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  • 1
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    Online Resource
    Acute Lower Respiratory Infections Associated With Respiratory Syncytial Virus in Children With Underlying Congenital Heart Disease: Systematic Review and Meta-analysis
    Oxford University Press (OUP) ; 2020
    In:  The Journal of Infectious Diseases Vol. 222, No. Supplement_7 ( 2020-10-07), p. S613-S619
    Details
    In: The Journal of Infectious Diseases, Oxford University Press (OUP), Vol. 222, No. Supplement_7 ( 2020-10-07), p. S613-S619
    Abstract: Respiratory syncytial virus (RSV) is the most common viral pathogen associated with acute lower respiratory infections (ALRIs), with significant childhood morbidity and mortality worldwide. Estimates reporting RSV-associated ALRI (RSV-ALRI) severity in children with congenital heart disease (CHD) are lacking, thus warranting the need to summarize the available data. We identified relevant studies to summarize the findings and conducted a meta-analysis of available data on RSV-associated ALRI hospitalizations in children aged & lt;5 years, comparing those with underlying CHD to those without CHD. Methods We conducted a systematic search of existing relevant literature and identified studies reporting hospitalization of children aged & lt;5 years with RSV-ALRI with underlying or no CHD. We summarized the data and conducted (where possible) a random-effects meta-analysis to compare the 2 groups. Results We included 18 studies that met our strict eligibility criteria. The risk of severe RSV-ALRI (odds ratio, 2.2; 95% confidence interval [CI], 1.6–2.8), the rate of hospitalization (incidence rate ratio, 2.8; 95% CI, 1.9–4.1), and the case-fatality ratio (risk ratio [RR] , 16.5; 95% CI, 13.7–19.8) associated with RSV-ALRI was higher among children with underlying CHD as compared to those without no CHD. The risk of admission to the intensive care unit (RR, 3.9; 95% CI, 3.4–4.5), need for supplemental oxygen therapy (RR, 3.4; 95% CI, .5–21.1), and need for mechanical ventilation (RR, 4.1; 95% CI, 2.1–8.0) was also higher among children with underlying CHD. Conclusion This is the most detailed review to show more-severe RSV-ALRI among children aged & lt;5 years with underlying CHD, especially hemodynamically significant underlying CHD, as compared those without CHD, supporting a need for improved RSV prophylactics and treatments that also have efficacy in children older than 1 year.
    Type of Medium: Online Resource
    ISSN: 0022-1899 , 1537-6613
    URL: Article
    DOI: 10.1093/infdis/jiz150
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1473843-0
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  • 2
    Online Resource
    Online Resource
    The Etiological Role of Common Respiratory Viruses in Acute Respiratory Infections in Older Adults: A Systematic Review and Meta-analysis
    Oxford University Press (OUP) ; 2020
    In:  The Journal of Infectious Diseases Vol. 222, No. Supplement_7 ( 2020-10-07), p. S563-S569
    Details
    In: The Journal of Infectious Diseases, Oxford University Press (OUP), Vol. 222, No. Supplement_7 ( 2020-10-07), p. S563-S569
    Abstract: Acute respiratory tract infections (ARI) constitute a substantial disease burden in adults and elderly individuals. We aimed to identify all case-control studies investigating the potential role of respiratory viruses in the etiology of ARI in older adults aged ≥65 years. We conducted a systematic literature review (across 7 databases) of case-control studies published from 1996 to 2017 that investigated the viral profile of older adults with and those without ARI. We then computed a pooled odds ratio (OR) with a 95% confidence interval and virus-specific attributable fraction among the exposed (AFE) for 8 common viruses: respiratory syncytial virus (RSV), influenza virus (Flu), parainfluenza virus (PIV), human metapneumovirus (HMPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV). From the 16 studies included, there was strong evidence of possible causal attribution for RSV (OR, 8.5 [95% CI, 3.9–18.5] ; AFE, 88%), Flu (OR, 8.3 [95% CI, 4.4–15.9]; AFE, 88%), PIV (OR, not available; AFE, approximately 100%), HMPV (OR, 9.8 [95% CI, 2.3–41.0] ; AFE, 90%), AdV (OR, not available; AFE, approximately 100%), RV (OR, 7.1 [95% CI, 3.7–13.6]; AFE, 86%) and CoV (OR, 2.8 [95% CI, 2.0–4.1] ; AFE, 65%) in older adults presenting with ARI, compared with those without respiratory symptoms (ie, asymptomatic individuals) or healthy older adults. However, there was no significant difference in the detection of BoV in cases and controls. This review supports RSV, Flu, PIV, HMPV, AdV, RV, and CoV as important causes of ARI in older adults and provides quantitative estimates of the absolute proportion of virus-associated ARI cases to which a viral cause can be attributed. Disease burden estimates should take into account the appropriate AFE estimates (for older adults) that we report.
