Abstract T MP46: Stroke Occurrence in Hereditary Hemorrhagic Telangiectasia

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Kristopher D Masilamani ◽  
Jennifer LaBranche ◽  
Shaun Malo ◽  
Larry Svenson ◽  
Thomas Jeerakathil ◽  
...  
Keyword(s):  
General Population ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Genetic Disorders ◽  
Age Groups ◽  
Population Based ◽  
Occurrence Rate ◽  
Middle Aged ◽  
Aged Group ◽  
The North ◽  
Significant Difference

Purpose: Stroke is an important manifestation of Hereditary Hemorrhagic Telangiectasia (HHT). Many individuals may be unaware they have HHT, even after a stroke, due to its rarity. Our goal was to assess the occurrence of stroke among patients with HHT compared to the general population. Methods: Population-based administrative health data on inpatient and ambulatory admissions were extracted for the period 1997 to 2012 in Alberta using ICD-9 and ICD-10 codes. We observed overall occurrence of strokes in the HHT population and subsequently analyzed the data by gender, specific age groups, and stroke subtypes. Then we compared our findings to stroke occurrence among the general population. Results: The age-standardized occurrence rate of stroke in HHT was about 450 [95% CI 276.4, 622.6] per 100,000 PY compared to 260 [95% CI 259.3, 262.1] per 100,000 PY in the general population. Less than 3% of strokes occurred under 30 years old in both groups. Although the majority of strokes occurred after 60 years of age, 23% of strokes in the general population occurred in the middle-aged group (31-60). The prevalence of HHT in Alberta is 1 in 3,800 and three times as many women were diagnosed with HHT than men by 2012. Conclusion: The prevalence of HHT in Alberta was considerably higher than the North American estimate (1 in 5,000). Individuals diagnosed with HHT were 1.73 times more likely to have a stroke than average, a statistically significant difference. Among the general population, a substantial number of strokes occurred in the middle-aged group. There is a higher probability of an underlying genetic component in strokes occurring before 60 years. For patients who have a stroke before 60 without a clear etiology, clinicians should consider evaluation for genetic disorders such as HHT. This is particularly true for males in whom there may be underdiagnosis of HHT.

How Czecho-Slovakia Bounces Back: Population-Based Validation of the Brief Resilience Scale in Two Central European Countries

2021 ◽  
pp. 003329412110296
Author(s):  
Jana Furstova ◽  
Natalia Kascakova ◽  
Iva Polackova Solcova ◽  
Jozef Hasto ◽  
Peter Tavel
Keyword(s):  
Convergent Validity ◽  
Factor Model ◽  
Age Groups ◽  
Reliability And Validity ◽  
Well Being ◽  
Population Based ◽  
Resilience Scale ◽  
Significant Difference ◽  
Mental Well Being ◽  
Best Fit

Objective In recent years, resilience has become a focus of research in the medical and behavioral sciences. The Brief Resilience Scale (BRS) was developed to assess the individual ability to recover from stress (“to bounce back”) after experiencing adversities. The aim of the study was to validate the Czech and Slovak versions of the BRS. Methods A representative sample of the Czech and Slovak populations (NCZ = 1800, mean age MCZ = 46.6, SDCZ = 17.4, 48.7% of men; NSK = 1018, mean age MSK = 46.2, SDSK = 16.6, 48.7% men) completed a survey assessing their health and well-being. Several confirmatory factor analysis (CFA) models of the BRS were compared to find the best fit. Cronbach’s alpha and McDonald’s omega coefficients of reliability were evaluated. Convergent validity was assessed by correlating resilience (BRS), physical and mental well-being (SF-8) and psychopathology symptoms (BSI-53). Differences in gender and age groups were appraised. Results A single-factor model with method effects on the reverse items was evaluated to best fit the data in both the Czech and Slovak samples (χ2CZ(6) = 39.0, p < 0.001, CFICZ = 0.998, TLICZ = 0.995, RMSEACZ = 0.055, SRMRCZ = 0.024; χ2SK(6) = 23.9, p < 0.001, CFISK = 0.998, TLISK = 0.995, RMSEASK = 0.054, SRMRSK = 0.009). The reliability was high in both samples (αCZ = 0.80, ωCZ = 0.85; αSK = 0.86, ωSK = 0.91). The BRS was positively associated with physical and mental well-being and negatively associated with somatization, depression and anxiety. In both countries, a lower BRS score was associated with higher age. Czech men reported significantly higher BRS scores than women. No significant difference was found in the mean BRS scores between the two countries. Conclusion This study provides evidence of good psychometric properties, reliability and validity of the Czech and Slovak adaptations of the BRS.

