Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population

Platelet aggregation inhibitors (PAI) have widely proven their efficiency for the prevention of ischemic cardiovascular events. We aimed to describe PAI prescription in an elderly multimorbid population and to determine the factors that influence their prescription, including the impact of age, comorbidities and frailty, evaluated through a comprehensive geriatric assessment. This cross-sectional study included all patients admitted to the acute geriatric department of a university hospital from November 2016 to January 2017. We included 304 consecutive hospitalized patients aged 88.7 ± 5.5 years. One third of the population was treated with PAI. A total of 133 (43.8%) patients had a history of cardiovascular disease, 77 of whom were on PAI. For 16 patients, no indication was identified. The prescription or the absence of PAI were consistent with medical history in 61.8% of patients. In the multivariate analysis, among the 187 patients with an indication for PAI, neither age (odds ratio (OR) = 1.00; 95% confidence interval (CI): [0.91–1.08], per year of age), nor comorbidities (OR = 0.97; 95% CI: [0.75–1.26], per point of Charlson comorbidity index), nor cognitive disorders (OR = 0.98; 95% CI [0.91–1.06] per point of Mini Mental State Examination), nor malnutrition (OR = 1.07; 95% CI [0.96–1.18], per g/L of albumin) were significantly associated with the therapeutic decision. PAI were less prescribed in primary prevention situations, in patients taking anticoagulants and in patients with a history of bleeding. In conclusion, a third of our older comorbid population of inpatients was taking PAI. PAI prescription was consistent with medical history for 61.8% of patients. Age, multimorbidity and frailty do not appear to have a significant influence on therapeutic decision-making. Further research is needed to confirm such a persistence of cardiovascular preventive strategies in frail older patients from other settings and to assess whether these strategies are associated with a clinical benefit in this specific population.

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Malaria among migrants in a university hospital in Colombia during 2018: A case series

Tropical Doctor ◽

10.1177/0049475520981301 ◽

2020 ◽

pp. 004947552098130

Author(s):

Fabián R Carreño-Almánzar ◽

Adán Coronado-Galán ◽

Sonia A Cala-Gómez ◽

Agustín Vega-Vera

Keyword(s):

Latin American ◽

Previous History ◽

Case Series ◽

Cross Sectional Study ◽

Imported Malaria ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

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Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

Gynecology & Reproductive Health ◽

10.33425/2639-9342.1141 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Fatma Al Hoqani ◽

Wadha Al Ghafri ◽

Saneya El tayeb ◽

Yahya Al Farsi ◽

Vaidyanathan Gowri

Keyword(s):

Recurrent Miscarriage ◽

Cross Sectional Study ◽

University Hospital ◽

Control Group ◽

P Value ◽

Cross Sectional ◽

Recurrent Miscarriages ◽

Sultan Qaboos University ◽

Chi Squared ◽

History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

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Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195941 ◽

2019 ◽

Vol 8 (1) ◽

pp. 344

Author(s):

Bushra . ◽

Ambreen Ghori ◽

Azra Ahmed ◽

Najma Dalwani ◽

Mushtaque Ali Shah ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Previous History ◽

Cross Sectional Study ◽

University Hospital ◽

Prior History ◽

Singleton Pregnancy ◽

Cross Sectional ◽

History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

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Women's birth beliefs and associated factors in an obstetrics clinic in the Southeastern Anatolian Region of Turkey

Journal of Health Research ◽

10.1108/jhr-07-2019-0166 ◽

2020 ◽

Vol 34 (4) ◽

pp. 345-351

Author(s):

Figen Alp Yilmaz ◽

Yeter Durgun Ozan

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

University Hospital ◽

Healthcare Personnel ◽

Delivery Mode ◽

Cross Sectional ◽

Content Type ◽

Pregnancy And Delivery ◽

Consultation Services ◽

The Impact

PurposeThe impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and cultural characteristics. This study aimed to determine women's birth beliefs and examine their associated factors.Design/methodology/approachThis cross-sectional study was conducted with 548 primiparas in the obstetrics clinic of a university hospital located in the Southeastern Anatolian Region of Turkey from February to June 2019. Descriptive characteristics, form and the Birth Beliefs Scale were used in data collection. To analyze the data, descriptive statistics, T-tests and ANOVA analyses were used.FindingsIt was determined that factors such as age group, income level, any problems during pregnancy and preferred delivery mode statistically affected women's birth beliefs.Originality/valueBased on the findings from this study, healthcare personnel should provide training and consultation services to pregnant women starting from the prenatal period to help ensure a positive labor experience.

