scholarly journals Endoscopic Findings of Gastro-Esophageal Reflux Disease in Elderly and Younger Age Groups

2021 ◽  
Vol 8 ◽  
Author(s):  
Haydar Adanir ◽  
Bilge Baş ◽  
Betul Pakoz ◽  
Süleyman Günay ◽  
Hakan Camyar ◽  
...  
Keyword(s):  
Reflux Disease ◽  
Older Patients ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Esophageal Reflux ◽  
Female Ratio ◽  
Endoscopic Findings ◽  
Younger Age ◽  
The Mean

Objective: To determine and compare the clinical features and endoscopic findings of gastro-esophageal reflux disease (GERD) in elderly and younger age groups.Materials and Methods: The clinical and endoscopic features were evaluated for all patients with GERD between January 2017 and September 2020. The criteria for inclusion were being aged over 65 and under 50 years and having an upper gastrointestinal endoscopy with reflux symptoms resistant to ppi theraphy. The exclusion criteria included prior surgery, age under 18 years, and pregnancy. The diagnosis of GERD was made according to the patients' symptoms. The SPSS 11.0 for Windows pocket program was used for statistical analysis.Results: Two hundred eighty-six patients aged over 65 years and 261 patients aged below 50 years were enrolled in this study. The mean age of the older group was 68.2 ± 4.5 years and the mean age of the young group was 38 ± 7.2 years. The male/female ratio was 5/3 and 2/1 in the young and older groups, respectively. The older patients had less severe and rare typical symptoms than the young patients. However, significantly more serious endoscopic findings were noted in the older patients compared with the younger patients.Conclusion: The older and young patients with GERD were predominantly male and typical reflux problems were less common in older patients with GERD. Older patients had more important endoscopic findings such as hernia, esophagitis, and cancer.

A Study on the Correlation Between Endoscopic Findings and Symptoms of Gastro-Esophageal Reflux Disease

2021 ◽  
Vol 15 (9) ◽  
pp. 2413-2416
Author(s):  
Kamran Almani ◽  
Shakir Hussain Keerio ◽  
Shaista Zeb ◽  
Imran Arshad ◽  
Saqib Ali
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Gastrointestinal Symptoms ◽  
Esophageal Reflux ◽  
Endoscopic Findings ◽  
Asymptomatic Patients ◽  
Operative Endoscopy ◽  
The Mean ◽  
Barret's Esophagus

Background and Aim: Gastroesophageal reflux disease (GERD) is a physiological passage of stomach contents into the esophagus. It is basically the pathological complications and symptoms. Endoscopy is a gold standard investigation tool that eliminates the gastroesophageal reflux disease co-morbidities such as malignancy and Barret’s esophagus. The present study was carried out to evaluate the correlation between endoscopic findings and symptoms of gastroesophageal reflux disease. Materials and Methods: This intervention cross-sectional study was carried out on 109 gastro esophageal reflux disease patients in Gastroenterology department of Isra University Hospital, Hyderabad for six months duration from January 2021 to June 2021. Suspected gastroesophageal reflux disease patients were assessed thoroughly by physical examination, history, and endoscopy for gastrointestinal symptoms. Severity, symptom type, duration, and frequency were assessed as clinical symptoms. The upper gastrointestinal endoscopy findings were evaluated in terms of esophageal erosions, and their grades such as Grade A, Grade B, Grade C, and Grade D. The endoscopy abnormal findings such as hernia, esophagus, malignancy, and Barret’s esophagus were correlated with gastroesophageal reflux disease. Result: Out of 109 patients, 78 (71.5%) were females while 31 (28.5%) were male. The mean age of the patients was 43.54 ± 7.3 years with an age range between 25 and 67 years and the mean BMI was 43.34 ± 5.76 kg/m2. Gastro esophageal reflux disease symptoms such as malignancy and Barrett’s esophagus shown no evidence on pre-operative endoscopy. About 29 (26.6%) patients had normal endoscopy. The symptomatic patients were 80 (73.4%) which were categorized based on LA classifications into Grade A 62 (77.5%), Grade B 13 (16.3%), Grade C 3 (3.8%) and Grade D 2 (2.5%). Based on the reflux score system, patients were distributed as mild 43 (53.8%), moderate 11 (13.8%), severe 5 (6.3%), and very severe 21 (26.3%). Conclusion: Our study found a significant correlation between gastro esophageal reflux disease and endoscopy esophagitis findings. Pre-operative endoscopy should be carried for abnormal endoscopy in both symptomatic and asymptomatic patients. Keywords: Gastro-oesophageal reflux disease, Endoscopy, Esophagitis

