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卡塔尔
  • 文章类型: Journal Article
    背景:早发性新生儿败血症(EONS)显著影响新生儿发病率和死亡率,围产期产妇菌血症是一个潜在的危险因素。本研究旨在探讨围产期产妇菌血症与EONS之间的关系。
    方法:多哈妇女健康与研究中心的一项回顾性队列研究,卡塔尔(2015-2019)比较有和没有菌血症的女性,根据分娩前七天至分娩后48小时的血培养,检查与EONS的联系。
    结果:在分析的536个母体血液培养物中,102(19.0%)为阳性。最流行的生物是B组链球菌(GBS)(39.2%),其次是大肠杆菌(14.7%)和厌氧菌(10.8%)。来自菌血症母亲的新生儿出生体重较低(2913±86gvs.3140±745g;MD227.63g;95%CI61.72-393.55;p=0.007),需要更多的复苏(27.5%vs.13.2%;OR2.48;95%CI1.48-4.17;p<0.001),并更频繁地接受抗生素治疗≥7天(41.2%vs.16.6%;OR3.51;95%CI2.20-5.62;p<0.001)与非菌血症母亲相比。与革兰氏阴性(GN)(22.2%)和厌氧菌血症(9.9%)相比,在足月妊娠中分离出母体革兰氏阳性(GP)生物(67.9%)更为常见。在产时,GP菌血症占主导地位(67.1%)GN(21.4%)和厌氧菌(11.4%),GN菌血症在产后样本中更为常见。经过文化验证的EONS发生在队列的0.75%,影响3.9%的婴儿从菌血症的母亲与对照组无一例(OR2.34;95%CI1.27-4.31;p<0.001)。培养阴性EONS出现在14.7%的菌血症母亲婴儿中,与对照组为7.8%(OR2.02;95%CI,1.05-3.88;p=0.03)。40例GBS菌血症产妇中,经培养证实的GBSEONS发生在3名新生儿(7.5%)中,所有来自GBS筛查阴性的母亲,与对照组无相比。发现EONS与任何生物体引起的母体菌血症之间存在强烈关联(aOR2.34;95%CI,1.24-4.41;p=0.009),GP菌血症(aOR3.66;95%CI,1.82-7.34;p<0.001),或GBS(aOR5.74;95%CI,2.57-12.81;p<0.001)。GN和厌氧生物引起的菌血症与EONS无关。绒毛膜羊膜炎和产前发热是与重要细菌分离株相关的EONS的独立预测因子。
    结论:这项研究强调了孕产妇GP菌血症的显着影响,特别是来自GBS,在EONS上。这种强烈的关联凸显了对并发菌血症的妊娠进行警惕监测和干预的必要性,以减少不良的新生儿结局。
    BACKGROUND: Early-onset neonatal sepsis (EONS) significantly impacts neonatal morbidity and mortality, with maternal bacteremia during the peripartum period being a potential risk factor. This study aims to explore the association between peripartum maternal bacteremia and EONS.
    METHODS: A retrospective cohort study at the Women\'s Wellness and Research Center in Doha, Qatar (2015-2019) compared women with and without bacteremia, based on blood cultures taken from up to seven days before to 48 h after delivery, examining the association with EONS.