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ASSOCIATION OF SEROPOSITIVITY FOR CMV IGM AND IGG WITH ADVERSE PREGNANCY OUTCOME

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i3.2928 ◽

2021 ◽

Vol 71 (3) ◽

pp. 831-35

Author(s):

Ambreen Amna ◽

Farkhunda Nadeem ◽

Amin Fahim ◽

Altaf Hussian Jatoi ◽

Kanwal Abbas ◽

...

Keyword(s):

Pregnancy Outcome ◽

Adverse Pregnancy Outcome ◽

Cross Sectional Study ◽

Reproductive Age ◽

University Hospital ◽

Igg Antibodies ◽

Cross Sectional ◽

History Of ◽

Adverse Pregnancy ◽

Reproductive Age Group

Objective: To find out the prevalence of antibodies against cytomegalovirus and their association with adverse pregnancy outcome in women, at Isra University Hospital Hyderabad. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynaecology & Obstetrics, Isra University Hospital (IUH) Hyderabad, from Jan to Jun 2018. Methodology: Cytomegalovirus IgM and IgG antibodies in 305 women of reproductive age group were measured using the Enzyme Linked Fluorescent Assaysystem kit. Results: The combined positivity of anti cytomegalovirus IgG and IgM antibodies was 93 (30.40%). About 37 (37.37%) and 28 (34.14%) women were found to be seropositive for cytomegalovirus antibodies who had history of spontaneous miscarriage and recurrent miscarriages respectively. Conclusion: Higher association of seropositivity for cytomegalovirus IgM and IgG with bad obstetrical history and low economy was found.

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Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study (Preprint)

10.2196/preprints.9103 ◽

2017 ◽

Author(s):

Sami Omar Amawi ◽

Ahmed Hussein Subki ◽

Hazim Abdulkarim Khatib ◽

Omer Sameer Alkhateeb ◽

Rida Hashim Fida ◽

...

Keyword(s):

Saudi Arabia ◽

Behavioral Problems ◽

Electronic Devices ◽

Care Facility ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Communication Devices ◽

The Impact

BACKGROUND Excessive use of various electronic entertainment and communication devices, particularly among children, has been associated with increased behavioral problems. Despite children’s escalating use of these devices, parents’ awareness about the impact thereof is still lacking. OBJECTIVE The objective of this study was to assess the use of electronic entertainment and communication devices among children attending a health care facility in Jeddah, Saudi Arabia, as well as the parental impression regarding the impact of electronic devices use on the behavior of their child. METHODS A focused 15-item questionnaire was designed for this cross-sectional study involving mothers of children attending the Well Baby Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from July 1, 2016 to November 30, 2016. RESULTS This study included 190 mothers. The mean ages of the children, mothers, and fathers were 7.3 (SD 3.5), 35 (SD 6.5), and 43 (SD 8.3) years, respectively. Most children were of Saudi Arabian nationality (106/190, 55.8%). The most used device in this study was television (154/190, 81.0%), followed by mobile phones (134/190, 70.5%), and tablets (116/190, 61.0%). Computers were the least used device in this study (59/190, 31.0%). In total, 24.7% (47/190) of children in this study used electronic entertainment and communication devices for more than 4 hours per day. Most mothers (129/190, 67.9%) felt that their child spends too much time on electronic devices. Hyperactivity or behavioral problems were reported by 20.0% (38/190) of mothers in this study. Children spending longer hours on electronic devices were much more likely to be perceived to suffer from hyperactivity or behavioral problems (P=.01). CONCLUSIONS Parental awareness is necessary to counteract the harmful effects of using electronic devices for a prolonged period. Parents require help to cope with this problem effectively.

