Aliment Pharmacol Ther 31, 1132–1140
Summary
Background The roles of depression and antidepressants in triggering reflux symptoms remain unclear.
Aim To compare the incidence of gastro‐oesophageal ...reflux disease (GERD) in individuals with and without a depression diagnosis and to evaluate risk factors for a GERD diagnosis. The relationship between antidepressant treatment and GERD was also assessed.
Methods The Health Improvement Network UK primary care database was used to identify patients with incident depression and an age‐ and sex‐matched control cohort with no depression diagnosis. Incident GERD diagnoses were identified during a mean follow‐up of 3.3 years. Furthermore, we performed nested case‐control analyses where odds ratios (OR) with 95% confidence intervals (CI) were estimated by unconditional logistic regression in multivariable models.
Results The incidence of GERD was 14.2 per 1000 person‐years in the depression cohort and 8.3 per 1000 person‐years in the control cohort. The hazard ratio of GERD in patients with depression compared with controls was 1.72 (95% CI: 1.60–1.85). Among patients with depression, tricyclic antidepressant use was associated with an increased risk of GERD (OR: 1.71; 95% CI: 1.34–2.20), while selective serotonin reuptake inhibitors were not associated with GERD.
Conclusions A depression diagnosis is associated with an increased risk of a subsequent GERD diagnosis, particularly in individuals using tricyclic antidepressants.
Oral anti-diabetic drugs (OADs) have been associated with community-acquired pneumonia (CAP). We aimed to validate the recording of CAP in the Spanish Database for Pharmacoepidemiological Research in ...Primary Care (BIFAP) for the future evaluation of OAD–CAP association. The incidence rate (IR/1000 person-years) of CAP in type 2 diabetes mellitus (T2DM) was also determined. In total, 2966 pneumonia records (2040 listed as diagnosis and 926 as identified from comments added by physicians) were identified from 76 009 patients with T2DM after the first OAD in 2002–2013. Data around the CAP date were reviewed: 1803 (60·9%) were classified as ‘probable CAP’ (confirmed by X-ray/laboratory, referral letters or CAP lung site); 589 (19·8%) as ‘no-case’ (486 had other illness, 78 previous CAP, 25 cancer); and 574 (19·4%) as ‘possible CAP’ (441 without confirmatory information, 133 with uncertain diagnosis or uncertain diagnosis date). In total, 74·2% and 31·4% of pneumonia records in the diagnosis and comments, respectively, were ‘probable cases’ (IR: 6·04), which increased to 90·5% and 42·9%, respectively, when the 441 ‘possible cases’ without confirmatory information were included (IR: 7·52). In summary, diagnosis had a high positive predictive value, and adding cases automatically detected from comments decreased that value significantly.
The effectiveness of disease-modifying drugs in the treatment of multiple sclerosis is associated with adherence. RebiSmart® electronic device provides useful information about adherence to the ...treatment with subcutaneous (sc) interferon (IFN) β-1a (Rebif®). The aim of the study was to determine long-term adherence to this treatment in patients with relapsing-remitting multiple sclerosis (RRMS). This retrospective multicentre observational study analysed 258 patients with RRMS who were receiving sc IFN β-1a (Rebif®) treatment by using RebiSmart® until replacement (36 months maximum lifetime) or treatment discontinuation. Adherence was calculated with data (injection dosage, time, and date) automatically recorded by RebiSmart®. Patients in the study had a mean age of 41 years with a female proportion of 68%. Mean EDSS score at start of treatment was 1.8 (95% CI, 1.6-1.9). Overall adherence was 92.6% (95% CI, 90.6-94.5%). A total of 30.2% of patients achieved an adherence rate of 100%, 80.6% at least 90%, and only 13.2% of patients showed a suboptimal adherence (<80%). A total of 59.9% of subjects were relapse-free after treatment initiation. Among 106 subjects (41.1%) who experienced, on average, 1.4 relapses, the majority were mild (40.6%) or moderate (47.2%). Having experienced relapses from the beginning of the treatment was the only variable significantly related to achieving an adherence of at least 80% (OR = 3.06, 1.28-7.31). Results of this study indicate that sc IFN β-1a administration facilitated by RebiSmart® could lead to high rates of adherence to a prescribed dose regimen over 36 months.
The wild population of South Pacific bonito
, which has a wide distribution in northern Chile, is considered of importance in Chilean aquaculture. The biological feasibility of cultivation of any ...marine species begins with the establishment of an initial broodstock population to obtain eggs, larvae, and juveniles. In this work, 22 South Pacific bonito fishing campaigns were carried out in Pisagua, Chile, between spring in November 2011 and the summer in January 2012. At least 74 specimens were obtained of which 24 survived the capture and transport processes. Fish were stocked in a recirculating land-based aquaculture system, and at 14 months under captivity, fish began spawning. Eggs were collected, to describe some stages of development, and were placed in incubators at 20 °C and on the third-day eggs hatched. Larvae reached a total length between 1.435 and 1.7 mm, which were accurately characterized during their first morphological changes. This is the first work that describes the capture, transport, and acclimatization in captivity of a breeding population of wild Pacific bonito in Chile.
•Adipose-derived stem cells were tested as therapy for canine inflammatory bowel disease.•Endoscopic and histological scales were used to assess macroscopic and microscopic changes.•Endoscopic and ...histological scores decreased significantly after therapy.•Endoscopic remission was achieved in 4/11 patients.•Histological remission was not achieved in any patient.
