scholarly journals Colectomy Rates for Ulcerative Colitis Differ between Ethnic Groups: Results from a 15-Year Nationwide Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravi Misra ◽  
Alan Askari ◽  
Omar Faiz ◽  
Naila Arebi
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
South Asians ◽  
Epidemiological Studies ◽  
Hospital Episode Statistics ◽  
Confounding Factors ◽  
Diagnosis Code ◽  
Administrative Dataset ◽  
Significant Difference ◽  
Icd 10

Introduction. Previous epidemiological studies suggest a higher rate of pancolonic disease in South Asians (SA) compared with White Europeans (WE). The aim of the study was to compare colectomy rates for ulcerative colitis (UC) in SA to those of WE.Methods. Patients with UC were identified from a national administrative dataset (Hospital Episode Statistics, HES) between 1997 and 2012 according to ICD-10 diagnosis code K51 for UC. The colectomy rate for each ethnic group was calculated as the proportion of patients who underwent colectomy from the total UC cases for that group.Results. Of 212,430 UC cases, 73,318 (35.3%) were coded for ethnicity. There was no significant difference in the colectomy rate between SA and WE (6.93% versus 6.90%). Indians had a significantly higher colectomy rate than WE (9.8% versus 6.9%,p<0.001). Indian patients were 21% more likely to require colectomy for UC compared with WE group (OR: 1.21, 95% CI: 1.04–1.42, andp=0.001).Conclusions. Given the limitations in coding, the colectomy rate in this cohort was higher in Indians compared to WE. A prospectively recruited ethnic cohort study will decipher whether this reflects a more aggressive phenotype or is due to other confounding factors.

scholarly journals Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrés Moreno Roca ◽  
Luciana Armijos Acurio ◽  
Ruth Jimbo Sotomayor ◽  
Carlos Céspedes Rivadeneira ◽  
Carlos Rosero Reyes ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Survival Time ◽  
Univariate Analysis ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Icd 10 ◽  
The Difference ◽  
Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

scholarly journals P461 Intolerance to 5-aminosalicylate is a risk of poor prognosis in ulcerative colitis patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S409-S410
Author(s):  
T Fujii ◽  
S Hibiya ◽  
C Maeyashiki ◽  
E Saito ◽  
K Takenaka ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Confidence Interval ◽  
Maintenance Therapy ◽  
Retrospective Review ◽  
Poor Prognosis ◽  
Hazard Ratio ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Significant Difference

Abstract Background 5-Aminosalicylates (5-ASA) are the key drugs in induction and maintenance therapy in ulcerative colitis (UC). Some UC patients are involved in 5-ASA intolerance after induction of oral 5-ASA compounds. There is no evidence of the prognosis including the risk of colectomy in 5-ASA intolerant UC patients. Methods The aim of this study is to establish the prognosis of 5-ASA intolerant UC patients in a multicenter cohort study. A retrospective review of a prospective multicenter database (2014–2018) of 1,574 UC patients was carried out and a total of 1,286 patients treated with oral 5-ASA compounds were enrolled. We compared the risk of colectomy and biologics induction between patients (i) tolerant to first 5-ASA compound (1079), (ii) intolerant to first 5-ASA compound but tolerant to other 5-ASA compound (107) and (iii) intolerant to 5-ASA compound and withdrawal of 5-ASA (100). Results We identified 1,286 patients with UC, of which 40 patients (3.1%) resulted in colectomy and 247 patients (19%) treated with biologics. Colectomy rate in patients (iii) intolerant to 5-ASA and withdrawal of 5-ASA were higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (9.0%, 2.7%, 1.9%, respectively). (iii) Patients withdrawal of 5-ASA showed higher risk of colectomy compared with (i) tolerant to first 5-ASA (Hazard ratio (HR) 4.71, 95% Confidence interval (CI): 2.04–10.8). The risk of colectomy among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). The biologics induction rate in (iii) patients withdrawal of 5-ASA was significantly higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (37%, 18%, 16%, respectively). Also (iii) patients withdrawal of 5-ASA showed higher risk of induction with biologics compared with (i) tolerant to first 5-ASA (HR 2.35, 95% CI: 1.50–3.68). Those risk among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). Conclusion Patients with UC who had 5-ASA intolerance and withdrew from 5-ASA showed poor prognosis. We should consider trying other 5-ASA compounds even if the patients had intolerance to one 5-ASA compound.

