without dose reduction (p = 0.7971 for retrospective and p = 0.3163 for prospective patients). For both retrospective and prospective patients, the median overall survival was not reached. The most frequent treatment-emergent adverse event of interest was infections (57.6% retrospective; 71.4% prospective). A total of 14.6% of the retrospective patients and 22.4% of the prospective patients had an adverse event leading to death. Our findings on effectiveness were consistent with other studies and the fact that patients with dose reductions had similar PFS than patients without dose reduction is reassuring. No additional safety concerns than those already mentioned in previous studies could be noticed.Trial registration ClinicalTrials.gov, NCT03425591. Registered 1 February 2018 - Retrospectively registered.
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Affiliation(s)
- Caroline Dartigeas
- Hématologie et Thérapie Cellulaire, CHRU Hôpitaux de Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Véronique Leblond
- AP-HP Hôpital de La Pitié-Salpêtrière, Paris La Sorbonne, Paris, France
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Zhang S, Zeng N, Wu S, Wu HH, Kong MW. Research progress in spasmodic torticollis rehabilitation treatment. World J Clin Cases 2024; 12:1205-1214. [PMID: 38524504 PMCID: PMC10955543 DOI: 10.12998/wjcc.v12.i7.1205] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/31/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
Spasmodic torticollis (ST) is a focal dystonia that affects adults, causing limited muscle control and impacting daily activities and quality of life. The etiology and curative methods for ST remain unclear. Botulinum toxin is widely used as a first-line treatment, but long-term usage can result in reduced tolerance and adverse effects. Rehabilitation therapy, with its minimal side effects and low potential for harm, holds significant clinical value. This article explores the effectiveness of adjunctive therapies, including exercise therapy, transcranial magnetic stimulation, shockwave therapy, neuromuscular electrical stimulation, vibration therapy, electromyographic biofeedback, and acupuncture, in the treatment of ST. The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.
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Affiliation(s)
- Shuang Zhang
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Ni Zeng
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Shuang Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Hui-Hui Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Mo-Wei Kong
- Department of Cardiology, Guiqian International General Hospital, Guiyang 550018, Guizhou Province, China
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55
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Van Poel E, Vanden Bussche P, Pétré B, Ponsar C, Collins C, De Jonghe M, Donneau AF, Gillain N, Guillaume M, Willems S. Quality of care in Belgian general practices during the COVID-19 pandemic: results of the cross-sectional PRICOV-19 study. BMC Prim Care 2024; 24:282. [PMID: 38443780 PMCID: PMC10916333 DOI: 10.1186/s12875-024-02305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/09/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The COVID-19 pandemic immensely impacted care provision, including quality of care in general practice. This paper aimed: (1) to assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) to study differences between the three Belgian regions; and (3) to benchmark the performance of the Belgian practices against the performance in other European countries. METHODS The data collected from 479 Belgian practices during 2020-2021 using an online survey as part of the international cross-sectional PRICOV-19 study were analyzed. Hereby, descriptive statistics, chi-squared tests, and binary logistic regression analyses were performed. Thirty-four survey questions related to the six dimensions of quality of care were selected as outcome variables. The adjusted regression models included four practice characteristics as covariates: practice type, being a teaching practice for GP trainees, multidisciplinarity of the team, and payment system. RESULTS Belgian practices made important organizational changes to deliver high-quality care during COVID-19. Most practices (n = 259; 56.1%) actively reached out to vulnerable patients. Limitations to the practice building or infrastructure threatened high-quality care in 266 practices (55.5%). Infection prevention measures could not always be implemented during COVID-19, such as using a cleaning protocol (n = 265; 57.2%) and providing a separate doctor bag for infection-related home visits (n = 130; 27.9%). Three hundred and sixty practices (82.0%) reported at least one safety incident related to a delayed care process in patients with an urgent condition. The adjusted regression analysis showed limited significant differences between the Belgian regions regarding the quality of care delivered. Belgian practices demonstrated varied performance compared to other European countries. For example, they excelled in always checking the feasibility of isolation at home but reported more patient safety incidents related to timely care than at least three-quarters of the other European countries. CONCLUSIONS Future studies using different design methods are crucial to investigate which country and practice characteristics are associated with delivering high-quality care.
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Affiliation(s)
- Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Pierre Vanden Bussche
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Benoît Pétré
- Department of Public Health, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Cécile Ponsar
- Institute of Health and Society, University of Louvain, Louvain, Belgium
| | - Claire Collins
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Research Centre, Irish College of General Practitioners, Dublin, D02 XR68, Ireland
| | - Michel De Jonghe
- Centre Académique de Médecine Générale, Université Catholique de Louvain, Brussels, Belgium
| | | | - Nicolas Gillain
- Department of Public Health, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Michèle Guillaume
- Department of Public Health, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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56
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Szaflarski JP, Besson H, D'Souza W, Faught E, Klein P, Reuber M, Rosenow F, Salas-Puig J, Soto Insuga V, Steinhoff BJ, Strzelczyk A, Bourikas D, Daniels T, Floricel F, Friesen D, Laloyaux C, Villanueva V. Effectiveness and tolerability of brivaracetam in patients with epilepsy stratified by comorbidities and etiology in the real world: 12-month subgroup data from the international EXPERIENCE pooled analysis. J Neurol 2024:10.1007/s00415-024-12253-z. [PMID: 38436680 DOI: 10.1007/s00415-024-12253-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/31/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To assess the effectiveness and tolerability of brivaracetam (BRV) in adults with epilepsy by specific comorbidities and epilepsy etiologies. METHODS EXPERIENCE/EPD332 was a pooled analysis of individual patient records from several non-interventional studies of patients with epilepsy initiating BRV in clinical practice. Outcomes included ≥ 50% reduction from baseline in seizure frequency, seizure freedom (no seizures within prior 3 months), continuous seizure freedom (no seizures since baseline), BRV discontinuation, and treatment-emergent adverse events (TEAEs) at 3, 6, and 12 months. Analyses were performed for all adult patients (≥ 16 years of age) and stratified by comorbidity and by etiology at baseline (patients with cognitive/learning disability [CLD], psychiatric comorbidity, post-stroke epilepsy, brain tumor-related epilepsy [BTRE], and traumatic brain injury-related epilepsy [TBIE]). RESULTS At 12 months, ≥ 50% seizure reduction was achieved in 35.6% (n = 264), 38.7% (n = 310), 41.7% (n = 24), 34.1% (n = 41), and 50.0% (n = 28) of patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE, respectively; and continuous seizure freedom was achieved in 5.7% (n = 318), 13.7% (n = 424), 29.4% (n = 34), 11.4% (n = 44), and 13.8% (n = 29), respectively. During the study follow-up, in patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE, 37.1% (n = 403), 30.7% (n = 605), 33.3% (n = 51), 39.7% (n = 68), and 27.1% (n = 49) of patients discontinued BRV, respectively; and TEAEs since prior visit at 12 months were reported in 11.3% (n = 283), 10.0% (n = 410), 16.7% (n = 36), 12.5% (n = 48), and 3.0% (n = 33), respectively. CONCLUSIONS BRV as prescribed in the real world is effective and well tolerated among patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE.
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Affiliation(s)
- Jerzy P Szaflarski
- University of Alabama at Birmingham (UAB) Heersink School of Medicine Department of Neurology and UAB Epilepsy Center, Birmingham, AL, USA.
| | | | - Wendyl D'Souza
- Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Pavel Klein
- Mid-Atlantic Epilepsy and Sleep Center, Bethesda, MD, USA
| | | | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | | | - Victor Soto Insuga
- Pediatric Neurology, Hospital Universitario Infantil Niño Jesús, Madrid, Spain
| | - Bernhard J Steinhoff
- Kork Epilepsy Center, Kehl-Kork and Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | | | | | | | | | | | - Vicente Villanueva
- Refractory Epilepsy Unit, Hospital Universitario y Politécnico La Fe, EpiCARE member, Valencia, Spain
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57
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Hassold N, Bihan H, Moumba YP, Poilane I, Méchaï F, Assad N, Labbe-Gentils V, Sal M, Koutcha ON, Martin A, Radu D, Martinod E, Cordel H, Vignier N, Tatulashvili S, Berkane N, Carbonnelle E, Bouchaud O, Cosson E. BedBiopsy: diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection. Diabetes Metab 2024:101525. [PMID: 38442769 DOI: 10.1016/j.diabet.2024.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE - We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery. RESEARCH DESIGN AND METHODS - In this retrospective monocentric study, we compared the performance of ultrasound-guided (n=29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n=24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome). RESULTS - Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3%), SINBAD score, and wound location (phalanges 36%, metatarsus 43%, and calcaneus 21%). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97% versus 75%, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2%, P = 0.005) (94.4% versus 66.7%, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9% versus 36.8%; P = 0.790, and osteitis: 81.8 vs 55.6% P = 0.071). CONCLUSION - In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis.
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Affiliation(s)
- Nolan Hassold
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France.
| | - Hélène Bihan
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; LEPS (Laboratoire Educations et Promotion de la Santé) EA 3412-Université Paris 13
| | - Yolène Pambo Moumba
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | | | - Frédéric Méchaï
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Nabil Assad
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Véronique Labbe-Gentils
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Meriem Sal
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Omar Nouhou Koutcha
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Antoine Martin
- Department of anatomopathology, Avicenne Hospital, Bobigny, France
| | - Dana Radu
- Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny
| | - Emmanuel Martinod
- Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny
| | - Hugues Cordel
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Vignier
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France; IAME, INSERM UMR 1137, Université Sorbonne Paris Nord, Bobigny, France
| | - Sopio Tatulashvili
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | | | - Olivier Bouchaud
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Emmanuel Cosson
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
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58
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Peñalvo JL. The impact of taxing sugar-sweetened beverages on diabetes: a critical review. Diabetologia 2024; 67:420-429. [PMID: 38177563 DOI: 10.1007/s00125-023-06064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/18/2023] [Indexed: 01/06/2024]
Abstract
The global burden of type 2 diabetes is increasing at an alarming rate, fuelled by the obesity epidemic, with significant associated health and economic consequences and apparent inequalities. Sugar-sweetened beverages (SSBs) are a major source of added sugars in diets worldwide and have been linked to an increased risk of type 2 diabetes through a variety of mechanisms, including excess weight. Taxing SSBs has become a promising public health strategy to reduce consumption and mitigate the burden of type 2 diabetes. A substantial body of evidence suggests that SSB taxes lead to increased prices and subsequent reduced consumption, with a potentially greater effect among lower socioeconomic groups. This highlights the potential for tax policies to have an impact on type 2 diabetes and address health inequalities. Evidence from several ongoing SSB tax schemes, including sales and excise taxes, indicates positive effects on improving consumption patterns, and modelling studies point to health gains by averting type 2 diabetes and other cardiometabolic diseases. In contrast, evidence from empirical evaluation of the impact of SSB tax is scarce. Continued monitoring and the strengthening of evaluation research to develop context-tailored policies are required. In addition, there is a need to implement complementary efforts to amplify the impact of SSB taxation and effectively address the global burden of type 2 diabetes.
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Affiliation(s)
- José L Peñalvo
- Global Health Institute, University of Antwerp, Wilrijk, Belgium.
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Tangri N, Rastogi A, Nekeman-Nan C, Hong LS, Ozaki A, Franzén S, Sofue T. Dapagliflozin Utilization in Chronic Kidney Disease and Its Real-World Effectiveness Among Patients with Lower Levels of Albuminuria in the USA and Japan. Adv Ther 2024; 41:1151-1167. [PMID: 38240949 PMCID: PMC10879247 DOI: 10.1007/s12325-023-02773-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/14/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Sodium-glucose cotransporter 2 inhibitors such as dapagliflozin have been proven effective for slowing chronic kidney disease (CKD) progression in large outcomes trials that mainly included patients with higher levels of albuminuria. Understanding the real-world utilization and effectiveness of these drugs among patients with CKD with lower levels of albuminuria can inform clinical decision-making in this population. METHODS Claims data from the USA and Japan were used to describe patients with CKD and urinary albumin-to-creatinine ratio (UACR) < 200 mg/g who were eligible for dapagliflozin 10 mg treatment (initiators and untreated) following its approval for CKD. A quantile regression analysis was performed to evaluate the effect of dapagliflozin 10 mg initiation versus no initiation on estimated glomerular filtration rate (eGFR) slope in a propensity score-matched cohort, using a prevalent new-user design. RESULTS Dapagliflozin initiators (n = 20,407) mostly had stage 3-4 CKD (69-81% across databases). The most common comorbidities were type 2 diabetes, hypertension and cardiovascular disease. At baseline, a renin-angiotensin system inhibitor was prescribed in 53-81% of patients. Eligible but untreated patients were older and had a higher eGFR and lower comorbidity burden than initiators. Following dapagliflozin initiation, the differences in median eGFR slope between initiators and matched non-initiators were 1.07 mL/min/1.73 m2/year (95% confidence interval [CI] 0.40-1.74) in all patients with UACR < 200 mg/g and 1.28 mL/min/1.73 m2/year (95% CI - 1.56 to 4.12) in patients with UACR < 200 mg/g without type 2 diabetes. CONCLUSIONS Dapagliflozin 10 mg was prescribed to a broad range of patients with CKD. In patients with UACR < 200 mg/g, dapagliflozin initiation was associated with a clinically meaningful attenuation of eGFR slope compared with non-initiation. These findings supplement available clinical efficacy evidence and suggest that dapagliflozin effectiveness may extend to patients with CKD and UACR < 200 mg/g. Graphical Abstract and Video Abstract available for this article. (Video Abstract 245964 kb).
