Meckel’s diverticulum in adults: seldom suspected and frequently found

2020 ◽  
pp. jim-2020-001581
Author(s):  
Chance S Friesen ◽  
Thomas Mario Attard ◽  
Maria Cole ◽  
Jay G Berry ◽  
Matt Hall
Keyword(s):  
Meckel’S Diverticulum ◽  
Age Groups ◽  
Healthcare Research ◽  
Meckel's Diverticulum ◽  
Older Age ◽  
Adult Patients ◽  
Hospital Charges ◽  
Median Income ◽  
Older Individuals ◽  
Additional Information

Meckel’s diverticulum (MD) is a well-defined diagnosis in children presenting with either bleeding or obstruction. Although anecdotally adult patients may present with complications from MD, their presentation seems to be different, with a reported predominance of non-bleed-related presentations. Reports in this population, however, are limited, and little is known of the epidemiology of MD in older patients. We performed a retrospective analysis of the Agency of Healthcare Research and Quality National Inpatient Sample of all US hospital discharges from 2012 to 2016. We identified patients with a primary discharge diagnosis of MD. Data were abstracted as raw numbers and population weighted rates of discharge with age group, income level, length of stay (LOS) and hospital charges as additional information. On average, 2030 individuals were discharged annually; most (71.1%) were adults (>18 years). Although MD was predominant in males in all age groups, the gender ratio decreased with older age categories from 3.5:1.0 (1–17 years) to 1.6:1.0 (65–84 years). LOS averaged 5.3 days with no clear relationship to other parameters. Median income category, however, closely correlated (R2=0.9996) with diagnosis in older age categories. MD may be significantly more prevalent in adult patients than was previously understood. Differences in gender preponderance suggest that gender may influence the pattern of presentation. Diagnosis in older individuals is closely associated with income or socioeconomic status but not hospital charges or LOS.

scholarly journals Meckel’s Diverticulum: Factors Associated with Clinical Manifestations

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jeng-Jung Chen ◽  
Hung-Chang Lee ◽  
Chun-Yan Yeung ◽  
Wai-Tao Chan ◽  
Chuen-Bin Jiang ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pediatric Patients ◽  
Meckel’S Diverticulum ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Meckel's Diverticulum ◽  
Adult Patients ◽  
Ectopic Gastric Mucosa ◽  
Intestinal Hemorrhage ◽  
Clinical Presentations

Objectives. The purpose of this study was to investigate the clinical features of Meckel’s diverticula at different ages, genders, and pathology in order to serve as a reminder to clinicians when evaluating potential cases and to help obtain an early diagnosis. Methods. We collected information of patients with Meckel’s diverticulum diagnosed at Mackay Memorial Hospital in Taiwan from 1984 to 2009. After performing a thorough review of their charts, the clinical features of the Meckel’s diverticula were analyzed according to age groups, gender, and pathology. Result. A total of 126 patients, with 90 males and 36 females, were enrolled in this study. Seventy-five patients were symptomatic and 51 Meckel’s diverticula were found incidentally during surgery for other diseases. Among symptomatic patients, 39% of pediatric patients and 5% of adult patients had intestinal hemorrhage. Twenty-eight percent of pediatric patients and 67% of adult patients had inflammation of Meckel’s diverticulum. Forty-six percent of males and 16% of females had inflammation. Conversely, 27% of males and 58% percent of females had intestinal obstruction. When Meckel’s diverticulum had ectopic gastric mucosa, it tended to cause intestinal hemorrhage when the patient is young. Conclusions. Age, gender, and pathology affect the clinical presentations of Meckel’s diverticula.

scholarly journals Compositional changes in human gut microbiota reveal a putative role of intestinal mycobiota in metabolic and biological decline during aging

2021 ◽  
pp. 1-15
Author(s):  
Mohammad Tahseen Al Bataineh ◽  
Ayman Alzaatreh ◽  
Rima Hajjo ◽  
Bayan Hassan Banimfreg ◽  
Nihar Ranjan Dash
Keyword(s):  
Gut Microbiota ◽  
Age Groups ◽  
Older Age ◽  
Older Individuals ◽  
Human Gut ◽  
Shotgun Metagenomics ◽  
Age Related ◽  
Health And Disease ◽  
Compositional Changes ◽  
Profiling Analysis

