scholarly journals Evaluation of Charcot Triad, Reynolds Pentad, and Tokyo Guidelines for Diagnosis of Cholangitis Secondary to Choledocholithiasis Across Patient Age Groups

2021 ◽  
Author(s):  
Avesh J. Thuluvath ◽  
Joseph C. Ahn ◽  
Puru Rattan ◽  
Ahmed T. Kurdi ◽  
Thoetchai B. Peeraphatdit ◽  
...  
Keyword(s):  
Age Groups ◽  
Patient Age ◽  
Tokyo Guidelines ◽  
Patient Âgé

scholarly journals Survival Associations between Patient Age and Treatment Modality in Olfactory Neuroblastoma: A Retrospective Population-Based Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2685
Author(s):  
Andre J. Burnham ◽  
Phillip A. Burnham ◽  
Edwin M. Horwitz
Keyword(s):  
Treatment Modality ◽  
Age Groups ◽  
Olfactory Neuroblastoma ◽  
Population Based ◽  
Treatment Modalities ◽  
Long Term Outcomes ◽  
Patient Age ◽  
Population Based Study ◽  
Patient Âgé

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.

scholarly journals SAT-168 Adrenal Incidentalomas: Impact of Patient Age on Referral Rates for Endocrine Evaluation

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anthony Fryer ◽  
Sarah Hancock ◽  
Cherian George ◽  
Basil George Issa ◽  
Simon Lea ◽  
...  
Keyword(s):  
Age Groups ◽  
Adrenal Incidentaloma ◽  
Older Age ◽  
Age Group ◽  
Adrenal Incidentalomas ◽  
Patient Age ◽  
Radiology Reports ◽  
Patient Âgé ◽  
Mri Scans ◽  
Ct And Mri

Abstract It is estimated that the prevalence of adrenal incidentaloma increases with age: ~3% of those aged 50 years, rising to 10% in those >70 years (1). Given the aging population together with increased utilisation of cross-sectional imaging in the UK (eg CT urogram, MR angiogram), we explored the proportion of patients with adrenal incidentaloma by age based on current imaging trends. Furthermore, there is no information currently available on the relationship between age and pattern of endocrine referrals. We extracted data for all CT and MRI scans from Jan 2018-Oct 2019 and used key phrases in radiology reports (eg adrenal adenoma/lesion/mass/nodule/incidentaloma, incidental adrenal, indeterminate adrenal) to identify potential lesions. We also extracted data on patient age and referral patterns as identified by a logged referral or an attendance (new or follow-up) to endocrine clinic 3 months post index scan, stratified by 10 year age groups. Where possible, we excluded false hits (eg no adrenal lesion). Preliminary data showed that, of the 2604 potential lesions identified by CT and MRI scans, 78.7% were on patients aged over 60 years. The numbers of identified lesions gradually increased with age to a peak in the 71-80 year age group after which these declined. Whilst patients younger that 60 years had fewer potential lesions identified, they were more likely to be referred to endocrine services (73 out of 55 patients; 13.2%) than those in the older age group (168 out of 2049; 8.2%; p<0.001). Indeed there was a statistically significant trend towards decreasing referral with age group (Chi-squared test for trend; p<0.001). In conclusion, patients over 60 years have a higher number of potential adrenal incidentalomas. However, this group is less likely to be referred for endocrine evaluation. This is particularly concerning given the large number of scans requested and the higher prevalence of incidentalomas in this age group. This study represents preparatory work on innovations to enhance case detection, particularly in the older age groups (2). 1. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline. Eur J Endocrinol. 2016;175:G1-G34 2. Hanna FWF, Issa BG, Lea SC, George C, Golash A, Firn M, Ogunmekan S, Maddock E, Sim J, Xydopoulos G, Fordham R, Fryer AA. Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness. BMJ Open Quality. 2019;In press.

scholarly journals Initial Experience with Digital Patient Briefing in Computed Tomography

2018 ◽  
Vol 191 (06) ◽  
pp. 540-546
Author(s):  
Babak Alikhani ◽  
Bennet Hensen ◽  
Arne Grosser ◽  
Maria Inés Cartes Febrero ◽  
Markus von Bestenbostel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Statistical Significance ◽  
Age Groups ◽  
Patient Age ◽  
Open Questions ◽  
Patient Âgé ◽  
Significant Difference ◽  
Student’S T ◽  
The Individual ◽  
Time Required