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Affiliation(s)
- Navdeep Tangri
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Seven Oaks General Hospital, 2LB19-2300, McPhillips Street, Winnipeg, MB, R2V 3M3, Canada.
| | - Anjay Rastogi
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Cassandra Nekeman-Nan
- Epidemiology, Cardiovascular, Renal and Metabolism, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
| | | | - Asuka Ozaki
- Medical Affairs, AstraZeneca K. K., Osaka, Japan
| | - Stefan Franzén
- Medical and Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
| | - Tadashi Sofue
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Miki, Japan
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Diemer J, Kothgassner OD, Herrmann MJ, Zwanzger P. [VR-supported therapy for anxiety and posttraumatic stress disorder: current possibilities and limitations]. Nervenarzt 2024; 95:223-229. [PMID: 38051348 DOI: 10.1007/s00115-023-01570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Virtual reality (VR) is increasingly used in psychotherapy, and the speed of development of therapeutic VR tools is continuously increasing. OBJECTIVE This narrative review provides an overview of the state of the art regarding VR applications for psychotherapy. MATERIAL AND METHODS The current state of VR therapy research for anxiety disorders and posttraumatic stress disorder (PTSD) is summarized. The focus lies on VR exposure therapy. Current developments in the field are outlined. RESULTS For anxiety disorders, especially phobic disorders, there are already positive recommendations in the current German S3 guidelines. For PTSD, the development of VR therapy tools is still in a relatively early stage. CONCLUSION The development of mobile cost-effective VR solutions in recent years has enabled entirely new applications for VR. The empirical challenges of these new developments are considerable. Nevertheless, the chances for an improvement of psychotherapeutic routine care are good.
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Affiliation(s)
- Julia Diemer
- Fachbereich Psychosomatische Medizin, Kompetenzschwerpunkt Angst, Versorgungsforschung, kbo-Inn-Salzach-Klinikum, Gabersee 7, 83512, Wasserburg am Inn, Deutschland
- Department Psychologie, Ludwig-Maximilians-Universität München, München, Deutschland
| | - Oswald D Kothgassner
- Stress in Childhood & Adolescence Research Unit (SCAR-Unit), Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Wien, Österreich
| | - Martin J Herrmann
- Zentrum für Psychische Gesundheit (ZEP), Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Peter Zwanzger
- Fachbereich Psychosomatische Medizin, Kompetenzschwerpunkt Angst, Versorgungsforschung, kbo-Inn-Salzach-Klinikum, Gabersee 7, 83512, Wasserburg am Inn, Deutschland.
- Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, München, Deutschland.
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Wang X, Wang X, Bai J. Comparison of the effectiveness and safety between endoscope-assisted and traditional open surgery in the treatment of thyroid micropapillary carcinoma: A meta-analysis. Asian J Surg 2024; 47:1344-1350. [PMID: 38087697 DOI: 10.1016/j.asjsur.2023.12.037] [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: 08/29/2023] [Revised: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 03/13/2024] Open
Abstract
Endoscopic thyroidectomy (ET), a surgical procedure widely accepted by surgeons, has been proven to be feasible. The aim of this systematic review is to evaluate the effectiveness and safety of ET compared to conventional open thyroidectomy (COT) in the treatment of papillary thyroid microcarcinoma (PTMC) through a meta-analysis. Medical literature databases, including PubMed, Embase, Cochrane Library, CBM,CNKI, Wanfang, and VIP, were systematically searched for relevant studies on ET and COT for the treatment of PTMC. The search period was from January 2000 to June 2023. Two researchers independently performed literature screening and data extraction according to the inclusion and exclusion criteria, and the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Meta-analysis was conducted using Revman 5.3 software. Six studies were eventually included, involving a total of 440 patients with PTMC. The meta-analysis results demonstrated that the ET group had shorter incision length (MD = -2.96, 95 % CI: -4.27 to -1.65, P < 0.05) and less intraoperative blood loss (MD = -18.06, 95 % CI: -32.76 to -3.37, P = 0.02 < 0.05). There was no statistically significant difference between the two groups in terms of operative time (MD = -0.83, 95 % CI: -19.64 to 17.98, P = 0.93 > 0.05), lymph node dissection (MD = 1.03, 95 % CI: -1.47 to 3.54, P = 0.42 > 0.05), postoperative hospital stay (MD = -0.96, 95 % CI: -2.00 to 0.08, P = 0.07 > 0.05), and transient recurrent laryngeal nerve paralysis (OR = 3.32, 95 % CI: 0.65 to 16.90, P = 0.15 > 0.05). Compared with COT, ET has the advantages of shorter incision length, less intraoperative blood loss, better prognosis and comparable safety, making it a worthy choice for clinical application.
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Affiliation(s)
- Xueliang Wang
- Inner Mongolia Medical University, Department of Thyroid and Breast Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, North Street, Inner Mongolia, 010050, China
| | - Xia Wang
- Inner Mongolia Medical University, Department of Thyroid and Breast Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, North Street, Inner Mongolia, 010050, China.
| | - Junwen Bai
- Inner Mongolia Medical University, Department of Thyroid and Breast Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, North Street, Inner Mongolia, 010050, China
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Gebremichael LG, Champion S, Nesbitt K, Pearson V, Bulamu NB, Dafny HA, Sajeev S, Pinero de Plaza MA, Ramos JS, Suebkinorn O, Gulyani A, Bulto LN, Beleigoli A, Hendriks JM, Hines S, Clark RA. Effectiveness of cardiac rehabilitation programs on medication adherence in patients with cardiovascular disease: A systematic review and meta-analysis. Int J Cardiol Cardiovasc Risk Prev 2024; 20:200229. [PMID: 38188637 PMCID: PMC10770721 DOI: 10.1016/j.ijcrp.2023.200229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/20/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024]
Abstract
Background Education to improve medication adherence is one of the core components of cardiac rehabilitation (CR) programs. However, the evidence on the effectiveness of CR programs on medication adherence is conflicting. Therefore, we aimed to summarize the effectiveness of CR programs versus standard care on medication adherence in patients with cardiovascular disease. Methods A systematic review and meta-analysis was conducted. Seven databases and clinical trial registries were searched for published and unpublished articles from database inception to 09 Feb 2022. Only randomised controlled trials and quasi-experimental studies were included. Two independent reviewers conducted the screening, extraction, and appraisal. The JBI methodology for effectiveness reviews and PRISMA 2020 guidelines were followed. A statistical meta-analysis of included studies was pooled using RevMan version 5.4.1. Results In total 33 studies were included with 16,677 participants. CR programs increased medication adherence by 14 % (RR = 1.14; 95 % CI: 1.07 to 1.22; p = 0.0002) with low degree of evidence certainty. CR also lowered the risk of dying by 17 % (RR = 0.83; 95 % CI: 0.69 to 1.00; p = 0.05); primary care and emergency department visit by mean difference of 0.19 (SMD = -0.19; 95 % CI: -0.30 to -0.08; p = 0.0008); and improved quality of life by 0.93 (SMD = 0.93; 95 % CI: 0.38 to 1.49; p = 0.0010). But no significant difference was observed in lipid profiles, except with total cholesterol (SMD = -0.26; 95 % CI: -0.44 to -0.07; p = 0.006) and blood pressure levels. Conclusions CR improves medication adherence with a low degree of evidence certainty and non-significant changes in lipid and blood pressure levels. This result requires further investigation.
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Affiliation(s)
- Lemlem Gebremedhin Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Vincent Pearson
- JBI, School of Public Health, The University of Adelaide, Australia
| | - Norma B. Bulamu
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Hila A. Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Shelda Sajeev
- Centre for Artificial Intelligence Research and Optimisation (AIRO), Torrens University, Adelaide, South Australia, Australia
- College of Science and Engineering, Flinders University, Adelaide, SA, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, SA, Australia
| | - Joyce S. Ramos
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Orathai Suebkinorn
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Lemma N. Bulto
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - Jeroen M. Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
- Flinders Rural and Remote Health, NT. College of Medicine and Public Health, Flinders University, Australia
| | - Robyn A. Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
| | - On behalf of the NHMRC CHAP Project Team
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Australia
- JBI, School of Public Health, The University of Adelaide, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Centre for Artificial Intelligence Research and Optimisation (AIRO), Torrens University, Adelaide, South Australia, Australia
- College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, SA, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
- Flinders Rural and Remote Health, NT. College of Medicine and Public Health, Flinders University, Australia
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Weinstein P. Practice (In)Efficiency in Veterinary Medicine: Moving from Chaos to Control. Vet Clin North Am Small Anim Pract 2024; 54:337-353. [PMID: 38042711 DOI: 10.1016/j.cvsm.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
The veterinary profession has long struggled with inefficiency. The challenges of the pandemic and the increase in case load have truly highlighted how significant the in-efficiencies were. By working on more efficient use of the physical plants where veterinary care is delivered; more efficient use of the inventory that is sold; more efficient use of the people that deliver service and care; and more efficient use of systems, processes, and checklists, the veterinary profession can improve its efficiency, its profitability, and even the enjoyment of working in the profession.
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Affiliation(s)
- Peter Weinstein
- PAW Consulting, 3972 Barranca Parkway, Suite J-137, Irvine, CA 92606, USA.
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Taylor J, Majeed T, Remond M, Bagade T, Edwards L, Sullivan E. Are custodial-based mothers and children's units evaluated, effective and aligned with a human rights-based approach? - A systematic review of the evidence. EClinicalMedicine 2024; 69:102496. [PMID: 38384336 PMCID: PMC10878864 DOI: 10.1016/j.eclinm.2024.102496] [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: 12/11/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
Background Special considerations are warranted for incarcerated mothers and their children, as both experience substantial health and social disadvantage. Children residing in custodial settings are at risk of not having access to the equivalence of education, healthcare and socialisation commensurate to that of children living in the community. This systematic review describes the existing evidence regarding underpinning theories, accessibility, and the effectiveness of custody-based Mothers and children's units (M&Cs) globally. Methods A systematic database search was conducted on May 1, 2023, of PsycINFO, Scopus, Sociology Ultimate and Web of Science (January 1, 2010, and May 1, 2023). Findings Our systematic synthesis reveals evidence gaps related to best practice guidelines that align with a human right-based approach, and evaluations of the impact of the prison environment on mothers and their children. Interpretation These findings support re-design of M&Cs using co-design to develop units that are evidence-based, robustly evaluated, and underpinned by the 'best interest of the child'. Funding This systematic review was conducted as part of a broader review into M&C programs commissioned and funded by Corrective Services NSW, Australia (CSNSW), a division of the Department of Communities and Justice, as part of the NSW Premier's Priority to Reduce Recidivism within the Women as Parents workstream. No funding was received for this review.
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Affiliation(s)
- Jo Taylor
- University of Newcastle, Newcastle, Australia
| | | | - Marc Remond
- University of Newcastle, Newcastle, Australia
| | | | - Layla Edwards
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Elizabeth Sullivan
- University of Newcastle, Newcastle, Australia
- Justice Health and Forensic Mental Health Network, Sydney, Australia
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Cemin R, Cappato R. Lessons derived from post authorisation safety studies (ETNA-AF and XANTUS) on once daily direct oral anticoagulants for atrial fibrillation. Int J Cardiol 2024; 398:131618. [PMID: 38030040 DOI: 10.1016/j.ijcard.2023.131618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/19/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Phase III trials should be integrated by post authorisation safety studies (PASS) to confirm their conclusions in real life. In this setting, comorbidities are commonly more prevalent, decisions about drugs and regimens are left to the attending physicians and therapy monitoring is not usually as strict as in pivotal trials. AIMS AND METHODS To evaluate real life safety and effectiveness of edoxaban and rivaroxaban, ETNA-AF Europe (ETNA-AF-Eu) and XANTUS studies were reviewed and compared. A further comparison between data collected in these studies and in the pivotal studies ENGAGE AF-TIMI 48 and ROCKET-AF was also performed. RESULTS ETNA-AF-Eu and XANTUS showed lower bleeding, stroke, cardiovascular- and all-cause mortality rates as compared to those observed in Phase 3 trials, even when including subgroups with lower comorbidities. Patients in ETNA-AF-Eu were older, with a larger proportion of octogenarians (≥85 years in 10.5%) and patients with impaired renal function as compared to patients in XANTUS (CrCl <50 ml/min in 18.2% vs 12.2%) and in ENGAGE AF-TIMI 48 and ROCKET-AF, without paying any excess tribute in terms of safety. Therapy persistence was very high in the two real life studies (91.9% in ETNA-AF-Eu and 79.9% in XANTUS), thus showing that edoxaban and rivaroxaban are well tolerated in real life. CONCLUSION The ETNA-AF-Eu and XANTUS confirmed the safety and effectiveness of edoxaban and rivaroxaban in real life.
