scholarly journals P627 Change in urgency among ulcerative colitis patients: Analyses from the SPARC IBD

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S564-S566
Author(s):  
J Lewis ◽  
M Shan ◽  
X Xhou ◽  
A Naegeli ◽  
T Hunter
Keyword(s):  
Ulcerative Colitis ◽  
Well Being ◽  
Stool Frequency ◽  
Common Symptom ◽  
Physician Global Assessment ◽  
Chi Square ◽  
Bowel Movements ◽  
Urgency Symptoms ◽  
Baseline Characteristics ◽  
Fecal Urgency

Abstract Background The objective of this study was to assess the changes in prevalence and severity of fecal urgency in Ulcerative Colitis (UC) patients at 6-months from their enrollment visit. Methods Data from patients in the Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease (SPARC IBD) were analyzed. UC patients that had an enrollment visit and 6-month visit were included in these analyses. Fecal urgency at each visit was assessed on a scale ranging from 0 (none) to 4 (severe). The change in urgency status from enrollment visit to 6-months is categorized as Improvement (decrease of 1–3 points), No Change, or Worsening (increase of 1–3 points). Descriptive statistics and contingency tables were created to summarize baseline characteristics by fecal urgency group. Chi-square tests, Fisher’s exact tests, ANOVA and Wilcoxon rank sum tests were conducted to compare the distribution of baseline characteristics between change in urgency groups, with Bonferroni corrections used for multiple comparisons. Results Data from 272 UC patients were included in this analysis. 25% of UC patients had an improvement in urgency, 54.4% had no change, 20.6% had a worsening of urgency at 6-months from their enrollment visit. When compared to patients that had no change in urgency at 6-months, UC patients that had improvement in urgency were more likely to have a higher baseline UCDAI (p<0.0001), mean daily bowel movements (p<0.0001), mean daily liquid bowel movements (P<0.0001), elevated stool frequency relative to their normal when well (p<0.0001), liquid stool consistency (p=0.0418), blood in stools (p=0.0001), abdominal pain (p=0.0065), moderate/severe fecal urgency (p<0.0001), worse general well-being (p<0.0001), moderate/severe Physician Global Assessment (PGA) (p=0.0013), and steroid use (p=0.0287) (Table 1). When compared to patients with worsening urgency at 6-months, UC patients that had an improvement in urgency at 6-months were more likely to have a higher baseline UCDAI (p<0.0001), mean daily bowel movements (p<0.0001), mean daily liquid bowel movement (P<0.0001), more stool frequency relative to their normal when well (p<0.0001), moderate/severe fecal urgency (p<0.0001), worse general well-being (p=0.0053), and moderate/severe PGA (p=0.0022). There were no statistically significant differences in baseline characteristics between UC patients that had a worsening or no change in urgency at 6-months. Conclusion Fecal urgency is a common symptom among UC patients. Urgency is not a stable symptom, with nearly 50% experiencing either worsening or improvement over 6-months. Worse disease activity at enrollment in the cohort was associated with improved fecal urgency symptoms over 6-months.

scholarly journals P298 Budesonide MMX versus Prednisolone for Ulcerative Colitis: Comparative outcomes from a British retrospective multi-centre study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S327-S327
Author(s):  
K Rosiou ◽  
E Ong Ming San ◽  
A Kumar ◽  
K Esquivel ◽  
S Almas ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Rectal Bleeding ◽  
Global Assessment ◽  
Hospital Admissions ◽  
Physician Global Assessment ◽  
First Line ◽  
Multi Centre Study ◽  
End Of Treatment ◽  
Significant Difference ◽  
Baseline Characteristics

