scholarly journals Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults? Retrospective cohort study from Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033817 ◽  
Author(s):  
Eirik Østvoll ◽  
Ola Sunnergren ◽  
Joacim Stalfors
Keyword(s):  
Cohort Study ◽  
Surgical Treatment ◽  
Medical Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Control Group ◽  
Clinical Value ◽  
Recurrent Tonsillitis ◽  
Visit Rate ◽  
The Difference

ObjectiveTo assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.DesignRetrospective cohort study.SettingData were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.Participants1044 children (<15 years) and 2244 adults.InterventionTonsillectomy/adenotonsillectomy compared with no surgical treatment.Main outcome measuresChanges in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.ResultsIn children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.ConclusionIn this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

scholarly journals Separation and not residency permit restores function in resignation syndrome: a retrospective cohort study

2021 ◽  
Author(s):  
Karl Sallin ◽  
Kathinka Evers ◽  
Håkan Jarbin ◽  
Lars Joelsson ◽  
Predrag Petrovic
Keyword(s):  
Cohort Study ◽  
Social Services ◽  
Residential Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Home ◽  
Essential Components ◽  
Residential Care Home ◽  
The Difference ◽  
Oriented Approach

AbstractDespite poor treatment results, a family-oriented approach and the securing of residency have been deemed essential to recovery from resignation syndrome (RS). In a retrospective cohort study, we evaluated an alternative method involving environmental therapy, with patients separated from their parents, while actively abstaining from involving the asylum process in treatment. We examined medical records, social services acts, and residential care home acts from 13 individuals treated at Solsidan residential care home between 2005 and 2020. Severity and outcome were assessed with Clinical Global Impression, Severity and Improvement subscales. Thirteen participants were included and out of these nine (69%) recovered, i.e. they very much or much improved. Out of the eight that were separated, all recovered, also, one non-separated recovered. The difference in outcome between subjects separated and not was significant (p = 0.007). Moreover, out of the five which received a residency permit during treatment, one recovered whereas four did not. The difference in outcome between subjects granted residency and not was significant (p = 0.007). The data revealed three (23%) cases of simulation where parents were suspected to have instigated symptoms. Our evaluation suggests that separation from parents and abstaining from invoking residency permit could be essential components when treating RS. Relying on a family-oriented approach, and residency could even be detrimental to recovery. The examined intervention was successful also in cases of probable malingering by proxy.

scholarly journals Clomiphene Citrate Priming Increases Sensitivity During Ovarian Stimulation in Poor Ovarian Responders Undergoing In Vitro Fertilization Treatment: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Shan Liu ◽  
Xinyu Liu ◽  
Huanhuan Li ◽  
Minghui Liu ◽  
Yasu Lv ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Ovarian Stimulation ◽  
Retrospective Cohort ◽  
Clomiphene Citrate ◽  
Control Group ◽  
Study Group ◽  
Poor Ovarian Responders ◽  
Gonadotropin Dosage ◽  
Antagonist Protocol

Abstract Background: Since ovarian stimulation was introduced as an assisted reproductive technology, poor ovarian response (POR) management has challenged clinicians. Guidance on optimally managing patients with poor response and/or low sensitivity to ovarian stimulation is still lacking. We aimed to investigate whether a clomiphene citrate (CC) priming protocol could increase ovarian sensitivity in poor ovarian responders. Methods: This single-center retrospective cohort study included 294 patients (374 ovarian stimulation cycles). Of these, 193 cycles were treated by a CC priming antagonist protocol (study group) and 181 by the classical flexible gonadotropin-releasing hormone antagonist protocol (control group). Stimulation data and laboratory and clinical outcomes were compared between the groups. Results: Total gonadotropin dosage and dosage per follicle were considerably lower, the follicle-to-oocyte index was significantly higher, and the gonadotropin duration was shorter in the study group. After adjusting for potential confounders, multivariate regression analysis showed that cumulative ongoing pregnancy remained comparable between the groups (adjusted odds ratio: 0.761, 95% confidence interval: 0.300-1.933, P = 0.566). Age, body mass index, gonadotropin dosage per follicle, and the follicle-to-oocyte index were directly associated with the reproductive outcomes. The result of the sensitivity analysis showed that patients stimulated by the CC priming antagonist protocol were administered less gonadotropin (1,739.09 ± 719.39 vs. 3,114.77 ± 1,171.23, P < 0.001) at a lower gonadotropin dosage per follicle (637.36 ± 373.05 vs. 1286.26 ± 976.66, P < 0.001) and for a shorter duration (6.58 ± 2.23 vs. 9.80 ± 1.90, P < 0.001). Conclusions: The CC priming antagonist protocol offered a convenient and patient-friendly way to increase ovarian sensitivity during ovarian stimulation in poor ovarian responders.