    RESULTS: Among the 536 maternal blood cultures analyzed, 102 (19.0%) were positive. The most prevalent organisms were Group B streptococcus (GBS) (39.2%), followed by Escherichia coli (14.7%) and anaerobes (10.8%). Neonates from bacteremic mothers had lower birth weights (2913 ± 86 g vs. 3140 ± 745 g; MD 227.63 g; 95% CI 61.72 - 393.55; p = 0.007), required more resuscitation (27.5% vs. 13.2%; OR 2.48; 95% CI 1.48 - 4.17; p < 0.001), and received antibiotics for ≥ 7 days more frequently (41.2% vs. 16.6%; OR 3.51; 95% CI 2.20 - 5.62; p < 0.001) compared to those from non-bacteremic mothers. Maternal Gram-positive (GP) organisms were more commonly isolated in term gestation (67.9%) compared to Gram-negative (GN) (22.2%) and anaerobic bacteremias (9.9%). During intrapartum, GP bacteremia was predominant (67.1%) vs. GN (21.4%) and Anaerobes (11.4%), with GN bacteremia being more common in postpartum samples. Culture-proven EONS occurred in 0.75% of the cohort, affecting 3.9% of infants from bacteremic mothers vs. none in controls (OR 2.34; 95% CI 1.27 - 4.31; p < 0.001). Culture-negative EONS appeared in 14.7% of infants from bacteremic mothers vs. 7.8% in controls (OR 2.02; 95% CI, 1.05 - 3.88; p = 0.03). Among 40 cases of maternal GBS bacteremia, culture-proven GBS EONS occurred in 3 neonates (7.5%), all from mothers with negative GBS screening, compared to none in the control group. A strong association was found between EONS and maternal bacteremia due to any organism (aOR 2.34; 95% CI, 1.24 - 4.41; p = 0.009), GP bacteremia (aOR 3.66; 95% CI, 1.82 - 7.34; p < 0.001), or GBS (aOR 5.74; 95% CI, 2.57 - 12.81; p < 0.001). Bacteremia due to GN and Anaerobic organisms were not associated with EONS. Chorioamnionitis and antepartum fever were independent predictors for EONS associated with significant bacterial isolates.
    CONCLUSIONS: This study underscores the significant impact of maternal GP bacteremia, particularly from GBS, on EONS. The strong association highlights the need for vigilant monitoring and interventions in pregnancies complicated by bacteremia to reduce adverse neonatal outcomes.
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  • 文章类型: Journal Article
    宫颈癌仍然是全球健康挑战,每年夺去数百万人的生命,并对海湾合作委员会(GCC)国家产生重大影响。人乳头瘤病毒(HPV),主要病原体,起着核心作用,1从HPV感染到肿瘤性变化的过程需要5-25年才能发生,因此,知道它在我们社区的流行是至关重要的2。
    搜索PubMed和SCOPUS以确定与卡塔尔的宫颈和生殖器HPV患病率和基因型有关的文章,科威特,巴林,阿曼,阿拉伯联合酋长国(UAE),和沙特阿拉伯王国(KSA)在2017年至2024年之间发布。
    本综述共包括19篇文章。八项研究来自KSA,四人来自科威特,三个来自阿联酋,一个来自卡塔尔,阿曼,巴林,一个人提供了来自KSA的数据,阿联酋,卡塔尔,和巴林。在KSA的研究中,HPV的患病率在4.7%到77%之间。在科威特的研究中,15%到54.3%之间,在阿联酋的研究中,14.7%到88%之间,在卡塔尔的两项研究中,分别为8.1%和31.3%,在阿曼和巴林的研究中,分别为17.8%和20%,分别。HPV16是在KSA中进行的研究中发现的最普遍的高危基因型,阿联酋,科威特,卡塔尔。在阿曼,HPV82占优势。在巴林,大多数患者有其他非HPV16/18/45基因型.在阿联酋和科威特,HPV11是主要的低危型,其次是HPV6。在卡塔尔,HPV81是最常见的低危型。其次是HPV11。在阿曼,HPV54是最常见的低危型。其次是HPV42。
    在海湾合作委员会国家,没有关于接种HPV疫苗的女性HPV流行率和基因型数据的研究。
    UNASSIGNED: Cervical cancer remains a global health challenge, claiming the lives of millions annually and having a significant impact on Gulf Cooperation Council (GCC) countries. Human papillomavirus (HPV), the primary causative agent, plays a central role, with regional variations in prevalence.1 The process from HPV infection to neoplastic changes takes 5-25 years to occur, hence, knowing its prevalence in our community is vital.2.
    UNASSIGNED: PubMed and SCOPUS were searched to identify articles related to cervical and anogenital HPV prevalence and genotypes in Qatar, Kuwait, Bahrain, Oman, the United Arab Emirates (UAE), and the Kingdom of Saudi Arabia (KSA) published between 2017 and 2024.
