scholarly journals Tuberculosis Diagnostics and Susceptibility in Saudi Arabia’s Western Region

2020 ◽  
Vol 8 (`11) ◽  
pp. 430-436
Author(s):  
Mohammed Qutub ◽  
Ghassan Wali ◽  
Basem Alraddadi ◽  
Nezar Bahabri ◽  
Yasser Aldabbagh ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Elderly Population ◽  
The Elderly ◽  
Nucleic Acid Amplification ◽  
Multi Drug Resistance ◽  
Tuberculosis Complex ◽  
First Line ◽  
King Faisal Specialist Hospital ◽  
Younger Age ◽  
Extrapulmonary Site

Introduction: Saudi Arabia has a moderate infection rate of tuberculosis (TB) in comparison to other countries in the region. The prevalence of TB varies among different parts of the Kingdom, with its western provinces reporting to have the leading rate of incidence. Method : In this retrospective study, Acid-fast bacilli smear (AFB), and nucleic acid amplification test (NAAT) were performed on all positive cultures from 254 identified TB cases from November 2006 to August 2016 in King Faisal Specialist Hospital and Research Center – Jeddah, Saudi Arabia. Results: From the positive cultures for Mycobacterium tuberculosis complex, 99.1% were found to be positive by using NAAT. From the NAAT positive samples, only 36.8% were positive for AFB. TB was predominant among the younger age group (59.4%) compared to the elderly population (35.8%) and pediatrics (4.7%), and it was also observed that males had a higher prevalence of 56.3 % in comparison to females. In regards to the site of infection, 53.1 % were pulmonary and 46.9% from an extrapulmonary. It was noted that resistance to first-line anti-TB drugs individually was found to be 11.0% to Streptomycin, 10.2% to isoniazid, 5.1% to pyrazinamide, 2.4% to Rifampicin, and 1.2% Ethambutol, yet multi-drug resistance (MDR) was found in 2.4% of observed cases. Conclusion: Young age predominance, low direct smear positivity, increased incidence of the extrapulmonary site of infection, and re-emergence of TB resistance all were observed in our study compared to previous national surveys.

The Role of Novel Bone Forming Agents in the Treatment of Osteoporosis

2020 ◽  
pp. 089719002096122
Author(s):  
Hansita B. Patel ◽  
Lynsie J. Lyerly ◽  
Cheryl K. Horlen
Keyword(s):  
Elderly Population ◽  
Cost Effective ◽  
The Elderly ◽  
Bisphosphonate Therapy ◽  
Evidence Based ◽  
First Line ◽  
Treatment Of Osteoporosis ◽  
Cost Effective Treatment

Osteoporosis is a growing epidemic that leads to significant morbidity and mortality among the elderly population due to associated fractures that lead to disabilities and reduced quality of life. Bisphosphonates are well-established as a first-line and cost-effective treatment for osteoporosis. Unfortunately, clinicians are often uncertain as to how to select treatments when bisphosphonates are ineffective as initial treatment or contraindicated. Romosozumab and abaloparatide are 2 alternative agents that have been recently FDA approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture or patients who have failed or are intolerant to other osteoporosis therapies. Currently, the National Osteoporosis Foundation (NOF) has no formal recommendations in regard to these 2 novel agents. The purpose of this review is to help guide pharmacists on how to ensure appropriate utilization of these 2 novel bone-forming agents as potential alternatives to bisphosphonate therapy by providing evidence-based recommendations according to the current literature and key counseling points.

scholarly journals Lipid Management in the Elderly Population

2021 ◽  
Vol 3 (1) ◽  
pp. 60-63
Author(s):  
Micheli Ito Gimenes Pires ◽  
Thaise de Araujo Wrubleski ◽  
Gustavo Lenci Marques
Keyword(s):  
Elderly Population ◽  
Cholesterol Absorption ◽  
The Elderly ◽  
Population Ageing ◽  
Blood Levels ◽  
C Reactive Protein ◽  
First Line ◽  
Intestinal Cholesterol Absorption ◽  
Lipid Management ◽  
Reactive Protein

Considering that deaths from cardiovascular disease have been increasing in proportion to population ageing, prevention and treatment of dyslipidemia in elderly people is essential to avoid such outcome. Some biomarkers, albeit with limitations, have shown effectiveness in predicting cardiovascular events. Among them, blood levels of C-reactive protein, Lipoprotein A and, especially, coronary artery calcium. Dyslipidemia management primarily includes changes in lifestyle, such as physical activity, diet and smoking cessation. However, in elderly, drug therapy may be necessary, with statins being the first line treatment. In addition, therapies with drugs that decrease intestinal cholesterol absorption or increase LDL absorption by the liver, for example, have shown benefit when added to conventional therapy. Therefore, this review aims to contemplate some aspects of dyslipidemia in the elderly population, since appropriate management of such condition can significantly avoid undesirable outcomes.