scholarly journals Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

2020 ◽  
Author(s):  
Shao-Ang Chu ◽  
Te-Yuan Chen ◽  
Po-Yuan Chen ◽  
Wei-Jie Tzeng ◽  
Cheng-Loong Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Acupuncture Treatment ◽  
Lower Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Post Stroke ◽  
Incidence Of Dementia

Abstract BACKGROUND Stroke has been recognized as one of the major causes of adult disability worldwide, and post-stroke dementia may affect up to one-third of stroke survivors. This condition could be prevented if we could recognize and treat it earlier. Acupuncture as a complementary treatment for stroke has been shown to be beneficial for subsequent post-stroke rehabilitation. Our study investigated if acupuncture served additional advantages to decreasing the incidence of post-stroke dementia. METHODS We provide a retrospective cohort study from Taiwan National Health Insurance Research Database. This study compared the incidence of post-stroke dementia between cohorts with and without acupuncture treatment by calculating adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of acupuncture associated with post-stroke dementia using Cox proportional hazard regressions. The study group was composed of 9,547 patients who received first hospitalization for the treatment of stroke between 2002 and 2004; of which, 47,735 comparison patients were defined as the control group. The two groups were followed-up until the diagnosis of dementia presented or until the end of 2007. RESULTS The adjusted HRs of developing dementia among patients with stroke was 4.705 times the average (range, 4.353–5.085), and the incidence of dementia was higher in males. The study group tended to have less incidence of all kinds of dementia after acupuncture treatment, and patients without stroke receiving acupuncture had a lower probability of dementia than those untreated during the follow-up period. CONCLUSIONS This study presents evidence that acupuncture serves as an effective and alternative procedure to lower the risk of post-stroke dementia and the overall incidence of dementia in Taiwanese population.

scholarly journals Surgical treatment choices for breast cancer in Newfoundland and Labrador: a retrospective cohort study

2018 ◽  
Vol 61 (6) ◽  
pp. 377-384 ◽  
Author(s):  
Farah McCrate ◽  
Elizabeth Dicks ◽  
Erin Powell ◽  
Joanne Chafe ◽  
Rebecca Roome ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Retrospective Cohort Study ◽  
Newfoundland And Labrador ◽  
Retrospective Cohort ◽  
Treatment Choices

scholarly journals Herbal Medicines and Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Athar Rasekhjahromi ◽  
Masoumeh Hosseinpoor ◽  
Farzaneh Alipour ◽  
Mehrnoosh Maalhagh ◽  
Saeed Sobhanian
Keyword(s):  
Cohort Study ◽  
Side Effects ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Polycystic Ovary ◽  
Herbal Medicines ◽  
Group Versus ◽  
Control Group ◽  
Case Group ◽  
Significant Difference

Background. The aim of this study was to assess the association between herbal medication and OHSS.Methods. This retrospective cohort study was conducted with 101 polycystic ovary syndrome patients. 66 patients took conventional pharmacological medications and 35 took herbal medications. Data were analyzed by statistical test including Fisher’s Exact and binominal logistic regression.P<0.05was considered significant.Results. Of the 101 females, 53 were married and 48 were single. There was no significant association between the groups in marriage. No significant association was found in mean age between the two groups (23.9 ± 5.8 years in the control group versus 26.3 ± 6.7 years in the case group). There was a significant difference between the two groups .After adding the dependent (OHSS prevalence) and independent (marriage and group) variables into the model, the Hosmer-Lemeshow test showed suitability. Variances analyzed with this model ranged between 29.4% and 40.7%.Conclusion. The indiscriminate use of herbs is correlated with OHSS. Because patients increasingly consume herbs, they should be aware of potential side effects. However, appropriate dosages of herbs could be obtained for use instead of conventional treatments, which often have side effects.

scholarly journals A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Syed M. Asim Hussain
Keyword(s):  
Cohort Study ◽  
Standard Deviation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healing Rate ◽  
Leg Ulcer ◽  
University Hospital ◽  
Venous Leg Ulcer ◽  
Number Of Patients ◽  
The Difference

Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers.Study Design. Retrospective cohort study.Location. The leg ulcer clinic at the University Hospital of South Manchester.Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost.Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient.Results. Simple nonadherent dressings had a mean healing rate of 0.353 cm2/week (standard deviation ± 0.319) compared with a mean of 0.415 cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailedpvalue of 0.251 and a two-tailedpvalue of 0.508. Multiple regression analysis gave a significanceFof 0.8134.Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection.

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