How valid are IMS DA summary statistics of children's vaccination status?

Purpose: Accurate recording of immunisation status is essential for the evaluation of any immunization program. In September 2006, 7 Valent Pneumococcal Conjugate Vaccination (PCV7) was introduced into the UK’s routine childhood immunisation programme. This study validated the PCV7 immunization status of children aged 2 years recorded in the IMS Disease Analyses database. / Methods: The PCV7 vaccination uptake rate for children born in 2008 in the IMS DA database was calculated. A sample of 173 of the 2497 children not recorded as vaccinated was identified and a questionnaire was sent to each of their General Practitioners to ascertain the child’s true PCV7 vaccination status. / Results: In the IMS DA data of 15,237 children born in 2008, 12,740 (83.6%) had a vaccination record of PCV7. One hundred and eleven of the 167 questionnaires sent to the child’s general practitioners were returned, giving an adjusted response rate of 111/167 (66.5%). Based on the general practitioners’ responses, 71 (64%) of these children were fully vaccinated according to their General Practitioner’s records making the revised estimated vaccination rate for this cohort 94.1%. / Conclusion: This validation study has shown that caution is needed if using historical IMS patient-level data to analyse the effectiveness of PCV7 as there is a potential under-recording of immunization leading to underrepresentation of vaccination rates by approximately ten per cent. Coverage of other vaccines may also be underestimated in the IMS database

Perbandingan Nilai Agregasi Trombosit Pada Pasien Hipertensi Yang Diberi Aspirin Dan Tidak Diberi Aspirin Di Rsup. Prof. Dr. R. D. Kandou Manado

: Thrombocyte hyperaggregation occurs in hypertensive patients. Thrombocyte accumulates and thrombi formation caused by hyperaggregation are important factors in pathogenesis of cardiovaskular and cerebrovascular disease. Around 50 million people consume aspirin everyday to treat or to prevent cardiovascular or cerebrovascular disease. The use of aspirin known can increase bleeding risk especially when trauma occurs or intraoperative, but inhypertensive patients50 or over 50 years old, the benefit of aspirin can be greater then the bleeding risk it carries. Method: This study used comparative study, which compared thrombocyte aggregation value in hypertensive patients with aspirin and without aspirin. The tools that used for thrombocyte aggregation examination is an aggregometer and the data analysis is done by using SPSS software. Result: The difference value of thrombocyte aggregation in hypertensive patients with aspirin and without aspirin used T 2 independent samples test gave significant for ADP 10 µM and 5 µM(p <0.05), respectively 0.001 and 0.01. Conclusion: There is a difference between thrombocyte aggregation value in hypertensive patients with aspirin and without aspirin. Mean value ofthrombocyte aggregation in hypertensive patients with aspirin is lower than hypertensive patients without aspirin

Adverse drug reactions in hospitalized children in Germany are decreasing: results of a nine year cohort-based comparison

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Prevalence and characteristics of antidepressant prescribing in adults with comorbid depression and type 2 diabetes mellitus: A systematic review and meta-analysis

Background: Treatment guidelines do not provide specific recommendations for antidepressant prescribing in people with type 2 diabetes mellitus (T2DM). It is important to understand the prevalence of antidepressant prescribing and associated patient characteristics, to recognise safety issues or inequalities related to treatment access. Methods and Results: Seven databases were searched using terms related to depression, T2DM and antidepressant medication. From 14,389 reports retrieved, 9 met inclusion criteria. The prevalence of antidepressant prescribing varied considerably between studies from 18% to 87%. Where meta-analyses were possible, the pooled odds ratio for receiving an antidepressant were 1.52 (95% confidence intervals (CIs) 1.28 - 1.82) in women compared to men, 0.53 (95% CIs 0.23-1.20%) in Black and Ethnic Minorities compared to White ethnicity and 1.29 (95% CIs 0.92-1.80) in insulin users compared to individuals with non-insulin controlled T2DM. Conclusions: Antidepressant prescribing is more common in women with T2DM compared to men, however, the difference is less than in the general population. Insulin users, representing individuals with more advanced T2DM, were as likely to be prescribed antidepressants as those who did not use insulin. There is a gap in the literature concerning which antidepressant agents are being prescribed, and alongside which concurrent medications and comorbidities

Development and validation of a risk score (Delay-7) to predict the occurrence of a treatment delay following cycle 1 chemotherapy