scholarly journals 777. Ten-Year Experience of Tertiary Hospital Regarding Epidemiology, Diagnostic Method, and Drug Resistance of Tuberculosis—Jeddah, Saudi Arabia

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S278-S278
Author(s):  
Mohammed Qutub ◽  
Yasser Aldabbagh ◽  
Prasanth Govindan ◽  
Ebtihal Alamoudi
Keyword(s):  
Saudi Arabia ◽  
Diagnostic Method ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Young Age ◽  
Nucleic Acid Amplification ◽  
Tuberculosis Complex ◽  
High Clinical Suspicion ◽  
Extra Pulmonary ◽  
And Gender

Abstract Background The prevalence of tuberculosis across Saudi Arabia is variable with western provinces have the highest incidence. This study aimed to determine the epidemiology of tuberculosis in Jeddah, the age and gender distribution and the accuracy of conventional diagnostic method, for better understanding of tuberculosis-resistant pattern in the country. Methods Three hundred forty-four culture proven tuberculosis where collected from November 2006 to November 2016 in KFSHRC. AFB smear and nucleic acid amplification test (NAAT) were conducted in all positive cultures, and all data were analyzed using SPSS. Mean days number to culture positivity was 12.79. Results TB showed young age predominant (59.5%) compared with older population (37.0%) and pediatrics (3.5%), with 55.4% males and 44.6% females, 54.8% of samples were taken from pulmonary and 45.2% from extra pulmonary site of infection. 68.3% and 5.9% of the tuberculosis proven culture were negative by using AFB smear and NAAT, respectively, and only 68.8% were positive for mycobacterium tuberculosis complex by using NAAT. Resistant level to first-line anti tuberculosis of 12.5%, 10.3%, 5.2%, 2.6%, 1.3%, 2.6% to Streptomycin, isoniazid, pyrazinamide, Rifampicin, Ethambutol and multidrug-resistant, respectively, was observed in our study. Conclusion Young age predominance, high values of negative smear and NAAT increased incidence of extra pulmonary site of infection and Re-emergence of tuberculosis resistant which was observed in our study compared with previous national surveys (Illustrated in Figure 1), all should alter physicians’ Attention when investigating patients in Saudi Arabia and high clinical suspicion should be considered. Disclosures All authors: No reported disclosures.

Screening the Elderly in the Community for Psychiatric Disorder

1990 ◽  
Vol 24 (2) ◽  
pp. 203-206 ◽  
Author(s):  
B. J. Mowry ◽  
P. W. Burvill
Keyword(s):  
Anxiety Disorders ◽  
Psychiatric Disorder ◽  
Elderly Population ◽  
Age Groups ◽  
The Elderly ◽  
Screening Instrument ◽  
Younger Age ◽  
Community Population

The use of the 30-item GHQ as a screening instrument in a community population aged 70 years and older was examined. An acceptable sensitivity (70%) and specificity (84%) was obtained. As in the younger age groups, the GHQ was not good at detecting chronic, generalised anxiety disorders. The GHQ is best used in combination with the MMSE to screen out cases of dementia in an elderly population.

Benefits of Early Hemoglobin Response to Epoetin Alfa in Elderly Patients with Chemotherapy-Related Anemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2216-2216
Author(s):  
James Rosberg ◽  
Pierre Y. Cremieux ◽  
Scott R. McKenzie ◽  
John M. Fastenau ◽  
Catherine T. Piech
Keyword(s):  
Elderly Population ◽  
Age Groups ◽  
Response Rates ◽  
The Elderly ◽  
Epoetin Alfa ◽  
Elderly Age ◽  
Younger Age ◽  
Transfusion Requirements ◽  
Clinical Benefits

