IQVIA, formerly Quintiles and IMS Health, Inc., is an American multinational company serving the combined industries of health information technology and clinical research. It is a provider of biopharmaceutical development and commercial outsourcing services, focused primarily on Phase I-IV clinical trials and associated laboratory and analytical services, including consulting services. It has a network of more than 58,000 employees in more than 100 countries. As of 2019, IQVIA was reported to be one of the world's largest contract research organizations.
Metabolic bariatric surgery (MBS) is an effective treatment for severe obesity. While randomized trials have shown comparable medium-term outcomes for laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB), real-world data on perioperative safety remain limited. This study compares in-hospital mortality, complications, and length of stay between LSG and LRYGB in a large German cohort. We performed a cross-sectional analysis of anonymized hospital data from 49 German institutions (January 2019–January 2024), including 3,389 MBS procedures (LSG: n = 2,664; LRYGB: n = 725). Outcomes included in-hospital mortality, defined perioperative complications (e.g., hemorrhage, infection, anastomotic leak), and length of hospital stay. Logistic regression adjusted for age, sex, BMI categories, and comorbidities was used to assess associations. Most individuals (69.1
Purpose Incisional hernia is a common long-term complication of abdominal surgery and is traditionally seen as a structural defect. However, recent patient-centered research suggests that abdominal wall pathology may also impose substantial psychological burden. Whether incisional hernia is associated with an increased risk of clinically diagnosed depression at the population level remains unclear. Methods This retrospective cohort study used data from the German Disease Analyzer database (IQVIA). Adults with a first documented diagnosis of incisional hernia (ICD-10: K43.0-K43.2) between 2005 and 2024 were identified. Individuals with recent psychiatric disorders were excluded to assess incident depression. Patients were matched 1:1 to controls without hernia using propensity scores based on age, sex, index year, consultation frequency, somatic comorbidities, and remote history of depression. The primary outcome was incident depression (ICD-10: F32, F33) within five years. Associations were analyzed using conditional Cox regression. Results A total of 10,075 patients with incisional hernia were matched to 10,075 patients without hernia. During five years of follow-up, 18.4% of patients with and 16.5% without incisional hernia were diagnosed with depression. Incisional hernia was associated with a slightly increased risk of incident depression (hazard ratio 1.12; 95% confidence interval 1.04-1.20). The association was more pronounced among women and among individuals without prior depression. Conclusion Incisional hernia is associated with a slightly increased risk of clinically diagnosed depression. These findings indicate a modest statistical association between incisional hernia and subsequent depression diagnoses in routine care. While the magnitude of the association was small, awareness of potential psychosocial comorbidity may be relevant in selected clinical contexts.
INTRODUCTION:Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, requiring a multidisciplinary approach for effective management. The MDT Project aimed to define and pilot a structured care model for HCC management in Italy, supported by the implementation of integrated care pathways (ICPs), to standardize organizational processes and ensure the organizational requirements needed for appropriate patient management. METHODS:A multi-phase approach included a narrative review, semi-structured interviews with national experts, and the development of an optimal care model operationalized through a maturity model with 15 organizational elements. A total of 13 hospitals, selected to reflect national heterogeneity, participated in a pilot phase involving tailored action plans and hospital-specific ICPs. In total, ten hospitals proceeded to ICP implementation, and eight achieved certification by an external accreditation body. An expert consensus meeting subsequently validated the care model, key performance indicator (KPI) panel, and assessment tools. Organizational changes were assessed pre- and post intervention through the maturity model evaluation and a survey capturing clinicians' perceptions. RESULTS:Organizational improvements were observed primarily in areas directly targeted by the action plans, including the formalization of care-flow processes, multidisciplinary team structuring, case management, and coordination processes. More limited progress was seen in information systems and KPI monitoring, which require structural investments. Clinicians perceived the certification process as helpful in consolidating procedural standardization and documentation quality. CONCLUSIONS:The MDT Project piloted an organizational model for HCC management in Italy, focusing on care-pathway governance, multidisciplinary coordination, and center readiness. These findings represent an initial step toward broader implementation; future phases should incorporate clinical outcomes and patient-reported measures to evaluate the model's long-term impact.
Although effective pertussis vaccines are available and have been incorporated into national immunization programs for infants and children, and adolescents and adults in some countries, pertussis remains endemic worldwide. Periodic outbreaks occur every 2 to 5 years. In 2013, France revised its pediatric vaccination program, transitioning from a 3 + 1 to a 2 + 1 schedule. The effects of this change have raised some concerns; however, data on the effectiveness of pediatric vaccines in France post 2013 remain limited. This matched case-control study aimed to estimate the effectiveness of vaccination against pertussis in children born in France between 2013 and 2019, using the French National Health Data System. Children were included in the study if they were alive and free of pertussis at 6 weeks of age, and if their mother-child linkage was available. Pertussis-related hospitalizations were captured using the International Classification of Diseases-10 codes (A37.0 and A37.9), and vaccine exposure status was confirmed using ATCC codes (J07CA02, J07CA06, and J07CA09). The odds ratio (OR) of exposure to vaccine against pertussis for 1, 2, and 3 effective doses was calculated using conditional logistic regression models. Vaccine effectiveness (VE) was estimated as (1-adjusted OR) × 100% in at-term infants. In total, 1,481,884 children were included in the study. When stratified by age groups, a gradient of increasing VE was observed, with highest VE (93.4%) observed among children aged 11.5 to 60 months who were fully vaccinated according to 2 + 1 schedule and lowest (24.1%) among children aged 2 to 4.5 months who received only the first dose. In sensitivity analyses, imputation of missing data on vaccinations potentially received outside the healthcare insurance setting (Protection maternelle et infantile) resulted in an approximately 6% increase in VE. Results demonstrated that adherence to the 2 + 1 schedule provided effective protection against pertussis in full term children in France.
Although prior studies have examined healthcare providers’ perspectives on opioid prescribing for postoperative pain, limited research exists on surgeons’ experiences managing acute postoperative pain in adults. This study evaluated surgeons’ perceptions and experiences to better understand challenges in managing acute pain and assess perceived impacts of inadequately managed pain on patients. A sequential mixed methods study was conducted using concept elicitation interviews and a descriptive quantitative survey, with a convenience sample of United States (US)-based general, orthopedic, and plastic surgeons. Interview findings identified key themes related to surgeons’ perceptions of challenges and barriers associated with managing postoperative acute pain. These themes informed the development of a survey to quantify surgeons’ unmet needs, challenges, and experiences regarding postoperative pain management. Key themes from the interviews (N = 30) included challenges with effective pain management, advantages and disadvantages of commonly used pain medications, and difficulties managing pain in special populations. Among surveyed surgeons (N = 80), the most frequently reported challenges were managing patient pain management expectations (72.5
