At-risk populations

2021 ◽  
pp. 69-100
Author(s):  
Nicholas Kennedy ◽  
Katherine Reeve ◽  
Elizabeth Fontaine ◽  
Stuart White ◽  
Rebecca Mawer ◽  
...  

This chapter focuses on those vulnerable patient groups who carry high perioperative risk and need special perioperative consideration, such as those with obesity, malnourished patients, older patients, and patients with learning disabilities and/or autism.

2020 ◽  
Author(s):  
Areen Omary

Aims: This study aims to examine if age and marital status can predict the risk for binge alcohol use (BAU) among adults with a major depressive episode (MDE). Methods: Data from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey for Drug Use and Health (NSDUH) were analyzed. The unweighted sample included 6,999 adults representing a weighted population size of 33,900,452.122 in the US. Results and Conclusions: The findings of this retrospective research confirmed that age and marital status significantly predicted BAU in the past month among adults with MDE. Adults with MDE at higher risk for BAU were adults under the age of 50, adults who were never married, and adults who were divorced/separated. Special attention must be paid to those in age groups under 50, never married, and have been separated/divorced who are particularly at-risk for future alcohol abuse. Future research should consider examining additional potential confounders for BAU among other at-risk populations.


2020 ◽  
Vol 222 (4) ◽  
pp. S886.e1-S886.e9 ◽  
Author(s):  
Abigail Liberty ◽  
Kimberly Yee ◽  
Blair G. Darney ◽  
Ana Lopez-Defede ◽  
Maria I. Rodriguez

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Justyna Mika ◽  
Joanna Tobiasz ◽  
Joanna Zyla ◽  
Anna Papiez ◽  
Małgorzata Bach ◽  
...  

AbstractIn the DECODE project, data were collected from 3,114 surveys filled by symptomatic patients RT-qPCR tested for SARS-CoV-2 in a single university centre in March-September 2020. The population demonstrated balanced sex and age with 759 SARS-CoV-2( +) patients. The most discriminative symptoms in SARS-CoV-2( +) patients at early infection stage were loss of taste/smell (OR = 3.33, p < 0.0001), body temperature above 38℃ (OR = 1.67, p < 0.0001), muscle aches (OR = 1.30, p = 0.0242), headache (OR = 1.27, p = 0.0405), cough (OR = 1.26, p = 0.0477). Dyspnea was more often reported among SARS-CoV-2(-) (OR = 0.55, p < 0.0001). Cough and dyspnea were 3.5 times more frequent among SARS-CoV-2(-) (OR = 0.28, p < 0.0001). Co-occurrence of cough, muscle aches, headache, loss of taste/smell (OR = 4.72, p = 0.0015) appeared significant, although co-occurrence of two symptoms only, cough and loss of smell or taste, means OR = 2.49 (p < 0.0001). Temperature > 38℃ with cough was most frequent in men (20%), while loss of taste/smell with cough in women (17%). For younger people, taste/smell impairment is sufficient to characterise infection, whereas in older patients co-occurrence of fever and cough is necessary. The presented study objectifies the single symptoms and interactions significance in COVID-19 diagnoses and demonstrates diverse symptomatology in patient groups.


2020 ◽  
pp. 095646242094756
Author(s):  
Sabina O Nduaguba ◽  
Kentya H Ford ◽  
James P Wilson ◽  
Kenneth A Lawson ◽  
Robert L Cook

We aimed to identify subgroups within age, racial/ethnic, and transmission categories that drive increased risk for late HIV diagnosis (LHD). A 1996–2013 retrospective study of HIV-diagnosed individuals (N = 77,844) was conducted. The proportion of individuals with LHD (AIDS diagnosis within 365 days of HIV diagnosis) was determined, stratified by age, race/ethnicity, and transmission category. Logistic regression with interaction terms was used to identify groups/subgroups at risk for LHD during 1996–2001, 2002–2007, and 2008–2013. Respectively, 78%, 27%, 38%, and 31% were male, White, Black, and Hispanic. Overall, 39% had LHD with a 6.7% reduction for each year increase (OR = 0.93, 95% CI = 0.93–0.94, p < 0.01). Older age was significantly associated with increased odds of LHD (OR range = 1.90–4.55). Compared to their White counterparts, all Hispanic transmission categories (OR range = 1.31–2.58) and only Black female heterosexuals and men who have sex with men (MSM) (OR range = 1.14–1.33) had significantly higher odds of LHD during 1996–2001 and/or 2002–2007. Significance was limited to Hispanic MSM (all age categories), MSM/IDUs (30–59 years), and heterosexuals (18–29 years) and Black MSM (30–39 years) during 2008–2013. Older individuals and Hispanics (driven by MSM) are at increased risk for LHD. HIV testing interventions directed at seniors and Hispanic MSM can further reduce rates of LHD.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 784
Author(s):  
Ebony T. Lewis ◽  
Kathrine A. Hammill ◽  
Maree Ticehurst ◽  
Robin M. Turner ◽  
Sally Greenaway ◽  
...  

We aimed to identify the level of prognostic disclosure, type of prognostic information and delivery format of prognostic communication that older adults diagnosed with a life-limiting illness or caregivers prefer to receive. We developed and pilot tested an open-ended survey to 15 older patients and caregivers who had experience in health services for life-limiting illness either for a relative, friend or themselves. Five hypothetical clinical scenarios of prognostic options were presented to ascertain preferences. The preferred format to receive prognostic information was verbal delivery by the clinician with a written summary. Photos and videos were less favoured, and a table with numbers/percentages was least preferred. Distress levels to the prognostic scenarios were low, with the exception of a photo. We conclude that older patients/caregivers want end-of-life prognostic information delivered the traditional way, verbally by clinicians. Options to deliver prognostic information may vary across patient groups but empower clinicians in introducing end-of-life discussions with patients/caregivers. Our study illustrates the feasibility of involving terminal patients and caregivers in research that contributes to eliciting prognostic preferences. Further research is needed to understand whether the prognostic preferences of hospitalized patients with life-limiting illness differ.


PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e80594 ◽  
Author(s):  
Huanmiao Xun ◽  
Dianmin Kang ◽  
Tao Huang ◽  
Yuesheng Qian ◽  
Xiufang Li ◽  
...  

2011 ◽  
Vol 57 ◽  
pp. S96-S99 ◽  
Author(s):  
Chris Beyrer ◽  
Stefan Baral ◽  
Deanna Kerrigan ◽  
Nabila El-Bassel ◽  
Linda-Gail Bekker ◽  
...  

2016 ◽  
Vol 63 (6) ◽  
pp. 717-722 ◽  
Author(s):  
John N. Galgiani ◽  
Neil M. Ampel ◽  
Janis E. Blair ◽  
Antonino Catanzaro ◽  
Francesca Geertsma ◽  
...  

Abstract It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere. Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection. In this practice guideline, we have organized our recommendations to address actionable questions concerning the entire spectrum of clinical syndromes. These can range from initial pulmonary infection, which eventually resolves whether or not antifungal therapy is administered, to a variety of pulmonary and extrapulmonary complications. Additional recommendations address management of coccidioidomycosis occurring for special at-risk populations. Finally, preemptive management strategies are outlined in certain at-risk populations and after unintentional laboratory exposure.


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