Background Ondansetron is a selective 5-hydroxytryptamine type 3 serotonin-receptor antagonist with antiemetic properties used inadvertently in the emergency department for controlling nausea. However, ondansetron is linked with a number of adverse effects, including prolongation of the QT interval. Therefore, the purpose of this meta-analysis was to assess the occurrence of QT prolongation in pediatric, adult, and elderly patients receiving oral or intravenously administered ondansetron. Methods A thorough electronic search was conducted on PubMed (Medline) and Cochrane Library from the databases' inception to August 10, 2022. Only those studies were considered in which ondansetron was administered orally or intravenously to participants for the treatment of nausea and vomiting. The prevalence of QT prolongation in multiple predefined age groups was the outcome variable. Analyses were conducted using Review manager 5.4 (Cochrane collaboration, 2020). Results A total of 10 studies involving 687 ondansetron group participants were statistically analyzed. The administration of ondansetron was associated with a statistically significant prevalence of QT prolongation in all age groups. An age-wise subgroup analysis was conducted which revealed that the prevalence of QT prolongation among participants younger than 18 years was not statistically significant, whereas it was statistically significant among participants aged 18–50 years and among patients older than 50 years. Conclusions The present meta-analysis provides further evidence that oral or intravenous administration of Ondansetron may lead to QT prolongation, particularly among patients older than 18 years of age.
Introduction: Colorectal cancer screening via colonoscopy decreased significantly due to the COVID-19 pandemic, with mail-out fecal immunochemical testing (FIT) initiated to maintain screening. Due to concerns surrounding 1FIT follow-up we added FIT navigation (FITNav) via a nurse practitioner who followed 1FIT to colonoscopy in August 2020. After implementation we noted little improvement in colonoscopy , 180 days compliance. This prompted a quality improvement (QI) project which resulted in a centralized database. Here we report a subgroup analysis to answer the question: were there racial disparities in 1FIT follow-up prior to FITNav implementation? Methods: We queried 1FIT from patients 45-85 y/o from 3/1/2019/20-9/3/2019/20, defined as the pre-pandemic and pandemic cohorts respectively. Patients with dementia & .65 y/o, diagnostic/inpatient FIT, or provider-initiated cancellation of colonoscopy due to comorbidities were excluded. Chart review retrieved FIT indications, patient/navigator notification time, GI consult placement time, and colonoscopy. We added Area deprivation index (ADI) to evaluate neighborhood-level disparities. An adjusted and unadjusted cox regression model was used to evaluate colonoscopy , 180 days between pandemic/pre-pandemic, summarizing via hazard ratios (HR) and 95% confidence intervals (CI). (Figure)Results: There were 121 & 103 1FIT meeting criteria in the pandemic & pre-pandemic respectively. Demographics (age, marital status, race, ADI, and sex) between periods showed no statistically significant differences. Proportion receiving colonoscopy , 180 days in the pre-pandemic and pandemic periods was 53.7% and 60.2% (unadjusted HR 1.08, 95% CI 0.76-1.54, p50.676). This remained insignificant when adjusted for race/ethnicity, marital status, priority group, ADI, time to notification, and age (adjusted HR 1.03, 95% CI 0.71-1.50, p50.872). While Black, non-Hispanic individuals had a univariate HR of 2.09 (95% CI 1.33-3.29 p50.001), multivariate HR was 1.59 (95% CI 0.92-2.74, p50.093). ADI did not show a statistically significant difference upon univariate or multivariate analysis. (Table ) Conclusion: No findings were present which suggested new or exacerbated racial disparities. Additionally, neighborhood-level disparities did not modify these findings; however, this evaluation is limited by sample size.
Table 1. (continued) Frequency or percent Overall (n559) SRC Q1 (n515) SRC Q21Q31Q4 (n544) p-value Private Ins (median %)
Background: Over the previous few decades, trends in author demographics have significantly changed. Such trends have already been studied for many sub-specialties but endocrinology is among the few branches that are yet to see an analysis of such trends. This paper aims to fill this gap. Methods: Journal of Endocrinology and General & Comparative Endocrinology are two landmark journals that publish articles from around the world. Each decade during the 70-year period from 1961 to 2021 has been examined in this study. Funding source, first author – senior author gender, their demographics and proportion of papers with at least one female author were the parameters considered while studying each publication. It was predicted that the number of female authors per paper would increase with time, as would the range of degrees held by the authors, demographical variations in authorship, and the funding source. The aim was also to determine the distribution of female first authors and senior authors in endocrinology journals over a 70-year period, as well as to check the gender combinations using the Punnett square. Results: Female first authors rose from 7% to 29.6% (p<0.0006) between 1961 and 2021, whereas female senior authors rose from 15.6% to 22.2%. Despite women's small contributions to first and senior authors, female participation rose from 17.48% (25/143) to 70% (170/250) between 1961 and 2021. Male-Female and Female-Male combinations rose with Chi-Square = 124.6, (p<0.0001). Europe and the Americas had the most female academic medical contributors (p<0.0001) Regardless of author status, female participation rose from 17.48% in 1961 to 68% in 2021. Conclusion: In papers published in endocrinology journals, there was a rising trend in female contributions to academic medicine. Even with the large growth of female endocrinologists, there is still a disparity in why the increase in female authors is comparably fewer.
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