Pancreatic Surgery in the Older Population: A Single Institution’s Experience over Two Decades

Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups. Results. Even though patients aged 75 years or older had significantly more postoperative morbidities compared with the younger patient group, the age group was not associated with increased risk of 90-day mortality after pancreatic resection. Discussion. The study suggests that age alone should not preclude patients from undergoing curative pancreatic resection.

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The changing face of cancer in the elderly—Only a demographic change?

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.18597 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 18597-18597

Author(s):

Y. Rottenberg ◽

T. Peretz

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Lung Cancer ◽

Older Women ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Industrial Countries ◽

Cancer Burden ◽

Two Age Groups

18597 Background: In industrial countries, the cancer burden of the elderly is high and is increased. One reason is longer life expectancy. Increasing age standardized rates of cancer in this age group compared to younger groups may also explain this phenomenon. Methods: Two age groups were examined, above and below 65 years. Each age group was further divided into men and women. The age standardized rates for all cancers combined among the Jewish population in Israel were identified through the Israel Cancer Registry during the years 1973–2002. In addition, lung and colorectal cancers according to sexes, prostate cancer in men and breast cancer in women were examined. Results: Between the first 5 years of the study (1973–1977) and the last 5 years (1998–2002) the age standardized rates for all cancers combined were raised by about one third in the two age groups. In males, the overall change was higher in the older group (42% in men aged 65 years and older compared to 31% in men younger than 65). However, the rise in the younger group was more prominent in females (42% in women younger than 65 years compared to 33 % in women aged 65 and older). The most outstanding increase was in prostate cancer in men, but mainly in the younger group (176% in the older group and 368% in the younger group) followed by breast cancer in women, more prominent in the older group (64% in the older group and 50% in the younger group). In both sexes, more noticeable increases were noted in the older groups in colorectal cancer and in lung cancer. Between the years 1993–1997 and 1998–2002 shifts towards stabilization and even a decrease was noted in some of the cancers that were examined. In men aged 65 years and older rates for all cancers combined were decreased by 2.5%, among the specific tumors and a decrease was noted in lung cancer (6.7%) and prostate cancer (5.8%). The rates for all cancers combined among the older women were slightly decreasing (2.0%). No decrease was noted in the specific tumors in this group. Among the younger groups in both sexes, no decrease (defined >0.5%) was noted. Conclusions: These data argue against the hypothesis that the overall change in the cancer burden in the aged could be also explained by differences changes in the risk of developing cancer between these two age groups. No significant financial relationships to disclose.

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LOW VISION DEVICES

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.10.1041 ◽

2015 ◽

Vol 22 (10) ◽

pp. 1345-1350

Author(s):

Muhammad Saad Ullah ◽

Sohail Safdar ◽

Muhammad Nabeel Ahmad

Keyword(s):

Tertiary Care Hospital ◽

Low Vision ◽

Tertiary Care ◽

Age Groups ◽

Care Hospital ◽

Age Group ◽

Vision Assessment ◽

Study Results ◽

Two Age Groups

Objective: The main objective of the present study was to find out visual outcomeof Low Vision Devices among patients suffering from different diseases causing reduced visualacuity in the area of Dera Ghazi Khan, Southern Punjab, Pakistan. Setting: OphthalmologyDepartment, Dera Ghazi Khan which is a tertiary care hospital. Period: 10th February, 2014 to31st December, 2014. Material and Methods: Patients (n=55) presented for their low visionassessment included two groups age wise as patients equal or more than 18 years age (n=22)and patients less than 18 years (n=33). LOG MAR VA charts, contrast sensitivity test, visualfields through arc perimeters, color vision with color pencils hue 16 test along with objective andsubjective refractions were applied. All the data were entered and analyzed using SPSS version16.00. Results: Patients (n=55) aged 7-90 years presented for their low vision assessment hadmean age 23.73+ 2.9 years. The patients were divided into two age groups. First group was22 (40%) patients equal or more than 18 years age and second consisted of 33(60%) patientsless than 18 years age group. Among the patients examined, 40 (72.7%) were males and 15(27.3%) were females. Our study results revealed that the low vision devices provision wasassociated with a statistically significant improvement in both near and distance visual acuitiesand with patients’ fulfillment. Conclusion: There was a significant improvement in far and nearvisual acuity of the patients suffering from a multiplicity of blindness caused diseases by whichpatients are able to improve their quality of life and able to do their tasks without getting helpfrom others.

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A study on clinical characteristics of herpes zoster in a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170081 ◽

2017 ◽

Vol 3 (1) ◽

pp. 79

Author(s):

Rachana R. ◽

Shivaswamy K. N. ◽

Anuradha H. V.

