Telephone Questionnaire Research Articles

Does a correlation exist between delayed vaccination and a decreased vaccine confidence?

ABSTRACT Delay in vaccination schedule may result in increased risk of vaccine-preventable outbreaks. Lack of parental confidence in vaccines and sociodemographic factors could be related to those delays. Vaccine Confidence Index (VCI) is an indicator to estimate confidence in vaccines, composed of simple dimensions about it and evaluated using a 5-point Likert scale. Objectives of this study, conducted in the Region of Murcia, Spain, were to determine which sociodemographic factors were associated with delayed administration in measles, mumps and rubella (MMR) vaccine, both first and second doses, and to evaluate if there were differences in parental vaccine confidence of children who were delayed on MMR vaccine schedule compare to vaccinated on time. The 2019–2020 (first dose) and 2016–2017 (second dose) cohorts were divided into four categories: vaccinated on time, slightly delayed, moderately delayed and highly delayed. Online questionnaire was sent to their parents, followed by a telephone questionnaire for non-responders. Regarding MMR first dose, a significant association was found between delay and birth order and intellectual/motor delay of children. Parental educational status, the main source of vaccine information and the social networks more frequently used by parents were also associated with delay. Suffering motor/intellectual delay and the obstacles to vaccination process derived from caring for other siblings were associated with delay in second MMR dose. The VCI decreased significantly in first dose group as delay increases but did not change in the second one. Confidence in vaccines and sociodemographic factors, respectively, were associated with delaying MMR first and second dose.

Rasch analysis of the new general self efficacy scale: an evaluation of its psychometric properties in older adults with low vision

BackgroundWhile general self-efficacy is known to relate to achievement in many areas, it has rarely been evaluated in individuals with low vision. Here we explore the psychometric properties and targeting of the New General Self Efficacy Scale (NGSES) using Rasch analysis in data collected from older adult clinical trial participants with low vision.MethodsParticipants (n = 121) completed pre-intervention telephone questionnaires (i.e., NGSES, Activity Inventory (AI), Beck Depression Inventory (BDI), SF-36, and the Telephone Interview for Cognitive Status (TICS). Rasch analysis using the Method of Successive Dichotomizations (MSD) was applied to NGSES, AI, and BDI datasets to estimate person and item measures, and ordered rating category thresholds.NGSES infit mean square statistics and standard errors were analyzed to test whether data fit Rasch model requirements, and targeting was assessed by comparing distributions of person and item measures. Multiple linear regression evaluated the influence of participant characteristics on NGSES person measures.ResultsThere was a significant difference (p = 0.01) in the distributions of NGSES person measures (mean = 0.85, range -2.1-3.2) and item measures (mean = 0, range -1.0-0.72). Infit mean square statistics and standard errors for item and person measures conformed to expectations of the Rasch model.Greater NGSES person measure was related to lower BDI person measure (β = -0.48, p < 0.0005, 95% CI -0.67—-0.28) and higher AI person measure (β = 0.11, p = 0.047, 95% CI 0.0013 – 0.22) after controlling for cognitive status (TICS). Other variables including SF-36, visual acuity, and patient demographics were not related to NGSES person measure.ConclusionsWhile NGSES person measures estimated from a low vision patient population conformed to basic Rasch model requirements, the significant differences in the person and item measure distributions indicate poor NGSES targeting, specifically a ceiling effect. Therefore, there is limited discrimination between persons at the upper end of the scale. While further work can evaluate how self-efficacy may be associated with other factors in the low vision patient population, the ceiling effect found in this study cautions interpretation of NGSES results for those with high general self-efficacy.Trial registrationPre-registered on clinicaltrials.gov, identifier NCT04926974.

