ULTRASOUND DIAGNOSTICS OF CHRONIC CONSTIPATION IN CHILDREN: RESULTS OF A CLINICAL STUDY

2021 ◽  
Vol 100 (6) ◽  
pp. 59-65
Author(s):  
L.N. Tsvetkova ◽  
◽  
M.M. Kolisnichenko ◽  
O.A. Goryacheva ◽  
◽  
...  
Keyword(s):  
Clinical Study ◽  
Anal Sphincter ◽  
Chronic Constipation ◽  
Diagnostic Method ◽  
Age Distribution ◽  
Age Groups ◽  
Pathological Process ◽  
Number Of Patients ◽  
Ultrasound Diagnostics ◽  
Sphincter Insufficiency

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

816 Geographic Analysis of the Outpatient Burn Population of an Urban Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S247-S247
Author(s):  
Mathangi A Chandramouli ◽  
Jamie Heffernan ◽  
Angela Rabbitts ◽  
Philip Chang
Keyword(s):  
Catchment Area ◽  
Burn Injury ◽  
Age Distribution ◽  
Age Groups ◽  
Significant Shift ◽  
Burn Center ◽  
Number Of Patients ◽  
Patterns Of Injury ◽  
Age Range ◽  
Geospatial Mapping

Abstract Introduction Previous work has utilized geospatial mapping of pediatric burn inpatients at a major urban burn center to analyze the distribution of patients across the catchment area. Over the past several years, our center has seen a significant shift in the number of patients cared for inpatient to outpatient care. The purpose of our study was to geographically identify and compare the incidence and location of burn inpatients versus outpatients within the catchment area. Methods Demographic and clinical data from both inpatient and outpatients was collected from a single urban ABA verified burn center over a 3 year period between 1/2016 and 12/2018 with an age range from 1 month to 101 years old. Geriatric patients were defined as age 60 or greater to facilitate comparison with NBR data which breaks down age by decades. The patients were mapped by their home zip code. Results 1985 burn patients were admitted to this single tertiary burn center between 1/2016 and 12/2018 with an age range from 1 month-101 years of age. During the same time period, 11281 outpatient encounters occurred with an age range of 1 month to 101 years of age. 28.9% of the inpatients were 60 years or older while 17.4% of the outpatient encounters involved patients 60 years or older. For pediatrics (< age 16), 31.4% of the inpatients were 15 years and younger vs. 26% of the outpatient encounters. The top “hotspots” for inpatient burn zip codes vs. outpatient burn zip codes were different for 3 of the 6 zip codes compared. Conclusions The inpatient and outpatient populations at this tertiary urban burn center appear to be different with the geographic distribution of the patient’s domicile and the age distribution. Further analysis of the etiologies of burn injury and socioeconomic status of the patients will elucidate additional trends. Applicability of Research to Practice Applying geospatial mapping to a burn center’s outpatient and inpatient populations may reveal differential patterns of injury that can better focus prevention and outreach efforts in the community better target etiologies and age groups.

Features of the complex treatment of ulcerative colitis in clinical practice

2020 ◽  
pp. 6-11
Author(s):  
Svetlana Svetlana ◽  
Mikhail Klimentov ◽  
Olga Neganova ◽  
Alina Nazmieva ◽  
Anastasiya Kochurova
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Statistical Study ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Unknown Etiology ◽  
Number Of Patients ◽  
First Republic ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Nowadays there are certain difficulties in the early diagnosis of ulcerative colitis, proceeding with minimal intestinal symptoms. The etiology of the disease remains unclear to this day; there is no exact information about the prevalence of the disease due to the large number of latent forms and the low number of patients seeking medical help. This article presents the results of a retrospective analysis of the incidence of ulcerative colitis in the coloproctology department of the First Republic Clinical Hospital of Izhevsk. The study was conducted to assess the frequency of occurrence and determine the internal picture of ulcerative colitis. To achieve this goal, we selected 34 patients with ulcerative colitis. A statistical study was conducted on the following criteria: gender composition, age groups, forms of the disease, localization, complications, and main complaints. The length of hospital stay often was not more than 20 days. The literature on this pathology was also studied and presented in the form of a theoretical basis, which consisted of the determination and etiology of inflammatory bowel diseases. Due to the unknown etiology, insufficiently studied pathogenesis, difficult differential diagnosis with other intestinal diseases and insufficiently perfect treatment methods, there are a large number of unresolved problems in the field of ulcerative colitis. That is why, in this article we tried to reveal the problem of the features of the course and complex therapy of that disease in clinical practice.