Abstract Background Budesonide MMX (Cortiment) is superior to placebo for mild to moderate UC flares and has a favourable side effect profile. However, no head-to-head data with Prednisolone exist. During the COVID-19 pandemic many IBD units chose Cortiment as first line treatment for outpatients’ flares of UC. The aim of this retrospective study was to compare outcomes of Cortiment vs Prednisolone treatment for UC. Methods Hospital based prescriptions from of 3 UK IBD units were extracted from computerized pharmacy records for the time periods between 1/3/2019 – 30/6/2019 and 1/3/2020 – 30/6/2020. All adult outpatients treated with oral steroids for a flare of UC were included. Baseline data included age, sex, phenotype, IBD medications, symptoms and changes to medication at time of steroid prescription. Follow up data included need for hospital admission for acute severe ulcerative colitis, symptoms at 4 weeks and end of treatment, need for rescue Prednisolone (Cortiment group only). Primary outcome was symptomatic improvement at 4 weeks. Results The 2019 (94 patients) and 2020 (127 patients) cohorts did not differ significantly with regards to age, sex, phenotype and baseline characteristics. The proportion of Cortiment prescriptions rose significantly from 24.5% in 2019 to 70.1% in 2020 (p<0.001). At week 4 of treatment there were statistically significant differences in mean bowel frequency (3.49 in 2019 vs 5.85 in 2020, p=0.001), rectal bleeding <50% (89.7% of patients in 2019 vs 73.1% in 2020, p=0.039) and physician global assessment (39.2% of patients in remission in 2019 compared to 19.8% in 2020, p=0.045).There was no significant difference in hospital admissions, rectal bleeding and physician global assessment at end of treatment. Patients prescribed Cortiment in 2019 had similar baseline characteristics to those prescribed Cortiment in 2020. Mean bowel frequency at four weeks was significantly higher in 2020 (6.18) compared to 2019 (3.69, p=0.034), but rectal bleeding (p=0.388) and physician global assessment at week four did not differ between 2019 and 2020 (p=0.422). Rescue Prednisolone was required in 10% of Cortiment patients in 2019 vs 31.3% in 2020 (p=0.058). Conclusion Cortiment was used as the main first line steroid for UC during the pandemic to reduce the risk of adverse COVID-19 outcomes. This change in treatment was, however, associated with worse UC outcomes at 4 weeks and 31% needed rescue Prednisolone. As active IBD is associated with worse COVID-19 outcomes clinicians should carefully evaluate the choice of steroid to achieve optimal disease control and COVID-19 risk minimization.

Late-Onset of Acute Severe Ulcerative Colitis: Clinical Case

2017 ◽  
Vol 35 (1-2) ◽  
pp. 45-49 ◽  
Author(s):  
A.E. Dorofeyev ◽  
O.A. Rassokhina ◽  
A.A. Dorofeyeva
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Case ◽  
Late Onset ◽  
Lower Abdominal Pain ◽  
Well Being ◽  
Stool Frequency ◽  
Careful Examination ◽  
Histological Evaluation ◽  
Architectural Distortion ◽  
Infectious Colitis

Ulcerative colitis (UC) in adult age requires more careful examination because more often it turns out to be a complication related to the precancer condition. The onset of colitis in older age is predicted to follow a more aggressive clinical course and requires more frequent hospitalizations and steroids prescription in contrast to its onset in young patients. Even as this remains unclear, we present here a clinical case of late onset of acute severe UC to represent interesting clinical peculiarities and response to the therapy. Patient P., a 57-year-old male complained of 8 days of bloody diarrhea and lower abdominal pain. He reported having up to 3-5 urgent stool per day and 3-4 stool per night weight loss with dehydration. Stool culture was negative for infection, but fecal leukocytes were present. Flexible colonoscopy and biopsies were performed, which showed friable and erythematous mucosa with erosions and ulcers in a diffuse circumferential distribution from the anal verge to the cecum. There were no pseudomembranes. Histological evaluation revealed acute inflammation without architectural distortion consistent with either acute infectious colitis or new inflammatory bowel disease, favoring UC. Treatment for presumed UC is initiated with mesalazine 8 g daily: 4 g orally, 4 g per rectum and prednisone at 40 mg orally daily. After 48 h, stool frequency was 12 times per day (2 per night) with urgency, and blood was seen in stool occasionally. Intravenous steroids were prescribed - 16 mg of dexamethasone. After 48 h, stool frequency reduced to 8 per day, 1-2 per night, with traces of blood in stool and general well-being was increased. But after 14 days, the condition did not change significantly. Infliximab 5 mg/kg was administered and after the first infusion, stool frequency reduced to 4 times per day without urgency and night diarrhea. Azathioprine 100 mg per day was prescribed after steroid (prednisone) withdrawal. But after the third infusion of infliximab, the patient felt pain along the intercostal nerves along with skin redness and itching. Herpes zoster virus infection was diagnosed. Famciclovir 750 mg per day was prescribed, azathioprine was stopped, infusions of infliximab were continued and after 12 months, patient was started on a monotherapy of infliximab 1 time per 8 weeks and he had stable remission.

Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center

2021 ◽  
pp. 194338752110206
Author(s):  
Ashton Christian ◽  
Beatrice J. Sun ◽  
Nima Khoshab ◽  
Areg Grigorian ◽  
Christina Y. Cantwell ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Trauma Center ◽  
Demographic Data ◽  
Open Reduction Internal Fixation ◽  
Facial Fractures ◽  
Chi Square ◽  
Single Level ◽  
Baseline Characteristics ◽  
Level I ◽  
Complications And Mortality

Study Design: Retrospective cohort. Objective: Traumatic facial fractures (FFs) often require specialty consultation with Plastic Surgery (PS) or Otolaryngology (ENT); however, referral patterns are often non-standardized and institution specific. Therefore, we sought to compare management patterns and outcomes between PS and ENT, hypothesizing no difference in operative rates, complications, or mortality. Methods: We performed a retrospective analysis of patients with FFs at a single Level I trauma center from 2014 to 2017. Patients were compared by consulting service: PS vs. ENT. Chi-square and Mann-Whitney-U tests were performed. Results: Of the 755 patients with FFs, 378 were consulted by PS and 377 by ENT. There was no difference in demographic data ( P > 0.05). Patients managed by ENT received a longer mean course of antibiotics (9.4 vs 7.0 days, P = 0.008) and had a lower rate of open reduction internal fixation (ORIF) (9.8% vs. 15.3%, P = 0.017), compared to PS patients. No difference was observed in overall operative rate (15.1% vs. 19.8%), use of computed tomography (CT) imaging (99% vs. 99%), time to surgery (65 vs. 55 hours, P = 0.198), length of stay (LOS) (4 vs. 4 days), 30-day complication rate (10.6% vs. 7.1%), or mortality (4.5% vs. 2.6%) (all P > 0.05). Conclusion: Our study demonstrated similar baseline characteristics, operative rates, complications, and mortality between FFs patients who had consultation by ENT and PS. This supports the practice of allowing both ENT and PS to care for trauma FFs patients, as there appears to be similar standardized care and outcomes. Future studies are needed to evaluate the generalizability of our findings.

scholarly journals Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

2021 ◽  
Author(s):  
Kemar J Brown ◽  
Njambi Mathenge ◽  
Daniela Crousillat ◽  
Jaclyn Pagliaro ◽  
Connor Grady ◽  
...  
Keyword(s):  
Statistical Significance ◽  
The Elderly ◽  
P Value ◽  
Chi Square ◽  
Cardiovascular Patients ◽  
Baseline Characteristics ◽  
Racial Ethnic ◽  
Cardiovascular Care ◽  
Zip Code ◽  
Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value < 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of <$75,000, age >85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy

2021 ◽  
pp. 019459982110137
Author(s):  
Catherine T. Haring ◽  
Janice L. Farlow ◽  
Marie Leginza ◽  
Kaitlin Vance ◽  
Anna Blakely ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Electronic Communication ◽  
Well Being ◽  
Chi Square ◽  
Communication Device ◽  
Patient Reported ◽  
Communication Devices ◽  
Related Quality

Objective Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. Methods Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses. Results Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%, P = .03), including less difficulty communicating about treatment or discharge plans (35% vs 78%, P < .01). V-RQOL scores were unchanged. Discussion Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being. Implications for Practice Electronic communication devices may benefit patients with acute aphonia.

scholarly journals Gender Differences in Witnessing and the Prevalence of Intimate Partner Violence from the Perspective of Children in Finland

2021 ◽  
Vol 18 (9) ◽  
pp. 4724
Author(s):  
Johanna Hietamäki ◽  
Marjukka Huttunen ◽  
Marita Husso
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Well Being ◽  
Intimate Partner ◽  
Clinical Samples ◽  
Chi Square ◽  
Child Victim ◽  
Chi Square Test ◽  
And Gender ◽  
Gender Variations