    UNASSIGNED: A total of 19 articles were included in this review. Eight studies were from KSA, four were from Kuwait, three were from the UAE, one was from Qatar, Oman, and Bahrain, and one presented data collectively from the KSA, UAE, Qatar, and Bahrain. The prevalence of HPV ranged between 4.7% and 77% in studies from the KSA, between 15% and 54.3% in studies from Kuwait, between 14.7% and 88% in studies from the UAE, was 8.1% and 31.3% in the two studies from Qatar, and was 17.8% and 20% in the studies from Oman and Bahrain, respectively. HPV 16 was the most prevalent high-risk genotype found in studies conducted in the KSA, UAE, Kuwait, and Qatar. In Oman, HPV 82 predominated. In Bahrain, the majority had other non-HPV 16/18/45 genotypes. In the UAE and Kuwait, HPV 11 was the predominant low-risk type, followed by HPV 6. In Qatar, HPV 81 was the most common low-risk type, followed by HPV 11. In Oman, HPV 54 was the most common low-risk type, followed by HPV 42.
    UNASSIGNED: There are no studies with data on HPV prevalence and genotypes among women who have been vaccinated against HPV in GCC countries.
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  • 文章类型: Journal Article
    背景:唇腭裂是先天性颅面畸形,对个体及其家庭有显著影响,医学和社会心理。卡塔尔人口具有独特的特征,暗示先天性异常的高患病率:高血缘率,大家庭规模,父亲年龄高,某些遗传性疾病患病率高。卡塔尔缺乏有关唇裂和/或腭裂流行病学的现有数据,因此需要进行描述性研究。
    方法:进行了一项以全国医院为基础的回顾性横断面研究,以确定2016年至2021年卡塔尔口面裂的患病率。数据是从该公司的Cerner数据库和电子健康记录中提取的。关于裂口特征的信息,type,患侧,患者的性别,相关综合征的存在,国籍,和母亲的年龄被收集。
    结果:在147,727例活产中,148口面裂。唇裂和/或腭裂的患病率确定为每1000例活产中有1例(95%CI:0.85,1.18)。唇裂的患病率为0.18(95%CI:0.12,0.27),腭裂0.39(95%CI:0.30,0.51),唇腭裂0.43(95%CI:0.33,0.55)。Qataris的患病率为CL0.25,CP0.40和CLP0.56,而非Qataris的患病率为0.16、0.39、0.39(p值0.186)。单侧裂隙在双侧占主导地位(74.4%和25.6%,分别)。在单方面案件中,70.2%发生在左侧。大多数病例是孤立的裂隙,只有10.2%的人患有相关综合征。
    结论:卡塔尔口面裂痕的患病率与全球报告的患病率一致。大多数病例是单方面的,在左侧。相关综合征很少见,仅left裂更常见。卡塔尔国民和非卡塔尔居民之间揭示了有趣的模式,特定亚型的口面裂痕在国民中患病率较高。
    BACKGROUND: Cleft lip and palate are congenital craniofacial anomalies that significantly impact individuals and their families, both medically and psychosocially. The Qatari population has unique characteristics that are suggestive of a high prevalence of congenital anomalies: high consanguinity rate, large family size, advanced paternal age and high prevalence of certain genetic disorders. The lack of existing data concerning the epidemiology of cleft lip and/or palate in Qatar warrants a descriptive study addressing this topic.
    METHODS: A retrospective nationwide hospital-based cross-sectional study conducted to determine the prevalence of orofacial clefts in Qatar from 2016 to 2021. Data were extracted from the corporation\'s Cerner database and electronic health records. Information concerning the cleft\'s characteristics, type, affected side, patient\'s gender, presence of associated syndromes, nationality, and maternal age were collected.
    RESULTS: Out of the 147,727 live births, 148 had an orofacial cleft. The prevalence of cleft lip and/or palate was determined to be 1 per 1000 livebirths (95% CI: 0.85, 1.18). The prevalence of cleft lip was 0.18 (95% CI: 0.12, 0.27), cleft palate 0.39 (95% CI: 0.30, 0.51), and cleft lip and palate 0.43 (95% CI: 0.33, 0.55). Qataris had a prevalence of CL 0.25, CP 0.40, and CLP 0.56, compared to 0.16, 0.39, 0.39 for non-Qataris (p-value 0.186). Unilateral clefts predominated over bilateral (74.4% and 25.6%, respectively). Among the unilateral cases, 70.2% occurred on the left side. Most cases were isolated clefts, with only 10.2% having associated syndromes.
