Influence of patient age and colorectal polyp size on histopathology findings

BACKGROUND: Colorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening. AIM: To assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size. METHODS: Retrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older. RESULTS: A total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia. CONCLUSION: Polyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.

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Demographic And Histopathological Characteristics Of Colorectal Polyps: A Descriptive Study Based On Samples Obtained From Symptomatic Patients

Slovenian Journal of Public Health ◽

10.1515/sjph-2016-0016 ◽

2016 ◽

Vol 55 (2) ◽

pp. 118-123

Author(s):

Genta Cekodhima ◽

Altin Cekodhima ◽

Arben Beqiri ◽

Mehdi Alimehmeti ◽

Gerhard Sulo

Keyword(s):

Colorectal Cancer ◽

Histopathological Examination ◽

Colorectal Polyps ◽

Medium Size ◽

Polyp Size ◽

Patient Age ◽

Patient Âgé ◽

Potentially Malignant ◽

Study Population ◽

And Gender

Abstract Background Colorectal polyps (CP) are common among individuals older than 50 years. Some polyp types can precede colorectal cancer (CRC). This study aimed at describing histopathological characteristics of colorectal polyps in relation to age and gender among symptomatic patients referred for a colonoscopy examination during 2011-2014 in Tirana, Albania. Methods Study population included 267 individuals aged ≥ 20 years and diagnosed with ≥ 1 polyp during a colonoscopy examination. A total of 346 polyps were identified, excised and measured, and underwent histopathological examination. Results Adenomas accounted for 79.8% of all polyps and tubular type was the most frequent one (74.4%). The majority of polyps (42.5%) were small (<1 cm), 38.7% of a medium size (1-2 cm) and 18.8% large (>2 cm). Adenomas were larger than non-adenomatous polyps (p<0.01) There was no gender difference with regard to patient age (p=0.22) or polyp size (p=0.84) Adenomas were more frequent among men compared to women (p=0.02). Age was strongly related to polyp characteristics. The proportion of adenomas increased significantly with age (p<0.01). Within adenomas, the proportion of villous types - a precursor of colorectal cancer - increased remarkably with age (p=0.01). Older age was positively associated with potentially malignant adenomas (defined as adenomas > 1 cm and showing high-grade dysplasia) (p<0.01). Conclusion Adenomas accounted for the majority of polyps. Their morphology, size and malignant potential were related to patient age.

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Health-related quality of life in different trimesters during pregnancy

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01811-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Huailiang Wu ◽

Weiwei Sun ◽

Hanqing Chen ◽

Yanxin Wu ◽

Wenjing Ding ◽

...

Keyword(s):

Quality Of Life ◽

Pregnant Women ◽

Demographic Data ◽

Cross Sectional Study ◽

University Hospital ◽

Health Related Quality ◽

Cross Sectional ◽

Related Quality ◽

Health Related

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

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The epidemiology of Moebius syndrome in Italy

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01808-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Arturo Carta ◽

Stefania Favilla ◽

Giacomo Calzetti ◽

Maria Cristina Casalini ◽

Pier Francesco Ferrari ◽

...

Keyword(s):

Demographic Data ◽

Geographical Area ◽

National Level ◽

Age At Diagnosis ◽

University Hospital ◽

Italian Population ◽

Moebius Syndrome ◽

Cross Sectional ◽

Geographical Regions ◽

Chi Square Analysis

Abstract Background The epidemiology of Moebius syndrome (MBS) is difficult to assess. In the present study, we investigated the epidemiology of MBS in a well-defined population within a precise geographical area. Materials and methods Our university hospital is the only national referral center for the diagnosis and treatment of MBS. Participants in this cross-sectional study were patients affected by MBS who had been periodically followed by our medical staff since 1998. Most of the patients were referred to our hospital by the Italian Association of Moebius Syndrome (AISMO). Demographic data necessary for study purposes were made available in the AISMO database, updated to April 2018. Subjects were assigned to geographical macroareas that are conventionally used in surveys and epidemiological investigations by the Italian National Institute of Statistics. The rates and prevalence of MBS cases were calculated on the basis of the last available survey of the Italian population. Each study parameter was then calculated with reference to the whole country and macroarea partition. The sex rate and the corresponding prevalence were calculated with respect to the weighted whole population and to the respective sex population. Chi-square analysis was adopted to investigate possible differences among geographical regions and/or sexes. A p value < 0.05 was considered statistically significant. Results One hundred and sixty-four out of 212 MBS patients fulfilled our inclusion criteria. All cases occurred in Caucasian patients and were sporadic. The median age at diagnosis was 3.6 years, ranging from 0 to 55 years; this range was significantly reduced to 0–5 years (median age at diagnosis: 2.2 years) in patients included after 2007. The calculated prevalence at birth was 0.06 cases per 10,000 live births, with an overall prevalence of 0.27/100,000, without any sex or geographical predominance. Conclusions The prevalence of MBS observed herein, rounded for possible underestimation, was 0.3/100,000 people, without any regional difference in the distribution of cases. Our data confirm the rarity of the disease on a national level.

