scholarly journals Israeli Arabs develop diverticulitis at a younger age and are more likely to require surgery than Jews

2015 ◽  
Vol 28 (2) ◽  
pp. 102-104
Author(s):  
Itai GHERSIN ◽  
Nadav SLIJPER ◽  
Gideon SROKA ◽  
Ibrahim MATTER
Keyword(s):  
Surgical Treatment ◽  
Racial Differences ◽  
Rural Areas ◽  
Age Of Onset ◽  
Acute Diverticulitis ◽  
First Episode ◽  
Urban Centers ◽  
Younger Age ◽  
Israeli Arabs ◽  
The Impact

BACKGROUND: Only few studies have examined the impact of racial differences on the age of onset, course and outcomes of diverticulitis. AIM: To provide data about the epidemiology of diverticulitis in northern Israel, and to determine whether ethnicity is a predictor of age of onset, complications, and need for surgery. METHODS: Was conducted a retrospective review of the charts of all patients diagnosed with a first episode of diverticulitis in our hospital between 2005 and 2012. RESULTS: Were found 638 patients with a first episode of acute diverticulitis in the eight year interval. Israeli Arabs developed a first episode of diverticulitis at a younger age compared to Jews (51.2 vs 63.8 years, p<0.01). Arabs living in rural areas developed diverticulitis at a younger age than Arabs living in urban centers (49.4 vs 54.5 years, P=0.03). Jewish and Arabic men developed diverticulitis at younger age compared to their female counterparts (59.9 vs 66.09, p<0.01, and 47.31 vs 56.93, p<0.01, respectively). Arabs were more likely [odds ratio (OR)=1.81 ,95% confidence interval (CI)1.12-2.90, p=0.017] than Jews to require surgical treatment (urgent or elective) for diverticulitis. CONCLUSIONS: Israeli Arabs tend to develop diverticulitis at a younger age and are more likely to require surgical treatment for diverticulitis compared to Jews. Arabs living in rural areas develop diverticulitis at a younger age than Arabs living in urban centers. These findings highlight a need to address the root cause for ethnic differences in onset, course and outcome of acute diverticulitis.

scholarly journals Relationship between substance abuse and first-episode psychosis - a South African perspective

2003 ◽  
Vol 9 (1) ◽  
pp. 5 ◽  
Author(s):  
Sandra Brink ◽  
Piet Oosthuizen ◽  
Robin Emsley ◽  
Irene Mbanga ◽  
Natasha Keyter
Keyword(s):  
Substance Abuse ◽  
South African ◽  
Age Of Onset ◽  
First Episode Psychosis ◽  
First Episode ◽  
Younger Age ◽  
Co Morbidity ◽  
Episode Psychosis ◽  
First Onset ◽  
African Perspective

Background. Co-morbidity between substance abuse and psy- chotic disorders is high. Few studies have examined therelationship between first-episode psychosis and substance abuse. Several questions emerge from this common relationship and many of them remain unanswered.Objectives. To determine the effect of substance abuse on psychosis in terms of onset, duration, severity of symptoms, use of medication and outcome.Method. Thirty - three subjects with first-episode psychosis, as well as primary caregivers, were interviewed re g a rding substance abuse and its relation to illness. Thirty-six control subjects were also interv i e w e d .Results. Twenty-seven per cent of subjects abused substances in the 3 months before onset of illness, and 77.8% of the abusers w e re male. Subjects in the first-episode psychosis group were m o re likely to choose cannabis as their substance of abuse than c o n t rols. They also started abusing substances at a younger age than controls. Subjects with first-episode psychosis who abused substances presented at an earlier age than non-abusers. Substances affected symptoms at baseline presentation .Conclusions. Substance abuse has a significant impact on first- onset psychosis as far as age of onset and symptom severity are c o n c e rned. Subjects with an underlying vulnerability to psychosis seem to start abusing substances at an earlier age than the general population. Males are more likely to abuse substances than females.