Systemic administration of mesenchymal stem cells (MSCs) has been shown to be safe and efficacious in humans with Crohn's disease. The aim of this study was to evaluate the safety of an intravenous (IV) infusion of adipose tissue-derived mesenchymal stem cells (ASCs) and to assess macroscopic and histological effects in the digestive tract of dogs with inflammatory bowel disease (IBD). Eleven dogs with confirmed IBD received a single ASC infusion (2 × 106 cells/kg bodyweight). Full digestive endoscopic evaluation was performed pre-treatment and between 90 and 120 days post-treatment with mucosal changes being assessed using a fit-for-purpose endoscopic scale. Endoscopic biopsies from each digestive section were evaluated histologically according to the World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group criteria. The pre- and post-treatment canine IBD endoscopic index (CIBDEI) and histological score (HS) were calculated and compared using the Wilcoxon test. Remission was defined as a reduction of >75% of the CIBDEI and HS compared with pre-treatment.
No acute reactions to ASC infusion or side effects were reported in any dog. Significant differences between pre- and post-treatment were found in both the CIBDEI (P = 0.004) and HS (P = 0.004). Endoscopic remission occurred in 4/11 dogs with the remaining dogs showing decreased CIBDEI (44.8% to 73.3%). Histological remission was not achieved in any dog, with an average reduction of the pre-treatment HS of 27.2%. In conclusion, a single IV infusion of allogeneic ASCs improved gastrointestinal lesions as assessed macroscopically and slightly reduced gastrointestinal inflammation as evaluated by histopathology in dogs with IBD.
The proposal of the article is to advance on the concept of Hybrid World War and to relate it to the conflict between the United States and China in the present historical-spatial transition of the ...world system. The concept of Hybrid World War is developed in contrast to that of the New Cold War, and in relation to the characteristics acquired by the world capitalist system from 1970 to 1980 as a transnational system of production, trade, and finance, the dynamics of strategic competition in the crisis of the unipolar globalist order, and the characteristics of the rise of China and its significance, different from that of the USSR. From this conceptual framework, the United States-China rivalry is observed, analyzing: the systemic tension between unipolarism and multipolarism, the central dispute in Asia Pacific, and the development of a war on all fronts or unrestricted.
This observational study included patients who underwent pre-operative coronavirus disease 2019 (COVID-19) screening in order to preserve patient safety. Reverse transcriptase polymerase chain ...reaction (PCR) for severe acute respiratory syndrome coronavirus-2 was performed in 2292 of 8740 surgical procedures, and the incidence of a positive PCR result was 0.0022%. No healthcare-associated infections were detected. There was no difference in overall mortality or length of hospital stay compared with the same period from the previous year. A selective screening strategy to identify patients for PCR testing, based on isolation measures, presurgical clinical-epidemiological assessment and selected major surgeries susceptible to a poor COVID-19-related outcome, is effective and safe for patients and healthcare workers.
We present RibEx (riboswitch explorer), a web server capable of searching any sequence for known riboswitches as well as other predicted, but highly conserved, bacterial regulatory elements. It ...allows the visual inspection of the identified motifs in relation to attenuators and open reading frames (ORFs). Any of the ORF's or regulatory elements' sequence can be obtained with a click and submitted to NCBI's BLAST. Alternatively, the genome context of all other genes regulated by the same element can be explored with our genome context tool (GeConT). RibEx is available at http://www.ibt.unam.mx/biocomputo/ribex.html.
The Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) is a public-private collaboration aiming to develop and test a system for rapid benefit-risk (B/R) monitoring of ...vaccines using European healthcare databases. Event misclassification can result in biased estimates. Using different algorithms for identifying cases of Bordetella pertussis (BorPer) infection as a test case, we aimed to describe a strategy to quantify event misclassification, when manual chart review is not feasible.
Four participating databases retrieved data from primary care (PC) setting: BIFAP: (Spain), THIN and RCGP RSC (UK) and PEDIANET (Italy); SIDIAP (Spain) retrieved data from both PC and hospital settings. BorPer algorithms were defined by healthcare setting, data domain (diagnoses, drugs, or laboratory tests) and concept sets (specific or unspecified pertussis). Algorithm- and database-specific BorPer incidence rates (IRs) were estimated in children aged 0–14 years enrolled in 2012 and 2014 and followed up until the end of each calendar year and compared with IRs of confirmed pertussis from the ECDC surveillance system (TESSy). Novel formulas were used to approximate validity indices, based on a small set of assumptions. They were applied to approximately estimate positive predictive value (PPV) and sensitivity in SIDIAP.
The number of cases and the estimated BorPer IRs per 100,000 person-years in PC, using data representing 3,173,268 person-years, were 0 (IR = 0.0), 21 (IR = 4.3), 21 (IR = 5.1), 79 (IR = 5.7), and 2 (IR = 2.3) in BIFAP, SIDIAP, THIN, RCGP RSC and PEDIANET respectively. The IRs for combined specific/unspecified pertussis were higher than TESSy, suggesting that some false positives had been included. In SIDIAP the estimated IR was 45.0 when discharge diagnoses were included. The sensitivity and PPV of combined PC specific and unspecific diagnoses for BorPer cases in SIDIAP were approximately 85% and 72%, respectively.
Retrieving BorPer cases using only specific concepts has low sensitivity in PC databases, while including cases retrieved by unspecified concepts introduces false positives, which were approximately estimated to be 28% in one database. The share of cases that cannot be retrieved from a PC database because they are only seen in hospital was approximately estimated to be 15% in one database. This study demonstrated that quantifying the impact of different event-finding algorithms across databases and benchmarking with disease surveillance data can provide approximate estimates of algorithm validity.
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