scholarly journals A81 POST COLONOSCOPY COLORECTAL CANCERS IN MANITOBA: A POPULATION-BASED ANALYSIS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 95-96
Author(s):  
H Singh ◽  
S Derksen ◽  
M Sirski ◽  
S McCulloch ◽  
L M Lix
Keyword(s):  
Linear Models ◽  
Adult Population ◽  
Age Groups ◽  
Population Based ◽  
Colorectal Cancers ◽  
Root Cause ◽  
Funding Agencies ◽  
Increased Risk ◽  
Study Results ◽  
Manitoba Health

Abstract Background Recent consensus guidelines from the World Endoscopy Organization (WEO) recommend all jurisdictions report unadjusted rates of post colonoscopy (PC) colorectal cancers (CRC). Until recently, prior reports have mostly focused on PC-CRC in the CRC screening age groups. Aims We evaluated the rate and predictors of PC-CRC in the adult population for the province of Manitoba from 1990 to 2016. Methods Individuals 18+ years at CRC diagnosis were identified from the Manitoba Cancer Registry. Colonoscopies in the 3 years preceding CRC diagnosis were identified via linkage to Manitoba Health (MH) physicians billing claims. CRCs were classified, based on WEO recommendations, as: (1) detected CRC (colonoscopy up to 6 months before CRC diagnosis) and (2) PC-CRC-3y (colonoscopy 6–36 months before CRC diagnosis). Generalized linear models with generalized estimating equations (to adjust for clustering within endoscopy physicians) were used to test for differences in rates over 3-time intervals (1990/91 – 1999/00; 2000/01 - 2009/10; 2010/11 – Dec 31 2016), provincial region of performance of colonoscopy and identify other associations from the MH data. Results Overall, 10.5% of the 16,639 CRCs diagnosed in the study period and with colonoscopy in the preceding 3 years were PC-CRC-3y. CRCs diagnosed between April 2000 and March 2010 were more likely to be PC-CRC-3y than those diagnosed between April 2010 and December 2016 (odds ratio [OR] 1.18; 95% confidence interval [CI]: 1.03–1.37). Female sex (OR for male: 0.86; 95% CI: 0.77–0.94), IBD diagnosis (OR 3.04; 95% CI: 2.56–4.52), prior CRC (OR 5.41; 95% CI: 4.61–6.34), prior colonoscopy (OR 2.10; 95% CI 1.88–2.36), diverticulosis (OR 2.39; 95% CI: 2.16–2.6), colonoscopy by GP (OR: 1.62; 95% CI 1.16–2.26 vs. surgeons) were associated with increased odds of PC-CRC-3y. There were no regional differences, and no effect of colonoscopy volume or age greater than 75 (or lower than 50). Conclusions In Manitoba, the PC-CRC-3y rate decreased slightly in recent years. The study results of large number of PC-CRC-3y along with only a slight decrease in rates over the years, support calls for root cause analysis to evaluate individual cases of PC-CRC. An initial focus could be the groups with increased risk of PC-CRC. Funding Agencies Manitoba Health

scholarly journals Neighbourhood characteristics as a predictor of adherence to dietary recommendations: A population-based cohort study of Finnish adults

2020 ◽  
pp. 140349482097149
Author(s):  
Hanna Lagström ◽  
Jaana I. Halonen ◽  
Sakari Suominen ◽  
Jaana Pentti ◽  
Sari Stenholm ◽  
...  
Keyword(s):  
Population Density ◽  
Dietary Habits ◽  
Metabolic Diseases ◽  
Adult Population ◽  
Age Groups ◽  
Population Based ◽  
Dietary Recommendations ◽  
Neighbourhood Characteristics ◽  
Severe Life Events ◽  
Dietary Score

Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20–24, 30–34, 40–44 and 50–54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database ( n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0–100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) −1.89 to −1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38−1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits.

scholarly journals Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

2021 ◽  
Vol 15 (4) ◽  
pp. e0009312
Author(s):  
Yi-Hua Pan ◽  
Mei-Ying Liao ◽  
Yu-Wen Chien ◽  
Tzong-Shiann Ho ◽  
Hui-Ying Ko ◽  
...  
Keyword(s):  
Older Adults ◽  
Adult Population ◽  
Age Groups ◽  
The Elderly ◽  
Denv Infection ◽  
Serum Samples ◽  
Increased Risk ◽  
Southern Taiwan ◽  
Older Populations ◽  
Age Range

