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Santhakumaran S, Baiad A, Ranjbari D, Correa JA, Chaudhry Z, Toffoli D. Impact of 5 waves of COVID-19 on pediatric ophthalmology. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00187-X. [PMID: 39106963 DOI: 10.1016/j.jcjo.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/05/2024] [Accepted: 06/16/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVE To characterize the impact of multiple waves of COVID-19 on pediatric ophthalmology at a tertiary care hospital. METHODS Medical records were reviewed from pediatric patients seen for ophthalmic emergencies at the Montreal Children's Hospital (Montreal, Canada) from 5 COVID-19 periods: March 13 to May 31, 2020; September 20, 2020, to February 21, 2021; March 21 to May 31, 2021; August 17 to November 5, 2021; and December 19, 2021, to January 25, 2022, as well as 2 pre-COVID time periods: March 13 to May 31, in 2018 and 2019). RESULTS There was a significant reduction in ophthalmic consultations when comparing pre-COVID to all 5 COVID waves (p < 0.0001). There was an increase in the average number of daily urgent (p = 0.01) ophthalmic consultations from waves 1 to 4. Mean household income of patients was not significantly different pre-COVID compared to during the 5 COVID waves (p = 0.96). The most common referral reason was ocular trauma (38.0% of cases). There was a non-significant trend demonstrating more infectious disease presentations during waves 3 to 5 (p = 0.07). There was no difference in symptom duration prior to presentation (p = 0.54); however, there was a difference in the time between emergency room and ophthalmology assessment in waves 3 and 4 compared with wave 5 (p = 0.003). CONCLUSION The number of pediatric ophthalmology consultations was less during the 5 COVID waves than pre-COVID. An increase in urgent pediatric ophthalmology consultations occurred as COVID-19 infection rates in Quebec decreased. Access to health care and time to care were preserved across waves compared with pre-pandemic.
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Affiliation(s)
| | - Abed Baiad
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Dorsai Ranjbari
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - José A Correa
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - Zoya Chaudhry
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, Canada
| | - Daniela Toffoli
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, Canada
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Nitzan I, Shakarchy N, Megreli J, Akavian I, Derazne E, Afek A, Peled A. Body mass index and visual impairment in Israeli adolescents: A nationwide study. Pediatr Obes 2024; 19:e13083. [PMID: 37989292 DOI: 10.1111/ijpo.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/22/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Previous research on the association between body mass index (BMI) and visual impairment (VI) in youth has reported inconsistent findings. We aimed to investigate this association in a national cohort of Israeli adolescents. METHODS This retrospective, population-based, cross-sectional study included 1 697 060 adolescents (56.4% men; mean age 17 years) who underwent mandatory pre-military service assessments from 1993 to 2017. BMI was classified based on the US age- and sex-matched percentiles. Unilateral or bilateral VI was classified as best-corrected visual acuity (BCVA) worse than 6/9 in either or both eyes, respectively. Sex-stratified regression models adjusted for sociodemographic variables were used to analyse the BMI-VI relationship. RESULTS Overall, 17 871 (1.05%) and 5148 (0.30%) adolescents had unilateral and bilateral VI, respectively. Compared with high-normal BMI (50th to 85th percentile), adjusted odds ratios (ORs) for unilateral and bilateral VI gradually increased with higher BMI, reaching 1.33 (1.13-1.55) and 1.80 (1.37-2.35) in men with severe obesity, and 1.51 (1.24-1.84) and 1.52 (1.08-2.14) in women with severe obesity, respectively. Men with underweight also had increased ORs for unilateral and bilateral VI (1.23; 1.14-1.33 and 1.59; 1.37-1.84, respectively), a pattern not observed in women (0.96; 0.86-1.07 and 1.02; 0.83-1.25, respectively). Results were maintained when the outcome was restricted to mild VI, as well as in subgroups of adolescents with unimpaired health and those without moderate-to-severe myopia. CONCLUSIONS Abnormal BMI, and particularly obesity, is associated with increased OR for VI in late adolescence.
