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Zulli A, Varkila MR, Parsonnet J, Wolfe MK, Boehm AB. Observations of Respiratory Syncytial Virus (RSV) Nucleic Acids in Wastewater Solids Across the United States in the 2022-2023 Season: Relationships with RSV Infection Positivity and Hospitalization Rates. ACS ES T Water 2024; 4:1657-1667. [PMID: 38633368 PMCID: PMC11019535 DOI: 10.1021/acsestwater.3c00725] [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: 11/16/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
Respiratory syncytial virus (RSV) is a leading cause of respiratory illness and hospitalization, but clinical surveillance detects only a minority of cases. Wastewater surveillance could determine the onset and extent of RSV circulation in the absence of sensitive case detection, but to date, studies of RSV in wastewater are few. We measured RSV RNA concentrations in wastewater solids from 176 sites during the 2022-2023 RSV season and compared those to publicly available RSV infection positivity and hospitalization rates. Concentrations ranged from undetectable to 107 copies per gram. RSV RNA concentration aggregated at state and national levels correlated with infection positivity and hospitalization rates. RSV season onset was determined using both wastewater and clinical positivity rates using independent algorithms for 14 states where both data were available at the start of the RSV season. In 4 of 14 states, wastewater and clinical surveillance identified RSV season onset during the same week; in 3 states, wastewater onset preceded clinical onset, and in 7 states, wastewater onset occurred after clinical onset. Wastewater concentrations generally peaked in the same week as hospitalization rates but after case positivity rates peaked. Differences in onset and peaks in wastewater versus clinical data may reflect inherent differences in the surveillance approaches.
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Affiliation(s)
- Alessandro Zulli
- Department
of Civil and Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Meri R.J. Varkila
- Division
of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, California 94305, United States
| | - Julie Parsonnet
- Division
of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, California 94305, United States
- Department
of Epidemiology and Population Health, Stanford
University, 300 Pasteur Drive, Stanford, California 94305, United States
| | - Marlene K. Wolfe
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia 30322, United States
| | - Alexandria B. Boehm
- Department
of Civil and Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
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Myers NT, Dodd KE, Hale JM, Blackley DJ, Scott Laney A, Hall NB. Acute occupational inhalation injuries-United States, 2011-2022. Am J Ind Med 2024; 67:376-383. [PMID: 38356289 DOI: 10.1002/ajim.23573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/22/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Inhalation injuries due to acute occupational exposures to chemicals are preventable. National surveillance of acute inhalation exposures is limited. This study identified the most common acute inhalation exposure-related incidents by industry sector among US workers. METHODS To characterize inhalation-related injuries and their exposures during April 2011-March 2022, state and federal records from the Occupational Safety and Health Administration (OSHA) Occupational Safety and Health Information System (OIS) accident database were analyzed. Industry-specific injury, hospitalization, and fatality rates were calculated. RESULTS The most frequent acute inhalation incidents investigated by OSHA were caused by inorganic gases (52.9%) such as carbon monoxide (CO) or acids, bases, and oxidizing chemical agents (12.9%) such as anhydrous ammonia. The largest number of fatal and nonfatal injuries were reported in the manufacturing (28.6%) and construction (17.2%) sectors. CONCLUSIONS Workers were affected by acute inhalation exposures in most industries. Using this surveillance, employers can recognize frequently-occurring preventable acute inhalation exposures by industry, such as inorganic gases in the manufacturing sector, and implement prevention measures. Training of workers on exposure characteristics and limits, adverse health effects, and use of protective equipment by exposure agent can prevent inhalation injuries.
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Affiliation(s)
- Nirmala T Myers
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Katelynn E Dodd
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Janet M Hale
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - David J Blackley
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - A Scott Laney
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Noemi B Hall
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Mills WR, Howard S, Pitzen K, Smitherman J, Cole L, Wolfram J, Deane W, Sender S, Poltavski D. A Novel Home-Based Medication Management Program and Its Influence on Hospitalization Rates among Home Health Care Recipients. J Am Med Dir Assoc 2024; 25:155-157.e1. [PMID: 37989498 DOI: 10.1016/j.jamda.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/23/2023]
Abstract
Patients do not take their medicine as prescribed 50% of the time, and of medication-related hospital admissions in the United States, 33% to 69% are due to poor medication adherence, at a cost of approximately $100 billion a year. Continue CareRx (CCRx) is a novel home-based medication management program that includes adherence packaging alongside medication reconciliation, review, and education by clinicians. We hypothesized that home health patients receiving the CCRx service may have a lower hospitalization rate than control home health patients. Between May 1, 2021, and March 31, 2023, 113 home health patients whose insurance covered the program were enrolled in CCRx. Home health patients not eligible for the program due to a noncovered pharmacy insurance benefit made up the control group (n = 21,304), which was matched with the CCRx group on age range (45-99 years old) and gender (67% women). Hospitalization rate was calculated in both groups and compared using generalized estimating equations analysis. The control group had a total of 7015 hospitalizations during the study period during 2,128,738 total managed days, whereas the CCRx group had 21 hospitalizations during 23,622 total managed days. These translated into rates of 1203 hospitalizations per 1000 per year for the control group, and 324 hospitalizations per 1000 per year for the CCRx group. The results showed that there was a significant main effect of group in predicting individual annual hospitalization rate (Wald χ2 = 56.415, P < .01). Specifically, being in the control group was associated with a 43.42-fold increase in the likelihood of a higher hospitalization rate (95% Wald CI for odds ratios: 7.24-230.44). Home health recipients enrolled in CCRx experienced a 73.1% lower hospitalization rate than controls. Making the program more widely available to patients receiving home health care may present a significant opportunity to reduce hospitalizations in this group.
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Affiliation(s)
| | | | | | | | - Laura Cole
- BrightSpring Health Services, Louisville, KY, USA
| | | | | | - Susan Sender
- BrightSpring Health Services, Louisville, KY, USA
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Zhu Y, He J, Li Y, Cao M, Cheng Y, Zhang F, Yang G. Influencing factors of hospitalization in maintenance haemodialysis outpatients after a diagnosis of COVID-19. Ann Med 2023; 55:2286638. [PMID: 38056005 PMCID: PMC10836266 DOI: 10.1080/07853890.2023.2286638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The clinical manifestations of maintenance haemodialysis (MHD) outpatients diagnosed with coronavirus disease 2019 (COVID-19) are highly heterogeneous. They are prone to progress to severe conditions, and they often require hospitalization. To better guide the management of MHD outpatients, this retrospective observational study assessed risk factors for hospitalization of MHD patients after a diagnosis of COVID-19. METHODS The demographic data, comorbidities, laboratory indicators and imaging data of 128 MHD outpatients at our haemodialysis centre with confirmed COVID-19 infection from December 2022 to January 2023 were collected. The relationships between these factors and hospitalization of patients were analyzed. RESULTS Among the 128 patients, 25 (19.53%) were hospitalized. One of the 25 inpatients was mechanically ventilated, and two of them died. Multivariate logistic regression analysis showed that the hospitalization rate was correlated with age, comorbid diabetes and peripheral blood lymphocyte count. CONCLUSION Older age, comorbid diabetes and lower lymphocyte count are important risk factors for hospitalization of MHD outpatients after a diagnosis of COVID-19. Focusing on these factors may help in early identification of patients who may need to be admitted due to potential disease progression.
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Affiliation(s)
- Yanlin Zhu
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Jie He
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Yunming Li
- Department of Statistics, General Hospital of Western Theater Command, Chengdu, PR China
| | - Mingyuan Cao
- Department of Statistics, General Hospital of Western Theater Command, Chengdu, PR China
| | - Yue Cheng
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Fan Zhang
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Guchuan Yang
- Department of Medical management, General Hospital of Western Theater Command, Chengdu, PR China
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Tampakoudis G, Anastasiou OE. Burden of HPV-Related Hospitalization in Germany from 2000 to 2021. Viruses 2023; 15:1857. [PMID: 37766265 PMCID: PMC10538031 DOI: 10.3390/v15091857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
HPV has been linked to the development of precancerous and cancerous lesions. The aim of this study was to evaluate the burden of HPV-related hospitalization in Germany from 2000 to 2021 and the potential impact of the COVID-19 pandemic on it. METHODS We performed a retrospective query using data from the German Statistical Office from 2000 to 2021, including hospital admission, inpatient mortality and hospital stay length data on cervical cancer/dysplasia, female genitourinary tract, anal, penile, head and neck cancers. RESULTS The HPV-attributable hospitalization rate per 100,000 inhabitants in Germany has decreased over time, from 89 cases in 2000 to 60 in 2021, with an average annual percent change (AAPC) of -1.93 (CI -2.08--1.79, p < 0.05). The same trend was observed for the average hospital stay, which declined from 9 to 7 days, with an AAPC of -1.33 (CI -1.52--1.21, p < 0.05). An undulating but overall slightly declining pattern was observed for the inpatient mortality (AAPC -0.92, CI -1.21--0.64, p < 0.05). We observed a reduction in the hospitalization rates for invasive and non-invasive cervical cancer, which was observed in almost all age groups and in all German federal states. CONCLUSION Our study provides a comprehensive analysis of the trends in HPV-related hospitalizations over the past two decades. The decline in hospitalization rates for cervical cancer and dysplasia suggests the potential efficacy of the HPV vaccination and screening programs.
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Affiliation(s)
- Georgios Tampakoudis
- Maternal-Fetal Medicine and Obstetrics Saint Luke’s Hospital, 55236 Thessaloniki, Greece;
- First Department of Obstetrics and Gynaecology Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Olympia E. Anastasiou
- Institute for Virology, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
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Knopp BW, Weiss HZ, Fahmy S, Goldstein E, Parmar J. A Comparison of the Adverse Effects and Utility of Different Monoclonal Antibodies for SARS-CoV-2: A Retrospective Cohort Study. Cureus 2023; 15:e43094. [PMID: 37680398 PMCID: PMC10482545 DOI: 10.7759/cureus.43094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Multiple monoclonal antibody (mAb) treatments have been developed to combat the growing number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains. These treatments have been shown to be effective in reducing the risk of hospitalization and death from SARS-CoV-2 infection with a low risk of adverse effects; however, more data is required to evaluate the comparative efficacy of mAbs. The primary objective of this study is to describe the hospitalization rate, length of stay (LOS), and mortality rate in SARS-CoV-2 patients treated with four different mAb treatments, including bamlanivimab plus etesevimab, casirivimab plus imdevimab, sotrovimab, and bebtelovimab. Methods A retrospective chart review and prospective phone surveys of SARS-CoV-2 patients treated with mAbs in a 400-bed tertiary, suburban medical center were conducted between June 2020 and April 2022. Eligibility criteria for mAbs included non-hospitalized patients over the age of 18 with less than 10 days of SARS-CoV-2 symptoms and no oxygen requirement on emergency department (ED) admission. Data were collected from the retrospective chart review and subjective patient surveys. A chi-squared test was used. Significance was assessed at p < 0.05. Results The study population included 3249 patients, with 1537 males and 1712 females and an average age of 62.48 ± 17.54 years. Five hundred forty-two patients received bamlanivimab plus etesevimab; 849 received bebtelovimab; 1577 received casirivimab plus imdevimab; and 281 received sotrovimab. The overall hospitalization rate was 1.0%, and the mortality rate was 0.2% following mAb treatment. The hospitalization rate was greatest among patients administered Sotrovimab (2.1%) and least among patients administered Bebtelovimab (0.1%) (p = 0.010). 2.4% of patients who were discharged from the ED after receiving one of the four mAbs returned within 30 days with SARS-CoV-2 symptoms. The average length of stay was 4.75 ± 4.56 days, with no significant differences between the mAbs. The provider-reported adverse event rate was 2.2%, with significant differences in adverse event rates between mAbs. Bamlanivimab-etesevimab was associated with the highest adverse event rate (4.6%), and sotrovimab was associated with the lowest adverse event rate (1.4%) (p < 0.001). Conclusion This study shows a low hospitalization and mortality rate following mAb infusion in patients with mild and moderate COVID-19. However, there were significant differences in hospitalization and mortality among patients receiving each of the four mAb treatments. There was a high degree of patient-reported symptom improvement, and adverse reactions were reported in only 2.2% of patients with no severe reactions. Multiple monoclonal antibody treatments are not effective as monotherapy; however, this study shows the potential benefits of including a mAb infusion as part of a SARS-CoV-2 treatment plan.
