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Schiellerup NS, Wismann J, Madsen GI, Le DQS, Qvist N, Ellebæk MB. Incorporation of a Poly-ε-Caprolactone Scaffold in a ;Circular Stapled End-To-End Small Intestine Anastomosis Does Not Have Any Adverse Effects Within 30 days: A Study in Piglets. Surg Innov 2021; 28:679-687. [PMID: 33745358 DOI: 10.1177/1553350621999294] [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: 11/15/2022]
Abstract
Background. Incorporation of a poly-ε-caprolactone (PCL) scaffold in circular stapled anastomoses has been shown to increase the anastomotic tensile strength on postoperative day (POD) 5 in a pig model. The aim of this study was to investigate the effects of incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis, with stricture formation and anastomotic histology as primary outcomes in a 30-day observation period. Methods. A total of 15 piglets were included. In each piglet, three circular stapled end-to-end anastomoses were made in the small intestines. Two were interventional and one was a control. On POD 10, 20, or 30, the anastomoses were subjected to in vivo intraluminal contrast study, and the index for anastomotic lumen was calculated. The anastomotic segment was resected and subjected to a tensile strength test and histological examination. Results. At POD 10, the mean ± SD value for anastomotic index was .749 ± .065 in control anastomoses and .637 ± .051 in interventional anastomosis (P = .0046), at POD 20, .541 ± .150 and .724 ± .07 (P = .051), and at POD 30, .645 ± .103 and .686 ± .057 (P = .341), respectively. No significant difference was observed in maximum tensile strength and histology at POD 30. Conclusions. The incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis does not increase the risk of stricture or impair wound healing after 30 days.
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Affiliation(s)
| | - Joakim Wismann
- Department of Surgery, 573154Odense University Hospital, Odense, Denmark
| | - Gunvor I Madsen
- Department of Pathology, 573154Odense University Hospital, Odense, Denmark
| | - Dang Q S Le
- Department of Clinical Medicine, 1006Aarhus University, Aarhus C, Denmark
| | - Niels Qvist
- Department of Surgery, 573154Odense University Hospital, Odense, Denmark.,Danish Centre for Regenerative Medicine (CRM), 573154Odense University Hospital, Odense, Denmark
| | - Mark B Ellebæk
- Department of Surgery, 573154Odense University Hospital, Odense, Denmark
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Johnson SB. Clinical Research Informatics: Supporting the Research Study Lifecycle. Yearb Med Inform 2017; 26:193-200. [PMID: 29063565 PMCID: PMC6239240 DOI: 10.15265/iy-2017-022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Indexed: 12/27/2022] Open
Abstract
Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions.
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Affiliation(s)
- S. B. Johnson
- Healthcare Policy and Research, Weill Cornell Medicine, New York, USA
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Gault N, Castañeda-Sanabria J, De Rycke Y, Guillo S, Foulon S, Tubach F. Self-controlled designs in pharmacoepidemiology involving electronic healthcare databases: a systematic review. BMC Med Res Methodol 2017; 17:25. [PMID: 28178924 PMCID: PMC5299667 DOI: 10.1186/s12874-016-0278-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/15/2016] [Indexed: 11/29/2022] Open
Abstract
Background Observational studies are widely used in pharmacoepidemiology. Several designs can be used, in particular self-controlled designs (case-crossover and self-controlled case series). These designs offer the advantage of controlling for time-invariant confounders, which may not be collected in electronic healthcare databases. They are particularly useful in pharmacoepidemiology involving healthcare database. To be valid, they require the presence of some characteristics (key validity assumptions), and in such situations, these designs should be preferred. We aimed at describing the appropriate use and reporting of the key validity assumptions in self-controlled design studies. Methods Articles published between January 2011 and December 2014, and describing a self-controlled study design involving electronic healthcare databases were retrieved. The appropriate use (fulfilment of key assumptions) was studied in terms of major (abrupt onset event, rare or recurrent event, and intermittent exposure) and minor assumptions (those for which the design can be adapted). Results Among the 107 articles describing a self-controlled design, 35/53 (66%) case-crossover studies, and 48/55 (87%) self-controlled case series fulfilled the major validity assumptions for use of the design; 4/35 and 14/48 respectively did not fulfill the minor assumptions. Overall, 31/53 (58%) case-crossover studies and 34/55 (62%) self-controlled case series fulfilled both major and minor assumptions. The reporting of the methodology or the results was appropriate, except for power calculation. Conclusions Self-controlled designs were not appropriately used in34% and 13% of the articles we reviewed that described a case-crossover or a self-controlled case series design, respectively. We encourage better use of these designs in situations in which major validity assumptions are fulfilled (i.e., for which they are recommended), accounting for situations for which the design can be adapted. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0278-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nathalie Gault
- APHP, Département d'Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Bichat, 75018, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 ECEVE, 75018, Paris, France. .,INSERM CIC-EC 1425, Hôpital Bichat, 75018, Paris, France.