A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

scholarly journals ULTRASOUND;

2012 ◽  
Vol 19 (02) ◽  
pp. 187-192
Author(s):  
EJAZ HUSSAIN SIDDIQUI ◽  
SAAD SIDDIQUI ◽  
NOREEN SHAH
Keyword(s):  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
X Rays ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Study Results ◽  
Significant Difference ◽  
Ultrasound Findings ◽  
Hepatobiliary Diseases

Objectives: To assess common presenting features and the role of Ultrasound in evaluation of Hepatobiliary diseases in ourpopulation. Design: Cross sectional study. Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: August 2010 to December2010. Material and Methods: Data from patients presenting for evaluation of Hepatobiliary diseases was analyzed for presenting complaintsand ultrasound findings according to objectives of the study. Results: In total 197 cases were included in the study. The age wise categorizationincluded pediatric population (6.1%) adult population (87.3%) and geriatric population (6.6%). Upper abdominal pain was the most commonpresenting feature in all age groups as well as in both genders. Cholelithiasis with or without cholecystitis was the most common ultrasoundfinding in all age groups. No statistically significant difference was found between presenting features or ultrasound findings in different agegroups as well as across gender. Conclusions: Hepatobiliary diseases are among major illnesses in our region. Ultrasound is a sensitive anduseful tool for screening and evaluation of Hepatobiliary disorders.

scholarly journals PREVALENCE OF HYPERTENSION IN ADULT POPULATION OF HAYATABAD PESHAWAR

1969 ◽  
Vol 5 (1) ◽  
pp. 644-647
Author(s):  
SARA GUL ◽  
ATIF HUSSAIN ◽  
KASHIF UR REHMAN KHALIL ◽  
IMRANULLAH ◽  
MUHAMMAD ISHTIAQ ◽  
...  
Keyword(s):  
Communicable Disease ◽  
Adult Population ◽  
Positive Association ◽  
Developed Countries ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Study Results ◽  
History Of ◽  
Study Population

BACKGROUND: Hypertension is one of the common non communicable disease and is reported to beprevalent in 20% to 50% of the adult population, hypertension is one of the major contributor ofmortality and morbidity in developing and developed countries. The cross-sectional descriptive studywas formulated to find the prevalence and to assess different etiological factors of hypertension.MATERIAL & METHODS: This cross-sectional study among 400 adults of age 25-75 years wasconducted in months of June to December 2014 in Phase 5, Hayatabad Peshawar. A detailed structuredproforma having important questions was used to collect important data regarding various variables.RESULTS: Our study results showed that 22.75% of the study people were hypertensive i.e. 10.25% ofmales and 12.5% of females; and the prevalence of hypertension showed positive association withadvancing age. Out of all respondents; 60.25% were males while 39.75% were females; 28.5% weresmokers; 5.25% consume predominantly meat; 32.5% were obese & overweight; 36.75% checked theirB.P regularly; and 19.75% had positive history of hypertension in family.CONCLUSION: We conclude that hypertension prevalence was high among our study population andwas associated with various modifiable and non modifiable risk factors thus population based preventivestrategies are needed to control and prevent hypertension.KEY WORDS: Hypertension, Age, Diet, Smokers, Hayatabad, Peshawar.

scholarly journals Prescribing Analgesics to Older People: A Challenge for GPs

2020 ◽  
Vol 17 (11) ◽  
pp. 4017
Author(s):  
Ljiljana Trtica Majnarić ◽  
Thomas Wittlinger ◽  
Dunja Stolnik ◽  
František Babič ◽  
Zvonimir Bosnić ◽  
...  
Keyword(s):  
Older People ◽  
Chronic Diseases ◽  
Musculoskeletal Diseases ◽  
Age Groups ◽  
Treatment Strategies ◽  
Opioid Analgesics ◽  
Psychotropic Medications ◽  
High Rate ◽  
Increased Risk ◽  
Study Results

Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.