Evaluating the outcome of a physiotherapy intervention in the treatment of mastitis, blocked ducts and engorgement in the lactating breast

Physiotherapists are well placed within the multidisciplinary team to offer safe interventions for the management of the symptoms of mastitis, blocked ducts and engorgement (MBE). However, these are not widely utilized in the UK. The purpose of this service evaluation was to evaluate patient satisfaction with treatment and outcomes following a physiotherapy intervention. The World Health Organization recommends that all infants are breastfed exclusively for 6 months. Despite the known benefits, the UK has some of the lowest breastfeeding rates in the world. A primary cause of premature cessation is pain, which can result from MBE, with mastitis alone affecting up to 25% of lactating women. The target population was breastfeeding mothers who had utilized the clinic’s mastitis service for therapeutic treatment of MBE between January 2021 and January 2023. A service evaluation was conducted using telephone questionnaires. Verbal informed consent was obtained prior to data collection. The protocol, which was uniquely developed by the principal clinicians in this service evaluation, included therapeutic ultrasound, manual therapy, advice and education. Ninety-two per cent of participants found the treatment helpful, 76.5% reported an initial improvement in symptoms within 24 h of treatment, and 76% said that the protocol helped them to continue breastfeeding for longer. The participants reported that the protocol was effective for managing the symptoms of MBE, and that it supported an increase in breastfeeding duration.

Veteran comfort and satisfaction with comprehensive geriatric assessment via video telehealth to home.

The purpose of this project was to measure satisfaction with virtual comprehensive geriatric assessments (CGA) among older Veterans (OVs). The CGA involved five different healthcare providers and four one-hour VA Video Connect (VVC) calls. Using specific enrollment criteria, OVs were recruited in four cohorts separated by time. After completing the CGA, participants were asked to complete a 10-statement telephone questionnaire. Before analyses, responses to each statement were dichotomized as Agree (Agree/Strongly agree) or Do not Agree (Neutral/Disagree/Strongly Disagree). Descriptive statistics and Binomial generalized linear models (GLMs) were used to analyze the data. All 269 enrolled OVs completed all components of the CGA. This included 79, 57, 61, and 72 Veterans in cohorts 1 to 4, respectively. Their average age was 76.0 ± 5.9 years, and they were predominately white (82%), male (94%), and residents of rural settings (64%). Of the 236 (88%) OVs who completed the telephone survey, 57% indicated they were comfortable using VVC and 57% expressed willingness to use VVC again; 44% felt that VVC was easier than going to in-person visits. The OVs in Cohort 1 were more likely to agree with these statements than those in the remaining cohorts, especially Cohorts 2 and 4. Differences in demographics partially explained some of these findings. The majority (89% or higher) of survey participants agreed with the remaining seven survey statements indicating they were satisfied with the CGA program. OVs were very satisfied with their participation in a program of CGA, although not necessarily the mode of delivery. The percentage of participants who indicated discomfort using VVC for the CGA visits appeared to increase with time. Further work is needed to determine which OVs would be the best candidates to use VVC to complete all or part of a CGA.

Characteristics of emotional and sexuality education programs in the Spanish school population

Sexuality education should be integrated into educational centers as a human right of children and adolescents, and an international recommendation based on scientific evidence. This study sought to identify the sexuality education interventions that were carried out in Spain in year 2021-2022, and to analyze whether they are in line with best practice recommendations. A descriptive study was carried out, considering organization territorial called Autonomous Communities as the unit of study, through key informants identified by purposive sampling. The variables used were based on international recommendations and the information was collected via a telephone questionnaire, by e-mail or by consulting websites referenced by the key informant. Fifteen of 17 Autonomous Communities had sexuality education interventions. Most were programs and only three had optional curricular subjects. Ninety-four percent were aimed at secondary school and were taught by teachers (72%). Only one program had an impact evaluation and only 28% complied with best practice recommendations. The voluntary or optional nature of the interventions reduces their scope, which is usually limited to secondary school students. It is necessary to implement mandatory curricular subjects, with a focus on sexual rights and gender.