BACKGROUND: Age-related alterations in the composition and function of gut microbiota may influence human health and disease mechanisms. However, connections between compositional changes in gut bacterial and fungal communities, and their role in the aging process, remain poorly understood. OBJECTIVE: Compare the gut microbiota and mycobiota composition in different age groups and evaluate the functionality. METHODS: In this study, we performed 16S rRNA and ITS2 gene-based microbial profiling analysis and shotgun metagenomics using the NextSeq platform. RESULTS: We observed a shift in compositional changes of human gut microbiota with age. Older individuals revealed a significantly different gut microbiota profile compared to younger individuals. For example, gut microbiota composition of the older individuals showed increase in genera Bacteroides, Blautia, Ruminococcaceae, and Escherichia coli. Additionally, older individuals had significant reduction in fungi belonging to saccharomyces cerevisiae and candida albicans in comparison to their younger counterparts. Moreover, metagenomics functional profiling analysis using shotgun metagenomics sequencing data showed substantial differences in the enrichment of 48 pathways between the young and older age groups. Metabolic pathways such as amino acid biosynthesis, carbohydrate metabolism, cell structure biosynthesis and vitamin biosynthesis were declined in the older age group, in comparison with the younger individuals. CONCLUSIONS: The identified differences provide a new insight to enrich our understanding of age-related changes in gut microbiota, their metabolic capabilities, and potential impact on health and disease conditions.

How do cardiovascular risk prediction equations developed among 30–74 year olds perform in older age groups? A validation study in 125 000 people aged 75–89 years

2020 ◽  
pp. jech-2019-213466 ◽  
Author(s):  
Suneela Mehta ◽  
Rod Jackson ◽  
Katrina Poppe ◽  
Andrew J Kerr ◽  
Romana Pylypchuk ◽  
...  
Keyword(s):  
Older People ◽  
Risk Prediction ◽  
Performance Metrics ◽  
Age Groups ◽  
Older Age ◽  
Older Individuals ◽  
Prediction Equations ◽  
Cvd Risk ◽  
Individual Level ◽  
New Zealanders

BackgroundCardiovascular disease (CVD) risk prediction equations are being used to guide risk management among increasingly older individuals. We examined the performance of recent equations, derived from a 2006 cohort including almost all New Zealanders aged 30–74 years, among older people.MethodsAll New Zealanders aged 75–89 years in contact with state-funded health services in 2006 without prior CVD or heart failure and with complete predictor data were identified by anonymised individual-level linkage of eight national administrative health datasets. Baseline 5-year CVD risk was estimated using sex-specific New Zealand risk equations, and CVD hospitalisations or deaths occurring between 2007 and 2011 inclusive were ascertained. Performance was assessed with calibration plots and standard metrics.ResultsAmong 124 358 New Zealanders aged 75–89 years old, 30 152 CVD events were recorded during follow-up. Sex-specific equations derived from 30–74 year olds slightly underestimated CVD risk among women and slightly overestimated risk among men aged 75–89 years. Discrimination metrics were poor in both sexes and the risk equations explained only 9.4% of the variation in time to CVD event among women and 6.0% for men. In the 5-year age bands, progressively worsening underprediction in women, overprediction in men and poorer performance metrics were observed with increasing age.ConclusionEntire-population CVD risk equations developed among 30–74 year olds do not perform well among older people. Existing risk algorithms developed from primarily middle-aged or early-retirement cohorts should be used with caution in those aged ≥75 years until carefully validated in narrow age bands to avoid masking poorer performance in older age groups.

INFLUENCE OF THE LEVEL OF EDUCATION ON THE DEGREE OF COMPLIANCE OF THE POPULATION OF OLDER AGE GROUPS

2021 ◽  
pp. 55-61
Author(s):  
Cherkasov S.N. ◽  
Polozkov O.I. ◽  
Fedyaeva A.V. ◽  
Avsadzhanishvili V.N.
Keyword(s):  
Age Groups ◽  
Older Age ◽  
Age Group ◽  
Self Medication ◽  
Men And Women ◽  
Level Of Education ◽  
Additional Information ◽  
High Level ◽  
Medical Recommendations ◽  
Two Age Groups

