Treatment of high-grade spondylolisthesis with Schanz recoil screws: our experience.

PURPOSE: Spondylolisthesis surgical treatment is often difficult with higher degree of slip and related techniques still debated. We have taken into consideration double thread recoil Schanz screws. This system should allow the best reduction of the slip, treating only the affected vertebrae. METHODS: We retrospectively analyzed 46 patients affected by grade II or higher spondylolisthesis, treated with circumferential arthrodesis using Schanz screws. Duration of surgery, complications, reduction, and rate of fusion have been recorded. RESULTS: We found that duration of surgery and complications were similar or slightly lower if compared to our standard Posterior Lumbar Interbody Fusion procedures. However, radiological results and clinical outcome appear better in cases treated with Schanz screws. CONCLUSIONS: Fixation system with Schanz screws seems to be effective in reducing the slip, treating only the affected level, in high grade of spondylolisthesis.

Corrigendum to "Socioeconomic Status, Cultural Capital, and Social Capital in Adults: A Structural Equation Model" [Psicothema 34(1), 74-83].

DOI: https://doi.org/10.7334/psicothema2023.193 Text: This article was originally published with errors, which have now been corrected in the online version: 1. The investigated alternative models have now been described more clearly. The method for comparing them with the original model has been correctly specified based only on Akaike's Information Criterion (AIC) and not on the delta Comparative Fit Index, given that the models are not nested. 2. The formula for computing the critical value to which comparing the Mardia's index for verifying if the data are multivariate normally distributed is equal to k(k+2) and not, as previously written, equal to k(k+1). 3. We have now specified that, in the Structural Equation Model, the correlations introduced between the dependent variables are correlations between the unexplained variance and thus may be described as partial correlations. 4. Finally, we have corrected the direction of the arrows of the lines from Participating, Consuming, and Expert Using observed variables toward the corresponding Cultural Capital latent variable and from Bonding and Bridging observed variables toward the corresponding social capital latent variable. DOI of original article: (https://doi.org/10.7334/ psicothema2021.231)

The Effects of the COVID-19-induced Lockdown on the Social Capital and Cultural Capital in Italy.

The present study investigated the effects of the first COVID-19 lockdown on the Cultural and Social Capitals in Italy in a large group of adults (n = 1125). The relationships between the COVID-19 spread and participants' Cultural Capital, Social Capital, educational level, occupational prestige, and age were studied using structural equation models. For women but not for men, pandemic spread was positively affected by occupational prestige and it had a positive relationship with their Social Capital (women: CFI = 0.949; RMSEA = 0.059 [CI = 0.045-0.075]; men: CFI = 0.959; RMSEA = 0.064 [CI = 0.039-0.087]). Moreover, the participants were divided into three validated clusters based on their Cultural and Social Capitals levels to investigate changes in the Capitals compared with the pre-lockdown period. It was found that the lockdown contributed to improving the gap among individuals increasing high levels and decreasing low levels of both the Capitals. People with high Cultural and Social Capitals seemed to have seized the opportunity given by COVID-19 restrictions to cultivate their cultural interests and become more involved within their networks. In contrast, individuals with low Cultural and Social Capitals paid the highest price for the social isolation. Given that the Capitals encourage healthy behavior and influence well-being and mental health, institutions should develop or improve their policies and practices to foster individual resources, and make fairer opportunities available during the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s11205-023-03140-7.

Perceived COVID-19 Threat and Reactions to Noncompliant Health-Protective Behaviors: The Mediating Role of Desired Cultural Tightness and the Moderating Role of Age.

The COVID-19 pandemic is a health crisis that requires individuals to comply with many health-protective behaviors. Following the previous literature, cultural tightness has been found to be a key mechanism to increase coordination in order to mitigate collective threats (e.g., COVID-19). In this study, we test a moderated mediation model to examine whether the perceived COVID-19 threat could intensify the extent of desired tightness (i.e., a personal desire for cultural tightness), moderated by age. Subsequently, we test whether this could intensify individuals' emotional reactions to non-compliance with COVID-19 health protective behaviors. The study relies on a cross-sectional design, with a sample of 624 participants residing in central Italy (i.e., Lazio). The data were collected from February to October 2021. Questionnaires contained self-reporting measures of the perceived COVID-19 threat, desired tightness, and personal emotional reactions to non-compliance with COVID-19 preventive measures (e.g., wearing a mask). The results confirm that the perceived COVID-19 threat is associated with an increase in the desire for cultural tightness-and that this relationship was moderated by age-and, consequently, with intolerance for noncompliance with preventive behaviors. Additionally, both direct and indirect effects of the perceived COVID-19 threat on negative emotional reactions to noncompliance were significant; this indirect effect was larger at high (+1 SD) age than at low (-1 SD) age. Overall, this research provides some insight into how people can respond to the current pandemic threat, and how this may have implications for violating rules and regulations to keep contagion under control.