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Affiliation(s)
- Roberto Cemin
- Department of Cardiology, San Maurizio Regional Hospital of Bolzano, Bolzano, Italy.
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy
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Ruiz AN, Alberola FT, Aceituno S. [Translated article] Risk-sharing agreement based on health outcomes for the treatment of moderate-severe psoriasis with certolizumab pegol. Farm Hosp 2024; 48:T51-T56. [PMID: 38148255 DOI: 10.1016/j.farma.2023.11.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE To provide evidence of the effectiveness of certolizumab pegol (CZP) in real clinical practice in adult patients with moderate-to-severe plaque psoriasis (PsO) in the context of a risk-sharing agreement (RSA). METHODS Retrospective observational study based on variables collected in the RSA for treatment with CZP of adult patients with moderate-severe plaque PsO. Ten Spanish hospitals where the RSA was implemented participated. The percentage of patients who achieved the target clinical response of the RSA at the follow-up visit (week 16) was evaluated: absolute Psoriasis Area and Severity Index (PASI) value ≤3 for biologic naïve population, and ≤5 in case of previous failure to a single biologic drug. In addition, the improvement in the scores of other scales included in the study was analysed: Body Surface Area (BSA), Dermatology Life Quality Index (DLQI), Physician's Global Assessment (PGA), and Nail Psoriasis Severity Index (NAPSI). A descriptive analysis was performed for the total population and by patient subgroups (naive vs. non-naive to biologic, male vs. female, and with vs. without discontinuation). RESULTS Sixty-six patients were included, 12 men and 54 women. 90.9% achieved the target clinical response, with a mean reduction of 8 (-78.4%) absolute PASI points. Improvement was observed in BSA, PGA, NAPSI, and DLQI, with a reduction of 11.3 (-80.6%), 1.9 (-65.5%), 3.3 (-30.7%), and 9.0 (-66.4%) absolute value points, respectively. Despite not achieving the therapeutic target set in the RSA in 6 patients (9%) (the cost of the drug was assumed by the laboratory), only 2 (3%) discontinued treatment. CONCLUSION Our study shows that CZP is effective in real clinical practice in patients with moderate-severe plaque PsO, with an improvement in absolute PASI and DLQI, as well as other scales, both for the total population and in the subgroups analysed. Nearly 91% of patients reached the therapeutic target fixed in the RSA. Implementing this type of agreement can provide a direct or indirect benefit for all the agents involved in the process, providing valuable information for decision-making.
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Affiliation(s)
- Andrés Navarro Ruiz
- Servicio de Farmacia del Hospital General Universitario de Elche, Alicante, Spain.
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De Greef A, Benjelloun G, Harkemanne E, Baeck M. Successful Treatment of Disseminated Granuloma Annulare with Upadacitinib. Dermatol Ther (Heidelb) 2024; 14:813-817. [PMID: 38438785 DOI: 10.1007/s13555-024-01117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 03/06/2024] Open
Abstract
Disseminated granuloma annulare (DGA) is an inflammatory skin disorder characterized by more than 10 erythematous, raised, ring-shaped plaques. Its treatment remains challenging, with conventional therapies showing variable efficacy. We report the case of a woman in her 50s with a 2-year history of DGA refractory to multiple treatments. Given the recent evidence of the role of the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway in the granuloma annulare pathophysiology, treatment with upadacitinib 30 mg per day was started with rapid effectiveness and good tolerance. This case underscores the potential of JAK inhibitors as promising therapeutic options for recalcitrant granuloma annulare.
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Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Ghita Benjelloun
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Evelyne Harkemanne
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
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Wols A, Pingel M, Lichtwarck-Aschoff A, Granic I. Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies. Clin Psychol Rev 2024; 108:102396. [PMID: 38320420 DOI: 10.1016/j.cpr.2024.102396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.
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Affiliation(s)
- Aniek Wols
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Michelle Pingel
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Anna Lichtwarck-Aschoff
- Rijksuniversiteit Groningen, Department of Pedagogical & Educational Sciences, Groningen, the Netherlands
| | - Isabela Granic
- McMaster University, Health, Aging & Society, Hamilton, Ontario, Canada
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Vassallo R, Maida M, Zullo A, Venezia L, Montalbano L, Mitri RD, Peralta M, Virgilio C, Pallio S, Pluchino D, D'amore F, Santagati A, Sinagra E, Graceffa P, Nicosia G, Camilleri S, Gibiliaro G, Abdelhadi Y, Rancatore G, Scalisi G, Melita G, Magnano A, Conoscenti G, Facciorusso A. Efficacy of 1 L polyethylene glycol plus ascorbate versus 4 L polyethylene glycol in split-dose for colonoscopy cleansing in out and inpatient: A multicentre, randomized trial (OVER 2019). Dig Liver Dis 2024; 56:495-501. [PMID: 37574430 DOI: 10.1016/j.dld.2023.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND AND AIMS Adequate bowel cleansing is essential for colonoscopy quality. A novel 1 L polyethylene glycol plus ascorbate (1 L PEG+ASC) solution has been recently introduced. Nevertheless, the efficacy of 1 L PEG+ASC as compared to that of high-volume bowel preparation in both inpatients and outpatients is still unclear. PATIENTS AND METHODS This single-blinded, non-inferiority study randomized patients undergoing colonoscopy to receive split-dose 1 L PEG+ASC or 4 L PEG. The primary endpoint was the overall cleansing success. Secondary endpoints were excellent cleansing and high-quality cleansing of the right colon, as well as lesions detection rate, patient compliance, tolerability and safety. RESULTS Overall, 478 patients were randomized to 1 L PEG+ASC (N = 236) or 4 L PEG (N = 242). The 1 L PEG+ASC showed higher cleansing success rate (91.8% vs 83.6%; P=0.01) and a high-quality cleansing of the right colon (52.3% and 38.5%; P=0.004) compared to 4 L PEG. Moreover, 1 L PEG+ASC achieved a higher cleansing success in out-patients (96.3%% vs 88.6%; P=0.018), and a similar success rate in the in-patients (84.7% vs 76.7%; P=0.18). Adenoma detection rate, tolerability and incidence of adverse events were comparable between preparations. CONCLUSIONS The 1 L PEG+ASC showed higher efficacy in achieving adequate colon cleansing compared with 4 L PEG, particularly in the right colon. No differences in the tolerability and safety were detected.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy
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Guillamet CV, Kollef MH. Is Zero Ventilator-Associated Pneumonia Achievable? Updated Practical Approaches to Ventilator-Associated Pneumonia Prevention. Infect Dis Clin North Am 2024; 38:65-86. [PMID: 38040518 DOI: 10.1016/j.idc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Ventilator-associated pneumonia (VAP) remains a significant clinical entity with reported incidence rates of 7% to 15%. Given the considerable adverse consequences associated with this infection, VAP prevention became a core measure required in most US hospitals. Many institutions took pride in implementing effective VAP prevention bundles that combined at least head of bed elevation, hand hygiene, chlorhexidine oral care, and subglottic drainage. Spontaneous breathing and awakening trials have also consistently been shown to shorten the duration of mechanical ventilation and secondarily reduce the occurrence of VAP.
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Affiliation(s)
| | - Marin H Kollef
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA.
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Navarro Ruiz A, Toledo Alberola F, Aceituno S. Risk-sharing agreement based on health outcomes for the treatment of moderate-severe psoriasis with certolizumab pegol. Farm Hosp 2024; 48:51-56. [PMID: 37739901 DOI: 10.1016/j.farma.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To provide evidence of the effectiveness of certolizumab pegol (CZP) in real clinical practice in adult patients with moderate-to-severe plaque psoriasis (PsO) in the context of a risk-sharing agreement (RSA). METHODS Retrospective observational study based on variables collected in the RSA for treatment with CZP of adult patients with moderate-severe plaque PsO. Ten Spanish hospitals where the RSA was implemented participated. The percentage of patients who achieved the target clinical response of the RSA at the follow-up visit (week 16) was evaluated: absolute Psoriasis Area and Severity Index (PASI) value ≤3 for biologic naïve population, and ≤5 in case of previous failure to a single biologic drug. In addition, the improvement in the scores of other scales included in the study was analyzed: Body Surface Area (BSA), Dermatology Life Quality Index (DLQI), Physician's Global Assessment (PGA), and Nail Psoriasis Severity Index (NAPSI). A descriptive analysis was performed for the total population and by patient subgroups (naive vs. non-naive to biologic, male vs. female, and with vs. without discontinuation). RESULTS Sixty-six patients were included, 12 men and 54 women. 90.9% achieved the target clinical response, with a mean reduction of 8 (-78.4%) absolute PASI points. Improvement was observed in BSA, PGA, NAPSI and DLQI, with a reduction of 11.3 (-80.6%), 1.9 (-65.5%), 3.3 (-30.7%) and 9.0 (-66.4%) absolute value points, respectively. Despite not achieving the therapeutic target set in the RSA in six patients (9%) (the cost of the drug was assumed by the laboratory), only two (3%) discontinued treatment. CONCLUSION Our study shows that CZP is effective in real clinical practice in patients with moderate-severe plaque PsO, with an improvement in absolute PASI and DLQI, as well as other scales, both for the total population and in the subgroups analyzed. Nearly 91% of patients reached the therapeutic target fixed in the RSA. Implementing this type of agreement can provide a direct or indirect benefit for all the agents involved in the process, providing valuable information for decision-making.
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Affiliation(s)
- Andrés Navarro Ruiz
- Servicio de Farmacia, Hospital General Universitario de Elche, Alicante, España.
| | | | - Susana Aceituno
- Departamento de Investigación, Outcomes'10, SLU, Castellón, España
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Ruiz Romer MV, Porrúa Del Saz A, Gómez Hernández MB, Lobato Parra E, Soler Jiménez A, Pereira Delgado C. [Impact of a multicomponent program with nonpharmacological therapies for patients with chronic pain]. J Healthc Qual Res 2024; 39:109-119. [PMID: 38402091 DOI: 10.1016/j.jhqr.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION 25.9% of Spanish people suffer from chronic pain. An integrated, interdisciplinary approach is recommended, with pharmacological and non-pharmacological therapies, involving patients in their self-care. OBJECTIVE To evaluate the effectiveness and impact on resources of a program with non-pharmacological therapies in the control of non-oncological chronic pain in the short and medium term. MATERIAL AND METHODS Quasi-experimental before-after study, follow-up 3-6 months, measuring: pain, well-being, quality of life, self-esteem, resilience, anxiety/depression (validated scales); patient-reported outcomes of workshop impact on pain management, habits and mood; ED and office visits; drug consumption and employment status. RESULTS One hundred and forty-two patients completed the program; 131 (92.3%) were women, age: 56.0. Decreased: pain (scale 0-10) (start: 6.0; end of workshop: 4.0; 3 months: 5.0); anxiety (12.9; 10.4; 8.8) and depression (12.3; 7.23; 6.47) (scales 0-21). They increased: well-being (scale 0-10) (4.0; 6.0; 4.0); quality of life (scale 0-1) (0.418; 0.580; 0.536); health status (scale 0-100) (47.5; 60.0; 60.0); self-esteem (scale 9-36) (24.1; 27.5; 26.7); resilience (scale 6-30) (14.8; 17.4; 18.6). Patient-reported outcomes were performed by 136 patients at the end of the workshop and 79 at 3 months: pain decreased (end of program: 104, 76.5%; 3 months: 66, 83.5%); medication decreased (96, 76.2%; 60, 78.9%); habits improved (112, 88.2%; 69, 90.8%). Forty patients (37.4%) reduced visits to the emergency room, 40 (37.4%) reduced scheduled visits. Overall satisfaction: 9.8 out of 10. CONCLUSIONS Patients learn to mitigate their pain, participate in their self-care and improve their quality of life, self-esteem and emotional state. The effects remained for 3-6 months.
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Affiliation(s)
- M V Ruiz Romer
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Porrúa Del Saz
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - M B Gómez Hernández
- Fisioterapia. Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España.
| | - E Lobato Parra
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Soler Jiménez
- Especialista interno residente de Cirugía Traumatológica y Ortopédica, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - C Pereira Delgado
- Unidad de Medicina Interna, Servicio de Medicina, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
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Chen J, Lin J, Weng J, Ju Y, Li Y. Clinical success of anti-infective combination therapy compare to monotherapy in patients with carbapenem-resistant Pseudomonas aeruginosa infection: a 10-years retrospective study. BMC Infect Dis 2024; 24:248. [PMID: 38395760 PMCID: PMC10885531 DOI: 10.1186/s12879-024-09060-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy. METHODS A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality. RESULTS A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p<0.001). In a multivariate logistic regression analysis, monotherapy was found to be significantly correlated with clinical success (OR, 0.559, 95% CI, 0.321-0.976; p = 0.041). CONCLUSION Combination therapy is more effective for CRPA infection patients, especially those whose SOFA score is ≥ 2 or whose Charlson comorbidity index is ≥ 6.