Streamlining Preoperative Evaluation for Dialysis Access: A Pilot Study

Outpatient in-person clinic evaluation is the standard consultation practice for an initial referral for hemodialysis (HD) access. However, most factors predicting the complexity of first-time access surgery can be determined from history rather than physical exam. This study investigates the outcomes of patients undergoing first-time arteriovenous fistula creation screened with a standardized preoperative phone interview and no preoperative clinic visit (SPEEDY group) versus those opting for a standard in-person clinic visit. From 9/2021 to 8/2022, all patients scheduled in our vascular clinic for first-time dialysis access were telephoned using a standardized history questionnaire. Those meeting criteria and expressing desire to bypass the initial clinic visit were scheduled for surgery without an in-person preoperative evaluation (SPEEDY group). The comparison group included patients who were study-eligible but desired to meet with the surgeon preoperatively. Time from referral to fistula creation, overall fistula patency rates, and the incidence of access-specific complications were compared between the two groups. Of the 107 patients contacted, 43 (40%) were study eligible. Of these eligible patients, 21 (49%) were scheduled for surgery without a preoperative visit, of whom 19 (90%) underwent surgery. Compared to eligible controls, SPEEDY patients had a younger median age (49.3 years v. 58.9, p=0.056) but similar median duration of HD prior to fistula creation. SPEEDY patients had significantly shorter median time from initial referral to surgery than eligible controls (48 days vs. 82, p=0.01). Incidence of complications did not differ between the groups. At median follow up of 18.3 months (IQR 11.4-20.9) there was no difference in overall access patency between SPEEDY participants and eligible controls (p=0.83). A standardized telephone questionnaire can effectively be used to identify patients who can safely undergo first time dialysis access surgery without an in-person clinic evaluation, significantly reducing time from initial referral to surgery without increasing complications or compromising patency rates.

Long-term survival and complications following small intestinal resection and partially stapled, functional end-to-end anastomosis.

The aim of the present study was to investigate the long-term survival and postoperative complications in horses that had undergone small intestinal resection and a modified anastomosis technique using a partially stapled, functional end-to-end anastomosis. Observational retrospective case series. A total of 25 horses underwent small intestinal resection and a partially stapled, functional end-to-end anastomosis. A modified technique to create a partially stapled, functional end-to-end anastomosis is described. The clinical case records of all horses that fulfilled the criteria between January 1, 2010 and January 1, 2020 were reviewed. Data on short-term survival and postoperative complications were collated. A telephone questionnaire of owners was undertaken to evaluate long-term survival. Duration of follow up was from one to 4232 days (median 785 days). A total of 21/25 (84%) of horses survived to discharge, 19/25 (76%) horses were alive at 6 and 12 months and 64% survived to 2 years. A total of 64% of horses developed at least one postoperative complication. Two horses developed a small intestinal volvulus necessitating repeat laparotomy. One horse had kinking at the anastomosis site diagnosed at post-mortem examination. Partially stapled functional end-to-end anastomosis technique in this study had similar short- and long-term survival to those reported in previous studies using handsewn techniques, but severe complications at the anastomosis site occurred in >10% of cases. The anastomosis technique described appears to have similar short- and long-term survival and complication rates, compared to more commonly used anastomosis techniques. However, there is potential for severe complications at the anastomosis site.

Treatment of Acquired Deforming Hypertonia with Botulinum Toxin in Older Population: A Retrospective Study.

Acquired deforming hypertonia (ADH) affects the daily care of numerous nursing home residents. The aim of this study was to analyze the practice, aims, and effectiveness of botulinum toxin injections (BTxis) in the treatment of older patients with contractures, an indication for which BTxis are still underused. Data were extracted retrospectively from medical records regarding population, contractures, and injections. A prospective analysis was conducted to evaluate treatment goals set by goal attainment scaling (GAS) at T0 and at T1, to evaluate the therapeutic effects. We also recorded the occurrence of side effects, using a telephone questionnaire. This study included 41 patients older than 70 years who had received one or more BTxis for the first time between January 2018 and December 2021. Most of the older people we included lived in an institution (66%), manifested severe dependence, and presented significant morbi-mortality (37% of the patients died in the year after the last injection). The main objectives of these injections were purely comfort, without any functional goals. The GAS scores suggested effectiveness for comfort GAS scores. No complications were recorded. This study highlights the BTxis potential to address the needs of a larger number of older patients with ADH.

