scholarly journals Mortality of surgically treated 80-year-old or older intracranial meningioma patients in comparison to matched general population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ilari Rautalin ◽  
Christoph Schwartz ◽  
Mika Niemelä ◽  
Miikka Korja
Keyword(s):  
General Population ◽  
Odds Ratio ◽  
Excess Mortality ◽  
Population Aging ◽  
Intracranial Meningioma ◽  
Short Term ◽  
Very Old ◽  
Survival Difference ◽  
Age And Sex ◽  
At Home

AbstractPopulation aging is likely increasing the number of surgically treated very old (≥ 80–year-old) intracranial meningioma (IM) patients. Since there is little data on mortality in this patient group, we studied whether survival of surgically treated very old IM patients differs from survival of a matched general population. We retrospectively identified 83 consecutive very old IM patients (median age 83 years; 69% women) operated between 2010 and 2018. During the first postoperative year, operated IM patients suffered 2.5 times higher mortality as compared to age- and sex-matched general population but no annual survival difference occurred thereafter. Regarding cumulative estimates, no excess mortality was detected after the second postoperative year. Of the patient who were and who were not able to live at home preoperatively, 78% and 42% lived at home within 3 months, respectively. Preoperative loss of capability to live at home associated with a less frequent return to home [odds ratio (95% confidence interval) 0.21 (0.06–0.67)]. Operated very old IM patients had short-term excess mortality but similar cumulative survival as the matched general population. Moreover, most patients returned home soon after surgery.

scholarly journals The Impact of Sampling and Measurement on the Prevalence of Self-Reported Pain in Canada

2003 ◽  
Vol 8 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Elizabeth G Van Den Kerkhof ◽  
Wilma M Hopman ◽  
Tanveer E Towheed ◽  
Tassos P Anastassiades ◽  
David H Goldstein
Keyword(s):  
Chronic Pain ◽  
General Population ◽  
Health Survey ◽  
Public Health Problem ◽  
Short Term ◽  
Canadian Population ◽  
Prevalence Estimates ◽  
Prevalence Of Pain ◽  
The Impact ◽  
Age And Sex

BACKGROUND: Pain is an important public health problem in Canada. International estimates of general population pain prevalence range from 2% to 46%.OBJECTIVES: The purpose of this paper is to critically examine the potentially misleading use of overall prevalence estimates in the pain literature and to use two Canadian population-based surveys to assess the impact of sampling and measurement on prevalence.METHODS: Two of the secondary data sets used were the 1996/97 National Population and Health Survey (NPHS) and the Canadian Multicentre Osteoporosis Study (CaMos). This paper is based on the assessment of chronic pain in the NPHS, and the assessment of short term pain using the Medical Outcomes Trust's 36-item health survey and the Health Utilities Index, both collected by CaMos. Data are presented as frequencies and percentages overall and stratified by age and sex. CaMos prevalence estimates were age and sex-standardized to the NPHS population.RESULTS: The overall prevalence of pain was 39% for one-week pain, 66% for four-week pain and 15% for chronic pain. Women were more likely to report pain than men and the prevalence of pain increased with age.CONCLUSIONS: This study yields useful information about the self-reported responses to a variety of questions assessing pain in the general population. Responses to the different questions likely represent different categories of pain, such as short term versus chronic pain, which in turn may have different epidemiological risk factors and profiles. Longitudinal studies of the epidemiology, predictors and natural history of chronic pain are urgently needed in the Canadian population.

Introduction

2017 ◽  
Author(s):  
Frances Harris
Keyword(s):  
Cultural Influences ◽  
Short Term ◽  
Historical Figures ◽  
Platonic Love ◽  
Close Friendship ◽  
The Ideal ◽  
At Home

This introduces the Marlborough-Godolphin partnership as not just a political alliance, but a close friendship founded on ideals of platonic love and heroic virtue. It reviews the various discourses of friendship, noting the cultural influences (the essayists Montaigne, Sir William Temple, Saint-Évremond, as well as heroic drama and opera) which carried the ideal forward, but with the growing sense that it must prove itself in actual human transactions. It suggests that studying the Marlborough-Godolphin friendship as it proved itself in war abroad and party conflict at home is revealing of two historical figures whom historians have often found enigmatic, though in the end their commitment to it contributed to their short-term failure as well as their longer-term success. The distinction between friendship and royal favour is also touched on.

