scholarly journals Regional differences in mortality rates during the COVID-19 epidemic in Italy

2020 ◽  
pp. 1-22
Author(s):  
Danila Azzolina ◽  
Giulia Lorenzoni ◽  
Luciano Silvestri ◽  
Ilaria Prosepe ◽  
Paola Berchialla ◽  
...  
Keyword(s):  
Regional Differences ◽  
Southern Italy ◽  
Meta Analysis ◽  
Analysis Data ◽  
Mortality Rates ◽  
Northern Italy ◽  
Admission Rates ◽  
Considerable Impact ◽  
The Difference ◽  
Disease Diffusion

Abstract Objective The COVID-19 outbreak started in Italy on February 20th, 2020, and has resulted in many deaths and intensive care unit (ICU) admissions. This study aimed to illustrate the epidemic COVID-19 growth pattern in Italy by considering the regional differences in disease diffusion during the first three months of the epidemic. Study design and methods Official COVID-19 data were obtained from the Italian Civil Protection Department of the Council of Ministers Presidency. The mortality and ICU admission rates per 100 000 inhabitants were calculated at the regional level and summarized via a Bayesian multilevel meta-analysis. Data were retrieved until April 21st, 2020. Results The highest cumulative mortality rates per 100 000 inhabitants were observed in northern Italy, particularly in Lombardia (85.3, 95% credibility intervals [CI] 75.7–94.7). The difference in the mortality rates between northern and southern Italy increased over time, reaching a difference of 67.72 (95% CI = 66–67) cases on April 2nd. Conclusions Northern Italy showed higher and increasing mortality rates during the first three months of the epidemic. The uncontrolled virus circulation preceding the infection spreading in southern Italy had a considerable impact on system burnout. This experience demonstrates that preparedness against the pandemic is of crucial importance to contain its disruptive effects.

Variations between and within Countries in Hospital Care for Peptic Ulcer

1982 ◽  
Vol 10 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Bengt Jönsson ◽  
Raymunda Silverberg
Keyword(s):  
Duodenal Ulcer ◽  
Regional Differences ◽  
Hospital Care ◽  
Mortality Rates ◽  
Hospital Patient ◽  
Ulcer Disease ◽  
Hospital Resources ◽  
Bed Days ◽  
The Difference ◽  
Surgical Operations

The present study tries to examine variations in utilization rates for hospital care for ulcer disease between and within Denmark and Sweden. The focus is on how utilization rates differ but an attempt is also made to explain why regional differences occur. Hospital patient statistics from both countries show that ulcer disease accounts for 35% more bed-days per 100 000 inhabitants in Denmark than in Sweden. The main source for this difference is duodenal ulcer, where the number of bed-days is 63% higher in Denmark. The differences in length of stay are negligible and the numbers of surgical operations are about the same in the two countries. The greater utilization of hospital resources in Denmark is explained mainly by the fact that more medical cases are treated as in-patients in Denmark than in Sweden. Neither mortality rates nor other data support the hypothesis that the incidence of duodenal ulcer is higher in Denmark than in Sweden. The difference between Denmark and Sweden widens when utilization rates are adjusted for differences in the age structure of the population in the two countries. There are wide variations in utilization rates between regions within both countries. The findings support the hypothesis that the intertemporal change in the technology for management of ulcer disease is one of the main reasons for variations between and within countries.

scholarly journals Effect of the COVID-19 pandemic on mortality of patients with STEMI: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
pp. heartjnl-2020-318360
Author(s):  
Manuel Rattka ◽  
Jens Dreyhaupt ◽  
Claudia Winsauer ◽  
Lina Stuhler ◽  
Michael Baumhardt ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Incidence Rates ◽  
St Segment Elevation ◽  
Admission Rates ◽  
St Segment ◽  
Significant Difference ◽  
Door To Balloon