Keyword(s):

Herpes Zoster ◽

Clinical Characteristics ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Age Group ◽

Female Ratio ◽

Varicella Zoster ◽

Medical College ◽

Male To Female

Background: Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.Methods: A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.Results: Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least. Conclusions: Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.

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Assessment of Predictors of Hyperkalemia in Cardiovascular Diseased Patients

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v11i2.4587 ◽

2021 ◽

Vol 11 (2) ◽

pp. 51-54

Author(s):

Manasa R ◽

Aksa Johnson ◽

Presly Thomas Augustine ◽

Anjana Tom

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Diseases ◽

Observational Study ◽

Tertiary Care ◽

Age Groups ◽

Common Type ◽

Age Group ◽

Aged Patients ◽

Cross Sectional ◽

Increased Risk

Purpose: The objective is to determine the predictors of hyperkalaemia, severity of hyperkalaemia and to access the prevalence of cardiovascular diseases Methodology: A cross sectional observational study was conducted on the predictors of hyperkalaemia in CVD patients, in a tertiary care teaching hospital for a period of 6 months. Results: Among 105 patients, there were 83 males and 22 females, the age group from 41-60 year shows more CVDs and 61-80 years aged patients are more prone to hyperkalaemia and shows more prevalent when compared to other age groups. The major risk factors of hyperkalaemia were Drugs (30.23%), Disease (58.13%), and Drug interactions (11.62%).Among the cardiovascular diseases, Myocardial Infarction (38%) were the most common type of CVD, while in hyperkalaemia Ischemic Heart Disease (48.83%) were more prevalent. The severity of hyperkalaemia is measured as Mild (60.46%), Moderate (37.20%), and Severe (2.32%). Conclusion: The present study was carried out in order to assess the predictors, prevalence and severity of hyperkalaemia in cardiovascular disease patients. Our study concluded that patients with cardiovascular disease can have an increased risk of hyperkalaemia. Keywords: CVD, Hyperkalaemia, Cross sectional observational study, Predictors, Prevalence, Severity.

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Management of Postpartum Haemorrhage: A study on Transfusion of Blood and its components

Obsgyne Review: Journal of Obstetric and Gynecology ◽

10.17511/joog.2020.i06.01 ◽

2020 ◽

Vol 6 (6) ◽

pp. 108-113

Author(s):

Dr. Swati Swati ◽

◽

Dr. Fayaz Khan H ◽

Dr. Manju M ◽

◽

...

Keyword(s):

Postpartum Haemorrhage ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Obstetric Care ◽

Age Group ◽

Blood Products ◽

Medical College ◽

Essential Components ◽

A Prospective Study

Introduction: Blood Transfusion is identified as one of the essential components of comprehensiveemergency obstetric care which has drastically reduced maternal mortality. Material and Methods:This is a prospective study conducted at NC Medical College and Hospital, in the Department ofOBGY. (Tertiary care center) from January 2019 – September 2020. All patients requiringintrapartum transfusion of blood or blood products are enrolled in the study. No exclusion criteria.Results: In the present study, various age groups of patients were enrolled. Maximum transfusion(77.8%) rates are seen in the age group of 21-30 years and the minimum no. of patients wereranges from 31-40 years (8.4%). Conclusion: Postpartum hemorrhage, placental causes, andanemia are the commonest causes of the need for transfusion in obstetric practice.

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A clinical study of anemia in children aged 6 months–5 years in a tertiary care center, Bengaluru, Karnataka, India

Indian Journal of Child Health ◽

10.32677/ijch.v8i10.3067 ◽

2021 ◽

Vol 8 (10) ◽

pp. 367-370

Author(s):

Siva Saranappa ◽

Jennifer Wu

Keyword(s):