scholarly journals Excess mortality among people with podoconiosis: secondary analysis of two Ethiopian cohorts

2020 ◽  
Vol 114 (12) ◽  
pp. 1035-1037
Author(s):  
Hannah Masraf ◽  
Temesgen Azemeraw ◽  
Meseret Molla ◽  
Christopher Iain Jones ◽  
Stephen Bremner ◽  
...  
Keyword(s):  
General Population ◽  
Surveillance System ◽  
Excess Mortality ◽  
Secondary Analysis ◽  
Demographic Surveillance System ◽  
Northern Ethiopia ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Standardised Mortality Ratios ◽  
Patients Experience

Abstract Background While morbidity attributable to podoconiosis is relatively well studied, its pattern of mortality has not been established. Methods We compared the age-standardised mortality ratios (SMRs) of two datasets from northern Ethiopia: podoconiosis patients enrolled in a 1-y trial and a Health and Demographic Surveillance System cohort. Results The annual crude mortality rate per 1000 population for podoconiosis patients was 28.7 (95% confidence interval [CI] 17.3 to 44.8; n=663) while that of the general population was 2.8 (95% CI 2.3 to 3.4; n=44 095). The overall SMR for the study period was 6.0 (95% CI 3.6 to 9.4). Conclusions Podoconiosis patients experience elevated mortality compared with the general population and further research is required to understand the reasons.

Determinants of Anthropometric Failure Among Tribal Children Younger than 5 Years of Age in Palghar, Maharashtra, India

2021 ◽  
Vol 42 (1) ◽  
pp. 55-64
Author(s):  
Angeline Jeyakumar ◽  
Swapnil Godbharle ◽  
Bibek Raj Giri
Keyword(s):  
Odds Ratio ◽  
Composite Index ◽  
Z Score ◽  
Short Term ◽  
Cross Sectional Survey ◽  
Crude Odds Ratio ◽  
Cross Sectional ◽  
Independent Variables ◽  
Child Undernutrition

Background: Measuring undernutrition using composite index of anthropometric failure (CIAF) and identifying its determinants in tribal regions is essential to recognize the true burden of undernutrition in these settings. Objective: To determine anthropometric failure and its determinants among tribal children younger than 5 years in Palghar, Maharashtra, India. Methods: A cross-sectional survey employing CIAF was performed in children <5 years to estimate undernutrition in the tribal district of Palghar in Maharashtra, India. Anthropometric measurements, maternal and child characteristics were recorded from 577 mother–child pairs in 9 villages. Results: As per Z score, prevalence of stunting, wasting, and underweight were 48%, 13%, and 43%, respectively. According to CIAF, 66% of children had at least one manifestation of undernutrition and 40% had more than one manifestation of undernutrition. Odds of anthropometric failure were 1.5 times higher among children of mothers who were illiterate (adjusted odds ratio [AOR] =1.57, 95% CI: 1.0-2.3), children who had birth weight >2.5 kg had lesser odds (AOR: 0.63, 95% CI: 0.4-0.9) of anthropometric failure, and children who had initiated early breastfeeding had 1.5 times higher odds of anthropometric failure (crude odds ratio: 1.5, 95% CI: 1.0-2.1). However, when adjusted for other independent variables, the results were not significant. Conclusion: The alarming proportion of anthropometric failure among tribal children calls for urgent short-term interventions to correct undernutrition and long-term interventions to improve maternal literacy and awareness to prevent and manage child undernutrition.

scholarly journals Thematic research clusters in very old populations (≥ 80 years): a bibliometric approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gregorio Gonzalez-Alcaide ◽  
Sergio Palacios-Fernandez ◽  
Jose-Manuel Ramos-Rincon
Keyword(s):  
Elderly People ◽  
Bacterial Infections ◽  
Healthy Aging ◽  
Population Aging ◽  
Publication Output ◽  
Geographic Region ◽  
Geriatric Syndromes ◽  
Research Attention ◽  
Very Old ◽  
Subject Areas