BACKGROUND: The risk of toxicity-related dose delays, with cancer treatment, should be included as part of pretreatment education and be considered by clinicians upon prescribing chemotherapy. An objective measure of individual risk could influence clinical decisions, such as escalation of standard supportive care and stratification of some patients, to receive proactive toxicity monitoring. PATIENTS AND METHODS: We developed a logistic regression prediction model (Delay-7) to assess the overall risk of a chemotherapy dose delay of 7 days for patients receiving first-line treatments for breast, colorectal and diffuse large B-cell lymphoma. Delay-7 included hospital treated, age at the start of chemotherapy, gender, ethnicity, body mass index, cancer diagnosis, chemotherapy regimen, colony stimulating factor use, first cycle dose modifications and baseline blood values. Baseline blood values included neutrophils, platelets, haemoglobin, creatinine and bilirubin. Shrinkage was used to adjust for overoptimism of predictor effects. For internal validation (of the full models in the development data) we computed the ability of the models to discriminate between those with and without poor outcomes (c-statistic), and the agreement between predicted and observed risk (calibration slope). Net benefit was used to understand the risk thresholds where the model would perform better than the ‘treat all’ or ‘treat none’ strategies. RESULTS: A total of 4604 patients were included in our study of whom 628 (13.6%) incurred a 7-day delay to the second cycle of chemotherapy. Delay-7 showed good discrimination and calibration, with c-statistic of 0.68 (95% confidence interval 0.66-0.7), following internal validation and calibration-in-the-large of −0.006. CONCLUSIONS: Delay-7 predicts a patient’s individualised risk of a treatment-related delay at cycle two of treatment. The score can be used to stratify interventions to reduce the occurrence of treatment-related toxicity

An ancient genome duplication contributed to the abundance of metabolic genes in the moss Physcomitrella patens

<p>Abstract</p> <p>Background:</p> <p>Analyses of complete genomes and large collections of gene transcripts have shown that most, if not all seed plants have undergone one or more genome duplications in their evolutionary past.</p> <p>Results:</p> <p>In this study, based on a large collection of EST sequences, we provide evidence that the haploid moss <it>Physcomitrella patens </it>is a paleopolyploid as well. Based on the construction of linearized phylogenetic trees we infer the genome duplication to have occurred between 30 and 60 million years ago. Gene Ontology and pathway association of the duplicated genes in <it>P. patens </it>reveal different biases of gene retention compared with seed plants.</p> <p>Conclusion:</p> <p>Metabolic genes seem to have been retained in excess following the genome duplication in <it>P. patens</it>. This might, at least partly, explain the versatility of metabolism, as described for <it>P. patens </it>and other mosses, in comparison to other land plants.</p

Did the accuracy of oral amoxicillin dosing of children improve after British National Formulary dose revisions in 2014? National cross-sectional survey in England.

OBJECTIVES: Inaccurate antibiotic dosing can lead to treatment failure, fuel antimicrobial resistance and increase side effects. The British National Formulary for Children (BNFC) guidance recommends oral antibiotic dosing according to age bands as a proxy for weight. Recommended doses of amoxicillin for children were increased in 2014 'after widespread concerns of under dosing'. However, the impact of dose changes on British children of different weights is unknown, particularly given the rising prevalence of childhood obesity in the UK. We aimed to estimate the accuracy of oral amoxicillin dosing in British children before and after the revised BNFC guidance in 2014. SETTING AND PARTICIPANTS: We used data on age and weights for 1556 British children (aged 2-18 years) from a nationally representative cross-sectional survey, the Health Survey for England 2013. INTERVENTIONS: We calculated the doses each child would receive using the BNFC age band guidance, before and after the 2014 changes, against the 'gold standard' weight-based dose of amoxicillin, as per its summary of product characteristics. PRIMARY OUTCOME MEASURE: Assuming children of different weights were equally likely to receive antibiotics, we calculated the percentage of the children who would be at risk of misdosing by the BNFC age bands. RESULTS: Before 2014, 54.6% of children receiving oral amoxicillin would have been underdosed and no child would have received more than the recommended dose. After the BNFC guidance changed in 2014, the number of children estimated as underdosed dropped to 5.8%, but 0.5% of the children would have received too high a dose. CONCLUSIONS: Changes to the BNFC age-banded amoxicillin doses in 2014 have significantly reduced the proportion of children who are likely to be underdosed, with only a minimal rise in the number of those above the recommended range

Validation of the perceived stress scale (Pss-10) in medical and health sciences students in Hong Kong

INTRODUCTION: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context. METHODS: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach’s alpha coefficient and corrected item-total correlations for reliability. RESULTS: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach’s alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale. CONCLUSIONS: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students