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Shah SC, Canakis A, Halvorson AE, Dorn C, Wilson O, Denton J, Hauger R, Hunt C, Suzuki A, Matheny ME, Siew E, Hung A, Greevy RA, Roumie CL. Associations Between Gastrointestinal Symptoms and COVID-19 Severity Outcomes Based on a Propensity Score-Weighted Analysis of a Nationwide Cohort. Gastro Hep Adv 2022; 1:977-984. [PMID: 35966642 PMCID: PMC9357443 DOI: 10.1016/j.gastha.2022.06.015] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 01/25/2023]
Abstract
Background and Aims Gastrointestinal (GI) symptoms are well-recognized manifestations of coronavirus disease 2019 (COVID-19). Our primary objective was to evaluate the association between GI symptoms and COVID-19 severity. Methods In this nationwide cohort of US veterans, we evaluated GI symptoms (nausea/vomiting/diarrhea) reported 30 days before and including the date of positive SARS-CoV-2 testing (March 1, 2020, to February 20, 2021). All patients had ≥1 year of prior baseline data and ≥60 days follow-up relative to the test date. We used propensity score (PS)-weighting to balance covariates in patients with vs without GI symptoms. The primary composite outcome was severe COVID-19, defined as hospital admission, intensive care unit admission, mechanical ventilation, or death within 60 days of positive testing. Results Of 218,045 SARS-CoV-2 positive patients, 29,257 (13.4%) had GI symptoms. After PS weighting, all covariates were balanced. In the PS-weighted cohort, patients with vs without GI symptoms had severe COVID-19 more often (29.0% vs 17.1%; P < .001). When restricted to hospitalized patients (14.9%; n=32,430), patients with GI symptoms had similar frequencies of intensive care unit admission and mechanical ventilation compared with patients without symptoms. There was a significant age interaction; among hospitalized patients aged ≥70 years, lower COVID-19-associated mortality was observed in patients with vs without GI symptoms, even after accounting for COVID-19-specific medical treatments. Conclusion In the largest integrated US health care system, SARS-CoV-2-positive patients with GI symptoms experienced severe COVID-19 outcomes more often than those without symptoms. Additional research on COVID-19-associated GI symptoms may inform preventive efforts and interventions to reduce severe COVID-19.
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Key Words
- BMI, body mass index
- CDW, Corporate Data Warehouse
- COVID-19
- COVID-19, coronavirus disease 2019
- Epidemiology
- GI, gastrointestinal
- ICD, International Classification of Diseases
- ICU, intensive care unit
- Infectious diseases
- OMOP, Observational Medical Outcomes Partnership
- OR, odds ratios
- Outcomes
- PCR, polymerase chain reaction
- PS, propensity score
- RAASi, renin-angiotensin-aldosterone system inhibitors
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SD, standard deviation
- SDR, Shared Data Resource
- SMD, standardized mean differences
- VHA, Veterans Health Administration
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Affiliation(s)
- Shailja C Shah
- Gastroenterology Section, VA San Diego, San Diego, California
- Division of Gastroenterology, University of California, San Diego, San Diego, California
| | - Andrew Canakis
- Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Alese E Halvorson
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Chad Dorn
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Otis Wilson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jason Denton
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Richard Hauger
- Department of Psychiatry, University of California San Diego, La Jolla, California
- Center of Excellence for Stress and Mental Health, San Diego, California
| | - Christine Hunt
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina
- Gastroenterology Section, Durham VA Health Care System, Durham, North Carolina
| | - Ayako Suzuki
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina
- Gastroenterology Section, Durham VA Health Care System, Durham, North Carolina
| | - Michael E Matheny
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
- VA Tennessee Valley Healthcare System, Health Services Research and Development, Nashville, Tennessee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Edward Siew
- VA Tennessee Valley Healthcare System, Health Services Research and Development, Nashville, Tennessee
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Adriana Hung
- VA Tennessee Valley Healthcare System, Health Services Research and Development, Nashville, Tennessee
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
- VA Tennessee Valley Healthcare System, Clinical Services Research and Development, Nashville, Tennessee
| | - Christianne L Roumie
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- VA Tennessee Valley Healthcare System, Clinical Services Research and Development, Nashville, Tennessee
- VA Geriatrics Research Education and Clinical Center (GRECC), VA Tennessee Valley Health System, Nashville, Tennessee
