AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease(CHD) treated in German primary care practices.METHODS Longitudinal data from nationwide general practices i...AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease(CHD) treated in German primary care practices.METHODS Longitudinal data from nationwide general practices in Germany(n = 1072) were analyzed.Individuals initially diagnosed with CHD(2009-2013) were identified,and 59992 patients were included and matched(1:1) to 59992 controls.The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD.Cox proportional hazards models were used to adjust for confounders.RESULTS Mean age was equal to 68.0 years(SD = 11.3).A total of 55.9% of patients were men.After a five-year follow-up,21.8% of the CHD group and 14.2% of the control group were diagnosed with depression(P < 0.001).In the multivariate regression model,CHD was a strong risk factor for developing depression(HR =1.54,95%CI:1.49-1.59,P < 0.001).Prior depressive episodes,dementia,and eight other chronic conditions were associated with a higher risk of developing depression.Interestingly,older patients and women were also more likely to be diagnosed with depression compared with younger patients and men,respectively.CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany.CHD patients should be routinely screened for depression to ensure improved treatment and management.展开更多
The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,...The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,the COVID-19pandemic has resulted in limited face-to-face school contact and thus missed milestones in preventing alcohol and substance use.展开更多
Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review...Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review and meta-analysis of randomized controlled trials(RCTs)to compare the clinical results of UKA and TKA for treating unicompartmental KOA.Methods:PubMed,Embase,and the Cochrane Library were systematically searched for articles published up to January 2,2023.The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA.A systematic review and meta-analysis were performed to calculate the mean difference(MD),relative risk(RR),and 95%confidence interval(CI)according to the Cochrane standards.Results:Thirteen publications involving 683 UKAs and 683 TKAs were analyzed.Except for one study with a follow-up period of 15 years,all outcome measures reported were within 5 years of follow-up.Meta-analysis showed better knee recovery(MD:1.23;95%CI:1.01–1.45;P<0.001),greater knee function(MD:1.78;95%CI:0.34–3.22;P=0.020),less pain(MD:0.75;95%CI:0.43–1.06;P<0.001),and better health status(MD:3.75;95%CI:0.81–6.69;P=0.010)after UKA than TKA.However,considering the minimal clinically important difference values for these variables,the findings were not clinically relevant.Moreover,UKA patients had fewer complications(RR:0.59;95%CI:0.45–0.78;P<0.001)and shorter hospital stays(MD:–0.89;95%CI:–1.57 to–0.22;P=0.009)than did TKA patients.There were no statistically significant differences in terms of postoperative range of movement,revision,failure,operation time,and patient satisfaction.Conclusions:In terms of clinical efficacy,there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference.The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay.It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.展开更多
Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends o...Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period.Methods The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey(KYRBS).We evaluated the smoking prevalence(ever or daily)by year groups and estimated the slope in smoking prevalence before and during the pandemic.Results A total of 1,137,823 adolescents participated in the study[mean age,15.04 years[95%confidence interval(CI)15.03-15.06];and male,52.4%(95%CI 51.7-53.1)].The prevalence of ever smokers was 27.7%(95%CI 27.3-28.1)between 2005 and 2008 but decreased to 9.8%(95%CI 9.3-10.3)in 2021.A consistent trend was found in daily smokers,as the estimates decreased from 5.4%(95%CI 5.2-5.6)between 2005 and 2008 to 2.3%(95%CI 2.1-2.5)in 2021.However,the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period.In the subgroup with substance use,the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period.Conclusions The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic.The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents.展开更多
Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during ...Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).展开更多
文摘AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease(CHD) treated in German primary care practices.METHODS Longitudinal data from nationwide general practices in Germany(n = 1072) were analyzed.Individuals initially diagnosed with CHD(2009-2013) were identified,and 59992 patients were included and matched(1:1) to 59992 controls.The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD.Cox proportional hazards models were used to adjust for confounders.RESULTS Mean age was equal to 68.0 years(SD = 11.3).A total of 55.9% of patients were men.After a five-year follow-up,21.8% of the CHD group and 14.2% of the control group were diagnosed with depression(P < 0.001).In the multivariate regression model,CHD was a strong risk factor for developing depression(HR =1.54,95%CI:1.49-1.59,P < 0.001).Prior depressive episodes,dementia,and eight other chronic conditions were associated with a higher risk of developing depression.Interestingly,older patients and women were also more likely to be diagnosed with depression compared with younger patients and men,respectively.CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany.CHD patients should be routinely screened for depression to ensure improved treatment and management.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&WelfareRepublic of Korea[grant number:HV22C0233]。
文摘The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,the COVID-19pandemic has resulted in limited face-to-face school contact and thus missed milestones in preventing alcohol and substance use.