scholarly journals Effects of Appendectomy on the Onset and Course of Ulcerative Colitis in Chinese Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Dafan Chen ◽  
Jing Ma ◽  
Shengzheng Luo ◽  
Lungen Lu ◽  
Xinjian Wan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Protective Factor ◽  
Clinical Course ◽  
Smoking Status ◽  
Immunosuppressive Treatment ◽  
Epidemiological Studies ◽  
Chinese Patients ◽  
Chinese Populations ◽  
Significant Difference ◽  
Control Study

Background. Previous epidemiological studies have suggested that appendectomy may be a protective factor against the development of ulcerative colitis (UC). However, the results of these studies were inconsistent, with rare studies in Chinese populations. Aim. This study examined the associations between appendectomy performed before UC diagnosis and the occurrence and clinical course of UC in Chinese patients. Methods. A case control study was conducted to compare the rate of appendectomy between UC patients and controls matched for age and sex at two Chinese hospitals. Clinical course of UC was compared between UC patients who underwent appendectomies before UC diagnosis and who did not. Results. 402 UC patients and 402 controls were included. The percentage of appendectomy performed before UC diagnosis in UC patients did not differ significantly from controls (2.74% vs 3.98%, P=0.442). Subgroup analysis on the basis of localization of UC patients did not find significant difference from controls. The extent of disease involvement in UC patients who underwent appendectomy was smaller than patients who did not (P=0.009). Appendectomy was found to be significantly related to the location of the disease independent of smoking status in multivariate analysis (P<0.001). Appendectomy did not influence severity of disease and need for immunosuppressive treatment or colectomy. Conclusion. We did not find a significant negative association between appendectomy and the UC occurrence in Chinese patients. Appendectomy performed before UC diagnosis may reduce the extent of UC involvement.

scholarly journals Intravenous Immunoglobulin-based Adjuvant Therapy for Severe COVID-19: a Single-center Retrospective Cohort Study

2021 ◽  
Author(s):  
Xiao Hou ◽  
Li Tian ◽  
Lei Zhou ◽  
Xinhua Jia ◽  
Li Kong ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Length Of Hospital Stay ◽  
Confounding Factors ◽  
Single Center ◽  
Significant Difference

Abstract Objective Coronavirus disease 2019 (COVID-19) is a major challenge facing the world. Certain guidelines recommend intravenous immunoglobulin (IVIG) for adjuvant treatment of COVID-19. However, there is a lack of clinical evidence to support the use of IVIG.Methods This single-center retrospective cohort study included all adult patients with laboratory-confirmed severe COVID-19 in the Respiratory and Critical Care Unit of Dabie Mountain Regional Medical Center, China. Patient information, including demographic data, laboratory indicators, the use of glucocorticoids and IVIG, hospital mortality, the application of mechanical ventilation, and the length of hospital stay was collected. The primary outcome was the composite end point, including death and the use of mechanical ventilation. The secondary outcome was the length of hospital stay.Results Of the 285 patients with confirmed COVID-19, 113 severely ill patients were included in this study. Compared with the non-IVIG group, more patients in the IVIG group reached the composite end point [12 (25.5%) vs 5 (7.6%), P=0.008]. However, there was no statistically significant difference in the primary outcome between the two groups (P=0.167) after adjusting for confounding factors. Patients in the IVIG group had a longer hospital stay [23.0 (19.0-31.0) vs 16.0 (13.8-22.0), P<0.001]. After adjusting for confounding factors, there was still a statistically significant difference between the two groups (P=0.041).Conclusion Adjuvant therapy with IVIG did not improve the in-hospital mortality rate or the need for mechanical ventilation in patients with severe COVID-19. In contrast, the application of IVIG was related to a longer hospital stay.

scholarly journals Incidence and Prevalence of Microscopic Colitis Between 2001 and 2016: A Danish Nationwide Cohort Study

