Global prevalence of antidepressant utilization in the community: A protocol for a systematic review

Introduction Antidepressant drugs are the most frequently prescribed medication for mental disorders. They are also used off-label and for non-psychiatric indications. Prescriptions of antidepressants have increased in the last decades, but no systematic review exists on the extent of their use in the community. Methods and analysis We will conduct a systematic review to estimate the prevalence of antidepressant use in the community. We will search for studies published from 1 January 2010 in the Embase and MEDLINE databases using a combination of controlled vocabulary and keywords adjusted for each database without any language restriction. The main inclusion criterion is the presence of prevalence data of antidepressant utilization. Thus, we will include all studies with a descriptive observational design reporting the prevalence of antidepressant use in the community. Study selection (by title/abstract and full-text screening) and data extraction for included studies will be independently conducted by pairs of reviewers. We will then synthesize the data on the prevalence of antidepressant use in individuals living in the community. If possible, we will perform a meta-analysis to generate prevalence-pooled estimates. If the data allows it, we will conduct subgroup analyses by antidepressant class, age, sex, country and other sociodemographic categories. We will evaluate the risk of bias for each included study through a quality assessment using the Joanna Briggs Institute Critical Appraisal tool: Checklist for Studies Reporting Prevalence Data. DistillerSR software will be used for the management of this review. Ethics and dissemination Ethical approval is not required for this review as it will not directly involve human or animal subjects. The findings of our systematic review will be disseminated through publications in peer-reviewed journals, the Qualaxia Network (https://qualaxia.org), presentations at international conferences on mental health and pharmacoepidemiology, as well as general public events. PROSPERO registration number CRD42021247423

Impact of the timing of hepatitis B virus identification and antiâ hepatitis B virus therapy initiation on the risk of adverse liver outcomes for patients receiving cancer therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138209/1/cncr30729_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138209/2/cncr30729.pd

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Indicateurs de santé, mesure de la qualité de vie et évaluation médico-économique

Health indicators, quality of life measures and economic evaluation The objectives of this research are the comparison between health status and quality of life measures, between quantitative measures and the perception of the patients on their quality of life, a discussion of the results in decision making. The data corne from a survey which included elderly persons in a rehabilitation unit after hip fracture and patients in palliative care. The following tools were used: the Karnofsky Index, the EORTC- QLQ30, Euroqol, the STAS. Three measures were realised along a period of 45 days. Interviews were done at the same time to get the patient' s perception on his (her) quality of life. The results show some convergence but also differences according to the indicators and between the quantitative measures and the patient' s perception. The discussion indicates advocate for a plurality and a complementarity of measures, not for a single one.Résumé. L'objectif de ce travail exploratoire est de comparer plusieurs mesures d'état de santé et de qualité de vie sur deux populations, pour analyser leurs convergences et divergences, comparer les résultats des indicateurs quantitatifs avec l'expression libre des patients sur leur qualité de vie, recueillie par entretien, discuter les résultats du point de vue de leurs implications en terme d'aide à la décision. Les populations qui ont servi de support à ce travail sont des personnes âgées en rééducation après fracture du col du fémur et des patients en soins palliatifs en hospitalisation à domicile. Les outils utilisés sont l'Index de Karnofsky, l'EORTC-QLQ30, Euroqol, le STAS. Ils ont été passés à trois reprises dans un intervalle de 45 jours. Aux mêmes moments ont été réalisés des entretiens non-directifs. Les résultats montrent des convergences mais aussi des divergences entre les indicateurs, en niveau comme en variation. Un écart important existe entre le contenu des indicateurs et la perception des malades sur la qualité de vie. La discussion porte sur la nécessité d'un pluralisme de la mesure.Indicadores de salud, medición de la calidad de vida y evaluación médico-económica Este trabajo exploratorio compara varias mediciones de estado de salud y de calidad de vida en dos tipos de población. Su objetivo es analizar sus convergencias y divergencias, comparar los resultados de los indicadores cuantitativos con lo que han expresado libremente los pacientes en las entrevistas sobre su calidad de vida y debatir los resultados desde el punto de vista de las implicaciones que estos pueden tener en términos de ayuda a la décision. La población que sirve de soporte a este trabajo esta compuesta por personas de edad que se encuentran en reeducacion a consecuencia de la fractura del cuello del fémur y por pacientes que estan bajo cuidados médicos paliativos en hospitalización a domicilio. Los instrumentos utilizados très veces en el intervalo de 45 días, al mismo tiempo que se realizaban las entrevistas no-directivas, han sido : el Index de Karnofsky, el EORTC-QLQ30, El Euroqol y el STAS. Los resultados muestran convergencias así como también divergencias entre los indicadores, tanto en nivel como en variación. Existe una diferencia importante entre el contenido de los indicadores y la percepción de los enfermos en cuanto a su calidad de vida. El debate trata sobre la necesidad de un pluralismo de la medición.Frossard Michel, Jasso Mosqueda Guillermo, Suarez Cathy, Couturier Pascal, Guyot Françoise, Franco Alain. Indicateurs de santé, mesure de la qualité de vie et évaluation médico-économique. In: Sciences sociales et santé. Volume 17, n°4, 1999. pp. 45-64