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Starace M, Iorizzo M, Sechi A, Alessandrini AM, Carpanese M, Bruni F, Vara G, Apalla Z, Asz-Sigall D, Barruscotti S, Camacho F, Doche I, Estrada BD, Dhurat R, Gavazzoni MF, Grimalt R, Harries M, Ioannidis D, McMichael A, Melo DF, Oliveira R, Ovcharenko Y, Pirmez R, Ramot Y, Rudnicka L, Shapiro J, Silyuk T, Sinclair R, Tosti A, Vano-Galvan S, Piraccini BM. Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management. JAAD Int 2021; 5:11-18. [PMID: 34368790 PMCID: PMC8328568 DOI: 10.1016/j.jdin.2021.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, postinfectious telogen effluvium and trichodynia have also been reported. OBJECTIVE To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to the other signs and symptoms of the disease. METHODS Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms were questioned about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. RESULTS Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of the patients and trichodynia in 58.4%. Trichodynia was associated with telogen effluvium in 42.4% of the cases and anosmia and ageusia in 66.1% and 44.1% of the cases, respectively. In majority (62.5%) of the patients, the hair signs and symptoms started within the first month after COVID-19 diagnosis, and in 47.8% of the patients, these started after 12 weeks or more. LIMITATIONS The recruitment of patients in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. CONCLUSION The severity of postviral telogen effluvium observed in patients with a history of COVID-19 infection may be influenced by COVID-19 severity. We identified early-onset (<4 weeks) and late-onset (>12 weeks) telogen effluvium.
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Affiliation(s)
- Michela Starace
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | - Andrea Sechi
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Aurora Maria Alessandrini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Miriam Carpanese
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giulio Vara
- Radiology Unit, Policlinico Sant'Orsola, University of Bologna, Bologna, Italy
| | - Zoe Apalla
- Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stefania Barruscotti
- Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Francisco Camacho
- University of Seville, Medical-Surgical Dermatology Department, University Hospital, Seville, Spain
| | - Isabella Doche
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Bruna Duque Estrada
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Rachita Dhurat
- Department of Dermatology, LTM Medical College & Hospital Sion, Mumbai, India
| | | | - Ramon Grimalt
- Facultat de Medicina i Ciencies de la Salut, UIC-Barcelona, Universitat Internacional de Catalunya, Sant Cugat del `Valles, Barcelona, Spain
| | - Matthew Harries
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Dimitrios Ioannidis
- Department of Dermatology-Venereology, Aristotle University Medical School, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Amy McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Rui Oliveira
- Trichology Unit, Dermatology Center CUF Descobertas Hospital, Lisbon, Portugal
| | - Yuliya Ovcharenko
- Department of General and Clinical Immunology and Allergology, V.N. Karazin Kharkiv National University Medical School, Kharkiv, Ukraine
| | - Rodrigo Pirmez
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Tatiana Silyuk
- Hair Treatment and Transplantation Center, Private Practice, Saint Petersburg, Russia
| | | | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Sergio Vano-Galvan
- Dermatology Department, Ramon y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Bianca Maria Piraccini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Valero-Elizondo J, Chouairi F, Khera R, Grandhi GR, Saxena A, Warraich HJ, Virani SS, Desai NR, Sasangohar F, Krumholz HM, Esnaola NF, Nasir K. Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States. JACC CardioOncol 2021; 3:236-246. [PMID: 34396329 PMCID: PMC8352280 DOI: 10.1016/j.jaccao.2021.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/12/2021] [Indexed: 12/30/2022]
Abstract
Background Financial toxicity (FT) is a well-established side-effect of the high costs associated with cancer care. In recent years, studies have suggested that a significant proportion of those with atherosclerotic cardiovascular disease (ASCVD) experience FT and its consequences. Objectives This study aimed to compare FT for individuals with neither ASCVD nor cancer, ASCVD only, cancer only, and both ASCVD and cancer. Methods From the National Health Interview Survey, we identified adults with self-reported ASCVD and/or cancer between 2013 and 2018, stratifying results by nonelderly (age <65 years) and elderly (age ≥65 years). We defined FT if any of the following were present: any difficulty paying medical bills, high financial distress, cost-related medication nonadherence, food insecurity, and/or foregone/delayed care due to cost. Results The prevalence of FT was higher among those with ASCVD when compared with cancer (54% vs. 41%; p < 0.001). When studying the individual components of FT, in adjusted analyses, those with ASCVD had higher odds of any difficulty paying medical bills (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.09 to 1.36), inability to pay bills (OR: 1.25; 95% CI: 1.04 to 1.50), cost-related medication nonadherence (OR: 1.28; 95% CI: 1.08 to 1.51), food insecurity (OR: 1.39; 95% CI: 1.17 to 1.64), and foregone/delayed care due to cost (OR: 1.17; 95% CI: 1.01 to 1.36). The presence of ≥3 of these factors was significantly higher among those with ASCVD and those with both ASCVD and cancer when compared with those with cancer (23% vs. 30% vs. 13%, respectively; p < 0.001). These results remained similar in the elderly population. Conclusions Our study highlights that FT is greater among patients with ASCVD compared with those with cancer, with the highest burden among those with both conditions.
