scholarly journals Effect of ethnicity and other sociodemographic factors on attendance at diabetic eye screening: a 12-month retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046264
Author(s):  
Abraham Olvera-Barrios ◽  
Michael Seltene ◽  
Tjebo F C Heeren ◽  
Ryan Chambers ◽  
Louis Bolter ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cohort Study ◽  
South Asian ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Black People ◽  
Reference Group ◽  
North East ◽  
Eye Screening ◽  
Diabetic Eye Screening

ObjectivesTo examine the association of sociodemographic characteristics with attendance at diabetic eye screening in a large ethnically diverse urban population.DesignRetrospective cohort study.SettingScreening visits in the North East London Diabetic Eye Screening Programme (NELDESP).Participants84 449 people with diabetes aged 12 years or older registered in the NELDESP and scheduled for screening between 1 April 2017 and 31 March 2018.Main outcome measureAttendance at diabetic eye screening appointments.ResultsThe mean age of people with diabetes was 60 years (SD 14.2 years), 53.4% were men, 41% South Asian, 29% White British and 17% Black; 83.4% attended screening. Black people with diabetes had similar levels of attendance compared with White British people. However, South Asian, Chinese and 'Any other Asian' background ethnicities showed greater odds of attendance compared with White British. When compared with their respective reference group, high levels of deprivation, younger age, longer duration of diabetes and worse visual acuity, were all associated with non-attendance. There was a higher likelihood of attendance per quintile improvement in deprivation (OR, 1.06; 95% CI, 1.03 to 1.08), with increasing age (OR per decade, 1.17; 95% CI, 1.15 to 1.19), with better visual acuity (OR per Bailey-Lovie chart line 1.12; 95% CI, 1.11 to 1.14) and with longer time of NELDESP registration (OR per year, 1.02; 95% CI, 1.01 to 1.03).ConclusionEthnic differences in diabetic eye screening uptake, though small, are evident. Despite preconceptions, a higher likelihood of screening attendance was observed among Asian ethnic groups when compared with the White ethnic group. Poorer socioeconomic profile was associated with higher likelihood of non-attendance for screening. Further work is needed to understand how to target individuals at risk of non-attendance and reduce inequalities.

scholarly journals The Association of Low Admission Serum Creatinine with the Risk of Respiratory Failure Requiring Mechanical Ventilation: A Retrospective Cohort Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Api Chewcharat ◽  
Michael A. Mao ◽  
Sorkko Thirunavukkarasu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Respiratory Failure ◽  
Serum Creatinine ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Reference Group ◽  
Hospitalized Patients ◽  
Tertiary Referral Hospital ◽  
Time Of Admission

AbstractTo assess the association between low serum creatinine (SCr) value at admission and the risk of respiratory failure requiring mechanical ventilation in hospitalized patients. A retrospective cohort study was conducted at a tertiary referral hospital. All hospitalized adult patients from 2011 through 2013 who had an admission SCr value were included in this study. Patients who were mechanically ventilated at the time of admission were excluded. Admission creatinine was stratified into 7 groups: ≤0.4, 0.5–0.6, 0.7–0.8, 0.9–1.0, 1.1–1.2, 1.3–1.4, and ≥1.5 mg/dL. The primary outcome was the occurrence of respiratory failure requiring mechanical ventilation during hospitalization. Logistic regression analysis was used to assess the independent risk of respiratory failure based on various admission SCr, using SCr of 0.7–0.8 mg/dL as the reference group in the analysis of all patients and female subgroup and of 0.9–1.0 mg/dL in analysis of male subgroup. A total of 67,045 eligible patients, with the mean admission SCr of 1.0 ± 0.4 mg/dL, were studied. Of these patients, 799 (1.1%) had admission SCr of ≤0.4 mg/dL, and 2886 (4.3%) developed respiratory failure requiring mechanical ventilation during hospitalization. The U-curve relationship between admission SCr and respiratory failure during hospitalization was observed, with the nadir incidence of in-hospital respiratory failure in SCr of 0.7–0.8 mg/dL and increased in-hospital respiratory failure associated with both reduced and elevated admission SCr. After adjustment for confounders, very low admission SCr of ≤0.4 mg/dL was significantly associated with increased in-hospital respiratory failure (OR 3.11; 95% CI 2.33–4.17), exceeding the risk related to markedly elevated admission SCr of ≥1.5 mg/dL (OR 1.61; 95% CI 1.39–1.85). The association remained significant in the subgroup analysis of male and female patients. Low SCr value at admission is independently associated with increased in-hospital respiratory failure requiring mechanical ventilation in hospitalized patients.