Background—Intimate partner violence (IPV) has both direct and longer-term effects on children’s well-being. Much of the research thus far has relied on caregiver reports of IPV and clinical samples of children. By contrast, minimal research has examined violence between parents from the perspective of children using nationwide samples. Objective—This study explored the frequency of IPV witnessed by children and gender variations regarding the victims, perpetrators, and witnesses. Methods—The data were derived from a sample of 11,364 children from the Finnish Child Victim Survey 2013. The children were between 11 and 17 years old and were enrolled in the Finnish school system. The main methods of analysis included crosstabulation and the chi-square test. Results—The results indicate that children witnessed more IPV against their mother (4.9%) than their father (3.5%). Girls reported having witnessed more violence against both their mother (7.0%) and father (5.1%) than boys did (mothers 2.7%, fathers 1.8%). Girls’ reports of IPV against both parents were twice or more than twice as common as boys’ reports. Conclusions—The above differences might result from gendered expectations and boys’ and girls’ different relationships to violence, as well as differences in the recognition and interpretation of violent incidents. Therefore, practitioners should adopt a gender-sensitive approach as a precondition and practice for working with children in social and health care.

Outdoor Falls Prevention Strategy Use and Neighborhood Walkability Among Naturally Occurring Retirement Community Residents

2020 ◽  
pp. 109019812098035
Author(s):  
Tracy Chippendale
Keyword(s):  
Route Planning ◽  
Well Being ◽  
Strategy Use ◽  
Prevention Strategy ◽  
Falls Prevention ◽  
Retirement Community ◽  
Chi Square ◽  
Neighborhood Walkability ◽  
Naturally Occurring ◽  
Community Residents

Background Outdoor falls present a significant challenge to the health and well-being of older adults. Safe strategy use is an important component of falls prevention, yet little is known regarding use of outdoor falls prevention strategies. Aims To examine outdoor falls prevention strategy use among naturally occurring retirement community residents at risk for falls, and to examine associations with neighborhood walkability. Methods Descriptive analyses of pretest data from an intervention study ( N = 97) were conducted to examine frequency of outdoor falls prevention strategy use. Walk Score® data were added to the dataset, and chi-square tests of independence were used to examine associations between walkability categories and outdoor falls prevention strategy use. Results Some strategies, such as visual scanning and holding rails on stairs, were used by 70% or more of participants while others, such as route planning, were infrequently or inconsistently used. With the exception of avoiding cell phone use while walking outdoors, no significant associations were found between walkability categories and outdoor falls prevention strategy use. Conclusion Study findings serve as a needs assessment for health education and behavioral training.

scholarly journals Effect of MS on pregnancy and the effect of pregnancy on MS patients in Isfahan

2020 ◽  
Author(s):  
Freshteh Ashtari ◽  
Fatemeh Mokhtari ◽  
Mohammad Soudavi ◽  
Homa Saadat ◽  
Mahboubeh Valiani
Keyword(s):  
Ectopic Pregnancy ◽  
Protective Role ◽  
Common Symptom ◽  
Demographic Information ◽  
Blurred Vision ◽  
Chi Square ◽  
Pregnancy Status ◽  
History Of ◽  
The Mean ◽  
Spss Software

Abstract Background Multiple sclerosis is a chronic disease of the central nervous System.Most women with MS are diagnosed during their reproductive ages.This study evaluated the effect of pregnancy on MS and the effect of MS disease on fertility and pregnancy health. Material & methods: A retrospective descriptive-analytic study was conducted on 110 women suffering from MS with a history of pregnancy(between 2007 and 2017years) in Isfahan, Iran.Samples were selected in a census model.Women completed a researcher-constructed questionnaire by telephone.The questionnaire consisted of three parts: demographic information,MS and its symptoms and its treatment, and the third part was related to the reproductive system and the history of pregnancy associated with MS. Data were analyzed by SPSS software version 16 using Chi-square, ANOVA and t-test.Results The mean age of women with MS was 32.4 years.The most common primary symptom was blurred vision(42.7%).In this population,the average number of pregnancies was 1.61,the number of deliveries was 1.35,the number of abortions was 0.24,the history of ectopic pregnancy was 0.01,the number of alive children was 1.36 and the number of dead children was 0.01.The average time of the last MS attack before the pregnancy was 21.36 months. Fatigue(24.5%) was the most common symptom exacerbated during pregnancy. MS symptoms improved in55.0% of subjects in the second trimester.Discussion MS had no effect on the pregnancy status, such as the number of abortions,ectopic pregnancy, alive and dead children and the duration of pregnancy.The symptoms of the disease are improved during pregnancy.Therefore, pregnancy has a protective role against MS.