scholarly journals Updated Incidence of Thyroid Cancer in the North East Region of Romania after 35 Years of Chernobyl Fallout. Is There a Link between?

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 907
Author(s):  
Laura Teodoriu ◽  
Maria Christina Ungureanu ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Delia Ciobanu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Age Distribution ◽  
Age Groups ◽  
Chernobyl Fallout ◽  
Statistical Correlations ◽  
North East ◽  
The North ◽  
East Region ◽  
Radioactive Cloud ◽  
The Moment

Thyroid cancer (TC) represents a worldwide problem, the consistent growth of the incidence increment issues about management of risk factors and curative treatment. Updated statistical data are not complete in the North East region of Romania and need to be improved. Therefore, through this study, we aim to renew the existing data on thyroid cancer. We conducted a retrospective study covering a period of 10 years. Data were collected from a hospital information system (InfoWorld) between 2009 and 2019. Patients’ age groups were stratified in relation with the age at the moment of the Chernobyl event. A database was obtained (Microsoft Excel) and statistical correlations were applied. In the studied period, 1159 patients were diagnosed: 968 females and 191 males, distributed by region, with the highest addressability in Iasi (529), followed by neighboring counties. Age distribution displayed that most of the thyroid cancers were in the range 4060 years old (50.94%), followed by 60–80 years old (32.41%). Most patients were diagnosed with papillary carcinoma 63.10%, then follicular 14.7%, medullary 6.74% and undifferentiated 1.02%. Romania was in the vicinity of the radioactive cloud at Chernobyl fallout, so we must deliberate whether the increased incidence of thyroid cancer in the age group 40–60 years is associated with radiogenicity (iodine 131) given the fact that over has 35 years and the half-life of other radioisotopes like Caesium-137 and Strontium -90 is completed.

scholarly journals Characteristics of Osteoporosis & Osteoporotic Fractures in Korea Based on Health Insurance Review and Assessment (HIRA) Database: 2009–2017

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 324
Author(s):  
Ho-Seok Oh ◽  
Sung-Kyu Kim ◽  
Hyoung-Yeon Seo
Keyword(s):  
Health Insurance ◽  
Age Groups ◽  
Osteoporotic Fractures ◽  
Prescription Data ◽  
Diagnostic Codes ◽  
Number Of Patients ◽  
Upper And Lower Extremities ◽  
Fractures Of The Spine ◽  
And Gender ◽  
Age Range

To investigate the incidence and characteristics of osteoporosis and osteoporotic fractures in Korea, we used the Health Insurance Review and Assessment Service (HIRA) database. Patients over 50 years old, who were diagnosed or treated for osteoporosis and osteoporotic fractures in all hospitals and clinics, were analyzed between 1 January 2009 and 31 December 2017 by using the HIRA database that contains prescription data and diagnostic codes. These data were retrospectively analyzed by decade and age-specific and gender-specific incidents in each year. We also evaluated other characteristics of patients including medication state of osteoporosis, primary used medical institution, regional-specific incidence of osteoporosis, and incidence of site-specific osteoporotic fractures. The number of osteoporosis patients over 50 years old, as diagnosed by a doctor, steadily increased from 2009 to 2017. The number of osteoporosis patients was notably greatest in the 60′s and 70′s age groups in every study period. Patients undergoing treatment for osteoporosis increased significantly (96%) from 2009 to 2017. Among the patients diagnosed with osteoporosis, the proportion who experienced osteoporotic fracture increased gradually (60%) from 2009 to 2017. The number of patients with osteoporotic fractures of the spine and hip was highest in the 70 to 90 age range, and the number of patients with osteoporotic fractures in the upper and lower extremities was highest in the 50 to 70 age range. Understanding the trends of osteoporosis in Korea will contribute to manage the increased number of patients with osteoporosis and osteoporotic fractures.

