Category: Statistics

Ocul Immunol Inflamm. 2021 Sep 15:1-6. doi: 10.1080/09273948.2021.1974491. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of surgical mask use on infection rates for office-based periocular surgeries during the pandemic.

METHODS: An Institutional Review Board-approved retrospective review of medical records identified patients who had an office-based oculofacial plastic surgery procedure during the pandemic between March and December 2020. Statistical analysis was used to compare this group to patients that underwent procedures between March and December 2019, prior to the pandemic when neither surgeon nor patient wore a surgical mask.

RESULTS: The study consisted of 680 patients. Thirty-one different types of procedures were encountered. The incidence of infections in 2020 compared to 2019 was not statistically significant (1.12% (n = 3) versus 1.21% (n = 5), p = 1). All patients with infections were treated with oral antibiotics and improved without long-term complications.

CONCLUSIONS: Periocular surgical site infections are uncommon, and the wearing of surgical masks by patient and surgeon during our office-based oculofacial procedures did not change the incidence of SSIs.

PMID:34524950 | DOI:10.1080/09273948.2021.1974491

Health Rep. 2021 Sep 15;32(9):3-13. doi: 10.25318/82-003-x202100900001-eng.

ABSTRACT

BACKGROUND: As Canadian immigration levels increase, knowledge concerning immigrant health becomes increasingly important for health system policy and planning. This study compares the rate of all-cause hospitalization among immigrants with that of their Canadian-born counterparts.

DATA AND METHODS: Using records from the Discharge Abstract Database (2004/2005 to 2016/2017) and the Ontario Mental Health Reporting System (2006/2007 to 2017/2018) linked to the 2016 Longitudinal Immigration Database, this study compared the age-standardized hospitalization rates (ASHRs) among immigrants with those of the Canadian-born population; the latter were obtained from a linkage based on the 2011 National Household Survey. Comparisons were made at the International Classification of Diseases chapter level by immigrant landing year, admission category and world region of birth. Quebec data were not available.

RESULTS: Overall, ASHRs among immigrants were lower than for the Canadian-born population. Immigrants in the economic class had the lowest ASHR, followed by those in the family class and among refugees. After pregnancy was excluded, leading hospitalization causes were similar for immigrants and the Canadian-born population, where top causes included digestive system and circulatory diseases, injuries, and cancer. In male and female immigrants, the ASHRs were lowest among those from East Asia. By landing year, males arriving earlier had the highest ASHR compared with the most recent arrivals. When pregnancy was excluded and while the differential in ASHRs among females by landing year remained, the magnitude was smaller.

INTERPRETATION: These results corroborate those from previous studies suggesting a healthy immigrant effect, but also reveal heterogeneity in ASHRs within the immigrant population. They provide a baseline for comparison of health status between populations, which enables further monitoring and informs health-system policy and planning.

PMID:34523869 | DOI:10.25318/82-003-x202100900001-eng

Health Rep. 2021 Sep 15;32(9):14-26. doi: 10.25318/82-003-x202100900002-eng.

ABSTRACT

BACKGROUND: A comprehensive evaluation of progress in cancer survival for all cancer types combined has not previously been conducted for Canada. The cancer survival index (CSI) is superior to age standardization in measuring such progress.

DATA AND METHODS: Data are from the population-based Canadian Cancer Registry, record-linked to the Canadian Vital Statistics Death database. CSI estimates for both sexes combined were calculated as the weighted sum of the sex- and cancer-specific age-standardized net survival estimates. Sex-specific CSI estimates were calculated separately using sex-specific cancer type weights.

RESULTS: From the 1992-to-1994 period to the 2015-to-2017 period, the five-year CSI increased 8.6 percentage points to 63.7%. It increased by 8.9 percentage points to 61.8% among males, and by 8.2 percentage points to 65.8% among females. The contribution of a cancer and sex combination to change in the CSI over time is a function of its assigned weight and changes in its age-standardized net survival. Female breast was the most influential cancer and sex combination, contributing 10.1% to the overall increase, followed by prostate (8.2%) and female lung (7.3%). The increase in the index since the 2005-to-2007 period was most impacted by lung cancer among both females (11.1%) and males (9.4%). While prostate cancer survival increased over the entire study period, it has recently decreased, resulting in a counterproductive 8.1% contribution since the 2005-to-2007 period.

INTERPRETATION: Steady progress has been made in overall cancer survival in Canada since the early 1990s. Female breast cancer has contributed the most to this progress overall, but more recently female lung cancer has been the most influential.

PMID:34523870 | DOI:10.25318/82-003-x202100900002-eng

Orthop Surg. 2021 Sep 15. doi: 10.1111/os.13025. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to compare the radiological features of intravertebral clefts (IVC) between Kümmell disease (KD) and acute osteoporotic vertebral compression fracture (OVCF).

