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The primary objective of this research was to meticulously evaluate the therapeutic potential of steroid nebulization, administered over a 2-week period post-tracheostomy, in attenuating postoperative complications with a concentrated emphasis on tracheal stenosis. The study spanned three years, commencing in 2019 and concluding in 2022, examining a patient cohort of 400 individuals. Utilizing a retrospective cohort methodology, the participants were systematically stratified into two cohorts: those subjected to steroid nebulization (n = 200) and a control group (n = 200). Adverse outcomes were bifurcated into minor complications, which encompass stomal infections and inflammations, and major complications, which include bleeding, tracheoesophageal fistula, and tracheal stenosis. These complications were evaluated at distinct post-operative junctures: 1 week, 1 month, 3 months, and 6 months. The primary outcome was deduced through a rigorous multivariate logistic regression model, incorporating variables such as age, sex, and the diagnosis of chronic obstructive pulmonary disease (COPD). Analytical data unveiled that the cohort administered with steroid nebulization manifested a statistically significant diminution in the incidence of complications when juxtaposed with the control group (25 vs. 38%). Predominantly, the incidence of tracheal stenosis was discernibly lower in the steroid nebulization group (10 vs. 22%). The multivariate analytical framework further corroborated the pivotal role of steroid nebulization in substantially reducing the propensity for tracheal stenosis. The therapeutic intervention of steroid nebulization in the aftermath of a tracheostomy procedure presents a commendable avenue in curtailing major complications, with an acute focus on tracheal stenosis. To fortify these preliminary findings, it is quintessential to undertake more exhaustive studies, such as randomized controlled trials, to ascertain the optimal regimen concerning nebulization's timing, dosage, and duration. [ABSTRACT FROM AUTHOR]

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in children/adolescents and occurs frequently with psychiatric/neurologic comorbidities. The objective of this study was to assess the impact of psychiatric/neurologic comorbidities on pharmacotherapy patterns among patients with ADHD in Sweden. Methods: A retrospective cohort analysis was conducted using medical records from a regional database in Sweden. Patients aged 6-17 years, with ≥1 prescription for ADHD medication between July 1, 2007 and June 30, 2009, and continuously active in the database for ≥12 months before and after their prescription index date were selected. Patients were categorized as ADHD alone (ADHD-only) or with comorbidities (ADHD-comorbid). Between-group differences were analyzed before and after adjusting for potentially confounding variables. Results: Data on 1794 patients (1083 ADHD-only; 711 ADHD-comorbid) were analyzed. Among newly treated patients, 21.7% augmented their index therapy (ADHD-only, 20.5%; ADHD-comorbid, 24.4%; p = 0.23). After adjustment, ADHD-only patients were less likely ( p = 0.002) to augment versus ADHD-comorbid patients [odds ratio = 0.44, 95% confidence interval (CI) 0.27, 0.73]. ADHD-comorbid patients received more prescriptions versus ADHD-only patients (mean 13.1 vs 10.0; p < 0.001), and had more outpatient visits (mean 11.9 vs. 8.1; p < 0.001) and hospitalizations (10.7% vs. 6.0%; p < 0.001). After adjustment, ADHD-only patients had fewer outpatient visits ( p < 0.001) and referrals ( p < 0.001) versus ADHD-comorbid patients (visits: β = −0.21, 95% CI −0.28, −0.13; referrals: β = −0.25, 95% CI −0.33, −0.18). Conclusion: Patients with ADHD with comorbidities had more hospitalizations, physician visits, and medication prescriptions during 12 months' follow-up than did those with ADHD alone. ADHD therapy augmentation was prevalent among children/adolescents with ADHD, even among those without psychiatric/neurologic comorbidities. [ABSTRACT FROM AUTHOR]