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Ma HY, Lin IF, Liu YC, Yen TY, Huang KYA, Shih WL, Lu CY, Chang LY, Huang LM. Risk Factors for Severe Respiratory Syncytial Virus Infection in Hospitalized Children. Pediatr Infect Dis J 2024; 43:487-492. [PMID: 38295229 DOI: 10.1097/inf.0000000000004270] [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: 02/02/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a common cause of bronchiolitis and pneumonia in infants and young children. Starting in December 2010, RSV monoclonal antibody (RSV mAb) was endorsed by Taiwan National Health Insurance and given to children with prematurity and/or congenital heart diseases, which are considered high-risk factors for severe RSV diseases. Investigating other important contributing risk factors is warranted. METHODS We conducted a cohort study at National Taiwan University Hospital to determine the rate of severe outcomes among children hospitalized due to RSV infection from 2008 to 2018. Adjusted for age, sex and birth cohorts born before and after RSV mAb endorsement, we identified risk factors for severe RSV infection, defined as the requirement of invasive ventilator support. RESULTS There were 1985 admissions due to RSV infections. Among them, 66 patients (3.3%) had severe RSV infection. The proportion of severe RSV infections decreased significantly after RSV mAb endorsement. Multivariable analysis revealed that age <1.5 months and cardiovascular and congenital/genetic diseases were high-risk underlying conditions. In addition, bacterial coinfections, elevated creatinine levels and initial abnormal chest radiograph findings posed warning signs for severe RSV infection. CONCLUSIONS Children younger than 1.5 months of age with cardiovascular or congenital/genetic diseases were predisposed to severe RSV infection and might benefit from RSV mAb prophylaxis.
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Affiliation(s)
- Hsuan-Yin Ma
- From the Center for Drug Evaluation, Taipei, Taiwan
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - I-Fan Lin
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Yun-Chung Liu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Ting-Yu Yen
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Kuan-Ying A Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Wei-Liang Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Luan-Yin Chang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
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Nurchis MC, Radio FC, Salmasi L, Heidar Alizadeh A, Raspolini GM, Altamura G, Tartaglia M, Dallapiccola B, Pizzo E, Gianino MM, Damiani G. Cost-Effectiveness of Whole-Genome vs Whole-Exome Sequencing Among Children With Suspected Genetic Disorders. JAMA Netw Open 2024; 7:e2353514. [PMID: 38277144 PMCID: PMC10818217 DOI: 10.1001/jamanetworkopen.2023.53514] [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] [Received: 08/04/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024] Open
Abstract
Importance The diagnosis of rare diseases and other genetic conditions can be daunting due to vague or poorly defined clinical features that are not recognized even by experienced clinicians. Next-generation sequencing technologies, such as whole-genome sequencing (WGS) and whole-exome sequencing (WES), have greatly enhanced the diagnosis of genetic diseases by expanding the ability to sequence a large part of the genome, rendering a cost-effectiveness comparison between them necessary. Objective To assess the cost-effectiveness of WGS compared with WES and conventional testing in children with suspected genetic disorders. Design, Setting, and Participants In this economic evaluation, a bayesian Markov model was implemented from January 1 to June 30, 2023. The model was developed using data from a cohort of 870 pediatric patients with suspected genetic disorders who were enrolled and underwent testing in the Ospedale Pediatrico Bambino Gesù, Rome, Italy, from January 1, 2015, to December 31, 2022. The robustness of the model was assessed through probabilistic sensitivity analysis and value of information analysis. Main Outcomes and Measures Overall costs, number of definitive diagnoses, and incremental cost-effectiveness ratios per diagnosis were measured. The cost-effectiveness analyses involved 4 comparisons: first-tier WGS with standard of care; first-tier WGS with first-tier WES; first-tier WGS with second-tier WES; and first-tier WGS with second-tier WGS. Results The ages of the 870 participants ranged from 0 to 18 years (539 [62%] girls). The results of the analysis suggested that adopting WGS as a first-tier strategy would be cost-effective compared with all other explored options. For all threshold levels above €29 800 (US $32 408) per diagnosis that were tested up to €50 000 (US $54 375) per diagnosis, first-line WGS vs second-line WES strategy (ie, 54.6%) had the highest probability of being cost-effective, followed by first-line vs second-line WGS (ie, 54.3%), first-line WGS vs the standard of care alternative (ie, 53.2%), and first-line WGS vs first-line WES (ie, 51.1%). Based on sensitivity analyses, these estimates remained robust to assumptions and parameter uncertainty. Conclusions and Relevance The findings of this economic evaluation encourage the development of policy changes at various levels (ie, macro, meso, and micro) of international health systems to ensure an efficient adoption of WGS in clinical practice and its equitable access.
