Background The impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making.However,information on mental health-related healthcare service utilisa...Background The impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making.However,information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited.Aims We examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia,Canada,during the COVID-19 pandemic compared with the prepandemic period.Methods We conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits,emergency department visits,hospital admissions and psychotropic drug dispensations.We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019(prepandemic period)and January 2020 to December 2021(pandemic period).In addition,we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic,stratified by year,sex,age and condition.Results By late 2020,except for emergency department visits,utilisation of healthcare services recovered to prepandemic levels.Between 2019 and 2021,the monthly average rate for overall mental health-related outpatient physician visits,emergency department visits and psychotropic drug dispensations increased significantly by 24%,5%and 8%,respectively.Notable and statistically significant increases were observed among 10–14 year-olds(44%in outpatient physician visits,30%in emergency department visits,55%in hospital admissions and 35%in psychotropic drug dispensations)and 15–19 year-olds(45%in outpatient physician visits,14%in emergency department visits,18%in hospital admissions and 34%in psychotropic drug dispensations).Additionally,these increases were more prominent among females than males,with some variation for specific mental health-related conditions.Conclusions The increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures.Recovery efforts in British Columbia should consider these findings,especially among the most affected subpopulations,such as adolescents.展开更多
AIM To determine acute kidney in jury(AKI) incidence and potential risk factors of AKI in children undergoing spinal instrumentation surgery.METHODS AKI incidence in children undergoing spinal instrumentation surgery ...AIM To determine acute kidney in jury(AKI) incidence and potential risk factors of AKI in children undergoing spinal instrumentation surgery.METHODS AKI incidence in children undergoing spinal instrumentation surgery at British Columbia Children's Hospital between January 2006 and December 2008 was determined by the Acute Kidney Injury Networ classification using serum creatinine and urine output criteria. During this specific time period, all patients following spinal surgery were monitored in the pediatric intensive care unit and had an indwelling Foley catheter permitting hourly urine output recording. Cases of AKI were identified from our database. From the remaining cohort, we selected group-matched controls that did not satisfy criteria for AKI. The controls were matched for sex, age and underlying diagnosis(idiopathic vs nonidiopathic scoliosis).RESULTS Thirty five of 208 patients met criteria for AKI with an incidence of 17%(95%CI: 12%-23%). Of all children who developed AKI, 17(49%) developed mild AKI(AKI Stage 1), 17(49%) developed moderate AKI(Stage 2) and 1 patient(3%) met criteria for severe AKI(Stage 3). An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively. An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively classified by fluid tertiles: 70% incidence in those that received the least amount of fluids vs 29% that received the most fluids(> 7.9, P = 0.02). Patients who developed AKI were more frequently exposed to nephrotoxins(non steroidal anti inflammatory drugs or aminoglycosides) than control patients during their peri-operative course(60% vs 22%, P < 0.001).CONCLUSION We observed a high incidence of AKI following spinal instrumentation surgery in children that is potentially related to the frequent use of nephrotoxins and the amount of fluid administered peri-operatively.展开更多
Diminished ovarian reserve(DOR)refers to a decrease in the number and/or quality of oocytes in the ovary,accompanied by a decline in reproductive potential,which is generally related to advanced age or ovarian disease...Diminished ovarian reserve(DOR)refers to a decrease in the number and/or quality of oocytes in the ovary,accompanied by a decline in reproductive potential,which is generally related to advanced age or ovarian disease.In in vitro fertilization(IVF)clinical practice,managing patients with DOR remains one of the most challenging tasks.In recent years,increased research on improving ovarian function has provided us with new insights into treating patients with DOR.Many therapeutic options have been proposed to improve the ovarian function of patients with DOR,yet they are not widely utilized in clinical practice because of limited evidence of safety and effectiveness.In this review,we focus on the mechanisms from animal models and clinical trials that have been applied to the treatment of DOR in recent years,intending to improve IVF outcomes in patients with DOR.Furthermore,new insights and perspectives on the molecular and cellular regulation of follicular development and ovarian reserve are emphasized to provide more clues for research on the treatment of DOR.展开更多
Background:The autoimmune disease Sjogren's syndrome(SS)is often characterized by salivary changes that may affect swallowing.No known study has investigated the association between salivary biomarkers and percept...Background:The autoimmune disease Sjogren's syndrome(SS)is often characterized by salivary changes that may affect swallowing.No known study has investigated the association between salivary biomarkers and perceptions of swallowing in individuals with SS.Our objectives were to explore:(1)the operational feasibility of investigating saliva volume and composition,along with perceptions of swallowing,in those with and without SS;and(2)the relationship between saliva composition and perceptions of oral dryness,swallowing,and quality of life.Methods:We conducted a prospective,case–control feasibility study,collecting feasibility data(recruitment rate and optimal saliva collection methods)and whole mouth saliva samples(unstimulated and stimulated).We measured total protein content and conducted sialochemical(α-amylase,cortisol,C-reactive protein[CRP],and mucins),sialometric(flow rate),and perceptual(oral dryness and swallowing-related quality of life[SWAL-QOL])assessments.Our exploratory analyses focused on the main and fixed effects.We summarized all data descriptively,comparing:(a)outcomes between groups(t tests or Mann–Whitney U)and(b)salivary and perceptual data across participants(partial least-squares correlation[PLSC]).Results:We enrolled 12(N)participants(6 per group),all providing analyzable saliva.Cases had lower flow rate(p=0.003)and higher total protein,cortisol,and CRP concentrations(p<0.02)than controls.PLSC revealed inverse covariance between sialochemical and SWAL-QOL data across participants.Conclusion:Our study was feasible as designed.We explored novel relationships between salivary outcomes and participant-reported perceptions,distinguishing individuals with and without SS.Our findings support further study of saliva's role in perceptions of swallowing,specifically analytes with lubricative properties.展开更多
基金The BCC19C was established and maintained through operational support from Data Analytics,Reporting and Evaluation(DARE)BC Centre for Disease Control(BCCDC)at the Provincial Health Services Authority(PHSA).