Direct health care costs associated with COVID-19 in the United States.

BACKGROUND: Data on the real-world health care burden of COVID-19 in the United States are limited. OBJECTIVE: To compare health care resource use (HRU), direct health care costs, and long-term COVID-19-related complications between patients with vs patients without COVID-19 diagnoses. METHODS: Using IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits administrative claims databases (January 1, 2018, to March 1, 2021), this retrospective, matched cohort study compared patients with a recorded COVID-19 diagnosis to control subjects with no recorded diagnosis for COVID-19, personal history of COVID-19, or pneumonia due to COVID-19. To capture typical health care utilization, the control group was analyzed in 2019 (prepandemic); their index date was assigned as 1 year before the index date (first observed COVID-19 diagnosis) of their matched COVID-19 patient. All patients had continuous health plan coverage for at least 6 months pre-index (baseline) and at least 6 months post-index (allowing censoring during month 6). Separately for commercial and Medicare cohorts, COVID-19 and control patients were matched 1:1 using propensity scores, number of followup months, and indicator of age 18 years or older. During each month of the 6-month follow-up, all-cause HRU, health care costs, and COVID-19-related complications were compared between patients with COVID-19 and controls. RESULTS: After matching COVID-19 and control patients 1:1, a total of 150,731 commercial matched pairs and 1,862 Medicare matched pairs were retained; baseline characteristics were similar between patients with COVID-19 and controls. Patients with COVID-19 and controls had mean ages of 38.9 and 39.7 years in the commercial cohort and 74.3 and 75.3 years in the Medicare cohort, respectively. In month 1 of follow-up, patients with COVID-19 relative to controls were significantly more likely to have at least 1 inpatient admission (commercial: 6.9% vs 0.5%; Medicare: 29.1% vs 1.3%; both P < 0.001) and at least 1 emergency department visit (commercial: 37.3% vs 3.4%; Medicare: 26.2% vs 4.1%; both P < 0.001). Total health care costs in month 1 were significantly higher among patients with COVID-19 than controls (mean differences: $3,706 for commercial; $10,595 for Medicare; both P < 0.001), driven by inpatient costs. Though the incremental HRU and cost burden of COVID-19 decreased over time, patients with COVID-19 continued to have significantly higher total costs through month 5 (all P < 0.001 for both commercial and Medicare). During follow-up, patients with COVID-19 had significantly higher rates of complications than controls (commercial: 52.8% vs 29.0% with any; Medicare: 74.5% vs 47.9% with any; both P < 0.001), most commonly cough, dyspnea, and fatigue. CONCLUSIONS: COVID-19 was associated with significant economic and clinical burden, both in the short-term and over 6 months following diagnosis. DISCLOSURES: Jessica K DeMartino is an employee of Janssen Scientific Affairs, LLC. Elyse Swallow, Debbie Goldschmidt, Karen Yang, Marta Viola, Tyler Radtke, and Noam Kirson are employees of Analysis Group, Inc., which has received consulting fees from Janssen Scientific Affairs, LLC. This study was funded by Janssen Scientific Affairs, LLC. The sponsor was involved in the study design, interpretation of the results, manuscript review, and the decision to publish the article.

Socioeconomic Status, Cultural Capital, and Social Capital in Adults: A Structural Equation Model.

BACKGROUND: Sociocultural level (SCL) comprises Socioeconomic Status (SES), Cultural Capital (CC), and Social Capital (SC). The relationships between all SCL dimensions have never been investigated. This study aimed to develop a structural equation model representing how age affects the relationships between educational level, occupational prestige (as a measure of SES), CC, and SC for men and women. METHOD: SES, dimensions of CC and SC were measured with valid scales for 654 adults (63% female) aged 19 to 74 years ( M[SD] = 42.86 [13.32]), that had or used to have an occupation and the majority of whom had at least a university degree (65%). All lived in a medium-sized town in Italy. RESULTS: Age affected the interrelated indicators of SES (educational level and occupational prestige), which in turn affected the interrelated dimensions CC and SC (CFI = .97; RMSEA = .073 [CI = .053 - .095]; SRMR = 0.031). The system of relationships was simpler in men than in women, with educational level being less relevant in affecting the other constructs. CONCLUSIONS: The hierarchical structure of SCL and effect of age and gender must be properly taken into account in studies on the effects of SCL on human behavior.