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Affiliation(s)
- Brandon W Knopp
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Hannah Z Weiss
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Samer Fahmy
- Department of Emergency Medicine, Boca Raton Regional Hospital, Boca Raton, USA
| | - Evan Goldstein
- Department of Emergency Medicine, Boca Raton Regional Hospital, Boca Raton, USA
| | - Jeniel Parmar
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
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Lin B, Costakis A, John M, Linder H. Decreased inpatient psychiatric admissions with telepsychiatry use during the COVID-19 pandemic. Front Psychiatry 2023; 14:1172019. [PMID: 37351003 PMCID: PMC10284274 DOI: 10.3389/fpsyt.2023.1172019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/17/2023] [Indexed: 06/24/2023] Open
Abstract
Objective This study examines the quality of care provided through telepsychiatry by comparing psychiatric hospitalization rates among patients receiving in-person psychiatric care prior to the COVID-19 pandemic with rates among patients receiving virtual psychiatric care during the COVID-19 pandemic. Methods Mental health-related hospitalization rates among patients enrolled in a large academic hospital's outpatient psychiatry programs between March 1, 2018 and February 28, 2022 were retrospectively analyzed. Four time periods were created, spanning March 1 to February 28 of the following year. Demographic and clinical data were collected from the electronic health record, and descriptive statistics were calculated. Change in hospitalization rate between time periods was evaluated using McNemar's test. Results In the 2018 time period, 7.38% of all enrolled patients were hospitalized, compared to 7.70% hospitalized in the 2019 period, 5.74% in the 2020 period, and 5.38% in the 2021 period. Patients enrolled in both the 2018 and the 2019 periods saw no difference in hospitalization rate between the 2 years (2.93% in 2018, 2.83% in 2019; p = 0.830); patients enrolled in both 2019 and 2020 saw significantly lower hospitalization rates in 2020 (5.47% in 2019, 4.58% in 2020; p = 0.022); and patients enrolled in both 2020 and 2021 saw no difference (3.34% in 2020, 3.23% in 2021; p = 0.777). Conclusion Psychiatric hospitalization rates significantly decreased between the 2019 and the 2020 periods, suggesting a decrease in admissions associated with adoption of telepsychiatry. Future research should differentiate the roles played by telepsychiatry and COVID-19-related factors in reducing hospitalization rates during the pandemic.
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Affiliation(s)
- Brendon Lin
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Anna Costakis
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Majnu John
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Howard Linder
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
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Seyler BC, Luo H, Wang X, Zuoqiu S, Xie Y, Wang Y. Assessing the impact of urban greenspace on physical health: An empirical study from Southwest China. Front Public Health 2023; 11:1148582. [PMID: 37026143 PMCID: PMC10070954 DOI: 10.3389/fpubh.2023.1148582] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction As the world becomes increasingly urbanized and human-nature contact declines, urban greenspace's impact on human health has garnered growing interest across academic disciplines. Various definitions and multiple indicators of greenspace have been utilized, with most studies finding an overall positive association between greenspace and health. Nevertheless, studies directly comparing how different greenspace indicators impact different disease types have been limited. Moreover, to verify the robustness of conclusions drawn, studies should compare multiple measures of greenspace across various spatial scales. Thus, a more comprehensive analysis is necessary to help inform future study design, especially in determining which greenspace indicators would be most useful in data-limited areas. Methods Chengdu, the capital city of Sichuan Province, is West China's largest and most urban city, being typical of other large cities in lower to middle-income countries (LMICs). With twenty county-level jurisdictions spanning various degrees of urbanization, Chengdu's landscape heterogeneity and large population make it ideal for studying greenspace's impact on public health. This study took Chengdu as a case study to assess the association and potential impact of three traditional measures of greenspace (Normalized Difference Vegetation Index, Enhanced Vegetation Index, and Fractional Vegetation Cover) and urban ratio (% of population being urban) on hospitalization rates and medical expenses paid for three major disease categories (circulatory system diseases, neoplasms, and respiratory system diseases). Results and discussion We found greenspace did have a significant impact on public health, but this relationship differed by disease type. Greenspace exhibited significant positive association with respiratory diseases, but insignificant negative associations with the other disease categories. Urban ratio showed significant negative association with greenspace abundance. The higher the urban ratio (e.g., less greenspace), the more money was paid on medical expenses. This relationship was found not only in terms of urban ratio being positively correlated with medical expenses, but also in that all three greenspace indicators were negatively correlated with medical expenses. Consequently, in future health outcome studies, urban ratio could be an acceptable negative indicator of greenness in LMICs where urban ratio is likely to imply less greenness.
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Affiliation(s)
- Barnabas C. Seyler
- Department of Environment, Sichuan University, Chengdu, China
- Shude International, Chengdu Shude High School, Chengdu, China
| | - Han Luo
- School of Software Engineering, Chengdu University of Information Technology, Chengdu, China
- Sichuan Province Informationization Application Support Software Engineering Technology Research Center, Chengdu, China
| | - Xiuli Wang
- West China School of Public Health, Sichuan University, Chengdu, China
- *Correspondence: Xiuli Wang
| | - Sophia Zuoqiu
- Department of Environment, Sichuan University, Chengdu, China
| | - Yao Xie
- Department of Environment, Sichuan University, Chengdu, China
- State Key Laboratory of Marine Pollution, Department of Chemistry, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yuan Wang
- Department of Environment, Sichuan University, Chengdu, China
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Yin C, Zhang X, Zhu J, Yuan Z, Wang T, Wang X. Comparison of hospitalization cause and risk factors between patients undergoing hemodialysis and peritoneal dialysis. Medicine (Baltimore) 2022; 101:e31186. [PMID: 36482565 PMCID: PMC9726322 DOI: 10.1097/md.0000000000031186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This retrospective study was designed to compare the cause of hospitalization and influencing factors between patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Baseline data and laboratory parameters of 192 dialysis patients (92 HD patients and 100 PD patients) were compared. Quantitative parameters with normal distribution were assessed using independent t-test or analysis of variance (ANOVA). Quantitative parameters with non-normal distribution were assessed by non-parametric test. Qualitative data were statistically compared using χ2 test. The number of patients with urban employee medical insurance (88 HD patients and 60 PD patients) and rural cooperative medical care (12 HD patients and 40 PD patients) significantly differed (P < .01). The hospitalization rate of PD patients was significantly higher than that of HD counterparts. The average length of hospital stay of PD patients was 10 days, remarkably longer than 8 days of HD patients (P < .01). The primary cause of hospitalization for HD patients was infection-related complications, followed by cardiovascular, cerebrovascular complications and dialysis access disorders. The primary cause of hospitalization for PD patients was infection-related complications, followed by dialysis access disorders, cardiovascular, and gastrointestinal complications. Compared with the HD group, the levels of hemoglobin, serum albumin, alkaline phosphatase, intact parathyroid hormone were significantly decreased, whereas serum urea nitrogen, serum creatinine, phosphorus levels and cardiothoracic ratio were remarkably increased in the PD group (all P < .01). The hospitalization rate of PD patients is relatively higher, and the length of hospital stay is longer. Extensive attention and efforts should be delivered to enhance the understanding of disease and lower the risk of complications for patients.
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Affiliation(s)
- Caixia Yin
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Xiumei Zhang
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Jiang Zhu
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Zijing Yuan
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Tao Wang
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Xixi Wang
- Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
- * Correspondence: Xixi Wang, Department of Nephrology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing Jiangning Hospital, Nanjing, Jiangsu 211100, China (e-mail: )
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Cedrone F, Santoleri F, Di Martino G, Carfagnini F, Romagnoli A, Catalini A, Del Duca L, Fortunato V, Costantini A. Predictive comorbidities of hospital admission in 1,571 SARS- CoV-2 positive patients: analysis of administrative data from an Italian Local Health Autority. Clin Ter 2022; 173:528-533. [PMID: 36373450 DOI: 10.7417/ct.2022.2477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Globally, age and some comorbidities have been associ-ated with the risk of more severe outcomes of COVID-19. The purpose of this research is to calculate the hospitalization rate of SARS-CoV-2 positive patients in an Italian Local health Authority (LHA) and to examine whether medical comorbidities encoded through pharmaceutical administrative data are predictors of hospital admission in patients with a positive SARS-CoV-2 naso-pharyngeal swab. METHODS This retrospective observational study was conducted in a LHA of Pescara. Comorbidities were coded through the consumption of drugs, using the WHO's Anatomical Therapeutic Chemical (ATC) classification System. The admission was ascertained by checking the hospital discharge records where generated. RESULTS During the study period, 1571 patients were tested positive for SARS-CoV-2 oro-and-nasopharyngeal swab. Multivariable logistic analisys showed as predictors of admission an age ≥65 in the total sample (aOR 10.91; 95%CI 6.86-17.36) as well as in the male (aOR 12.64;95%CI 6.42-24.87) and female. (aOR 9.27; 95%CI 4.87-17.66) in SARS-CoV-2 positive patients. Comorbidities assiociated with admission were (GERD) in overall (AdjOR 1.58; 95% CI 1.06-2.34) and male (AdjOR 2.30; 95%CI 1.12-4.72) samples and anticoagulants drugs use in male (AdjOR 3.90; 95% 1.11-13.65) sample, the presence of congestive heart failure (CHF) in female (AdjOR 0.47;95%CI 0.27-0.83) sample results as protective factor. CONCLUSION In conclusion, increasing age, male gender and PPI use are positively associated while female gender and CHF-related drug use are negatively associated with hospitalization in SARS-CoV-2 positive patients.
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Affiliation(s)
- F Cedrone
- Health Management of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - F Santoleri
- Hospital Pharmacy of of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - G Di Martino
- Unit of Hygiene Epidemiology and Public Health, Local Health Autority of Pescara, Pescara, Italy
| | - F Carfagnini
- Health Management of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - A Romagnoli
- ospital Pharmacy of of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - A Catalini
- ostgraduate School of Hygiene and Preventive Medicine, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - L Del Duca
- Health Management of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - V Fortunato
- Health Management of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
| | - A Costantini
- Hospital Pharmacy of of "SS. Spirito" Hospital of Pescara, Local Health Autority of Pescara, Pescara, Italy
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Mills WR, Huffman MM, Roosa J, Pitzen K, Boyd R, Schraer B, Poltavski D. Provision of Home-Based Primary Care to Individuals With Intellectual and/or Developmental Disability Is Associated With a Lower Hospitalization Rate Than a Traditional Primary Care Model. J Am Med Dir Assoc 2022:S1525-8610(22)00403-0. [PMID: 35714700 DOI: 10.1016/j.jamda.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The objective of this study was to determine if providing home-based primary care (HBPC) to individuals with intellectual and/or developmental disabilities (IDD) was associated with a lower hospitalization rate than a control group receiving traditional primary care. DESIGN AND INTERVENTION Individuals with IDD living in supported residential settings in Ohio were offered HBPC. Individuals electing HBPC made up the intervention group. Those who did not opt for HBPC continued to receive traditional primary care services and made up the control group. Hospitalizations were tracked in both groups. SETTING AND PARTICIPANTS The 757 study participants had IDD diagnoses and received residential support services throughout the study period. METHODS Annualized hospitalization rate was determined in both groups and was compared using generalized estimating equations while controlling for patients' age and hospitalization rate in the year prior to the study. RESULTS The results showed that group membership had a significant effect on the hospitalization rate (Wald χ2 = 20.71, P < .01). Being in the control group was associated with a 2.12-fold increase in annual hospitalization rate for a given patient. The overall population hospitalization rate was 329 hospitalizations per 1000 per year in the HBPC-receiving individuals and 619 hospitalizations per 1000 per year in the control group. CONCLUSIONS AND IMPLICATIONS We found that individuals with IDD receiving HBPC were hospitalized at a lower rate than a control group receiving traditional primary care. Expanding access to HBPC may be a worthwhile priority for organizations that support individuals with IDD.
