Trend of hospital utilization for encephalitis

SUMMARYEncephalitis generally results in a serious illness requiring hospitalization. The aim of this study was to describe the epidemiology of hospitalization for encephalitis in Italy, taking into account the geographical distribution, aetiology, seasonality and evolution of hospitalization rates over recent years. The mean hospitalization rate was 5·88/100 000. For most of these hospitalizations (n=13 119, 55·6%), no specific cause of encephalitis was reported. The most common aetiological category was ‘viral’, which accounted for 40·1% (n=4205) of such hospitalizations (rate 1·05/100 000). Within this category, herpes virus was the leading causative agent (n=1579, 0·39/100 000). This report highlights a significant increase of ‘viral encephalitis not otherwise specified’ (ICD-9 code 049·9) vs. a reduction of all other causes. A seasonal pattern was noted in people aged ⩾65 years in this group. Specific surveillance of encephalitis without known origin should be reinforced in order to identify the potential role of emerging pathogens and to design preventive interventions.

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Study of the Immunological Status of Iraqi Vitiligo Patients

Baghdad Science Journal ◽

10.21123/bsj.13.3.454-462 ◽

2016 ◽

Vol 13 (3) ◽

pp. 454-462

Author(s):

Baghdad Science Journal

Keyword(s):

Potential Role ◽

Immunoglobulin E ◽

Ultraviolet B ◽

Enzyme Linked Immunosorbent Assay ◽

Control Serum ◽

Healthy Control ◽

The Mean ◽

Age Range ◽

Apparently Healthy

Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Assay (ELISA); while immunoglobulins (IgM, IgG and IgA) were detected by using Single Radial Immunodiffusion (SRID) method. The results showed that the mean levels of serum IL-17A and TNF-? in both untreated and NB-UVB treated vitiligo patients were increased significantly (p ? 0.05) as compared with healthy control. The mean levels of serum IgG and IgA in untreated vitiligo patients showed non significant decreased (P

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Treatment of Large Non-Muscle-Invasive Bladder Cancer: The Potential Role of Neoadjuvant Intravesical Chemotherapy

Urologia Internationalis ◽

10.1159/000512052 ◽

2020 ◽

pp. 1-6

Author(s):

Marco Raber ◽

Noor Buchholz ◽

Augusto Vercesi ◽

Nashaat A. Hendawi ◽

Vincenzo Inneo ◽

...

Keyword(s):

Potential Role ◽

Tumor Volume ◽

Neoadjuvant Treatment ◽

Complete Resection ◽

Bladder Mucosa ◽

Bladder Tumors ◽

Muscle Invasive Bladder Cancer ◽

The Mean ◽

Muscle Invasive

Introduction: The endoscopic resection of large and bulky bladder cancers represents a challenge. To reduce the tumor and make it more easy to resect, we used neoadjuvant short and intensive intravesical mitomycin (MMC) therapy. Methods: Patients with large bladder tumors were evaluated for this study. At cystoscopy, the surgeon evaluated the feasibility of complete resection. In patients where this was not possible, biopsies from the tumor, bladder mucosa, and prostatic urethra were taken. These patients then underwent a short and intensive cytoreductive schedule of intravesical MMC. This was then followed by TUR-BT. Results: Fifteen patients were included in our study. The mean age was 74 years (range: 56–82; SD ±6 years). Mean tumor size was 51 mm (range: 35–65; SD ±8 mm). After neoadjuvant treatment, complete resection was then feasible in all patients. The mean tumor volume after the chemo-resection had reduced to 34 mm (range: 10–50; SD ±13 mm). No adverse effects were reported. Conclusion: Intravesical cytoreductive neoadjuvant MMC as an initial treatment of large NMIBC can be considered safe, effective, and feasible.