Effects of epidural anesthesia and analgesia on the incidence of chronic pain after thoracoscopic lung surgery: A retrospective cohort study

ObjectiveChronic postoperative pain (CPSP) is common after thoracic surgery, even after the less invasive video-assisted thoracoscopic surgery (VATS). This study investigated the effect of thoracic epidural anesthesia (TEA) on the development of CPSP. MaterialsWe retrospectively analyzed the data of patients who underwent VATS at our center between 2020 and 2022. The enrolled patients were divided into the epidural block (EPI) and patient-controlled intravenous analgesia (PCIA) groups. A telephone questionnaire was used to collect information regarding CPSP, which was defined as a numerical rating scale (VAS) score ≥1 at 3 or 6 months postoperatively. Additionally, statistical analyses were performed to identify the risk factors for CPSP in the two groups. ResultsOverall, 894 patients completed the follow-up interviews at 3 and 6 months, with 325 and 569 patients in the PCIA and EPI groups, respectively. The incidence rates of CPSP in the PCIA group at 3 and 6 months were 16.9 % (95 % confidence interval [CI]: 9.3–32.7 %) and 13.5 % (95 % CI: 8.7–33.4 %), and 10.3 % (95 % CI: 8.1–30.5 %) and 3.6 % (95 % CI: 3.5–21.5 %) in EPI group, respectively. The incidence of CPSP at 3 months (P = 0.0048) and 6 months (P < 0.005) was statistically significant in both groups. Age and lymph node dissection were significantly associated with CPSP. ConclusionsCompared to PCIA, TEA was associated with a lower incidence of CPSP after VATS, and should be considered an important part of the analgesia regimen for patients with VATS.

A case-control study of behavioural and built environment determinants of COVID-19 transmission in sheltered markets

BackgroundIn July 2021, amid occasional COVID-19 community transmission, an outbreak in a seafood wholesale centre propagated secondary clusters in sheltered markets in Singapore. This period offers a unique chance to study COVID-19 transmission risk factors related to environmental features and personal behaviours in markets. Only 40 % of the population was vaccinated during this period. MethodsA two-tier case-control study was conducted. The first tier entailed site assessments of markets where primary cases, presumed to have acquired COVID-19 at the seafood wholesale centre, worked. Markets with secondary cases (case markets) were compared against those without (control markets). The second tier comprised telephone questionnaires administered to individuals who worked at or visited the three markets with the highest number of secondary cases, with respondents either testing positive or negative for SARS-CoV-2. ResultsAssessment of 38 markets showed that markets “seeded” with more primary cases were more likely to experience a secondary outbreak (adjusted odds ratio, aOR: 2.0; 95 % confidence interval, CI: 1.3–4.7). From 333 visitor responses, maintaining social distancing (aOR: 0.34; 95 % CI: 0.11–1.06) and completing vaccination (aOR: 0.25; 95 % CI: 0.07–0.95) decreased infection risk, while using public washrooms increased the risk (aOR: 3.12; 95 % CI: 0.87–11.00). Among 86 staff responses, statistically significant risk factors were gender and mask type: male staff (aOR: 0.14; 95 % CI: 0.02–0.62) and those wearing surgical/N95 masks (aOR: 0.10; 95 % CI: 0.01–0.71) had lower infection risk. Wider aisles of the markets correlated with a higher chance of secondary transmission (aOR: 2.5; 95 % CI: 1.3–6.7). ConclusionThese findings underscore the importance of considering both built environment features and individual behaviours in devising effective measures to mitigate COVID-19 transmission in markets and community hubs in general. The observed association of wider market aisles with increased risk could be attributed to these facilitating the gathering and intermingling of more individuals, underlining the importance of maintaining social distancing. The identified individual risk factors among different populations within the market environment highlight the need for population-specific measures for infection prevention.