MATERIALS AND METHODS: This is a retrospective study. A total of 79 patients with IVC from January 2014 to December 2018 were included in this study. There were 22 men and 57 women, with an average of 73.5 years. Based on the exact time interval from injury to treatment and the pathological examination results, the patients were divided into KD group (44 patients) and acute OVCF group (35 patients). The two groups were compared by the margin sclerosis of IVC, vertebra and pedicle ossification, stress fracture of the spinous process, paravertebral callus, the shape of IVC, cleft in the adjacent disc, and flatness of IVC’s margin from plain radiographs and computed tomography (CT). The two groups were compared by the IVC content, double-line sign, and signal of fracture vertebral from their magnetic resonance imaging (MRI).

RESULTS: There were no significant differences in sex, age, and fracture distribution between the KD group and the acute OVCF group. IVC was present in both the KD group and the acute OVCF group. Six radiological features were only present in the KD group, including sclerosis of the cleft margin (95.5%, 42/44), ossification of the fractured vertebrae (100%, 44/44), ossification of the pedicle (31.8%, 14/44), double-line sign (27.3%, 12/44), stress fracture of the spinous process (13.6%, 6/44), and even formation of paravertebral callus (18.2%, 8/44). Although there were statistical differences in the other four radiological features of content of IVC (P = 0.02), cleft sign in adjacent intervertebral disc (P < 0.01), margin of IVC (P = 0.02), and the shape of IVC (P = 0.01) between the KD group and acute OVCF group, these characteristics could be found in both groups.

CONCLUSION: IVC could present in patients with both KD and acute OVCF; however, we found that marginal cleft sclerosis, vertebral and pedicle ossification, double-line sign, spinous process fracture, and formation of paravertebral callus are unique radiological features of KD and could be used for differentiation of KD from acute OVCF with IVC.

PMID:34523812 | DOI:10.1111/os.13025

Int J Health Policy Manag. 2021 Sep 1. doi: 10.34172/ijhpm.2021.103. Online ahead of print.

ABSTRACT

BACKGROUND: To assess whether the imposition of the coronavirus disease 2019 (COVID-19) national quarantine (March 10, 2020) resulted in a shift in the proportion of patients operated for hip fracture on the day of admission, the following day and two days after admission in the region of Piedmont, northern Italy.

METHODS: Interrupted time-series analysis (ITSA) comparing hospitalization rate and timing of hip-fracture surgeries between pre- and post-quarantine period. The same data observed in Piedmont the year before were included as a control time series with no “intervention” (quarantine) in the middle of the observation period.

RESULTS: We found that 70.3% and 69.4% of hip-fracture patients received surgery within 2 days of hospital admission in the 16 weeks before and after the national quarantine, respectively. One-day surgery went from 46.0% to 46.5%, and same-day surgery from 13.3% to 12.4%. Unchanged trends were confirmed by ITSA after controlling for the 32-week time-series observed the year before. In the second week of March 2020, there was a borderline significant decrease in weekly hospital admissions for hip fractures as compared with that of the same week of March 2019 (-1.95 per 100 000, 95% CI = -4.10 to 0.21, P value = .075), followed by a weekly significant increase in the hospitalization rate (+0.14 per 100 000, 95% CI = 0.01 to 0.27, P value = .039), although the difference-in-differences of slopes failed to achieve statistical significance (0.19 per 100 000, 95% CI = -0.03 to 0.41, P value = .090).

CONCLUSION: Our study shows that the timing of hip-fracture surgery was unchanged during the lockdown period. This suggests that the healthcare systems can be resilient and able to guarantee a high-quality and safe healthcare to hip-fracture patients, even in the most challenging working conditions.

PMID:34523862 | DOI:10.34172/ijhpm.2021.103

Matern Child Nutr. 2021 Sep 15:e13262. doi: 10.1111/mcn.13262. Online ahead of print.

ABSTRACT

Child undernutrition disproportionally affects children in low- and middle-income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6-23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight-for-length Z-score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently.

PMID:34523809 | DOI:10.1111/mcn.13262

Influenza Other Respir Viruses. 2021 Sep 15. doi: 10.1111/irv.12911. Online ahead of print.

ABSTRACT

BACKGROUND: Lower respiratory tract infections (LRTIs) are the most common cause for hospitalization in pediatric patients. Pediatric patients with LRTIs are at an increased risk of morbidity and mortality. The national data analysis of epidemiologic variations facilitates awareness and develops solutions to prevent these conditions in the future.

OBJECTIVE: This study aims to evaluate the epidemiology, causative pathogens, morbidity, and mortality of LRTIs in pediatric patients of Thailand from 2015 to 2019.

METHODS: This was a retrospective study among pediatric patients aged between 0 and 18 years old admitted in hospitals due to LRTIs in Thailand from January 2015 to December 2019. The data were extracted from National Health Security Office using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification; ICD-10-TM of J09 to J22.