P5309Age and gender distributions of coronary artery calcium in the Dutch adult population: preliminary results of the ImaLife study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Xia ◽  
M Rook ◽  
G J Pelgrim ◽  
J N Van Bolhuis ◽  
P M A Van Ooijen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Reference Values ◽  
Coronary Artery Calcium ◽  
Adult Population ◽  
Age Groups ◽  
Population Based ◽  
Imaging Biomarkers ◽  
Dutch Population ◽  
Age And Gender ◽  
And Gender

Abstract Background Coronary artery calcium (CAC) scoring is a promising tool for cardiovascular risk classification. Population-based reference values are important for the clinical interpretation of CAC scores. Purpose To establish standards of CAC distributions by age and gender in an unselected Dutch population, which can be used to determine reference values. Methods ImaLife (Imaging in Lifelines) is a computed tomography (CT) based substudy of the Lifelines cohort, with a primary aim to establish reference values of imaging biomarkers for early stages of coronary artery disease in adults (above 45 years old). In total, 12,000 participants will be enrolled from an unselected adult population in the northern Netherlands for CAC scoring with third generation dual-source CT. CAC is quantified with dedicated commercial software using the Agatston method. Results Included so far were 3,702 participants (57.5% females, mean age 54 years, range 45–82 years). CAC was present in 39.2% of participants, with a higher prevalence of CAC in men (55.3%) than in women (27.3%). CAC scores increased with increasing age in both genders. The percentiles of CAC scores by age and gender groups are summarized in the table. Agatston CAC score percentiles by age and gender Percentiles Women – Age, years Men – Age, years 45–49 50–54 55–59 60–64 65∼ 45–49 50–54 55–59 60–64 65∼ N 505 634 719 260 10 355 473 543 185 18 25th 0 0 0 0 0 0 0 0 1 75 50th 0 0 0 0 4 0 1 6 22 556 75th 0 0 6 33 386 6 21 72 129 751 90th 4 26 77 120 1037 49 154 242 500 1803 Conclusion This preliminary result presents CAC distribution by age and gender in a middle-aged unselected Dutch population. Compared with the Heinz Nixdorf Recall study, CAC scores in our cohort for both genders were lower in the 5-year age groups between 45 and 64 years. Based on the overall data, expected within 2 years, reference values of CAC for the Dutch population can be established.

Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017

2020 ◽  
Vol 105 (10) ◽  
pp. 3134-3140 ◽  
Author(s):  
Trine Koch ◽  
Elvira V Bräuner ◽  
Alexander S Busch ◽  
Martha Hickey ◽  
Anders Juul
Keyword(s):  
Age Groups ◽  
Population Based ◽  
Incidence Rates ◽  
National Registry ◽  
Registry Study ◽  
Age Related ◽  
Danish Health ◽  
Increased Risk ◽  
National Patient ◽  
First Time

Abstract Context Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias. Objective The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population. Design An observational, 20-year national registry study was conducted. Setting This population-based study used nationwide registry data. Participants Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia. Main Outcome Measures All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection. Results Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period. Conclusions The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.

scholarly journals 2212. Burden of Community-Acquired Pneumonia Attributable to Co-morbid Conditions in Adults

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S754-S754
Author(s):  
Melissa A Rolfes ◽  
Seema Jain ◽  
Anna Bramley ◽  
Wesley Self ◽  
Richard G Wunderink ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Adult Population ◽  
Age Groups ◽  
Population Attributable Fraction ◽  
Community Acquired Pneumonia ◽  
Behavioral Risk ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
Co Morbidity ◽  
Combining Data