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Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.919 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 1

Author(s):

Sidra Hameed ◽

Faisal Faiyaz Zuberi ◽

Sagheer Hussain ◽

Syed Khalid Ali

Keyword(s):

Risk Factors ◽

Pulmonary Tuberculosis ◽

Demographic Data ◽

Sampling Technique ◽

Cross Sectional Study ◽

University Hospital ◽

Smoking History ◽

Cross Sectional ◽

Creative Commons ◽

Smear Positive Pulmonary Tuberculosis

Objective: To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods: A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results: Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion: Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases. doi: https://doi.org/10.12669/pjms.35.5.919 How to cite this:Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.919 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Evaluation of Hepatitis C Patients' Satisfaction Regarding Care and Treatment in Different Hospitals in Cairo, Egypt, 2020

QJM ◽

10.1093/qjmed/hcab118.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Shaimaa S Yousef ◽

Lamyaa S Al Bagoury ◽

Sahar A Dewedar ◽

Sahar M Sabbour ◽

Wagida A Anwar

Keyword(s):

Viral Hepatitis ◽

Demographic Data ◽

University Hospital ◽

Health Providers ◽

Cross Sectional ◽

Indirect Measure ◽

Patients Satisfaction ◽

Significant Difference ◽

Care And Treatment

Abstract Background Patient satisfaction can be considered as an indirect measure of health outcomes and quality of provided services. Objectives To compare HCV patients' satisfaction regarding care and treatment in different selected Viral Hepatitis Outpatients Clinics in Cairo. Method: The current study is a cross sectional study. It recruited 300 HCV patients from Viral Hepatitis Outpatients Clinics in University, Ministry of Health (MOH) and Insurance Hospitals (100 HCV patients from each clinic). Recruited HCV patients attended at least 2 visits to the Viral Hepatitis Clinics. They completed an interview questionnaire about socio- demographic data, history of diagnosis of HCV, onset and type of treatment and Hepatitis Patients Satisfaction Questionnaire (HPSQ). Results Mean age of HCV patients were (48.9 ±13.5), (50.4 ± 10.4), and (54.8 ± 10.9) from University, MOH and Insurance Hospitals, respectively. Females accounted for (63%) of HCV patients in University Hospital sample however, males were (54%) and (57%) in MOH and Insurance Hospitals, respectively. Most of studied HCV patients were referred by specialists; (59%), (86%) and (87%) from University, MOH, and Insurance Hospitals, respectively. A statistically significant difference was found between the 3 Clinics as regards rating the quality of received HCV services, meeting patients’ needs, coping with HCV disease, and helping patients access to specialist services (p < 0.01). The study revealed that the majority of health providers in the 3 Viral Hepatitis Clinics didn't involve HCV patients in making decisions about their treatment. Conclusion HPSQ findings identified University Hospital's patients more satisfied about their HCV treatment management than MOH and Insurance Hospitals' patients except for involvement of HCV patients in making decisions which was lacking in the 3 hospitals.

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Trait-anxiety and pain intensity predict symptoms related to dysfunctional breathing (DB) in patients with chronic pain

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2016.05.020 ◽

2016 ◽

Vol 12 (1) ◽

pp. 123-123

Author(s):

L.S. Nævestad ◽

S. Halvorsen ◽

G. Kvarstein

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Trait Anxiety ◽

Strong Predictor ◽

Demographic Data ◽

Brief Pain Inventory ◽

University Hospital ◽

Cross Sectional ◽

Pain Clinics ◽

Dysfunctional Breathing

Abstract Aims The purpose of this cross-sectional study was to inves-tigate the occurrence of symptoms related to dysfunctional breathing (DB) in chronic pain patients and to examine factors associated with these symptoms. Methods A questionnaire was sent to 527 adults referred to out-patient pain clinics at Oslo university hospital. The questionnaire provided demographic data, Brief Pain Inventory, Spielberger state- trait anxiety inventory, and Nijmegen questionnaire (NQ). Multiple regression analyses were performed using SPSS. Results A total of 108 patients (20%) responded to the questionnaire and was included. Mean age was 49 years and two third of the participants were female. More than four out of ten had a NQ score ≥ 23 (a conservative cutoff value for DB). The median NQ score in the sample was 19. Trait-anxiety (Beta = .412, p < 0.001) and maximal pain intensity during the past week (Beta = .264, p = 0.004) predicted symptoms related to DB even when controlling for age and gender. Conclusions The study shows that a large portion of patients with chronic pain experiences symptoms that have been associated with hyperventilation and DB and at a higher level than previously reported. Although trait-anxiety is a strong predictor for symptoms related to DB, we find it interesting that maximal pain intensity during the last week also was associated with these symptoms. The cross-sectional design, low response rate, and lack of diagnoses limit our ability to draw conclusions about causal relationship and extrapolate to a larger populations of patients with chronic pain.