AimsSince the beginning of the SARS-CoV-2 outbreak, hospitals reported declining numbers of patients admitted with ST-segment elevation myocardial infarction (STEMI), indicating that the pandemic might keep patients from seeking urgent medical treatment. However, data on outcomes and mortality rates are inconsistent between studies.MethodsA literature search and meta-analysis were performed on studies reporting the mortality of patients with STEMI admitted before and during the COVID-19 pandemic using PubMed, Embase and Web of Science. Additionally, prehospital and intrahospital delay times were evaluated.ResultsOutcomes of a total of 50 123 patients from 10 studies were assessed. Our study revealed that, despite a significant reduction in overall admission rates of patients with STEMI during the COVID-19 pandemic (incidence rate ratio=0.789, 95% CI 0.730 to 0.852, I2=77%, p<0.01), there was no significant difference in hospital mortality (OR=1.178, 95% CI 0.926 to 1.498, I2=57%, p=0.01) compared with patients with STEMI admitted before the outbreak. Time from the onset of symptoms to first medical contact was similar (mean difference (MD)=33.4 min, 95% CI −10.2 to 77.1, I2=88%, p<0.01) while door-to-balloon time was significantly prolonged in those presenting during the pandemic (MD=7.3 min, 95% CI 3.0 to 11.7, I2=95%, p<0.01).ConclusionThe significant reduction in admission of patients with STEMI was not associated with a significant increase of hospital mortality rates. The causes for reduced incidence rates remain speculative. However, the analysed data indicate that acute and timely medical care of these patients has been maintained during the pandemic in most countries. Long-term data on mortality have yet to be determined.

scholarly journals A systematic review and meta-analysis of regional risk factors for critical outcomes of COVID-19 during early phase of the pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyung-Jun Kim ◽  
Hyeontaek Hwang ◽  
Hyunsook Hong ◽  
Jae-Joon Yim ◽  
Jinwoo Lee
Keyword(s):  
Risk Factors ◽  
North America ◽  
Regional Differences ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Hepatic Disease ◽  
Medical Conditions ◽  
Laboratory Findings ◽  
Patient Demographics ◽  
Included Patient

AbstractThe mortality rates of COVID-19 vary across the globe. While some risk factors for poor prognosis of the disease are known, regional differences are suspected. We reviewed the risk factors for critical outcomes of COVID-19 according to the location of the infected patients, from various literature databases from January 1 through June 8, 2020. Candidate variables to predict the outcome included patient demographics, underlying medical conditions, symptoms, and laboratory findings. The risk factors in the overall population included sex, age, and all inspected underlying medical conditions. Symptoms of dyspnea, anorexia, dizziness, fatigue, and certain laboratory findings were also indicators of the critical outcome. Underlying respiratory disease was associated higher risk of the critical outcome in studies from Asia and Europe, but not North America. Underlying hepatic disease was associated with a higher risk of the critical outcome from Europe, but not from Asia and North America. Symptoms of vomiting, anorexia, dizziness, and fatigue were significantly associated with the critical outcome in studies from Asia, but not from Europe and North America. Hemoglobin and platelet count affected patients differently in Asia compared to those in Europe and North America. Such regional discrepancies should be considered when treating patients with COVID-19.

Relationship between total plasma homocysteine and the risk of aneurysms – a meta-analysis

VASA ◽  
2020 ◽  
pp. 1-6
Author(s):  
Hanji Zhang ◽  
Dexin Yin ◽  
Yue Zhao ◽  
Yezhou Li ◽  
Dejiang Yao ◽  
...  
Keyword(s):  
Large Scale ◽  
Meta Analysis ◽  
Single Species ◽  
Total Plasma ◽  
Control Groups ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
The Difference ◽  
The Relationship ◽  
Healthy Participants

Summary: Our meta-analysis focused on the relationship between homocysteine (Hcy) level and the incidence of aneurysms and looked at the relationship between smoking, hypertension and aneurysms. A systematic literature search of Pubmed, Web of Science, and Embase databases (up to March 31, 2020) resulted in the identification of 19 studies, including 2,629 aneurysm patients and 6,497 healthy participants. Combined analysis of the included studies showed that number of smoking, hypertension and hyperhomocysteinemia (HHcy) in aneurysm patients was higher than that in the control groups, and the total plasma Hcy level in aneurysm patients was also higher. These findings suggest that smoking, hypertension and HHcy may be risk factors for the development and progression of aneurysms. Although the heterogeneity of meta-analysis was significant, it was found that the heterogeneity might come from the difference between race and disease species through subgroup analysis. Large-scale randomized controlled studies of single species and single disease species are needed in the future to supplement the accuracy of the results.