scholarly journals Demographic and Clinical Characteristics of Early Travel-Associated COVID-19 Cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Reham M. Marei ◽  
Mohamed M. Emara ◽  
Omar M. Elsaied ◽  
Gheyath K. Nasrallah ◽  
Tawanda Chivese ◽  
...  
Keyword(s):  
Clinical Data ◽  
Clinical Symptoms ◽  
Age Groups ◽  
The Elderly ◽  
World Health ◽  
Female Ratio ◽  
Younger Age ◽  
The Mean ◽  
Health Organization ◽  
Male To Female

Background: SARS-CoV-2 continues to claim hundreds of thousands of people's lives. It mostly affects the elderly and those with chronic illness but can also be fatal in younger age groups. This article is the first comprehensive analysis of the epidemiological and clinical outcomes of the travel-associated SARS-CoV-2 cases until April 19, 2020.Methods: Demographic and clinical data of travel-associated SARS-CoV-2 cases were collected for the period between January 16, 2020 and April 19, 2020. More than one hundred and eighty databases were searched, including the World Health Organization (WHO) database, countries' ministries websites, and official media sites. Demographic and clinical data were extracted and analyzed.Results: A total of 1,186 cases from 144 countries meeting the inclusion criteria were reported and included in the analysis. The mean age of the cases was 44 years, with a male to female ratio of 1.6:1. Travel-associated cases originated from more than 40 countries, with China, Italy, and Iran reporting the highest numbers at 208, 225, and 155, respectively. Clinical symptoms varied between patients, with some reporting symptoms during the flights (117 cases; 9.87%). A total of 312 (26.31%) cases were hospitalized, of which 50 cases (4.22%) were fatal.Conclusion: Major gaps exist in the epidemiology and clinical spectrum of the COVID-19 travel-associated cases due to a lack of reporting and sharing data of many counties. The identification and implementation of methodologies for measuring traveler's risk to coronavirus would help in minimizing the spread of the virus, especially in the next waves.

scholarly journals Mandibular Fractures: A Comparative Analysis between Different Age Groups of Patients Seen at Kantipur Dental College Teaching Hospital and Research Center

2017 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Teaching Hospital ◽  
Age Groups ◽  
Young Patients ◽  
College Teaching ◽  
Adult Patients ◽  
Research Center ◽  
Mandibular Fractures ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Mean

Objective: The purpose of this study was to compare the differences between mandibular fractures in different age group of patients. Material and Methods: Patients treated at the Oral and Maxillofacial Department of Kantipur dental college teaching hospital and research center during a two-year period between 2013 and 2015 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. Results: 532 patients were included in the study, 370 (70%) males and 162 (30%) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65%) in young patients and traffic accidents (38%) in adults. The most common fracture sites were the symphysis (35%) and condyle (36%) in young patients, and the symphysis in adults (36%). Mandibular fractures were generally treated by arch bar and intermaxillary fixation in both young (67%) and adult (39%) patients, and 43% of the adult patients were treated by open reduction and internal fixation. Conclusion: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the hospital. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

The impact of a time target on older patients attending the emergency department

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A2.1-A2
Author(s):  
Sue Mason
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Age Groups ◽  
Unintended Consequences ◽  
Older Patient ◽  
Younger Patients ◽  
Patient Level ◽  
Level Data ◽  
Younger Age ◽  
The Impact

