International Journal of Clinical Practice最新文献

{"title":"Fluoroscopy Is Essential in Retrograde Intrarenal Surgery","authors":"Mehmet Yoldas, Tuba Kuvvet Yoldas","doi":"10.1155/2023/8896681","DOIUrl":"https://doi.org/10.1155/2023/8896681","url":null,"abstract":"<i>Objective</i>. This study aimed to investigate the necessity of using fluoroscopy in retrograde intrarenal surgery (RIRS). <i>Material and Methods</i>. A total of 612 patients who underwent RIRS for kidney stones were evaluated and divided into two groups. Group 1 routinely underwent the operation with fluoroscopy due to opaque stones (<i>n</i>: 504). In group 2, the procedure was performed without fluoroscopy because of nonopaque stones (<i>n</i>: 108). Both groups were assessed for stone size, location, and number. Success and complication rates were compared between the two groups. <i>Conclusion</i>. This study was designed with the thought of not using fluoroscopy in RIRS patients with nonopaque stones and having the same stone-free rates in opaque stones. In the statistical analysis, there was no difference between the groups with and without scope for stone side, size, localization, and number; likewise, the complication rates developed in the comparison of both groups, stone-free rates, and hospital stay were the same. <i>Discussion</i>. Advances in the calibration of instruments, the development of optical systems, and improvements in imaging system resolution have gradually reduced the need for fluoroscopy in RIRS. This study provides further evidence that fluoroscopy is unnecessary in RIRS procedures, thereby eliminating unnecessary radiation exposure.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138515198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Medical Students: Harnessing Artificial Intelligence for Precision Point-of-Care Echocardiography Assessment of Left Ventricular Ejection Fraction","authors":"Ziv Dadon, Amir Orlev, Adi Butnaru, David Rosenmann, Michael Glikson, Shmuel Gottlieb, Evan Avraham Alpert","doi":"10.1155/2023/5225872","DOIUrl":"https://doi.org/10.1155/2023/5225872","url":null,"abstract":"<i>Introduction</i>. Point-of-care ultrasound (POCUS) use is now universal among nonexperts. Artificial intelligence (AI) is currently employed by nonexperts in various imaging modalities to assist in diagnosis and decision making. <i>Aim</i>. To evaluate the diagnostic accuracy of POCUS, operated by medical students with the assistance of an AI-based tool for assessing the left ventricular ejection fraction (LVEF) of patients admitted to a cardiology department. <i>Methods</i>. Eight students underwent a 6-hour didactic and hands-on training session. Participants used a hand-held ultrasound device (HUD) equipped with an AI-based tool for the automatic evaluation of LVEF. The clips were assessed for LVEF by three methods: visually by the students, by students + the AI-based tool, and by the cardiologists. All LVEF measurements were compared to formal echocardiography completed within 24 hours and were evaluated for LVEF using the Simpson method and eyeballing assessment by expert echocardiographers. <i>Results</i>. The study included 88 patients (aged 58.3 ± 16.3 years). The AI-based tool measurement was unsuccessful in 6 cases. Comparing LVEF reported by students’ visual evaluation and students + AI vs. cardiologists revealed a correlation of 0.51 and 0.83, respectively. Comparing these three evaluation methods with the echocardiographers revealed a moderate/substantial agreement for the students + AI and cardiologists but only a fair agreement for the students’ visual evaluation. <i>Conclusion</i>. Medical students’ utilization of an AI-based tool with a HUD for LVEF assessment achieved a level of accuracy similar to that of cardiologists. Furthermore, the use of AI by the students achieved moderate to substantial inter-rater reliability with expert echocardiographers’ evaluation.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Crotonylation Metabolism Signature Predicting Overall Survival for Clear Cell Renal Cell Carcinoma.","authors":"Jie Zheng, Yingqing Liu, Kai Wei, Jiewu Shi, Lin Li, Xuefeng Jiang, Lingsong Tao","doi":"10.1155/2023/5558034","DOIUrl":"10.1155/2023/5558034","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy shows promise in treating cancer by leveraging the immune system to combat cancer cells. However, the influence of crotonylation metabolism on the prognosis and tumor environment in ccRCC patients is not fully understood.</p><p><strong>Methods: </strong>We conducted various systematic analyses, including prognosis and cluster analyses, to investigate the role of KAT2A in immunotherapy. We used qRT-PCR to compare KAT2A expression in cancer and adjacent tissues and among different cell lines. Additionally, we employed Cell Counting Kit-8, wound healing, and Transwell chamber assays to assess changes in the proliferative and metastatic ability of A498 and 786-O cells.