Age Differences in Eye Movements During Reading: Degenerative Problems or Compensatory Strategy?

2019 ◽  
Vol 24 (4) ◽  
pp. 297-311
Author(s):  
José David Moreno ◽  
José A. León ◽  
Lorena A. M. Arnal ◽  
Juan Botella
Keyword(s):  
Eye Movements ◽  
Eye Movement ◽  
Meta Analysis ◽  
Age Groups ◽  
Behavioral Changes ◽  
Aging Effects ◽  
Movement Data ◽  
Sentence Reading ◽  
The Difference ◽  
Eye Movements During Reading

Abstract. We report the results of a meta-analysis of 22 experiments comparing the eye movement data obtained from young ( Mage = 21 years) and old ( Mage = 73 years) readers. The data included six eye movement measures (mean gaze duration, mean fixation duration, total sentence reading time, mean number of fixations, mean number of regressions, and mean length of progressive saccade eye movements). Estimates were obtained of the typified mean difference, d, between the age groups in all six measures. The results showed positive combined effect size estimates in favor of the young adult group (between 0.54 and 3.66 in all measures), although the difference for the mean number of fixations was not significant. Young adults make in a systematic way, shorter gazes, fewer regressions, and shorter saccadic movements during reading than older adults, and they also read faster. The meta-analysis results confirm statistically the most common patterns observed in previous research; therefore, eye movements seem to be a useful tool to measure behavioral changes due to the aging process. Moreover, these results do not allow us to discard either of the two main hypotheses assessed for explaining the observed aging effects, namely neural degenerative problems and the adoption of compensatory strategies.

ANALYTICAL INDICATOR. ANALYSIS OF THE REAL STATE OF DYNAMICS OF MORTALITY OF THE POPULATION OF RUSSIA FROM MALIGNANT TUMORS AND CHANGES IN ITS STRUCTURE

2019 ◽  
Vol 65 (2) ◽  
pp. 205-219 ◽  
Author(s):  
V. Merabishvili
Keyword(s):  
Malignant Tumors ◽  
Specific Weight ◽  
Mortality Rates ◽  
Retirement Age ◽  
Medium Term ◽  
Age Composition ◽  
The Real ◽  
Indicator Analysis ◽  
The Difference ◽  
Real State

The mortality rate is one of the most important criteria for assessing the health of the population. However, it is important to use analytical indicators correctly, especially when evaluating time series. The value of the “gross” mortality is closely linked with a specific weight of persons of elderly and senile ages. All international publications (WHO, IARC, territorial cancer registers) assess the dynamics of morbidity and mortality only by standardized indicators that eliminate the difference in the age composition of the compared population groups. In Russia, from 1960 to 2017, the share of people of retirement age has increased more than 2 times. The structure of mortality from malignant tumors has changed dramatically. The paper presents the dynamics of gross and standardized mortality rates from malignant tumors in Russia and in all administrative territories. Shows the real success of the Oncology service. The medium-term interval forecast until 2025 has been calculated.

PENGAKUAN CALABAI: SEBUAH ANALISIS INTERTEKSTUAL NOVEL PASUNG JIWA KARYA OKKY MADASARI DAN NOVEL CALABAI KARYA PEPI AL-BAYQUNIE

Jurnal KATA ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 50
Author(s):  
Krisna Aji Kusuma ◽  
Herman J Waluyo ◽  
Nugraheni Eko Wardani
Keyword(s):  
Content Analysis ◽  
Analysis Data ◽  
Qualitative Approach ◽  
The Novel ◽  
Research Results ◽  
Self Actualization ◽  
Similarities And Differences ◽  
The Difference ◽  
Descriptive Qualitative