scholarly journals Fifteen years of heroin-assisted treatment in a Swiss prison—a retrospective cohort study

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Michael Liebrenz ◽  
Alex Gamma ◽  
Anna Buadze ◽  
Roman Schleifer ◽  
Stéphanie Baggio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Option ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Work Performance ◽  
Reference Group ◽  
Prison Population ◽  
Primary Objective ◽  
Medical Complication ◽  
Health Staff

Abstract Background In the context of the current US opioid crisis and the compelling fact that a quarter to a third of all those addicted to heroin pass through its prisons and jails each year, the care of incarcerated opioid-using individuals (OUI) needs to be improved. Aims Little has been published on the effectiveness or outcomes of heroin-assisted treatment (HAT), a treatment option for severely dependent OUI delivered in a prison setting. The aim of this study was therefore to evaluate such treatment since its implementation. The primary objective was to investigate whether heroin-assisted treatment was associated with severe detrimental health outcomes. The secondary objective was to compare the heroin-assisted treatment group with the general prison population in terms of occupational functioning. Design Retrospective cohort study Setting An open prison with 120 places Subjects Data on 1885 male prisoners with a total of 2239 imprisonment periods between 2000 and 2015 was available. Ninety-seven inmates in heroin-assisted treatment were compared with 1788 inmates from the general prison population (reference group). Measurements Mortality, medical complications (including overdoses), and work performance (days worked, sick days, and monthly wages earned). Findings Inmates receiving HAT were on average 1 year younger (33.8 vs. 34.9 years), had longer prison stays (7.3 vs. 3.0 months), were more often of Swiss nationality (68.0% vs. 28.9%), and had committed more drug- and property-related offenses (49.5% vs. 23.2% and 63.9% vs. 38.3%, respectively) compared to the reference group. No serious heroin-related medical complication occurred during the 15-year window of observation among inmates with heroin-assisted treatment. Their work performance was comparable to that of the reference group. Conclusions This study shows that heroin-assisted treatment can be a valuable treatment option for severely dependent OUI during imprisonment, can be delivered safely by prison health staff over extended periods of time, and allows OUI in treatment to achieve work performance rates comparable to that of the general prison population.

Baseline visual acuity and interdigitation zone as predictors in idiopathic epiretinal membranes: A retrospective cohort study

2020 ◽  
pp. 112067212093209 ◽  
Author(s):  
Tiago Filipe Fernandes ◽  
Keissy Sousa ◽  
Inês Azevedo ◽  
Petra Gouveia ◽  
Gil Calvão-Santos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Outer Nuclear Layer ◽  
Internal Limiting Membrane ◽  
Epiretinal Membranes ◽  
Pars Plana ◽  
Interdigitation Zone ◽  
Baseline Visual Acuity

Objective: Determine which functional and anatomical characteristics may be predictors of final visual acuity in patients with idiopathic ERM (iERM) submitted to pars plana vitrectomy (PPV) with ERM and internal and internal limiting membrane (ILM) peeling. Design: Retrospective cohort study. Subjects: Patients with iERM submitted to PPV between 2016 and 2017. Methods: Data regarding the best-corrected visual acuity (BCVA) and the characteristics of the retinal layers observed in SD-OCT were collected preoperatively and until 12 months postoperatively. Central macular thickness (CMT), disorganization of the retinal inner layers (DRIL), outer nuclear layer (ONL) thickness, integrity of subfoveal external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) were evaluated. Results: A total of 128 eyes with iERM from 121 patients were included. BCVA improved significantly ( p < 0.001). Significant improvement of BCVA, CMT, DRIL, ONL, ELM, and EZ were obtained. The final IZ was not different from baseline until the end of the study. A significant correlation was observed between the baseline BCVA, EZ, IZ, and the postoperative BCVA ( p < 0.001). However, only the baseline BCVA and the integrity of the subfoveal baseline IZ were predictive factors for final BCVA ( p < 0.005 and p < 0.001, respectively). Conclusion: PPV provides a significant improvement of BCVA and retinal anatomy recovery in iERM eyes. Baseline IZ didn’t change during the 12 months following surgery. Baseline BCVA and subfoveal IZ at baseline were prognostic factors for the final BCVA.