    CONCLUSIONS: The prevalence of orofacial clefts in Qatar is consistent with the globally reported prevalence. Most cases were unilateral and on the left side. Associated syndromes were infrequent and more common with cleft palate alone. Intriguing patterns were revealed between Qatari nationals and non-Qatari residents, with specific subtypes of orofacial clefts showing higher prevalence among nationals.
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  • 文章类型: Journal Article
    目的:本研究旨在评估东地中海地区儿童和青少年哮喘的流行病学。
    方法:在数据库中进行了详尽的搜索,包括PubMed,Scopus,WebofKnowledgeCoreCollection,Embase,谷歌学者。选择标准包括报告0至19岁个体哮喘患病率的研究,使用经过验证的问卷。使用DerSimonian和Laird随机效应模型提取和合成数据。
    结果:东地中海区域办事处(EMRO)国家的哮喘总体患病率,在这项荟萃分析中纳入的514,468名儿童和青少年中,为10.61%,从95项研究中合成。在研究的国家中,卡塔尔的患病率最高,为16.69%,其次是沙特阿拉伯,占16.57%,伊拉克为16.22%,阿曼为15.20%,阿富汗占14.90%。青少年的哮喘患病率略高,为10.10%,而儿童为9.70%。男孩的患病率更高,为11.48%,而女孩为9.75%。城市地区的患病率为11.27%,高于农村地区的8.29%。
    结论:在EMRO中努力降低阿拉伯国家的哮喘患病率并解决非洲国家的低诊断问题至关重要。有针对性的干预措施应侧重于解决环境触发因素和改善获得医疗保健的机会。非洲国家需要加强诊断能力和医疗基础设施。协作行动对于减轻整个EMRO地区的哮喘负担和促进呼吸健康至关重要。
    OBJECTIVE: This study aims to evaluate the epidemiology of asthma among children and adolescents in the Eastern Mediterranean Region.
    METHODS: Exhaustive searches were conducted across databases, including PubMed, Scopus, Web of Knowledge Core Collection, Embase, and Google Scholar. The selection criteria included studies reporting asthma prevalence in individuals aged 0 to 19 years, using validated questionnaires. Data were extracted and synthesized using the DerSimonian and Laird random effects model.
    RESULTS: The overall prevalence of asthma in Eastern Mediterranean Regional Office (EMRO) countries, among the 514,468 children and adolescents included in this meta-analysis, was 10.61%, synthesized from 95 studies. Among the countries studied, Qatar exhibited the highest prevalence at 16.69%, followed by Saudi Arabia at 16.57%, Iraq at 16.22%, Oman at 15.20%, and Afghanistan at 14.90%. Adolescents showed a slightly higher prevalence of asthma at 10.10% compared to children at 9.70%. Boys exhibited a higher prevalence at 11.48% compared to girls at 9.75%. Urban areas demonstrated a higher prevalence at 11.27% than rural areas at 8.29%.
    CONCLUSIONS: Efforts to reduce asthma prevalence in Arab countries and address underdiagnosis in African nations within the EMRO are crucial. Targeted interventions should focus on addressing environmental triggers and improving access to healthcare. Enhanced diagnostic capabilities and healthcare infrastructure are necessary in African countries. Collaborative action is essential to alleviate the asthma burden and promote respiratory health across the EMRO region.