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Affiliation(s)
- Jialong Chen
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital,National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Lin
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jianzhen Weng
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital,National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yang Ju
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital,National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yanming Li
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital,National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
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Xiaodan J, Yuanting L, Li X, Huibin L, Nana Z, Shuxuan L, Yiren W, Xuemin L. Effectiveness and safety of Jiejing Runmu decoction in treatment of dry eye disease. Explore (NY) 2024:S1550-8307(24)00028-4. [PMID: 38458955 DOI: 10.1016/j.explore.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/10/2024] [Accepted: 02/13/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the effectiveness and safety of Jiejing Runmu decoction in relieving the clinical manifestations of dry eye disease (DED). DESIGN AND INTERVENTIONS This single-arm prospective intervention study was conducted at the Peking University Third Hospital and People's Hospital of Yongqing. Of the 211 patients recruited, 200 completing the follow-up were included in the analysis. Patients received Jiejing Runmu decoction once a day for 4 weeks continuously, without any change in eye care habits. Individuals were evaluated at four time points: pretreatment (baseline), 2 weeks, 1 month, and 3 months (2 months after completion of treatment), using the Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), corneal fluorescein staining, Schirmer test I and meibomian gland assessments. Adverse effects were evaluated at each follow-up visit and systematic examinations were performed during the first and last visits. RESULTS OSDI, TBUT, corneal fluorescein staining, Schirmer test I, meibomian gland expressibility, and quality of secretions improved at 2 weeks, 1 month and 3 months compared to baseline (P < 0.0001). No significant differences were found between the sexes. Patients above 45 years showed worse subjective symptoms and objective signs, and greater improvements in corneal fluorescein staining, meibomian gland expressibility, and quality of secretions were observed in this group. No obvious adverse effects were detected during any follow-up visit. CONCLUSION Jiejing Runmu decoction significantly improved both the subjective symptoms and objective signs of DED, with favorable tolerance.
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Affiliation(s)
- Jiang Xiaodan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, PR China
| | - Li Yuanting
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, PR China
| | - Xiaodan Li
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing 100191, PR China; Beijing Key Laboratory of Sports Injuries, Beijing 100191, PR China; Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing 100191, China
| | - Lv Huibin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, PR China
| | - Zhao Nana
- Department of Ophthalmology, People's hospital of YongQing, Hebei, China
| | - Lv Shuxuan
- Department of Ophthalmology, People's hospital of YongQing, Hebei, China
| | - Wang Yiren
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, PR China
| | - Li Xuemin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, PR China.
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Liao J, Qin C, Wang Z, Gao L, Zhang S, Feng Y, Liu J, Tao L. Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials. J Ethnopharmacol 2024; 320:117431. [PMID: 37981120 DOI: 10.1016/j.jep.2023.117431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/03/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Shenfu injection (SFI) is a well-known Chinese herbal medicine widely used in the treatment of septic shock in China. AIM OF THE STUDY To explore the clinical safety and effectiveness of combined application of Shenfu injection in the treatment of septic shock on the basis of routine western medical treatment. MATERIALS AND METHODS Randomized controlled trials published before February 28, 2022 in patients with septic shock were searched in the Chinese Biomedical Literature Service System (SinoMed), Embase, PubMed, Cochrane Library, WOS, Scopus. Stata 15.0 and R 4.2.2 were used to meta-analyze sequential organ failure assessment (SOFA) score, case fatality rate, mean arterial pressure (MAP), arterial lactate (Lac). Adverse effects were analyzed by description. RESULTS A total of 904 articles were searched and 56 RCTs were included, with a total of 4279 participants. Among them, there were 2148 cases in the SFI group and 2131 cases in the control group. The meta-analysis showed that, comparing with routine western medical therapy, the combined use of SFI could effectively reduce 24 h SOFA (MD = -0.79, 95%CI: (-1.12) - (-0.46)), 72 h SOFA (MD = -1.53, 95%CI: (-1.89) - (-1.17)) and 7 d SOFA (MD = -1.55; 95%CI: (-2.86) - (-0.24)). Besides, combined use of SFI could reduce 14 d case fatality rate (RR = 0.16, 95% CI: 0.07-0.37) and 28 d case fatality rate (RR = 0.82, 95% CI: 0.71-0.95). While SFI group showed almost the same effect in 7 d case fatality rate as control (RR: 0.76; 95% CI: 0.42-1.37; P = 0.37). SFI could increase 6 h MAP (MD = 6.40, 95% CI: 3.43-9.37) and 24 h MAP (MD = 4.79, 95% CI: 1.62-7.95). Additionally, SFI could decrease 6 h Lac (MD = -0.90, 95% CI: (-1.34) - (-0.45)), 24 h Lac (MD = -0.80, 95% CI: (-1.20) - (-0.40)), 48 h Lac (MD = -0.67, 95% CI: (-1.05) - (-0.29)). CONCLUSIONS Shenfu injection combined with RWT showed better therapeutic effect than RWT. SFI plus RWT can improve clinical prognosis of patients with septic shock.
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Affiliation(s)
- Jiaojiao Liao
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Zongyu Wang
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, PR China
| | - Ling Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Shimo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Yuting Feng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Liyuan Tao
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China.
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Htoo PT, Tesfaye H, Schneeweiss S, Wexler DJ, Everett BM, Glynn RJ, Schmedt N, Koeneman L, Déruaz-Luyet A, Paik JM, Patorno E. Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study. Cardiovasc Diabetol 2024; 23:57. [PMID: 38331813 PMCID: PMC10854040 DOI: 10.1186/s12933-024-02150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND No randomized clinical trials have directly compared the cardiorenal effectiveness of empagliflozin and GLP-1RA agents with demonstrated cardioprotective effects in patients with a broad spectrum of cardiovascular risk. We reported the final-year results of the EMPRISE study, a monitoring program designed to evaluate the cardiorenal effectiveness of empagliflozin across broad patient subgroups. METHODS We identified patients ≥ 18 years old with type 2 diabetes who initiated empagliflozin or GLP-1RA from 2014 to 2019 using US Medicare and commercial claims databases. After 1:1 propensity score matching using 143 baseline characteristics, we evaluated risks of outcomes including myocardial infarction (MI) or stroke, hospitalization for heart failure (HHF), major adverse cardiovascular events (MACE - MI, stroke, or cardiovascular mortality), a composite of HHF or cardiovascular mortality, and progression to end-stage kidney disease (ESKD) (in patients with chronic kidney disease stages 3-4). We estimated hazard ratios (HR) and rate differences (RD) per 1,000 person-years, overall and within subgroups of age, sex, baseline atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF). RESULTS We identified 141,541 matched pairs. Compared with GLP-1RA, empagliflozin was associated with similar risks of MI or stroke [HR: 0.99 (0.92, 1.07); RD: -0.23 (-1.25, 0.79)], and lower risks of HHF [HR: 0.50 (0.44, 0.56); RD: -2.28 (-2.98, -1.59)], MACE [HR: 0.90 (0.82, 0.99); RD: -2.54 (-4.76, -0.32)], cardiovascular mortality or HHF [HR: 0.77 (0.69, 0.86); RD: -4.11 (-5.95, -2.29)], and ESKD [0.75 (0.60, 0.94); RD: -6.77 (-11.97, -1.61)]. Absolute risk reductions were larger in older patients and in those with baseline ASCVD/HF. They did not differ by sex. CONCLUSIONS The cardiovascular benefits of empagliflozin vs. cardioprotective GLP-1RA agents were larger in older patients and in patients with history of ASCVD or HF, while they did not differ by sex. In patients with advanced CKD, empagliflozin was associated with risk reductions of progression to ESKD.
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Affiliation(s)
- Phyo T Htoo
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA
| | - Helen Tesfaye
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA
| | - Deborah J Wexler
- Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, USA
| | - Brendan M Everett
- Divisions of Cardiovascular and Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Robert J Glynn
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA
| | - Niklas Schmedt
- Global Epidemiology, Boehringer Ingelheim International GmbH (Germany) DE, Berlin, Germany
| | - Lisette Koeneman
- Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - Anouk Déruaz-Luyet
- Global Epidemiology, Boehringer Ingelheim International GmbH (Germany) DE, Berlin, Germany
| | - Julie M Paik
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA
- Division of Renal (Kidney) Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Elisabetta Patorno
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
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Belete AM, Melese DM, Asefa A, Aynalem YA, Bewket B, Shiferaw WS, Yazie TS. The effectiveness of short mobile phone text message reminders compared to usual care on medication adherence in patients with hypertension: a systematic review protocol. Syst Rev 2024; 13:53. [PMID: 38317254 PMCID: PMC10840260 DOI: 10.1186/s13643-023-02394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/17/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Poor adherence to long-term medication increases the risk of morbidity and mortality and decreases the quality of life of patients with hypertension. One strategy to improve treatment adherence is to use a short text message reminder. Although evidence indicates that such programs increase medication adherence, the extent of their effectiveness and translation into clinical practice needs to be better documented. Our systematic review will collect and analyze the available evidence for clinical practice implementation. This systematic review aimed to evaluate the effectiveness of short mobile phone text message reminders versus usual/standard care for medication adherence in patients with hypertension. METHODS This review will include and summarize evidence from randomized controlled trials. Adults (age > 18 years) with hypertension. The comparator group received either the usual care or standard care. It encompasses standard medical care for patients not participating in a structured and supervised intervention program such as a telemedicine program. We will include studies that assess the effectiveness of short mobile phone text message reminders in improving medication adherence in patients with hypertension compared to usual care. We will search the following databases: PubMed, EMBASE, CINAHL, SCOPUS, Web of Science, Cochrane Library Central Register of Controlled Trials, and Cochrane Library. We will include studies published in English. Furthermore, we will consider studies published from the inception of the database until April 20, 2024. At least two reviewers will independently conduct study selection, data extraction, and quality assessment. A third reviewer will determine and resolve discrepancies. We will conduct a quality assessment using the ROBIS 2 critical appraisal checklist. At least two independent reviewers will crosscheck the data synthesis. DISCUSSION We expect this review to provide current evidence for future studies and clinical practice concerning the impact of mobile phone text message reminders on medication adherence issues. We will publish our results in a peer-reviewed journal for publication. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023391236.
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Affiliation(s)
- Abebe Muche Belete
- Department of Biomedical Science, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Daniel Molla Melese
- Department of Biomedical Science, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Addisu Asefa
- Department of Biomedical Science, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Bekalu Bewket
- Department of Nursing, College of Health Science, Injibara University, Injibara, Ethiopia
| | | | - Taklo Simeneh Yazie
- Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Jiang M, Liu T, Liu X, Liu L, Jiang X, Zhang Z, Kong M, Wu C, Zhang J. A Network Meta-analysis to Explore the Effectiveness of the Different Treatment Modalities in Acne Scars. Aesthetic Plast Surg 2024:10.1007/s00266-023-03818-w. [PMID: 38316648 DOI: 10.1007/s00266-023-03818-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Multiple treatments are used to treat acne scars, but comparing the effectiveness of these treatments have not been studied yet. This research aimed to conduct a complete analysis of the effectiveness of commonly used therapies in acne scars. METHODS PubMed, Embase, and Cochrane's Library (Cochrane Center Register of Controlled Trials) databases were searched through May 2023. We used patient satisfaction score as the primary outcome and Goodman Baron qualitative scar grading system as the secondary outcome to evaluate the effectiveness of different commonly used therapies for acne scarring, including laser, microneedling (MN), platelet-rich plasma (PRP), autologous fat grafting and combined therapies. RESULTS Herein, 495 patients from 13 studies were included. Our results showed that PRP combined with laser was the most effective among therapies in treating acne scars. Ranking of effectiveness by the surface under the cumulative ranking (SUCRA) curve for patient satisfaction score was as following: PRP + laser (96.2%) > laser (71.2%) > MN (45.5%) > MN + PRP (42.0%) > autologous fat grafting (24.5%) > PRP (20.5%). Additionally, ranking of effectiveness by the SUCRA curve for Goodman Baron qualitative scar grading system was as following: PRP + laser (86.3%) > laser (64.2%) > MN + PRP (54.2%) > MN (37.2%) > PRP (8.1%). CONCLUSION This network meta-analysis indicated that the combined therapy of PRP and laser might be the most effective. Additionally, more high-quality randomized controlled trials are needed to verify our findings. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Min Jiang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Tian Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaoqiang Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Luojia Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xupin Jiang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Ze Zhang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Meng Kong
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Chao Wu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Jiaping Zhang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Lipton RB, Contreras-De Lama J, Serrano D, Engstrom E, Ayasse ND, Poh W, Cadiou F, Manack Adams A. Real-World Use of Ubrogepant as Acute Treatment for Migraine with an Anti-Calcitonin Gene-Related Peptide Monoclonal Antibody: Results from COURAGE. Neurol Ther 2024; 13:69-83. [PMID: 37910303 PMCID: PMC10787718 DOI: 10.1007/s40120-023-00556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Although acute and preventive treatments for migraine are commonly given in combination, data on the real-world effectiveness of ubrogepant as an acute treatment when used with an anti-calcitonin gene-related peptide (CGRP) monoclonal antibody (with or without onabotulinumtoxinA) are limited. This analysis sought to evaluate the real-world effectiveness, treatment satisfaction, and optimization of ubrogepant for the acute treatment of migraine when used in combination with an anti-CGRP monoclonal antibody, with or without concomitant onabotulinumtoxinA. METHODS This prospective, multiple-attack, open-label, observational study (COURAGE) assessed meaningful pain relief (MPR), return to normal function (RNF), treatment satisfaction, and acute treatment optimization of ubrogepant (50 or 100 mg) when combined with an anti-CGRP monoclonal antibody, onabotulinumtoxinA, or both in adult users of Migraine Buddy, a migraine tracking application. RESULTS In the ubrogepant and anti-CGRP monoclonal antibody arm (n = 245), following the first ubrogepant-treated attack, 61.6% (151/245) and 80.4% (197/245) of ubrogepant-treated participants achieved MPR at 2 and 4 h post-dose, respectively, and 34.7% (85/245) and 55.5% (136/245) achieved RNF at 2 and 4 h post-dose, respectively. Across up to 10 ubrogepant-treated attacks (N = 1153), MPR was achieved in 51.3% (592/1153) and 73.5% (847/1153) at 2 and 4 h post-dose, respectively. RNF was achieved by 32.2% (371/1153) and 53.2% (613/1153) at 2 and 4 h post-dose. After 30 days, 72.7% (168/231) of participants reported satisfaction (using a 7-point scale) with ubrogepant when used in combination with an anti-CGRP monoclonal antibody, and 79.7% (184/231) of participants achieved acute treatment optimization (defined as moderate-maximum treatment efficacy using the Migraine Treatment Optimization Questionnaire-4). CONCLUSION Real-world ubrogepant use with an anti-CGRP monoclonal antibody was associated with MPR, RNF, satisfaction, and acute treatment optimization.