scholarly journals Colonoscopy and Flexible Sigmoidoscopy Practice Patterns in Ontario: A Population-Based Study

2007 ◽  
Vol 21 (7) ◽  
pp. 431-434 ◽  
Author(s):  
Susan E Schultz ◽  
Chris Vinden ◽  
Linda Rabeneck
Keyword(s):  
Flexible Sigmoidoscopy ◽  
Practice Patterns ◽  
Age Groups ◽  
Population Based ◽  
Insurance Plan ◽  
Ontario Health Insurance Plan ◽  
Population Based Study ◽  
The North ◽  
General Surgeons ◽  
Statistics Canada

OBJECTIVE: To conduct a population-based study on the provision of large bowel endoscopic services in Ontario.METHODS: Data from the following databases were analyzed: the Ontario Health Insurance Plan, the Institute for Clinical Evaluative Sciences Physicians Database and Statistics Canada. The flexible sigmoidoscopy and colonoscopy rates per 10,000 persons (50 to 74 years of age) by region between April 1, 2001, and March 31, 2002, were calculated, as well as the numbers and types of physicians who performed each procedure.RESULTS: In 2001/2002, a total of 172,108 colonoscopies and 43,400 flexible sigmoidoscopies were performed in Ontario for all age groups. The colonoscopy rate was approximately five times that of flexible sigmoidoscopy; rates varied from 463.1 colonoscopies per 10,000 people in the north to 286.8 colonoscopies per 10,000 people in the east. Gastroenterologists in all regions tended to perform more procedures per physician, but because of the large number of general surgeons, the total number of procedures performed by each group was almost the same.CONCLUSION: Population-based rates of colonoscopies and flexible sigmoidoscopies are low in Ontario, as are the procedure volumes of approximately one-quarter of physicians.

scholarly journals Characteristic Movement of the Ribs, Thoracic Vertebrae while Elevating the Upper Limbs - Influences of Age and Gender on Movements

2019 ◽  
Vol 13 (1) ◽  
pp. 170-176
Author(s):  
Hisayoshi Tachihara ◽  
Junichiro Hamada
Keyword(s):  
Young Group ◽  
Thoracic Vertebrae ◽  
Middle Aged ◽  
Age And Gender ◽  
Aged Group ◽  
Age Related ◽  
Significant Difference ◽  
Shoulder Disorders ◽  
Arm Elevation ◽  
And Gender

Background: The rib cage, such as the thoracic spine and ribs, influences glenohumeral mobility and the development of shoulder disorders. Objective: To evaluate movements of the ribs, thoracic vertebrae during bilateral arm elevation and to clarify the characteristic influences of age and gender. Methods: Subjects comprised 33 healthy individuals divided into a young group (10 males, 7 females; mean age, 25 years) and a middle-aged group (8 males, 8 females; mean age, 52 years). Chest CT was performed with two arm positions: arms hanging downwards; and arms elevated at 160°. Images were three-dimensionally reconstructed to evaluate rib movement, extension angle of thoracic vertebrae. Results: Maximal movement was observed at the fifth rib, and rib movement decreased with increasing distance from the fifth rib in both the groups. In males, movement of the second to fourth ribs was smaller in the middle-aged group than in the young group (p < 0.05). Movement of the first to ninth ribs was smaller in females than in males (p < 0.05). No significant difference in the extension angle of the thoracic vertebrae was found. Conclusion: Fifth rib movement is the largest among all ribs during bilateral arm elevation. Reduction of upper rib movement initially arises as an age-related degradation in males. Women exhibit less rib movement during bilateral arm elevation.

scholarly journals Pattern of Glucose Tolerance among Patients with Peripheral Spondyloarthritis