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Affiliation(s)
- Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.,Center for Outcomes Research, Houston Methodist, Houston, Texas, USA
| | - Fouad Chouairi
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Rohan Khera
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gowtham R Grandhi
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
| | - Anshul Saxena
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
| | - Haider J Warraich
- Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, Massachusetts, USA.,Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.,Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, USA
| | - Nihar R Desai
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Farzan Sasangohar
- Center for Outcomes Research, Houston Methodist, Houston, Texas, USA.,Department of Industrial and Systems Engineering, Texas A&M College of Engineering, Texas A&M University, College Station, Texas, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Nestor F Esnaola
- Cancer Center, Houston Methodist Research Institute, Houston, Texas, USA.,Department of Surgical Oncology, Fox Chase Cancer Center-Temple Health, Philadelphia, Pennsylvania, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.,Center for Outcomes Research, Houston Methodist, Houston, Texas, USA
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4
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Fei Q, Lin Y, Chen X. Treatments for infantile Hemangioma: A systematic review and network meta-analysis. EClinicalMedicine 2020; 26:100506. [PMID: 33089121 PMCID: PMC7565185 DOI: 10.1016/j.eclinm.2020.100506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis. METHODS We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability. FINDINGS A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction. INTERPRETATION A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred. FUNDING No funding was received.
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Key Words
- ATL, atenolol
- CAP, captopril
- CI, confidence intervals
- H, a higher dose
- Hemangioma
- IH, infantile hemangioma
- IMQ, imiquimod
- L, a longer treatment duration
- LPDL, PDL at a long pulse duration
- Laser, PDL and Nd:YAG laser
- NMA, network meta-analysis
- Nd, Nd:YAG laser
- Network meta-analysis
- OR, odds ratios
- PDL, pulsed dye laser
- PED, prednisone
- PRO, propranolol
- RCT, randomized clinical trials
- S, a shorter treatment duration
- SUCRA, surface under the cumulative ranking curve
- TA, triamcinolone
- Therapeutics
- β, topical β-blockers treatment
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Mauro E, Marciano S, Torres MC, Roca JD, Novillo AL, Gadano A. Telemedicine Improves Access to Hepatology Consultation with High Patient Satisfaction. J Clin Exp Hepatol 2020; 10:555-562. [PMID: 33311892 PMCID: PMC7719958 DOI: 10.1016/j.jceh.2020.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS Telemedicine between health care providers could be useful for improving the access to hepatology consultations, which is challenging in some regions. The primary objective of this study was to estimate the proportion of consultations that were resolved through a telemedicine program. Additionally, we evaluated patient satisfaction with this strategy. METHODS Consecutive telemedicine consultations made by non-hepatologist health care providers from different regions of Argentina to a specialty hepatology team were included. Participants and hepatologists used e-mail, teleconference systems, WhatsApp, or telephone to interact, depending on their preferences. Consultations were considered to be resolved through telemedicine when a diagnosis and an adequate follow-up were achieved without the need to refer the patient to a hepatologist or other specialist. Patient satisfaction with telemedicine was evaluated using the Patient Satisfaction Questionnaire Short Form and Telemedicine Satisfaction Questionnaire. RESULTS A total of 200 telemedicine consultations made by 24 physicians from 10 different provinces of Argentina were evaluated, of which 145 (73%; 95% CI: 66%-79%) were resolved through telemedicine. Practitioners specialities were as follows: family physicians, internists, gastroenterologists, infectious diseases, and obstetrics. The most frequent final diagnoses for those patients whose consultation was resolved through telemedicine were non-alcoholic fatty liver disease, viral hepatitis, and benign hepatic lesions. A high degree of patient satisfaction with telemedicine was observed in both questionnaires. CONCLUSIONS Our results show the effectiveness of telemedicine in hepatology, with high resolution rate of consultations and rapid access to experts' assessment. Additionally, a high degree of patient satisfaction was observed using prevalidated questionnaires.
