scholarly journals The Efficacy and Safety of Elobixibat for the Elderly with Chronic Constipation: A Multicenter Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Akira Tomie ◽  
Naohisa Yoshida ◽  
Munehiro Kugai ◽  
Ryohei Hirose ◽  
Osamu Dohi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Chronic Constipation ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Stool Consistency ◽  
Related Factors ◽  
Improvement Rate ◽  
Short Period ◽  
Bowel Movements

Backgrounds and Aims. Elobixibat is a bile acid transporter inhibitor indicated for constipation. Previous studies were performed mainly for the nonelderly and were biased to female. We analyzed the efficacy of elobixibat also for the elderly and male. Materials and Methods. This was a multicenter retrospective cohort study. The subjects were patients aged ≥20 years treated for chronic constipation from May 2018 to November 2019 at 12 related institutions. Patients were divided into ≤74 years and ≥75 years old. Elobixibat at 10 mg/day was prescribed for two weeks. We then analyzed the discontinuation due to ineffectiveness, change of spontaneous bowel movements (SBM), stool consistency, the time until the first SBM, adverse events, and effect-related factors. Results. There were 140 cases (61 males) evaluated, with an average age of 72.1±13.6 years (≤74 years: 71 cases; ≥75 years: 69 cases). The discontinuation rate was 7.9%. The SBM (times/week) increased from 2.86 to 6.08 (p<0.001). The overall SBM improvement rate was 74.0% (≤74 years: 78.2% vs. ≥75 years: 68.9%, p=0.31; male: 75.0% vs. female: 73.3%, p=0.78). The overall improvement rate of stool consistency was 59.6% (≤74 years: 62.9%, ≥75 years: 56.1%, p=0.42). The time until the first SBM (hours) for those ≤74 years and ≥75 years was 17.2±14.3 and 11.2±8.4 (p=0.04). Adverse event rates for those ≤74 years and ≥75 years were 28.2% and 10.1% (p<0.01). There were no significant effect-related factors for gender, age, and use of laxatives. Conclusions. Short-period elobixibat is shown to be effective also for the elderly and male.

scholarly journals The Efficacy of Short-Duration Polyethylene Glycol plus Electrolytes for Improving Bowel Preparation of Colonoscopy in Patients with Chronic Constipation

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Naohisa Yoshida ◽  
Yoshikazu Inagaki ◽  
Kohei Fukumoto ◽  
Hiroyuki Yoriki ◽  
Yutaka Inada ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Short Duration ◽  
Bowel Preparation ◽  
Chronic Constipation ◽  
Performance Status ◽  
Stool Consistency ◽  
Related Factors ◽  
Improvement Rate ◽  
Bowel Movements

Backgrounds and Aims. Sachets of polyethylene glycol plus electrolytes (PEG+E: Movicol: EA Pharma, Tokyo, Japan) are used for chronic constipation, and its efficacy is reported only for female and nonelderly people. Chronic constipation is one of the reasons of poor colonoscopic bowel preparation (BP). We analyzed its efficacy in improving chronic constipation and poor colonoscopic BP related to it, including male and elderly people. Materials and Methods. This multicenter retrospective study was conducted from September 2019 to September 2020 at 5 related institutions among patients ≥ 20 years old diagnosed with chronic constipation whose previous colonoscopic BP had had a fair or poor Aronchick score. Two or four sachets of PEG+E (13.7 or 27.4 g/day) were prescribed for 1 week before colonoscopy. We analyzed the rate of improvement in BP, effect-related factors, spontaneous bowel movements (SBMs), stool consistency, improvement of constipation symptoms, and adverse events. Results. We evaluated 106 cases (56 males) with an average age of 69.5 ± 9.4 years old (≤74 years old: 68 cases, ≥75 years old: 38 cases). The improvement rate of BP was 72.6%, and the insertion time and pain score also improved. A performance status of 1 or 2 was associated with poor BP. SBMs (times/week) increased from 4.0 ± 1.9 to 6.1 ± 2.6 ( p < 0.001 ). The overall improvement rates of SBMs, stool consistency, symptoms of constipation, and rate of adverse events were 58.5%, 90.6%, 59.4%, and 6.6%, respectively, showing no significant differences with regard to age or gender. Conclusions. Short-duration PEG+E was effective for improving poor BP and chronic constipation.

scholarly journals Glucose variability and the risks of stroke, myocardial infarction, and all-cause mortality in individuals with diabetes: retrospective cohort study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Da Young Lee ◽  
Kyungdo Han ◽  
Sanghyun Park ◽  
Ji Hee Yu ◽  
Ji A. Seo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Glucose Variability ◽  
All Cause Mortality ◽  
Nationwide Observational Study ◽  
The Impact