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Hospitalization burden and comorbidities of patients with rheumatoid arthritis in Spain during the period 2002-2017

10.21203/rs.2.13530/v2 ◽

2020 ◽

Author(s):

Mario Gil-Conesa ◽

Juan Antonio Del-Moral-Luque ◽

Ruth Gil-Prieto ◽

Ángel Gil-de-Miguel ◽

Ramón Mazzuccheli-Esteban ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Circulatory System ◽

Length Of Hospital Stay ◽

Hospitalization Rate ◽

Main Diagnosis ◽

Autoimmune Rheumatic Disease ◽

Hospitalization Rates ◽

The Mean ◽

Spanish Health ◽

Observational Descriptive Study

Abstract Background: Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that is associated with multiple comorbidities and has a significant economic impact on the Spanish health system. The objective of this study was to estimate the rates of hospitalization of rheumatoid arthritis in Spain, and describing hospitalization rates and it's changing by age, region, RA variant, and when RA as a main cause of hospitalization or a comorbidity. Methods: Observational descriptive study that reviewed hospital records from the CMBD. We included all hospitalizations of patients in Spain whose main diagnosis or comorbidity in the ICD-9-CM was rheumatoid arthritis during the period of 2002-2017. Results: A total of 315,190 hospitalizations with the RA code were recorded; 67.3% were in women. The mean age of the patients was 68.5 ± 13.9 years. The median length of hospital stay was 7 days (IQR 3-11 days). In 29,809 of the admissions, RA was coded as the main diagnosis (9.4%). When RA was not coded as the main diagnosis, the most frequent main diagnoses were diseases of the circulatory system (18.9%) and diseases of the respiratory system (17.4%). The hospitalization rate during the period of 2002-2017 was 43.8 (95% CI: 43.7-44.0) per 100,000 inhabitants. The total cost for the healthcare system was 1.476 million euros, with a median of 3,542 euros per hospitalization (IQR 2,646-5,222 euros). Conclusions: In Spain, the hospitalization rate of patients with RA increased during the study period, despite the decrease in the hospitalization rate when RA was the main diagnosis.

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Abstract P11: Use of Hospital Claims Data to Estimate the Clinical and Economic Burden of Acute Coronary Syndrome Rehospitalizations in Real-World Clinical Practice

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap11 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Gregory Hess ◽

Durgesh Bhandary ◽

Sanjay Gandhi ◽

Deepa Kumar ◽

Eileen Fonseca ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Clinical Practice ◽

Real World ◽

Hospitalization Rate ◽

Index Hospitalization ◽

Coronary Syndrome ◽

Hospitalization Rates ◽

St Elevation ◽

The Mean

Background: Re-hospitalization rates are emerging as quality of care measures with reimbursement implications for inpatient care. Objective: To examine the rates of inpatient re-hospitalization and economic burden of acute coronary syndrome (ACS) patient admissions in real-world clinical practice. Methods: Patients (age >18 years) with an inpatient hospitalization for ACS [ICD-9-CM codes for acute myocardial infarction or unstable angina (UA)] between 1/1/2007-4/30/2009 were identified using claims from 450 hospitals representing 4.8 million inpatient visits. All-cause and ACS-related re-hospitalizations within 30 days and 12 months after index event were evaluated. In addition, the mean inpatient admission charges resulting from inpatient re-admissions at 30 days were also estimated. Results: Of 17,904 ACS patients [52% male; mean age 70.6 (median-73.0) years)], 13.3% had diagnostic coding for ST elevation myocardial infarction (STEMI), 47.9% had coding for non-ST elevation myocardial infarction (NSTEMI), 32.2% had UA, and 6.5% had not otherwise specified (NOS) ACS. The 30-day all-cause inpatient re-hospitalization rate was 14.7% (STEMI: 12.7%, NSTEMI: 17.1%, UA: 12.5%, NOS: 10.8%) and 5.5% for an ACS-related re-hospitalization (STEMI: 7.6%, NSTEMI: 7.0%, UA: 2.8%, NOS: 3.9%). The 12-month all cause re-hospitalization rate was 37.7% (STEMI: 31.3%, NSTEMI: 39.9%, UA: 39.7%, NOS: 25.4%) and 12.5% for an ACS-related re-hospitalization (STEMI: 12.7%, NSTEMI: 14.3%, UA: 10.9%, NOS: 7.0%). For patients with ages > 65 years (N = 12,627), the 30-day all-cause and ACS-related re-hospitalization rates were 15.1% and 5.8%, respectively. The mean per patient additional charges resulting from 30-day all-cause and ACS-related re-hospitalizations in the study cohort with an index hospitalization (N=17,904) were estimated to be $13,160 and $7,216, respectively. Conclusion: High rates of re-hospitalization for ACS patients within 30 days and 12-months post-index hospitalization were observed using real-world clinical practice data. More effective therapies may provide an opportunity to improve important clinical and economic outcomes in ACS patients.