scholarly journals Predictors of Clinical Course and Outcomes of Acute Diverticulitis: The Role of Age and Ethnicity

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1269
Author(s):  
Randa Taher ◽  
Yael Kopelman ◽  
Abdel-Rauf Zeina ◽  
Amir Mari ◽  
Fadi Abu Baker
Keyword(s):  
Multivariate Analysis ◽  
Acute Diverticulitis ◽  
Group Analysis ◽  
Age Groups ◽  
Young Patients ◽  
Distal Colon ◽  
Young Age ◽  
First Episode ◽  
Complicated Course ◽  
The Impact

Background and Objectives: Acute diverticulitis (AD) is the leading and most burdensome complication of colonic diverticulosis. However, risk factors for its development and predictors of its course are still poorly defined. In this regard, the association of a young age with a complicated course and worse outcome are still controversial. Moreover, little research has addressed the effect of ethnicity on the course of AD. The current study aimed to evaluate the impact of these variables on AD’s course and outcome in the diverse and unique ethnic landscape of Israel. Materials and Methods: We performed a retrospective review of the charts of patients with a radiologically confirmed diagnosis of AD. Patients’ outcomes and disease course, including hospitalization duration, complications, and recurrent episodes, were documented and compared among different age and ethnic groups. Multivariate analysis was performed to identify predictors of complicated AD. Results: Overall, 637 patients with AD were included, the majority (95%) had distal colon AD, and almost one quarter of them were aged less than 50 years. The majority of patients in the young age (<50) group were males (69.7%). Nonetheless, the rate of recurrent episodes (35.3% vs. 37.3%, p = 0.19), hospitalization duration (5 ± 4.7 vs. 6 ± 3.2, p = 0.09) and complications rate (17.3% vs. 13.7%; p = 0.16) were similar for both age groups. In the ethnicity group analysis, Arab minority patients had a first episode of AD at a significantly younger age compared to their Jewish counterparts (51.8 vs. 59.4 years, p < 0.001). However, factors such as a complicated course (16% vs. 15%; p = 0.08) and relapsing episode rates (33% vs. 38%; p = 0.36) did not differ significantly between groups. None of the variables, including young age and ethnic group, were predictors of complicated AD course in the multivariate analysis. Conclusion: AD is increasingly encountered in young patients, especially in ethnic minority groups, but neither ethnicity nor young age was associated with worse outcomes.

scholarly journals Fate of contralateral asymptomatic bullae in patients with primary spontaneous pneumothorax

2020 ◽  
Vol 58 (2) ◽  
pp. 365-370
Author(s):  
Hyo Jun Jang ◽  
Jun Ho Lee ◽  
Seung Hyuk Nam ◽  
Sun Kyun Ro
Keyword(s):  
Spontaneous Pneumothorax ◽  
Multivariable Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
High Resolution Computed Tomography ◽  
Contralateral Lung ◽  
Younger Age ◽  
Independent Risk Factors ◽  
The Impact

Abstract OBJECTIVES This retrospective cohort study aimed to analyse the impact of asymptomatic blebs/bullae on the occurrence of primary spontaneous pneumothorax (PSP) by monitoring the natural course of contralateral blebs/bullae in patients with ipsilateral pneumothorax. METHODS From January 2003 to December 2017, 1055 patients [age 19.6 ± 3.98 years (mean ± standard deviation), 953 men] experiencing the first episode of unilateral PSP were enrolled in this study, excluding patients aged 30 years or more. The presence, number and maximal size of the blebs/bullae were investigated in contralateral asymptomatic lungs based on high-resolution computed tomography. RESULTS Multiple and single blebs/bullae were noted in contralateral lungs in 425 (40.3%) and 88 (8.3%) patients, respectively. The median follow-up period was 44.0 (interquartile range 71.5) months. The 1-, 3- and 5-year cumulative occurrence rates of PSP in contralateral lungs were 7.9%, 13.7% and 16.7%, respectively. On multivariable analysis, younger age [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.12–1.27; P &lt; 0.001) and multiple bullae (HR 4.42, 95% CI 3.06–6.38; P &lt; 0.001) were independent risk factors for spontaneous pneumothorax in the contralateral lung. The 5-year cumulative occurrence rates of PSP were significantly higher in patients with multiple blebs/bullae than in those with no or a single bleb/bulla (28.2% vs 8.5%, respectively; P &lt; 0.001). CONCLUSIONS Asymptomatic blebs/bullae often lead to PSP. If the patient is eligible for surgery for pneumothorax, preemptive surgery for contralateral bullae could be considered, especially in patients with multiple blebs/bullae.