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Affiliation(s)
- Ezequiel Mauro
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
| | - Sebastián Marciano
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Corresponding author. Sebastián Marciano, Liver Unit, Hospital Italiano de Buenos Aires, Perón 4190, Buenos Aires, C1199ABB, Argentina. Tel.: +54 11 4959 0200x5370; fax: +54 11 4959 0346.
| | - María C. Torres
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
| | - Juan D. Roca
- Grupo Integral Clínico Cardiológico, Alvear 154, 6300, Santa Rosa, La Pampa, Argentina
| | - Abel L. Novillo
- Sanatorio 9 de Julio, 25 de Mayo 372, 4000, San Miguel de Tucumán, Tucumán, Argentina
| | - Adrían Gadano
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
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Lin W, Xiong Y, Tang H, Chen B, Ni J. Factors associated with delayed measles vaccination among children in Shenzhen, China: a case-control study. Hum Vaccin Immunother 2015; 10:3601-6. [PMID: 25668667 DOI: 10.4161/21645515.2014.979687] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A delay in the first dose of measles-containing vaccine (MCV1) may contribute to outbreaks of measles, resulting in a high age-specific incidence in infants<1 y of age. To determine the factors associated with delayed MCV1 vaccinations, we used data from the China Information Management System for Immunization Programming. Additionally, the parents/guardians of 430 children whose MCV1 vaccinations were delayed, as well as the parents/guardians of 424 children who received timely vaccinations, were surveyed by telephone. Children were less likely to receive timely MCV1 vaccinations if they belonged to an immigrant group, were male, had poor health status, had a father whose occupation e.g., a manager, had a history of delays in other Expanded Programs on Immunization (EPI) vaccinations, had parents who did not believe vaccinations were important for their children, and experienced shorter travel times to and longer waiting times in EPI clinics. The children of mothers whose occupational status (technician) were more likely to receive timely MCV1 vaccinations. The timeliness of MCV1 vaccinations should be considered as an additional indicator of the quality of vaccination programs.