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Intravenous Chemotherapy for Retinoblastoma in the Era of Intravitreal Chemotherapy: A Systematic Review

Ocular Oncology and Pathology ◽

10.1159/000510506 ◽

2020 ◽

Vol 7 (2) ◽

pp. 142-148

Author(s):

Vishal Raval ◽

Randy Christopher Bowen ◽

Hansell Soto ◽

Arun Singh

Keyword(s):

Potential Role ◽

Practice Patterns ◽

Survival Rates ◽

Published Data ◽

Intravenous Chemotherapy ◽

Intravitreal Chemotherapy ◽

The Mean ◽

Patterns Of Recurrence ◽

Vitreous Seeding

Purpose: The published data on ocular survival following intravenous chemotherapy of retinoblastoma (RB) seems to be skewed by evolving practice patterns induced by use of intravitreal chemotherapy (iVitc). We aimed to explore potential role of iVitc for vitreous seeding for patients treated with intravenous chemotherapy (IVC). Methods: A literature search was performed to identify cases of RB treated with primary IVC prior to advent of iVitc by various search engines (PubMed, Medline, and Google) from 1992 to 2018. Studies were excluded if number of cases were less than 40 or lacked data related to type of recurrence and its treatment. Rates and patterns of recurrence and its management were categorized. Results: Out of 15 studies identified, only 10 studies (797 eyes) met the inclusion criteria. The mean age at presentation was 15.3 months (range 0–192.8 months). Unilateral cases represented 25% of the cohort. The ocular survival rate with primary IVC was 63% (500/797 eyes). Of the 297 eyes (37%) that failed IVC therapy, additional 99 eyes could be salvaged with EBRT (599/797 eyes, 75%). Remaining 198 eyes were enucleated (198/797 eyes 25%). K-M survival analysis could not be done due lack of sufficient data. Recurrences that occurred (mean 12.2 months) after completion of primary IVC included relapse of retinal tumor (143 eyes [48%]), vitreous seeding (73 eyes [25%]), subretinal seeding (49 eyes [16%]), or any combination (103 eyes [35%]). Out of 73 eyes with vitreous seeding, additional 66 eyes (90%) would have been salvaged with iVitc, potentially improving ocular survival rates to 71% (500 + 66/797). Conclusions: Evolving practice patterns of RB treatment have unfavorably skewed published ocular survival rates following IVC. With incorporation of iVitc, the ocular survival rates with IVC can be potentially improved to be non-inferior to those achieved with intra-arterial chemotherapy.

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Congenital Hypertrophic Pyloric Stenosis: The Role of Gastrin Reevaluated

PEDIATRICS ◽

10.1542/peds.61.6.883 ◽

1978 ◽

Vol 61 (6) ◽

pp. 883-885

Author(s):

Steven L. Werlin ◽

Richard J. Grand ◽

David E. Drum

Keyword(s):

Cord Blood ◽

Pyloric Stenosis ◽

Potential Role ◽

Serum Gastrin ◽

Hypertrophic Pyloric Stenosis ◽

Elevated Serum ◽

Serum Gastrin Concentration ◽

Congenital Hypertrophic Pyloric Stenosis ◽

The Mean

In order to evaluate the potential role of gastrin in the etiology of pyloric stenosis, serum gastrin levels were measured in cord blood of affected infants, matched controls, and mothers of both. No differences were identified when values from infants with pyloric stenosis were compared with those from control infants. Mean cord serum gastrin levels of the infants were significantly greater than the mean maternal gastrin levels. The data effectively dismiss the possibility that elevated serum gastrin concentration in mother or infant at the time of delivery can be implicated as a cause of pyloric stenosis.