scholarly journals Fetal monitoring from 39 weeks’ gestation to identify South Asian-born women at risk of perinatal compromise: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rebecca Stone ◽  
Kirsten Palmer ◽  
Euan M. Wallace ◽  
Mary-Ann Davey ◽  
Ryan Hodges ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Asian ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Fetal Monitoring ◽  
Amniotic Fluid Index ◽  
Australian Health ◽  
Assisted Delivery ◽  
Nicu Admission ◽  
Fetal Compromise

AbstractTo investigate whether earlier “post-term” monitoring of South Asian (SA) pregnancies from 39 weeks’ gestation with amniotic fluid index (AFI) and cardiotocography (CTG) detected suspected fetal compromise. Retrospective cohort study of all SA-born women at an Australian health service with uncomplicated, singleton pregnancies following the introduction of twice-weekly AFI and CTG monitoring from 39 weeks. Monitoring results, and their association with a perinatal compromise composite (including assisted delivery for fetal compromise, stillbirth, and NICU admission) were determined. 771 SA-born women had earlier monitoring, triggering delivery in 82 (10.6%). 31 (4%) had a non-reassuring antepartum CTG (abnormal fetal heart rate or variability, or decelerations) and 21 (2.7%) had an abnormal AFI (≤ 5 cm). Women with abnormal monitoring were 53% (95% CI 1.2–1.9) more likely to experience perinatal compromise and 83% (95% CI 1.2–2.9) more likely to experience intrapartum compromise than women with normal monitoring. Monitoring from 39 weeks identified possible fetal compromise earlier than it otherwise would have been, and triggered intervention in 10% of women. Without robust evidence to guide timing of birth in SA-born women to reduce rates of stillbirth, earlier monitoring provides an alternative to routine induction of labour.

scholarly journals Is there a correlation between an eGFR slope measured over a 5-year period and incident cardiovascular events in the following 5 years among a Flemish general practice population: a retrospective cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023594 ◽  
Author(s):  
Gijs Van Pottelbergh ◽  
Pavlos Mamouris ◽  
Nele Opdeweegh ◽  
Bert Vaes ◽  
Geert Goderis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Reference Group ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Least Square ◽  
Egfr Slope

ObjectivesTo examine if the estimated glomerular filtration rate (eGFR) slope over a 5-year period is related to incident cardiovascular (CV) events in the following 5 years.DesignRetrospective cohort study.SettingPrimary care.ParticipantsAll patients aged ≥50 years with at least four eGFR measurements between 01 January 2006 and 31 December 2010 were included in the study.Outcome measuresDuring the follow-up period (01 January 2011 until 31 December 2015), CV events (acute myocardial infarction, stroke (cerebrovascular accident (CVA)/transient ischemic attack (TIA)), peripheral arterial disease and acute heart failure) were identified.MethodsThe slope was calculated by the least square method (in mL/min/year). The following slope categories were considered: (−1 to 1), (−3 to −1) (−5 to −3), ≤−5, (1 to 3), (3 to 5) and ≥5.00 mL/min/year. Cox proportional hazards model was used to assess the association between eGFR slope and incidence of CV events. Survival probability from CV events was estimated per slope category.Results19 567 patients had at least four eGFR measurements, of whom 52% was female. 12% of the ≤−5 slope category developed a new CV event in comparison to 7.8% of the reference group and 5.4% of the ≥5 slope category. Survival rates were worst in those with a slope ≤−5. Patients with a slope of (−5 to −3) and ≤−5 had an adjusted HR of 1.37 and 1.55, respectively. Most patients with a slope <−3 mL/min had an eGFR still >60 mL/min.ConclusionsNegative eGFR slopes of at least 3 mL/min/year give irrespectively of the eGFR itself a higher risk of CV events compared with patient groups with stable or improved kidney function. So the eGFR slope identifies an easy to define group of patients with a high risk for developing CV events.

scholarly journals Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women

2019 ◽  
Vol 34 (8) ◽  
pp. 1470-1478 ◽  
Author(s):  
Yousuf ElMokhallalati ◽  
Rik van Eekelen ◽  
Siladitya Bhattacharya ◽  
David J McLernon
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Cox Regression ◽  
Live Birth Rate ◽  
In Vitro Fertilisation ◽  
North East

