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.

scholarly journals Incidence of Kawasaki disease before and during the COVID-19 pandemic: a retrospective cohort study in Japan

2021 ◽  
Vol 5 (1) ◽  
pp. e001034
Author(s):  
Kyohei Iio ◽  
Kousaku Matsubara ◽  
Chisato Miyakoshi ◽  
Kunitaka Ota ◽  
Rika Yamaoka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kawasaki Disease ◽  
Infectious Diseases ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Epidemiological Studies ◽  
Primary Objective ◽  
Temporal Association ◽  
Difference In Difference

BackgroundEpidemiological studies in Kawasaki disease (KD) have suggested infectious aetiology. During the COVID-19 pandemic, measures for mitigating SARS-CoV-2 transmission also suppress the circulation of other contagious microorganisms. The primary objective is to compare the number and incidence of KD before and during the COVID-19 pandemic in Japan, and the secondary objective is to investigate temporal association between the KD epidemiology and activities of SARS-CoV-2 and other viral and bacterial infections.MethodsA retrospective cohort study was conducted between 2016 and 2020 in Kobe, Japan. We collected information of hospitalised KD children in Kobe. Child population was identified through the resident registry system. Activity of COVID-19 and 11 other infectious diseases was derived from a public health monitoring system. Monthly change of KD incidence was analysed using a difference-in-difference regression model.ResultsThroughout the study period, 1027 KD children were identified. KD had begun to decline in April 2020, coinciding with the beginning of the COVID-19 pandemic. The number of KD cases (n=66) between April and December 2020 was 40% of the average in the same period in 2016–2019 (165/year). Annual KD incidence was 315, 300, 353, 347 and 188/100 000 children aged 0–4 years in 2016–2020, respectively. The difference-in-difference value of KD incidence was significantly reduced in the fourth quarter in 2020 (−15.8, 95% CI −28.0 to −3.5), compared with that in 2016–2019. Sentinel surveillance showed a marked decrease of all infectious diseases except exanthema subitum after the beginning of the COVID-19 pandemic. There were 86 COVID-19 cases aged <10 years and no KD children associated with COVID-19.ConclusionThis study showed that the number and incidence of KD was dramatically reduced during the COVID-19 pandemic in Japan. This change was temporally associated with decreased activities of various infectious diseases other than COVID-19, supporting the hypothesis of infection-triggered pathogenesis in KD.

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 Segmental aponeurectomy with Z-Plasty as a treatment option in Dupuytren's disease: A retrospective cohort study

2019 ◽  
Vol 105 (8) ◽  
pp. 1627-1631
Author(s):  
Ludivine Gardeil ◽  
Valérie Matter Parrat ◽  
Anne Carole Portenard ◽  
Dorothée Coquerel ◽  
Albane Bonmarchand ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Option ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease

scholarly journals Factors Associated With Short Length of Stay After Long Fusions for Adult Spinal Deformity: Initial Steps Toward Developing an Enhanced Recovery Pathway

2020 ◽  
pp. 219256822094144
Author(s):  
Francis Lovecchio ◽  
Michael Steinhaus ◽  
Jonathan Charles Elysee ◽  
Alex Huang ◽  
Bryan Ang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Spinal Deformity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adult Spinal Deformity ◽  
Clinical Care ◽  
Medical Complication ◽  
Factors Associated ◽  
Estimated Blood Loss

Study Design: Retrospective cohort study. Objectives: The identification of case types and institutional factors associated with reduced length of stay (LOS) is a key initial step to inform the creation of clinical care pathways that can assist hospitals to maximize the benefit of value-based payment models. The objective of this study was to identify preoperative, intraoperative, and postoperative factors associated with shorter than expected LOS after adult spinal deformity (ASD) surgery. Methods: A retrospective cohort study was performed of 82 patients with ASD who underwent ≥5 levels of fusion to the pelvis between 2013 and 2018. A LOS <6 days was determined as a basis for comparison, as 5.7 days was the “expected LOS” generated through Poisson regression modeling of the sample. Clinical, radiographic, surgical, and postoperative factors were compared between those staying ≥6 days (L group) and <6 days (S group). Logistic regression was used to identify factors associated with LOS <6 days. Results: A total of 35 patients were in group S (42.7%). Gender, age, body mass index, ASA (American Society of Anesthesiologists) class, and use of preoperative narcotics, revision surgery, day of admission, and surgical complications did not vary between the cohorts ( P > .05). Mild-moderate preoperative sagittal deformity (sagittal Schwab modifiers 0 or +), lower estimated blood loss (<1200 mL), fewer levels fused (7 vs 10 levels), shorter operating room time, procedure end time before 15:00, and no intensive care unit stay, were associated with short LOS ( P < .05). Only 1 major medical complication occurred in the short LOS group ( P < .05). Conclusions: This study identifies the ASD “case phenotype,” intra-, and postoperative benchmarks associated with shorter LOS, providing targets for pathways designed to reduce LOS.

scholarly journals Endometriosis and the risk of ectopic pregnancy: 10-year retrospective cohort study

2019 ◽  
Vol 12 (1) ◽  
pp. 10-15
Author(s):  
Ally Saetta ◽  
Michael Magro ◽  
Reeba Oliver ◽  
Funlayo Odejinmi
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Ectopic Pregnancy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Primary Objective ◽  
University Hospital ◽  
Chi Square Analysis

Objective: Our primary objective is to give weight to the unanswered and recently heavily debated question, as to whether endometriosis is a statistically significant risk factor for ectopic pregnancy. Our study also provides information on the ethnicity, age and parity of each woman. We report the clinical presentation, the presence of other risk factors as well as intraoperative findings. Design: A retrospective cohort study. Settings: Whipps Cross University Hospital, Bart’s Health NHS Trust which is a district general University hospital in East London. Population: All women, over 10-year period (2005–2014), who were surgically treated for an ectopic pregnancy. Methods: In total, 800 patients were surgically managed. A total of 100 had incomplete data and were, therefore, excluded from analysis. The clinical details, demographics and operation notes were retrospectively analysed for 700 patients. Data were analysed using the student’s t test or chi-square analysis as appropriate. Results: In total, 37 women (5.3%) had endometriosis and 663 women (94.7%) had no evidence of endometriosis. Of the 37 patients, 24 had stage 1, 11 had stage 2 and 2 patients had stage 3 endometriosis. Conclusion: Our data support the theory that endometriosis is not a statistically significant occurrence in women with surgically managed ectopic pregnancy and is not risk factor for ectopic pregnancy.

scholarly journals Chemoradiation as a nonsurgical treatment option for early-stage esophageal cancers: a retrospective cohort study

2021 ◽  
Vol 13 (1) ◽  
pp. 140-148
Author(s):  
Ranjan Pathak ◽  
Maureen E. Canavan ◽  
Samantha Walters ◽  
Michelle C. Salazar ◽  
Daniel J. Boffa
Keyword(s):  
Cohort Study ◽  
Treatment Option ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Nonsurgical Treatment ◽  
Esophageal Cancers

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 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.

Sign in / Sign up

Export Citation Format

Share Document