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He YM, Mao R, Yuan G, Liang RM, Long JY, Ye XQ, Iacucci M, Ghosh S, Ben-Horin S, Kaplan GG, He Y, Sung JJ, Peng S, Wang HB, Chen MH. The hospitalization burden of inflammatory bowel disease in China: a nationwide study from 2013 to 2018. Therap Adv Gastroenterol 2022; 15:17562848221102307. [PMID: 35721841 PMCID: PMC9201315 DOI: 10.1177/17562848221102307] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The past decade has witnessed a dramatic increase in the number of patients with inflammatory bowel disease (IBD) in China. The nationwide burden of hospitalization remains unclear, however. We aimed to address this gap by conducting analysis using a nationwide database. METHODS Population-based hospitalization rates from 2013 to 2018 were calculated by extrapolating the number of patients in the database to the national level. Surgical rates, annual hospital charges, and length of stay were also used for quantification of hospitalization burden. The Poisson regression analysis and the Cochran-Armitage trend test were conducted to analyze temporal trends as expressed as annual percentage of change (APC) with 95% confidential intervals (CIs). RESULTS From 2013 to 2018, the hospitalization rates for Crohn's disease (CD) and ulcerative colitis (UC) in China increased from 2.20 (95% CI = 2.17-2.22) to 3.62 (3.59-3.65) per 100,000 inhabitants (p < 0.0001) with an APC of 10.68% (6.00-15.36%) and from 6.24 (6.20-6.28) to 8.29 (8.23-8.33) per 100,000 inhabitants (p < 0.0001) with an APC of 5.73% (2.32-9.15%), respectively. Surgical rates decreased from 7.96% (7.29-8.63%) to 5.56% (5.11-6.00%) for CD patients (p < 0.0001) with APC of -6.30% (-11.33 to -1.27%) and from 3.54% (3.26-3.82%) to 2.52% (2.32-2.72%) for UC patients (p < 0.0001) with APC of -6.35% (-16.21 to 3.51). In 2018, there were estimated 166,000 IBD patients hospitalized costing a total of $426.37 million ($149.91 + $276.46 million) across the entire China. CONCLUSION The population-based hospitalization rate of IBD increased, whereas the surgical rate decreased from 2013 to 2018 in China.
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Affiliation(s)
| | | | | | | | - Jian-Yan Long
- Clinical Trials Unit, The First Affiliated
Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiao-Qi Ye
- Department of Gastroenterology, The First
Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Marietta Iacucci
- Institute of Immunology and Immunotherapy,
National Institute for Health Research (NIHR) Birmingham Biomedical Research
Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham,
UK
| | - Subrata Ghosh
- College of Medicine and Health, University
College Cork, Cork, Ireland
| | - Shomron Ben-Horin
- Department of Gastroenterology, Sheba Medical
Center, Tel-Hashomer, and Sackler School of Medicine, Tel-Aviv University,
Tel-Aviv, Israel
| | - Gilaad G. Kaplan
- Departments of Medicine and Community Health
Sciences, University of Calgary, Calgary, AB, Canada
| | - Yao He
- Department of Gastroenterology, The First
Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Joseph J.Y. Sung
- Department of Medicine and Therapeutics,
Institute of Digestive Disease, State Key Laboratory of Digestive Diseases,
LKS Institute of Health Science, The Chinese University of Hong Kong, Hong
Kong Special Administrative Region, P.R. China,Institute of Precision Medicine, The First
Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated
Hospital, Sun Yat-sen University, Guangzhou, P.R. China,Institute of Precision Medicine, The First
Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
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Ren S, Shi T, Shan W, Shen S, Chen Q, Zhang W, Dai Z, Xue J, Zhang T, Tian J, Zhao G. Hospitalization rate of respiratory syncytial virus-associated acute lower respiratory infection among young children in Suzhou, China, 2010-2014. Influenza Other Respir Viruses 2022; 16:789-799. [PMID: 34989118 PMCID: PMC9178065 DOI: 10.1111/irv.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background There is a limited amount of data in China on the disease burden of respiratory syncytial virus‐ (RSV) associated acute lower respiratory infection (ALRI) among young children. This study aimed to estimate the hospitalization rate of RSV‐associated ALRI (RSV‐ALRI) among children aged 0–59 months in Suzhou, China. Methods All cases from children hospitalized with ALRI who were aged 0–59 months in Suzhou University Affiliated Children's Hospital during January 2010 to December 2014 were retrospectively identified. Detailed diagnosis and treatment data were collected by reviewing each individual's medical chart. In accordance with the World Health Organization (WHO) influenza disease burden estimation, the hospitalization rate of RSV‐ALRI among children aged 0–59 months in Suzhou, China, was then estimated. Results Out of the 28,209 ALRI cases, 19,317 (68.5%) were tested for RSV, of which the RSV positive proportion was 21.3% (4107/19,317). The average hospitalization rate of RSV‐ALRI for children aged 0–59 months was 14 (95% confidence interval [CI]:14–14)/1000 children years, and that for children aged 0–5, 6–11, 12–23, and 24–59 months were 70 (95% CI: 67–73), 31 (95% CI: 29–33), 11 (95% CI: 10–12), and 3 (95% CI: 3–3)/1000 children years, respectively. Conclusion A considerable degree of RSV‐ALRI hospitalization exists among children aged 0–59 months, particularly in those under 1 year of age. Therefore, an effective monoclonal antibody or vaccine is urgently needed to address the substantial hospitalization burden of RSV infection.
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Affiliation(s)
- Shaolong Ren
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ting Shi
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Wei Shan
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Si Shen
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qinghui Chen
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Wanqing Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zirui Dai
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jian Xue
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianmei Tian
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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Costa LHSDM, Costa LFSDM, Kachan GR, Gentile JKDA, Mendonça RA, Costa MRDCD, Ribas JM. The impact of bariatric and metabolic surgery on the morbidity and mortality of patients infected during the COVID-19 pandemic: a retrospective cohort study. SAO PAULO MED J 2022; 141:120-124. [PMID: 36043675 PMCID: PMC10005465 DOI: 10.1590/1516-3180.2021.0952.r2.11052022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Since the impact of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, several studies have shown a strong relationship between obesity and severe cases of COVID-19. It is imperative to assess whether bariatric surgery exerts a protective effect in such cases. OBJECTIVE This study aimed to assess the impact of bariatric surgery on the morbidity and mortality in obese patients during the COVID-19 pandemic. A comprehensive search was performed using the PubMed and Cochrane Library databases. DESIGN AND SETTING Retrospective cohort studies conducted in the Faculdade de Medicina da Universidade Cidade de São Paulo, São Paulo (SP), Brazil. METHODS The search comprised the following descriptors: "bariatric, surgery, COVID-19". Current retrospective cohort studies that examined the influence of bariatric surgery on the morbidity and mortality of obese patients during the COVID-19 pandemic were considered eligible. RESULTS After removing duplicates, 184 studies were obtained from the databases. Of these, 181 were excluded from the analysis as they did not meet the eligibility criteria. Patients undergoing postoperative follow-up of bariatric surgery had a similar probability of SARS-CoV-2 infection compared to the general population, and persistent comorbidities were associated with an increased risk and severity of infection. CONCLUSION Bariatric surgery has a protective effect against severe COVID-19 in the obese population, bringing the prevalence of severe disease cases to levels equivalent to those of the nonobese general population, with a positive impact on morbidity and mortality.
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Affiliation(s)
- Luiz Henrique Sala de Melo Costa
- MD. Physician and General Surgeon, Postgraduate Program in
Digestive Tract Surgery, Colégio Brasileiro de Cirurgia Digestiva (CBCD),
Aracaju (SE), Brazil
| | - Luiz Filipe Sala de Melo Costa
- Undergraduate Student of Medical Sciences, Faculdade de
Medicina-Universidade Cidade de São Paulo (FM-UNICID), São Paulo (SP),
Brazil
| | - Gabriela Rezende Kachan
- MD. Physician, Department of Medicine, Faculdade de
Medicina-Universidade Cidade de São Paulo (FM-UNICID), São Paulo (SP),
Brazil
| | - João Kleber de Almeida Gentile
- MD. Gastrosurgeon, General Surgeon, Doctoral Student, and
Assistant Professor, Department of Surgery, Faculdade de Medicina-Universidade
Cidade de São Paulo (FM-UNICID), São Paulo (SP), Brazil
| | - Raul Andrade Mendonça
- MD. Gastrosurgeon and General Surgeon, Department of Urgency of
Hospital de Urgências de Aracajú, Aracaju (SE), Brazil
| | | | - Jurandir Marcondes Ribas
- PhD. Physician and General Surgeon, Department of Digestive
Surgery, Universidade Federal do Paraná (UFRP), Curitina (PR), Brazil
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Kasimov EM, Hajiyeva BK. [The nosologic structure and rate of hospitalization in third level ophthalmologic center]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:60-64. [PMID: 35157381 DOI: 10.32687/0869-866x-2022-30-1-60-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
THE PURPOSE OF THE STUDY To investigate nosologic structure and hospitalization rate in the National Center of Ophthalmology depending on accessibility of ophthalmologic care in the regions. MATERIALS AND METHODS The data of hospitalization in the National Center of Ophthalmology in December 2019 was used (12 882 cases of in-patient treatment). The patients were allocated in groups according to living addresses considering degree of accessibility of primary and secondary ophthalmologic care (residents of Baku; cities of the Republican subordination (Ganja, Sumgayit, Mingachevir, Shirvan); district centers; rural settlements). RESULTS The predominant cause of hospitalization is associated with cataract (39.43%), percentage of remaining causes of hospitalization is less than 10%. Among the causes of hospitalization in all groups of settlements the first place is for cataract. But percentage of this pathology is relatively low among residents of Baku (37.00±0.69%) and cities of the Republican subordination (37.5 ±1.88%). The corresponding indices are significantly higher (p≤0.05) among residents of rural settlements (39.40±0.68%) and district centers (45.09±1.03%). CONCLUSION In the nosologic structure of the causes of hospitalization in third level ophthalmologic center dominate cataract (39.43%), retinal detachment with ruptured retina (8.65%), eye and retinal injuries (6.22%). The nosologic structure of causes and rate of hospitalization in third level ophthalmologic center depends on accessibility of primary and secondary ophthalmologic medical care to population. The residents of Baku, where the tertiary ophthalmologic center is located, (223.23±3.20) are hospitalized up to 1.6 times more often as compared with residents of other regions (≤131.71±2.74). The residents of cities of the Republican subordination with developed ophthalmologic care of primary and secondary level are hospitalized less (84.0±3.26).