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Affiliation(s)
| | - Janette Contreras-De Lama
- Therapeutic Neurotoxins & Migraine, US Medical Affairs, AbbVie, 2525 Dupont Dr, Irvine, CA, 92612, USA
| | | | | | | | | | | | - Aubrey Manack Adams
- Therapeutic Neurotoxins & Migraine, US Medical Affairs, AbbVie, 2525 Dupont Dr, Irvine, CA, 92612, USA.
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Karlström P, Pivodic A, Dahlström U, Fu M. Sodium-glucose cotransporter 2 inhibitors are associated with reduced risk of mortality and readmissions in heart failure. ESC Heart Fail 2024; 11:327-337. [PMID: 38012065 PMCID: PMC10804187 DOI: 10.1002/ehf2.14582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/27/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
AIMS Compelling evidence from randomized trials has shown that sodium-glucose cotransporter 2 inhibitors (SGLT2is) are effective in heart failure (HF) across the spectrum of left ventricular ejection fractions. However, there are very few studies with real-world data. METHODS AND RESULTS A retrospective cohort analysis was performed based on patient-level data from the Swedish Heart Failure Registry (SwedeHF) linked with three other national registers. Patients included had an index registration between 3 September 2013 and 31 December 2020 in SwedeHF and were on treatment with guideline-recommended therapy without or with SGLT2i 3 months before or 6 months after their index registration. Endpoints were mortality or readmissions. Association between the use of SGLT2i and endpoints was studied using adjusted Cox models. In the overall cohort, 796/22 405 patients were included with/without SGLT2i. In patients with SGLT2i, 93.5% had diabetes mellitus. In the overall cohort, SGLT2i was statistically significantly associated with all-cause mortality {hazard ratio [HR]: 0.61 [95% confidence interval (CI) 0.48-0.79], P < 0.0001}, cardiovascular mortality [HR: 0.29 (95% CI 0.17-0.50), P < 0.0001], cardiovascular mortality or HF readmission [HR: 0.89 (95% CI 0.80-1.00), P = 0.046], and all-cause readmissions [HR: 0.90 (95% CI 0.81-0.99), P = 0.038]. Similar results were obtained for the diabetes cohort. However, no association with cause-specific readmissions was observed. CONCLUSIONS This nationwide real-world study indicates that patients with HF, in which majority coexisted with diabetes mellitus, who received SGLT2i were statistically significantly associated with lower risk for all-cause mortality, cardiovascular mortality, cardiovascular mortality or HF readmissions, and all-cause readmissions, in line with the randomized trials assessing SGLT2i.
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Affiliation(s)
- Patric Karlström
- Department of Internal MedicineRyhov County HospitalSE‐551 85JönköpingSweden
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Aldina Pivodic
- Department of Clinical Neuroscience, Institute of Neuroscience and PhysiologySahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Ulf Dahlström
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Michael Fu
- Department of Molecular and Clinical Medicine, Institute of MedicineSahlgrenska Academy, Sahlgrenska University Hospital/Östra Hospital, University of GothenburgGothenburgSweden
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Gross-Goupil M, Bodnar L, Campbell MT, Michael A, Venugopal B, Żołnierek J, Dutailly P, Procopio G, Albiges L. Cabozantinib in the Routine Management of Renal Cell Carcinoma: A Systematic Literature Review of Real-World Evidence. Clin Genitourin Cancer 2024; 22:84-97. [PMID: 38101983 DOI: 10.1016/j.clgc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023]
Abstract
Real-world cabozantinib use has increased since its approval to treat patients with advanced renal cell carcinoma (RCC) in 2016. We reviewed cabozantinib use in real-world clinical practice and compared outcomes with pivotal cabozantinib randomized control trials (RCTs). This PRISMA-standard systematic literature review evaluated real-world effectiveness and tolerability of cabozantinib in patients with RCC (PROSPERO registration: CRD42021245854). Systematic MEDLINE, Embase, and Cochrane database searches were conducted on November 2, 2022. Eligible publications included ≥ 20 patients with RCC receiving cabozantinib. After double-screening for eligibility, standardized data were abstracted, qualitatively summarized, and assessed for risk of bias using the Newcastle-Ottawa Scale. Of 353 screened publications, 41 were included, representing approximately 11,000 real-world patients. Most publications reported cabozantinib monotherapy cohort studies (40/41) of retrospective (39/41) and multicenter (32/41) design; most included patients from North America and/or Europe (30/41). Baseline characteristics were demographically similar between real-world and pivotal RCT populations, but real-world populations showed greater variation in prevalence of prior nephrectomy, multiple-site/brain metastasis, and nonclear-cell RCC histology. Cabozantinib activity was reported across real-world treatment lines and tumor types. Overall survival, progression-free survival, and objective response rate values from pivotal RCTs were within the ranges reported for equivalent outcomes across real-world studies. Common real-world grade ≥ 3 adverse events were consistent with those in pivotal RCTs (fatigue, palmar-plantar erythrodysesthesia syndrome, diarrhea, hypertension), but less frequent. No new tolerability concerns were identified. Real-world RCC survival outcomes for cabozantinib monotherapy were broadly consistent with pivotal RCTs, despite greater heterogeneity in real-world populations.
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Affiliation(s)
| | - Lubomir Bodnar
- University of Natural Sciences and Humanities in Siedlce, Institute of Health Sciences, Siedlce, Poland
| | | | - Agnieszka Michael
- University of Surrey, School of Biosciences and Medicine, Guildford, UK
| | - Balaji Venugopal
- Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, UK
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Jia YY, Song JP, Yang L. Can virtual reality have effects on cardiac rehabilitation? An overview of systematic reviews. Curr Probl Cardiol 2024; 49:102231. [PMID: 38052348 DOI: 10.1016/j.cpcardiol.2023.102231] [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: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This paper aims to provide a review of the use of virtual reality in cardiac rehabilitation. BACKGROUND Can virtual reality technology improve outcomes in patients with cardiovascular disease? The question is still open. DESIGN Systematic review and meta-analyses. METHODS A literature search was conducted in the Embase, the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, and China Biological Medicine Database. Databases were searched to July 2023. The inclusion criteria were as follows: the nature of the studies was set as a systematic review; the research participants were patients with cardiovascular diseases undergoing cardiac rehabilitation; the research content was a comparison of virtual reality effects between other care approaches. A Measurement Tool to Assess Systematic Reviews was employed to evaluate the quality of included studies and judge the overall certainty of evidence by using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. When there were differences between the outcomes, we used the RevMan 5.3 to recalculate. RESULTS A total of 7 reviews were included in our synthesis, including 3 low-quality articles and 4 very low-quality articles. Virtual reality was effective in improving patients' depression symptoms, anxiety, stress, and improving athletic ability, but it remains unknown whether virtual reality is effective for other outcomes or not. CONCLUSIONS Virtual reality can effectively improve the mental health of patients with cardiovascular disease. However, its role in improving other health indicators such as adherence, satisfaction, and quality of life has not been shown.
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Affiliation(s)
- Ying Ying Jia
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Nursing Department, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Jian Ping Song
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Li Yang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
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Elias L, Mushi L. Effectiveness of prime vendor system on availability of medicines and medical supplies in the selected public health facilities in Arusha district council. BMC Health Serv Res 2024; 24:161. [PMID: 38303051 PMCID: PMC10836008 DOI: 10.1186/s12913-024-10581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION The shortage of medicines and medical supplies remains to be a major issue that is facing public health facilities in Tanzania. This situation has been influenced by lack of consistency in the supply chain, increase in healthcare demand, poor regulatory system, insufficient funds, and lack of conducive infrastructure. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed. OBJECTIVES This study aimed to assess the effectiveness of PVS on the availability of medicine and medical supplies in the selected public health facilities in Arusha District Council. METHODS The study used a case study design with mixed research approach. The study involved 77 respondents which included 25 health facility in-charges, 50 patients, 1 District Pharmacist and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021-2022. Thematic analysis was used to analyze the qualitative data whereas descriptive analysis was used to analyze the quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0. RESULTS The analysis indicates that PVS is not completely effective in supplying medicines and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, while 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines. CONCLUSION Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions to reinforce an adherence to the contracted terms and improve PVS effectiveness.
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Affiliation(s)
- Liberatus Elias
- Now For Compassion (NFC) Tanzania, Arusha, United Republic of Tanzania.
| | - Lawrencia Mushi
- Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, United Republic of Tanzania
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Zhang J, Li Z, Cheng Z, Wang T, Shi W. Comparison of the clinical efficacy of orthokeratology and 0.01% atropine for retardation of myopia progression in myopic children. Cont Lens Anterior Eye 2024; 47:102094. [PMID: 37985346 DOI: 10.1016/j.clae.2023.102094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of orthokeratology (ortho-k) and 0.01% atropine for retardation of myopia progression in myopic children. METHODS This was a retrospective cohort study. A total of 282 patients, aged 8-17 years, were enrolled, including 100 children treated with ortho-k, 84 with 0.01% atropine, and 98 with single-vision spectacles. During the follow-up of 1 year, ortho-k wearers were examined at 1 day, 1 week, 1 month, 3 months after treatment, and thereafter every 3 months, while the others were examined every 3 months by measurements of uncorrected vision, intraocular pressure, refractive power, slit-lamp microscopy, corneal topography, and the lens fitting when necessary. The axial length was measured every 6 months. RESULTS Patients with ortho-k had stable uncorrected vision after 1 month of lens wear, all reaching 0 logMAR. The annual axial elongation was 0.23 ± 0.19 mm, 0.22 ± 0.20 mm, and 0.39 ± 0.27 mm in the ortho-k, atropine, and spectacle groups, respectively, with significant difference (F = 23.251, P = 0.000). The axial length was delayed to increase by 41.03% and 43.59% within a year in patients with ortho-k and atropine, respectively, as compared to patients with spectacles (F = 0.006, P = 0.936). The elongation was ≤ 0.3 mm in 69.0% and 66.7% of patients in the two groups, respectively, versus 38.8% in the spectacle group (χ2 = 17.251, P = 0.000). During the follow-up, the rate of corneal staining was 11.0% and 2.0% in the ortho-k and spectacle groups, respectively (χ2 = 8.076, P = 0.003). The use of atropine did not increase corneal staining, but the incidence of related photophobia was 4.8%. No other serious complications were observed. CONCLUSION Ortho-k lenses and 0.01% atropine can achieve similar efficacy of myopia retardation, which was significantly better than that obtained with single-vision spectacles, in myopic children. The risk of corneal staining after ortho-k wear may be slightly higher than that with spectacles, but could be well controlled.
