Over 1200 drugs-related deaths and 190,000 opiate-user-years of follow-up: Relative risks by sex and age group

Abstract Background Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04). Conclusions In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.

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Are telephone consultations here to stay in rheumatology?

Rheumatology Advances in Practice ◽

10.1093/rap/rkaa071 ◽

2020 ◽

Author(s):

Sabrina R Raizada ◽

Natasha Cleaton ◽

James Bateman ◽

Diarmuid M Mulherin ◽

Nick Barkham

Keyword(s):

Older Patients ◽

Online Survey ◽

Vulnerable Groups ◽

Age Group ◽

Telephone Consultation ◽

Survey Tool ◽

Face To Face ◽

Vulnerable Patients ◽

Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

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Impact of the Healing in Harmony program on women's mental health in a rural area in South Kivu province, Democratic Republic of Congo

Global Mental Health ◽

10.1017/gmh.2021.11 ◽

2021 ◽

Vol 8 ◽

Author(s):

Justin Cikuru ◽

Ali Bitenga ◽

Juvenal Bazilashe Mukungu Balegamire ◽

Prince Mujumbe Salama ◽

Michelle M. Hood ◽

...

Keyword(s):

Mental Health ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Women’S Mental Health ◽

Post Traumatic Stress ◽

Republic Of Congo ◽

Women's Mental Health ◽

Relative Risks ◽

Post Test

Abstract Background To assess whether Healing in Harmony (HiH), a form of music therapy, improved women's mental health following conflict-related trauma and sexual violence in the Democratic Republic of Congo. Methods This study used a step-wedged design and included 167 women, who completed up to two pre-tests, a post-test, and up to two follow-up interviews at 3 and 6 months after completing the program. The Hopkins Symptoms Checklist was used to measure anxiety and depression. The Harvard Trauma Questionnaire was used to measure post-traumatic stress disorder (PTSD). Generalized estimating equations with unstructured covariance were used to estimate mean change in mental health scores and relative risks (RRs) for screening positive. Results Prior to starting the HiH program, 73.9, 84.2, and 68.5% screened positive with median scores being 2.20, 2.70, and 2.06 for depression, anxiety, and PTSD, respectively. The RR for screening positive declined significantly (RR = 0.49 for depression, 0.61 for anxiety, and 0.54 for PTSD) and mean scores declined significantly by −0.54, −0.67, and −0.53 points, respectively, from the pre- to the post-test, declines that were sustained at the 3-month and 6-month follow-up interviews. Conclusion The HiH program was associated with significant improvement in women's mental health that was sustained up to 6 months post completion of the program despite instability in the region and evidence of continued experience of conflict-related trauma during the study. These data support the value of providing psychological care in the context of ongoing humanitarian crises.

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10 Years' Experience in Balanitis Xerotica Obliterans: A Single-Institution Study

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1668562 ◽

2018 ◽

Vol 29 (03) ◽

pp. 302-306 ◽

Cited By ~ 3

Author(s):

Akhilesh Pradhan ◽

Radhika Patel ◽

A. Said ◽

Manasvi Upadhyaya

Keyword(s):

Average Duration ◽

Age Group ◽

Histological Findings ◽

Single Institution ◽

Exact Test ◽

Balanitis Xerotica Obliterans ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital ◽

High Degree

Introduction Balanitis xerotica obliterans (BXO) is uncommon in children. Diagnosis of the condition is almost always clinical and supported by histology. Our aim was to evaluate the outcomes of children undergoing circumcision for BXO and explore the correlation between surgical and histological findings. Materials and Methods A 10-year retrospective review (2007–2017) of all children, aged 16 and less, undergoing circumcision at a tertiary teaching hospital was conducted. Statistical analysis was performed using Fisher's exact test. Results BXO occurred in 91/1025 (8.9%) children. The highest incidence of BXO was in the 5 to 10 age group (13.3%; p < 0.0001). The commonest symptom was foreskin scarring (62.6%). Intraoperatively, involvement of foreskin alone was seen in 26.4%, foreskin and meatus in 47.2%, and foreskin, meatus, and glans in 26.4%. Preoperatively, 24.2% of patients were prescribed steroid cream. Histologically, all patients showed microscopic changes confirming BXO. A total of 87.9% of patients only had a circumcision, and 11% required a meatal procedure along with the circumcision. Postoperatively, 19.8% of patients required a further procedure after an average duration of 5.8 months (range: 2–12 months); the majority of whom (83.3%) were prescribed postoperative steroid cream. Conclusion Clinical correlation by surgeons has a high degree of accuracy (>90%). Meatal involvement is more common than previously reported. The use of pre- or postoperative steroids does not obviate the need for further surgical procedures. Patients can have recurrent symptoms 1 year following surgery, and prolonged follow-up is necessary.