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Affiliation(s)
- E M Kasimov
- The Academician Zarifa Aliyeva National Center of Ophthalmology, AZ1114, Baku, Azerbaijan
| | - B Kh Hajiyeva
- The Academician Zarifa Aliyeva National Center of Ophthalmology, AZ1114, Baku, Azerbaijan,
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Abstract
Objective: To estimate the out-of-pocket (OOP) expenditure and catastrophic expenditure due to stroke-related hospitalization and determine associated predictors.Methods: Secondary analysis of household-based survey conducted by National Sample Survey Organization from June 2017 to 2018.Results: A total of 1152 and 407 individuals reported stroke-related hospitalization and outpatient care, respectively, in the survey. Stroke-related hospitalization rate in India is 46 per 100,000 persons. The mean and median expenditure per episode of stroke-related hospitalization was INR 40,360 (US$ 539.75) and INR 17,140 (US$ 229.22), respectively, with significant OOP hospitalization expenditure across wealth quintiles (p < 0.001). About 29% (25-34%) of households seeking stroke treatment in public medical institutions experienced catastrophic expenditure. 37% (34-40%) of households resorted to distress health financing due to stroke-related hospitalization. Medicines accounted on an average 38% and 73% of public sector hospitalization and outpatient care, respectively. Patients treated in a private facility, hospitalized for over 7 days, within the poorest wealth quintiles had higher odds of incurring catastrophic expenditure.Conclusion: Economic burden associated with stroke-related hospitalization is substantial in India. The publicly funded health insurance scheme should cover expenses on stroke-related medicines to reduce OOP expenditure of patients seeking treatment in public sector facilities.
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Affiliation(s)
- Subramania Raju Rajasulochana
- Health Technology Assessment Resource Centre, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sitanshu Sekhar Kar
- Health Technology Assessment Resource Centre, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Mesri M, Esmaeili Saber SS, Godazi M, Roustaei Shirdel A, Montazer R, Koohestani HR, Baghcheghi N, Karimy M, Azizi N. The effects of combination of Zingiber officinale and Echinacea on alleviation of clinical symptoms and hospitalization rate of suspected COVID-19 outpatients: a randomized controlled trial. J Complement Integr Med 2021; 18:775-781. [PMID: 33787192 DOI: 10.1515/jcim-2020-0283] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/12/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Herbal medicines, as a treatment method, have received a great deal of attention. The effects of two herbal medicines namely Zingiber officinale and Echinacea on alleviation of clinical symptoms and hospitalization rate of suspected COVID-19 outpatients were examined. METHODS A clinical trial with 100 suspected COVID-19 outpatients as participants was conducted. The participants were allocated randomly to two groups of 50 members. The intervention group received concurrent Zingiber officinale (Tablet Vomigone 500 mg II tds) and Echinacea (Tablet Rucoldup I tds) for seven days in addition to the standard treatment. The control group only received the standard treatment (Hydroxychloroquine). After seven days, alleviation of clinical symptoms and hospitalization rate were examined. In addition, 14 days after treatment, the hospitalization was assessed again by telephone follow up. RESULTS The two groups were identical in terms of basic characteristics. Improvement level as to coughing, dyspnea, and muscle pain was higher in the intervention group (p value <0.05). There was no significant difference between the two groups in terms of the other symptoms. In addition, the hospitalization rate in the intervention and control groups were 2 and 6% respectively, which are not significantly different (p value >0.05). CONCLUSIONS Taking into account the efficiency and trivial side-effects of Zingiber officinale and Echinacea, using them for alleviation and control of the clinical symptoms in COVID-19 outpatients is recommended.
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Affiliation(s)
- Mehdi Mesri
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | | | - Mohammadreza Godazi
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | | | - Reza Montazer
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Hamid Reza Koohestani
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Nayereh Baghcheghi
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Nemat Azizi
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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Zhou S, Ma X, Jiang S, Huang X, You Y, Shang H, Lu Y. A retrospective study on the effectiveness of Artificial Intelligence-based Clinical Decision Support System (AI-CDSS) to improve the incidence of hospital-related venous thromboembolism (VTE). Ann Transl Med 2021; 9:491. [PMID: 33850888 PMCID: PMC8039638 DOI: 10.21037/atm-21-1093] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Artificial intelligence technology is widely used in the medical industry. Our retrospective study evaluated the effectiveness of an AI-CDSS in improving the incidence of hospital-related VTE and the impact of anticoagulant drug use. Methods This study collected relevant data on adult patients over 18 years of age who are not discharged 24 hours, from January to July 2019 and from January to July 2020, the VTE high-risk department of Ruijin Hospital. Before and after using AI-CDSS, the incidence of hospital-related VTE and using anticoagulants were analyzed. Results Between January to July 2019 and January to July 2020, 3,565 and 4,423 adult patients over 18 years old were hospitalized in our hospital and were designed as a control group and intervention group, respectively (7,988 in total). Both groups had similar baseline characteristics. There were 4,716 (59.03%) male patients, the mean age was 60.43±13.09 years, and the mean stay was 7.56±7.76 days. More than half of the patients (4,605, 57.58%) came from the respiratory. VTE events during hospitalization occurred in 41 patients; overall, 5.13/1,000 (41 episodes in 7,988 patients). Compared with the control group, before implementing AI-CDSS, the rate of VTE during hospitalization was reduced from 5.89/1,000 (21 episodes in 3,565 patients) to 4.75/1,000 patients (20 episodes in 4,423 patients) (relative reduction of 19.35%) in the intervention group. The use rate of anticoagulant drugs was increased from 19.97% (712/3,565) in the control group to 22.88% (1,012/4,423) in intervention group [P<0.01, odds ratio (OR): 1.19, 95 percent confidence interval (95% CI) (1.07-1.32)], (relative 14.57% increase). Poisson's regression results showed that department, age ≥75 years [OR: 3.09, 95% Cl (1.45-6.33)], duration of hospitalization [OR: 1.04, 95% CI (1.03-1.05)], heart failure [OR: 5.13, 95% CI (1.74-13.54)] and renal failure [OR: 3.60, 95% CI (0.90-11.34)] were high-risk factors for VTE events. Conclusions Implementing AI-CDSS can help clinicians identify hospitalized patients at increased VTE risk, take effective preventive measures, and improve clinicians' compliance with the American College of Chest Physicians (ACCP) guidelines.
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Affiliation(s)
- Shuai Zhou
- Division of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xudong Ma
- National Health Commission of the People's Republic of China, Beijing, China
| | - Songyi Jiang
- Beijing Huimei Technology Ltd,. Co., Beijing, China
| | - Xiaoyan Huang
- Division of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Director's Office, Ruijin Hospital, Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi You
- Beijing Huimei Technology Ltd,. Co., Beijing, China
| | - Hanbing Shang
- Division of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Lu
- Division of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Director's Office, Ruijin Hospital, Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Aldarmaki R, Al Khogali HI, Al Dhanhani AM. Hospitalization in patients with systemic lupus erythematosus at Tawam Hospital, United Arab Emirates (UAE): Rates, causes, and factors associated with length of stay. Lupus 2021; 30:845-851. [PMID: 33497303 DOI: 10.1177/0961203321990086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Systemic lupus erythematosus (SLE) is a relapsing and remitting multiorgan disease associated with significant morbidity and mortality. The survival rate of patients with SLE has recently improved, which was associated with increased morbidity and hospitalization rates. Therefore, this study aimed to examine the rate and causes of hospitalization in patients with SLE and explore factors associated with increased length of stay (LOS). METHODS Patients who visited rheumatology clinics (Tawam hospital, United Arab Emirates (UAE)) and fulfilled the American College of Rheumatology (ACR) SLE criteria were identified. Retrospective charts were reviewed to determine previous admissions. Demographic data, reason for hospitalization, duration of hospitalization, intensive care unit (ICU) admission, number of specialist consultations, medications used, and SLE characteristics at time of admission were collected. The hospitalization rate was calculated as the number of hospitalized patients divided by the total number of patients with the disease. We performed multivariable regression analysis for factors associated with increased LOS. RESULTS A total of 91 patients with SLE (88 women and 3 men) met the inclusion criteria with a mean disease duration of 10.2 years (SD 5.5). A total of 222 admissions were identified, and 66 of 91 patients were admitted at least once. The mean crude hospitalization rate calculated was 29.8%. The primary reason for admission was pregnancy (29%), SLE activity (24%), and infection (20%). When combining primary and secondary reasons, the proportion of admissions due to SLE activity increased to 32%. The mean LOS was 5.9 (SD 6.0) days. About 7% of admitted patients required ICU admission. In multivariable analysis, patients with lupus nephritis, complications during hospitalization, and increased number of specialists consultations and who were admitted to ICU and started new medication were all associated with increased LOS. CONCLUSION A significant proportion of patients with SLE were hospitalized during their disease course. The hospitalization rate in this study appears to be higher than those reported elsewhere. Disease flare is the leading cause of admission in patients with SLE in this relatively young cohort. Lupus nephritis has been found to be significantly related to longer LOS. Measurements taken to reduce the incidence and severity of flares would likely decrease hospitalization rate and LOS in patients with SLE.
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Affiliation(s)
- Reem Aldarmaki
- Medical Intern, College of Medicine & Health Science, UAE University, Al Ain, UAE
| | | | - Ali M Al Dhanhani
- Department of Internal Medicine, College of Medicine & Health Science, UAE University, Al Ain, UAE
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Paredes MC, Muñoz MP, Valdés Salgado M, Maldonado AK. Association between coal and firewood combustion and hospital admissions and mortality in Chile 2015 - An ecological approach. Ann Agric Environ Med 2020; 27:418-426. [PMID: 32955225 DOI: 10.26444/aaem/125010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVE Burning coal and firewood generates toxic emissions that are associated with respiratory illness, cardiovascular disease, and even death. The aim of the study is to evaluate the association between county-level prevalence of household coal and firewood use and health outcomes, including total, respiratory, and cardiovascular mortality, as well as total and respiratory hospitalization rates. MATERIAL AND METHODS The ecological study included data on the use of household coal and firewood in 139 counties obtained from the 2015 Chilean National Socio-economic Characterization Survey. Total, respiratory, and cardiovascular mortality, as well as total and respiratory hospitalization rates, were obtained from the Department of Health Statistics. Poisson models with robust error variance, Pearson linear correlation coefficients, and scatterplots were used to explore associations between household coal and firewood use and morbidity-mortality, stratifying by geographic zone. RESULTS Total, respiratory, and cardiovascular mortality and total and respiratory hospitalization rates were 5.7 per 1,000, 552 per 100,000, 157 per 100,000, 92.5 per 1000, and 8.8 per 1000 inhabitants, respectively. The median prevalence of coal use for residential cooking, heating, or water heating was 3.64%, while the median prevalence of firewood combustion was 12%. In southern counties, age- and gender-adjusted respiratory mortality increased 2.02 (95% CI: 1.17-3.50), 1.5 (95% CI: 1.11-1.89), and 1.76-fold (95% CI: 1.19-2.60) for each percentage increase in household coal and firewood use for heating, cooking and heating water, respectively. CONCLUSIONS The prevalence of household coal and firewood used for heating and cooking was positively correlated with respiratory mortality and hospitalization in southern zone counties.