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Affiliation(s)
- Ju Zhang
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China
| | - Zhenzhen Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Zhiwei Cheng
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Ting Wang
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
| | - Weiyun Shi
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
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Shanazarov N, Bariyeva G, Avdeyev A, Albayev R, Kisikova S, Zinchenko S, Galiev I. Evaluation of the effectiveness and safety of photodynamic therapy in the treatment of precancerous diseases of the cervix (neoplasia) associated with the human papillomavirus: A systematic review. Photodiagnosis Photodyn Ther 2024; 45:103925. [PMID: 38070631 DOI: 10.1016/j.pdpdt.2023.103925] [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: 08/01/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
This study provides an overview of the effectiveness and safety of PDT for the treatment of HPV-associated precancerous cervical conditions and contains recent findings from relevant research studies. A comprehensive literature search of MEDLINE/PubMed, Cochrane Central Library, and Google Scholar was conducted, including analytic epidemiological studies, and 11 papers were included. The narrative synthesis approach was used to summarize the results of the included studies. Studies were critically appraised using The Joanna Briggs Institute (JBI) tool for assessing the risk of bias. The results of the study demonstrate that CRR for HPV remission ranges from 66.7 % to 92.73 %, whereas for CIN1 it fluctuates from 57.1 % to 83.3 %. The frequency of recurrence of the disease ranged from 3.3 % to 8.9 % during the follow-up period of up to 2 years. Adverse events were observed in 8 (66 %) studies and the most common were cervical stenosis, abdominal pain, vaginal pain, and focal edema. Five types of topical and intravenous applications along with lasers of various wavelengths and intensities were mostly used. However, all studies demonstrated relatively similar results. According to the results, PDT has demonstrated favorable outcomes, but no impressive effect on the treatment of CIN. It should be emphasized, that the effectiveness of PDT for the treatment of HPV-associated CIN may vary depending on some variables, including the kind of PDT agent used, the dosage, duration and frequency of PDT administration, the severity and location of the lesions, and the host immunological response.
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Affiliation(s)
- Nasrulla Shanazarov
- Medical Centre Hospital of President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Gulzada Bariyeva
- Medical Centre Hospital of President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan.
| | - Andrey Avdeyev
- Medical Centre Hospital of President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Rustam Albayev
- Medical Centre Hospital of President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Saule Kisikova
- President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | | | - Ilfat Galiev
- Kazan (Volga Region) Federal University, Kazan, Russia
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86
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Scheepers L, Yang Y, Chen YL, Jones G. Persistence of Janus-kinase (JAK) inhibitors in rheumatoid arthritis: Australia wide study. Semin Arthritis Rheum 2024; 64:152314. [PMID: 38029717 DOI: 10.1016/j.semarthrit.2023.152314] [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: 08/15/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND To compare persistence of disease-modifying antirheumatic (DMARDs), with a focus on Janus kinase (JAK) inhibitors in Australian rheumatoid arthritis (RA) patients. METHODS A retrospective observational study was conducted among 4,521 RA patients (females n=3,181 [70.4%]), using data from the Services Australia 10% Pharmaceuticals Benefits Scheme (PBS) dataset, aged ≥18 years and initiating a DMARD between 2011 to 2021. Kaplan-Meier analysis was used to estimate persistence rates, defined as occurrence of 6 months gap after the end of a drug dispensing. RESULTS Twelve-month persistence rates were 72% for upadacitinib, 61% for baricitinib, 58% for subcutaneous tumor necrosis factor-alpha inhibitors (TNFi), 55% for tocilizumab, 53% for tofacitinib, and 49% for abatacept. Median treatment persistence was not reached for upadacitinib (n=574) and baricitinib (n=553); and was 15.0 months for tofacitinib (95% CI 13.5-19.5), 20.5 months for TNFi (95% CI 19.0-22.4), 19.1 months for tocilizumab (95% CI 17.9-23.6), and 12.5 months for abatacept (95% CI 10.4-14.9). Persistence rates on first-line JAK inhibitors were 68% for upadacitinib and baricitinib and 55% for tofacitinib, and 49% for TNFi, 55% for abatacept, and 57% for tocilizumab; rates were sustained for upadacitinib, TNFi, and tocilizumab but dropped to 59% for baricitinib and 47% for abatacept in the second-line treatment. For each b/tsDMARD, persistence rates were higher when combined with methotrexate or other conventional synthetic DMARDs. The median oral glucocorticoid dose decreased from 4.3 mg/day (range:0-40) to 2.3 mg/day (range:0-22) over 2 years. Changes were significant for all RA DMARDs, tofacitinib and baricitinib combined (1-2 years post initiation only), TNFi, abatacept, and tocilizumab. CONCLUSIONS In a real-world setting, we showed highest persistence rates on upadacitinib, followed by baricitinib and then TNFi therapy and was improved by co-therapy. All agents appeared to be corticosteroid sparing.
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Affiliation(s)
- Lieke Scheepers
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | | | | | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Ma J, Wang Y, Joshi S, Wang H, Young C, Pervez A, Qu Y, Washburn S. Using immersive virtual reality technology to enhance nursing education: A comparative pilot study to understand efficacy and effectiveness. Appl Ergon 2024; 115:104159. [PMID: 37924578 DOI: 10.1016/j.apergo.2023.104159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/05/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Abstract
The U.S. faces a national shortage of nurses. The emergence of human-centered digital technologies has directly impacted nursing education. Using immersive Virtual Reality related digital technology to assist and enhance nurse education is promising but not yet fully understood. This study aims to understand the effectiveness and efficacy of immersive Virtual Reality nursing education approaches through a comparative pilot study. Three immersive Virtual Reality scenarios based on basic nursing skills were developed. A traditional video lecture approach including the same contents was used as a comparable approach to investigate the effectiveness and efficacy performance of the proposed immersive Virtual Reality approach. 22 participants were recruited from a college. Effectiveness was measured through motivation and knowledge gain, while efficacy was evaluated through simulation sickness, user experience, and system usability. The results showed that the VR approach has above "acceptable" efficacy performance, which indicates participants are willing to accept this novel education approach. The effectiveness results indicate that the VR approach has similar performance with the video approach in delivering nursing contents. One limitation of this investigation is that the sample size is relatively small and further larger sample sizes are needed for future analysis.
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Affiliation(s)
- Junfeng Ma
- Department of Industrial and Systems Engineering, Mississippi State University, Mississippi State, MS, 39762, USA.
| | - Yu Wang
- Center for Continuing Education, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Sayali Joshi
- Department of Industrial and Systems Engineering, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Haifeng Wang
- Department of Industrial and Systems Engineering, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Carlton Young
- Meridian Division of Business, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Adam Pervez
- Meridian Division of Business, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Yingge Qu
- Meridian Division of Business, Mississippi State University, Mississippi State, MS, 39762, USA
| | - Shey Washburn
- Master pf Physical Assistant Studies, Meridian Division of Arts & Sciences, Mississippi State University, Mississippi State, MS, 39762, USA
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Wagenaar O, Gilles A, Van Rompaey V, Blom H. Goal Attainment Scale in tinnitus (GAS-T): treatment goal priorities by chronic tinnitus patients in a real-world setting. Eur Arch Otorhinolaryngol 2024; 281:693-700. [PMID: 37488402 DOI: 10.1007/s00405-023-08134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Standard treatment for tinnitus is cognitive behavioral therapy, although level of evidence of effectiveness is low. There is need for a Goal Attainment Scale to evaluate treatment effects based on patient satisfaction. Preliminary work in a clinical sample has identified six common personal treatment goals. The purpose of this study is to determine whether the preliminary identified goals are confirmed by a heterogeneous sample of people with bothersome tinnitus and to identify any other common personal goals with the intention to construct a closed-end Goal Attainment Scale for tinnitus for use in research of effectiveness of (new) tinnitus treatments. METHODS Two consecutive polls were plotted in an online peer support group form a heterogeneous sample. First, members were asked to vote for preliminary identified goals and asked to formulate additional personal goals. Corresponding goals were grouped together. Goals that were acknowledged by at least 10% of respondents were used in the second poll in which respondents could vote for statements that they recognized themselves in. RESULTS The first poll (N = 180) resulted in 15 personal treatment goals. Comparison resulted in five common goals, which were confirmed in the second poll (N = 238): to gain control, to improve well-being and sleep, to reduce effects on hearing and to understand tinnitus. CONCLUSIONS We expect that if a patient achieves personal goals, he will be likely to reduce healthcare consumption. Based on common personal goals, validity of treatment evaluations is increased. We present a closed-end Goal Attainment Scale in tinnitus.
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Affiliation(s)
- Olav Wagenaar
- Department of Neurology, Rijndam Rehabilitation Center, Rotterdam, The Netherlands.
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Henk Blom
- Otorhinolaryngology, Haga Teaching Hospital, The Hague, The Netherlands
- Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium
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Mosnaim GS, Hoyte FCL, Safioti G, Brown R, Hill TD, Li T, Sagalovich K, DePietro M, Wechsler ME. Effectiveness of a Maintenance and Reliever Digihaler System in Asthma: 24-Week Randomized Study (CONNECT2). J Allergy Clin Immunol Pract 2024; 12:385-395.e4. [PMID: 38040117 DOI: 10.1016/j.jaip.2023.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/07/2023] [Accepted: 11/25/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Digital health tools have been shown to help address challenges in asthma control, including inhaler technique, treatment adherence, and short-acting β2-agonist overuse. The maintenance and reliever Digihaler System (DS) comprises 2 Digihaler inhalers (fluticasone propionate/salmeterol and albuterol) with an associated patient App and web-based Dashboard. Clinicians can review patients' inhaler use and Digihaler inhalation parameter data to support clinical decision-making. OBJECTIVE CONNECT2 evaluated asthma control in participants using the DS versus standard-of-care (SoC) maintenance and reliever inhalers. METHODS Participants (13 years or older) with uncontrolled asthma (Asthma Control Test [ACT] score <19) were randomized 4:3 (open-label) to the DS (n = 210) or SoC (n = 181) for 24 weeks. The primary endpoint was the proportion of patients achieving well-controlled asthma (ie, an ACT score ≥20 or increase from baseline of ≥3 units at week 24). RESULTS There was an 88.7% probability that participants using the DS would have greater odds of achieving improvement in asthma control compared with SoC after 24 weeks. The mean odds ratio (95% credible interval) for DS versus SoC was 1.35 (0.846-2.038), indicating a 35% higher odds of improved asthma control with the DS. The DS group had more clinician-participant interactions versus SoC, mainly addressing a poor inhaler technique. DS participants' maintenance treatment adherence was good (month 1: 79.2%; month 6: 68.6%); reliever use decreased by 38.2% versus baseline. App and Dashboard usability was rated "good." CONCLUSION The positive results in asthma control in this study after 24 weeks demonstrate the effectiveness of the DS in asthma management.
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Affiliation(s)
- Giselle S Mosnaim
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, NorthShore University Health System, Evanston, Ill.
| | - Flavia C L Hoyte
- Division of Allergy/Immunology, Department of Medicine, National Jewish Health, Denver, Colo; University of Colorado Hospital, Aurora, Colo
| | | | - Randall Brown
- Teva Branded Pharmaceutical Products R&D, Inc., Parsippany, NJ
| | - Tanisha D Hill
- Teva Branded Pharmaceutical Products R&D, Inc., Parsippany, NJ
| | - Thomas Li
- Teva Branded Pharmaceutical Products R&D, Inc., Parsippany, NJ
| | | | | | - Michael E Wechsler
- Division of Allergy/Immunology, Department of Medicine, National Jewish Health, Denver, Colo; University of Colorado Hospital, Aurora, Colo
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90
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Weiss KA, Baker SD, El-Sawi N, Gray V. Effectiveness of an Online Preceptor Development Program Across Health Professions. Med Sci Educ 2024; 34:77-87. [PMID: 38510398 PMCID: PMC10948627 DOI: 10.1007/s40670-023-01923-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 03/22/2024]
Abstract
Introduction An online Preceptor Development Program (PDP) was developed to meet the needs of geographically dispersed preceptors across health professions. We aimed to measure the audience, their engagement, and effectiveness of an online PDP developed and implemented amid the COVID-19 pandemic. Methods The mixed methods study included survey and attendance data for live and asynchronous formats. T-tests compared overall session perception to self-reported session impact. Objective alignment and self-reported measures of impact were analyzed around Kirkpatrick's levels of reaction, learning, and behavior. Results Participants engaged in live and/or asynchronous PDP sessions from various professions, specialties, and geographical locations. Quantitative findings indicated significant associations between overall session perception and knowledge (session 2), competence (sessions 1, 2), and performance (session 1). Objectives were met, and key learning takeaways were reported. While most participants indicated no barriers to implementation, two barriers identified were a lack of time and uninterested students. Conclusion Participants were afforded flexibility and choice and likely benefitted in the areas of knowledge, competence, and behavior. This online PDP effectively addressed preceptor needs in common areas, including feedback. Future program development may include advisory group input and interactive learning opportunities.