Nutritional Status ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

World Health ◽

Deficiency Anemia ◽

Age Group ◽

Female Ratio ◽

Male Predominance ◽

Health Organization

Background: Anemia is the most commonly observed hematological diseases in children. The World Health Organization (WHO) has estimated that globally, 1.62 billion people are anemic, with the highest prevalence of anemia (47.4%) among preschool-aged children. Of these 293 million children, 89 million live in India. Aim: This study aims to evaluate the factors causing anemia in children aged between 6 months and 5 years and its prevalence within this age group. Methods: This study is a prospective observational study conducted in KIMS Hospital, Bengaluru, Karnataka. A total of 200 children in the age group of 6 months–5 years with features of anemia or having hemoglobin <11 g/dl were included in the study for a duration of 18 months between January 2019 and June 2020. Detailed history was recorded and examination findings were noted. The data collected were tabulated and statistically analyzed accordingly. Results: About 57.5% of the children with anemia fell between the age group of 6 months and 2 years and 42.5% of children were in the age groups of 2–5 years. A male predominance was seen (61%) with male-to-female ratio of approximately 1.56:1. Most of the children were found to have mild (46%) and moderate anemia (46%) with only a minority (8%) presenting with severe anemia. About 56.5% of the children had a normal nutritional status while 41% were malnourished and 2.5% had both wasting and stunting. Exclusive breastfeeding (for 6 months) history was present in 59% of the children. These children belonged mostly to the upper lower (45%) and lower middle (41%) socioeconomic status. This study also showed anemia in children most commonly presented majorly with concurrent involvement of the respiratory system (31%) followed by infectious diseases (30%) and gastrointestinal disorders (23%). Conclusion: The current study concludes that iron deficiency anemia is a multifactorial hematological disease. Learning about the predisposing risk factors can help to adopt the necessary precautions to prevent anemia in these children. Improving the nutritional status of the children by involving parents and counseling them regarding important feeding practices can help to prevent anemia.

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The Older, the More Forgiving? Characteristics of Forgiveness of Chinese Older Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2021.732863 ◽

2021 ◽

Vol 12 ◽

Author(s):

Linjin Tao ◽

Tingting Zhu ◽

Yanglu Min ◽

Mingxia Ji

Keyword(s):

Older Adults ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Implicit Measures ◽

Chinese Older Adults ◽

Significant Difference ◽

Single Category ◽

The Difference ◽

Two Age Groups

This study explores the characteristics of forgiveness in the aging cohorts, which is regarded to be associated with healthy outcomes. Data were drawn from a sample of 308 older adults (aged from 60 to 98 years) who completed the forgiveness questionnaire: forgiving others of The Heartland Forgiveness Scale (HFS) to examine explicit forgiveness, and among the participants, 44 older adults were administrated on the variant single category of implicit association test (SC-IAT) to examine the implicit forgiveness. The results revealed that (1) there is no correlation between explicit forgiveness and implicit forgiveness of older adults. (2) The result of explicit forgiveness is relatively high while that of implicit forgiveness is relatively low. (3) There was no significant correlation between explicit forgiveness and age, but there was significant difference between age groups, as forgiveness tendency of the elderly had a trough in the age group of 70–79 and then rebounded. (4) Implicit forgiveness was significantly correlated with age, and the difference between age groups was marginal. The forgiveness tendency of the elderly over 80 years old was significantly higher than that of the other two age groups. (5) Gender differences are found in both explicit and implicit forgiveness. The findings indicated that (1) explicit and implicit measures in this study have assessed independent and complementary aspects of forgiveness tendency in older adults. (2) Implicit forgiveness falls behind explicit forgiveness, and true internal forgiveness is difficult and rare in older adults according to data analysis. (3) The trend of explicit forgiveness with age is not obvious, because explicit forgiveness in the middle old age group presents an inflection point. However, implicit forgiveness increases slowly with age. (4) Women excel men in scores obtained with both explicit and implicit measures for forgiveness.

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Significantly longer Covid-19 incubation times for the elderly, from a case study of 136 patients throughout China

10.1101/2020.04.14.20065896 ◽

2020 ◽

Cited By ~ 4

Author(s):

Ally Bi-Zhu Jiang ◽

Richard Lieu ◽

Siobhan Quenby

Keyword(s):

Incubation Time ◽

Age Groups ◽

The Elderly ◽

Individual Case ◽

Age Group ◽

Log Normal ◽

Case Data ◽

Larger Sample ◽

Two Age Groups

AbstractObjectiveTo infer Covid-19 incubation time distribution from a large sample.MethodBased on individual case data published online by 21 cities of China, we investigated a total of 136 COVID-19 patients who traveled to Hubei from 21 cities of China between January 5 and January 31, 2020, remained there for 48 hours or less, and returned to these cities with onset of symptoms between January 10 and February 6, 2020. Among these patients, 110 were found to be aged 15 – 64, 22 aged 65 – 86, and 4 aged under 15.FindingsThe differential incubation time histogram of the two age groups 15 – 64 and 65 – 86 are adequately fitted by the log normal model. For the 15 - 64 age group, the median incubation time of days (uncertainties are 95 −0.90 % CL) is broadly consistent with previous literature. For the 65-86 age group, the median is days is statistically significantly longer. Moreover, for −2.0 this group, the 95 % confidence contour indicates the data cannot constrain the upper bound of the log normal parameters µ, σ by failing to close there; this is because the sample has a maximum incubation time of 17 days, beyond which we ran out of data even though the histogram has not yet peaked. Thus there is the potential of a much longer incubation time for the 65-86 age group than 10 – 14 days. Only a much larger sample can settle this.