Hoof wall masses removal in 30 standing sedated horses: Surgical technique, postoperative complications and long-term outcome.

To describe the surgical technique for removal of hoof wall masses in horses under standing sedation (SS) and local anesthesia (LA), and to report complications and long-term outcome following surgery. Observational retrospective study. Client-owned horses (n = 30). Horses undergoing keratoma removal under SS and LA in a single equine hospital between August 2016 and July 2023 were included in the study. Signalment, affected foot, history of lameness and/or foot abscesses, degree of lameness on admission, imaging findings (radiography and magnetic resonance imaging [MRI] when available), location of the mass, surgical technique, remedial farriery, postoperative care, complications and outcome were recorded. Long-term follow-up information was obtained by telephone questionnaire. A total of 30 horses met the inclusion criteria. Duration of lameness ranged from 1 to 289 days (mean 90 days). The degree of lameness varied from absent to grade 4/5 (AAEP) (mean grade 3/5). All horses underwent preoperative radiographic examination and 14/30 underwent MRI. All horses underwent partial hoof wall resection. The surgery was performed safely in all cases. Postoperative complications included marked lameness in the early postoperative period in 3/30 horses and exuberant granulation tissue formation in 2/30 horses. Long-term (>6 months) follow-up information was available for 28 horses, and 26/28 horses returned to previous levels of exercise. Recurrence was suspected in 1/30 horses. The complication rate was lower than previously reported for keratoma removal under general anesthesia (GA). Removal of hoof wall masses under SS and LA can be considered as an alternative to removal under GA.

Effect of climate on emergency department admissions for renal colic: a comparative analysis of sedentary and non-sedentary lifestyles.

To investigate the impact of climate and seasonal variations on emergency department (ED) admissions for renal colic, while specifically comparing the differences between individuals with sedentary and non-sedentary lifestyles. A retrospective, single center study was conducted. Between the years 2017- 2020, medical records of patients admitted to the ED with renal colic, found to harbor ureteric stones on CT scans, were examined. Data on patients' occupational activities was collected through telephone questionnaires. Patients were categorized into two groups: sedentary and active. Precise weather data was obtained from the Israeli Meteorological Service website. The monthly average daily maximum temperatures were calculated. In the final sample of 560 participants, 285 were in the sedentary group, and 275 were in the active group. The study population consisted of 78.1% males and 21.9% females, with consistent gender ratios in both occupational groups. Prevalence of uric acid stones was higher in the sedentary group (p < 0.05). While there was a slight increase in admissions during the summer, seasonal distribution did not significantly differ among occupational groups. The study found no significant differences in admissions across different temperature ranges. Both groups exhibited a pattern of increased referrals during the summer and reduced referrals in the colder winter months. The baseline data revealed notable differences between the sedentary and active groups, particularly in the prevalence of uric acid stones. Climate factors, including temperature and seasonal variations, had limited impact on ED admissions for renal colic in patients with kidney stones, irrespective of their sedentary or active lifestyles. Both groups exhibited similar admission patterns, with a higher rate of admissions during the summer and a lower rate of admissions during the winter.