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  • 文章类型: Journal Article
    心理健康影响青少年成功的所有方面。这项研究检查了PERMA的心理测量特性,由五个领域组成的主观幸福感度量:积极情绪,订婚,关系,意思是,和成就。样本量包括来自卡塔尔公立学校的502名高中生。与预期相反,PERMA的五因素结构不能很好地符合我们的数据;然而,在通过项目之间的协方差的误差改进模型之后,单因素模型被认为是适用的。多变量分析显示,社会经济地位(SES)和学业成绩水平与总体幸福感得分呈独立正相关。而内化和外化行为是负相关的。值得注意的是,未观察到性别或年龄对幸福感的显著影响.这些结果表明,针对社会经济地位的干预措施,学术卓越,在学校环境中内化和外化行为可以产生更有效的结果,涉及学生的福祉。
    Psychological well-being influences all the facets of adolescent success. This study examined the psychometric properties of PERMA, a subjective well-being measure consisting of five domains: positive emotions, engagement, relationships, meaning, and accomplishment. The sample size consisted of 502 high school students from public schools in Qatar. Contrary to expectations, the five-factor structure for PERMA did not fit our data well; however, after refining the model by the errors of the covariances between items, the one-factor model was found to be applicable. Multivariate analysis revealed that socioeconomic status (SES) and level of academic performance were independently and positively associated with overall well-being scores, whereas internalizing and externalizing behaviors were negatively associated. Notably, no significant effects of gender or age on well-being were observed. These findings suggest that interventions specific to socioeconomic status, academic excellence, and internalizing and externalizing behaviors in the school setting can produce more effective outcomes concerning student well-being.
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  • 文章类型: Journal Article
    在多哈的室内和室外环境中确定了细颗粒物(PM2.5)中的水溶性和痕量金属种类,卡塔尔。在学习期间,PM2.5浓度在多个室内位置显示出显着差异,范围为7.1至75.8μgm-3,而室外质量浓度范围为34.7-154.4μgm-3。室内和室外PM2.5水平没有统计学上显著的相关性,建议有效的建筑围护结构防止室外PM2.5污染。而不是户外来源,人类活动,如烹饪,清洁,吸烟对室内PM2.5化学成分的影响最大。NH4+浓度不足以中和室内和室外的SO42-,表明NH4HSO4的主要存在。富集因子表明,户外Fe,Mn,Co,Cr,PM2.5中的Ni主要来自地壳来源。相比之下,剩余的户外微量金属(铜,Zn,As,Cd,Pb,和V)主要来自人为来源。室内/室外浓度比揭示了NH4和Cu的重要室内来源。地壳物质,水溶性离子,海盐解释了42%,21%,和1%的室内PM2.5质量,分别。同一组依次占41%,16%,和1%的室外PM2.5质量。
    Water-soluble and trace metal species in fine particulate matter (PM2.5) were determined for indoor and outdoor environments in Doha, Qatar. During the study period, PM2.5 concentrations showed significant variability across several indoor locations ranging from 7.1 to 75.8 μg m-3, while the outdoor mass concentration range was 34.7-154.4 µg m-3. The indoor and outdoor PM2.5 levels did not exhibit statistically significant correlation, suggesting efficient building envelope protection against outdoor PM2.5 pollution. Rather than outdoor sources, human activities such as cooking, cleaning, and smoking were the most significant influence on chemical composition of indoor PM2.5. NH4+ concentration was insufficient to neutralize SO42- indoors and outdoors, indicating the predominant presence of NH4HSO4. The enrichment factors indicated that outdoor Fe, Mn, Co, Cr, and Ni in PM2.5 mostly originated from crustal sources. In contrast, the remaining outdoor trace metals (Cu, Zn, As, Cd, Pb, and V) were mainly derived from anthropogenic sources. The indoor/outdoor concentration ratios revealed significant indoor sources for NH4+ and Cu. The crustal matter, water-soluble ions, and sea salt explained 42%, 21%, and 1% of the indoor PM2.5 mass, respectively. The same groups sequentially constituted 41%, 16%, and 1% of the outdoor PM2.5 mass.
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  • 文章类型: Journal Article
    Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.
    Руководствуясь передовым международным опытом и достижениями доказательной медицины, служба психиатрической помощи в Катаре за последние два десятилетия прошла серьезные преобразования, в ходе которых стационарная модель заменялась доступной мультдисциплинарной внебольничной помощью.В данной статье представлено краткое сообщение об истории служб охраны психического здоровья в Катаре, а также о прогрессе и развитии внебольничной психиатрической помощи.Проанализированы проблемы, с которыми сталкивается новая модель оказания помощи в Катаре, включая социальные и культуральные особенности, а также различные решения, предпринимаемые для преодоления этих проблем.Представлены современные планы по дальнейшему развитию внебольничной психиатрической службы в Катаре, включая предоставление доступной и комбинированной полипрофессиональной помощи в области охраны психического здоровья в условиях первичной медицинской сети.