| | - Johann Castañeda-Sanabria
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 ECEVE, 75018, Paris, France.,APHP, Département Biostatistiques Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpital Pitié-Salpétrière, 75013, Paris, France
| | - Yann De Rycke
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 ECEVE, 75018, Paris, France.,APHP, Département Biostatistiques Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpital Pitié-Salpétrière, 75013, Paris, France
| | - Sylvie Guillo
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 ECEVE, 75018, Paris, France.,APHP, Département Biostatistiques Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpital Pitié-Salpétrière, 75013, Paris, France
| | - Stéphanie Foulon
- Biostatistics unit, Gustave Roussy, 94800, Villejuif, France.,CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, 94800, Villejuif, France
| | - Florence Tubach
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 ECEVE, 75018, Paris, France.,APHP, Département Biostatistiques Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpital Pitié-Salpétrière, 75013, Paris, France.,Université Pierre et Marie Curie, Sorbonne Universités, 75013, Paris, France
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4
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Pouwels KB, Widyakusuma NN, Bos JHJ, Hak E. Association between statins and infections among patients with diabetes: a cohort and prescription sequence symmetry analysis. Pharmacoepidemiol Drug Saf 2016; 25:1124-1130. [PMID: 27365184 PMCID: PMC5129506 DOI: 10.1002/pds.4052] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/12/2016] [Accepted: 05/27/2016] [Indexed: 12/26/2022]
Abstract
Purpose A previous meta‐analysis of randomized trials did not confirm findings from observational studies that suggested that statins reduce the risk of infection. However, animal experiments indicate that statins may be more effective in reducing the risk and/or the severity of infection among patients with diabetes. Hence, we evaluated the effect of statins on antibiotic prescriptions (a proxy for infections) among patients with drug‐treated type 2 diabetes using two confounding‐reducing observational designs. Methods We conducted a prescription sequence symmetry analysis and a cohort study using the IADB.nl pharmacy prescription database. For the prescription sequence symmetry analysis, a sequence ratio was calculated. The matched cohort study, comparing the time to first antibiotic prescription between periods that statins are initiated and non‐use periods, was analyzed using stratified Cox regression. Results Prescription sequence symmetry analysis of 4684 patients with drug‐treated type 2 diabetes resulted in an adjusted sequence ratio of 0.86 (95% confidence interval [CI]: 0.81 to 0.91). Corresponding figures for the cohort analysis comparing 9852 statin‐initiation with 4928 non‐use periods showed similar results (adjusted hazard ratio: 0.88, 95%CI: 0.83 to 0.95). Conclusions These findings suggest that statins are associated with a reduced risk of infections among patients with drug‐treated type 2 diabetes. © 2016 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Koen B Pouwels
- Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
| | - Niken N Widyakusuma
- Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Jens H J Bos
- Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Eelko Hak
- Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands
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