Étude RIESC : risques d’infections uro-génitales et d’expulsion dans l’association stérilet et coupe menstruelle

ObjectivesThe increase in intrauterine devices (IUDs) contraception, and the growing use of reusables menstrual hygiene products such as the menstrual cup, necessitates an assessment of the implications of their co-use. The objectives are to assess whether women with IUDs who use menstrual cups have an increased risk of IUD expulsion and/or a change in the risk of upper and lower urogenital tract infections compared to women who use other menstrual hygiene products. MethodAn observational, prospective, multicenter study was conducted in France between 2020 and 2023. Participants were recruited by health professionals and data were collected by telephone questionnaire at the time of IUD insertion and at one year. The primary endpoints were the occurrence of IUD expulsion and the occurrence of urogenital tract infections in menstrual cup users compared to non-users. ResultsOne hundred and three women out of 119 included were analyzed, 25 of them were regular menstrual cup users and five experienced IUD expulsion. Among regular users, 12% experienced IUD expulsion compared to 2.6% among non-users, with no statistically significant difference (Chi2=3.65; P=0.056). Regarding urogenital tract infections, nine women (36%) of the regular menstrual cup users had urogenital infections, compared with 27 (34.6%) of the non-users or not regular users, with no statistically significant difference. ConclusionThe tendency of menstrual cup users to expel their IUDs is a reason for caution, although it is not sufficient to contraindicate co-use. Physicians should therefore systematically screen such co-use and inform patients of the risks and monitoring instructions.

Caregiver report of adverse childhood events: comparison of self-administered and telephone questionnaires

Adverse childhood experiences (ACEs) are traumatic experiences that increase people’s susceptibility to adverse physical health, mental health, and social consequences in adulthood. Screening for ACEs in primary care settings is complicated by a lack of consensus on appropriate methods for identifying exposure to ACEs. It is unclear whether self-report methods could increase disclosure of ACEs as compared to interview-based methods. This study compares data on the prevalence of ACEs from two publicly available surveys conducted on the same population of children’s caregivers: the 2019 Ohio subsample of the web/mail-based National Survey of Children’s Health and the telephone-based 2019 Ohio Medicaid Assessment Survey. We find higher disclosure of caregiver-reported child exposure to ACEs in the telephone interview survey, highlighting the importance of the role of verbal communication in developing a safe and trusting relationship in the disclosure of trauma.

Longitudinal Follow-Up Study on the Side Effects of COVID-19 Vaccines: A Telephonic Questionnaire Approach.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has prompted urgent efforts to develop and deploy effective vaccines. Covishield and Covaxin are two prominent COVID-19 vaccines authorized for emergency use; however, concerns regarding their safety persist. This longitudinal follow-up study aimed to comprehensively assess and compare the demographic characteristics, frequencies, severities of reported side effects, and associations between vaccine type and demographic factors among individuals vaccinated with Covishield and Covaxin. A telephonic questionnaire was used to collect data from individuals who attended COVID-19 vaccination programs between January 1, 2021, and January 1, 2022. Logistic regression analysis was performed to investigate the associations between vaccine type, demographic factors, and likelihood of experiencing side effects. Covaxin recipients exhibited a lower incidence of mild flu-like illness (16 cases) and post-vaccination infection (55 cases) than Covishield recipients (110 and 98 cases, respectively). However, Covaxin recipients reported more cases of soreness at the injection site (139 cases) than did Covishield recipients (172 cases). Logistic regression analysis revealed significantly higher odds of experiencing side effects among Covaxin recipients than among Covishield recipients (OR = 1.687, p < 0.001). Age was inversely associated with the likelihood of experiencing side effects (OR = 0.982, p < 0.001), while sex and ethnicity also exhibited significant associations. This study provides valuable insights into the safety profiles of the Covishield and Covaxin COVID-19 vaccines. These findings underscore the importance of ongoing surveillance and evaluation of vaccine safety and tolerability to inform public health policies and vaccination strategies.

Sensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis

BackgroundNails accumulate the alcohol metabolite, ethyl glucuronide (ETG), and the cannabis metabolite, carboxy- delta-9-THC over 3–6 months. Few studies have examined nail toxicology testing’s sensitivity and specificity and the agreement between nail testing and self-reported alcohol and marijuana use. MethodsIn an ongoing clinical trial, 1101 veterans completed initial telephone questionnaires and were then asked to mail nail clippings for substance use analysis. We examined sensitivity and specificity of ETG and carboxy- delta-9-THC in nails compared to self-report of alcohol use patterns (the AUDIT-C) and substance-related harms (alcohol and THC subscales of the ASSIST). We then examined factors associated with discordance between nails and self-report. ResultsAlmost two-thirds (707/1101) of respondents mailed in nail clippings. Those with returned nails were disproportionately married, white race, older, and less depressed. At a threshold of 8pg/mg, sensitivity was only.50 to detect risky alcohol use and.49 to detect alcohol-related issues. Sensitivity for marijuana issues was only.61. Specificity was greater than.77 for all measures.Factors associated with positive nails/negative self-report (i.e. false positives) for risky alcohol use on the Audit-C included more pain and being unmarried; false positive nails for alcohol-related issues on the ASSIST were associated with being unmarried and non-Hispanic ethnicity. False positive nails for THC-related issues on the ASSIST were associated with being African American, Hispanic, and having had legal issues. ConclusionsAt standard cut-offs, nail measures had low sensitivity and higher specificity. The groups who disproportionately submit positive nails/negative self-report could have substance use patterns not adequately captured by self-report, inaccurate self-report due to social pressures, or distinct drug metabolism.

Outcome of tenoscopically guided palmar/plantar annular ligament desmotomy for the treatment of palmar/plantar annular ligament constriction without concurrent intrathecal soft-tissue injury in a UK horse population.

To determine the outcome of tenoscopically guided palmar/plantar annular ligament (PAL) desmotomy to treat PAL constriction without concurrent intrathecal soft-tissue injury, notably of the digital flexor tendons and manica flexoria. Retrospective multicenter cohort study. Sixty-five horses. Horses from four UK equine hospitals, with digital flexor tendon sheath (DFTS) tenosynovitis, which underwent tenoscopically guided PAL desmotomy for treatment of PAL constriction between 2017 and 2022 were included. All horses had lameness isolated to the DFTS/PAL, and PAL constriction was diagnosed tenoscopically when there was difficulty maneuvering the endoscope into or through the fetlock canal. Horses with tearing of the digital flexor tendons and/or manica flexoria, or any other intrathecal pathology, were excluded. Follow up was via structured telephone questionnaire. Follow up (median 25 months) was available for 61 horses with cobs and ponies predominating. Forty-two returned to their previous level of work, or a higher level, postoperatively and 50 owners were satisfied with the outcome of surgery. Eleven horses returned to lower level exercise, and six were retired/euthanized as they did not regain soundness. Fifty-two horses achieved soundness (median 3 months postoperatively). Tenoscopically guided PAL desmotomy for the treatment of PAL constriction in the absence of intrathecal soft tissue injury had a good prognosis for return to previous levels of exercise in a UK horse population. The prognosis for horses undergoing tenoscopically guided PAL desmotomy to treat PAL constriction in the absence of intrathecal injury is better than previously described. Cobs and ponies seem to be predisposed to PAL constrictionin agreement with the previous literature.

Use of etonogestrel subcutaneous implant in Sardinia, Italy: women’s compliance and satisfaction

Purpose of the article The main aim of the study was to analyze the population of women who used etonogestrel implant, the reason that led them to this type of contraception, and the degree of compliance with it. Materials and methods: We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015–2021). We submitted the women a series of questions by telephone questionnaire (range 10–72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant. Materials and methods We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015–2021). We submitted the women a series of questions by telephone questionnaire (range 10–72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant. Results The average age of placement of etonogestrel implant was 33.8 ± 3.45 years. As regards level of education, 16/47 (34%) of the women had a university degree, 21/47 (44%) had a high school diploma and 10/47 (21%) had a secondary school diploma. The 12/47 (25%) of the women were, at the time of the counselling, unemployed and only 8% did not use in the past contraceptive methods other than etonogestrel implant. The 92% of women choose etonogestrel implant because it offered safe, comfortable and long-lasting contraception. Among the main side effects evaluated, we reported spotting in 24 out of 47 (51%), headache in 4 out of 47 (8.5%). The 85% of the women recommended etonogestrel implant to their friends as a contraceptive method, with an approval rating for the implant, expressed a rating from 1 to 10 with the mean that was 7.79, the median 8. Conclusions Our results are of interest because they derive from a region of Italy in which the Long acting reversible contraception (LARC) is strongly underused. Etonogestrel implant was a safe and effective, long-acting, reversible hormonal contraception (LARC) and majority of women recommended the etonogestrel implant to their friends as a contraceptive method.