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Affiliation(s)
| | - María Pía Muñoz
- School of Public Health. Faculty of Medicine. University of Chile, Santiago, Chile
| | | | - Ana Karina Maldonado
- School of Public Health. Faculty of Medicine. University of Chile, Santiago, Chile
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Poss J, McGrail K, McGregor MJ, Ronald LA. Long-Term Care Facility Ownership and Acute Hospital Service Use in British Columbia, Canada: A Retrospective Cohort Study. J Am Med Dir Assoc 2020; 21:1490-1496. [PMID: 32646822 DOI: 10.1016/j.jamda.2020.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/26/2020] [Accepted: 04/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Previous studies report higher hospitalization rates in for-profit compared with nonprofit long-term care facilities (LTCFs), but have not included staffing data, a major potential confounder. Our objective was to examine the effect of ownership on hospital admission rates, after adjusting for facility staffing levels and other facility and resident characteristics, in a large Canadian province (British Columbia). DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS Our cohort included individuals resident in a publicly funded LTCF in British Columbia at any time between April 1, 2012 and March 31, 2016. MEASURES Health administrative data were extracted from multiple databases, including continuing care, hospital discharge, and Minimum Data Set (MDS 2.0) assessment records. Cox extended hazards regression was used to estimate hospitalization risk associated with facility- and resident-level factors. RESULTS The cohort included 49,799 residents in 304 LTCF facilities (116 publicly owned and operated, 99 for-profit, and 89 nonprofit) over the study period. Hospitalization risk was higher for residents in for-profit (adjusted hazard ratio [adjHR] 1.34; 95% confidence interval [CI] 1.29-1.38) and nonprofit (adjHR 1.37; 95% CI 1.32-1.41) facilities compared with publicly owned and operated facilities, after adjustment for staffing, facility size, urban location, resident demographics, and case mix. Within subtypes, risk was highest in single-site facilities: for-profit (adjHR 1.42; 95% CI 1.36-1.48) and nonprofit (adjHR 1.38, 95% CI 1.33-1.44). CONCLUSIONS AND IMPLICATIONS This is the first Canadian study using linked health data from hospital discharge records, MDS 2.0, facility staffing, and ownership records to examine the adjusted effect of facility ownership characteristics on hospital use of LTCF residents. We found significantly lower adjHRs for hospital admission in publicly owned facilities compared with both for-profit and nonprofit facilities. Our finding that publicly owned facilities have lower hospital admission rates compared with for-profit and nonprofit facilities can help inform decision-makers faced with the challenge of optimizing care models in both nursing homes and hospitals as they build capacity to care for aging populations.
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Affiliation(s)
- Jeffrey Poss
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Margaret J McGregor
- Community Geriatrics, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa A Ronald
- Community Geriatrics, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
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Czarkowska-Pączek B, Wawiórko E, Młynarczyk G, Paczek L. Antibiotic-resistant bacterial colonization increases the number of hospitalizations in patients after solid organ transplantation or with non-communicable diseases. ADV CLIN EXP MED 2020; 29:307-312. [PMID: 32207588 DOI: 10.17219/acem/116068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Healthcare-associated infections could affect the rate of morbidity, mortality and post-discharge hospitalization among patients. They are also dangerous to healthcare professionals and generate significant cost to the healthcare system. OBJECTIVES The aim of this study was to evaluate the occurrence rate of colonization with various antibiotic-resistant (AR) bacteria among patients admitted to the Department of Immunology, Transplantology and Internal Diseases. MATERIAL AND METHODS The study used retrospective analysis of patients (n = 280) with no clinical signs of infection admitted into the department between November 2015 and May 2017. The observational period lasted until January 2019. Collected data included sex, age at admission, location directly prior to current hospitalization, and medical history. Nasal and rectal swabs were collected, and stool and urine samples were obtained on the day of admission. Specimens were cultured according to standard microbiological procedures. In all cases, the appropriate bioMerieux (Marcy-l'Étoile, France) media were used. Isolates were identified using mass spectrometer (Vitek MS; bioMerieux). RESULTS One-hundred ninety-one (68.2%) of patients were colonized with AR bacteria. The incidence of colonization was not influenced by age or sex. The risk of colonization was associated with admission from another hospital and history of kidney transplantation (p = 0.0136 and p < 0.001, respectively). The number of hospitalizations during the whole observational period was higher in the group of colonized patients compared to non-colonized (2.76 ±2.4 vs 2.07 ±1.68, p = 0.0099). The number of hospitalizations correlated positively with the number of positive cultures obtained from the same patients (rho = 0.18, p = 0.0274). CONCLUSIONS The rate of colonization at admission to the ward could be high, depending on previous hospitalization and medical history. Colonization significantly increased post-discharge hospitalization rate.
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Affiliation(s)
- Bożena Czarkowska-Pączek
- Department of Clinical Nursing, Medical University of Warsaw, Poland
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Poland
| | - Elżbieta Wawiórko
- Department of Clinical Nursing, Medical University of Warsaw, Poland
| | - Grażyna Młynarczyk
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Poland
| | - Leszek Paczek
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Poland
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Restivo V, Costantino C, Amato L, Candiloro S, Casuccio A, Maranto M, Marrella A, Palmeri S, Pizzo S, Vitale F, Amodio E. Evaluation of the Burden of HPV-Related Hospitalizations as a Useful Tool to Increase Awareness: 2007-2017 Data from the Sicilian Hospital Discharge Records. Vaccines (Basel) 2020; 8:vaccines8010047. [PMID: 31991909 PMCID: PMC7157634 DOI: 10.3390/vaccines8010047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 12/28/2019] [Revised: 01/15/2020] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in Sicily. A retrospective observational study estimated 43,531 hospitalizations attributable to HPV from 2007 to 2017. During the observed period, there was a decrease for all HPV-related conditions with a higher reduction, among neoplasms, for cervical cancer (annual percent change (APC) = −9.9%, p < 0.001). The median age for cervical cancer was 45 years old, with an increasing value from 43 to 47 years (p < 0.001). The age classes with greater decreases in hospital admissions for invasive cancers were women aged 35 years or more (APC range from −5.5 to −9.86) and 25–34 years old (APC = −11.87, p < 0.001) for women with cervical carcinoma in situ. After ten years for vaccine introduction and sixteen years for cervical cancer screening availability, a relatively large decrease in hospital admissions for cervical cancer and other HPV-related diseases in Sicily was observed. Some clinical characteristics of hospitalization, such as increasing age, are suggestive clues for the impact of preventive strategies, but further research is needed to confirm this relationship.
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Bellino S, Piovesan C, Bella A, Rizzo C, Pezzotti P, Ramigni M. Determinants of vaccination uptake, and influenza vaccine effectiveness in preventing deaths and hospital admissions in the elderly population; Treviso, Italy, 2014/2015-2016/2017 seasons. Hum Vaccin Immunother 2019; 16:301-312. [PMID: 31486347 PMCID: PMC7062427 DOI: 10.1080/21645515.2019.1661754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 12/15/2022] Open
Abstract
Seasonal influenza is an important cause of morbidity and mortality, particularly among the elderly population. Determinants of vaccination uptake and its impact on health outcomes in the seasons 2014/2015–2016/2017 in elderly living in Treviso area (Veneto Region, North-Eastern Italy) were evaluated. A retrospective cohort study was conducted combining information from several health administrative databases, and multiple Poisson regression models were applied to evaluate the influenza vaccine effectiveness, also adjusting for confounding factors. MF59-adjuvanted trivalent-inactivated vaccine was mainly administered. Data from more than 83,000 elderly people were analyzed by year. Vaccine coverage was about 50%; influenza vaccination uptake was independently associated with older age, male sex, increasing number of underlying chronic conditions, previous pneumococcal vaccination, annual expenses for specialist medical cares, and general practitioner to whom the elderly was in charge. After adjusting for previously described characteristics, vaccination was associated with lower mortality and influenza-related hospitalization rates. Specifically, during influenza season the adjusted incidence rate ratio of death and of influenza-related hospitalizations for vaccinated compared to unvaccinated persons was 0.63 [95% confidence interval (CI) 0.58–0.69, p < .001] and 0.86 (95% CI 0.81–0.91, p < .001), respectively. A similar effectiveness was estimated for death in all age groups (≤74, 75–84, ≥85 years old), whereas a higher effect was found for hospitalizations in subjects aged ≥75 years old. Vaccination was also effective both in males and females. Findings suggest a health benefit of the influenza vaccination in the elderly population. Efforts should be focused on strategies to increase the vaccination uptake as important instrument of prevention.
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Affiliation(s)
- Stefania Bellino
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Cinzia Piovesan
- Department of Epidemiology, Local Health Unit 2 Marca Trevigiana, Treviso, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Caterina Rizzo
- Direction of Clinical Departments, Bambino Gesù Children's Hospital, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Mauro Ramigni
- Department of Epidemiology, Local Health Unit 2 Marca Trevigiana, Treviso, Italy
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Vandenberk B, Siau C, Vandael E, Puype L, Branders J, Dewolf P, Foulon V, Willems R, Verelst S. A prolonged QTc-interval at the emergency department: Should we always be prepared for the worst? J Cardiovasc Electrophysiol 2019; 30:2041-2050. [PMID: 31402492 DOI: 10.1111/jce.14114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION QTc-interval prolongation is associated with ventricular arrhythmias and mortality in a general population. Bazett's correction formula (QTcB) is routinely used despite its overcorrection at high heart rates. Recently, we proposed a patient-specific QT correcting algorithm (QTcA) resulting in improved rate correction and predictive value in a general population. We hypothesize risk stratification at the Emergency Department (ED) could be improved using QTcA. METHODS AND RESULTS A retrospective case-control study including a randomized age- and sex-matched control population was performed at a tertiary care ED. A total of 1930 patients were included in the analysis (63.0% males, age 71.5 ± 15.6 years). Patient characteristics, history, and test results at the time of the electrocardiogram were collected. QTc was dichotomized as prolonged (>450 millisecond for men, >470 millisecond for women) or severely prolonged (>500 millisecond). Implementation of QTcA would reduce the number of patients considered to have a prolonged QTc by 65.2%, for severely prolonged QTc 79.6%. Multivariate regression was performed for in-hospital mortality, cardiovascular endpoints, and hospital admission. Neither a prolonged QTcB (HR 1.04; 95% CI, 0.64-1.69) nor QTcA (HR 0.76; 95% CI, 0.42-1.38) was an independent predictor of in-hospital mortality. A severely prolonged QTcA (OR, 2.54; 95% CI, 1.04-6.23) was an independent predictor of cardiovascular events. Both a prolonged QTcA (OR, 1.52; 95% CI, 1.06-2.18) and a prolonged QTcB (OR, 1.37; 95% CI, 1.05-1.79) were associated with higher hospitalization rates. CONCLUSIONS QTcA reduced the number of patients considered at risk. Neither QTcB nor QTcA were predictors of in-hospital mortality. A severely prolonged QTcA was associated with cardiovascular events.
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Affiliation(s)
- Bert Vandenberk
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Caroline Siau
- Emergency Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Eline Vandael
- Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Belgium
| | - Laura Puype
- Emergency Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Jordi Branders
- Emergency Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Philippe Dewolf
- Emergency Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Belgium
| | - Rik Willems
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Sandra Verelst
- Emergency Medicine, University Hospital of Leuven, Leuven, Belgium
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Rashidian A, Salavati S, Hajimahmoodi H, Kheirandish M. Does rural health system reform aimed at improving access to primary health care affect hospitalization rates? An interrupted time series analysis of national policy reforms in Iran. J Health Serv Res Policy 2019; 24:73-80. [PMID: 30638078 DOI: 10.1177/1355819618815721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the effects of rural health insurance and family physician reforms on hospitalization rates in Iran. METHODS An interrupted time series analysis of national monthly hospitalization rates in Iran (2003-2014), starting from two years before the intervention. Segmented regression analysis was used to assess the effects of the reforms on hospitalization rates. RESULTS The analyses showed that hospitalization rates increased one year after the initiation of the reforms: 1.55 (95% CI: 1.24-1.86) additional hospitalizations per 1000 rural inhabitants per month ('immediate effect'). This increase was followed by a further gradual increase of 0.034 per 1000 inhabitants per month (95% CI: 0.02-0.04). The gradual monthly increase continued for two years after the reforms. The higher hospitalization rates were maintained in the following years. We observed a significant increase in hospitalization rates at a national level in rural areas that continued for over 10 years after the policy implementation. CONCLUSION Primary health care reforms are often proposed for their efficiency outcomes (i.e. reduction in costs and use of hospitals) as well as their impact on improving health outcomes. We demonstrated that in populations with unmet needs, such reforms are likely to substantially increase hospitalization rates. This is an important consideration for successful design and implementation of interventions aimed at achieving universal health coverage in low- and middle-income countries.