2020 ◽  
Vol 5 (9) ◽  
pp. 773-777
Author(s):  
A T M Tanveer Hasan ◽  
Al-Mamun .
Keyword(s):  
Diabetes Mellitus ◽  
General Population ◽  
Glucose Tolerance ◽  
Inflammatory Diseases ◽  
Age Groups ◽  
Oral Glucose ◽  
Increased Risk ◽  
Significant Difference ◽  
Study Population ◽  
Peripheral Spondyloarthritis

Peripheral spondyloarthritis is a variant of spondyloarthritis which usually has a chronic course. There is an increased risk of cardiovascular diseases among patients with chronic inflammatory diseases in general. Coexisting diabetes mellitus can potentially add to the risk. The objective of this study was to determine the frequency of glucose intolerance in patients with spondyloarthritis The study was conducted among 35 participants with peripheral spondyloarthritis who visited the Department of Rheumatology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from September, 2018 to January, 2020. The participants underwent either oral glucose tolerance test or estimation of HbA1C. The mean age of participants was 43.96 years. The majority (80%) of them were young to muddle-aged (≤40 years). 22.9% of the participants were prediabetic. Diabetes mellitus was found to be present in 37.1% of the participants. There was no significant difference between the study population and the general population in terms of frequency of prediabetes. But the frequency of diabetes in the study population was higher than that in the general population. There was no significant difference between males and females with regard to the frequencies of prediabetes and DM. Moreover, there was no significant difference in the frequencies of prediabetes and DM between young and middle-aged to elderly population. Considering the greater burden of DM among patients with peripheral spondyloarthritis across all age groups, routine screening for DM may be indicated in these individuals.

scholarly journals Links Between Strokes and Hereditary Hemorrhagic Telangiectasia: A Population-Based Study

2018 ◽  
Vol 46 (1) ◽  
pp. 44-50
Author(s):  
Farah N. Chowdhury ◽  
G. Sanjaya Chandrarathne ◽  
Kristopher D. Masilamani ◽  
Jennifer T. N. LaBranche ◽  
Shaun Malo ◽  
...  
Keyword(s):  
General Population ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Female Gender ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Centre Of Excellence ◽  
Classification Of Diseases ◽  
Icd 10

AbstractBackgroundHereditary hemorrhagic telangiectasia (HHT) is a disease of abnormal vasculature where patients are predisposed to strokes of multiple etiologies. We assessed yearly stroke incidence among Albertans with HHT and compared with the general population. Given the tendency for stroke in HHT patients, we expected HHT patients to have higher stroke incidence, in particular at younger ages.MethodsPopulation-based administrative health data on inpatient and ambulatory admissions were extracted over a 16-year period using International Classification of Diseases (ICD)-9 and ICD-10, Canada codes. We analyzed overall occurrence of strokes in Alberta by age, gender, stroke subtype, and diagnosis of HHT.ResultsThe age-standardized incidence rate of stroke in HHT was 450 per 100,000 compared with 260 per 100,000 in the general population with a rate ratio of 1.73 (95% confidence interval (CI) [1.046-2.842]). This study found a higher HHT prevalence in Alberta (1 in 3800) compared to the world average of 1 in 5000. Women were also more likely to be diagnosed with HHT, with a 3.25:1 female gender preponderance in the yearly incidence.InterpretationThis study not only shows that HHT patients are at higher risk of having a stroke but also quantifies that risk using an age-adjusted metric in Alberta. This province has a higher than expected disease burden of HHT, with the majority of cases affecting women. Our study found that acute ischemic strokes and transient ischemic attacks are far more common than hemorrhage in HHT. As HHT is a rare, multi-system, chronic disease, these patients should be referred to an HHT Centre of Excellence.

scholarly journals Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033334 ◽  
Author(s):  
Deborah A Marshall ◽  
Xiaoxiao Liu ◽  
Cheryl Barnabe ◽  
Karen Yee ◽  
Peter D Faris ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Population Based ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Age Group ◽  
Case Definitions ◽  
Obstructive Pulmonary Disease ◽  
Physician Visits ◽  
Significant Difference