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Affiliation(s)
- Itay Nitzan
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nitzan Shakarchy
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Megreli
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Akavian
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Alon Peled
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Assaf-Harofeh Medical Center, Zerifin, Israel
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Ulangca RA, Oh CJ, Atiga CR, Dunbar JA, Khazaeni LM. Reaching Target Communities in a Community Preschool Vision Screening Program. J Pediatr Ophthalmol Strabismus 2022; 59:375-379. [PMID: 35275775 DOI: 10.3928/01913913-20220210-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To develop a method to identify preschools with the greatest need for vision screening, correlations between socioeconomic status, preschool capacity, and rates of pediatric vision screenings performed by a community vision screening program were investigated. Geoinformatics mapping software was used to visually display the areas of greatest need. METHODS Vision screening data from a community vision screening program, child care facility data from California Department of Social Services, and income data from the U.S. Census Bureau through ArcGIS software (Esri) were collected. When possible, data were consolidated at the ZIP code level. Kolmogorov-Smirnov analysis was used to determine correlations between data elements. Licensed child care facilities were scored on a scale (from 1 to 5) based on the socioeconomic status of the ZIP code and the facility capacity. The scoring system prioritized larger facilities in lower income communities to most efficiently use vision screening program resources. RESULTS There was a positive correlation between the capacity of the child care facility and the median household income (P = .005). Second, we found a positive correlation between child care capacity and the median household income (P = .005). Licensed child care facilities were mapped and colored using GIS software according to their cumulative score. CONCLUSIONS Challenges to vision screening in under-served communities include the lack of child care facilities and smaller facility size. The use of a scoring system and mapping software can direct vision screening programs to reach a greater number of children with the most efficient use of resources. [J Pediatr Ophthalmol Strabismus. 2022;59(6):375-379.].
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Le T, Örge F. Treatment compliance in amblyopia: A mini-review and description of a novel online platform for compliance tracking. Surv Ophthalmol 2022; 67:1685-1697. [PMID: 35970235 DOI: 10.1016/j.survophthal.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022]
Abstract
Patient compliance with amblyopia therapies, including eye patching and atropine drops, is crucial for optimal visual acuity outcomes. Studies utilizing objective measures of compliance measurement have consistently shown that a majority of patients receive significantly less treatment than prescribed. We review the subjective and objective compliance rates reported in the literature, assess possible explanations for poor compliance and describe studies of interventions to improve compliance. Additionally, we report our experience implementing Inside Out Care, a novel online platform designed to improve monitoring of amblyopia patient compliance, in our clinics. We have found that this platform, which is accessible via both computer and smartphone, has improved monitoring of amblyopia patient patching compliance, as well as allowed for enhanced doctor-patient communication.
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Affiliation(s)
- Tinh Le
- Center for Pediatric Ophthalmology and Adult Strabismus, Rainbow Babies and Children's Hospital and University Hospitals Eye Institute
| | - Faruk Örge
- Center for Pediatric Ophthalmology and Adult Strabismus, Rainbow Babies and Children's Hospital and University Hospitals Eye Institute.
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Asare AO, Maurer D, Wong AMF, Ungar WJ, Saunders N. Socioeconomic Status and Vision Care Services in Ontario, Canada: A Population-Based Cohort Study. J Pediatr 2022; 241:212-220.e2. [PMID: 34687692 DOI: 10.1016/j.jpeds.2021.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To test the association of material deprivation and the utilization of vision care services for young children. STUDY DESIGN We conducted a population-based, repeated measures cohort study using linked health and administrative datasets. All children born in Ontario in 2010 eligible for provincial health insurance were followed from birth until their seventh birthday. The main exposure was neighborhood-level material deprivation quintile, a proxy for socioeconomic status. The primary outcome was receipt of a comprehensive eye examination (not to include a vision screening) by age 7 years from an eye care professional, or family physician. RESULTS Of 128 091 children included, female children represented 48.7% of the cohort, 74.4% lived in major urban areas, and 16.2% lived in families receiving income assistance. Only 65% (n = 82 833) had at least 1 comprehensive eye examination, with the lowest uptake (56.9%; n = 31 911) in the most deprived and the highest uptake (70.5%; n =19 860) in the least deprived quintiles. After adjusting for clinical and demographic variables, children living in the least materially deprived quintile had a higher odds of receiving a comprehensive eye examination (aOR 1.43; 95% CI 1.36, 1.51) compared with children in the most materially deprived areas. CONCLUSIONS Uptake of comprehensive eye examinations is poor, especially for children living in the most materially deprived neighborhoods. Strategies to improve uptake and reduce inequities are warranted.