Abstract Background Few studies have quantified the risk of community-acquired pneumonia (CAP) among adults with co-morbidities. Combining data from the population-based, prospective Etiology of Pneumonia in the Community study (EPIC) and the nationwide health-related Behavioral Risk Factor Surveillance System (BRFSS) telephone-survey, we estimated the annual risk of hospitalization for CAP among adults with co-morbidities. Methods We identified adults hospitalized with radiographic and clinical CAP at hospitals in Chicago, IL and Nashville, TN from July 2010 to June 2012. Using 2011 BRFSS data, we estimated the prevalence of the population with selected co-morbidities (chronic lung disease [CLD], cardiovascular disease [CVD], chronic kidney disease [CKD], or diabetes) in the EPIC study catchment counties, as well as the population without co-morbidities. We estimated the incidence of hospitalized CAP, age-adjusted relative risk (RR) using Poisson regression, and population attributable fraction for each co-morbidity. Results Among 2,061 adult patients enrolled in EPIC, 1,428 (69%) had at least one selected co-morbidity, most commonly CLD (42%) and CVD (35%). Among the adult population in the EPIC catchment area, 17% had ≥1 selected co-morbidity. The overall incidence of hospitalized CAP was 24.8/10,000, 118.7/10,000 among adults with ≥1 co-morbidity, and 11.2/10,000 among adults without a co-morbidity. Compared with patients without co-morbidities, the incidence of hospitalization for CAP was higher among patients with CLD (aRR: 20.7 [95% confidence interval [CI]: 20.0–21.5]), CKD (aRR: 14.5 [CI: 13.8–15.1]), CVD (aRR: 14.0 [CI: 13.5–14.6]), and diabetes (aRR: 6.2 [CI: 5.9–6.4]). While CLD and CVD accounted for high proportions of the incidence of CAP hospitalizations in the study population, the contribution of the selected co-morbidities varied by age groups (figure). Conclusion There is an increased risk of hospitalization for CAP among adults with co-morbidities, particularly chronic lung and cardiovascular disease. As a large portion of CAP is attributable to these co-morbidities, targeted public health interventions, such as vaccination and risk communication, need to be reinforced among these high-risk groups. Disclosures All authors: No reported disclosures.

scholarly journals Healthcare utilisation and cost expenditures for pneumonia in individuals with diabetes mellitus in the USA

2019 ◽  
Vol 147 ◽  
Author(s):  
K. Liu ◽  
G. C. Lee
Keyword(s):  
Diabetes Mellitus ◽  
Adult Population ◽  
Healthcare Utilisation ◽  
Population Based ◽  
Medical Expenditure ◽  
Inpatient Setting ◽  
Cross Sectional ◽  
Panel Surveys ◽  
Increased Risk ◽  
The Usa

AbstractPneumonia is one of the leading causes of hospitalisations among adults in the USA. Individuals with diabetes mellitus (DM) have been associated with increased risk for pneumonia and complications including death. The objectives of this study were to (1) compare the prevalence and healthcare utilisation patterns for pneumonia in individuals with and without DM, and (2) identify risk factors for pneumonia in those with DM. We performed a retrospective, cross-sectional analysis of the US adult population using Medical Expenditure Panel Surveys (MEPS) data from 2014. Overall, the data represented 24 million individuals with DM and 218 million without DM in the USA. The population-based rate for a pneumonia event was 34 per 1000 persons for individuals with DM and 19 per 1000 persons without DM. Compared to the non-DM group, individuals with DM were treated 1.8x, 2.6x and 1.4x more in the ED, hospital and outpatient, respectively. Furthermore, the average cost per pneumonia event was significantly higher among individuals with DM compared to non-DM in the inpatient setting ($11 931 vs. $7751; P < 0.001). Among individuals with DM, female sex, DM complications, smokers and administration of pneumococcal vaccines were significant factors associated with a pneumonia event.

scholarly journals Trends in self-poisoning and psychotropic drug use in people aged 5–19 years: a population-based retrospective cohort study in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e026001 ◽  
Author(s):  
Rose Cairns ◽  
Emily A Karanges ◽  
Anselm Wong ◽  
Jared A Brown ◽  
Jeff Robinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Cohort Effect ◽  
Population Based ◽  
Psychotropic Medicine ◽  
Increased Risk ◽  
Self Harm

ObjectivesTo characterise trends in self-poisoning and psychotropic medicine use in young Australians.DesignPopulation-based retrospective cohort study.SettingCalls taken by the New South Wales and Victorian Poisons Information Centres (2006–2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).ParticipantsPeople aged 5–19 years.Main outcome measuresYearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).ResultsThere were 33 501 intentional poisonings in people aged 5–19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006–2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5–14 and 15–19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5–14 and 15–19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.ConclusionsOur results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

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