scholarly journals Pediatric Brain tumors in Southeast Nigeria; An 8-year prospective longitudinal cohort study

2019 ◽  
Author(s):  
Enoch Uche ◽  
Nkechi Judith Uche ◽  
Obinna V Ajuzieogu ◽  
Dubem Amuta ◽  
ephraim Onyia ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Survival Rates ◽  
Pediatric Brain Tumors ◽  
Common Symptom ◽  
Chi Square ◽  
Study Results ◽  
Chi Square Test ◽  
Poor Outcomes ◽  
Prospective Longitudinal ◽  
Pediatric Brain

Abstract Background: Pediatric brain tumors (PBT’s) from previous studies are associated with poor outcomes in our subregion. Methods. An 8 -year single center prospective study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc) Chicago IL, USA version 23. Chi Square test, One-way Anova and confidence limits were used to evaluate associations using the 95% level of significance. Patients were followed up for a range of 1 to 7.5 years with a mean of 4.9 ±1.3years. Ethical approval was obtained for our study. Results: 95 patients were enrolled, 84 satisfied the study criteria. There were 45 males and 39 females, M: F=1.1. The mean age was 9.9±2.7 years 95%CI with a range of 9 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location (45(54.2%), while 33(37.1%) were infratentorial. Craniopharyngiomas (n=19), medulloblastomas(n=17) and astrocytomas (n=11) were the most common tumors. Hemoglobin genotype(AA and AS) had some influence on tumor phenotype, Odds ratio 8.9 and 3.3 for medulloblastoma and craniopharyngioma. 69 cases were microsurgically resected while 14 patients were treated with radiotherapy alone. The 30-day mortality for operated cases is 7.9±1.3%. Overall 1-year and 5-year survival was 67.9% and 53.6 % respectively. Survival rates varied among treatment groups (X2=8.9, P=0.017). Conclusion: Survival profile in this series suggests some improvement in comparison to previous studies from our region.

scholarly journals Habit of tooth brushing with the dental caries incidence

2018 ◽  
Vol 6 (8) ◽  
pp. 2606
Author(s):  
Dwi Retnaningsih ◽  
Rani Arinti
Keyword(s):  
Dental Caries ◽  
Well Being ◽  
Statistical Test ◽  
Tooth Brushing ◽  
School Age Children ◽  
P Value ◽  
School Age ◽  
Chi Square ◽  
Cross Sectional ◽  
Nonparametric Correlation

Background: Teeth and mouth are important parts that must be kept clean, because through these organs various germs can enter. In general, dental and oral hygiene was very important for the health and well-being of the human body because it can affect the function of mastication, speech and confidence.1 Dental caries was an infectious disease that damages tooth structure and can cause cavities. Children age under 12 years old who suffer from dental and oral diseases can be affect with student achievement in school. A preliminary study conducted at SDN 2 Ngabean was 7 out of 10 children with dental caries marked with cavities, accumulating plaque and black teeth.Methods: Quantitative research with Cross Sectional study design. The population in this study were all students of grade 4 and 5 SD Negeri 2 Ngabean Boja District Kendal District in the academic at June 2017 amounted to 80 students. Statistical test using Chi Square. Iinstrument used in this study was a questionnaire of 14 questions submitted to respondents using Likert scale type. The statistical test used was chi square nonparametric correlation because independent and dependent variables use ordinal and nominal scale.Results: Results of research obtained from 80 respondents in school-age children in SD Negeri 2 Ngabean showed that of respondents students who experience dental caries as many as 48 students (60.0%), while students who did not experience dental caries as many as 32 students (40.0%). Based on the result of chi square test it can be seen that p value = 0.000 (p value <α) or 0.000 <0.05 then Ho was rejected, and Ha accepted.Conclusions: There was a correlation of tooth brushing habit with the dental caries incidence of school age children at the elementary school state Ngabean 2 Boja District, Kendal Regency.

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