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Affiliation(s)
- Kathleen A. Weiss
- Center for Educational Enhancement, Des Moines University, Des Moines, IA USA
| | - S. Dennis Baker
- Department of Family Medicine, Florida State University, Tallahassee, FL USA
| | - Nehad El-Sawi
- Office of Academic Affairs, Des Moines University, Des Moines, IA USA
| | - Vanessa Gray
- Continuing Medical Education Program, Des Moines University, Des Moines, IA USA
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91
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Horigome Y, Iino M, Harazaki Y, Kobayashi T, Handa H, Hiramatsu Y, Kuroi T, Tanimoto K, Matsue K, Abe M, Ishida T, Ito S, Iwasaki H, Kuroda J, Shibayama H, Sunami K, Takamatsu H, Tamura H, Hayashi T, Akagi K, Maeda T, Yoshida T, Mori I, Shinozaki T, Iida S. A prospective, multicenter, observational study of ixazomib plus lenalidomide-dexamethasone in patients with relapsed/refractory multiple myeloma in Japan. Ann Hematol 2024; 103:475-488. [PMID: 37695378 PMCID: PMC10798923 DOI: 10.1007/s00277-023-05428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023]
Abstract
Real-world studies permit inclusion of a more diverse patient population and provide more information on the effectiveness of treatments used in routine clinical practice. This prospective, multicenter, observational study investigated the effectiveness and safety of ixazomib plus lenalidomide and dexamethasone (IRd) in 295 patients with relapsed/refractory multiple myeloma (RRMM) in routine clinical practice in Japan. Patients had a median age of 74 years, 80.0% were aged ≥ 65 years, 42.0% had received ≥ 3 lines of prior treatment, and 28.5% were "frail" according to the International Myeloma Working Group frailty score. After a median follow-up of 25.0 months, median progression-free survival (PFS) was 15.3 (95% CI 12.4-19.5) months, while median overall survival was not reached. The overall response rate was 53.9%, and 31.5% of patients had a very good partial response or better. In the subgroup analysis, median PFS was better in patients with 1 versus 2 or ≥ 3 lines of prior treatment (29.0 vs 19.2 or 6.9 months) and paraprotein versus clinical relapse (16.0 vs 7.9 months), but median PFS was not notably affected by frailty score or age group. Dose adjustment was more frequent among patients aged > 75 years, especially early after IRd treatment initiation. Treatment-emergent adverse events (TEAEs) of any grade occurred in 84.4% of patients and 24.7% of patients discontinued treatment due to TEAEs; no new safety concerns were found. These findings suggest that oral IRd triplet regimen is an effective and tolerable treatment option for RRMM patients in real-world settings outside of clinical trials.ClinicalTrials.gov identifier: NCT03433001; Date of registration: 14 February 2018.
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Affiliation(s)
- Yuichi Horigome
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yoriko Harazaki
- Department of Hematology, Miyagi Cancer Center, Natori, Japan
| | - Takahiro Kobayashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasushi Hiramatsu
- Department of Hematology and Oncology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Taiga Kuroi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - Kazuki Tanimoto
- Department of Hematology and Oncology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Kosei Matsue
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School, Tokushima, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shigeki Ito
- Department of Hematology and Oncology, Iwate Medical University Hospital, Iwate, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirohiko Shibayama
- Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | - Hideto Tamura
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Hayashi
- Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kiwamu Akagi
- Division of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Ina, Japan
| | - Takahiro Maeda
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Yoshida
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Ikuo Mori
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
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Moffat GT, Kong W, MacKay HJ, McGee J, Booth CM, Ethier JL. Real-world outcomes associated with bevacizumab combined with chemotherapy in platinum-resistant ovarian Cancer. Gynecol Oncol 2024; 184:51-56. [PMID: 38281412 DOI: 10.1016/j.ygyno.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVES The addition of bevacizumab to chemotherapy for platinum-resistant (PL-R) ovarian cancer (OC) improved progression-free (PFS) but not overall survival (OS) in clinical trials. We explored real-world outcomes in Ontario, Canada, and compared survival in the pre- and post-bevacizumab era. METHODS Administrative databases were utilized to identify all patients treated with bevacizumab for PL-R OC. Time on treatment (ToT) was used as surrogate for PFS. Median OS was determined using the Kaplan-Meier method. Factors associated with ToT/OS were identified using a Cox proportional hazard model. A before and after comparative effectiveness analysis was performed to determine mOS for patients treated pre- and post-bevacizumab approval. RESULTS From 2017 to 2019, 176 patients received bevacizumab. Median ToT was 3 months and OS was 11 months. Sixty-four percent received liposomal doxorubicin and 34% received paclitaxel. ToT (6 vs 3 months; HR 0.44; p < 0.0001) and OS (14 vs 9 months; HR 0.45; p = 0.0089) were longer with bevacizumab/paclitaxel. OS was not significantly different pre- and post-bevacizumab funding (8 vs 9 months; HR 1.01; 0.937). Median OS increased for those receiving paclitaxel (6 vs 11 months), but those in the post group were younger, more likely to have undergone primary surgery and had less co-morbidities. CONCLUSION Real-world outcomes with bevacizumab in PL-R OC are inferior to those in the pivotal clinical trial. Survival has not significantly improved since funding became publicly available, indicating a substantial efficacy-effectiveness gap between trial and real-world outcomes. Median OS and ToT were significantly better when bevacizumab was given with paclitaxel.
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Affiliation(s)
- Gordon Taylor Moffat
- Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Weidong Kong
- Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada
| | - Helen J MacKay
- Division of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jacob McGee
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada; Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Josee-Lyne Ethier
- Division of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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Rosen JB, Arciuolo RJ, Pathela P, Boyer CB, Baumgartner J, Latash J, Malec L, Lee EH, Reddy V, King R, Edward Real J, Lipsitch M, Zucker JR. JYNNEOS™ effectiveness as post-exposure prophylaxis against mpox: Challenges using real-world outbreak data. Vaccine 2024; 42:548-555. [PMID: 38218669 PMCID: PMC10960631 DOI: 10.1016/j.vaccine.2023.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND JYNNEOSTM vaccine has been used as post-exposure prophylaxis (PEP) during a mpox outbreak in New York City (NYC). Data on effectiveness are limited. METHODS Effectiveness of a single dose of JYNNEOSTM vaccine administered subcutaneously ≤ 14 days as PEP for preventing mpox disease was assessed among individuals exposed to case-patients from May 22, 2022-August 24, 2022. Individuals were evaluated for mpox through 21 days post-exposure. An observational study was conducted emulating a sequence of nested "target" randomized trials starting each day after exposure. Results were adjusted for exposure risk and race/ethnicity. Analyses were conducted separately based on last (PEPL) and first (PEPF) exposure date. We evaluated the potential to overestimate PEP effectiveness when using conventional analytic methods due to exposed individuals developing illness before they can obtain PEP (immortal time bias) compared to the target trial. RESULTS Median time from last exposure to symptom onset (incubation period) among cases that did not receive PEPL was 7 days (range 1-16). Time to PEPL receipt was 7 days (range 0-14). Among 549 individuals, adjusted PEPL and PEPF effectiveness was 19 % (95 % Confidence Interval [CI], -54 % to 57 %) and -7% (95 % CI, -144 % to 53 %) using the target trial emulation, respectively, and 78 % (95 % CI, 50 % to 91 %) and 73 % (95 % CI, 31 % to 91 %) using conventional analysis. CONCLUSIONS Determining PEP effectiveness using real-world data during an outbreak is challenging. Time to PEP in NYC coupled with the observed incubation period resulted in overestimated PEP effectiveness using a conventional method. The target trial emulation, while yielding wide confidence intervals due to small sample size, avoided immortal time bias. While results from these evaluations cannot be used as reliable estimates of PEP effectiveness, we present important methodologic considerations for future evaluations.
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Affiliation(s)
- Jennifer B Rosen
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA.
| | - Robert J Arciuolo
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Preeti Pathela
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Christopher B Boyer
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer Baumgartner
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Julia Latash
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Lenka Malec
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Ellen H Lee
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Vasudha Reddy
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Renee King
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Joseph Edward Real
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jane R Zucker
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Khan J, Suau Sans M, Okot F, Rom Ayuiel A, Magoola J, Rassi C, Huang S, Mubiru D, Bonnington C, Baker K, Ahmed J, Nnaji C, Richardson S. A quasi-experimental study to estimate effectiveness of seasonal malaria chemoprevention in Aweil South County in Northern Bahr El Ghazal, South Sudan. Malar J 2024; 23:33. [PMID: 38267985 PMCID: PMC10810022 DOI: 10.1186/s12936-024-04853-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Seasonal malaria chemoprevention (SMC) is an effective intervention to prevent malaria in children in locations where the burden of malaria is high and transmission is seasonal. There is growing evidence suggesting that SMC with sulfadoxine-pyrimethamine and amodiaquine can retain its high level of effectiveness in East and Southern Africa despite resistance concerns. This study aims to generate evidence on the effectiveness of SMC when delivered under programmatic conditions in an area with an unknown anti-malarial drug resistance profile in the Northern Bahr el-Ghazal region of South Sudan. METHODS A non-randomized quasi experimental study was conducted to compare an intervention county with a control county. Five monthly SMC cycles were delivered between July and November 2022, targeting about 19,000 children 3-59 months old. Data were obtained from repeated cross-sectional household surveys of caregivers of children aged 3-59 months using cluster sampling. Wave 1 survey took place in both counties before SMC implementation; Waves 2 and 3 took place after the second and fourth monthly SMC cycles. Difference-in-differences analyses were performed by fitting logistic regression models with interactions between county and wave. RESULTS A total of 2760 children were sampled in the study across the three survey waves in both study counties. Children in the intervention arm had 70% lower odds of caregiver-reported fever relative to those in the control arm during the one-month period prior to Wave 2 (OR: 0.30, 95% CI 0.12-0.70, p = 0.003), and 37% lower odds in Wave 3 (OR: 0.63, 95% CI 0.22-1.59, p = 0.306) after controlling for baseline difference between counties in Wave 1. Odds of caregiver-reported RDT-confirmed malaria were 82% lower in the previous 1-month period prior to Wave 2 (OR: 0.18, 95% CI 0.07-0.49, p = 0.001) and Wave 3 (OR: 0.18, 95% CI 0.06-0.54, p = 0.003). CONCLUSION These results show high effectiveness of SMC using SPAQ in terms of reducing malaria disease during the high transmission season in children 3-59 month. Despite the promising results, additional evidence and insights from chemoprevention efficacy cohort studies, and analyses of relevant resistance markers, are required to assess the suitability of SMC for this specific context.
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Affiliation(s)
| | | | | | | | | | | | - Sikai Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | | | | | - Kevin Baker
- Malaria Consortium, London, UK
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | | | - Sol Richardson
- Malaria Consortium, London, UK
- Vanke School of Public Health, Tsinghua University, Beijing, China
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95
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Abusafia AH, Khraisat AMS, Tableb OK, Al-Mugheed K, Alabdullah AA, Abdelaliem SMF. The impact of a nursing spiritual care module on nursing competence: an experimental design. BMC Palliat Care 2024; 23:21. [PMID: 38246991 PMCID: PMC10802070 DOI: 10.1186/s12904-024-01356-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE This study aimed to assess the impact of the Nursing Spiritual Care Module on the competence of nurses in providing spiritual care in the context of Malaysia. METHOD This study employed an experimental design and involved a total of 122 nurses, with 59 in the experimental group and 63 in the control group. Participants were selected from palliative care wards associated with Hospital Universiti Sains Malaysia. Nurses in the experimental group underwent a two-week educational module on nursing spiritual care, while nurses in the control group attended a single lecture on spiritual care provided by the hospital. RESULTS The results indicated no significant differences in sociodemographic characteristics between the two groups. A significant difference in spiritual care competence within the intervention group and the control group over time (p-value = 0.001), between the two groups (p-value = 0.038), and in the interaction between time and group (p-value = 0.001). CONCLUSION The Nursing Spiritual Care Module is crucial in aiding nurses and healthcare professionals in cultivating the appropriate and wholesome attitudes and practices necessary to address the spiritual needs of patients.
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Chen Y, Liu S, Li B, Lin R, Lai W, Liu D, Wang Z, Liu J, Qin X, Wu X, Li J, Jia K, Chen J. Application of the quality of recovery-40 questionnaire to evaluate the effectiveness of enhanced recovery after surgery protocols in gastric cancer. Updates Surg 2024:10.1007/s13304-023-01719-w. [PMID: 38245892 DOI: 10.1007/s13304-023-01719-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024]
Abstract
Patient reported outcomes is currently considered to be an important supplement to evaluate the effectiveness of enhanced recovery after surgery (ERAS) clinical practice. The Quality of Recovery-40 Questionnaire (QoR-40) is one of the most frequently used and validation tool to assess the subjective feelings of quality of life after surgery. The present study aimed to use the QoR-40 to evaluate the effectiveness of ERAS protocols in gastric cancer from the perspective of patient-reported quality of recovery. The study was designed as a prospective, non-randomized clinical trial, conducted in a single center. Patients in our hospital who were scheduled to undergo radical surgery for gastric cancer were divided into ERAS group and control group (Contr group). The QoR-40 were administered one day before surgery (Baseline) and on postoperative day 1, 3, 6, and 30. The difference in QoR-40 scores between the ERAS and Contr groups was compared by repeated-measures ANOVA. A total of 200 patients completed the study, including 100 patients in the ERAS group and 100 patients in the Contr group. The Baseline time point QoR-40 scores of the ERAS and Contr groups were 179.68 ± 14.46 and 180.12 ± 17.12, respectively, and no significant difference was noted between the two groups (p = 0.845). The postoperative QoR-40 score of the ERAS group was significantly higher than that of the Contr group, and the difference was statistically significant (p = 0.006). This study demonstrated that, in terms of patient-reported quality of recovery, the postoperative recovery effect of ERAS protocols in gastric cancer is significantly better than that of the traditional treatment model.