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Affiliation(s)
- Afua Oteng Asare
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; The Hospital for Sick Children, Toronto, Canada
| | - Daphne Maurer
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Psychology, Neuroscience, and Behavior, McMaster University, Hamilton, Canada
| | - Agnes M F Wong
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; The Hospital for Sick Children, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Wendy J Ungar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada; ICES, Toronto, Canada
| | - Natasha Saunders
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; The Hospital for Sick Children, Toronto, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada; ICES, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada.
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6
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Nitzan I, Bez M, Megreli J, Bez D, Barak A, Yahalom C, Levine H. Socio-demographic disparities in amblyopia prevalence among 1.5 million adolescents. Eur J Public Health 2021; 31:1211-1217. [PMID: 34518882 DOI: 10.1093/eurpub/ckab111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Amblyopia, when not diagnosed at appropriate age, leads to uncorrectable visual impairment with considerable social and financial implications. The aim of this study was to assess socio-demographic disparities in amblyopia prevalence among Israeli adolescents, in order to identify susceptible groups in the population. METHODS A nationwide, population-based, cross-sectional study of Israeli adolescents examined between 1993 and 2017. All study participants underwent visual acuity examination with socio-demographic data and previous medical history documented. Associations were analyzed using univariable and multivariable logistic regression models. RESULTS Among 1 334 650 Israeli-born candidates aged 17.15±0.26 years, amblyopia was diagnosed in 1.07%. The overall prevalence of amblyopia has declined from 1.59% in 1993 to 0.87% in 2017. Being in the lowest socioeconomic status and below average cognitive function scores increased the odds of amblyopia in both males [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.45-1.87; OR 1.27, 95% CI 1.19-1.35, respectively] and females (OR 1.61, 95% CI 1.30-1.98; OR 1.27, 95% CI 1.18-1.36, respectively). Among males, Orthodox and ultra-Orthodox educational systems were associated with increased odds of amblyopia (OR 1.16, 95% CI 1.09-1.25; OR 1.90, 95% CI 1.73-2.09). A significantly higher prevalence of amblyopia was recorded among 219 983 immigrants (1.51%, P<0.001). CONCLUSIONS Although the overall prevalence of amblyopia has decreased during the observed years, we found substantial evidence of socio-demographic disparities in amblyopia prevalence among adolescents, suggesting disparities in the prevention of the disease and its treatment. Demonstration of inequities at a national level could aid future guidance of health policy and augment current vision screening programs.