</p><p><strong>Results: </strong>We identified three clusters related to crotonylation metabolism, each with distinct prognosis and immune characteristics in ccRCC. We categorized CT1 as immune-inflamed, CT2 as immune-excluded, and CR3 as immune-desert. A new system, CRS, emerged as an effective predictor of patient outcomes with differing immune characteristics. Moreover, qRT-PCR revealed elevated KAT2A levels in ccRCC tissues and cell lines. KAT2A was found to promote ccRCC and correlate significantly with immunosuppressive elements and checkpoints. Reducing KAT2A expression hindered ccRCC cell growth and metastasis.</p><p><strong>Conclusion: </strong>Our study highlights the critical role of crotonylation metabolism in cancer development and progression, particularly its link to poor prognosis. CRS proves to be an accurate predictor of patient outcomes and immune features in ccRCC. KAT2A shows strong associations with clinical factors and the immunosuppressive environment, suggesting potential for innovative immunotherapies in ccRCC treatment.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Mellitus and HIV Infection among Newly Diagnosed Pulmonary Tuberculosis Patients in the North West Region of Cameroon: A Cross-Sectional Study.","authors":"Leonard Fonkeng Sama, Sidoine Sadjeu, Thibau Flaurant Tchouangueu, Solange Dabou, Georges Ful Kuh, Omer Bebe Ngouateu, Michel Noubom","doi":"10.1155/2023/5998727","DOIUrl":"10.1155/2023/5998727","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence rate of HIV and diabetes among tuberculosis (TB) patients and also the comorbidity rate.</p><p><strong>Design: </strong>Cross-sectional study. <i>Setting</i>. This study was carried out at the Tuberculosis Reference Laboratory, Regional Hospital Bamenda, North West Region of Cameroon, from January 2017 to December 2019. <i>Participants</i>. 1115 cases of pulmonary tuberculosis aged ≥14 years (mean 42.5 ± 15.28 years).</p><p><strong>Methods: </strong>Sputum samples collected were acid-fast stained and examined macroscopically as well as inoculated for culture. A chest X-ray was performed for further confirmation of TB diagnosis. After the TB diagnosis was done, fasting blood glucose, 2 h-PG test, HbA1c, and biochemical enzymatic tests were performed for the diagnosis of diabetes. Rapid strip test and enzyme-linked immunosorbent assay were used to diagnose HIV infection. <i>Interventions</i>. No intervention was done during the period of study. <i>Outcome Measures</i>. The prevalence of TB/HIV and TB/HIV/DM, signs and symptoms, imaging results, and bacteriology status among TB/HIV, TB/HIV/DM coinfected, and comorbidity cases.</p><p><strong>Results: </strong>Of 1115 participants, 38.57% had TB/HIV, and 5.83% had TB/HIV/DM. Among TB/HIV/DM cases, 20.39% had a cough for more than 2 weeks [<i>p</i>  <  0.0001; OR (95%CI): 4.866 (3.170-7.404)], and 35.71% had a fever for at least 2 weeks [<i>p</i>  <  0.0001; OR (95%CI): 7.824 (5.336-11.36)]. The majority of TB/HIV/DM patients (77.42%) had chest pain for at least 2 weeks [<i>p</i>  <  0.0001; OR (95%CI): 114.3 (59.78-207.1)]. 7.41%, 14.18%, and 9.09% of TB/HIV/DM, respectively, had chest abnormality, positive smear, and positive culture (<i>p</i> = 0.018). Significant differences were observed between signs and symptoms, imaging results, bacteriology, treatment history for TB cases and those with HIV and/or DM, and those without HIV and/or DM coinfection and comorbidity.</p><p><strong>Conclusion: </strong>This study reports a high prevalence of DM comorbidity and HIV coinfection among active TB patients in the North West Region of Cameroon as well as TB/HIV/DM comorbidity.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing Factors of Massive Hemorrhage and High-Grade Renal Vascular Injury after PCNL: A Retrospective Comparative Study.","authors":"Qiushi He, Ziyan Song, Xinrui Wang, Bingbing Hou, Zongyao Hao","doi":"10.1155/2023/5521691","DOIUrl":"10.1155/2023/5521691","url":null,"abstract":"<p><strong>Purpose: </strong>Severe hemorrhage after percutaneous nephrolithotomy (PCNL) is a rare but alerting event. In this study, we report the factors affecting massive hemorrhage after PCNL, various levels of vascular damage during renal angiography, and the therapeutic effect of superselective renal artery embolization (SRAE). <i>Patients and Methods</i>. A retrospective analysis was performed on the data of 69 patients with postoperative PCNL hemorrhage who underwent SRAE from January 2010 to March 2021. Inclusion criteria for all cases were failure of conservative treatment for severe renal hemorrhage after surgery and then treatment with SRAE. In addition, 98 patients without significant hemorrhage after PCNL were randomly selected as the control group. All clinical data are confirmed by imaging and laboratory examinations. We performed univariate and multivariate analyses to find risk factors of massive hemorrhage and high-grade renal vascular injury after PCNL.