<p><em>This study aims to describe the intertextuality relationship between the novel Pasung Jiwa by Okky Madasari and Calabai by Pepi Al-Bayqunie. The type of research is descriptive qualitative approach using content analysis. Data are collected by inventorying events that are similarities and differences, specifications on the characters, settings, plots, and themes of both text. The research results indicate that there are similar themes on the two novels, the theme of self actualization in addition with the theme of family and friendship. The same characterization are also used by both author, masculine figures with feminine soul characters. The difference between the two novels lies on the plot and setting. Pasung Jiwa uses progressive plot and Calabai uses a flash-back plot.. Okky Madasari takes Java Island as the background in the novel Pasung Jiwa, while the novel Calabai, Pepi Al-Bayqunie using the setting of Sulawesi Island. The basis of the similarity of theme and characterization supported by the similirity of events in the story shows the existence of intertextual relationship between the two novels. As a previously published work, the novel Pasung Jiwa by Okky Madasari is a hipogram and novel Calabai by Pepi A-Bayqunie as a transformational text. On the theme and characterization, the transformation of Calabai forward the hypogram, while in the plot and setting deviates his hypogram, Pasung Jiwa.</em></p><p>Penelitian ini bertujuan untuk mendeskripsikan hubungan intertekstualitas antara novel Pasung Jiwa karya Okky Madasari dan novel Calabai karya Pepi Al-Bayqunie. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan konten analisis. Data dikumpulkan dengan menginventariskan peristiwa yang merupakan persamaan dan perbedaan, spesifikasi pada tokoh, latar, alur, dan tema dari kedua teks. Hasil penelitian ini menunjukkan bahwa terdapat kesamaan tema pada kedua novel, yaitu tema aktualisasi diri, ditambah dengan tema keluarga dan persahabatan. Penokohan yang sama juga digunakan oleh kedua penulis, yaitu tokoh maskulin dengan karakter jiwa feminin. Perbedaan kedua novel terletak pada alur dan latar. Pasung Jiwa menggunakan alur maju dan Calabai menggunakan alur campuran. Latar dalam novel Pasung Jiwa, Okky Madasari mengambil latar Pulau Jawa, sedangkan novel Calabai, Pepi Al-Bayqunie menggunakan latar Pulau Sulawesi. Dasar kesamaan tema dan penokohan didukung kesamaan peristiwa-peristiwa dalam cerita menunjukkan adanya hubungan intertekstual antara kedua novel. Sebagai karya yang terbit terlebih dahulu menjadikan novel Pasung Jiwa karya Okky Madasari adalah hipogram dan novel Calabai karya Pepi Al-Bayqunie sebagai teks transformasi. Pada tema dan penokohan, transformasi Calabai meneruskan hipogram, sedangkan pada alur dan latar menyimpangi hipogramnya, Pasung Jiwa.</p>

scholarly journals P89 Patient reported comorbidity is not a reliable data source: a systematic review of the literature

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chung Mun Alice Lin ◽  
Alexander Orman ◽  
Nicholas D Clement ◽  
David J Deehan ◽  
Chung M A Lin
Keyword(s):  
Medical Record ◽  
Meta Analysis ◽  
Analysis Data ◽  
Fundamental Factor ◽  
Resource Limitations ◽  
Patient Reported ◽  
Data Source ◽  
Reported Data ◽  
Operative Assessment ◽  
Source Of Information

Abstract Introduction There is currently an increased demand for elective orthopaedic surgery. However, due to the ever-growing financial, time and resource limitations, there is a pressing need to identify those who would benefit most from surgery but with the lowest risk of complications. Comorbidities are a fundamental factor in this decision and the traditional way to ascertain this is through medical record data abstraction during pre-operative assessment. However, this can be time consuming and expensive. We therefore set out to establish whether patient reported comorbidities are reliable as a principal source of information. Method Searches were performed on PubMed and Medline, and citations independently screened. Included studies were published between 2010 to 2020 assessing the reliability of at least one patient reported comorbidity against their medical record or clinical assessment as gold standard. Cohen’s kappa coefficient values were grouped into systems and a meta-analysis performed comparing the reliability between studies. Results Meta-analysis data showed poor-to-moderate reliability for diseases in cardiovascular, musculoskeletal, neurological and respiratory systems as well as for malignancy and depression. Endocrine diseases showed good-to-excellent reliability. Factors found to affect the concordance included sex, age, ethnicity, education, living alone, marital status, number or severity of comorbidities, mental health and disability. Conclusion Our study showed poor-to-moderate reliability for all systems except endocrine, consisting of thyroid disease and diabetes mellitus, which demonstrated good-to-excellent reliability. Although patient reported data is useful and can facilitate a complete pre-operative overview of the patient, it is not reliable enough to be used as a standalone measure.

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