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  • 文章类型: Journal Article
    我们的目的是研究减肥之间的关系,饮食模式,糖尿病,有减肥手术史(BS)的卡塔尔成年人的血糖控制。分析了来自卡塔尔生物库研究的1893名成年人的数据。糖尿病是由血糖定义的,HbA1c,和病史,血糖控制不良定义为HbA1c≥7.0%。饮食模式来自使用因子分析的食物频率问卷。参与者的平均年龄是38.8岁,平均体重减轻23.4%,血糖控制不佳的患病率为6.1%。体重减轻与糖尿病和血糖控制不良呈负相关。传统的膳食模式(高摄入Biryani,鸡肉,肉,鱼菜,zaatarfatayer,羊角面包,千层面,和阿拉伯面包)与糖尿病患病率呈负相关,比较极端四分位数时,OR为0.61(95CI,0.41-0.99)。谨慎或甜蜜的饮食模式与糖尿病之间没有显着关联。在已知的糖尿病患者中,缓解率为33.4%,对于体重减轻的极端四分位数,OR为5.94(95CI,1.89-18.69)。总之,在有BS病史的成年人中,体重减轻和传统饮食模式与糖尿病和血糖控制呈负相关。体重减轻是主要的决定因素。
    We aimed to examine the association between weight loss, dietary patterns, diabetes, and glycemic control among Qatari adults with a history of bariatric surgery (BS). Data from 1893 adults from the Qatar Biobank study were analyzed. Diabetes was defined by blood glucose, HbA1c, and medical history, with poor glycemic control defined as HbA1c ≥ 7.0%. The dietary patterns were derived from a Food Frequency Questionnaire using factor analysis. The participants\' mean age was 38.8 years, with a mean weight loss of 23.4% and a 6.1% prevalence of poor glycemic control. Weight loss was inversely associated with diabetes and poor glycemic control. The traditional dietary pattern (high intake of Biryani, chicken, meat, fish dishes, zaatar fatayer, croissant, lasagna, and Arabic bread) was inversely associated with diabetes prevalence, with an OR of 0.61 (95%CI, 0.41-0.99) when comparing extreme quartiles. No significant associations were found between prudent or sweet dietary patterns and diabetes. Among the individuals with known diabetes, the prevalence of remission was 33.4%, with an OR for remission of 5.94 (95%CI, 1.89-18.69) for the extreme quartiles of weight loss. In conclusion, weight loss and traditional dietary patterns are inversely associated with diabetes and glycemic control among adults with a history of BS, with weight loss being the main determinant.
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    文章类型: Journal Article
    背景:全球第二常见的血液肿瘤是多发性骨髓瘤(MM)。在过去的30年里,发病率和死亡率增加了一倍多。临床试验证明了达雷妥单抗方案治疗新诊断的MM(NDMM)的安全性和有效性。目的:评估在三个海湾国家(卡塔尔,阿曼和阿拉伯联合酋长国;阿联酋),构建了成本最小化模型。方法:我们从社会角度进行了静态成本最小化分析,以评估在5年时间范围内NDMM患者从dara-IV输注转向dara-SC注射相关的成本和资源利用率的可能降低。该模型包括2种情况:当前的情况下,100%的NDMM患者接受dara-IV输注治疗,未来的情况下,dara-SC注射在建模的时间范围内逐渐采用。就每组中的数量和相关的治疗方案而言,该模型在符合自体干细胞移植(ASCT)的NDMM患者和不符合ASCT的NDMM患者之间进行了精确区分。还进行了单向敏感性分析。结果:该模型表明,在符合或不符合ASCT的NDMM患者中使用dara-SC可以降低非药物成本,包括药物前用药费用,不利影响成本,管理费用,医务人员费用,和间接成本。在哈马德医疗公司的模型的5年时间范围内,由此产生的总节省,苏丹卡布斯大学医院/皇家医院,SheikhShakhbout医疗城(SSMC),和Tawam医院分别为QAR-2522686、OMR-143214、AED-30010627和AED-5003471。结论:在卡塔尔引入dara-SC作为NDMM患者的一线治疗(HamadMedicalCorporation),阿曼(苏丹卡布斯大学医院,皇家医院-卫生部),和阿联酋(SSMC和Tawam医院)可以帮助节约资源并最大程度地减少对医疗保健系统的限制。
    Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)-eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR -2 522 686, OMR -143 214, AED -30 010 627, and AED -5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.