    Type of Medium: Online Resource
    ISSN: 0022-1899 , 1537-6613
    URL: Article
    DOI: 10.1093/infdis/jiy662
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1473843-0
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  • 3
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    Online Resource
    Immunological and Inflammatory Biomarkers of Susceptibility and Severity in Adult Respiratory Syncytial Virus Infections
    Oxford University Press (OUP) ; 2020
    In:  The Journal of Infectious Diseases Vol. 222, No. Supplement_7 ( 2020-10-07), p. S584-S591
    Details
    In: The Journal of Infectious Diseases, Oxford University Press (OUP), Vol. 222, No. Supplement_7 ( 2020-10-07), p. S584-S591
    Abstract: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in young infants. However, it is also a significant pathogen in older adults. Validated biomarkers of RSV disease severity would benefit diagnostics, treatment decisions, and prophylactic interventions. This review summarizes knowledge of biomarkers for RSV disease in adults. Methods A literature review was performed using Ovid Medline, Embase, Global health, Scopus, and Web of Science for articles published 1946–October 2016. Nine articles were identified plus 9 from other sources. Results From observational studies of natural infection and challenge studies in volunteers, biomarkers of RSV susceptibility or disease severity in adults were: (1) lower anti-RSV neutralizing antibodies, where neutralizing antibody (and local IgA) may be a correlate of susceptibility/severity; (2) RSV-specific CD8+ T cells in bronchoalveolar lavage fluid preinfection (subjects with higher levels had less severe illness); and (3) elevated interleukin-6 (IL-6), IL-8, and myeloperoxidase levels in the airway are indicative of severe infection. Conclusions Factors determining susceptibility to and severity of RSV disease in adults have not been well defined. Respiratory mucosal antibodies and CD8+ T cells appear to contribute to preventing infection and modulation of disease severity. Studies of RSV pathogenesis in at-risk populations are needed.
    Type of Medium: Online Resource
    ISSN: 0022-1899 , 1537-6613
    URL: Article
    DOI: 10.1093/infdis/jiaa063
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1473843-0
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  • 4
    Online Resource
    Online Resource
    Cost of Respiratory Syncytial Virus-Associated Acute Lower Respiratory Infection Management in Young Children at the Regional and Global Level: A Systematic Review and Meta-Analysis
    Oxford University Press (OUP) ; 2020
    In:  The Journal of Infectious Diseases Vol. 222, No. Supplement_7 ( 2020-10-07), p. S680-S687
    Details
    In: The Journal of Infectious Diseases, Oxford University Press (OUP), Vol. 222, No. Supplement_7 ( 2020-10-07), p. S680-S687
    Abstract: Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection (ALRI) in young children aged & lt;5 years. Methods We aimed to identify the global inpatient and outpatient cost of management of RSV-ALRI in young children to assist health policy makers in making decisions related to resource allocation for interventions to reduce severe morbidity and mortality from RSV in this age group. We searched 3 electronic databases including Global Health, Medline, and EMBASE for studies reporting cost data on RSV management in children under 60 months from 2000 to 2017. Unpublished data on the management cost of RSV episodes were collected through collaboration with an international working group (RSV GEN) and claim databases. Results We identified 41 studies reporting data from year 1987 to 2017, mainly from Europe, North America, and Australia, covering the management of a total of 365 828 RSV disease episodes. The average cost per episode was €3452 (95% confidence interval [CI], 3265–3639) and €299 (95% CI, 295–303) for inpatient and outpatient management without follow-up, and it increased to €8591(95% CI, 8489–8692) and €2191 (95% CI, 2190–2192), respectively, with follow-up to 2 years after the initial event. Conclusions Known risk factors (early and late preterm birth, congenital heart disease, chronic lung disease, intensive care unit admission, and ventilator use) were associated with €4160 (95% CI, 3237–5082) increased cost of hospitalization. The global cost of inpatient and outpatient RSV ALRI management in young children in 2017 was estimated to be approximately €4.82 billion (95% CI, 3.47–7.93), 65% of these in developing countries and 55% of global costs accounted for by hospitalization. We have demonstrated that RSV imposed a substantial economic burden on health systems, governments, and the society.