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Size of colorectal polyps determines time taken to remove them endoscopically

Endoscopy International Open ◽

10.1055/a-0587-4681 ◽

2018 ◽

Vol 06 (05) ◽

pp. E610-E615

Author(s):

Heechan Kang ◽

Mo Thoufeeq

Keyword(s):

Multivariate Analysis ◽

Time Allocation ◽

Univariate Analysis ◽

Lateral Spreading ◽

Procedure Time ◽

Retrospective Case ◽

Polyp Size ◽

Patient Age ◽

Patient Âgé ◽

The Mean

Abstract Background an study aims Polypectomy and endoscopic mucosal resection (EMR) are effective and safe ways of removing polyps from the colon at endoscopy. Guidelines exist for advising the time allocation for diagnostic endoscopy but not for polypectomy and EMR. The aim of this study was to identify if time allocated for polypectomy and EMR at planned therapeutic lists in our endoscopy unit is sufficient for procedures to be carried out. We also wanted to identify factors that might be associated with procedures taking longer than the allocated time and to identify factors that might predict duration of these procedures. Patients and methods A retrospective case study of planned 100 lower gastrointestinal EMR and polypectomy procedures at colonoscopy and sigmoidoscopy was performed and analyzed with quantitative analysis. Results The mean actual procedural time (APT) for 100 procedures was 52 minutes and the mean allocated time (AT) was 43.05 minutes. Hence the mean APT was 9 minutes longer than the mean AT. Factors that were significantly associated with procedures taking longer than the allocated time were patient age (P = 0.029) and polyp size (P = 0.005). Factors that significant changed the actual procedure time were patient age (P = 0.018), morphology (P = 0.002) and polyp size (P < 0.001). Procedures involving flat and lateral spreading tumor (LST) type polyps took longer than the protruding ones. On multivariate analysis, polyp size was the only factor that associated with actual procedure time. Number of polyps, quality of bowel preparation, and distance of polyp from insertion did significantly change procedure duration. Conclusion Factors that significantly contribute to duration of polypectomy and EMR at lower gastrointestinal endoscopy include patient age and polyp size and morphology on univariate analysis, with polyp size being the factor with a significant association on multivariate analysis. We recommend that endoscopy units take these factors into consideration locally when allocating time for these procedures to be safe and effective.

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Patient-level and practice-level factors associated with consultation duration: a cross-sectional analysis of over one million consultations in English primary care

BMJ Open ◽

10.1136/bmjopen-2017-018261 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018261 ◽

Cited By ~ 14

Author(s):

Sarah Stevens ◽

Clare Bankhead ◽

Toqir Mukhtar ◽

Rafael Perera-Salazar ◽

Tim A Holt ◽

...

Keyword(s):

Older Patient ◽

Consultation Rate ◽

Patient Age ◽

Cross Sectional ◽

Face To Face ◽

Practice Level ◽

Patient Level ◽

Patient Gender ◽

Patient Âgé ◽

General Practices

ObjectivesConsultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care.Design and settingCross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement.Participants218 304 patients, from 316 English general practices, consulting from 1 April 2013 to 31 March 2014.AnalysisMultilevel mixed-effects models described the association between consultation duration and patient-level and practice-level factors (patient age, gender, smoking status, ethnic group, deprivation and practice rurality, number of full-time equivalent GPs/nurses, list size, consultation rate, quintile of overall QOF achievement and training status).ResultsMean duration of face-to-face GP consultations was 9.24 min and 5.32 min for telephone consultations. Nurse face-to-face and telephone consultations lasted 9.70 and 5.73 min on average, respectively. Longer GP consultation duration was associated with female patient gender, practice training status and older patient age. Shorter duration was associated with higher deprivation and consultation rate. Longer nurse consultation duration was associated with male patient gender, older patient age and ever smoking; and shorter duration with higher consultation rate. Observed differences in duration were small (eg, GP consultations with female patients compared with male patients were 8 s longer on average).ConclusionsSmall observed differences in consultation duration indicate that patients are treated similarly regardless of background. Increased consultation duration may be beneficial for older or comorbid patients, but the benefits and costs of increased consultation duration require further study.