</p><p><strong>Results: </strong>A total of 69 patients underwent angiography, 64 of which received SRAE due to positive hemorrhages detected by angiography. Urinary tract infection (OR (95% CI) = 11.214 (2.804∼44.842)), high blood pressure (OR (95% CI) = 5.686 (1.401∼23.083)), and no hydronephrosis (OR (95% CI) = 0.189 (0.049∼0.724)) are the most important factors leading to massive hemorrhage after PCNL. In patients who need SRAE after hemorrhage, high-grade vascular injury (grade III) is related to advanced age and decreased hemoglobin.</p><p><strong>Conclusion: </strong>During the perioperative period of PCNL, patients with a risk of hypertension, urinary tract infection, and no hydronephrosis should be strengthened to monitor their high risk of postoperative hemorrhage. For patients with postoperative hemorrhage, we can use the patient's age and decreased hemoglobin before and after operation for analysis. In this way, individualized assessment can greatly improve the efficiency of SRAE treatment.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Various Combinations of Peripheral Nerve Blocks on Postoperative Pain in Laparoscopic Cholecystectomy: A Comparative Prospective Study.","authors":"Zoya Haitov Ben Zikri, Maryna Volis, Andrei Mazur, Tatjana Orlova, Hana Alon, Sara Bar Yehuda, Vladislav Gofman","doi":"10.1155/2023/8864012","DOIUrl":"10.1155/2023/8864012","url":null,"abstract":"<p><strong>Objectives: </strong>Most patients who undergo laparoscopic cholecystectomy (LC) experience moderate to severe pain in the first 24 hours after surgery. The transversus abdominal plane (TAP) is currently used for post-LC analgesia. Posterior, subcostal, or rectus sheath TAP blocks are the conventional approaches used. The aim of the current study was to compare the efficacy of combinations of various peripheral blocks on pain intensity and the use of pain killers, shortly after LC.</p><p><strong>Methods: </strong>This was a prospective, double-blind study, in which 200 patients who were about to undergo a LC procedure were recruited and randomized into 4 groups: patients receiving one of the following: TAP block alone, subcostal Tap block alone, subcostal TAP block with a TAP block, or subcostal TAP with a rectus sheath block. The intensity of pain (VAS score) and the use of painkillers were monitored in the recovery unit and in the department for up to 24 hours after surgery.</p><p><strong>Results: </strong>Pain levels decreased with time from 3.6 ± 3.2 at 30 minutes to 0.9 ± 2.0 at 24 hours after the surgery. Nevertheless, no difference between the various block types groups was noted. The percentage of patients who consumed analgesic medications decreased over time, from 83% at 30 to 21% at 24 hours after surgery. The mean/median number of medications consumed by each of the patients was lower among the patients who received a combination of 2 blocks compared to those who received a single one (mean/median of 2.7/3 and 2.8/3 for the TAP or subcostal TAP blocks, respectively; 2.5/2 and 2.3/2 for the subcostal TAP + TAP or subcostal TAP + rectus sheath blocks, respectively).</p><p><strong>Conclusion: </strong>A combination of peripheral nerve blocks reduced the use of analgesic consumption during the 24 hours after LC surgery, compared to standalone blocks.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Machine Learning-Based Classification of Immunogenic Cell Death Regulators and Characterisation of Immune Microenvironment in Acute Ischemic Stroke","authors":"Mengying Wang, Guolian Wei, Shaorui Gu, Zhengyuan Huo, Xue Han","doi":"10.1155/2023/9930172","DOIUrl":"https://doi.org/10.1155/2023/9930172","url":null,"abstract":"Immunogenic cell death (ICD) regulators exert a crucial part in quite a few in numerous biological processes. This study aimed to determine the function and diagnostic value of ICD regulators in acute ischemic stroke (AIS). 31 significant ICD regulators were identified from the gene expression omnibus (GEO) database in this work (the combination of the GSE16561 dataset and the GSE37587 dataset in the comparison of non-AIS and AIS patients). The random forest model was applied and 15 potential ICD regulators were screened to forecast the probability of AIS. A nomogram, on the basis of 11 latent ICD regulators, was performed. The resolution curve analysis indicated that patients can gain benefits from the nomogram. The consensus clustering approach was applied, and AIS patients were divided into 2 ICD clusters (cluster A and cluster B) based on the identified key ICD regulatory factors. To quantify the ICD pattern, 181 ICD-related dissimilarly expressed genes (DEGs) were selected for further investigation. The expression levels of NFKB1, NFKB2, and PARP1 were greater in gene cluster A than in gene cluster B. In conclusion, ICD regulators exerted a crucial part in the progress of AIS. The investigation made by us on ICD patterns perhaps informs prospective immunotherapeutic methods for AIS.