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Affiliation(s)
- Arash Rashidian
- 1 Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Science, Iran
| | - Sedigheh Salavati
- 2 PhD Candidate, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Science, Iran
| | - Hanan Hajimahmoodi
- 3 Physician, Director General of Family Physician Program, Iran Health Insurance Organization, Iran
| | - Mehrnaz Kheirandish
- 4 Director General of Assessment and Control of Prescribing and Use of Medicines and Health Products, Food and Drug administration, Iran
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Zhang Z, Lei J, Shao X, Dong F, Wang J, Wang D, Wu S, Xie W, Wan J, Chen H, Ji Y, Yi Q, Xu X, Yang Y, Zhai Z, Wang C. Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China. Chest 2018; 155:342-353. [PMID: 30419233 DOI: 10.1016/j.chest.2018.10.040] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/07/2018] [Accepted: 10/29/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND VTE has emerged as a major public health problem. However, data on VTE burden in China are seldom reported. METHODS This study collected data on patients with a principal diagnosis of VTE, pulmonary embolism (PE), or DVT by using the International Classification of Diseases, 10th Revision, from 90 hospitals across China. The trends in hospitalization rates, mortality, length of stay (LOS), and comorbidities from 2007 to 2016 were analyzed. RESULTS In total, 105,723 patients with VTE were identified. For patients with VTE, the age- and sex-adjusted hospitalization rate increased from 3.2 to 17.5 per 100,000 population, and in-hospital mortality decreased from 4.7% to 2.1% (P < .001). The mean LOS declined from 14 to 11 days (P < .001). In addition, the data in 2016 showed that the hospitalization rate of VTE was higher in elderly male patients (male patients vs female patients, 155.3 vs 125.4 per 100,000 population in patients aged ≥ 85 years; P < .001) and in northern China (north vs south, 18.4 vs 13.4 per 100,000 population; P < .001). Higher mortality rates were found in patients with cancer and Charlson Comorbidity Index scores > 2. Similar trends were also observed in patients with PE and those with DVT. The hospitalization rate in China was much lower than that of the United States or selected sites in Canada and Europe, the LOS was much longer, and the in-hospital mortality rates were similar. CONCLUSIONS The hospitalization rates of VTE increased steadily, and the mortality declined. This study provides important information on the disease burden of VTE in China.
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Affiliation(s)
- Zhu Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jieping Lei
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Xiang Shao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Fen Dong
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Jing Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Peking University Health Science Center, Beijing, China
| | - Dingyi Wang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Sinan Wu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Wanmu Xie
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Jun Wan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Hong Chen
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yingqun Ji
- Department of Respiratory Medicine, First Affiliated Hospital of Dalian Medical University, Liaoning Province, China
| | - Qun Yi
- Department of Pulmonary and Critical Medicine, West China Hospital, Sichuan University, Sichuan Province, China
| | - Xiaomao Xu
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, Beijing, China
| | - Yuanhua Yang
- Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, and the Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Zhenguo Zhai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
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Zhang L, Gunther CB, Franco OS, Klassen TP. Impact of hypertonic saline on hospitalization rate in infants with acute bronchiolitis: A meta-analysis. Pediatr Pulmonol 2018; 53:1089-1095. [PMID: 29893029 DOI: 10.1002/ppul.24066] [Citation(s) in RCA: 15] [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: 03/01/2018] [Accepted: 05/11/2018] [Indexed: 11/09/2022]
Abstract
AIM This meta-analysis aimed to assess the efficacy of nebulized hypertonic saline (HS) on the rate of hospitalization in infants with acute bronchiolitis in the Emergency Department (ED) setting. METHOD We searched PubMed, Virtual Health Library-BVS and Cochrane CENTRAL from inception until January 31, 2018. We selected randomized trials that compared nebulized HS with normal saline (NS) or standard care in children up to 24 months of age with acute bronchiolitis in the ED setting. We conducted random-effects meta-analyses to estimate the risk ratio (RR) and 95% confidence interval (CI). RESULTS A total of 293 records were screened and 8 trials involving 1708 patients were included. The meta-analysis showed a 16% reduction in the risk of hospitalization among patients treated with HS compared to NS (risk ratio [RR]: 0.84, 95% confidence interval [CI]: 0.71-0.98, P = 0.03). A significant effect of HS in reducing the risk of hospitalization was found only in the subgroup analyses of trials in which HS was mixed with bronchodilators, multiple doses (≥3) were given, and risk of bias was low. CONCLUSIONS Nebulized hypertonic saline may potentially reduce the risk of hospitalization in infants with acute bronchiolitis in the ED setting. Quality of evidence is moderate due to substantial clinical heterogeneity between studies and large multicenter trials are still warranted.
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Affiliation(s)
- Linjie Zhang
- Postgraduate Program in Health Sciences and Postgraduate Program in Public Health, Faculty of Medicine, Federal University of Rio Grande, Rio Grande-RS, Brazil
| | - Carlos B Gunther
- Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil
| | - Ozeia S Franco
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil
| | - Terry P Klassen
- Department of Pediatrics, Children's Hospital Research Institute of Manitoba, Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Canada
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Abstract
OBJECTIVES The prime objective of this study is to examine the trends of disease and age pattern of hospitalisation and associated costs in India during 1995-2014. DESIGN Present study used nationally representative data on morbidity and healthcare from the 52nd (1995) and 71st (2014) rounds of the National Sample Survey. SETTINGS A total of 120 942 and 65 932 households were surveyed in 1995 and 2014, respectively. MEASURES Descriptive statistics, logistic regression analyses and decomposition analyses were used in examining the changes in patterns of hospitalisation and associated costs. Hospitalisation rates and costs per hospitalisation (out-of-pocket expenditure) were estimated for selected diseases and in four broad categories: communicable diseases, non-communicable diseases (NCDs), injuries and others. All the costs are presented at 2014 prices in US$. RESULTS Hospitalisation rate in India has increased from 1661 in 1995 to 3699 in 2014 (per 100 000 population). It has more than doubled across all age groups. Hospitalisation among children was primarily because of communicable diseases, while NCDs were the leading cause of hospitalisation for the 40+ population. Costs per hospitalisation have increased from US$177 in 1995 to US$316 in 2014 (an increase of 79%). Costs per hospitalisation for NCDs in 2014 were US$471 compared with US$175 for communicable diseases. It was highest for cancer inpatients (US$942) followed by heart diseases (US$674). Age is the significant predictor of hospitalisation for all the selected diseases. Decomposition results showed that about three-fifth of the increase in unconditional costs per hospitalisation was due to increase in mean hospital costs, and the other two-fifth was due to increase in hospitalisation rates. CONCLUSION There has been more than twofold increase in hospitalisation rates in India during the last two decades, and significantly higher rates were observed among infants and older adults. Increasing hospitalisation rates and costs per hospitalisation are contributing substantially to the rising healthcare costs in India.
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Affiliation(s)
- Anshul Kastor
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - Sanjay K Mohanty
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
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Cammarota S, Cargiolli M, Andreozzi P, Toraldo B, Citarella A, Flacco ME, Binda GA, Annibale B, Manzoli L, Cuomo R. Increasing trend in admission rates and costs for acute diverticulitis during 2005-2015: real-life data from the Abruzzo Region. Therap Adv Gastroenterol 2018; 11:1756284818791502. [PMID: 30159036 PMCID: PMC6109850 DOI: 10.1177/1756284818791502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/14/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Scarce data are available on the epidemiological trend of diverticulitis and its financial burden in Italy. The aim of this work was to explore a potential variation in the rate and costs of hospital admissions for uncomplicated and complicated diverticulitis over the last decade. METHODS We selected all hospitalizations for diverticulitis of residents in the Abruzzo Region, Italy between 2005 and 2015. Age-standardized hospitalization rates (HRs) per 100,000 inhabitants for overall, uncomplicated and complicated diverticulitis were calculated. A linear model on the log of the age-standardized rates was used to calculate annual percentage changes (APC). Costs were derived from the official DRG tariff. RESULTS From 2005 to 2015, the HR for acute diverticulitis increased from 38.9 to 45.2 per 100,000 inhabitants (APC + 1.9%). The HR for complicated diverticulitis increased from 5.9 to 13.3 (APC + 7.6%), whereas it remained stable for uncomplicated diverticulitis. The mean hospital cost was 1.8-times higher for complicated diverticulitis compared with that for uncomplicated disease and 3.5-times higher for patients with a surgery stay compared with that for patients with a medical stay. CONCLUSION During the last decade, in the Abruzzo Region, the HRs for diverticulitis and their costs increased significantly, mainly due to disease complications. Further studies are needed to explore strategies to prevent complications and to realise cost-saving policies.
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Affiliation(s)
- Simona Cammarota
- LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., Naples, Italy
| | - Martina Cargiolli
- Gastroenterology Unit, Department of Clinical Medicine and Surgery University Federico II, Naples, Italy
| | - Paolo Andreozzi
- Gastroenterology Unit, Department of Clinical Medicine and Surgery University Federico II, Naples, Italy
| | | | - Anna Citarella
- LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., Naples, Italy
| | | | | | - Bruno Annibale
- Medical-Surgical Science and Translational Medicine Department, Sapienza University, Rome, Italy
| | - Lamberto Manzoli
- Department of Medicine Sciences, University of Ferrara, Ferrara, Italy; Regional Healthcare Agency of Abruzzo, Pescara, Italy
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Moe N, Stenseng IH, Krokstad S, Christensen A, Skanke LH, Risnes KR, Nordbø SA, Døllner H. The Burden of Human Metapneumovirus and Respiratory Syncytial Virus Infections in Hospitalized Norwegian Children. J Infect Dis 2017; 216:110-116. [PMID: 28838133 PMCID: PMC7107394 DOI: 10.1093/infdis/jix262] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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] [Received: 02/13/2017] [Accepted: 05/26/2017] [Indexed: 01/13/2023] Open
Abstract
Background The burden of severe human metapneumovirus (HMPV) respiratory tract infections (RTIs) in European children has not been clarified. We assessed HMPV in Norwegian children and compared hospitalization rates for HMPV and respiratory syncytial virus (RSV). Methods We prospectively enrolled children (<16 years old) hospitalized with RTI and asymptomatic controls (2006-2015). Nasopharyngeal aspirate samples were analyzed with polymerase chain reaction (PCR) tests for HMPV, RSV, and 17 other pathogens. We genotyped HMPV-positive samples and assessed shedding time in 32 HMPV-infected children. Results In children with RTI, HMPV was detected in 7.3% (267 of 3650) and RSV in 28.7% (1048 of 3650). Among controls, 2.1% (7 of 339) had low HMPV levels detected by PCR, but all were culture negative. HMPV primarily occurred from January to April and in regular epidemics. At least 2 HMPV subtypes occurred each season. The average annual hospitalization rates in children <5 years old with lower RTI were 1.9/1000 (HMPV) and 10.4/1000 (RSV). Among children with RTI, the median HMPV shedding time by PCR was 13 days (range, 6-28 days), but all were culture negative (noninfectious) after 13 days. Conclusions HMPV appears in epidemics in Norwegian children, with a hospitalization rate 5 times lower than RSV. Low levels of HMPV are rarely detected in healthy children.