    Type of Medium: Online Resource
    ISSN: 0022-1899 , 1537-6613
    URL: Article
    DOI: 10.1093/infdis/jiz683
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1473843-0
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  • 5
    Online Resource
    Online Resource
    Association Between Antipsychotic Treatment and Hyperlipidemia Among California Medicaid Patients With Schizophrenia
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Journal of Clinical Psychopharmacology Vol. 25, No. 1 ( 2005-02), p. 12-18
    Details
    In: Journal of Clinical Psychopharmacology, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 1 ( 2005-02), p. 12-18
    Type of Medium: Online Resource
    ISSN: 0271-0749
    URL: Article
    DOI: 10.1097/01.jcp.0000150224.38630.ae
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 2057059-4
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  • 6
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    Cost Effectiveness of Adjunctive Quetiapine Fumarate Extended-Release Tablets with Mood Stabilizers in the Maintenance Treatment of Bipolar I Disorder
    Springer Science and Business Media LLC ; 2010
    In:  PharmacoEconomics Vol. 28, No. 9 ( 2010-09), p. 751-764
    Details
    In: PharmacoEconomics, Springer Science and Business Media LLC, Vol. 28, No. 9 ( 2010-09), p. 751-764
    Type of Medium: Online Resource
    ISSN: 1170-7690
    URL: Article
    DOI: 10.2165/11538350-000000000-00000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2010
    detail.hit.zdb_id: 2043876-X
    SSG: 15,3
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  • 7
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    Costs of Lower-Extremity Ulcers Among Patients With Diabetes
    American Diabetes Association ; 2004
    In:  Diabetes Care Vol. 27, No. 9 ( 2004-09-01), p. 2129-2134
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 27, No. 9 ( 2004-09-01), p. 2129-2134
    Abstract: OBJECTIVE—The objective of this study was to characterize health care costs associated with diabetic lower-extremity ulcers. RESEARCH DESIGN AND METHODS—Adult patients with diabetes who had a lower-extremity ulcer episode during 2000 and 2001 were identified using claims data. Ulcer-related direct health care costs were computed for each episode. Episodes were stratified according to severity level based on the Wagner classification. RESULTS—A total of 2,253 patients were identified. The mean age was 68.9 years, and 59% of the patients were male. The average episode duration was 87.3 ± 82.8 days. Total ulcer-related costs averaged $13,179 per episode and increased with severity level, ranging from $1,892 (level 1) to $27,721 (level 4/5). Inpatient hospital charges accounted for 77% ($10,188) of the overall cost, indicating that hospitalization was a major cost driver. Total ulcer-related costs were significantly higher for patients & lt;65 years of age compared with those of older patients ($16,390 vs. $11,925, P = 0.02) and for patients with inadequate vascular status compared with patients with adequate vascular status ($23,372 vs. $5,218, P & lt; 0.0001). Patients who progressed to a higher severity level also had significantly higher ulcer-related costs compared with patients who did not progress ($20,136 vs. $3,063, P & lt; 0.0001). CONCLUSIONS—The high costs of treating diabetic lower-extremity ulcers emphasize the value of intensive outpatient interventions designed to prevent ulcer progression.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.27.9.2129
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
    detail.hit.zdb_id: 1490520-6
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  • 8
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    Online Resource
    Are Standardized Patient Ratings Influenced by Patient Perceptions of the Preceding Examinee?