Heterogeneous body compositions and all-cause mortality in acute coronary syndrome patients: a ten-year retrospective cohort study.

The association of different body components, including lean mass and body fat, with the risk of death in acute coronary syndrome (ACS) patients are unclear. We enrolled adults diagnosed with ACS at our center between January 2011 and December 2012 and obtained follow-up outcomes via telephone questionnaires. We used restricted cubic splines (RCS) with the Cox proportional hazards model to analyze the associations between body mass index (BMI), predicted lean mass index (LMI), predicted body fat percentage (BF), and the value of LMI/BF with 10-year mortality. We also examined the secondary outcome of death during hospitalization. During the maximum 10-year follow-up of 1398 patients, 331 deaths (23.6%) occurred, and a U-shaped relationship was found between BMI and death risk (P nonlinearity = 0.03). After adjusting for age and history of diabetes, the overweight group (24 ≤ BMI < 28 kg/m2) had the lowest mortality (HR = 0.53, 95% CI: 0.29-0.99). Predicted LMI and LMI/BF had an inverse linear relationship with a 10-year death risk (P nonlinearity = 0.24 and P nonlinearity = 0.38, respectively), while an increase in BF was associated with increased mortality (P nonlinearity = 0.64). During hospitalization, 31 deaths (2.2%) were recorded, and the associations of the indicators with in-hospital mortality were consistent with the long-term outcome analyses. Our study provides new insight into the "obesity paradox" in ACS patients, highlighting the importance of considering body composition heterogeneity. Predicted LMI and BF may serve as useful tools for assessing nutritional status and predicting the prognosis of ACS, based on their linear associations with all-cause mortality.

Stable Clinical and Radiological Outcomes at Medium and over 5 Year Follow Up of Calcaneus Fracture Open Reduction Internal Fixation Using a Sinus Tarsi Approach

The sinus tarsi approach is increasingly growing in popularity for open reduction internal fixation of calcaneus fractures. Multiple studies have demonstrated favorable short-term results compared to the traditional extensile L incision, however long-term data over 5 years is currently limited to a single retrospective case series. Following local ethical approval, all patients who had completed a minimum 5 years from time of operation were contacted with a Standardized Telephone Questionnaire completed. This followed a previous retrospective chart review, with follow up telephone or clinic consultation performed by Davey et al. of this cohort at mean 35 months. Thirty-four fractures (31 patients) completed minimum 5 year follow up from the eligible group of 54 fractures (49 patients). Regarding functional outcomes, a significant improvement in mean Maryland Foot Score was observed between short- (mean 35.8 months) and medium-term (mean 81.9 months) of 77.6 (SD 15.0) to 86 (SD 7.9) (p = .0082). There was no significant difference in postoperative and long term radiographic Bohler's angle (p = .9683). Eleven feet (32%) proceeded to require reoperation, with removal of metal performed in 10 (29%), fusion in 2 (6%), and skin grafting following wound breakdown for 1 (3%). Four feet (12.9%) experienced post operative wound complications, including 3 (9.68%) cases of infection and 2 (6.45%) of delayed wound healing. This study demonstrated stable clinical and radiographic outcomes over 5 years following Calcaneus Fracture Open Reduction Internal Fixation using a sinus tarsi approach, supporting its continued usage when treating intraarticular calcaneus fractures for which operative intervention is indicated.