基金This work was supported by the National Natural Science Foundation of China(Nos.82072506,82272611,92268115)National Key R&D Program of China(No.2019YFA0111900)+6 种基金Provincial Clinical Medical Technology Innovation Project of Hunan(Nos.2023SK2024,2020SK53709)Hunan Young Talents of Science and Technology(No.2021RC3025)Provincial Natural Science Foundation of Hunan(No.20203060)National Natural Science Foundation of Hunan Province(No.2023JJ30949)Program of Health Commission of Hunan Province(No.202204074879)Wu Jieping Medical Foundation(No.320.6750.2020-03-14)National Clinical Research Center for Geriatric Disorders(Xiangya Hospital,Nos.2021KFJJ02,2021LNJJ05).
文摘Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review and meta-analysis of randomized controlled trials(RCTs)to compare the clinical results of UKA and TKA for treating unicompartmental KOA.Methods:PubMed,Embase,and the Cochrane Library were systematically searched for articles published up to January 2,2023.The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA.A systematic review and meta-analysis were performed to calculate the mean difference(MD),relative risk(RR),and 95%confidence interval(CI)according to the Cochrane standards.Results:Thirteen publications involving 683 UKAs and 683 TKAs were analyzed.Except for one study with a follow-up period of 15 years,all outcome measures reported were within 5 years of follow-up.Meta-analysis showed better knee recovery(MD:1.23;95%CI:1.01–1.45;P<0.001),greater knee function(MD:1.78;95%CI:0.34–3.22;P=0.020),less pain(MD:0.75;95%CI:0.43–1.06;P<0.001),and better health status(MD:3.75;95%CI:0.81–6.69;P=0.010)after UKA than TKA.However,considering the minimal clinically important difference values for these variables,the findings were not clinically relevant.Moreover,UKA patients had fewer complications(RR:0.59;95%CI:0.45–0.78;P<0.001)and shorter hospital stays(MD:–0.89;95%CI:–1.57 to–0.22;P=0.009)than did TKA patients.There were no statistically significant differences in terms of postoperative range of movement,revision,failure,operation time,and patient satisfaction.Conclusions:In terms of clinical efficacy,there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference.The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay.It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HV22C0233)the National Research Foundation of Korea(NRF)grant funded by the Korea government(NRF2021R1I1A2059735)。
文摘Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period.Methods The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey(KYRBS).We evaluated the smoking prevalence(ever or daily)by year groups and estimated the slope in smoking prevalence before and during the pandemic.Results A total of 1,137,823 adolescents participated in the study[mean age,15.04 years[95%confidence interval(CI)15.03-15.06];and male,52.4%(95%CI 51.7-53.1)].The prevalence of ever smokers was 27.7%(95%CI 27.3-28.1)between 2005 and 2008 but decreased to 9.8%(95%CI 9.3-10.3)in 2021.A consistent trend was found in daily smokers,as the estimates decreased from 5.4%(95%CI 5.2-5.6)between 2005 and 2008 to 2.3%(95%CI 2.1-2.5)in 2021.However,the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period.In the subgroup with substance use,the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period.Conclusions The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic.The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HV22C0233 and grant number:HI22C1976)The funders had no role in study design,data collection,data analysis,data interpretation,or writing of the report.
文摘Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).