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Affiliation(s)
- Mario Cesare Nurchis
- School of Economics, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | | | - Luca Salmasi
- Department of Economics and Finance, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Aurora Heidar Alizadeh
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Marco Raspolini
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gerardo Altamura
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Tartaglia
- Molecular Genetics and Functional Genomics, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
| | - Bruno Dallapiccola
- Molecular Genetics and Functional Genomics, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
| | - Elena Pizzo
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Maria Michela Gianino
- Department of Public Health Sciences and Paediatrics, Università di Torino, Turin, Italy
| | - Gianfranco Damiani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
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Schimpf J, Münster T. [Rare diseases in anesthesia : Knowledge mining and core points of perioperative anesthesiological care]. DIE ANAESTHESIOLOGIE 2023; 72:907-918. [PMID: 37947803 DOI: 10.1007/s00101-023-01353-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/12/2023]
Abstract
Due to refined and new diagnostic possibilities and improved medical care, in the future anesthesiologists will be more frequently confronted with patients suffering from rare diseases. As the physicians providing perioperative care often have little or no experience with the diseases of such patients, the access to high-quality specific literature is essential. In this respect they must be able to assess and classify the quality of the information which is predominantly available online, especially as when evidence-based knowledge is available, it is only available to a very limited extent. Patients with rare diseases mostly present with recurring problem constellations. A systematic assignment to the most important problem areas (airway, circulation, metabolism, etc.) as well as a structured and interdisciplinary approach are decisive for a successful perioperative treatment of these patients. Due to low prevalence, lack of personal experience and lack of evidence-based data, anesthesia in patients with SE is an absolute challenge, especially in time-critical situations.
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Affiliation(s)
- J Schimpf
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland.
| | - T Münster
- Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland
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Mazzucato M, Visonà Dalla Pozza L, Minichiello C, Toto E, Vianello A, Facchin P. Estimating mortality in rare diseases using a population-based registry, 2002 through 2019. Orphanet J Rare Dis 2023; 18:362. [PMID: 37978388 PMCID: PMC10655462 DOI: 10.1186/s13023-023-02944-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/04/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Rare diseases (RD) are a heterogeneous group of diseases, sharing aspects of complexity. Prognosis is variable, even in individuals with the same disease. Real-world data on RD as a whole are scarce. The aim of this study is to provide data on mortality and survival for a substantial group of RD deriving from a population-based registry, which covers the Veneto region in Italy (4.9 million inhabitants). RESULTS During the study period, 3367 deaths occurred, mainly in males (53.9%), elderly patients (63.5%) and patients with diseases having a reported prevalence of 1-9/100000 (65.6%). When standardizing by age, the mortality ratio was higher in RD patients than in the general population, SMR = 1.93 (95% CI 1.84-2.11), with an observed gender difference, 2.01 (95% CI 1.88-2.29) in females and 1.86 (95% CI 1.73-2.10) in males. The lowest survival rates are experienced by patients with rare neurologic diseases, rare skin diseases and rare systemic or rheumatologic diseases, 58%, 68% and 81%, respectively, after a 15-year observation period. It should be noted that only 18% of patients diagnosed with motor neuron diseases were alive after 15 years from diagnosis. CONCLUSIONS Despite progress in diagnosis, treatment and care in recent years, RD patients globally have higher mortality rates and reduced survival compared to the general population, with specific variations according to gender, age and disease group.
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Affiliation(s)
- Monica Mazzucato
- Rare Diseases Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy.