Cost per PASI-75 responder of calcipotriol plus betamethasone dipropionate cutaneous foam versus nonbiologic systemic therapies for the treatment of plaque psoriasis in seven European countries.

PURPOSE: To compare the short-term cost and effectiveness of calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam against nonbiologic systemics in psoriasis patients for whom oral systemic or topical therapy is considered appropriate in seven European countries. METHODS: Matching-adjusted indirect comparisons of four-week PASI-75 responses of Cal/BD foam were performed versus 12-week responses of methotrexate, acitretin, fumaric acid esters (FAE) and 16-week responses of apremilast. Analyses took a payer perspective and included drug, physician visit and monitoring costs. RESULTS: In all countries, Cal/BD foam generated the lowest cost per responder (CPR). Against methotrexate, apremilast and acitretin, Cal/BD foam generated response for less than €190 in Italy, €195 in Portugal, €216 in Greece, £218 in the United Kingdom, €250 in Belgium, €319 in Spain, and €359 in the Netherlands. Relative to treatment with FAE, Cal/BD foam resulted in response for less than €298, €430, €382 and £262 in Belgium, the Netherlands, Spain and the United Kingdom, respectively. For Cal/BD foam, apremilast and FAE, total costs were driven by drug costs; for methotrexate and acitretin, by monitoring. CONCLUSIONS: Driven by its lower costs and high response rates, Cal/BD foam is likely to be a cost-effective option over the short-term in the investigated psoriasis population.

Determining the Baseline Strategy in a Cost-Effectiveness Analysis with Treatment Sequences.

In response to a growing number of treatment options in many disease areas, health technology assessments need to evaluate sequences of treatments instead of individual interventions. This study investigated the impact of the baseline strategy on the cost-effectiveness results, when a sequence of treatments was used. First, we reviewed submissions to the UK National Institute for Health and Care and Excellence to understand how economic models that used comparisons of treatment sequences defined the baseline strategy. We then built a simple Markov model to use as a case study. The analysis we conducted contained four hypothetical treatments of varying cost-effectiveness relationships to a fixed control (best supportive care): Treatment A was cost effective, Treatment B was extendedly dominated by Treatment A, Treatment C was cost effective, but had a greater cost than both Treatment A and Treatment B, and Treatment D was not cost effective. Our review of the National Institute for Health and Care and Excellence submissions showed that, in most cases, authors relied on clinical guidelines, expert opinion or previously developed models to define the baseline strategy (n = 31). In several cases, the choice of a baseline strategy was not explained (n = 9). Several studies used the model to identify the optimal position for the new intervention (n = 5). Using the model, all possible permutations between the hypothetical treatments were generated and ranked by their net monetary benefit. We showed that (1) a non-cost-effective treatment would never be part of an optimal sequence and (2) the choice of baseline treatment sequence can change the cost-effectiveness estimate of a new intervention. If the aim of the decision maker is the efficient distribution of healthcare resources based on cost effectiveness, then the baseline strategy should be created based on the ranking of the net-monetary benefit. Ignoring the cost effectiveness of individual treatments when defining the baseline strategy, may lead to spurious results.

First impressions about Adherus, a new dural sealant.

PURPOSE: The aim of the study is to report our first impressions about Adherus, a novel dural sealant, used in neurosurgical endoscopic transnasal procedures. METHODS: We retrospectively reviewed the clinical and surgical records of the first 11 patients with intraoperative high-flow cerebrospinal fluid leak treated with the aid of Adherus at our center between February and October 2014. The healing at the level of the dural plasty was monitored and evaluated radiologically and with regular endoscopic inspections. RESULTS: With a median follow-up of 210 days, no postoperative CSF leak or surgical site infections were found in any of the cases. CONCLUSIONS: Based on our preliminary experience, this new dural sealant seems to provide an effective aid in dural plasty during endoscopic transphenoidal procedures.

Haemorrhagic presentation of a craniopharyngioma in a pregnant woman.

Objective. Craniopharyngioma is a rare tumour, and, consequently, acute clinical presentation and diagnosis, during pregnancy, of this pathology are quite difficult to find. Only few cases are reported in the literature, and no one describes these two conditions in association. Methods. We report a particular case of craniopharyngioma presenting both of the above conditions. Results. The patient was successfully operated with endoscopic technique. Conclusions. Rare and difficult cases, created by the superposition of different clinical conditions, need multidisciplinary management, with collaboration, integration, and cooperation between different medical specialists.