Purpose To assess digital patient briefing as an alternative to conventional paper documentation. Materials and Methods 502 patients with a planned computed tomography (CT) examination were selected for digital patient briefing using the E-ConsentPro software from Thieme Compliance on an iPad by Apple (Cupertino, California, USA). For the analysis, three age groups were formed. The time required for the patient briefing, the number of open questions as well as the time needed for discussion with physicians were determined. Student’s t-test was performed to assess statistical significance. Results There was no significant difference between patient age and briefing time which was about 20 minutes on average. The number of open or unclear questions increased with patient age. While patients younger than 30 years of age had about 2 open questions, patients over 30 and 60 years had about 4 and 5 questions, respectively. The total time needed for discussion with physicians was less than 2 minutes on average. A significant difference in the time required for discussion with physicians could not be observed between the individual age groups. Conclusion Tablet-based digital briefing allows the storage of patient documents with reasonable time and effort. Furthermore, it minimizes the risk of data loss. Key Points  Citation Format

scholarly journals Potential Overtreatment and Undertreatment of Diabetes in Different Patient Age Groups in Primary Care After the Introduction of Performance Measures

Diabetes Care ◽  
2014 ◽  
Vol 37 (5) ◽  
pp. 1312-1320 ◽  
Author(s):  
Sieta T. de Vries ◽  
Jaco Voorham ◽  
Flora M. Haaijer-Ruskamp ◽  
Petra Denig
Keyword(s):  
Primary Care ◽  
Performance Measures ◽  
Age Groups ◽  
Patient Age ◽  
Patient Âgé

Age-Dependent Frequencies of NPM-1/FLT3-ITD Mutations in Patients with Normal Karyotype AML

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2531-2531 ◽  
Author(s):  
Friederike Schneider ◽  
Eva Hoster ◽  
Michael Unterhalt ◽  
Stephanie Schneider ◽  
Annika Dufour ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Negative Impact ◽  
Age Groups ◽  
Prognostic Impact ◽  
Patient Age ◽  
Term Survival ◽  
Long Term Outcome ◽  
Patient Âgé ◽  
Group 1

Abstract Background: Long-term survival in NK-AML is influenced by different clinical and molecular markers. Whereas the presence of a NPM-1 mutation is associated with a positive prognostic effect on long-term outcome, the presence of a FLT3-ITD mutation has a negative impact on survival. Interestingly, a significant interaction between NPM-1 and FLT3-ITD mutations has been shown. The positive prognostic impact on clinical outcome was evident predominantly in patients with NK-AML carrying NPM1 gene mutations when FLT3-internal tandem duplications (ITD) were absent. In contrast, the survival in all other groups of NPM-1 and FLT3-ITD combinations was not different so far. A clinical parameter with negative impact on all outcome parameters (OS, EFS, RFS, CR) is patient age at diagnosis. Certainly the worse prognosis in elderly patients is due to adverse patient characteristics and comorbidities. Nevertheless also disease-associated parameters reveal differences between older and younger patients with AML. Therefore we investigated the frequencies of NPM-1/FLT3-ITD mutations in different age groups. Patients and methods: Analyses were based on 803 patients with NK-AML included in the AMLCG (German AML Cooperative Group) 2000 trial until 01/2006. Patient age ranged from 17 to 85 years (median: 60 yrs). Information about the mutation status of NPM-1 and FLT3-ITD mutations at diagnosis was available in 689 patients. Patients were divided into six age groups (1: 17–30yrs; 2: 31–40yrs; 3: 41–50yrs; 4: 51–60yrs; 5: 61–70yrs; 6: 71–85yrs). The incidence of the molecular markers NPM-1 and FLT3-ITD as well as the four NPM-1 and FLT3-ITD combinations were calculated in cross tables (Pearson’s Chi Square test) in the different age groups. Results: In 689 patients with available mutations status we found a significant decrease in the frequency of the two molecular markers with higher age. Whereas the incidence of NPM-1 mutation decreased abruptly in patients >60 yrs [Group 1: 18/28 (64.3%), 2: 35/59 (59.3%), 3: 70/114 (61.4%), 4: 84/143 (58.7%), 5: 98/234 (41.9%), 6: 46/111 (41.4%); p<0.0001], the incidence of a FLT3-ITD decreased continuously with increasing age [Group 1: 14/28 (50.0%), 2: 21/59 (35.6%), 3: 36/114 (31.6%), 4: 47/143 (32.9%), 5: 60/234 (25.6%), 6: 22/111 (19.8%); p=0.013)]. Combining both markers we found a significant relative increase of NPM-1−/FLT3-ITD− patients (p<0.0001) with a sharp cut at 60 years whereas the NPM-1+/FLT3-ITD+ group diminished continuously (p=0.020). The proportion of the positive prognostic group of NPM-1+/FLT3-ITD− patients showed an increase between 40–60 years and a decrease afterwards (p=0.024) (see table 1 and figure 1). Conclusions: Our data show in a large cohort of 689 patients with NK-AML that the presence of mutations of the molecular markers NPM-1 and FLT3-ITD significantly decreases with age. Consequently the proportion of NPM-1−/FLT3-ITD− patients increases over time. This observation sheds light on the disease biology in older patients with AML. Table 1: Distribution of the NPM-1, FLT3-ITD and the 4 NPM-1/FLT3-ITD subgroups in different age groups age groups NPM-1 + % FLT3-ITD+ (%) NPM-1−/FLT3-ITD−(%) NPM-1+/FLT3-ITD+ (%) NPM-1−/FLT3-ITD+ (%) NPM-1+/FLT3-ITD− (%) 17–30 64.3 50.0 25.0 39.3 10.7 25.0 31–40 59.3 35.6 30.5 25.4 10.2 33.9 41–50 61.4 31.6 28.9 21.9 9.6 39.5 51–60 58.7 32.9 31.5 23.1 9.8 35.7 61–70 41.9 25.6 51.3 18.8 6.8 23.1 71–85 41 4 19.8 50.5 11.7 8.1 29.7 all age groups (%) 50.9 29.0 40.5 20.5 8.5 30.5 p-value < 0.0001*** 0.013* < 0.0001*** 0.020* 0.886 0.024* Figure 1: Proportions of the four NPM-1/FLT3-ITD subgroups in different age groups Figure 1:. Proportions of the four NPM-1/FLT3-ITD subgroups in different age groups