The purpose of the study: to study the influence of the level of education on the degree of compliance of the population of older age groups. Materials of research. Data from a survey of 1,045 people of both sexes aged 60 years and older were used. The proposed questionnaire included three questions that characterize the level of compliance with medical recommendations, as well as the attitude to self-medication. The results were evaluated for men and women separately in two age groups of 60–74 years and 75 years and older. Results. Women are more compliant with the doctor's prescriptions, as they are more likely to perform them in full. With increasing age, the degree of compliance significantly increases in both men and women, and therefore, the differences between the sexes are leveled. The level of education affects the behavior in relation to the fulfillment of doctor's appointments only in men in the age group of 75 years and older and does not affect the age group of 60–74 years. In women, there was no significant effect in both age groups. Men and women with higher levels of education are more likely to make doctor's appointments only in some cases. A greater proportion of non-respondents, that is, doubters, is also observed in the group of men and women with a high level of education, regardless of age. The results of responses to specific questions concerning the degree of compliance confirmed earlier conclusions about the greater degree of compliance of older women compared to men. A large proportion of doubting men and women with a high level of education, regardless of age, requires a more attentive attitude to them in terms of providing additional information about the need and importance of following doctor's prescriptions.

National trends of incidence, treatment, and hospital charges of isolated C-2 fractures in three different age groups

2015 ◽  
Vol 38 (4) ◽  
pp. E19 ◽  
Author(s):  
Sunil Kukreja ◽  
Piyush Kalakoti ◽  
Richard Murray ◽  
Menarvia Nixon ◽  
Symeon Missios ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Resource Utilization ◽  
Age Groups ◽  
Older Age ◽  
Hospital Charges ◽  
Age Group ◽  
Elderly Age ◽  
Cord Injury ◽  
National Trends ◽  
Incidence Of Hospitalization

OBJECT Incidence of C-2 fracture is increasing in elderly patients. Patient age also influences decision making in the management of these fractures. There are very limited data on the national trends of incidence, treatment interventions, and resource utilization in patients in different age groups with isolated C-2 fractures. The aim of this study is to investigate the incidence, treatment, complications, length of stay, and hospital charges of isolated C-2 fracture in patients in 3 different age groups by using the Nationwide Inpatient Sample (NIS) database. methods The data were obtained from NIS from 2002 to 2011. Data on patients with closed fractures of C-2 without spinal cord injury were extracted using ICD-9-CM diagnosis code 805.02. Patients with isolated C-2 fractures were identified by excluding patients with other associated injuries. The cohort was divided into 3 age groups: < 65 years, 65–80 years, and > 80 years. Incidence, treatment characteristics, inpatient/postoperative complications, and hospital charges (mean and total annual charges) were compared between the 3 age groups. RESULTS A total of 10,336 patients with isolated C-2 fractures were identified. The majority of the patients were in the very elderly age group (> 80 years; 42.3%) followed by 29.7% in the 65- to 80-year age group and 28% in < 65-year age group. From 2002 to 2011, the incidence of hospitalization significantly increased in the 65- to 80-year and > 80-year age groups (p < 0.001). However, the incidence did not change substantially in the < 65-year age group (p = 0.287). Overall, 21% of the patients were treated surgically, and 12.2% of the patients underwent nonoperative interventions (halo and spinal traction). The rate of nonoperative interventions significantly decreased over time in all age groups (p < 0.001). Regardless of treatment given, patients in older age groups had a greater risk of inpatient/postoperative complications, nonroutine discharges, and longer hospitalization. The mean hospital charges were significantly higher in older age groups (p < 0.001). CONCLUSIONS The incidence of hospitalization for isolated C-2 fractures is progressively increasing in older age groups. Simultaneously, there has been a steadily decreasing trend in the preference for nonoperative interventions. Due to more complicated hospital stay, longer hospitalizations, and higher rates of nonroutine discharges, the patients in older age groups seem to have a higher propensity for greater health care resource utilization.

scholarly journals Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada

Infection ◽  
2020 ◽  
Author(s):  
Christian Hoffmann ◽  
Eva Wolf
Keyword(s):  
National Health ◽  
Demographic Data ◽  
Age Distribution ◽  
Age Groups ◽  
Case Fatality ◽  
Older Age ◽  
European Countries ◽  
Older Individuals ◽  
Health Authorities ◽  
Country Specific