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The Potential Role of Chemerin, Lipocalin 2, and Apelin in the Diagnosis and Pathophysiology of Gestational Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2021/5547228 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Radzisław Mierzyński ◽

Elżbieta Poniedziałek-Czajkowska ◽

Dominik Dłuski ◽

Maciej Kamiński ◽

Agnieszka Mierzyńska ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Potential Role ◽

Potential Contribution ◽

Strong Positive Correlation ◽

Lipocalin 2 ◽

Novel Biomarkers ◽

The Mean

The exact role of adipokines in the pathogenesis of gestational diabetes mellitus (GDM) still remains not fully clear, and multiple studies have analyzed their potential contribution to the pathophysiology of this pregnancy complication. This study is aimed at evaluating serum chemerin, lipocalin 2, and apelin concentrations in GDM and healthy pregnant patients, assessing the correlation between these adipokines, and suggesting the potential role of these cytokines in the diagnosis and pathophysiology of GDM. The study comprised 237 pregnant women: 153 with GDM and 84 with physiological pregnancy. Serum concentrations of chemerin, lipocalin 2, and apelin were obtained at 24–29 weeks of gestation. The mean concentrations of chemerin and lipocalin 2 were significantly higher in the GDM group. The concentration of apelin was slightly higher in the GDM group, but not statistically significant. The strong positive correlation between chemerin and lipocalin 2 concentrations was noticed in both groups. Our data suggest that maternal chemerin and lipocalin 2 may play a significant role in the pathophysiology of GDM. We imply that these adipokines could potentially be established as novel biomarkers for the early identification of GDM. However, more studies are needed to analyze the effect of these adipokines on glucose metabolism during early pregnancy.

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Pertussis Serodiagnosis in Belgium from 1990 to 2009

Clinical and Vaccine Immunology ◽

10.1128/cvi.00003-11 ◽

2011 ◽

Vol 18 (4) ◽

pp. 588-594 ◽

Cited By ~ 8

Author(s):

Muriel Vincent ◽

Caroline Rodeghiero ◽

Romain Eylenbosch ◽

Yvan Mans ◽

Jeannine Swalus-Steenhouwer ◽

...

Keyword(s):

Potential Role ◽

Whooping Cough ◽

Age Groups ◽

Childhood Vaccination ◽

Clinical Samples ◽

Content Type ◽

The Mean ◽

Children And Young Adolescents ◽

Vaccination Campaigns

ABSTRACTDiagnosis of pertussis by culture and PCR is most sensitive when performed on nasopharyngeal specimens collected <2 weeks and <3 weeks, respectively, after the onset of clinical disease. Conversely, serological testing allows the diagnosis of patients (mostly adults) with less typical whooping cough symptoms, for whom clinical samples are often collected at later time points. Here, we report on a 20-year serodiagnostic survey of pertussis in Belgium from 1990 to 2009. In total, 13,163 patients were analyzed forBordetella pertussis-specific antibodies by agglutination, complement fixation, immunofluorescence, and ELISA. The number of positive pertussis cases detected by serodiagnosis ranged between 50 and 150 annually. The mean age of positive cases increased from 9.9 years in 1990 to 33.9 years in 2009. Whereas from 1990 to 2003, children and young adolescents made up the majority of cases, from 2004 onwards, cases were detected in all age groups and the distribution became bimodal, with a first peak at the age of 10 to 20 years and a second at the age of 35 to 50 years. In contrast, patients diagnosed since 2001 by PCR and/or culture were mostly children younger than 1 year of age. Despite extensive childhood vaccination campaigns, whooping cough is still present in Belgium. Our findings confirm the potential role of adults in the continued transmission of pertussis and strongly warrant booster or cocoon vaccinations in older age groups.

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Infectious Disease Hospitalizations, New York City, 2001-2014

Public Health Reports ◽

10.1177/0033354920935080 ◽

2020 ◽

Vol 135 (5) ◽

pp. 587-598

Author(s):

Chaorui C. Huang ◽

David E. Lucero ◽

Sungwoo Lim ◽

Yihong Zhao ◽

Robert J. Arciuolo ◽

...