Abstract Background Population aging will be one of humanity’s major challenges in the decades to come. In addition to focusing on the pathologies causing the greatest mortality and morbidity in this population, such as dementia, health research in elderly people must consider a myriad of other interlinked factors, such as geriatric syndromes, social aspects, and factors related to preserving quality of life and promoting healthy aging. This study aims to identify the main subject areas attracting research attention with regard to very old (≥ 80 years) populations. Methods Documents assigned with the medical subject heading “Aged, 80 and over” were retrieved from MEDLINE and the Web of Science. This dataset was used to determine publication output by disease, geographic region, country, and discipline. A co-word analysis was undertaken to identify thematic research clusters. Results Since the mid-2000s, there has been a boom in scientific output focusing specifically on very old populations, especially in Europe (43.7% of the documents) but also in North America (30.5%) and Asia (26%); other regions made only nominal contributions (0.5 to 4.4%). The USA produced the most research, while the most growth over the study period occurred in Japan, Spain, and China. Four broad thematic clusters were identified: a) geriatric diseases, health services for the aged, and social and psychological issues of aging; b) cardiovascular diseases; c) neoplasms, and d) bacterial infections & anti-bacterial agents. Conclusions Scientific research in very old populations covers a wide variety of interrelated topics. In quantitative terms, the top subject areas have to do with cardiovascular and cerebrovascular diseases (including aortic valve stenosis and stroke), dementia, and neoplasms. However, other degenerative pathologies, geriatric syndromes, and different social and psychosocial aspects also attract considerable interest. It is necessary to promote more equal participation in global research on pathologies and topics related to very elderly populations, as the highest rates of population aging and the largest numbers of elderly people in the next decades will be in low- and middle-income countries.

scholarly journals Non-steroidal anti-inflammatory drugs in the pharmacological management of osteoarthritis in the very old: prescribe or proscribe?

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110221
Author(s):  
Christian Cadet ◽  
Emmanuel Maheu ◽  
Keyword(s):  
Elderly Patients ◽  
Excess Mortality ◽  
Absolute Risk ◽  
Accurate Information ◽  
Plain Language ◽  
Very Elderly ◽  
Old Patients ◽  
Very Old ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Osteoarthritis (OA) is the most common form of arthritis worldwide, and ranges in the top 5–10 most disabling diseases. Contrary to common opinion, this disease is severe, often symptomatic, and may lead to loss of mobility and independence, as well as being responsible for increased frailty and excess mortality [standardized ratio: 1.55 (95% confidence interval, CI: 1.41–1.70)]. The incidence of OA increases dramatically with age in an increasingly ageing world. Therefore, practitioners involved in the management of OA often have to manage very old patients, aged 75–80 years and above, as part of their daily practice. Treatment options are limited. In addition to education and physical treatments, which are at the forefront of all treatment recommendations but require a low level of symptoms to be implemented, many pharmacological options are proposed. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used as a second-line treatment but with great caution. However, the precise incidence of cardiovascular, renal, and gastrointestinal adverse events in very elderly patients is unclear. All of these risks are increased in the elderly. The relative risks can be extrapolated from various studies. However, what is the absolute risk according to age categorization? The answer to this question is important because NSAIDs should be used in very elderly patients with OA only if full information has been provided and the decision to prescribe this treatment is shared between the patient and their doctor. This article reviews the risks and currently available recommendations, and proposes practical options and warnings to allow for a responsible and limited use of NSAIDs in the very old. Plain language summary NSAIDS in the very Old : Prescribe or Proscribe? Osteoarthritis (OA) in the very old is a serious disease leading to loss of independence, frailty, and excess mortality. Quantitative data from clinical trials and population-based observational studies on the risk of NSAID-related side effects allow the prescriber to provide more accurate information to each patient. If there is no contraindication, the decision to initiate NSAID therapy in a very old OA patient should be made in a shared manner, with the patient fully informed of the risks.

scholarly journals Incidence, Characteristics, and Outcome of COVID-19 in Adults on Kidney Replacement Therapy: A Regionwide Registry Study