    Informa UK Limited ; 1998
    In:  Teaching and Learning in Medicine Vol. 10, No. 4 ( 1998-10), p. 201-206
    Details
    In: Teaching and Learning in Medicine, Informa UK Limited, Vol. 10, No. 4 ( 1998-10), p. 201-206
    Type of Medium: Online Resource
    ISSN: 1040-1334 , 1532-8015
    URL: Article
    DOI: 10.1207/S15328015TLM1004_2
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 1998
    SSG: 5,3
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  • 9
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    Online Resource
    Cost-effectiveness of quetiapine with lithium or divalproex for maintenance treatment of bipolar I disorder
    Informa UK Limited ; 2009
    In:  Journal of Medical Economics Vol. 12, No. 4 ( 2009-12), p. 259-268
    Details
    In: Journal of Medical Economics, Informa UK Limited, Vol. 12, No. 4 ( 2009-12), p. 259-268
    Type of Medium: Online Resource
    ISSN: 1369-6998 , 1941-837X
    URL: Article
    DOI: 10.3111/13696990903266612
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2009
    detail.hit.zdb_id: 2156786-4
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  • 10
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    P0671THE ASSOCIATION BETWEEN HYPERKALAEMIA RISK AND CARDIOVASCULAR AND RENAL COMORBIDITIES IN A LARGE REAL-WORLD COHORT OF CKD PATIENTS
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: Approximately 275.9 million people globally and 5.6 million people in the UK are living with chronic kidney disease (CKD). The risk of hyperkalaemia (HK) is elevated in CKD due to renal impairment and may increase further upon treatment with renin-angiotensin-aldosterone system inhibitors, which are commonly used in many cardiovascular and renal conditions. This study aimed to assess the relationship between comorbidity burden and HK risk in a large cohort of UK CKD patients. Method Primary and secondary care data from the UK Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) were used to identify patients aged ≥18 years who had a diagnosis of stage 3+ CKD (identified as either a READ code for non-dialysis CKD stage 3+ or an estimated glomerular filtration rate (eGFR) & lt;60 mL/min/1.73m2 without a prior READ code for dialysis) during the study period (2008–June 2018) or the five-year look-back period (2003–2007). Patient’s index date was 1st January 2008 or the first date of CKD diagnosis, whichever occurred later. Diagnoses based on the presence of READ codes were used to define the accumulation of further cardiovascular or renal comorbidities of interest (resistant hypertension, heart failure, diabetes or dialysis-dependent CKD). The incidence of HK was defined as serum potassium (K+) thresholds of ≥5.0, ≥5.5 and ≥6.0 mmol/L. Results In total, 297,702 eligible patients had a CKD diagnosis during the study or look back periods and their mean follow-up was 5.6 (SD 3.2) years from index date. At baseline, mean age was 74.7 (11.3) years, mean body mass index was 28.3 (5.9) kg/m2, and 58.6% of patients were female. CKD was the first diagnosis in 169,532 patients (56.9% of all CKD diagnoses), second diagnosis in 92,651 patients (31.1%), third in 32,606 patients (11.0%) and fourth or fifth in 2,913 patients (1.0%); however, only 11,129 CKD patients (3.74%) developed four or more comorbidities of interest. In total, 1.5% of the cohort (4,544 patients) progressed to dialysis and 29.6% (88,245 patients) died during the study period. In general, the incidence of HK increased with the number of comorbidities of interest (Figure 1). At a K+ threshold of ≥5.0 mmol/L, crude incidence rate of HK was 286.5 (95% CI: 285.2–287.8) per 1,000 patient-years in patients with CKD only; this increased 2.8-fold to 806.8 (741.5–876.4) in patients with five comorbidities of interest. A similar trend was observed at K+ thresholds of ≥5.5 mmol/L and ≥6.0 mmol/L. A 5.9 fold increase was observed in crude incidence rate of HK (from 59.7 [59.1–60.3] with CKD only, to 350.3 [307.7–397.1] with all five comorbidities) at a threshold of ≥5.5 mmol/L and a 10.6-fold increase (from 9.1 [8.9–9.4] to 96.2 [74.6–122.2] ) at the ≥6.0 mmol/L threshold. Conclusion This assessment of a large real-world patient cohort showed that the risk of HK in patients with CKD increases with the number of cardiovascular or renal comorbidities. Emphasis should be put on effective prevention and treatment of HK in CKD, especially in patients with high comorbidity burden.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa142.P0671
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1465709-0
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