Abstract Purpose To evaluate the association between the percentages of older age groups among confirmed SARS-CoV-2 infections and the country-specific case fatality rate (CFR). Methods This ecological study analyzed data from the 20 most severely affected European countries, USA and Canada, in which national health authorities provided data on age distribution and gender among confirmed SARS-CoV-2 cases and deaths. Results The proportion of individuals older than 70 years among confirmed SARS-CoV-2 cases differed markedly between the countries, ranging from 4.9 to 40.4%. There was a strong linear association between the proportion of individuals older than 75 years and the country-specific CFRs (R2 = 0.803 for all countries, R2 = 0.961 after exclusion of three countries with incongruent data). Each 5% point increase of this older age group among confirmed SARS-CoV-2 cases was associated with an increase in CFR of 2.5% points (95% CI 1.9–3.1). Conclusion Data from 20 European countries and the USA and Canada showed that the variance of crude CFR of COVID-19 is predominantly (80–96%) determined by the proportion of older individuals who are diagnosed with SARS-CoV-2. The age distribution of SARS-CoV-2 infections is still far from being homogeneous. Detailed demographic data have to be taken into account in all the analyses on COVID-19-associated mortality. We urgently call for standardized data collection by national health authorities.

High Incidence of Symptomatic Meckel's Diverticulum in Patients Less than Fifty Years of Age: An Indication for Resection

2007 ◽  
Vol 73 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Robert Mckay Frcsc
Keyword(s):  
Small Intestine ◽  
Surgical Management ◽  
Complication Rate ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Adult Patients ◽  
Asymptomatic Patients ◽  
High Incidence ◽  
Heterotopic Tissue ◽  
Congenital Diverticulum

Meckel's diverticulum is a congenital diverticulum of the small intestine. Complications include perforation, inflammation, bleeding, obstruction, and volvulus. Resection of asymptomatic Meckel's diverticuli has been recommended; however, indications are not well defined. To delineate indications to resect asymptomatic Meckel's diverticulum, the charts of 16 men and 13 women, mean age 55.1 ± 23 years, confirmed at surgery with Meckel's diverticuli, were retrospectively reviewed. Two groups were identified: symptomatic resected (9); asymptomatic (20), which included resected (10) or not resected (10). The age ranges, male:female (M:F) ratios, the height:diameter ratios, heterotopic tissue, surgical management, and complications were recorded and compared. The average age for symptomatic resection was 34.9 ± 23.2 years compared with 64.2 ± 16.5 years for asymptomatic patients ( P = 0.0006). Of patients under 50 years of age, 70 per cent (7/10) were symptomatic compared with 10 per cent (2/19) of those over 50 years of age. Overall, the M:F ratios between the groups were similar, and the average M:F ratio was 1.23:1. Surgical management of resected Meckel's diverticuli included 10 segmental resections and 10 diverticulectomies; one of each was laparoscopic. There were no differences in the complication rate, nor in outcomes between the groups. Heterotopic tissue was only identified in symptomatic patients, 33 per cent (3/9) versus 0 per cent (0/10) in resected asymptomatic patients. The height:diameter ratios were similar between the groups. Adult patients with symptomatic Meckel's diverticuli were more likely to be under the age of 50 and to have heterotrophic tissue. Resection of asymptomatic Meckel's diverticulum should be considered in patients under 50 years of age; patients over age 50 years of age will be less likely to benefit from prophylactic resection.

Ultrastructure of the Omphalomesenteric Duct Rest in the Umbilical Cord at Term

1982 ◽  
Vol 40 ◽  
pp. 250-251
Author(s):  
B. A. Clark ◽  
T. Okagaki
Keyword(s):  
Umbilical Cord ◽  
Umbilical Vein ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Columnar Epithelium ◽  
Omphalomesenteric Duct ◽  
Umbilical Arteries

Vestiges of the omphalomesenteric or vitello-intestinal duct and the pathologic implications attributed to these remnants have been treated in great detail by several investigators. Persistence of the omphalomesenteric duct is associated with such conditions as Meckel's diverticulum, umbilical fistula, mucosal polyps, and sinuses or cysts of the umbilicus. Remnants of the duct in the umbilical cord, although infrequent, are located outside of the triangle formed by the two umbilical arteries and the umbilical vein, are usually discontinuous and are often represented by a small lumen lined by cuboidal or columnar epithelium. This study will examine the ultrastructure of these cells.

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