- Department of Child and Maternal Health, Padua University Hospital, University of Padova, Padua, Italy.
| | | | - Cinzia Minichiello
- Rare Diseases Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy
| | - Ema Toto
- Rare Diseases Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy
| | - Andrea Vianello
- Department of Child and Maternal Health, Padua University Hospital, University of Padova, Padua, Italy
| | - Paola Facchin
- Rare Diseases Coordinating Centre, Veneto Region, Padua University Hospital, Padua, Italy.
- Department of Child and Maternal Health, Padua University Hospital, University of Padova, Padua, Italy.
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Willmen T, Willmen L, Pankow A, Ronicke S, Gabriel H, Wagner AD. Rare diseases: why is a rapid referral to an expert center so important? BMC Health Serv Res 2023; 23:904. [PMID: 37612679 PMCID: PMC10463573 DOI: 10.1186/s12913-023-09886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Patients with rare diseases usually go through years of diagnostic odysseys. The large number of rare diseases and the associated lack of expertise pose a major challenge to physicians. There are few physicians dealing with patients with rare diseases and they usually work in a limited number of specialized centers. The aim of this study was to evaluate the diagnostic efficiency of an expert center. METHODS The diagnostic pathway of 78 patients of the outpatient clinic for rare inflammatory systemic diseases with renal involvement was analyzed retrospectively. For this purpose, each examination day was documented with the corresponding examinations performed from the onset of initial symptoms. Three time points were considered: The time when patients first visited a physician with symptoms, the time when patients consulted an expert, and the time when they received the correct diagnosis. In addition, it was documented whether the diagnosis could be made without the expert, or only with the help of the expert. The examinations that confirmed the diagnosis were also documented for each patient. RESULTS A correct diagnosis was made without the help of the expert in only 21% of cases. Each patient visited an average of 6 physicians before consulting the expert. Targeted diagnostics enabled the expert to make the correct diagnosis with an average of seven visits, or one inpatient stay. However, referral to the expert took an average of 4 years. CONCLUSION The data show that rapid and targeted diagnostics were possible in the expert center due to the available expertise and the interdisciplinary exchange. Early diagnosis is of great importance for many patients, as an early and correct therapy can be decisive for the course of the disease.
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Affiliation(s)
- Tina Willmen
- Department of Nephrology, Hannover Medical School, Hanover, Germany
- Department of Prosthetic Dentistry and Biomedical Materials Research, Hannover Medical School, Hanover, Germany
| | - Lukas Willmen
- Department of Nephrology, Hannover Medical School, Hanover, Germany
| | - Anne Pankow
- Department of Nephrology, Hannover Medical School, Hanover, Germany
- Department of Rheumatology and Clinical Immunology, Charité Berlin, Berlin, Germany
| | - Simon Ronicke
- Medical Clinic for Nephrology and Internal Intensive Care Medicine, Charité Berlin, Berlin, Germany
| | - Heinz Gabriel
- Practice for Human Genetics Tübingen, Tübingen, Germany
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Mazzucato M, Minichiello C, Vianello A, Visonà dalla Pozza L, Toto E, Facchin P. Real-world use of orphan medicinal products (OMPs) in rare disease (RD) patients: A population-based registry study. Front Pharmacol 2022; 13:940010. [PMID: 36249759 PMCID: PMC9563616 DOI: 10.3389/fphar.2022.940010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Despite calls for the use of real-world data, the rare diseases (RD) treatment landscape suffers from a scarcity of data referred to orphan medicinal products (OMP) use at the population level. Objectives: We aim to describe the characteristics and patterns of utilization of OMP in a sizable group of RD patients globally monitored by an area-based rare diseases registry located in the Veneto region, Italy, during a 3-year period (1 January 2019 to 31 December 2021). Methods: A list of OMP (n = 60) was assembled for study purposes, according to extensive criteria with regard to the status of orphan designation and of national reimbursement decisions. Results: OMP prescriptions involved 1,010 patients, corresponding to the 2.3% of all the patients monitored by the RD registry. Nearly one out of five (22.8%) was a pediatric patient at the time of the first prescription. OMP use interested a limited proportion (17.5%) of diseases approaching the rarity threshold, having a prevalence of less than five per 10,000, while individuals affected by these more common rare conditions represented 49% of all the patients receiving an OMP prescription. A clustering effect of OMP use was observed in selected groups of diseases, mainly, neurological, hematological, and hereditary metabolic ones. Medication plans including an OMP show in the 45.9% of the cases a high level of complexity, both in terms of nature and number of co-prescribed treatments. Off-label use interested 15.3% (n = 155) of all the RD patients with at least an OMP prescription during the study period. Conclusion: Data collected in a real-world setting through population-based registries globally monitoring RD patients, including related medication plans, have the potential to identify which diseases, and thus patients, have less benefit from the advent of OMP so far. Furthermore, in the rapidly evolving RD therapeutic landscape, they can help understand which therapeutic areas are most in need of investment to address existing unmet care needs.