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Affiliation(s)
- Yeyang Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
- Department of Thyroid and Breast surgery, The First People's Hospital of Yulin, Yulin, China
| | - Siyu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Bopei Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Rujing Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Weikun Lai
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Dejun Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Zhen Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Jinlu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Xingan Qin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Xianghua Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Jiehua Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Kui Jia
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China
| | - Junqiang Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China.
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi, China.
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Vella SP, Melman A, Coombs D, Maher CG, Swain MS, Monk E, Machado GC. The effectiveness of allied health and nurse practitioner models-of-care in managing musculoskeletal conditions in the emergency department: a systematic review and meta-analysis. BMC Emerg Med 2024; 24:13. [PMID: 38233743 PMCID: PMC10795385 DOI: 10.1186/s12873-023-00925-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/26/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Musculoskeletal conditions are the most common health condition seen in emergency departments. Hence, the most effective approaches to managing these conditions is of interest. This systematic review aimed to evaluate the effectiveness of allied health and nursing models of care for the management of musculoskeletal pain in ED. METHODS MEDLINE, EMBASE, CINAHL and LILACS databases were searched from inception to March 2023 for published randomised trials that compared the effectiveness of allied health and nursing models of care for musculoskeletal conditions in ED to usual ED care. Trials were eligible if they enrolled participants presenting to ED with a musculoskeletal condition including low back pain, neck pain, upper or lower limb pain and any soft tissue injury. Trials that included patients with serious pathology (e.g. malignancy, infection or cauda equina syndrome) were excluded. The primary outcome was patient-flow; other outcomes included pain intensity, disability, hospital admission and re-presentation rates, patient satisfaction, medication prescription and adverse events. Two reviewers performed search screening, data extraction, quality and certainty of evidence assessments. RESULTS We identified 1746 records and included 5 randomised trials (n = 1512 patients). Only one trial (n = 260) reported on patient-flow. The study provides very-low certainty evidence that a greater proportion of patients were seen within 20 min when seen by a physician (98%) than when seen by a nurse (86%) or physiotherapist (77%). There was no difference in pain intensity and disability between patients managed by ED physicians and those managed by physiotherapists. Evidence was limited regarding patient satisfaction, inpatient admission and ED re-presentation rates, medication prescription and adverse events. The certainty of evidence for secondary outcomes ranged from very-low to low, but generally did not suggest a benefit of one model over another. CONCLUSION There is limited research to judge the effectiveness of allied health and nursing models of care for the management of musculoskeletal conditions in ED. Currently, it is unclear as to whether allied health and nurse practitioners are more effective than ED physicians at managing musculoskeletal conditions in ED. Further high-quality trials investigating the impact of models of care on service and health outcomes are needed.
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Affiliation(s)
- Simon P Vella
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia.
- Royal Prince Alfred Hospital, Level 10N, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Alla Melman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Danielle Coombs
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Christopher G Maher
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Michael S Swain
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Elizabeth Monk
- St George Hospital Emergency Department, Sydney, Australia
| | - Gustavo C Machado
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
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98
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Teodoro MI, Mayer A, da Costa Miranda A, Nunes H, da Costa FA, Lourenço A. Real-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer: a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institution. J Pharm Policy Pract 2024; 17:2296551. [PMID: 38250517 PMCID: PMC10798277 DOI: 10.1080/20523211.2023.2296551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Background Monotherapy with aromatase inhibitors and fulvestrant were the standard-of-care for hormone receptor-positive (HR+)/human epidermal growth factor receptor-type2 negative (HER2-) advanced breast cancer, before integration of cyclin-dependent kinase 4/6 inhibitors. Effectiveness data is essential for regulatory action, but little is known about real-world use of aromatase inhibitors and fulvestrant. Methods A retrospective cohort study was conducted resorting to data from a cancer registry to identify adult women with HR+/HER- advanced breast cancer exposed to aromatase inhibitors or fulvestrant (31 May 2017-31 March 2019) at the main oncology hospital in Portugal. Cases were updated with follow-up until death or cut-off (31 March 2021) and pseudoanonymized data extracted. Primary outcome was overall survival (OS) and secondary time to treatment failure (TTF), estimated using survival analysis and compared with published trials. Results 192 patients were distributed by subgroups according to the medicine. Letrozole: OS 30.8 (95% confidence interval (CI) 20.6-41.4); TTF 11.2 (95%CI 8.7-13.7). Exemestane: OS 22.1 (95%CI 9.7-34.6); TTF 6.0 (95%CI 4.1-7.8). Fulvestrant: OS 21.6 (95%CI 16.5-26.7); TTF 5.6 (95%CI 4.5-6.6). Conclusions Estimated effectiveness (OS) of letrozole and fulvestrant was, respectively, 3.2-3.5 months lower than reported. The clinical meaning seems uncertain and may be explained a higher proportion of worse prognostic characteristics in patients treated in the real-world.
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Affiliation(s)
- Maria Inês Teodoro
- Unidade de Investigação em Epidemiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
- Research Institute for Medicines (iMED), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Alexandra Mayer
- Unidade de Investigação em Epidemiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Ana da Costa Miranda
- Unidade de Investigação em Epidemiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Hugo Nunes
- Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Filipa Alves da Costa
- Unidade de Investigação em Epidemiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
- Research Institute for Medicines (iMED), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - António Lourenço
- Unidade de Investigação em Epidemiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
- NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
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Coll-Planas L, Carbó-Cardeña A, Jansson A, Dostálová V, Bartova A, Rautiainen L, Kolster A, Masó-Aguado M, Briones-Buixassa L, Blancafort-Alias S, Roqué-Figuls M, Sachs AL, Casajuana C, Siebert U, Rochau U, Puntscher S, Holmerová I, Pitkala KH, Litt JS. Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project. BMC Public Health 2024; 24:172. [PMID: 38218784 PMCID: PMC10787456 DOI: 10.1186/s12889-023-17547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND The negative effects of loneliness on population health and wellbeing requires interventions that transcend the medical system and leverage social, cultural, and public health system resources. Group-based social interventions are a potential method to alleviate loneliness. Moreover, nature, as part of our social and health infrastructure, may be an important part of the solutions that are needed to address loneliness. The RECETAS European project H2020 (Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an international research project aiming to develop and test the effectiveness of nature-based social interventions to reduce loneliness and increase health-related quality of life. METHODS This article describes the three related randomized controlled trials (RCTs) that will be implemented: the RECETAS-BCN Trial in Barcelona (Spain) is targeting people 18+ from low socio-economic urban areas; the RECETAS-PRG Trial in Prague (Czech Republic) is addressing community-dwelling older adults over 60 years of age, and the RECETAS-HLSNK trial is reaching older people in assisted living facilities. Each trial will recruit 316 adults suffering from loneliness at least sometimes and randomize them to nature-based social interventions called "Friends in Nature" or to the control group. "Friends in Nature" uses modifications of the "Circle of Friends" methodology based on group processes of peer support and empowerment but including activities in nature. Participants will be assessed at baseline, at post-intervention (3 months), and at 6- and 12-month follow-up after baseline. Primary outcomes are the health-related quality-of-life according to 15D measure and The De Jong Gierveld 11-item loneliness scale. Secondary outcomes are health and psychosocial variables tailored to the specific target population. Nature exposure will be collected throughout the intervention period. Process evaluation will explore context, implementation, and mechanism of impact. Additionally, health economic evaluations will be performed. DISCUSSION The three RECETAS trials will explore the effectiveness of nature-based social interventions among lonely people from various ages, social, economic, and cultural backgrounds. RECETAS meets the growing need of solid evidence for programs addressing loneliness by harnessing the beneficial impact of nature on enhancing wellbeing and social connections. TRIAL REGISTRATION Barcelona (Spain) trial: ClinicalTrials.gov, ID: NCT05488496. Registered 29 July 2022. Prague (Czech Republic) trial: ClinicalTrials.gov, ID: NCT05522140. Registered August 25, 2022. Helsinki (Finland) trial: ClinicalTrials.gov, ID: NCT05507684. Registered August 12, 2022.
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Affiliation(s)
- Laura Coll-Planas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Aina Carbó-Cardeña
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Anu Jansson
- Department of General Practice, University of Helsinki, PO BOX 20, 00014, Helsinki, Finland
| | - Vladimira Dostálová
- Charles University, Faculty of Humanities - Centre of Expertise in Longevity and Long-Term Care, Pátkova 2137/5, 182 00, Prague, Czech Republic
| | - Alzbeta Bartova
- Charles University, Faculty of Humanities - Centre of Expertise in Longevity and Long-Term Care, Pátkova 2137/5, 182 00, Prague, Czech Republic
| | - Laura Rautiainen
- Department of General Practice, University of Helsinki, PO BOX 20, 00014, Helsinki, Finland
| | - Annika Kolster
- Department of General Practice, University of Helsinki, PO BOX 20, 00014, Helsinki, Finland
- Western Uusimaa Wellbeing Services, Health Services, Espoo, Finland
| | - Montse Masó-Aguado
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Laia Briones-Buixassa
- Innovation in Mental Health and Social Wellbeing Research group (ISAMBES), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Sergi Blancafort-Alias
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB C/ Sant Antoni M. Claret, 171, 4a planta, Barcelona, Spain
| | - Marta Roqué-Figuls
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB C/ Sant Antoni M. Claret, 171, 4a planta, Barcelona, Spain
| | - Ashby Lavelle Sachs
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB) Doctor Aiguader, 88 08003, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Cristina Casajuana
- Subdirecció General d'Addiccions, VIH, ITS i Hepatitis Víriques. Agència de Salut Pública de Catalunya, Carrer de Roc Boronat, 81-95, 08005, Barcelona, Spain
| | - Uwe Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria
- Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Institute for Technology Assessment, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Ursula Rochau
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Sibylle Puntscher
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Iva Holmerová
- Charles University, Faculty of Humanities - Centre of Expertise in Longevity and Long-Term Care, Pátkova 2137/5, 182 00, Prague, Czech Republic
| | - Kaisu H Pitkala
- Department of General Practice, University of Helsinki, PO BOX 20, 00014, Helsinki, Finland
- Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Jill S Litt
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB C/ Sant Antoni M. Claret, 171, 4a planta, Barcelona, Spain.
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB) Doctor Aiguader, 88 08003, Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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100
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Pieper C, Kaistha FTH, Schroeer S, Borgert M, Michalsen A, Mayer-Berger W. InterVFast- effectiveness and acceptance of intermittent fasting in cardiac rehabilitation patients: study protocol of a randomized controlled trial. Trials 2024; 25:32. [PMID: 38195578 PMCID: PMC10775558 DOI: 10.1186/s13063-023-07843-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/30/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Research on intermittent fasting has shown that it can improve a variety of health outcomes, including blood sugar control, blood lipid levels and blood pressure. Only few studies document longer periods of fasting, especially in rehabilitation participants. Cardiac inpatient rehabilitation follows a multidisciplinary approach including change of health behaviour to reduce patients' risk of future cardiovascular events. To date, evidence suggests that intermittent fasting can be an effective way to improve health and well-being, but more research is needed to fully understand its long-term effects and factors that promote the implementation. Therefore, the aim of the ongoing InterVFast trial is to investigate the effectiveness of intermittent fasting amongst cardiac rehabilitation patients after 4-week inpatient rehabilitation as well as 3 and 12 months subsequently including patients' perspective. METHODS This single-centre randomized controlled trial evaluates the effectiveness of the InterVFast intervention in weight loss (primary outcome). We also examine patients' acceptance and the effect on relevant outcomes as blood glucose and triglyceride levels, cholesterol and high-sensitivity C-reactive protein. Weight, blood samples and clinical data are collected as part of the initial and final examination during inpatient rehabilitation. During inpatient rehabilitation, participants daily note fasting intervals and meals eaten as well as practicability in a fasting diary. In addition, interviews about perceived advantages and disadvantages and acceptance are carried out with the participants in the IG. A standardized follow-up examination (weight, blood samples) will be carried out by the family doctor after 3 and 12 months (t2 and t3). DISCUSSION Compared to other weight-loss intervention studies, our study addresses patients with coronary heart disease and includes patients' acceptance as well as long-term maintenance. It is hypothesized that participation in the InterVfast intervention will improve relevant health outcomes in a sample of cardiac rehabilitation patients and thus constitute a behavioural prevention strategy to reduce the risk of future cardiac events and improve overall health and quality of life. TRIAL REGISTRATION ClinicalTrials.gov DRKS00023983. Registered on February 17, 2022.
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Affiliation(s)
- Claudia Pieper
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Florian Tim Hitesh Kaistha
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Sarah Schroeer
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Maria Borgert
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Andreas Michalsen
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
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