ObjectivesThe purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.DesignRetrospective cohort analysis.SettingAll residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.Primary outcome measuresWe selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.ConclusionsOur findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

scholarly journals The values of AHCY and CBS promoter methylation on the diagnosis of cerebral infarction in Chinese Han population

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Xiaodong Li ◽  
Shufang Bu ◽  
Ran Ran Pan ◽  
Cong Zhou ◽  
Kun Qu ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Promoter Methylation ◽  
Methylation Level ◽  
Young Group ◽  
Control Group ◽  
Case Group ◽  
Middle Aged ◽  
Aged Group ◽  
Significant Difference ◽  
And Control

Abstract Background The goal of our study is to investigate whether the methylation levels of AHCY and CBS promoters are related to the risk of cerebral infarction by detecting the methylation level of AHCY and CBS genes. Methods We extracted peripheral venous blood from 152 patients with cerebral infarction and 152 gender- and age-matched healthy controls, and determined methylation levels of AHCY and CBS promoters using quantitative methylation-specific polymerase chain reaction. We used the percentage of methylation reference (PMR) to indicate gene methylation level. Results We compared the promoter methylation levels of two genes (AHCY and CBS) in peripheral blood DNA between the cerebral infarction case group and the control group. Our study showed no significant difference in AHCY promoter methylation between case and control. Subgroup analysis by gender showed that the methylation level of AHCY in males in the case group was lower than that in the control group, but the difference was not statistically significant in females. In a subgroup analysis by age, there was no significant difference in the AHCY methylation level between the case and control in the young group (≤44 years old). However, the level of AHCY gene methylation in the middle-aged group (45–59 years old) was significantly higher and the aged group (≥60 years old) was significantly lower than that in the control groups. However, CBS promoter methylation levels were significantly lower in the case group than in the control group (median PMR: 70.20% vs 104.10%, P = 3.71E-10). In addition, the CBS methylation levels of males and females in the case group were significantly lower than those in the control group (male: 64.33% vs 105%, P = 2.667E-08; female: 78.05% vs 102.8%, P = 0.003). We also found that the CBS levels in the young (23–44), middle-aged (45–59), and older (60–90) groups were significantly lower than those in the control group (young group: 69.97% vs 114.71%; P = 0.015; middle-aged group: 56.04% vs 91.71%; P = 6.744E-06; older group: 81.6% vs 119.35%; P = 2.644E-04). Our ROC curve analysis of CBS hypomethylation showed an area under the curve of 0.713, a sensitivity of 67.4%, and a specificity of 74.0%. Conclusion Our study suggests that hypomethylation of the CBS promoter may be closely related to the risk of cerebral infarction and may be used as a non-invasive diagnostic biomarker for cerebral infarction.

Population-based assessment of visual impairment and pattern of corneal disease: results from the CORE (Corneal Opacity Rural Epidemiological) study

2019 ◽  
Vol 104 (7) ◽  
pp. 994-998
Author(s):  
Ritika Mukhija ◽  
Noopur Gupta ◽  
Praveen Vashist ◽  
Radhika Tandon ◽  
Sanjeev K Gupta
Keyword(s):  
General Population ◽  
Visual Impairment ◽  
Epidemiological Study ◽  
Age Groups ◽  
Corneal Opacity ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study ◽  
Corneal Disease ◽  
Corneal Opacities

ObjectiveTo characterise types of corneal diseases and resulting visual impairment (VI) in a rural North Indian population.DesignCross-sectional, population-based study.MethodsThe Corneal Opacity Rural Epidemiological study included 12 899 participants from 25 random clusters of rural Gurgaon, Haryana, India to determine the prevalence of the corneal disease in the general population. Sociodemographic details, presence and type of corneal morbidity, laterality, VI (presenting visual acuity (PVA) <6/18 in the better eye) and characteristics of corneal opacities were noted.ResultsOverall, 12 113 participants of all ages underwent detailed ophthalmic examination and prevalence of corneal opacity was found to be 3.7% (n=452) with bilateral involvement in 140 participants (31%) during the house-to-house visits. Of the total 571 eyes of 435 patients presenting with corneal opacity at the central clinic, PVA was <3/60 in 166 (29.1%), 3/60 to <6/60 in 14 (2.5%), 6/60 to <6/18 in 164 (28.7%), 6/18 to ≤6/12 in 85 (14.9%) and 6/9 to 6/6 in 142 eyes (24.9%), respectively. Further, there were a total of 115 eyes (20.1%) with nebular corneal opacity, 263 (46.1%) with macular, 162 (28.4%) with leucomatous and 31 (5.4%) with an adherent leucoma. The odds of having VI due to corneal disease were greater for the illiterate (OR:4.26; 95% CI: 2.88 to 6.31; p<0.001) and elderly (OR:11.05; 95% CI: 7.76 to 15.74; p<0.001).ConclusionThe data from this study give an insight into the characteristics of various corneal pathologies and resulting VI in the general population. This is a pioneer study involving all age groups on the burden of VI due to corneal diseases.