2020 ◽  
Vol 14 (12) ◽  
pp. 1717-1723
Author(s):  
Petra Weimers ◽  
Dorit Vedel Ankersen ◽  
Søren Lophaven ◽  
Ole Kristian Bonderup ◽  
Andreas Münch ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Regional Differences ◽  
Collagenous Colitis ◽  
Epidemiological Studies ◽  
Microscopic Colitis ◽  
Lymphocytic Colitis ◽  
The Past ◽  
Populated Region ◽  
Recorded Diagnosis

Abstract Background and Aims Epidemiological studies suggest an increasing global incidence of microscopic colitis, including collagenous colitis and lymphocytic colitis. We aimed to investigate the incidence and prevalence of microscopic colitis in Denmark. Methods In a nationwide cohort study, we included all incident patients with a recorded diagnosis of collagenous colitis or lymphocytic colitis in the Danish Pathology Register between 2001 and 2016. Results A total of 14 302 patients with microscopic colitis—8437 [59%] with collagenous and 5865 [41%] with lymphocytic colitis—were identified during the study period. The prevalence in December 2016 was estimated to be 197.9 cases per 100 000 inhabitants. Microscopic colitis was more prevalent among females (n = 10 127 [71%]), with a mean annual incidence of 28.8, compared with 12.3 per 100 000 person-years among males. The overall mean incidence during the study period was 20.7 per 100 000 person-years. Mean age at time of diagnosis was 65 years (standard deviation [SD]:14) for microscopic colitis, 67 [SD:13] for collagenous colitis, and 63 [SD:15] for lymphocytic colitis. The overall incidence increased significantly from 2.3 cases in 2001 to 24.3 cases per 100 000 person-years in 2016. However, the highest observed incidence of microscopic colitis was 32.3 cases per 100 000 person-years in 2011. Large regional differences were found, with the highest incidence observed in the least populated region. Conclusions The incidence of microscopic colitis in Denmark has increased 10-fold during the past 15 years and has now surpassed that of Crohn’s disease and ulcerative colitis. However, incidence has stabilised since 2012, suggesting that a plateau has been reached.

AWARENESS ABOUT INDOOR AIR POLLUTION IN GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD

2018 ◽  
Vol 8 (2) ◽  
pp. 80-83
Author(s):  
Nadia Tariq ◽  
Tamkeen Jaffry ◽  
Rahma Fiaz ◽  
Abdul Majid Rajput ◽  
Sadaf Khalid
Keyword(s):  
Air Pollution ◽  
General Population ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Economic Status ◽  
Educational Status ◽  
Epidemiological Studies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference

Background: Indoor air pollutants are increasingly being associated with respiratory illnesses leading to high degree of morbidity and mortality. There are not sufficient epidemiological studies from Pakistan which assess level of awareness of indoor air pollution resulting in respiratory diseases in population. Methods: This cross sectional survey was carried out on general population of Rawalpindi/Islamabad. Sample size was 223 study subjects selected by non-probability convenient sampling. Knowledge of the study subjects was determined with regard to indoor air pollution, its effects on health and different sources of indoor air pollution with the help of a questionnaire. The influence of age, gender, educational status and socio economic status on the level of awareness was also analyzed. Results: Out of total 223 participants, 115 were males and108 females. Participants aware of indoor air pollution were 91.5% and adequate awareness about its sources was 80.7%. Those who knew indoor air pollution is detrimental to health were 95.1%. Awareness about building construction dust as source of indoor air pollution was maximum (84.8%). There was significant difference in awareness among participants with different monthly incomes and educational status and also between males and females. Conclusion: This study concludes that general population of Rawalpindi/Islamabad has fairly good awareness about sources of indoor air pollution. Use of harmful material causing indoor air pollution should be limited or substituted with better ones where possible.

Incidence of nonaccidental head trauma in infants: a call to revisit prevention strategies

2019 ◽  
Vol 24 (6) ◽  
pp. 689-696 ◽  
Author(s):  
LaVerne W. Thompson ◽  
Kathryn D. Bass ◽  
Justice O. Agyei ◽  
Hibbut-Ur-Rauf Naseem ◽  
Elizabeth Borngraber ◽  
...  
Keyword(s):  
New York ◽  
Parent Education ◽  
Shaken Baby Syndrome ◽  
Retrospective Chart Review ◽  
Educational Interventions ◽  
Significant Rise ◽  
Significant Incidence ◽  
Significant Difference ◽  
Icd 10 ◽  
Parent Education Programs