RESULTS: A total of 1,423,509 children hospitalized due to LRTIs were identified. Most of the patients were of age 1-5 years. Pneumonia was the most common LRTI (876,557 children, 61.58%) in hospitalized children. Respiratory syncytial virus (RSV) is the main etiologic pathogen of bronchiolitis, which presents in approximately 10.86% of all episodes. Influenza viruses were found predominantly in children with pneumonia (15.52%). The mortality rate since 2015-2019 was highest in pneumonia under 1 year old (P < 0.001). Pneumonia in children under 5 years old had the highest mortality rate, which accounted for 11.85 per 100,000 children in 2019.

CONCLUSIONS: LRTIs had a high incidence rate of hospitalization and mortality, especially in children under 5 years old. Influenza virus was the most common pathogen of pneumonia.

PMID:34523811 | DOI:10.1111/irv.12911

Orthop Surg. 2021 Sep 15. doi: 10.1111/os.13005. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the safety and stability of 3D-printed interbody fusion cages (3D-printed cages) in anterior cervical discectomy and fusion (ACDF) by investigating the mid- and long-term follow-up outcomes.

METHODS: In this prospective study, the clinical data of 30 patients with CSM admitted to the Second Hospital of Shanxi Medical University from May 2012 to May 2014 were analyzed. The cohort comprised 18 males and 12 females with an average age of 60.22 ± 3.2 years. All patients were examined by X-ray, CT and MRI before the operation. A total of 30 cases of CSM were treated by ACDF with 3D printed cage implantation. Mid- and long-term follow-ups were performed after the surgery. Clinical efficacy was evaluated by comparing the JOA score, SF-36 score, change in neurological function, cervical curvature index (CCI), vertebral intervertebral height (VIH) and fusion rate before the operation, 6 months after the operation, and at the last follow-up.

RESULTS: Two of the 30 patients were lost to follow-up. The remaining patients were followed up for 48-76 (65.23 ± 3.54) months. The patients recovered satisfactorily with a significant clinical effect. The JOA score increased meanfully and the improvement rate was 89.4% at the final follow-up. The SF-36 score increased significantly from pre- to postoperatively. The height of the intervertebral space at the last follow-up was not statistically significantly different from that at 6 months after surgery (P > 0.05), showing that the height of the intervertebral space did not change much and the severity of cage subsidence (CS) decreased. The CCI improved from pre- to postoperatively. The CCI did not change much from the 6-month follow-up to the last follow-up. and the cage rate (CR) was 100% at the 6-month and last follow-ups. No severe complications, such as spinal cord injury, esophageal fistula, cerebrospinal fluid leakage, cervical hematoma or wound infection, occurred in any of the patients.

CONCLUSION: The clinical and radiological results show that the application of 3D-printed cages in ACDF can significantly relieve symptoms. Moreover, 3D-printed cages can restore the curvature of the cervical spine, effectively maintain the intervertebral height for a long time, and prevent complications related to postoperative subsidence.

PMID:34523808 | DOI:10.1111/os.13005

Orthop Surg. 2021 Sep 15. doi: 10.1111/os.13102. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze correlations between the selection of microtitanium plates with different specifications for use in a cervical vertebral dome expansion laminoplasty.

METHODS: Sixteen patients that underwent the cervical vertebral dome expansion laminoplasty with a cervical spinal stenosis angioplasty procedure for treatment of their cervical spinal cords were recruited at our hospital. From February 2017 to September 2018, medical records confirmed that all patients underwent cervical CT and MRI tests pre- and postsurgery. The anteroposterior diameter of the spinal canal, changes in the cross-sectional area of the spinal canal, and the pre- and postsurgery distance of the cervical spinal cord after applying microtitanium plates with different lengths were measured by Mimics version 17.0 software (Materialise NV, Leuven, Belgium). A statistical regression and correlation analysis of relevant specification parameters of the microtitanium plate was then studied.

RESULTS: As the size of the microtitanium plate increased, we found that the cross-sectional area of cervical spinal canal and distance between the descendants of the lamina and the distance of cervical spinal cord concordantly increased, and these data changes linearly. The regression equation associated with sagittal diameter, cross-sectional area, and posterior movement distance of the cervical spinal cord was obtained.

CONCLUSION: According to the correlation analysis of imaging data changes, the regression equation was obtained to guide the selection of microtitanium plates with appropriate specifications in a cervical vertebral dome expansion laminoplasty.

PMID:34523793 | DOI:10.1111/os.13102

Pediatr Blood Cancer. 2021 Sep 15:e29328. doi: 10.1002/pbc.29328. Online ahead of print.

ABSTRACT

Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.

PMID:34523798 | DOI:10.1002/pbc.29328