scholarly journals Letter to the Editor: Microbiota in the Respiratory System—A Possible Explanation to Age and Sex Variability in Susceptibility to SARS-CoV-2

2021 ◽  
Vol 14 ◽  
pp. 117863612098860
Author(s):  
Vishal Shah
Keyword(s):  
Respiratory System ◽  
Elderly Population ◽  
Age Groups ◽  
The Elderly ◽  
Elderly Adult ◽  
Human Respiratory Tract ◽  
System A ◽  
Number Of Patients ◽  
Children And Young Adults ◽  
Age And Sex

The Human respiratory tract is colonized by a variety of microbes and the microbiota change as we age. In this perspective, literature support is presented for the hypothesis that the respiratory system microbiota could explain the differential age and sex breakdown amongst COVID-19 patients. The number of patients in the older and elderly adult group is higher than the other age groups. The perspective presents the possibility that certain genera of bacteria present in the respiratory system microbiota in children and young adults could be directly or through eliciting an immune response from the host, prevent full-fledged infection of SARS-CoV-2. The possibility also exists that the microbiota in older adults and the elderly population have bacteria that make it easier for the virus to cause infection. I call upon the scientific community to investigate the link between human microbiota and SARS-CoV-2 susceptibility to further understand the viral pathogenesis.

scholarly journals Crohn’s disease: a population-based study of surgery in the age of biological therapy

2021 ◽  
Author(s):  
Christian Stöss ◽  
Maximilian Berlet ◽  
Stefan Reischl ◽  
Ulrich Nitsche ◽  
Marie-Christin Weber ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Minimally Invasive ◽  
Biological Therapy ◽  
Hospital Admissions ◽  
Diagnosis Related Groups ◽  
Age Distribution ◽  
Considerable Proportion ◽  
Discharge Data ◽  
Number Of Patients

Abstract Purpose Despite primary conservative therapy for Crohn’s disease, a considerable proportion of patients ultimately needs to undergo surgery. Presumably, due to the increased use of biologics, the number of surgeries might have decreased. This study aimed to delineate current case numbers and trends in surgery in the era of biological therapy for Crohn’s disease. Methods Nationwide standardized hospital discharge data (diagnosis-related groups statistics) from 2010 to 2017 were used. All patients who were admitted as inpatient Crohn’s disease cases in Germany were included. Time-related development of admission numbers, rate of surgery, morbidity, and mortality of inpatient Crohn’s disease cases were analyzed. Results A total number of 201,165 Crohn’s disease cases were included. Within the analyzed time period, the total number of hospital admissions increased by 10.6% (n = 23,301 vs. 26,069). While gender and age distribution remained comparable, patients with comorbidities such as stenosis formation (2010: 10.1%, 2017: 13.4%) or malnutrition (2010: 0.8%, 2017: 3.2%) were increasingly admitted. The total number of all analyzed operations for Crohn’s disease increased by 7.5% (2010: n = 1567; 2017: n = 1694). On average, 6.8 ± 0.2% of all inpatient patients received ileocolonic resections. Procedures have increasingly been performed minimally invasive (2010: n = 353; 2017: n = 687). The number of postoperative complications remained low. Conclusion Despite the development of novel immunotherapeutics, the number of patients requiring surgery for Crohn’s disease remains stable. Interestingly, patients have been increasingly hospitalized with stenosis and malnutrition. The trend towards more minimally invasive operations has not relevantly changed the rate of overall complications.