IntroductionThe 4 h emergency standard for English acute trusts was introduced in 2003 and became full established by 2008 at 98% for all Emergency Department (ED) patients to be seen and discharged. This study examined the impact of the target for older patients attending departments.MethodsRoutine patient level data was received from 15 English EDs representing 774 095 individual patient attendances during May and June for 2003 to 2006. The data were used to determine the distribution of the total time spent in the EDs. Attendances were compared for older patients (65 years and above) with younger age groups.ResultsA total of 145 596 attendances were for patients aged 65+ years (18.9%). Across each year analysed, these older patients have a significantly longer median total time in the ED than those younger than 65 years (162 min vs 103 min, p<0.001). In addition, older patients are significantly more likely to leave the emergency department in the last 20 min prior to 4 h (12.4% vs 5.2% in those <65 years, p<0.001). This proportion is growing year on year in both the admitted and discharged categories of patients. Finally, older patients are significantly more likely to breach the 4-h than their younger counterparts (16.6% vs 6.3%, p<0.001).ConclusionsThere are some unintended consequences of introducing the 4 h target in UK emergency departments. While the target has reduced overall time in departments, the older patient appears to be disadvantaged relative to younger patients. Older patients are more likely to be ‘rushed through’ to other unmonitored areas of the hospital just prior to the target or to breach the target altogether. This finding calls in to question the benefits that the target is conveying for individual patients, and especially the most vulnerable in society.

Variations in the Seasonal Distribution of Births of Psychotic Patients in England and Wales

1978 ◽  
Vol 132 (2) ◽  
pp. 155-158 ◽  
Author(s):  
E. H. Hare
Keyword(s):  
Personality Disorder ◽  
General Population ◽  
Older Patients ◽  
Age Groups ◽  
Seasonal Distribution ◽  
Fourth Quarter ◽  
Affective Psychosis ◽  
England And Wales ◽  
Live Births ◽  
Younger Age

SummaryThe quarterly distribution of births of patients born in England and Wales 1921–60 and first admitted in 1970–75 was examined by decade of birth and by age at year of admission. For patients with schizophrenia and affective psychosis, the distribution varied: in the early decade (1921–30), and for older patients (45–54 years) the proportion of births in the fourth quarter of the year was high, compared with expectation from live births in the general population; but it became lower in succeeding decades and for younger age groups. No comparable change occurred for births of patients with neurosis or personality disorder.

The Population of a Trout Stream and the Survival of Released Fish

1958 ◽  
Vol 9 (3) ◽  
pp. 319 ◽  
Author(s):  
AG Nicholls
Keyword(s):  
Salmo Trutta ◽  
Age Groups ◽  
River System ◽  
Fish Population ◽  
Curvilinear Relationship ◽  
Growth And Survival ◽  
Younger Age ◽  
Brown Trout Salmo Trutta ◽  
Preceding Season ◽  
The Mean

The fish population of a river system was studied by electro-fishing in 25 places, after which 1000 marked yearling brown trout, Salmo trutta L., were released at each of 10 sites. In a re-examination 8 to 9 months after the release it was estimated that about 10 per cent. of these were surviving; the survival after 18 months was estimated to be below 5 per cent., and the survival to takable size, at about 3 years of age, at 2 per cent. At no site were the younger age groups of the natural population truly represented in either season, but the numbers of older fish in the second season were greater than those of the corresponding year classes in the preceding season, showing that the streams receive recruitment of younger fish from other sources. Some evidence is produced to show that "nursery" streams provide the source of recruitment. The average annual mortality for fish of 2 and 3 years of age is estimated at from 70 to 80 per cent. for the system. It is estimated that there were about 45,000 takable fish in this river system at the beginning of each season. It is shown that the mean lengths of trout decrease with increasing density of population, and that there is a curvilinear relationship between population density and total weight of all fish per acre. The standing crop of trout at different sites ranged from 1 to 182 lb/acre over the two seasons. The condition factor showed a decrease with increasing age of the fish, and the released fish had a lower factor than resident fish of the same age at all sites. In general there was a relationship between the depth of water and the length of the fish, sections over 14 in. deep having greater populations of larger fish. A study of the ability of each section of stream to carry fish, based on the lengths and condition factors of the fish, the number and weight of the population per acre, and the ability of each section to absorb additions to the population, shows that where populations were low, conditions were Iess favourable to the growth and survival of fish.

scholarly journals Age-Associated Characteristics of Patients With Chronic Dizziness and Vertigo