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  • 文章类型: Journal Article
    医护人员(HCWs)可能面临SARS-CoV2感染的可变风险。不管他们参与提供直接的临床治疗,以前的大部分研究都包括了所有HCWs.了解感染率,不同HCWs亚组的危险因素和结局至关重要.从2020年2月28日至2022年1月1日,我们进行了一项回顾性分析,包括与哈马德医疗公司(HMC)设施分包的所有全职非临床工作人员(NCS)。为了确定当前或以前的SARS-CoV2感染,所有人员均接受RT-PCR和/或血清学检测.为了确定与感染风险相关的人口统计学因素,我们使用Cox-Hazard回归分析。在研究期间,3158/6231(50.7%)分包的NCS通过RT-PCR或血清学检测出SARS-CoV-2阳性。中位年龄为30岁(IQR25,35),69.8%的人口是男性,82.4%来自南亚,86.6%没有任何伴随条件。6032(96.8%)的人口居住在共享住房中,而4749人(76.2%)的教育水平低至中位数。虽然感染(PCR阳性,有或没有血清阳性结果)由男性独立预测,在餐饮业工作,洗衣房,和安全部门,处于中等水平(7-12年教育),较低(0-6年的教育),更高(暴露于确诊病例),并有症状。男性,在安全部门工作和处于中等水平(7-12年教育)与意外检测到的病例(PCR阴性和血清阳性)独立相关.299(4.8%)需要住院治疗,其中3例为重症肺炎,1例为未接受机械通气而需入住ICU,没有死亡报告。总之,NCS的感染率很高。大多数是无症状的,可能导致正在进行的疾病在公众或医疗机构中传播。在大流行期间,对该人群进行常规筛查至关重要,可能有助于遏制感染的传播。
    Health care workers (HCWs) may be at a variable risk of SARS-CoV2 infection. Regardless of their involvement in providing direct clinical treatment, most of the prior research had included all HCWs. Understanding infection rates, risk factors and outcomes among different subgroups of HCWs is crucial. From February 28, 2020 to January 1, 2022, we conducted a retrospective analysis encompassing all full-time non-clinical staff (NCS) subcontracted with Hamad Medical Corporation (HMC) facilities. To determine current or previous SARS-CoV2 infection, all personnel underwent RT-PCR and/or serology testing. To identify the demographic factors linked to the risk of infection, we utilized Cox-Hazard regression analysis. Herein 3158/6231 (50.7%) subcontracted NCS tested positive for SARS-CoV-2 by RT-PCR or serology during the research period. The median age was 30 years (IQR 25,35), 69.8% of the population were males, 82.4% were from South Asia, 86.6% did not have any concomitant conditions. 6032 (96.8%) of the population lived in shared housing, while 4749 (76.2%) had low to median levels of education. While infection (PCR positive with or without seropositive results) was independently predicted by male gender, working in the catering, laundry, and security sectors and being intermediate (7-12 years of education), lower (0-6 years of education), higher (exposure to confirmed case), and having symptoms. Male gender, working in the security sectors and being intermediate (7-12 years of education) were independently associated with accidently detected cases (PCR negative and seropositive). 299 (4.8%) required hospitalization, of them 3 cases were severe pneumonia and one required ICU admission without mechanical ventilation, with no deaths reported. In conclusion Infection rates among NCS are high. The majority are asymptomatic and may contribute to ongoing illness spread in the public or in healthcare facilities. During a pandemic, routine screening of this population is crucial and may aid in containing the spread of infection.
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