Abstract Background: Previous research has shown early hemoglobin (Hb) response to epoetin alfa (EPO) therapy is associated with reduced transfusion requirements, higher Hb response rates, quality of life score improvements, and decreased EPO drug utilization. This subgroup analysis of elderly (age >/=65) patients (pts) with chemotherapy-related anemia (CRA) assesses the benefit of an early Hb response in this distinct population. Methods: Data from three large multicenter EPO clinical trials were evaluated. In EPO 1, pts received 10,000 Units TIW with potential escalation to 20,000 Units TIW. In EPO 2 and EPO 3, pts received 40,000 Units QW with escalation to 60,000 Units QW. Pts eligible for this analysis were >/=65 years of age with a non-myeloid malignancy, had a baseline Hb </=11g/dL, and received chemotherapy with or without radiotherapy (EPO 1: N=935: EPO 2: N=1,270; EPO 3: N=269). Early Hb response was defined as >/=1g/dL Hb rise following four weeks of EPO therapy, independent of transfusion in the prior 28 days. Three outcomes of pts who exhibited early Hb response were compared to those of pts who did not: proportion of pts requiring transfusion, subsequent Hb response (Hb rise >/=2 g/dL independent of transfusion), and average weekly EPO dose. Results: Early Hb response was observed in 54.1%, 47.5%, and 47.2% of pts from EPO 1, 2 and 3, respectively. In all trials, early responders had markedly lower transfusion use (EPO 1: 7.6% v 22.5%, p<.0001; EPO 2: 5.4% v 18.7%, p<.0001; EPO 3: 8.8% v 17.2%, p=.0525), higher subsequent Hb response (EPO 1: 78.7% v, 47.6%; EPO 2: 84.0% v 46.2%, EPO 3: 72.8% v. 47.8%, all studies p<.0001), and lower average weekly EPO dose (EPO 1: 30,467 vs. 40,594 Units, EPO 2: 39,286 vs. 47,310 Units; EPO 3: 38,043 v. 45,835 Units; all studies p<.0001). Conclusions: Elderly cancer pts achieving an early Hb response to EPO QW or TIW experienced greater clinical benefits (lower proportion of pts transfused, higher subsequent Hb response rates, and less EPO utilization) compared to pts who did not. These findings are consistent with analyses involving pts with younger age groups. As early Hb response is associated with clinical benefits, it should be an important goal of erythropoietic therapy for chemotherapy-induced anemia, especially in the elderly population, as demonstrated here.

Clinical outcomes of FOLFIRINOX and gemcitabine-nab-paclitaxel for metastatic pancreatic cancer in the real-world setting.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 656-656
Author(s):  
Fabio Franco ◽  
Jose Ignacio Martin Valades ◽  
David Marrupe ◽  
Juan Carlos Camara ◽  
David Gutierrez Abad ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Elderly Population ◽  
Survival Rates ◽  
The Elderly ◽  
Metastatic Pancreatic Cancer ◽  
Second Line ◽  
First Line ◽  
The Real ◽  
Ca 19.9

656 Background: Randomized clinical trials have established new chemotherapeutic standards of care for metastatic pancreatic cancer, namely FOLFIRINOX (FFX) and gemcitabine + nab-paclitaxel (GNP) after demonstrating a significant and relevant increase of overall survival. However, there are some important uncertainties regarding how many patients are candidate to each of the two new regimens in the real life and how is the pattern of use in the elderly population. Methods: This is a retrospective study. Departments of Pharmacy of 7 Spanish hospitals generated the listings of patients (pts) treated in first line with these new regimens (FFX or GNP). Non-metastatic patients were excluded. An exploratory analysis was performed in the elderly population. Results: From Jan 2012 to Dec 2017, a total of 119 pts (M/F 58/42 %) were treated. Med age 63 y (38-83 y), 99% adenocarcinoma. 40% located in the head of pancreas. ECOG 87% 0-1. 89% had liver mets. In the 1st line 49.6% were treated with FFX and 50.4% with GNP. 53% of the pts could receive a 2nd line (82% after FFX 75% after GNP). The median OS was 12 months with no statistically significant differences between both regimens (12,7m for FFX vs 10,2 m for GNP). Elevated Ca 19.9 levels and Neutrophil-Lymphocyte ratio (NLR) increased the risk of death. Patients who received both regimens in first/second line had a median OS longer than 15 months whichever the sequence. 32 patients (27%) were older than 70 yo. 13 (41%) were treated with FFX and 19 (59%) with GNP. The median OS for patients older than 70 was 9.5m versus 12.3m for patients younger than 70. Conclusions: In our setting the use of FFX and GNP for treating metastatic pancreatic cancer is quite similar. Superiority could not be demonstrated for any of the schemes in first-line. Overall survival was determined by basal Ca 19.9 and NLR. Patients receiving both regimens (FFX or GNP) in first/second line whichever the sequence, exhibited the best survival rates. In our series elderly patients had poor survival rates.

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