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Responsiveness and minimally important difference of a generic quality of life measure for complementary health practices

Alternative Medicine Studies ◽

10.4081/ams.2012.e12 ◽

2012 ◽

Vol 2 (1) ◽

pp. 12 ◽

Cited By ~ 2

Author(s):

Tomoaki Kimura ◽

Kiyoshi Suzuki ◽

Seiya Uchida ◽

Hiroshi Katamura

Keyword(s):

Quality Of Life ◽

Minimally Important Difference ◽

Health Practices ◽

Life Questionnaire ◽

Age Group ◽

Japanese Adults ◽

The Mean ◽

Generic Quality

Shorter and easier methods of conducting community health surveys would be useful. We conducted a study to demonstrate the responsiveness of the 10-item Mokichi Okada Association quality of life questionnaire (MQL-10) in a follow-up survey and to determine the minimally important difference (MID) for this measure. In 2007, Japanese adults participated in a survey on health prac- tices. We analyzed the MQL-10 scores (n=6365) together with the following factors: gender, age group, disease, reason for participation, and complementary health practices, such as food and eating. The mean baseline MQL-10 score was 26.4±5.83 [standard deviation (SD)] and the mean follow-up score was 27.6±5.45 SD with a mean change of 1.20±4.41 SD. The effect size for change was 0.21 and the standardized response mean was 0.27. The MQL-10 scores in the baseline condition were associated with gender, age group, disease, reason for participation and complementary health practices. Furthermore, the changes in the MQL-10 during the 12 weeks of study were associated with age group, disease, reason for participa- tion and complementary health practices. The increase in frequency of health practices was significantly associated with improvements in the participants’ quality of life (QOL). These results suggest that the MQL-10 is use- ful for assessing the effects of complementary health practices on QOL. The estimate of 3 points for the range of this measure (0-40) was higher than half of the SD of scores; therefore, it was considered reasonable for the MID.

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GOLD severity stratification and risk of hospitalisation for COPD exacerbations

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2008.378 ◽

2016 ◽

Vol 70 (4) ◽

Cited By ~ 1

Author(s):

M. Lusuardi ◽

C. Lucioni ◽

F. De Benedetto ◽

S. Mazzi ◽

C.M. Sanguinetti ◽

...

Keyword(s):

Clinical Factors ◽

Copd Exacerbations ◽

Telephone Interviews ◽

Function Classes ◽

Prospective Multicentre Study ◽

Relative Risks ◽

Gold Stage ◽

Copd Patients ◽

Oral Corticosteroids

Background and Aim. The Italian Costs for Exacerbations in COPD (“ICE”) study, following a pharmacoeconomic assessment of costs due to COPD exacerbations (primary endpoint), aimed also at evaluating (secondary endpoint) which clinical factors, among those considered for cost-analysis, may, at follow up, present a risk of new exacerbations and re-admission to hospital. Materials and methods. A prospective, multicentre study was carried out on COPD patients admitted to 25 Hospital Centres as a result of an exacerbation from October- December 2002. Following discharge, a 6-month follow- up was performed in each patient via three bi-monthly telephone interviews with a questionnaire administered by an investigator clinician. Results. 570 patients were eligible for data processing, mean age 70.6 years (± 9.5 standard deviation, SD), males 69.2%. According to GOLD, severity stratification was as follows: moderate 36.4%; severe 31.3%; very severe 32.3%. 282 patients experienced at least one exacerbation at follow up, 42% of exacerbations requiring hospitalisation. No significant association was seen between exacerbations and GOLD stage or co-morbidities or treatments except LTOT. Conversely, COPD functional severity influenced hospitalisations very significantly, with relative risks 2.6 (95% Confidence Interval, CI 1.8-3.8) and 2.0 (CI 1.3-2.8) (GOLD very severe versus moderate and severe, respectively), and 1.3 (CI 0.85-2.1) (GOLD severe versus moderate). Hospitalisations were also significantly associated with treatments denoting more severe conditions (oral corticosteroids, oral theophylline, and LTOT). Conclusions. Severity stratification of COPD patients according to respiratory function classes as outlined in GOLD guidelines and need for LTOT are confirmed as important predictors of hospitalisation for an exacerbation.

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Diagnostic stability in a Dutch psychosis incidence cohort

The British Journal of Psychiatry ◽

10.1192/bjp.185.6.460 ◽

2004 ◽

Vol 185 (6) ◽

pp. 460-464 ◽

Cited By ~ 37

Author(s):

Natalie D. Veen ◽

Jean-Paul Selten ◽

Diede Schols ◽

Winfried Laan ◽

Hans W. Hoek ◽

...