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Affiliation(s)
- Itay Nitzan
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.,Medical Corps, Israel Defense Forces, Israel
| | - Maxim Bez
- Medical Corps, Israel Defense Forces, Israel
| | - Jacob Megreli
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.,Medical Corps, Israel Defense Forces, Israel
| | - Dana Bez
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.,Medical Corps, Israel Defense Forces, Israel
| | - Adiel Barak
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Yahalom
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hagai Levine
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
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Zhang XJ, Wong PPY, Wong ES, Kam KW, Yip BHK, Zhang Y, Zhang W, Young AL, Chen LJ, Ip P, Tham CC, Pang CP, Yam JC. Delayed Diagnosis of Amblyopia in Children of Lower Socioeconomic Families: The Hong Kong Children Eye Study. Ophthalmic Epidemiol 2021; 29:621-628. [PMID: 34620042 DOI: 10.1080/09286586.2021.1986551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS To determine the prevalence of amblyopia and the factors associated with delayed diagnosis among school-aged children in Hong Kong. METHODS Completed comprehensive ophthalmoscopic examinations were conducted among 4.273 children aged 6-8 years in the population-based Hong Kong Children Eye Study. New and previous diagnoses of amblyopia were identified. Socioeconomic status was surveyed through questionnaires. RESULTS According to criteria from the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS), amblyopia was present in 43 out of 4,273 children (1.01%; 95% CI, 0.71-1.31). Among them, 33 (0.77%) were newly detected cases that were more likely from families living in Public Rental Housing or subdivided flats (OR, 4.22; P = .012), with lower paternal (OR 6.68, P = .008) and maternal education levels (OR, 4.38; P = .039). Multivariate analysis revealed associations of amblyopia with hyperopia (≥+2.00D; OR, 6.23; 95% CI, 2.86-13.56, P < .001), astigmatism (≥+2.00D; OR, 24.88; 95% CI, 10.69-57.91, P < .001) and anisometropia (≥2.00D; OR, 14.49; 95% CI, 5.93-37.63, P < .001). CONCLUSION These children with delayed diagnoses of amblyopia were more likely to come from lower socioeconomic backgrounds. Public education aimed at increasing awareness and utilization of child vision screening among such families is needed.
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Affiliation(s)
- Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Tianjin Eye Hospital, Tianjin, China
| | - Posey Po-Yin Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily S Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Zhang
- Tianjin Eye Hospital, Tianjin, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Lks Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Tianjin Eye Hospital, Tianjin, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong
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8
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Xu D, Uhr J, Patel SN, Pandit RR, Jenkins TL, Khan MA, Ho AC. Sociodemographic Factors Influencing Rhegmatogenous Retinal Detachment Presentation and Outcome. Ophthalmol Retina 2021; 5:337-341. [PMID: 32771613 DOI: 10.1016/j.oret.2020.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The impact of sociodemographic factors on the presentation and outcomes of rhegmatogenous retinal detachment (RRD) in the United States has not been described. We analyzed the impact of these factors on the presenting fovea-on or off status of RRD, single operation anatomic success (SOAS) of repair, and postoperative visual acuity (VA). DESIGN Retrospective, single-center, cohort study. PARTICIPANTS Participants included 4061 patients from Wills Eye Hospital/Mid Atlantic Retina from February 2015 to February 2020. METHODS Sociodemographic factors including age, gender, race, and regional mean household income (MHI) as determined by ZIP code were recorded. The VA at baseline and 12 months post-RRD repair was recorded. Multiple regression analysis was used to evaluate the relationship between sociodemographic factors to fovea-on or off presentation of RRD, SOAS, and 12-month VA. MAIN OUTCOME MEASURES Foveal attachment at presentation of RRD, SOAS, and 12-month VA. RESULTS Older age (odds ratio [OR], 1.34 per decade, 95% confidence interval [CI], 1.27-1.41, P < 0.001), male gender (OR, 1.27, 95% CI, 1.11-1.45, P < 0.001), non-White race (OR, 2.41, 95% CI, 1.92-3.03, P < 0.001), and lower MHI (OR, 0.94 per $10 000, 95% CI, 0.91-0.98, P = 0.005) were independent risk factors for fovea-off presentation of RD. The need for reoperation to repair RRD within 90 days was independently associated with fovea-off presentation (OR, 1.47, 95% CI, 1.24-1.74, P < 0.001) and non-White race (OR, 1.72, 95% CI, 1.27-2.39, P < 0.001). Finally, 12-month postoperative VA was worse in patients who were fovea-off (P < 0.001), older (P = 0.041), male (P = 0.038), and non-White (P = 0.007) but was not related to MHI (P = 0.24). CONCLUSIONS These findings reveal associations between the sociodemographic factors and the presentation and outcomes of RRD. Physicians should be aware that socioeconomic disparities can negatively impact the prognosis of patients with RRD. Further study confirming these findings and efforts to mitigate their effects are warranted and will be of interest to the greater ophthalmology community.