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Affiliation(s)
- Nina Moe
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Department of Pediatrics
| | - Inger Heimdal Stenseng
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology
| | - Sidsel Krokstad
- Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Andreas Christensen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Lars Høsøien Skanke
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Department of Pediatrics
| | - Kari Ravndal Risnes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Department of Pediatrics
| | - Svein Arne Nordbø
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Henrik Døllner
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology.,Department of Pediatrics
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Nguyen NTT, Dien TM, Schindler C, Lien NTB, Probst-Hensch N, Lan VTH, Künzli N, Perez L. Childhood hospitalisation and related deaths in Hanoi, Vietnam: a tertiary hospital database analysis from 2007 to 2014. BMJ Open 2017; 7:e015260. [PMID: 28760788 PMCID: PMC5642783 DOI: 10.1136/bmjopen-2016-015260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe hospital admission and emergency visit rates and potential risk factors of prolonged hospitalisation and death among children in Hanoi. STUDY DESIGN A retrospective study reviewed 212 216 hospitalisation records of children (aged 0-17) who attended the Vietnam National Children's Hospital in Hanoi between 2007 and 2014. Four indicators were analysed and reported: (1) rate of emergency hospital visits, (2) rate of hospitalisation, (3) length of hospital stay and (4) number of deaths. The risk of prolonged hospitalisation was investigated using Cox proportion hazard, and the risk of death was investigated through logistic regressions. RESULTS During 2007-2014, the average annual rate of emergency visits was 2.2 per 1000 children and the rate of hospital admissions was 13.8 per 1000 children. The annual rates for infants increased significantly by 3.9 per 1000 children during 2012-2014 for emergency visits and 25.1 per 1000 children during 2009-2014 for hospital admissions. Digestive diseases (32.0%) and injuries (30.2%) were common causes of emergency visits, whereas respiratory diseases (37.7%) and bacterial and parasitic infections (19.8%) accounted for most hospital admissions. Patients with mental and behavioural disorders remained in the hospital the longest (median=12 days). Morbidities related to the perinatal period dominated mortality causes (32.5% of deaths among those admitted to the hospital. Among the respiratory diseases, pneumonia was the leading cause of both prolonged hospitalisation and death. CONCLUSIONS Preventable health problems, such as common bacterial infections and respiratory diseases, were the primary causes of hospital admissions in Vietnam.
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Affiliation(s)
- Nhung T T Nguyen
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nguyen T B Lien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Vu T H Lan
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Laura Perez
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Niewiadomska E, Kowalska M, Zejda JE. Spatial and temporal variability of idiopathic pulmonary fibrosis cases in Silesian Voivodeship in years 2006-2010. Int J Occup Med Environ Health 2017; 30:593-601. [PMID: 28584328 DOI: 10.13075/ijomeh.1896.00869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Idiopathic pulmonary fibrosis (IPF) (J84.1 by the International Statistical Classification of Diseases and Related Health Problems, 10th revision - ICD-10) is a rare disease of unknown cause. Among many risk factors, occupational exposure to metal dust is enumerated. Because of metal industry concentration in the Silesian Voivodeship, Poland, an attempt of spatial and temporal variability of the idiopathic pulmonary fibrosis occurrence evaluation in 2006-2010 is made. MATERIAL AND METHODS The research is a descriptive analysis. Data of the number of new treated cases and firsttime hospitalization due to idiopathic pulmonary fibrosis in the years 2006-2010 was obtained from the National Health Found (Narodowy Fundusz Zdrowia - NFZ). We also assessed spatial and temporal variability of both rates. Data concerned adults aged ≥ 19 years old inhabited the Silesian Voivodeship. RESULTS The standardized incidence rate due to idiopathic pulmonary fibrosis increased in the study period and was in the range of 2.9-3.8/100 000 population. The highest values of incidence were observed in districts localized in the centre of the Silesian Voivodeship. CONCLUSIONS Incidence of idiopathic pulmonary fibrosis is not so high in the Silesian Voivodeship but the number of newly treated cases slightly increased in 2006-2010. Spatial and temporal variability of incidence rates for treated registered cases of idiopathic pulmonary fibrosis in the Silesian Voivodeship was observed. It could be an effect of occupational exposure to metal dust, however, final conclusions need more precise studies to the extent of analytical epidemiology. Int J Occup Med Environ Health 2017;30(4):593-601.
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Affiliation(s)
- Ewa Niewiadomska
- Medical University of Silesia, Katowice, Poland (School of Public Health in Bytom, Department of Biostatistics).
| | - Małgorzata Kowalska
- Medical University of Silesia, Katowice, Poland (School of Medicine in Katowice, Department of Epidemiology)
| | - Jan E Zejda
- Medical University of Silesia, Katowice, Poland (School of Medicine in Katowice, Department of Epidemiology)
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Niewiadomska E, Kowalska M, Zejda JE. Spatial and temporal variability of bronchiectasis cases in Silesian voivodeship in 2006-2010. Int J Occup Med Environ Health 2017; 29:699-708. [PMID: 27443764 DOI: 10.13075/ijomeh.1896.00667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/21/2022] Open
Abstract
OBJECTIVES Reports on an increasing number of hospitalizations in other European countries and the lack of epidemiological data on the prevalence of bronchiectasis in Poland constituted motivation for the authors to investigate temporal changes of the registered incidence and hospitalization due to bronchiectasis in Silesian voivodeship, and to evaluate spatial variability of the disease in the study region. MATERIAL AND METHODS The study is a descriptive epidemiological project. Temporal and spatial variability of coefficients describing numbers of newly diagnosed cases and first time hospitalizations due to bronchiectasis (code J47 according to International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10)) were evaluated based on the registered data available from the National Health Found (2006-2010) and the data from MZ/Szp-11 reports (2000-2011). The data concerned adults aged ≥ 19 years, inhabitants of Silesian voivodeship. Maps of incidence or hospitalization rates due to bronchiectasis were constructed by the use of a geographical information system ArcGIS. RESULTS The obtained results show a stable trend of reported new diseases, whereas the number of first time hospitalizations is increasing. Values of the standardized incidence were 19.9-25.1/100 000 inhabitants, and values of the standardized first-time hospitalization were 1.2-2.9/100 000 inhabitants. The reported rates of bronchiectasis indicate significant spatial differences in epidemiological situation in the study region. CONCLUSIONS The findings showed territorial variability of the incidence and hospitalization of bronchiectasis recorded in Silesian voivodeship. The observed variability might result from regional differences in the availability of specialized medical services.
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Affiliation(s)
- Ewa Niewiadomska
- Medical University of Silesia, Katowice, Poland (School of Public Health in Bytom, Department of Epidemiology and Biostatistics).
| | - Małgorzata Kowalska
- Medical University of Silesia, Katowice, Poland (School of Medicine in Katowice, Department of Epidemiology)
| | - Jan E Zejda
- Medical University of Silesia, Katowice, Poland (School of Medicine in Katowice, Department of Epidemiology)
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Restivo V, Costantino C, Tramuto F, Vitale F. Hospitalization rates for intussusception in children aged 0-59 months from 2009 to 2014 in Italy. Hum Vaccin Immunother 2017; 13:445-449. [PMID: 28075671 DOI: 10.1080/21645515.2017.1264784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 10/20/2022] Open
Abstract
The real cause of intussusception is not fully understood and a variety of conditions have been associated with it (Meckel diverticulum, polyps, duplication cysts, parasites, Henoch-Schönlein purpura, cystic fibrosis, hemolytic-uremic syndrome and infectious gastroenteritis). Furthermore few European countries, following WHO recommendation to monitor baseline incidence of intussusception before implementation of immunization program for rotavirus, used intussusception rate as a baseline value to compare the same figures in the period before and after introduction of vaccination. In this study, data of intussusception hospitalizations occurred among Italian children aged 0 through 59 months from 2009 to 2014 were analyzed. A total amount of 3,088 children were included, accounting for a hospitalization rate of 20.2 per 100,000. Overall, the hospitalization rate for intussusception had a slight increase in trend from 2009 to 2014 (18%). In particular children 0-11 months had a hospitalization rate higher than 12-59 months with an aggregate value of 36 Vs. 16 per 100,000 respectively. Among all children hospitalized for intussusception a total of 239 (7.7%) had also a previous or concomitant hospitalization for gastroenteritis. This study demonstrates that Italian hospitalizations for intussusception are increasing by time and the role played by different risk factors, including acute gastroenteritis, have to be investigated in the future. These data could be useful to monitor intussusception hospitalization in the perspective of anti-rotavirus vaccination introduction in Italy.
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Affiliation(s)
- Vincenzo Restivo
- a Department of Science for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo , Italy
| | - Claudio Costantino
- a Department of Science for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo , Italy
| | - Fabio Tramuto
- a Department of Science for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo , Italy
| | - Francesco Vitale
- a Department of Science for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo , Italy
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Teshale EH, Xing J, Moorman A, Holmberg SD, Spradling PR, Gordon SC, Rupp LB, Lu M, Boscarino JA, Trinacity CM, Schmidt MA, Xu F. Higher all-cause hospitalization among patients with chronic hepatitis C: the Chronic Hepatitis Cohort Study (CHeCS), 2006-2013. J Viral Hepat 2016; 23:748-54. [PMID: 27186944 DOI: 10.1111/jvh.12548] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 01/08/2016] [Accepted: 04/04/2016] [Indexed: 01/28/2023]
Abstract
In the United States, hospitalization among patients with chronic hepatitis C virus (HCV) infection is high. The healthcare burden associated with hospitalization is not clearly known. We analysed data from the Chronic Hepatitis Cohort Study, an observational cohort of patients receiving care at four integrated healthcare systems, collected from 2006 to 2013 to determine all-cause hospitalization rates of patients with chronic HCV infection and the other health system patients. To compare the hospitalization rates, we selected two health system patients for each chronic HCV patient using their propensity score (PS). Propensity score matching was conducted by site, gender, race, age and household income to minimize differences attributable to these characteristics. We also compared primary reason for hospitalization between chronic HCV patients and the other health system patients. Overall, 10 131 patients with chronic HCV infection and 20 262 health system patients were selected from the 1 867 802 health system patients and were matched by PS. All-cause hospitalization rates were 27.4 (27.0-27.8) and 7.4 (7.2-7.5) per 100 persons-year (PY) for chronic HCV patients and for the other health system patients, respectively. Compared to health system patients, hospitalization rates were significantly higher by site, gender, age group, race and household income among chronic HCV patients (P < 0.001). Compared to health system patients, chronic HCV patients were more likely to be hospitalized from liver-related conditions (RR = 24.8, P < 0.001). Hence, patients with chronic HCV infection had approximately 3.7-fold higher all-cause hospitalization rate than other health system patients. These findings highlight the incremental costs and healthcare burden of patients with chronic HCV infection associated with hospitalization.
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Affiliation(s)
- E H Teshale
- Division of Viral Hepatitis, CDC, Atlanta, GA, USA.
| | - J Xing
- Division of Viral Hepatitis, CDC, Atlanta, GA, USA
| | - A Moorman
- Division of Viral Hepatitis, CDC, Atlanta, GA, USA
| | - S D Holmberg
- Division of Viral Hepatitis, CDC, Atlanta, GA, USA
| | | | | | - L B Rupp
- Henry Ford Hospital, Detroit, MI, USA
| | - M Lu
- Henry Ford Hospital, Detroit, MI, USA
| | | | | | - M A Schmidt
- Kaiser Permanente Northwest, Portland, OR, USA
| | - F Xu
- Division of Viral Hepatitis, CDC, Atlanta, GA, USA
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Mitselou N, Hedlin G, Hederos CA. Spacers versus nebulizers in treatment of acute asthma - a prospective randomized study in preschool children. J Asthma 2016; 53:1059-62. [PMID: 27186989 DOI: 10.1080/02770903.2016.1185114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare administration of bronchodilators by nebulizers with delivery by metered dose inhalers (MDIs) with spacers and to evaluate the clinical effect of the treatment of acute asthma in preschool children. METHODS A prospective randomized clinical trial in a pediatric emergency department (PED). Preschool children who were admitted for virus induced wheezing or acute asthma exacerbation were randomly allocated to receive bronchodilator treatment by nebulizer or by metered dose inhaler. The accompanying parents completed a questionnaire. RESULTS The length of stay in the PED and the hospitalization rate were similar and no difference was seen in the parents' view of ease of use and device acceptance. Baseline data were similar for both groups apart from the family history of asthma and atopic disease that was greater in the nebulizer group. No significant differences were seen in heart rate, respiratory rate and oxygen saturation at baseline and after the treatment. According to the parents 40% of the participants had asthma diagnosis though up to 66% had some kind of asthma medication. CONCLUSIONS Our data suggests that MDIs with spacers are at least as effective as nebulizers in the delivery of beta agonists to treat preschool children with virus induced wheezing or acute exacerbations of asthma in the PED. Parents may underestimate the gravity of their children's asthma. It is mandatory to provide adequate information to the staff and parents in order to treat pediatric acute asthma successfully.