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Assessing the prevalence of various modes of injury and type of malleolar fractures based on Lauge-Hansen classification presenting at a tertiary care center

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203718 ◽

2020 ◽

Vol 6 (5) ◽

pp. 987

Author(s):

Jairam D Jagiasi ◽

Mohit R. Upadhyaya ◽

Pranjal Rai

Keyword(s):

External Rotation ◽

Public Awareness ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Fracture Pattern ◽

Ankle Fractures ◽

Age Group ◽

Management Options ◽

Supination External Rotation

Background: Ankle fractures represent approximately 9% of all fractures and are a common occurrence with an incidence of 138-169 per 100,000 per year. The mechanism of injury differs in terms of mode of injury in various age groups. The Lague-Hansen classification is a pathologic-anatomic classification and emphasizes different stages of ligamentous injury, in addition to the fracture pattern, and provides options for fracture treatment.Methods: A retrospective observational study, where the prevalence of various types of ankle fractures were classified according to the Lauge-Hansen Classification, in the period of 2018 onwards till date. The mode of injury and age group of the patient was also noted.Results: A total of 84 patients were analyzed, supination-external rotation (48.7%) were the most frequently observed fractures in our study population, with no significant correlation between mode of injury and fracture pattern noted. There was a statistically significant association (p<0.05) between the velocity of injury and the age groups suffering ankle trauma.Conclusion: The Lauge-Hansen Classification continues to be an important tool in assessing the biomechanics of ankle fractures and the management options available, especially in a country like India where more expensive imaging modalities may not be available or affordable at times. Our study also highlights that high velocity fractures continue to be a major cause of morbidity in the younger age group, especially in developing countries such as India. Stringent traffic rules and public awareness need to be put into practice to reduce the toll of this problem.

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Association between body mass index and the risk of atrial fibrillation and ischemic stroke according to age: a nationwide population-based cohort study

European Heart Journal ◽

10.1093/eurheartj/ehab724.2411 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

H J Ahn ◽

S R Lee ◽

E K Choi ◽

K D Han ◽

S I Kwon ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Cohort Study ◽

Ischemic Stroke ◽

Body Mass ◽

Age Groups ◽

The Elderly ◽

Population Based ◽

Age Group ◽

Increased Risk

Abstract Background Atrial fibrillation (AF) and ischemic stroke (IS) are two significant cardiovascular diseases that confer an enormous healthcare burden. A limited study comprehensively evaluated the association between full ranges of body mass index (BMI), including underweight, and AF or IS risks, especially in the different age subgroups. Purpose We investigated the association between BMI and AF and IS incidence according to the Korean population's age groups. Methods This was a nationwide population-based cohort study using data from the Korea National Health Insurance Service, including 9 194 477 healthy adults who underwent a medical examination in 2009. We stratified the study population into three age subgroups: age 20–39 (young, 33.1%), age 40–64 (middle-aged, 56.3%), and age over 65 years (elderly, 10.6%). In each age group, the individuals were categorized based on BMI (kg/m2) into underweight (<18.5), normal (18.5 to <23), overweight (23 to <25), obese I (25 to <30), and obese II (≥30). The first occurrences of AF and IS were followed up until December 31, 2018. According to BMI in each age group, the risks of AF and IS were analyzed by Cox proportional hazards regression with 95% confidence intervals (CI) by adjusting age, sex, lifestyle behaviors, and comorbidities. Results Overall, both underweight and higher BMI were associated with an increased risk of AF and stroke across all age groups. The increased risk of AF for patients with obese II was slightly accentuated compared to patients with normal BMI in the young population than elderly population (hazard ratio [HR] 1.78, 95% CI 1.63–1.94 for age 20–39 years; HR 1.55, 95% CI 1.48–1.61 for age ≥65 years, respectively). For underweight individuals, however, the increased risk of AF became more prominent in the elderly: HR and 95% CI was 1.12 (1.07–1.17) in the age over 65 years old, and 1.05 (0.94–1.16) in the age 20–39. Regarding IS, the young group presented a considerable increment in the magnitude of HRs in both underweight and higher BMI groups. However, the association between the BMI and stroke risk became attenuated in the elderly: HRs and 95% CI in underweight and obese II individuals were 1.10 (0.93–1.30) and 2.223 (1.99–2.49) in the age 20–39 group, whereas 0.97 (0.93–1.01) and 1.03 (0.98–1.08) in the age over 65 years old. Conclusions Underweight as well as obesity was associated with increased risks of AF and IS in the general population. In both AF and IS, the gradient of risks according to BMI was apparent at young ages; thus, maintaining normal body weight should be warranted in early life. An interplay of several factors other than BMI may contribute to ischemic stroke in the old ages, requiring integrated risk management in older patients. FUNDunding Acknowledgement Type of funding sources: None.

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