2020 ◽  
pp. ASN.2020060875
Author(s):  
Johan De Meester ◽  
Dirk De Bacquer ◽  
Maarten Naesens ◽  
Bjorn Meijers ◽  
Marie M. Couttenye ◽  
...  
Keyword(s):  
General Population ◽  
Excess Mortality ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Registry Study ◽  
Additional Risk ◽  
Mortality Burden ◽  
Kidney Replacement Therapy ◽  
Expected Mortality ◽  
Chronic Comorbidities

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disproportionally affects frail, elderly patients and those with multiple chronic comorbidities. Whether patients on RRT have an additional risk because of their specific exposure and complex immune dysregulation is controversial.MethodsTo describe the incidence, characteristics, and outcomes of SARS-CoV-2 infection, we conducted a prospective, multicenter, region-wide registry study in adult patients on RRT versus the general population from March 2 to May 25, 2020. This study comprised all patients undergoing RRT in the Flanders region of Belgium, a country that has been severely affected by coronavirus disease 2019 (COVID-19).Results At the end of the epidemic wave, crude and age-standardized cumulative incidence rates of SARS-CoV-2 infection were 5.3% versus 2.5%, respectively, among 4297 patients on hemodialysis, and 1.4% versus 1.6%, respectively, among 3293 patients with kidney transplants (compared with 0.6% in the general population). Crude and age-standardized cumulative mortality rates were 29.6% versus 19.9%, respectively, among patients on hemodialysis, and 14.0% versus 23.0%, respectively, among patients with transplants (compared with 15.3% in the general population). We found no excess mortality in the hemodialysis population when compared with mean mortality rates during the same 12-week period in 2015–2019 because COVID-19 mortality was balanced by lower than expected mortality among uninfected patients. Only 0.18% of the kidney transplant population died of SARS-CoV-2 infection.ConclusionsMortality associated with SARS-CoV-2 infection is high in patients on RRT. Nevertheless, the epidemic’s overall effect on the RRT population remained remarkably limited in Flanders. Calculation of excess mortality and age standardization provide a more reliable picture of the mortality burden of COVID-19 among patients on RRT.

scholarly journals Patterns of Survival Among Patients With Myeloproliferative Neoplasms Diagnosed in Sweden From 1973 to 2008: A Population-Based Study

2012 ◽  
Vol 30 (24) ◽  
pp. 2995-3001 ◽  
Author(s):  
Malin Hultcrantz ◽  
Sigurdur Yngvi Kristinsson ◽  
Therese M.-L. Andersson ◽  
Ola Landgren ◽  
Sandra Eloranta ◽  
...  
Keyword(s):  
General Population ◽  
Life Expectancy ◽  
Excess Mortality ◽  
Myeloproliferative Neoplasms ◽  
Treatment Options ◽  
Large Population ◽  
Relative Survival ◽  
Population Based ◽  
Population Based Study ◽  
Over Time

PurposeReported survival in patients with myeloproliferative neoplasms (MPNs) shows great variation. Patients with primary myelofibrosis (PMF) have substantially reduced life expectancy, whereas patients with polycythemia vera (PV) and essential thrombocythemia (ET) have moderately reduced survival in most, but not all, studies. We conducted a large population-based study to establish patterns of survival in more than 9,000 patients with MPNs.Patients and MethodsWe identified 9,384 patients with MPNs (from the Swedish Cancer Register) diagnosed from 1973 to 2008 (divided into four calendar periods) with follow-up to 2009. Relative survival ratios (RSRs) and excess mortality rate ratios were computed as measures of survival.ResultsPatient survival was considerably lower in all MPN subtypes compared with expected survival in the general population, reflected in 10-year RSRs of 0.64 (95% CI, 0.62 to 0.67) in patients with PV, 0.68 (95% CI, 0.64 to 0.71) in those with ET, and 0.21 (95% CI, 0.18 to 0.25) in those with PMF. Excess mortality was observed in patients with any MPN subtype during all four calendar periods (P < .001). Survival improved significantly over time (P < .001); however, the improvement was less pronounced after the year 2000 and was confined to patients with PV and ET.ConclusionWe found patients with any MPN subtype to have significantly reduced life expectancy compared with the general population. The improvement over time is most likely explained by better overall clinical management of patients with MPN. The decreased life expectancy even in the most recent calendar period emphasizes the need for new treatment options for these patients.

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