Abstract Background Previous research regarding long-term glucose variability over several years which is an emerging indicator of glycemic control in diabetes showed several limitations. We investigated whether variability in long-term fasting plasma glucose (FG) can predict the development of stroke, myocardial infarction (MI), and all-cause mortality in patients with diabetes. Methods This is a retrospective cohort study using the data provided by the Korean National Health Insurance Corporation. A total of 624,237 Koreans ≥ 20 years old with diabetes who had undergone health examinations at least twice from 2005 to 2008 and simultaneously more than once from 2009 to 2010 (baseline) without previous histories of stroke or MI. As a parameter of variability of FG, variability independent of mean (VIM) was calculated using FG levels measured at least three times during the 5 years until the baseline. Study endpoints were incident stroke, MI, and all-cause mortality through December 31, 2017. Results During follow-up, 25,038 cases of stroke, 15,832 cases of MI, and 44,716 deaths were identified. As the quartile of FG VIM increased, the risk of clinical outcomes serially increased after adjustment for confounding factors including duration and medications of diabetes and the mean FG. Adjusted hazard ratios (95% confidence intervals) of FG VIM quartile 4 compared with quartile 1 were 1.20 (1.16–1.24), 1.20 (1.15–1.25), and 1.32 (1.29–1.36) for stroke, MI and all-cause mortality, respectively. The impact of FG variability was higher in the elderly and those with a longer duration of diabetes and lower FG levels. Conclusions In diabetes, long-term glucose variability showed a dose–response relationship with the risk of stroke, MI, and all-cause mortality in this nationwide observational study.

Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study

2016 ◽  
Vol 29 (S1) ◽  
pp. 29-33 ◽  
Author(s):  
Alessandra Panarese ◽  
Vito D’Andrea ◽  
Stefano Pontone ◽  
Pasqualino Favoriti ◽  
Daniele Pironi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Thyroid Diseases

scholarly journals Incidence of and improvement in inappropriate parental behaviors of mothers with young children: a retrospective cohort study conducted in collaboration with a local government

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Takehiro Arai ◽  
Aya Goto ◽  
Mitsuko Komatsu ◽  
Seiji Yasumura
Keyword(s):  
Cohort Study ◽  
Local Government ◽  
Young Children ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Parental Behavior ◽  
Parental Behaviors ◽  
Health Checkup ◽  
Related Factors ◽  
Financial Difficulties

Abstract Background Inappropriate parental behaviors of mothers toward young children require further study; few epidemiological studies have utilized longitudinal analysis of region-based cohorts. This study examined the frequency of incidence of and improvements in inappropriate parental behaviors of mothers with young children and related factors. Methods Among the mothers who underwent a checkup in Fukushima City in 2017, 586 mothers with data from 4-, 18-, and 42-month-old checkups were included in analysis. In this retrospective cohort study, an anonymous database was created by transcribing and matching health checkup records with questionnaires stored at the city health center. Data were analyzed using chi-square tests and logistic regression analysis, using the SPSS Ver.20.0. Results In 28.5% of mothers, inappropriate parental behaviors were not reported in the 18-month-old data but were reported in the 42-month-old data. In 3.8%, inappropriate parental behaviors were reported in the 18-month-old data but were not reported in the 42-month-old data. The most common inappropriate parental behavior reported was “yelling at the child using emotional words” (18-month-old data, 16.2%; 42-month-old data, 39.5%). Mothers with financial difficulties were 2.19 times (95%CI: 1.13–4.26) more likely to begin inappropriate parental behaviors between 18 and 42 months. Improvements in parental behaviors were significantly higher in mothers under 30 years old (p = 0.03). Conclusions It is necessary to identify mothers with financial difficulties early and to examine how to provide childcare and financial support from a local government at the time of child health checkup.

scholarly journals Efficacy of Vedolizumab in a Nationwide Cohort of Elderly Inflammatory Bowel Disease Patients

2021 ◽  
Author(s):  
Nabeel Khan ◽  
Tyler Pernes ◽  
Alexandra Weiss ◽  
Chinmay Trivedi ◽  
Manthankumar Patel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Cohort Study ◽  
Bowel Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Population Based ◽  
Published Data ◽  
Inflammatory Bowel

Abstract Background The elderly inflammatory bowel disease (IBD) population has historically been under-represented in clinical trials, and data on the efficacy of biologic medications in elderly IBD patients are generally lacking. Our study aims to evaluate the efficacy of vedolizumab (VDZ) among elderly IBD patients and compare it with younger IBD patients in a nationwide population-based cohort of IBD patients. Methods We conducted a retrospective cohort study of patients within the US national Veterans Affairs Healthcare System (VAHS). Patients were stratified into 2 groups based on age at the time of starting VDZ (60 years of age and older or younger than 60 years of age) with outcomes compared between the 2 groups. The primary outcome was steroid-free remission during the 6- to 12-month period after starting VDZ therapy among those patients who were on steroids when VDZ was started. Results There were 568 patients treated with VDZ, of whom 56.7% had Crohn’s disease and 43.3% had ulcerative colitis. Among them, 316 patients were on steroids when VDZ was started. The percentage of patients who were on VDZ and off steroids during the 6- to 12-month period after VDZ initiation was 46.8% and 40.1% for the younger and elderly groups, respectively (P = 0.2374). Rates of hospitalization for an IBD-related reason within 1 year of VDZ start among the whole cohort were nearly identical in the younger and elderly groups (11.2% vs 11.3%, P = 0.9737). Rates of surgery for an IBD-related reason within 1 year of VDZ start were also similar between the young and elderly (3.9% vs 3.9%, P = 0.9851). Conclusions In a nationwide real-world retrospective cohort study of elderly IBD patients, we found that the efficacy of VDZ was similar among younger and older IBD patients and comparable with the published data in clinical trials.

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