OBJECTIVETraumatic brain injury is a major sequela of nonaccidental trauma (NAT) that disproportionately affects young children and can have lasting sequelae. Considering the potentially devastating effects, many hospitals develop parent education programs to prevent NAT. Despite these efforts, NAT is still common in Western New York. The authors studied the incidence of NAT following the implementation of the Western New York Shaken Baby Syndrome Education Program in 1998.METHODSThe authors performed a retrospective chart review of children admitted to our pediatric hospital between 1999 and 2016 with ICD-9-CM and ICD-10-CM codes for types of child abuse and intracranial hemorrhage. Data were also provided by the Safe Babies New York program, which tracks NAT in Western New York. Children with a diagnosis of abuse at 0–24 months old were included in the study. Children who suffered a genuine accidental trauma or those with insufficient corroborating evidence to support the NAT diagnosis were excluded.RESULTSA total of 107 children were included in the study. There was a statistically significant rise in both the incidence of NAT (p = 0.0086) and the incidence rate of NAT (p = 0.0235) during the study period. There was no significant difference in trendlines for annual NAT incidence between sexes (y-intercept p = 0.5270, slope p = 0.5263). When stratified by age and sex, each age group had a distinct and statistically significant incidence of NAT (y-intercept p = 0.0069, slope p = 0.0374).CONCLUSIONSDespite educational interventions targeted at preventing NAT, there is a significant rise in the trend of newly reported cases of NAT, indicating a great need for better injury prevention programming.

Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers

2020 ◽  
pp. 107110072097126
Author(s):  
Jack Allport ◽  
Jayasree Ramaskandhan ◽  
Malik S. Siddique
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Smoking Status ◽  
Time Frame ◽  
Modifiable Risk Factor ◽  
Level Of Evidence ◽  
Significant Difference

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Incidence of Kawasaki disease before and during the COVID-19 pandemic: a retrospective cohort study in Japan

2021 ◽  
Vol 5 (1) ◽  
pp. e001034
Author(s):  
Kyohei Iio ◽  
Kousaku Matsubara ◽  
Chisato Miyakoshi ◽  
Kunitaka Ota ◽  
Rika Yamaoka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kawasaki Disease ◽  
Infectious Diseases ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Epidemiological Studies ◽  
Primary Objective ◽  
Temporal Association ◽  
Difference In Difference

BackgroundEpidemiological studies in Kawasaki disease (KD) have suggested infectious aetiology. During the COVID-19 pandemic, measures for mitigating SARS-CoV-2 transmission also suppress the circulation of other contagious microorganisms. The primary objective is to compare the number and incidence of KD before and during the COVID-19 pandemic in Japan, and the secondary objective is to investigate temporal association between the KD epidemiology and activities of SARS-CoV-2 and other viral and bacterial infections.MethodsA retrospective cohort study was conducted between 2016 and 2020 in Kobe, Japan. We collected information of hospitalised KD children in Kobe. Child population was identified through the resident registry system. Activity of COVID-19 and 11 other infectious diseases was derived from a public health monitoring system. Monthly change of KD incidence was analysed using a difference-in-difference regression model.ResultsThroughout the study period, 1027 KD children were identified. KD had begun to decline in April 2020, coinciding with the beginning of the COVID-19 pandemic. The number of KD cases (n=66) between April and December 2020 was 40% of the average in the same period in 2016–2019 (165/year). Annual KD incidence was 315, 300, 353, 347 and 188/100 000 children aged 0–4 years in 2016–2020, respectively. The difference-in-difference value of KD incidence was significantly reduced in the fourth quarter in 2020 (−15.8, 95% CI −28.0 to −3.5), compared with that in 2016–2019. Sentinel surveillance showed a marked decrease of all infectious diseases except exanthema subitum after the beginning of the COVID-19 pandemic. There were 86 COVID-19 cases aged <10 years and no KD children associated with COVID-19.ConclusionThis study showed that the number and incidence of KD was dramatically reduced during the COVID-19 pandemic in Japan. This change was temporally associated with decreased activities of various infectious diseases other than COVID-19, supporting the hypothesis of infection-triggered pathogenesis in KD.

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