scholarly journals Reporting of harms in oncological clinical study reports submitted to the European Medicines Agency compared to trial registries and publications—a methodological review

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Asger S. Paludan-Müller ◽  
Perrine Créquit ◽  
Isabelle Boutron
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Clinical Study ◽  
Primary Source ◽  
European Medicines Agency ◽  
Clinical Trial Registries ◽  
Number Of Patients ◽  
Journal Publications ◽  
Clinical Study Reports ◽  
Completeness Of Reporting

Abstract Background An accurate and comprehensive assessment of harms is a fundamental part of an accurate weighing of benefits and harms of an intervention when making treatment decisions; however, harms are known to be underreported in journal publications. Therefore, we sought to compare the completeness of reporting of harm data, discrepancies in harm data reported, and the delay to access results of oncological clinical trials between three sources: clinical study reports (CSRs), clinical trial registries and journal publications. Methods We used the EMA clinical data website to identify all trials submitted to the EMA between 2015 and 2018. We retrieved all CSRs and included all phase II, II/III or III randomised controlled trials (RCTs) assessing targeted therapy and immunotherapy for cancer. We then identified related records in clinical trial registries and journals. We extracted harms data for eight pre-specified variables and determined the completeness of reporting of harm data in each of the three sources. Results We identified 42 RCTs evaluating 13 different drugs. Results were available on the EMA website in CSRs for 37 (88%) RCTs, ClinicalTrials.gov for 36 (86%), the European Clinical Trials Register (EUCTR) for 20 (48%) and in journal publications for 32 (76%). Harms reporting was more complete in CSRs than other sources. We identified marked discrepancies in harms data between sources, e.g. the number of patients discontinuing due to adverse events differed in CSRs and clinical trial registers for 88% of trials with data in both sources. For CSRs and publications, the corresponding number was 90%. The median (interquartile range) delay between the primary trial completion date and access to results was 4.34 (3.09–7.22) years for CSRs, 2.94 (1.16–4.52) years for ClinicalTrials.gov, 5.39 (4.18–7.33) years for EUCTR and 2.15 (0.64–5.04) years for publications. Conclusions Harms of recently approved oncological drugs were reported more frequently and in more detail in CSRs than in trial registries and journal publications. Systematic reviews seeking to address harms of oncological treatments should ideally use CSRs as the primary source of data; however, due to problems with access, this is currently not feasible.

The most frequently asked question to a statistician: The sample size

2017 ◽  
Vol 23 (5) ◽  
pp. 644-646 ◽  
Author(s):  
Maria Pia Sormani
Keyword(s):  
Clinical Study ◽  
Sample Size ◽  
Study Design ◽  
Treatment Effect ◽  
Sample Size Calculation ◽  
Ethical Implications ◽  
Number Of Patients ◽  
Reducing Costs ◽  
Correct Size

The calculation of the sample size needed for a clinical study is the challenge most frequently put to statisticians, and it is one of the most relevant issues in the study design. The correct size of the study sample optimizes the number of patients needed to get the result, that is, to detect the minimum treatment effect that is clinically relevant. Minimizing the sample size of a study has the advantage of reducing costs, enhancing feasibility, and also has ethical implications. In this brief report, I will explore the main concepts on which the sample size calculation is based.

scholarly journals Estimating effective infection fatality rates during the course of the COVID-19 pandemic in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Staerk ◽  
Tobias Wistuba ◽  
Andreas Mayr
Keyword(s):  
Age Distribution ◽  
Age Groups ◽  
Case Fatality ◽  
Time Dependent ◽  
Temporary Increase ◽  
International Studies ◽  
Age Group ◽  
Fatality Rate ◽  
Substantial Fraction ◽  
Second Wave

