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Global Healthcare Study on Psoriasis (GHSP): cohort profile and first findings

Por: Maul · J.-T. · Fröhlich · F. · Nielsen · M.-L. · Maul · L. V. · Torres · T. · Thyssen · J. P. · Armstrong · A. · Oon · H. H. · Ji · M. · Kang · X. · Valenzuela · F. · Romiti · R. · Carvalho · A. V. E. d. · Novoa · F. · Sousa · M. · Luz · M. · Guevara · B. E. K. · doss · N. · Gisondi · P.
Purpose

Despite the intention of international psoriasis treatment guidelines to cover all patients globally, disparities persist in the availability and accessibility of adequate therapy in many countries. The Global Healthcare Study on Psoriasis (GHSP) aims to study patient characteristics, disease impact, treatment accessibility and healthcare systems worldwide. This study provides a description and data analysis of 22 countries.

Participants

The GHSP cohort was initiated in 2020, and the number of recruiting centres has gradually grown. Participants are recruited by dermatologists at reference centres worldwide. Data are collected using a standardised assessment questionnaire comprising 88 items, administered by trained experts.

Findings to date

By 26 October 2024, cross-sectional data had been collected from 3950 psoriasis patients at 130 reference centres in 22 countries on six continents. The majority (55.7%) of patients were male, and the median (IQR) body mass index was 26.5 (23.7–30.1) kg/m2. The median (IQR) Psoriasis Area and Severity Index was 5.0 (2.0–11.4), and median (IQR) Dermatology Life Quality Index was 7.0 (2.0–14.0). Psoriatic arthritis was present in 20.2% of the patients and nail psoriasis in 36.7%. Additionally, 16.5% of patients were current smokers, and 26.4% reported regular alcohol consumption.

Future plans

By identifying inequalities, special patient populations and country-specific differences, the GHSP will guide the development of strategies to enhance psoriasis care on a global level. Future directions include expanding the study to additional countries and sites worldwide, while transitioning into a long-term global registry of skin diseases, including atopic dermatitis and hidradenitis suppurativa, termed ‘Global Healthcare Registry on Skin Diseases’.

Obinutuzumab versus Rituximab to maintain remission in children with steroid-dependent and frequently relapsing nephrotic syndrome: the OBIRINS study protocol, a double-blind randomised controlled trial

Por: Dossier · C. · Sellier-Leclerc · A.-L. · Simon · T. · Parmentier · C. · Boyer · O. · Samaille · C. · Fila · M. · Roussey-Kesler · G. · Magnavacca · M. · Chartier · Y. · Louillet · F. · Zaloszyc · A. · Vrillon · I. · Elaribi · D. · Bouatia · S. · Kaguelidou · F. · Guilmin-Crepon · S. · Ho
Introduction

There is an unmet clinical need for the development of novel treatment strategies to improve the outcome of children with frequent relapsing or steroid-dependent nephrotic syndrome. Obinutuzumab (OBI) is a second-generation anti-CD20 monoclonal antibody that has demonstrated its superiority to rituximab (RTX) in vitro and in vivo. Our assumption is that a single infusion of low-dose OBI will induce longer B-cell depletion, longer sustained remission and reduce the frequency of relapses and the use of oral immunosuppressors compared with a single infusion of RTX.

Methods and analysis

We conduct a double-blind, multicentre, randomised, parallel group in a 1:1 ratio controlled trial. In the experimental group, patients receive 1 infusion of OBI (300 mg/1.73 m2) and in the control group, the patients receive 1 infusion of RTX (375 mg/m2). The primary outcome of the study is the occurrence of the first relapse within 12 months following the initiation of treatment and secondary outcomes include the time to first relapse, the total number of relapses during the 24-month follow-up period, and any adverse events such as infusion-related complications, infectious complications, hypogammaglobulinaemia and neutropenia.

Ethics and dissemination

The study has been approved by the ethics committee (Comité de Protection des Personnes) of Sud Méditerrannée 2 and authorised by the French drug regulatory agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé). Results of the primary study and the secondary aims will be disseminated through peer-reviewed publications.

Trial registration number

NCT05786768.

Eudract N°

2022-003336-59.

Changes and contributions to the gender pay gap in surgery in Canada: a repeated cross-sectional analysis from 1996 to 2020

Por: Cohen · M. · Dossa · F. · Moineddin · R. · Kiran · T.
Objectives

Occupational gender segregation is a contributing factor to gender pay inequity in medicine but has not been thoroughly characterised. We assessed the historical relationship between surgeon sex, type of work and value of procedural payments. We hypothesised that female surgeons perform lower-paying procedures as a group, and that this could be seen both with broad historical overview and with focused analysis of major operative procedures in a specific year.

Design

We conducted repeated cross-sectional studies using public payment data from the Canadian Institute for Health Information. We calculated average payment per service by sex and service category and used linear regression to assess the association between proportion of female surgeons performing a procedure and payment value per procedure for 41 major procedures in 2019–2020.

Participants

Surgeons in 10 Canadian jurisdictions from 1996 to 1997 (5459) to 2019–2020 (8069).

Results

The proportion of female surgeons increased over the study period from 10.5% (n=575) in 1996–1997 to 28.7% (n=2314) in 2019–2020. The sex gap in the average payment per service narrowed but persisted. A greater proportion of women’s earnings came from non-procedural work in consultation and visits (43% for women vs 36% for men in 2019–2020) while a greater proportion of men’s earnings was from procedural work in major surgery (23% for women vs 38% for men in 2019–2020). There was an inverse relationship between proportion of women performing a procedure and payment value such that for one percent increase in female proportion, the procedural payment was CAD$1.77 lower.

Conclusions

Our findings suggest that women receive fewer procedural payments than men and tend to perform lower paying procedures. Reforms to referral systems and billing codes can help address root causes for the gender pay gap in surgery.

Nutritional status and associated factors among adolescents in Senegal: a nationwide cross-sectional study

Por: Sy · M. · Diouf · A. · Badiane · A. · Diagne Camara · M. · Diagne · A. · Idohou-Dossou · N.
Objective

Adolescents are a vulnerable group as they undergo rapid physical changes that can impact their nutritional status. Despite the implementation of some interventions addressing adolescent nutrition in Senegal, there remains a lack of comprehensive data on their nutritional status. This study aimed to assess nutritional status and associated factors among Senegalese adolescents aged 10–19 years.

Design

This cross-sectional study was part of the national food consumption survey, which was conducted among children aged 24–59 months, adolescents aged 10–19 years and adults aged 20 years and older.

Setting

The study was conducted in Senegal at the national level, in rural and urban areas, from July to November 2021.

Participants

1433 adolescents, boys and girls aged 10–19 years were randomly selected from 1800 households in 150 census districts.

Outcome measures

Nutritional status was assessed using body mass index for age z-score and waist-to-height ratio through anthropometric measurements. Dietary practices, health and socioeconomic and sociodemographic data were collected using questionnaires. Data were weighted for representativeness and logistic regression models were used to identify factors associated with underweight, overweight and obesity.

Results

Among the 1433 adolescents, one in five (21.7%) were underweight, 5.9% were overweight, 1.8% had obesity and 5% had abdominal obesity. Male gender (OR=1.74; p

Conclusion

Underweight is high in Senegalese adolescents, particularly in rural areas and among boys and adolescents aged 10–14 years. Overweight and abdominal obesity among girls and urban adolescents require particular attention. Tackling the double burden of malnutrition in Senegalese adolescents requires a greater consideration of adolescents in policies and strategies, including the implementation of a malnutrition management programme as well as the promotion of healthy diets.

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