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Affiliation(s)
- Monica Mazzucato
- Veneto region Rare Diseases Coordinating Centre-Registry, Padua University Hospital, Padua, Italy
- *Correspondence: Monica Mazzucato,
| | - Cinzia Minichiello
- Veneto region Rare Diseases Coordinating Centre-Registry, Padua University Hospital, Padua, Italy
| | - Andrea Vianello
- Epidemiology and Community Medicine Unit, Padua University Hospital, Padua, Italy
| | - Laura Visonà dalla Pozza
- Veneto region Rare Diseases Coordinating Centre-Registry, Padua University Hospital, Padua, Italy
| | - Ema Toto
- Veneto region Rare Diseases Coordinating Centre-Registry, Padua University Hospital, Padua, Italy
| | - Paola Facchin
- Veneto region Rare Diseases Coordinating Centre-Registry, Padua University Hospital, Padua, Italy
- Epidemiology and Community Medicine Unit, Padua University Hospital, Padua, Italy
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Caracterización y factores asociados a la mortalidad debida a enfermedades huérfanas en Chile, 2002-2017. BIOMÉDICA 2022; 42:508-521. [PMID: 36122290 PMCID: PMC9550350 DOI: 10.7705/biomedica.6281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Indexed: 11/21/2022]
Abstract
Introducción. Las enfermedades huérfanas se caracterizan por su baja prevalencia, comúnmente son de evolución crónica, debilitantes y potencialmente mortales. Objetivo. Determinar las características y los factores asociados a la mortalidad por enfermedades huérfanas en Chile, entre 2002 y 2017. Materiales y métodos. Es un estudio transversal y analítico a partir de datos secundarios oficiales del Departamento de Estadística e Información en Salud (DEIS) del Ministerio de Salud de Chile. Se calcularon las tasas de mortalidad específica, y las ajustadas por sexo y edad. Se efectuó un análisis de normalidad mediante la prueba de Kolmogórov-Smirnov. Se aplicaron la prueba de ji al cuadrado de independencia para las asociaciones y el análisis de regresión logística multivariada para determinar la probabilidad de muerte. Resultados. Durante el periodo de estudio, 10.718 defunciones se atribuyeron a enfermedades huérfanas; 53,2 % ocurrieron en mujeres. La tasa media anual de mortalidad fue de 3,9 por 100.000 habitantes: 4,1 en mujeres y 3,8 en hombres. Las principales causas de muerte, en mujeres, fueron enfermedad de Creutzfeldt-Jakob, anencefalia, hepatitis autoinmunitaria y, en hombres, enfermedad de Creutzfeldt-Jakob, distrofia muscular y anencefalia. Las mujeres tienen 1,75 más veces la posibilidad de fallecer por este grupo de enfermedades en comparación con los hombres (OR ajustado=1,75; IC95% 1,69-1,82). La mayor probabilidad de morir se presentó en los menores de 0 a 4 años (OR ajustado=15,30; IC95% 14,10-19,20). Conclusión. En Chile, las mujeres constituyeron el grupo de población de mayor riesgo de morir por enfermedades huérfanas durante los años 2002 y 2017.