Keyword(s):

Psychotic Disorders ◽

Population Based ◽

Schizophrenic Disorder ◽

Diagnostic Stability ◽

Face To Face ◽

Follow Up Study ◽

Relative Risks ◽

Diagnostic Interviews ◽

The Uk

BackgroundNo study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.AimsTo determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.MethodA 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.ResultsDiagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.ConclusionsSchizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation.

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Longitudinal intra- and inter-individual variability in young swimmers' performance and determinant competition factors

Motriz Revista de Educação Física ◽

10.1590/s1980-65742014000300008 ◽

2014 ◽

Vol 20 (3) ◽

pp. 292-302 ◽

Cited By ~ 1

Author(s):

Jorge Estrela Morais ◽

Mario J. Costa ◽

Pedro Forte ◽

Mario C. Marques ◽

Antonio J. Silva ◽

...

Keyword(s):

Individual Variability ◽

Skill Level ◽

Age Group ◽

Determinant Factors ◽

Customized Training ◽

Level 2 ◽

Level Effect

The main purpose of this study was to follow-up the intra- and inter-individual variability of young swimmers' performance and determinant factors over two competitive seasons. Thirty young swimmers (14 boys: 12.33±0.65 years-old; 16 girls: 11.15±0.55 years-old) were followed-up throughout two consecutive seasons (seven evaluation moments). Performance (100m freestyle), anthropometric, kinematic, hydrodynamic and efficiency features were evaluated. A gender and skill-level effect was observed. Boys improved in a higher amount (%) comparing to girls. Overall, swimmers in skill-level 2 (both genders) presented a higher intra-individual variability. Performance and anthropometrics showed a significant inter-individual variability in most moments, but hydrodynamics, kinematics and efficiency did not. Within each skill-level hydrodynamics, kinematics and efficiency were the variables that showed a high inter-individual variability. As a gender and skill-level effect was noticed in an age-group of young swimmers, coaches and practitioners should put the focus in specific and customized training plans for each skill-level of swimmers.

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Mortality among young Nicaraguan immigrants to Costa Rica: deaths from disease versus injury

Población y Salud en Mesoamérica ◽

10.15517/psm.v13i1.19497 ◽

2015 ◽

Author(s):

Roger E. Bonilla ◽

Juan B. Chavarría

Keyword(s):

Relative Risk ◽

Costa Rica ◽

Population Data ◽

Mortality Rates ◽

Relative Importance ◽

Age Group ◽

Native Population ◽

Relative Risks ◽

Census 2000

The aim of this research was to investigate mortality among young Nicaraguan immigrants to Costa Rica (disease versus injury deaths) and compare it with the young native population. The study focused on persons aged 15 to 34 years, due to the relative importance of the injury deaths in this age group. Deaths (numerators) and population data (denominators), which were obtained from the 10th Population and Housing Census 2000, were used to calculate the mortality rates per 100,000 inhabitants. The relative risk (RR) results from dividing each set of causal standardized mortality rates. Approximately 66% of deaths among Nicaraguan immigrants are injury deaths versus 57% for the native population. Immigrants have higher relative risks (RR) of mortality than natives for injury deaths (homicides RR=2.00, other accidents RR=1.70, and vehicular accidents RR=1.17). We emphasize that Nicaraguan immigrants have twice the risk of dying from homicide than the native population.

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An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-6-1-74 ◽

2005 ◽

Vol 6 (1) ◽

pp. 74-84 ◽

Cited By ~ 9

Author(s):

Ozlem Tulunoglu ◽

Tezer Ulusu ◽

Yasemin Genç

Keyword(s):

Survival Time ◽

Success Rate ◽

Median Survival ◽

Median Survival Time ◽

Age Groups ◽

Age Group ◽

Follow Up Study ◽

Different Types ◽

Lost To Follow Up

Abstract The aim of this study was to evaluate the median survival time of fixed and removable space maintainers related to age groups, gender, and their distribution in upper and lower dental arches. The adherence of patients to a periodic recall program and the success rate of different types of space maintainers related to different arches were also evaluated. This study included 663 patients aged between 4-15 years old that were treated between the years of 1997 and 2002. The patients were categorized into four main groups: lost to follow-up, failed, successful, and censored at the end of study. Three hundred forty-five space maintainers were considered lost to follow-up, 83 were considered failed, 206 successful, and 20 censored-at-end. The overall median survival time of the appliances was 6.51 months. Median survival time was 7.25 months in the 4-6 age group, 6.35 months in the 7-12 age group, and 7.0 months in the 13+ age groups. Median survival time was 5.76 months in girls and 7.11 months in boys. Median survival time of space maintainers was 7.17 months for maxilla and 6.69 months in the mandible. Median survival time was 5.25 months for space maintainers fabricated in both arches. Citation Tulunoglu Ö, Ulusu T, Genç Y. An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study J Contemp Dent Pract 2005 February;(6)1:074-084.

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