The impact of Cannabis in Schizophrenia: Pafip Three-year Longitudinal Study on Outcome and Functionality After a First Episode of Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S136-S137
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
M. Fernández Rodríguez ◽  
D. Abejas Díez ◽  
...  
Keyword(s):  
Intervention Program ◽  
Age Of Onset ◽  
Cannabis Use ◽  
First Episode ◽  
Long Term Outcome ◽  
Clinical Prognosis ◽  
Increased Risk ◽  
The Impact

IntroductionThe association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.ObjectivesTo assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.Material and methodsPAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.ConclusionsThe interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Natural History of Anterior Shoulder Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 909-918 ◽  
Author(s):  
Eduardo Palma Carpinteiro ◽  
Andre Aires Barros
Keyword(s):  
Surgical Treatment ◽  
Natural History ◽  
Age Of Onset ◽  
Young Patients ◽  
The Body ◽  
Joint Disease ◽  
First Episode ◽  
Anterior Shoulder Instability ◽  
Bone Lesions ◽  
History Of

Background:The shoulder is the most complex joint in the body. The large freedom of motion in this joint is the main cause of instability. Instability varies in its degree, direction, etiology and volition and there is a large spectrum of conditions.Methods:Based on literature research and also in our own experience, we propose to elucidate the reader about the natural history of instability and its importance for the appropriate management of this pathology, by answering the following questions:What happens in the shoulder after the first dislocation? Which structures suffer damage? Who are the patients at higher risk of recurrence? How does the disease evolve without treatment? Will surgical treatment avoid future negative outcomes and prevent degenerative joint disease? Who should we treat and when?Results:80% of anterior-inferior dislocations occur in young patients. Recurrent instability is common and multiple dislocations are the rule. Instability is influenced by a large number of variables, including age of onset, activity profile, number of episodes,delay between first episode and surgical treatment.Conclusion:Understanding the disease and its natural evolution is determinant to decide the treatment in order to obtain the best outcome. It is crucial to identify the risk factors for recurrence. Delay in surgical treatment, when indicated, leads to worse results. Surgical technique should address the type and severity of both soft tissue and bone lesions, when present.

scholarly journals Genotypes in relation to phenotypic appearance and exposure to environmental factors in Graves' hyperthyroidism

2012 ◽  
Vol 167 (6) ◽  
pp. 783-792 ◽  
Author(s):  
Xander G Vos ◽  
Erik Endert ◽  
Jan G P Tijssen ◽  
Wilmar M Wiersinga
Keyword(s):  
Linkage Disequilibrium ◽  
Environmental Factors ◽  
Daily Hassles ◽  
First Episode ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Specific Analysis ◽  
Younger Age ◽  
Caucasian Patients ◽  
The Impact