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Abozaid GM, Kerr K, McKnight A, Al-Omar HA. Criteria to define rare diseases and orphan drugs: a systematic review protocol. BMJ Open 2022; 12:e062126. [PMID: 35906057 PMCID: PMC9345065 DOI: 10.1136/bmjopen-2022-062126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Rare diseases (RDs) are often chronic and progressive life-threatening medical conditions that affect a low percentage of the population compared with other diseases. These conditions can be treated with medications known as orphan drugs (ODs). Unfortunately, there is no universal definition of RDs or ODs. This systematic review (SR) will identify the quantitative and qualitative criteria and the underlying rationale used internationally to define RDs and ODs. METHODS AND ANALYSIS This protocol follows the conventions for the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (2015 guidelines). A SR will be conducted, including a search of the following databases: PubMed, MEDLINE, EMBASE, Scopus, Web of Science, GreyLit and OpenGrey. Eligible publications will be selected based on predetermined inclusion criteria. Extracted data will be analysed using thematic and content analyses of qualitative descriptors, whereas quantitative data will be analysed descriptively and reported in the form of frequencies and percentages. ETHICS AND DISSEMINATION No ethical approval is required since this SR focuses on the secondary analysis of data retrieved from the scientific literature. The outcomes of this SR will be published as part of a PhD thesis, presented at conferences, and published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021252701.
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Affiliation(s)
- Ghada Mohammed Abozaid
- Department of Pharmacy Practice, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Institute of Clinical Sciences B, Royal Victoria Hospital, Queen's University Belfast School of Medicine, Dentistry and Biomedical Sciences,Centre for Public Health, Belfast, UK
| | - Katie Kerr
- Institute of Clinical Sciences B, Royal Victoria Hospital, Queen's University Belfast School of Medicine, Dentistry and Biomedical Sciences,Centre for Public Health, Belfast, UK
| | - Amy McKnight
- Institute of Clinical Sciences B, Royal Victoria Hospital, Queen's University Belfast School of Medicine, Dentistry and Biomedical Sciences,Centre for Public Health, Belfast, UK
| | - Hussain A Al-Omar
- Deparment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Center of Health Technology Assessment, Ministry of Health, Riyadh, Saudi Arabia
- Health Technology Assessment Unit (HTAU), College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Healthcare Burden of Rare Diseases: A Population-Based Study in Tuscany (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137553. [PMID: 35805212 PMCID: PMC9265803 DOI: 10.3390/ijerph19137553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 01/27/2023]
Abstract
Patients with rare diseases (RDs) need tailored, continuous, and multidisciplinary hospital care. This retrospective cohort study aimed to analyse the healthcare burden of RD patients using a multi-database approach, by linking the data of the Rare Diseases Registry of Tuscany with the regional hospital discharge database. The study population included 21,354 patients diagnosed with a RD between 1 January 2000 and 31 December 2017. The healthcare burden was evaluated for all the RDs during 2009–2018 period. The hospitalisation rate (per 1000) decreased over the years, ranging from 606.9 in 2009 (95% CI: 589.2–625.0) to 443.0 in 2018 (95% CI: 433.2–453.0). A decrease in the average length of stay (LOS) was observed in the earlier years, followed by an increase up to a steady trend (8.3 days in 2018). The patients with RDs of metabolism and the genitourinary system showed the highest hospitalisation rate (903.3 and 644.0 per 1000, respectively). The patients with rare immune system disorders and diseases of the skin and subcutaneous tissue showed the highest LOS (9.7 and 9.5 days, respectively). The methodological approach presented in this population-based study makes it possible to estimate the healthcare burden of RDs, which is crucial in the decision-making and planning aimed at improving patient care.
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How to optimize the perioperative care of patients with orphan diseases: what the anesthesiologist needs to know. Curr Opin Anaesthesiol 2022; 35:419-424. [PMID: 35671032 DOI: 10.1097/aco.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Despite a very low individual prevalence, rare or orphan diseases are estimated to collectively affect as much as 6-8% of the general population. These diseases provide a challenge to anesthetic delivery because of the lack of evidence to guide optimal management. RECENT FINDINGS The expansion of information technology has made facts about individual orphan diseases easier to find. Several reputable websites, hosted variously by anesthetic societies, rare disease organizations, and government agencies, provide information about rare diseases and anesthetic management. SUMMARY Improved access to resources of knowledge may allow for more informed anesthetic management of orphan diseases. The combination of a thorough review of existing knowledge about individual diseases and a structured anesthetic assessment may assist in the delivery of well tolerated anesthetic care of rare conditions.
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