Didge you sleep: a feasibility study of didgeridoo training for obstructive sleep apnea

Abstract Intolerance of positive airway pressure therapy for obstructive sleep apnea is common. Upper airway muscle therapies show promise as alternative treatments. The didgeridoo, which is a musical instrument, can be used for upper airway muscle training. Our goal was to develop a group-based didgeridoo training program for obstructive sleep apnea. We conducted a proof-of-concept single-arm study consisting of a structured didgeridoo training regimen. We surveyed patients at a large medical facility about their interest in the program. We developed and tested a manual of procedures for conducting a 4-session group program conducted over 8 weeks that instructed participants on use of the Medical Didgeridoo. We also refined procedures for baseline and 4-month follow-up assessments, which included measures of daytime sleepiness and apnea–hypopnea index. Interviews were conducted at follow-up to obtain feedback about the program. Of the 56 survey respondents, 67% reported difficulty with positive airway pressure, expressed interest in participating in a structured upper airway muscle training program, and indicated that they would be willing to practice exercises for 30 min per day. After in-depth screening of 15 patients, we recruited five patients to participate in the structured training program; all five completed the program and were able to learn to play basic sounds on the provided instrument, and four stated they would continue to play the Medical Didgeridoo after completion of the program. Given the significant level of interest and excellent participation in the didgeridoo training program, it may be feasible to conduct a large-scale study to assess treatment response

PET/CT imaging of clear cell renal cell carcinoma with 124I labeled chimeric antibody

Clear cell renal cell carcinoma (ccRCC) presents problems for urologists in diagnosis, treatment selection, intraoperative surgical margin analysis, and long term monitoring. In this paper we describe the development of a radiolabeled antibody specific to ccRCC (124I-cG250) and its potential to help urologists manage each of these problems. We believe 124I-cG250, in conjunction with perioperative Positron emission tomography/computed tomography imaging and intraoperative handheld gamma probe use, has the potential to diagnose ccRCC, aid in determining a proper course of treatment (operative or otherwise), confirm complete resection of malignant tissue in real time, and monitor patients post-operatively

Human papillomavirus DNA prevalence and type distribution in anal carcinomas worldwide

Knowledge about human papillomaviruses (HPV) types involved in anal cancers in some world regions is scanty. Here, we describe the HPV DNA prevalence and type distribution in a series of invasive anal cancers and anal intraepithelial neoplasias (AIN) grades 2/3 from 24 countries. We analyzed 43 AIN 2/3 cases and 496 anal cancers diagnosed from 1986 to 2011. After histopathological evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping was performed using SPF-10/DEIA/LiPA25 system (version 1). A subset of 116 cancers was further tested for p16INK4a expression, a cellular surrogate marker for HPV-associated transformation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance in the anal cancer data set. HPV DNA was detected in 88.3% of anal cancers (95% confidence interval [CI]: 85.1-91.0%) and in 95.3% of AIN 2/3 (95% CI: 84.2-99.4%). Among cancers, the highest prevalence was observed in warty-basaloid subtype of squamous cell carcinomas, in younger patients and in North American geographical region. There were no statistically significant differences in prevalence by gender. HPV16 was the most frequent HPV type detected in both cancers (80.7%) and AIN 2/3 lesions (75.4%). HPV18 was the second most common type in invasive cancers (3.6%). p16INK4a overexpression was found in 95% of HPV DNA-positive anal cancers. In view of the results of HPV DNA and high proportion of p16INK4a overexpression, infection by HPV is most likely to be a necessary cause for anal cancers in both men and women. The large contribution of HPV16 reinforces the potential impact of HPV vaccines in the prevention of these lesions. What's new? Human papillomavirus (HPV) is linked to anal cancer through high HPV DNA-detection rates. Here, in one of the largest international studies to date, HPV DNA was detected in more than 88% of anal cancers and more than 95% of anal intraepithelial neoplasias grades 2/3. HPV16 was the most frequently detected virus type, followed by HPV18. Overexpression of p16INK4a, a surrogate marker for HPV-associated transformation, was found in 95% of HPV-positive anal cancers. The data implicate HPV as a causative factor in anal cancer.publishersversionpublishe