BackgroundGenetic polymorphisms and environmental factors are both involved in the pathogenesis of Graves' disease, but their interaction and effect on Graves' phenotypes have scarcely been investigated.ObjectiveTo test the hypothesis that subjects with susceptibility genotypes develop more severe Graves' hyperthyroidism at a younger age and after less exposure to environmental factors, with attention to gender differences.Study designA prospective observational multicenter study in 205 adult Caucasian patients with untreated first episode of Graves' hyperthyroidism.MethodsEvaluation of genotypes (HLA DRB1*03, DQA1*05, DQB1*02; CTLA4 49A/G, CT60 A/G; PTPN22 C/T) in relation to phenotypes (age, sex, severity (clinical, biochemical, and immunological)) of hyperthyroidism and environmental factors (smoking, stress questionnaires).ResultsG-alleles in CTLA4 single nucleotide polymorphisms were dose-dependently associated with younger age at the time of diagnosis and less exposure to daily hassles. In gender-specific analysis, this association is enhanced in men and attenuated in women. Males (but not females) in HLA linkage disequilibrium had more severe (biochemical and immunological) hyperthyroidism and a tendency to younger age at diagnosis, compared with those not in linkage disequilibrium.ConclusionGraves' hyperthyroidism occurs at a younger age with less exposure to environmental factors in subjects carrying susceptibility genotypes. The impact of genotypes seems to be greater in males than in females.

scholarly journals Predictors of treatment resistant schizophrenia: a systematic review of prospective observational studies

2019 ◽  
pp. 1-10 ◽  
Author(s):  
S. E. Smart ◽  
A. P. Kępińska ◽  
R. M. Murray ◽  
J. H. MacCabe
Keyword(s):  
Observational Studies ◽  
Prediction Models ◽  
Age Of Onset ◽  
Treatment Resistance ◽  
Healthcare Services ◽  
First Episode ◽  
Treatment Resistant ◽  
Younger Age ◽  
Future Prediction ◽  
Prospective Longitudinal

AbstractTreatment-resistant schizophrenia, affecting approximately 20–30% of patients with schizophrenia, has a high burden both for patients and healthcare services. There is a need to identify treatment resistance earlier in the course of the illness, in order that effective treatment, such as clozapine, can be offered promptly. We conducted a systemic literature review of prospective longitudinal studies with the aim of identifying predictors of treatment-resistant schizophrenia from the first episode. From the 545 results screened, we identified 12 published studies where data at the first episode was used to predict treatment resistance. Younger age of onset was the most consistent predictor of treatment resistance. We discuss the gaps in the literature and how future prediction models can identify predictors of treatment response more robustly.

scholarly journals Predictors of Treatment-Resistant and Clozapine-Resistant Schizophrenia: A 12-Year Follow-up Study of First-Episode Schizophrenia-Spectrum Disorders

2020 ◽  
Author(s):  
Sherry Kit Wa Chan ◽  
Hei Yan Veronica Chan ◽  
William G Honer ◽  
Tarun Bastiampillai ◽  
Yi Nam Suen ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Age Of Onset ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Treatment Resistant ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia ◽  
The Impact

Abstract Studies on the long-term development and early predictors of treatment-resistant schizophrenia (TRS) and clozapine-resistant TRS (CR-TRS) in patients with first-episode schizophrenia-spectrum disorders (FES) are limited and have not considered the impact of early intervention services (EIS). This study aimed to explore the development of TRS and CR-TRS among patients with FES over 12 years of follow-up. Of the 1234 patients with FES, 15% developed TRS. A total of 450 patients with schizophrenia or schizoaffective disorder were included in a nested case-control study (157 TRS and 293 non-TRS). Younger age of onset, poorer premorbid social adjustment during adulthood, longer duration of first episode, a greater number of relapses, and a higher antipsychotic dose in the first 24 months were associated with earlier TRS. CR-TRS patients, constituting 25% of TRS patients, had a poorer premorbid social adjustment in late adolescence and longer delay before clozapine initiation compared with non-CR-TRS. CR-TRS had poorer clinical and functional outcomes at 12-year follow-up. However, TRS patients on clozapine had a lower mortality rate compared with non-TRS patients. EIS did not have a significant impact on the development of TRS, but patients in the EIS group had a shorter delay of clozapine initiation. Results suggested that neurodevelopmental factors, early clinical characteristics, and requirement for higher antipsychotic dose may be associated with TRS development, highlighting multiple pathways leading to this form of illness. Specific interventions including relapse prevention and early initiation of clozapine during the early course of illness may reduce the rate of TRS and improve patient outcomes.

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