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Food Insecurity in a Pediatric Emergency Department and the Feasibility of Universal Screening

Western Journal of Emergency Medicine ◽

10.5811/westjem.2021.7.52519 ◽

2021 ◽

Vol 22 (6) ◽

pp. 1295-1300

Author(s):

Jaqueline Valdez Gonzalez ◽

Emily Hartford ◽

Jennifer Moore ◽

Julie Brown

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Food Insecurity ◽

Private Insurance ◽

Care Quality ◽

Screening Methods ◽

Patient Age ◽

Cross Sectional ◽

Patient Âgé ◽

Medical Complexity

Introduction: Children with food insecurity (FI) experience adverse health outcomes due to inadequate quantity or quality of food. Food insecurity may be high among families seeking emergency care. The Hunger Vital Sign (HVS) is a two-question validated tool used to screen families for FI. Our goal in this study was to assess prevalence of FI among emergency department (ED) patients, patient-level risk factors for FI, and the feasibility of screening. Methods: This was a cross-sectional analysis of FI in the ED. Parents or guardians of ED patients and adult patients (18 years or older) were approached for screening using the HVS during screening periods spanning weekdays/weekends and days/evenings. All ED patients were eligible, excluding siblings, repeat visits, critically ill patients, minors without a guardian, and families that healthcare staff asked us not to disturb. Families answered the HVS questions verbally or in writing, based on preference. Families with positive screens received information about food resources. We summarized patient and visit characteristics and defined medical complexity using a published algorithm. Multivariable logistic regression was used to assess FI risk factors. Results: In July-August 2019, 527 patients presented during screening periods: 439 agreed to screening, 18 declined, 19 met exclusions, and 51 were missed. On average the screening tool required five minutes (range 3-10 minutes) to complete. Most families (328; 75%) preferred to answer in writing rather than verbally. Overall, 77 participants (17.5%) screened positive for FI. In regression analyses, FI was associated with self-reported race/ethnicity (combined variable) of African American or Black (odds ratio [OR] 5.21, 95% confidence interval [CI], 2.13-12.77), Hispanic (OR 3.47, 95% CI, 1.48-8.15), or mixed/other (OR 3.81, 95% CI, 1.54-9.39), compared to non-Hispanic white. FI was also associated with public insurance type (OR 5.74, 95% CI, 2.52-13.07, reference: private insurance), and each year of increasing patient age (OR 1.05, 95% CI, 1.01-1.09). There were no associations between FI and medical complexity or preferred language. Conclusion: Food insecurity was common among our ED patients. Race and ethnicity, insurance status, and increasing patient age were associated with increased odds of FI. Efforts to include universal FI screening for ED patients with immediate connection to resources will enhance overall care quality and address important health needs.

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PREVELENACE OF LOW BACK PAIN AMONG NURSES WORKING IN ELMAK NIMER UNIVERSITY HOSPITAL – SHENDI - SUDAN 2015

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v3.i9.2015.2951 ◽

2015 ◽

Vol 3 (9) ◽

pp. 108-121

Author(s):

MuaadhAbdulghaniGhaithan Al-samawi ◽

Higazi Mohammed Ahmed Abdallah Awad

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Demographic Data ◽

Work Load ◽

University Hospital ◽

Low Back ◽

Related Factors ◽

Cross Sectional ◽

Work Related

Globally, Low Back Pain (LBP) comprises a significant occupational hazard in nursing profession. Objectives: To estimate the incidence, to identify risk factors, and impact of illness of LBP among nurses in AL-MakNimer university Hospital at Shendi city. A cross-sectional study was applied including nurses in AL-MakNimer university Hospital at Shendi city, republic of Sudan throughout the period May -June, 2015. Sample was chosen by using total coverage sample. A predesigned questionnaire was used for data collection. The questionnaire included demographic data, work-related factors as well as effect and management of LBP data obtained were analyzed using manually and by used SPSS soft program. Results: The results revealed that the overall incidence of low back pain among nurses was (n=70, 87.5%) Female participants complaining of LBP were significantly more than male participants (85%) of the total female reported LBP. There were significantly relate between age and working hours (.015) it can be seen that about (40%) of the participants experienced LBP at least once a week or more frequently. 52.9% subjects rated their pain as moderate pain. 35.7% nurses' concept regarding factors contributing to their LBP were lifting as well as 28.6% working load,(52.9%) sleep disturbance, (64.3%) restrict activities were nurse comment regarding LBP effect. LBP is a common health problem among working nurse, lifting, work load, were the most perceived work-related risk factors for LBP, restrict activities, taking many days off, might be the most predisposed effect related to LBP. Recommendation: These findings suggest that hospitals should focus and attempt to improve the ergonomics of nursing activities. In addition, effective methods of implementing changes in work systems are needed.

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