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Affiliation(s)
- Weiyan Lin
- a Department of Epidemiology and Biostatistics ; Dongguan , China
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Liu S, Xu E, Liu Y, Xu Y, Wang J, Du J, Zhang X, Che X, Gu W. Factors associated with pneumococcal vaccination among an urban elderly population in China. Hum Vaccin Immunother 2015; 10:2994-9. [PMID: 25483646 DOI: 10.4161/21645515.2014.972155] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate the coverage of the 23-valent pneumococcal polysaccharide vaccine (23-PPV) in the Chinese urban elderly population and to understand the attitudes, knowledge and beliefs of this population toward the 23-PPV vaccination. METHODS A cross-sectional approach was employed to survey the willingness of this population to receive the 23-PPV vaccination. Two thousand 9 hundred 2 six subjects over the age of 60 y were enrolled via a multi-stage random sampling method from the urban community population in Hangzhou, China. The relationships between the variables and the willingness to receive the 23-PPV vaccination were computed as odds ratios (ORs) by multivariate analysis. RESULTS Of the participants, 21.77% were willing to undergo 23-PPV vaccination, and 61.65% of the subjects agreed that pneumonia is a serious disease among elderly people. The rate of reasonable perceptions about vaccination, including the perception about vaccine efficacy and safety, among the subjects was below 50%. Only 1.23% of subjects had been vaccinated with 23-PPV, and a similarly low rate was observed for the seasonal influenza vaccine (4.17%). The factors that were independently related to the willingness to receive the 23-PPV vaccine included consensus with the hazards of pneumonia (OR = 1.67, 95% CI: 1.28 - 2.17), the safety of vaccination (OR = 2.00, 95% CI: 1.54 - 2.59), advice about the 23-PPV vaccination from family members (OR = 2.37, 95% CI: 1.39 - 4.40), influenza vaccination history (OR = 2.57, 95% CI: 1.66 - 3.98) and pneumococcal vaccination history (OR = 7.48, 95% CI: 2.4-22.92). CONCLUSION The administration of the 23-PPV vaccine among the urban elderly population is not optimistic in China. Emphasis on persuasion from families and the improvement of knowledge about vaccination might encourage elderly people to get the 23-PPV vaccination. Suggestions from physicians did not affect the participants' willingness to get the 23-PPV vaccination in multivariate analysis, but elderly people typically visited the Community Health Center (CHC) in their residential districts, and thus, systematic encouragement from healthcare physicians might be the key to increasing 23-PPV vaccination.
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Affiliation(s)
- Shijun Liu
- a Hangzhou Center for Disease Control and Prevention ; Hangzhou , China
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8
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Liu G, Liu J, Li N, Tang Z, Lan F, Pan L, Yang X, Hu G, Yu Z. Association between leg length-to-height ratio and metabolic syndrome in Chinese children aged 3 to 6 years. Prev Med Rep 2014; 1:62-7. [PMID: 26844042 DOI: 10.1016/j.pmedr.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study is to investigate the association between leg-length-to-height ratio (LLHR) and metabolic syndrome (MetS) among Chinese children. Methods 1236 children (619 obese and 617 nonobese children) aged 3–6 years participated in a cross-sectional survey in 2005 in Tianjin, China. Information on body adiposity, metabolic traits, and related covariates was obtained using a standardized protocol. LLHR was calculated as the ratio of leg length to stature. Results In the multivariable logistic regression analyses, compared with those in the lowest quartile, odds ratios (OR) and 95% confidence intervals (CI) of MetS among children in the second through the highest quartiles of LLHR Z-score were 0.89 (95% CI, 0.64–1.25), 0.45 (95% CI, 0.32–0.63), and 0.37 (95% CI, 0.26–0.53), respectively, (Pfor trend < 0.0001 across LLHR Z-score quartiles). Compared with children with both higher levels of LLHR and lower levels of adipose indices, the corresponding ORs of MetS for those with both lower levels of LLHR and higher levels of anthropometric indices were 4.51 (95% CI, 3.08–6.62) for BMI Z-score, 3.86 (95% CI, 2.60–5.73) for waist circumference, and 2.75 (95% CI, 1.85–4.10) for waist-to-hip ratio, respectively. Conclusions Greater LLHR is inversely associated with MetS in Chinese children. Leg-length-to-height ratio (LLHR) is negatively associated with childhood obesity. Greater LLHR is inversely associated with childhood metabolic syndrome (MetS). LLHR and adiposity have a synergistic effect in relation to pediatric MetS.
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Key Words
- BMI, body mass index
- CI, confidence interval
- CVD, cardiovascular disease
- HDL, high-density lipoprotein
- LDL, low-density lipoprotein
- LLHR, leg-length-to-height ratio
- Leg length-to-height ratio
- MetS, metabolic syndrome
- Metabolic syndrome
- OR, odds ratios
- Obesity
- PI, Ponderal index
- Pediatrics
- T2D, type 2 diabetes
- WHR, waist-to-hip ratio
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