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of Epileptic Brain Abnormalities among Neurological Patients at Taif Region Using MRI","authors":"Nahla L. Faizo, Amani A. Alrehaili","doi":"10.1155/2023/8783446","DOIUrl":"https://doi.org/10.1155/2023/8783446","url":null,"abstract":"This study was conducted to assess the prevalence of epilepsy among different age groups and gender of neurological patients in the Taif region and define the most common brain lesion, affecting epileptic patients living in the Taif city using MRI. Data from 150 patients who were clinically diagnosed with epilepsy and had brain MRIs were analyzed using SPSS. Statistical significance was considered when the <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> value is 0.05. The percentage of epilepsy was generally higher in males than in females in the Taif city, and seizures were different between the studied age groups. However, epilepsy was more pronounced in females than in males at certain age groups. Moreover, white matter lesions were most commonly found in the studied group (27.7%), followed by focal lesions, edema, and stroke with equal percentages (16.9%) and less commonly with congenital diseases (12%) and atrophic changes (9.6%). Epilepsy was more pronounced in females than in males at certain age groups. White matter lesions were identified as the most common lesion, presenting in epilepsy patients in the Taif city.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135043174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of ICT-Based Interventions on Physical Mobility of Older Adults: A Systematic Literature Review and Meta-Analysis","authors":"Hyori Kim, Gahye Kim, Yeonghun Kim, Jiyeon Ha","doi":"10.1155/2023/5779711","DOIUrl":"https://doi.org/10.1155/2023/5779711","url":null,"abstract":"Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = −0.33, 95% CI: −0.57 to −0.10, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> <mo>=</mo> <mn>0.005</mn> </math> , I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = −0.40, 95% CI: −0.72 to −0.08, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> <mo><</mo> <mn>0.001</mn> </math> , I2 = 75.0%) and in the exergame with virtual reality (VR) group (SMD = −0.33, 95% CI: −1.01 to 0.35, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> <mo><</mo> <mn>0.001</mn> </math> , I2 = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = −0.19, 95% CI: −0.61 to 0.23, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"> <mi>p</mi> <mo>=</mo> <mn>0.375</mn> </math> , I2 = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\"> <mi>p</mi> <mo>=</mo> <mn>0.004</mn> </math> , I2 = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Low Back Pain with and without Concomitant Osteoarthritis: A Retrospective, Longitudinal Cohort Study of Patients in England","authors":"Greg Coates, Peter Clewes, Christoph Lohan, Hannah Stevenson, Robert Wood, Theo Tritton, Roger D. Knaggs, Alastair J. Dickson, David A. Walsh","doi":"10.1155/2023/5105810","DOIUrl":"https://doi.org/10.1155/2023/5105810","url":null,"abstract":"Objective. Despite the high prevalence of chronic low back pain (CLBP) and osteoarthritis (OA), few estimates of the economic cost of these conditions in England have been published. The aim of the present analysis was to characterise the economic burden of moderate-to-severe pain associated with CLBP + OA and CLBP alone compared with general population-matched controls without CLBP or OA. The primary objective was to describe the total healthcare resource use (HCRU) and direct healthcare costs associated with the target patient populations. Secondary objectives were to describe treatment patterns and surgical procedures. Methods. This was a retrospective, observational cohort study of patients receiving healthcare indicative of moderate-to-severe chronic pain associated with CLBP, with or without OA. We used linked longitudinal data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics (HES). Patients (cases) were matched 1 : 1 with controls on age, sex, comorbidity burden, GP practice, and HES data availability. Results. The CLBP-alone cohort comprised 13 554 cases with CLBP and 13 554 matched controls; the CLBP + OA cohort comprised 7803 cases with both OA and CLBP and 7803 matched controls. Across all follow-up periods, patients with CLBP alone and those with CLBP + OA had significantly more GP consultations, outpatient attendances, emergency department visits, and inpatient stays than controls (all <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> < 0.0001). By 36 months after indexing, the mean (SD) per-patient total direct healthcare cost in the CLBP-alone cohort was £5081 (£5905) for cases and £1809 (£4451) for controls ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> </math> < 0.0001); in the CLBP + OA cohort, the mean (SD) per-patient total direct healthcare cost was £8819 (£7143) for cases and £2428 (£4280) for controls ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> </math> < 0.0001). Conclusion Moderate-to-severe chronic pain associated with CLBP—with or without OA—has a substantial impact on patients and healthcare providers, leading to higher HCRU and costs versus controls among people with CLBP alone or together with OA.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}