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Affiliation(s)
- David Xu
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania.
| | - Joshua Uhr
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Samir N Patel
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Ravi R Pandit
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Thomas L Jenkins
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - M Ali Khan
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Allen C Ho
- The Retina Service, Wills Eye Hospital, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
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9
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Yoon Y, Kim US. The 2016 Korea National Health and Nutritional Examination Survey of the Prevalence of Amblyopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.5.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Pelland-Marcotte MC, Pole JD, Sutradhar R, Nathan PC, Sung L. Infections as a potential long-term risk following childhood leukemia. Med Hypotheses 2020; 137:109554. [PMID: 31945656 DOI: 10.1016/j.mehy.2020.109554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/19/2019] [Accepted: 01/05/2020] [Indexed: 12/01/2022]
Abstract
Leukemia is the most common childhood cancer. While infections are a frequent and potentially severe complication while on treatment, less is known about the risk for infections following therapy completion. In this article, we propose that leukemia survivors might be at increased risk of infections following therapy completion than the general population, independently of potential confounders such as age, sex and Down syndrome. This association is conceivably due to several factors. First, therapy-induced immune dysfunction of both the humoral and cellular compartments appears to last for several years following anti-cancer therapy and after hematopoietic stem cell transplantation. Second, clinical and epidemiological research has shown leukemia survivors are disproportionally affected by comorbidities related to leukemia treatment and its complications, such as diabetes and obesity, which may induce secondary immunodeficiency and infections. Last, differences in health-related behaviors between leukemia survivors and the general population (such as re-vaccination practices) may affect the baseline risk of infections. Although under-represented in the epidemiological literature as a possible late effect of childhood leukemia and its treatment, it is plausible that leukemia survivors are at increased risk of infections for several years when compared to the general population and their siblings. Further research is needed to empirically test these hypotheses.
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Affiliation(s)
- Marie-Claude Pelland-Marcotte
- Department of Pediatrics, CHU de Québec, 2705 Boulevard Laurier, Quebec City, Quebec, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Jason D Pole
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, Ontario, Canada; Pediatric Oncology Group of Ontario, 480, University Ave, Toronto, Ontario, Canada; ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, Ontario, Canada; ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada
| | - Paul C Nathan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G 1X8, Canada; Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 686, Bay St., Toronto, Ontario, Canada
| | - Lillian Sung
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G 1X8, Canada; Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 686, Bay St., Toronto, Ontario, Canada
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11
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Tamariz L, Medina H, Suarez M, Seo D, Palacio A. Linking census data with electronic medical records for clinical research: A systematic review. ACTA ACUST UNITED AC 2018. [DOI: 10.3233/jem-180454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leonardo Tamariz
- Division of Population Health and Computational Medicine , Miller School of Medicine at the University of Miami, Miami, FL, USA
- GRECC, Veterans Affairs Medical Center, Miami, FL, USA
| | - Heidy Medina
- Division of Population Health and Computational Medicine , Miller School of Medicine at the University of Miami, Miami, FL, USA
| | - Maritza Suarez
- Division of General Medicine, Department of Medicine, University of Miami Leonard Miller School of Medicine, Miami, FL, USA
| | - David Seo
- Division of Population Health and Computational Medicine , Miller School of Medicine at the University of Miami, Miami, FL, USA
- Division of Cardiology, Department of Medicine, University of Miami Leonard Miller School of Medicine, Miami, FL, USA
| | - Ana Palacio
- Division of Population Health and Computational Medicine , Miller School of Medicine at the University of Miami, Miami, FL, USA
- GRECC, Veterans Affairs Medical Center, Miami, FL, USA
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