Abstract STUDY QUESTION What is the chance of a treatment-independent live birth following IVF (including ICSI) treatment? SUMMARY ANSWER Over 5 years of follow-up, the treatment-independent live birth rate was 17% in unsuccessfully treated women and 15% in those who had a live birth after IVF. WHAT IS KNOWN ALREADY A limited number of studies have investigated the chance of treatment-independent conception following completion of IVF, but most of them have been based on surveys with poor response rates and limited sample sizes. STUDY DESIGN, SIZE, DURATION This is a population-based, retrospective cohort study of 2133 women who received IVF treatment between 1998 and 2011 at a single regional IVF Unit and were followed for a minimum of 1 year and maximum of 15 years after their last IVF or ICSI treatment cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included all women, residing in the north-east of the UK, who attended the Aberdeen Fertility Clinic and received IVF treatment between 1998 and 2011. Clinical and diagnostic information of all women was linked with treatment and pregnancy outcome data. A total of 2133 women were divided into two groups: (i) those who achieved a live birth following successful IVF or ICSI treatment (n = 1060) and (ii) those in whom treatment was unsuccessful i.e. resulted in either no pregnancy or pregnancy loss (n = 1073). The two groups were followed from the date of the last embryo transfer until the first treatment-independent live birth or 31 December 2012, whichever came first. The primary outcome was the treatment-independent live birth rate at 1, 2.5, 5 and 10 years of follow-up. Cox regression was used to determine factors associated with treatment-independent live birth in each group. MAIN RESULTS AND THE ROLE OF CHANCE Within 5 years of follow-up, the treatment-independent live birth rate was 17% (95% CI, 15–19%) among women whose IVF or ICSI treatment was unsuccessful and 15% (95% CI, 12–17%) among women whose treatment resulted in live birth. In both groups, shorter duration of infertility, younger female age and IVF as compared to ICSI were associated with a higher chance of achieving treatment-independent live birth. Among unsuccessfully treated women, the chance of post-IVF live birth was reduced in those with tubal factor infertility. Three or more previous IVF or ICSI embryo transfers were associated with a lower chance of treatment-independent live birth among successfully treated women. LIMITATIONS, REASONS FOR CAUTION The study was conducted in a single fertility centre, which could compromise the generalizability of the findings. Moreover, data were unavailable on the women’s use of contraception or active attempts to get pregnant, both of which could influence treatment-independent live birth rates. WIDER IMPLICATIONS OF THE FINDINGS This study provides a better understanding of the long-term prognosis for treatment-independent live birth after completion of IVF or ICSI treatment. The results will inform women of their chances of a treatment-independent live birth following failed or successful treatment and the factors that are associated with it. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by a Chief Scientist Office Postdoctoral Training Fellowship in Health Services Research and Health of the Public Research (Ref PDF/12/06). The views expressed here are those of the authors and not necessarily those of the Chief Scientist Office. The authors have no competing interests. TRIAL REGISTRATION NUMBER Not applicable.

A Retrospective Cohort Study of Histology-proven Neuroendocrine Neoplasms in the Italian Area of Udine

2020 ◽  
Vol 20 ◽  
Author(s):  
Francesca Valent ◽  
Annarita Tullio ◽  
Elda Kara ◽  
Claudia Cipri ◽  
Silvia M. Sciannimanico ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Administrative Databases ◽  
Steady Increase ◽  
Neuroendocrine Neoplasms ◽  
Annual Percent Change ◽  
Individual Patient Level ◽  
North East

Aims: The aim of this study was to investigate the epidemiology of histology-proven Neuroendocrine neoplasms (NENs) in an Italian area. Background: NENs are a rare and poorly known disease and the global incidence and prevalence appears to be increasing over the past decades. Objective: The objectives of this study were to estimate the incidence and trends of NENs in a 250,000-inhabitant area in the North-East of Italy in the 1998-2018 period and to compare them with international data. Methods: This retrospective cohort study was based on the analysis of anonymous health administrative databases, linked with each other at the individual patient level through an anonymous stochastic key. NENs were identified from the anatomical pathology database. The standardized incidence rate (2010ESP and US2000) ± 95% CI per 100,000 were calculated, both annually and globally for the whole period. Incidence was also calculated for specific anatomical sites and by sex. Trends for the considered periods and sites were summarized through the annual percent change (APC) and average increase (cases per 100,000 per year). Results: In the 1998-2018 period, the standardized incidence rate of NENs in the area of Udine was 2.49 (APC 3.33). 162 cases were observed (51.2% males). Differences in incidence and trend were observed between sexes. Our results were consistent with those reported in other countries, confirming a significant and steady increase in NENs incidence in the last twenty years. Conclusions: This study provides new epidemiological data on NENs in Italy. The observed sex differences deserve further investigations.

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