文摘Background The impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making.However,information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited.Aims We examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia,Canada,during the COVID-19 pandemic compared with the prepandemic period.Methods We conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits,emergency department visits,hospital admissions and psychotropic drug dispensations.We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019(prepandemic period)and January 2020 to December 2021(pandemic period).In addition,we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic,stratified by year,sex,age and condition.Results By late 2020,except for emergency department visits,utilisation of healthcare services recovered to prepandemic levels.Between 2019 and 2021,the monthly average rate for overall mental health-related outpatient physician visits,emergency department visits and psychotropic drug dispensations increased significantly by 24%,5%and 8%,respectively.Notable and statistically significant increases were observed among 10–14 year-olds(44%in outpatient physician visits,30%in emergency department visits,55%in hospital admissions and 35%in psychotropic drug dispensations)and 15–19 year-olds(45%in outpatient physician visits,14%in emergency department visits,18%in hospital admissions and 34%in psychotropic drug dispensations).Additionally,these increases were more prominent among females than males,with some variation for specific mental health-related conditions.Conclusions The increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures.Recovery efforts in British Columbia should consider these findings,especially among the most affected subpopulations,such as adolescents.
文摘AIM To determine acute kidney in jury(AKI) incidence and potential risk factors of AKI in children undergoing spinal instrumentation surgery.METHODS AKI incidence in children undergoing spinal instrumentation surgery at British Columbia Children's Hospital between January 2006 and December 2008 was determined by the Acute Kidney Injury Networ classification using serum creatinine and urine output criteria. During this specific time period, all patients following spinal surgery were monitored in the pediatric intensive care unit and had an indwelling Foley catheter permitting hourly urine output recording. Cases of AKI were identified from our database. From the remaining cohort, we selected group-matched controls that did not satisfy criteria for AKI. The controls were matched for sex, age and underlying diagnosis(idiopathic vs nonidiopathic scoliosis).RESULTS Thirty five of 208 patients met criteria for AKI with an incidence of 17%(95%CI: 12%-23%). Of all children who developed AKI, 17(49%) developed mild AKI(AKI Stage 1), 17(49%) developed moderate AKI(Stage 2) and 1 patient(3%) met criteria for severe AKI(Stage 3). An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively. An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively classified by fluid tertiles: 70% incidence in those that received the least amount of fluids vs 29% that received the most fluids(> 7.9, P = 0.02). Patients who developed AKI were more frequently exposed to nephrotoxins(non steroidal anti inflammatory drugs or aminoglycosides) than control patients during their peri-operative course(60% vs 22%, P < 0.001).CONCLUSION We observed a high incidence of AKI following spinal instrumentation surgery in children that is potentially related to the frequent use of nephrotoxins and the amount of fluid administered peri-operatively.
基金the National Science Fund for Distinguished Young Scholars(No.81925013 to R.L.)。
文摘Diminished ovarian reserve(DOR)refers to a decrease in the number and/or quality of oocytes in the ovary,accompanied by a decline in reproductive potential,which is generally related to advanced age or ovarian disease.In in vitro fertilization(IVF)clinical practice,managing patients with DOR remains one of the most challenging tasks.In recent years,increased research on improving ovarian function has provided us with new insights into treating patients with DOR.Many therapeutic options have been proposed to improve the ovarian function of patients with DOR,yet they are not widely utilized in clinical practice because of limited evidence of safety and effectiveness.In this review,we focus on the mechanisms from animal models and clinical trials that have been applied to the treatment of DOR in recent years,intending to improve IVF outcomes in patients with DOR.Furthermore,new insights and perspectives on the molecular and cellular regulation of follicular development and ovarian reserve are emphasized to provide more clues for research on the treatment of DOR.
基金Faculty of Medicine,University of British Columbia,Grant/Award Number:Faculty of Medicine start up grant。
文摘Background:The autoimmune disease Sjogren's syndrome(SS)is often characterized by salivary changes that may affect swallowing.No known study has investigated the association between salivary biomarkers and perceptions of swallowing in individuals with SS.Our objectives were to explore:(1)the operational feasibility of investigating saliva volume and composition,along with perceptions of swallowing,in those with and without SS;and(2)the relationship between saliva composition and perceptions of oral dryness,swallowing,and quality of life.Methods:We conducted a prospective,case–control feasibility study,collecting feasibility data(recruitment rate and optimal saliva collection methods)and whole mouth saliva samples(unstimulated and stimulated).We measured total protein content and conducted sialochemical(α-amylase,cortisol,C-reactive protein[CRP],and mucins),sialometric(flow rate),and perceptual(oral dryness and swallowing-related quality of life[SWAL-QOL])assessments.Our exploratory analyses focused on the main and fixed effects.We summarized all data descriptively,comparing:(a)outcomes between groups(t tests or Mann–Whitney U)and(b)salivary and perceptual data across participants(partial least-squares correlation[PLSC]).Results:We enrolled 12(N)participants(6 per group),all providing analyzable saliva.Cases had lower flow rate(p=0.003)and higher total protein,cortisol,and CRP concentrations(p<0.02)than controls.PLSC revealed inverse covariance between sialochemical and SWAL-QOL data across participants.Conclusion:Our study was feasible as designed.We explored novel relationships between salivary outcomes and participant-reported perceptions,distinguishing individuals with and without SS.Our findings support further study of saliva's role in perceptions of swallowing,specifically analytes with lubricative properties.