scholarly journals Peripheral nerve blocks in pediatric anesthesia

2009 ◽  
Vol 137 (9-10) ◽  
pp. 497-501
Author(s):  
Dejan Novakovic ◽  
Ivana Budic ◽  
Dusica Simic ◽  
Nina Djordjevic ◽  
Andjelka Slavkovic ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
General Anesthesia ◽  
Age Groups ◽  
Pediatric Anesthesia ◽  
Anesthetic Techniques ◽  
Older Children ◽  
Nerve Blocks ◽  
Patient Age ◽  
Peripheral Nerve Blocks ◽  
Patient Âgé

Introduction Most children undergoing surgery can benefit from regional anesthetic techniques, either as the sole anesthetic regimen or, as usual in pediatric practice, in combination with general anesthesia. The use of peripheral nerve blocks (PNBs) in pediatric anesthesia is an effective way to decrease the side-effects and complications associated with central blocks. In spite of their many advantages, including easy performance end efficacy, peripheral nerve blocks are still underused. Objective This article discusses a general approach to PNBs in children and provides data concerning the practice of this regional technique in different age groups. Methods Data from 1,650 procedures were prospectively collected during the period from March 1, 2007 to February 29, 2008. The type of PNB, if any, as well as the patient age were noted. Our patients were divided into four groups: 0-3 years, 4-7 years, 8-12 years and 13-18 years. Results During the investigated period, PNBs as a sole technique or in anesthetized children were performed in 7.45% of cases. Ilioingunal/iliohypogastric nerve block and penile block were the most common (70% of all PNBs) distributed mainly among the children between 4-7 years of age (p<0.05). In older children, extremity PNBs predominate in regard to other types of blocks. PNBs are most frequently performed under general anesthesia (85%), so the perineural approach requires a safe technique to avoid nerve damage. Conclusion The observed differences in PNB usage seem to be related to patient age and correlate with common pathology and also with technical availability of PNB performance.

scholarly journals 77. Opportunity for Improved Use of a Commercially Available Meningitis/Encephalitis Panel in Pediatric Patients

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S155-S156
Author(s):  
Marilyn E Valentine ◽  
Jared Olson ◽  
Emily A Thorell ◽  
Anne Bonkowsky ◽  
Jason Lake
Keyword(s):  
Age Groups ◽  
Panel Member ◽  
High Power Field ◽  
Patient Age ◽  
Viral Pathogens ◽  
University Of Utah ◽  
Csf Analysis ◽  
Cell Counts ◽  
Patient Âgé ◽  
The University