2021 ◽  
pp. 089198872110361
Author(s):  
Alexander Wassermann ◽  
Sigrid Finn ◽  
Hubertus Axer
Keyword(s):  
Older Patients ◽  
Tertiary Care ◽  
Age Groups ◽  
Bilateral Vestibulopathy ◽  
Positional Vertigo ◽  
Younger Age ◽  
Chronic Dizziness ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

Objective: The incidence of dizziness and vertigo is increasing with age, and symptoms lead to significant limitations in daily living and to disability in older patients. Method: Data of 1,752 patients with chronic dizziness/vertigo subjected to a tertiary care, specialized interdisciplinary vertigo center were analyzed. Age, gender, symptoms, medical diagnosis, and Dizziness Handicap Inventory (DHI) were collected based on a questionnaire and analysis of associated patient records. The patients were assigned to 3 age groups (< 41, 41-65, and > 65 years). Results: 33.7% of the patients were older than 65 years. Frequency of symptoms and DHI score increased with age. Older patients reported less frequently about coexisting symptoms such as nausea, headache, tinnitus, ear pressure, and visual impairment. Multisensory deficit, central vertigo, bilateral vestibulopathy, and benign paroxysmal positional vertigo were diagnosed increasingly with age, while persistent postural–perceptual dizziness and vestibular migraine were diagnosed in the younger age groups. Conclusion: In the diagnostic work-up of older patients age-specific characteristics of dizziness/vertigo have to be considered. The older patient generally is more impaired by the symptoms but possibly will not report typical diagnosis-defining symptoms.

scholarly journals MON-180 Risk for Hypercoagulability Among Patients with Cushing Syndrome. From the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum ◽  
Wael Taha
Keyword(s):  
Cushing Syndrome ◽  
Metastatic Cancer ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Young Patients ◽  
Hypercoagulable State ◽  
National Database ◽  
Control Group ◽  
National Inpatient Sample ◽  
The Mean

Abstract Background: Patients with Cushing syndrome are at higher risk for hypercoagulability due to elevated levels of pro-coagulants and impaired fibrinolysis. Objective: We aimed to examine the association of Cushing syndrome and hypercoagulability using a large national database. Methods: The National Inpatient Sample (NIS) was queried for all patients diagnosed with Cushing syndrome during the year 2011-2015. Patients with Cushing syndrome were identified using the international classification of diseases (ICD-9) code “2550”. The control group was randomly selected from the same database in a 4:1 ratio matched by age and gender. Hypercoagulable state was defined by presence of either ICD-9 codes “28981 or 28982” for primary and secondary hypercoagulable state as well as personal history of venous thrombosis or pulmonary embolism identifed with ICD-9 codes “V1251 and V1255” respectively. Patients who were diagnosed with autoimmune diseases, solid tumors, metastatic cancer, as well as those who were bed-bound were excluded. Multivariable logistic regression with adjustment for patient’s demographics, socioeconomic factors, comorbidities and hospital factors was used to obtain Cushing syndrome related risk for hypercoagulability. Subgroup analysis was performed based on gender, race and age groups; young adults (aged 18-35 years), middle-aged (&gt; 35-&lt;55 years) and older adults (aged &gt; 55 years). Results: A total of 43,157 patients diagnosed with Cushing syndrome were identified. The mean age was 53.9 years (standard error of the mean 0.1). Majority of patients were females (75.2%) and of Caucasian race (74.6%). The prevalence of hypercoagulability was markedly higher among patients with Cushing syndrome 10 % vs 4%, p &lt;0.001. On multivariable analysis, presence of Cushing syndrome correlated with significanlty higher risk for hypercoagulability with adjusted odd ratio (a OR) 2.20 [95%CI: 1.98-2.44] p &lt;0.001. The risk for hypercoagulability was highest among young patients (age ≤ 35) with a OR 6.02 [95%CI: 4.06-8.94] p&lt;0.001 and among Hispanics with a OR 3.66 [95%CI: 2.38-5.64] p&lt;0.001. No significant gender difference on risk for hypercoagulability. Conclusion: Patients with Cushing syndrome are at higher risk for hypercoagulability. This risk is markedly higher among young patients and among Hispanics. Particular attention for early detection and prevention of venous thromboembolism in patients with Cushing Syndrome is advisable.

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