scholarly journals A comparative study of the epidemiology of Treponemal Infection in the Volta Region of Ghana: A Five-Year Multisite Parallel Population-Based Analysis vis-à-vis the Sentinel Survey

2019 ◽  
Author(s):  
Sylvester Yao Lokpo ◽  
Ellis Owusu-Dabo ◽  
John Gameli Deku ◽  
Verner Ndudiri Orish ◽  
Gideon Kye-Duodu ◽  
...  
Keyword(s):  
General Population ◽  
Pregnant Women ◽  
Blood Donors ◽  
Blood Donation ◽  
Age Groups ◽  
Population Based ◽  
Gender Disparity ◽  
Treponemal Infection ◽  
Volta Region ◽  
Study Sites

Abstract Abstract Background: Treponemal infection is contagious and one of the oldest blood-borne infections, with great public health consequences. This study aimed to comparatively describe the five–year (2013-2017) regional epidemiology of Treponemal infection using pregnant women in the Sentinel Survey and apparently healthy blood donors as proxy for the general population at the four sentinel sites in the Volta Region of Ghana. Method: We analysed retrospectively data from 17,744 prospective blood donors aged between 18 to 58 years and 7,805 pregnant women in a Sentinel Survey who fell within the 15 and 49 years age bracket at Hohoe, Ho, Tongu and Krachi-West sentinel sites in the Volta Region. Data extracted included age, gender, date of blood donation and Treponena pallidum chromatographic immunoassay results from the blood banks of the four study sites. Published reports of Sentinel Surveys conducted at the four sentinel sites from the years 2013-2017 were retrieved. Results: The cumulative five-year prevalence of Treponemal infections among the pregnant women in the Sentinel Survey and prospective blood donors was 0.38% and 2.38% respectively. Site-specific prevalence for population-base/Sentinel survey was 4.6%/0.4%, 2.0%/0.2%, 1.3%/0.8 and 1.2%/0.2 for Hohoe, Ho, Krachi-West and Tongu respectively. Treponemal infection rates among the younger age groups (15-24years) were 0.31% in the sentinel survey and 2.22% in the general population. Significant gender disparity in Treponemal infection exist with male preponderance. Conclusion: The regional prevalence of Treponemal infection in the Sentinel Survey is lower compared to the general population. Therefore, the use of pregnant women as proxy for population estimate could lead to underestimation of the burden in the study jurisdiction.

scholarly journals SF-36 predicts 13-year CHD incidence in a middle-aged Swedish general population

2019 ◽  
Vol 29 (4) ◽  
pp. 971-975
Author(s):  
Evalill Nilsson ◽  
Karin Festin ◽  
Mats Lowén ◽  
Margareta Kristenson
Keyword(s):  
General Population ◽  
Predictive Ability ◽  
Population Based ◽  
Health Study ◽  
Mortality Data ◽  
Middle Aged ◽  
Sf 36 ◽  
All Cause Mortality ◽  
Related Quality ◽  
Health Related

Abstract Purpose To study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population. Methods The population-based, longitudinal “Life-conditions, Stress and Health” study, in 2003–2004 enrolled 1007 persons aged 45–69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries. Results Seven of the eight SF-36 scales predicted CHD (sex- and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (self-reported) disease did not, in most cases, alter these significant predictions. Conclusion Low SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.

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