Abstract Background The BioFire® FilmArray Meningitis/Encephalitis (ME) panel delivers timely CSF analysis when meningitis or encephalitis is suspected and has the potential for earlier optimization of patient care. It is unclear if the M/E panel provides incremental benefit over standard microbiologic methods such as culture and cell counts, especially in the absence of significant pleocytosis. We evaluated the clinical utility of the ME panel with respect to CSF white blood cell count per high power field (WBC/hpf) and patient age. Methods We identified paired CSF ME panels and CSF cultures collected throughout a large healthcare system from 2016–May 2021 in children &lt; 18 years of age. CSF results from the same calendar day were included in the dataset. We reviewed standalone HSV and Enterovirus (EV) CSF studies to determine frequency of duplicative testing. Results were stratified by CSF WBC/hpf and patient age (&lt; 14 days, 14–60 days, &gt; 60 days and &lt; 5 years, and &gt; 5 years). Results 1045 paired cultures and ME panels were identified. Of those, 921 (88%) ME panels were negative, but 5 of those cultures grew bacteria. Of 124 (12%) positive ME panel results, 66% were viral: 46 (37%) EV, 22 (18%) HHV-6 and 6 (5%) parechovirus. In 498 cases, ME panels were sent when CSF had &lt; 10 WBC/hpf, resulting in only 2 (0.4%) PCRs positive for bacteria, one which was gram stain positive and the other was considered a false positive (Table 1). In addition to a ME panel, standalone PCRs for enterovirus and HSV were sent in 134 (13%) and 213 (20%) of cases, respectively, with &lt; 2% discordance. Pathogen distribution by ME panel did not vary with age (Table 2). Meningitis and encephalitis panel, standalone PCR and culture results overall and by age group. Conclusion In our cohort, the ME panels were overwhelmingly negative. Only 12% of ME panels were positive, mostly with self-limited viral pathogens (e.g., EV, parechovirus). Performance was worse when samples had &lt; 10 WBC/hpf. Duplicative testing was common and had no benefit. Performance was similar across age groups. More targeted use of the ME panel could improve the utility and efficacy of this test. Disclosures Anne Bonkowsky, MD/PhD, BioFire Diagnostics (Consultant, Grant/Research Support, Other Financial or Material Support, I have intellectual property through the University of Utah in BioFire Diagnostics and the FilmArray and receive royalties through the University of Utah.)Merck (Advisor or Review Panel member)

scholarly journals Eye Disorders in Bangladesh: A Hospital-based Descriptive Study

2019 ◽  
Vol 2 (1) ◽  
pp. 27-40 ◽  
Author(s):  
Md. Ali Hossain ◽  
Tania Akter Asa ◽  
Fazlul Huq ◽  
Mohammad Ali Moni
Keyword(s):  
Age Distribution ◽  
Age Groups ◽  
Incidence Rates ◽  
Comprehensive Overview ◽  
Patient Age ◽  
Clinical Challenge ◽  
Eye Disorders ◽  
Patient Âgé ◽  
Different Types ◽  
Retinal Disorder

The incidence and treatment of common eye disorders in Bangladesh are poorly understood. This study aims to provide a comprehensive overview of this clinical challenge to better enable the design of appropriate healthcare strategies.  The incidence and treatment of common eye disorders in Bangladesh are poorly understood. This study aims to provide a comprehensive overview of this clinical challenge to better enable the design of appropriate healthcare strategies.  Different types of eye disorder data were collected from patients aged 1 to 96 years admitted for eye surgery from March 2016 to October 2016 (N = 2390) at the Bangladesh Eye Hospital in Dhaka, Bangladesh. Patient age distribution and types of treatment received were analysed, and incidence rates calculated.  Patients (58% male) underwent a total of 43 different types of eye surgeries. Among the surgeries reported 32.8% were Avastin intravitreal injections, 25.5% were Phaco with IOL, 14.6% were retinal laser therapies, 7.5% were YAG Laser and 6.5% were VR surgery. It is notable that a higher number of people suffered in ocular, cataract and retinal disorder respectively among all the eye disorders. With increasing patient age, the number of eye disorder treatments increased and it reached to peak number in the age group 56-60 years, although numbers varied greatly across age groups.

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