Keyword(s):

Infectious Disease ◽

New York ◽

New York City ◽

York City ◽

Lower Respiratory Tract ◽

Hospitalization Rate ◽

Hospital Death ◽

Discharge Data ◽

Hospitalization Rates ◽

The Mean

Objective Hospital discharge data are a means of monitoring infectious diseases in a population. We investigated rates of infectious disease hospitalizations in New York City. Methods We analyzed data for residents discharged from New York State hospitals with a principal diagnosis of an infectious disease during 2001-2014 by using the Statewide Planning and Research Cooperative System. We calculated annual age-adjusted hospitalization rates and the percentage of hospitalizations in which in-hospital death occurred. We examined diagnoses by site of infection or sepsis and by pathogen type. Results During 2001-2014, the mean annual age-adjusted rate of infectious disease hospitalizations in New York City was 1661.6 (95% CI, 1659.2-1663.9) per 100 000 population; the mean annual age-adjusted hospitalization rate decreased from 2001-2003 to 2012-2014 (rate ratio = 0.9; 95% CI, 0.9-0.9). The percentage of in-hospital death during 2001-2014 was 5.9%. The diagnoses with the highest mean annual age-adjusted hospitalization rates among all sites of infection and sepsis diagnoses were the lower respiratory tract, followed by sepsis. From 2001-2003 to 2012-2014, the mean annual age-adjusted hospitalization rate per 100 000 population for HIV decreased from 123.1 (95% CI, 121.7-124.5) to 40.0 (95% CI, 39.2-40.7) and for tuberculosis decreased from 10.2 (95% CI, 9.8-10.6) to 4.6 (95% CI, 4.4-4.9). Conclusions Although hospital discharge data are subject to limitations, particularly for tracking sepsis, lower respiratory tract infections and sepsis are important causes of infectious disease hospitalizations in New York City. Hospitalizations for HIV infection and tuberculosis appear to be declining.

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The potential role of central obesity in male infertility: body mass index versus waist to hip ratio as they relate to selected semen parameters

BMC Public Health ◽

10.1186/s12889-020-8413-6 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Márton Keszthelyi ◽

V. Anna Gyarmathy ◽

András Kaposi ◽

Zsolt Kopa

Keyword(s):

Central Obesity ◽

Potential Role ◽

Sperm Count ◽

Sperm Concentration ◽

Semen Parameters ◽

Normal Morphology ◽

Semen Parameter ◽

Progressive Motility ◽

The Mean

Abstract Background Little is known about the potential role of central obesity among men. Our first aim was to confirm what is already known from prior research, namely that both BMI and WHR are inversely associated with selected semen parameters. Our second aim was to examine the potential role of central obesity by assessing if there was a difference between BMI and WHR regarding their relationships to these selected semen parameters. Methods In this cross-sectional study between January 2011 to January 2018, we analyzed semen samples from 1169 patients who visited an andrology clinic in Budapest for infertility reasons. Variables assessed were: body measurements (height, weight, waist circumference, and hip circumference), and the results of semen analysis (sperm concentration, total sperm count, progressive sperm motility, and normal sperm morphology). Results The mean height and weight were 180.6 cm and 87.3 kg, respectively – the mean BMI was 26.8. The mean waist and hip circumferences were 100.9 cm and 94.8 cm, respectively – the mean waist to hip ratio was 0.94. The mean sperm concentration, total sperm count, and percents of progressive motility and normal morphology were 48.7 M/ml, 165 million, 21.2, and 4.8%, respectively. Both BMI and WHR were significant correlates in all semen parameter regression models. When comparing the parameter estimates for BMI with those for WHR for each semen parameter, the parameter estimate for WHR was significantly lower (indicating a stronger negative association) than that for BMI for progressive motility and total sperm count, but not for normal morphology or concentration. Conclusions Our study is the first to examine, using a large patient sample, the potential role of central obesity by comparing the difference between BMI and WHR as they relate to selected semen parameters. Our findings indicate a potential role of central obesity for progressive motility and total sperm count, but not for normal morphology and concentration. Despite the limitations and the exploratory nature of this study, we can conclude that our results point to a potential role of central obesity in male infertility, but this finding should be confirmed and further explored in future research. Trial registration The trial was retrospectively authorized after the data collection on September 24, 2018. Registration number: SE RKEB: 169/2018.

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