Abstract Background The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic. In contrast to the case fatality rate (CFR), the IFR depends on the total number of infected individuals – not just on the number of confirmed cases. In order to estimate the IFR, several seroprevalence studies have been or are currently conducted. Methods Using German COVID-19 surveillance data and age-group specific IFR estimates from multiple international studies, this work investigates time-dependent variations in effective IFR over the course of the pandemic. Three different methods for estimating (effective) IFRs are presented: (a) population-averaged IFRs based on the assumption that the infection risk is independent of age and time, (b) effective IFRs based on the assumption that the age distribution of confirmed cases approximately reflects the age distribution of infected individuals, and (c) effective IFRs accounting for age- and time-dependent dark figures of infections. Results Effective IFRs in Germany are estimated to vary over time, as the age distributions of confirmed cases and estimated infections are changing during the course of the pandemic. In particular during the first and second waves of infections in spring and autumn/winter 2020, there has been a pronounced shift in the age distribution of confirmed cases towards older age groups, resulting in larger effective IFR estimates. The temporary increase in effective IFR during the first wave is estimated to be smaller but still remains when adjusting for age- and time-dependent dark figures. A comparison of effective IFRs with observed CFRs indicates that a substantial fraction of the time-dependent variability in observed mortality can be explained by changes in the age distribution of infections. Furthermore, a vanishing gap between effective IFRs and observed CFRs is apparent after the first infection wave, while an increasing gap can be observed during the second wave. Conclusions The development of estimated effective IFR and observed CFR reflects the changing age distribution of infections over the course of the COVID-19 pandemic in Germany. Further research is warranted to obtain timely age-stratified IFR estimates, particularly in light of new variants of the virus.

Social Well-Being of the Population of Russia During the Pandemic (Based on Sample Survey Data)

2021 ◽  
Vol 28 (4) ◽  
pp. 67-79
Author(s):  
L. A. Davletshina ◽  
N. A. Sadovnikova ◽  
A. V. Bezrukov ◽  
O. G. Lebedinskaya
Keyword(s):  
Health Status ◽  
Population Health ◽  
Age Distribution ◽  
Age Groups ◽  
Rank Correlation ◽  
Well Being ◽  
Russian Population ◽  
Sample Survey ◽  
The Social ◽  
The Relationship

The article present results of the authors’ study of the social well-being of the Russian population – an assessment of the population’s health and attitudes towards a healthy lifestyle amid viral pandemic, based on materials of the Rosstat sample surveys of 2019 and 2020 and data from the All-Russian survey conducted by the Russian Public Opinion Research Center (VCIOM) on 27 September 2020. The authors described the transformation of living conditions in the light of the complex epidemiological situation and the increase in coronavirus cases among the population. Changes in the health status of the Russian population were analyzed by individual age groups.The article assesses the strength of the relationship between the social well-being of the population by selected socio-demographic groups and the period of self-isolation, quarantine, or other restrictions imposed during the coronavirus pandemic in 2020. To solve this problem, demographic and socio-economic characteristics of respondents are presented, the distribution of responses according to the survey results is estimated, and the most signifcant factor characteristics are selected. Respondent replies were grouped according to the selected questions, including in the territorial context (by federal districts). To determine the strength of the relationship between the respondents' answers to the question and their gender or age distribution, the coefcients of mutual conjugacy and rank correlation coefcients were calculated and analyzed.Analysis of the changes in the social well-being of population for 2019–2020 and the assessment of the strength of the relationship between the discussed indicators (gender, wealth, territory of residence) revealed the parameters that form the differences. After comparing the health status of the Russian population as a whole and by age groups in 2019 and 2020 based on data of sample survey on population health status, the following points were identifed. With the expected assessment of the population health status in the age distribution (deterioration in the older ages and better health in the younger ones), it also remains unchanged that more than half of the respondents characterize their health status as «very good» and «good». Noteworthy is the fact that the assessment of the health status of the Russian population has improved during the year. It is evidenced from changes in the structure of respondent replies, even though population health status survey of 2020 was conducted in the middle of lockdown amid the continuing negative trends in coronavirus morbidity and mortality.

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