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Affiliation(s)
- Niki Mitselou
- a Department of Pediatrics , Örebro University Hospital , Örebro , Sweden
| | - Gunilla Hedlin
- b Department of Women's and Children's Health and Centre for Allergy Research , Karolinska Institutet, Astrid Lindgren Children's Hospital , Stockholm , Sweden
| | - Carl-Axel Hederos
- c Department of Pediatrics , Karlstad Central Hospital , Karlstad , Sweden
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Wang SM, Yin LY, Zhang Y, Fan JH, Chang IJ, Dawsey SM, Taylor PR, Abnet CC, Qiao YL. Multivitamin and mineral supplementation is associated with the reduction of fracture risk and hospitalization rate in Chinese adult males: a randomized controlled study. J Bone Miner Metab 2015; 33:294-302. [PMID: 24849736 PMCID: PMC5878018 DOI: 10.1007/s00774-014-0589-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 03/27/2014] [Indexed: 12/31/2022]
Abstract
Controversy exists in the literature regarding the efficacy of bone health-related nutrients, especially calcium and vitamin D, in preventing fractures. The aim of our present study was to determine the effect of multivitamin and mineral supplementation on fracture incidence among 3,318 participants from a nutritional intervention trial in Linxian, China. A total of 1,461 men and 1,857 women were enrolled and randomized to daily supplementation with 26 vitamins and minerals tablet or placebo pills for 6 years, followed by a 16-year post-interventional follow-up. The dates, sites, and causes of the fractures were collected retrospectively via a standardized questionnaire. Cox proportional hazard model was used to estimate hazard ratios and 95% confidence intervals of fracture incidence in the intervention versus the placebo group. A total of 221 fractures (57 in men and 164 in women) occurred during the entire study period of 21 years and 9 months. In men, the supplement reduced the risk of fracture by 63% during the trial period, and this protective effect was sustained and statistically significant when analysis included both the trial period and 5- or 10-year post-intervention follow-up (years 0-11, P = 0.04; years 0-16, P = 0.02, respectively). The protection against fracture was not apparent >10 years after cessation of the intervention. In women, no significant effect of supplementation on fracture incidence was seen in any of the study periods. These results demonstrate that a 6-year multivitamin and mineral intervention was associated with significant reduction of fracture risk and fracture-related hospitalization in men, but not in women.
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Affiliation(s)
- Shao-Ming Wang
- Cancer Institute/Hospital,, Chinese Academy of Medical Sciences, (17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, People’s Republic of China)
| | - Liang-Yu Yin
- Cancer Institute/Hospital,, Chinese Academy of Medical Sciences, (17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, People’s Republic of China)
| | - Yu Zhang
- Cancer Institute/Hospital,, Chinese Academy of Medical Sciences, (17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, People’s Republic of China)
| | - Jin-Hu Fan
- Cancer Institute/Hospital,, Chinese Academy of Medical Sciences, (17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, People’s Republic of China)
| | - Irene J. Chang
- Miller School of Medicine, University of Miami, (1150 Northwest 14th Street, Miami, FL 33136, United States of America)
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, (6120 Executive Boulevard, MSC 7242, Bethesda, Maryland 20892-7335, United States of America)
| | - Philip R. Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, (6120 Executive Boulevard, MSC 7242, Bethesda, Maryland 20892-7335, United States of America)
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, (6120 Executive Boulevard, MSC 7242, Bethesda, Maryland 20892-7335, United States of America)
- Correspondence to both: You-Lin Qiao, Department of Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, 17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, PR China, Phone: 011-86-10-8778-8489, Fax: 011-86-10-6771-3648, ; Christian C. Abnet, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 3042, 6120 Executive Boulevard, MSC 7232, Bethesda, Maryland 20892-7232, Phone: 301-594-1511, Fax: 301-496-6829,
| | - You-Lin Qiao
- Cancer Institute/Hospital,, Chinese Academy of Medical Sciences, (17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, People’s Republic of China)
- Correspondence to both: You-Lin Qiao, Department of Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, 17# South Panjiayuan Lane, Chaoyang District, Beijing 100021, PR China, Phone: 011-86-10-8778-8489, Fax: 011-86-10-6771-3648, ; Christian C. Abnet, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 3042, 6120 Executive Boulevard, MSC 7232, Bethesda, Maryland 20892-7232, Phone: 301-594-1511, Fax: 301-496-6829,
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Zhang J, Liu H, Jia L, Payne DC, Hall AJ, Xu Z, Gao Z, Chang Z, Jiang B, Parashar UD, Meng L, Yu H, Duan Z. Active, population-based surveillance for rotavirus gastroenteritis in Chinese children: Beijing Municipality and Gansu Province, China. Pediatr Infect Dis J 2015; 34:40-6. [PMID: 25105897 DOI: 10.1097/INF.0000000000000505] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Estimates of population-based incidence for rotavirus inpatient and outpatient visits, as well as their associated medical costs, can provide valuable information to assess the potential benefits of rotavirus vaccination. METHODS We conducted active surveillance for rotavirus gastroenteritis at 6 medical institutions for children younger than 5 years from July 2012 to June 2013 in Beijing Municipality and Gansu Province. We collected stool samples of diarrhea patients for testing rotavirus, and epidemiological, clinical and cost data. RESULTS The proportion of rotavirus-positive for inpatient and outpatient visits from Beijing was 28.7% (138/481) and 19.4% (133/687); a statistically lower proportion than observed in Gansu among inpatient visits (45.2%, 245/542, P < 0.001) and among outpatient visits (28.8%, 66/229, P = 0.003), respectively. The G9P[8] genotype was most prevalent in Beijing (60.6%) and in Gansu (77.6%). The median Vesikari scale value was 16 for rotavirus inpatients and 15 for nonrotavirus inpatients. Population-based estimated rates of rotavirus-related hospitalizations were 14.4 (95% CI, 13-16) per 10,000 children, and the rate of rotavirus gastroenteritis in the outpatient setting was 149 (95% CI, 145-153) per 10,000 children younger than 5 years. The estimated total number of rotavirus-related inpatient visits were 3790 (95% CI, 2488-3827) cases and 29,101 (95% CI: 27,748-29,279) outpatient visits. The total cost of rotavirus infection was $1.4 million (95% CI, $0.9-1.4 million) for hospitalizations and $4.2 million (95% CI, $4.0-4.2 million) for outpatient visits per year in Beijing and Gansu. CONCLUSION Rotavirus is the most common cause of severe acute gastroenteritis (AGE) in children younger than 5 years worldwide,accounting for an estimated 25 million clinic visits, 2 million hospitalizations and 453,000 deaths each year. In China, the world's most populous nation, surveillance at sentinel hospitals showed that approximately 48% of AGE hospitalizations among children younger than 5 years were attributed to rotavirus from 2003 to 2007, and 13,387 rotavirus deaths were estimated in China in 2002 alone.The Lanzhou lamb rotavirus vaccine, consisting of serotype G10P[12], was licensed in 2000 but is not included in the National Expanded Program of Immunization vaccine recommendations for Chinese children. License applications for new rotavirus vaccines (Rotarix, produced by GlaxoSmithKline Biologicals, and RotaTeq, produced by Merck and Company) have been submitted for administering these vaccines to Chinese infants [corrected].
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Saborío GG, Clara A, Garcia A, Quesada F, Palekar R, Minaya P, Cervantes M, Lopez M, Lara J, Jara J, Blanco N, Bresee J, Widdowson MA, Azziz-Baumgartner E. Influenza-associated Hospitalizations and Deaths, Costa Rica, 2009-2012. Emerg Infect Dis 2014; 20:878-81. [PMID: 24750897 PMCID: PMC4012819 DOI: 10.3201/eid2005.131775] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Data needed to guide influenza vaccine policies are lacking in tropical countries. We multiplied the number of severe acute respiratory infections by the proportion testing positive for influenza. There were ≈6,699 influenza hospitalizations and 803 deaths in Costa Rica during 2009-2012, supporting continuation of a national influenza vaccine program.
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Hsiao HJ, Wang LC, Yang YH, Lee JH, Yu HH, Lin YT, Chiang BL. A nationwide survey of the severity, comorbidity, and mortality of hospitalized patients with asthma in Taiwan. Pediatr Neonatol 2013; 54:254-60. [PMID: 23597519 DOI: 10.1016/j.pedneo.2013.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/30/2012] [Accepted: 01/29/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To clarify the epidemiology of asthma admission in a nationwide survey, we analyze the characteristics of hospitalized patients in Taiwan. METHODS Data regarding asthma-associated hospitalizations were obtained from the National Health Insurance Research Database of Taiwan from January 2001 to December 2002. Patient characteristics in terms of severity, mortality, and cost were stratified by age, gender, and presence of comorbidities. RESULTS A total of 59,983 hospitalizations with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 493.xx and asthma-related treatment were included in the current analysis. When stratified by age, the number and duration of hospitalizations were distributed in J-shape distribution, with the nadir located in the range of 8-18 years of age. The severity of asthma was found to increase with age (p < 0.001) and was more severe in men compared with women (p < 0.001). The severity of in-hospital patients was significantly greater in subjects with underlying respiratory disease compared to patients with other comorbidities, such as cardiovascular disease and infectious disease. The mortality rates of all hospitalized asthma patients and pediatric hospitalized asthma patients were 0.77% and 0.02%, respectively. The risk factor for mortality of asthma was older age and male gender in multiple regression. CONCLUSION The severity of asthma increased after 18 years of age. Increased comorbidities in elderly patients might contribute to asthma severity. The mortality rate was low in pediatric patients and significantly increased in males and the elderly. The above findings suggest that additional effort is required in the treatment of elderly and male asthmatic patients.
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Affiliation(s)
- Hui-Ju Hsiao
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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Hans U, Edward B. Regular vitamin C supplementation during pregnancy reduces hospitalization: outcomes of a Ugandan rural cohort study. Pan Afr Med J 2010; 5:15. [PMID: 21293742 PMCID: PMC3032617 DOI: 10.4314/pamj.v5i1.56178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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] [Received: 05/26/2010] [Accepted: 05/27/2010] [Indexed: 11/17/2022] Open
Abstract
Background Vitamin C or ascorbic acid is a hydro-soluble lactone (synthesized from glucose) essential to human body and available from diet. Despite its broad availability in fruits and vegetables, in many developing countries the incidence of clinical symptoms due to the vitamin deficiency is still very high. Also, pregnant women in the developing countries are frequently hospitalized for several preventable reasons such as anemia in pregnancy, mostly iron-deficient anemia (IDA) and the upper/lower respiratory tract infections (RTI). The aim of the study was to investigate, in a Ugandan rural pregnant women cohort, the preventive effects of vitamin C supplementation on hospital admission. Methods 384 pregnant women met the inclusion criteria and were randomly assigned to receive either 400 mg of vitamin C daily (187) or not (197) in addition to their standard antenatal vitamins until delivery. The primary outcome measure of this study was to assess the prevention of hospitalization during pregnancy in the group of women supplemented with vitamin C compared to the controls. Fisher‘s exact test was employed in this assessment. Results 42.2% women in the vitamin C group and 27.9% in the control group were not hospitalized during pregnancy; this difference was found statistically significant. Conclusion The results of this study suggest including vitamin C in the guidelines of multivitamin prevention for pregnant women, especially in developing countries where seasonal availability of fruits and vegetables could result in adverse clinical outcomes.
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Affiliation(s)
- Unim Hans
- Gastroenterology Unit, Department of Clinical Sciences, University La Sapienza, Rome, Italy
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