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Sex differences in impact of sarcopenia on falls in community-dwelling Korean older adults

BMC Geriatrics ◽

10.1186/s12877-021-02688-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yunsoo Soh ◽

Chang Won Won

Keyword(s):

Older Adults ◽

Sex Differences ◽

Diagnostic Algorithm ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Adjusted Model ◽

The Impact

Abstract Background Falls are one of the most serious health problems among older adults. Sarcopenia is characterized by a decrease in muscle mass, strength, and physical function. Due to potentially age-related conditions, both falls and sarcopenia have common risk factors. However, the association between sarcopenia and falls is controversial. Moreover, the sex differences in the impact of sarcopenia on falls is not yet clear. This study aimed to investigate the sex differences in the impact of sarcopenia, defined by the Asian Working Group for Sarcopenia (AWGS), on falls in Korean older adults. Methods In this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 2323 community-dwelling older adults (1111 males and 1212 females) aged 70–84 years were recruited in this cross-sectional study. To evaluate sarcopenia, the AWGS diagnostic algorithm was used. We compared the faller and non-faller groups. We performed unadjusted and fully adjusted logistic regression analyses to evaluate the relationship between sarcopenia, falls, and fall-related fractures. Results A total of 239 (24.1%) females in the faller group had a history of falls in the past year, which was statistically higher than that in males (176, 15.8%). In the fully adjusted model, handgrip strength (odds ratio [OR] = 1.508, 95% confidence interval [CI] = 1.028–2.211), and short physical performance battery (OR = 2.068, 95% CI = 1.308–3.271) were significantly lower in the male faller group. However, in the fully adjusted model, the female faller group only showed a significantly low appendicular skeletal muscle mass index (OR = 1.419, 95% CI = 1.058–1.903). Conclusions This large cohort study aimed to identify the sex differences in the incidence of sarcopenia in the older Korean population, using the AWGS diagnostic algorithm, and its correlation with falls and fall-related fractures. The incidence of falls did not increase in the sarcopenia group. Among the sarcopenia components, sex differences affect the history of falls. Therefore, when studying the risk of falls in old age, sex differences should be considered.

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CELIAC DISEASE

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.01.1414 ◽

2015 ◽

Vol 22 (01) ◽

pp. 072-075

Author(s):

Sana Zulfiqar ◽

Amin Fahim ◽

Aneela Qureshi ◽

Sadia Adnan ◽

Shomail Saeed Siddiqui ◽

...

Keyword(s):

Celiac Disease ◽

Histopathological Examination ◽

Duodenal Mucosa ◽

Cross Sectional Study ◽

University Hospital ◽

P Value ◽

Cross Sectional ◽

Marsh Type ◽

History Of ◽

And Gender

Objective: To find out the Modified Marsh type of celiac disease (CD)patients on histopathological examination of duodenal (D2) biopsies and to correlate it withtissue transglutaminase IgA levels. Study Design: Cross sectional study. Place of Study:Histopathology laboratory (Department of Pathology), Isra University Hospital and AsianInstitute of Medical Sciences (AIMS), Hyderabad. Duration of Study: July 2013 to December2013. Materials and Methods: 96 patients with a history of malabsorption or atypical symptomswith clinical suspicion of CD were subjected to endoscopy. Endoscopic duodenal (D2) biopsieswere taken regardless of age and gender. D2 biopsies were processed for histopathologicalexamination under light microscopy. Results: Out of 96 patients, 45 (46.9%) patients hadmoderate type of lamina propria inflammation along with highly significant p-value (0.0001).CDtype 3a was observed in 34 patients (35.4%). In this study the comparison of serological level oftissue Transglutaminase IgA (tTGA) and histological severity revealed significant correlation. AllModified Marsh types of CD with tTGA level seen in our study were highly significant (p-value0.001). Conclusion: In this study strong correlation was observed between the serologicaltTGA level and histological findings by Modified Marsh classification along with lamina propriainflammation of duodenal mucosa in CD patients.

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Epidemiological and diagnostic aspects of spontaneous miscarriage in the department of gynecology-obstetric of the university hospital of Treichville in Abidjan

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205745 ◽

2020 ◽

Vol 10 (1) ◽

pp. 1

Author(s):

Ignace N. Yao ◽

Jean Marc L. Dia ◽

Michelle M. Menin ◽

Mouhedeen A. Oyelade ◽

Corneille T. Saki ◽

...

Keyword(s):

Chromosomal Abnormalities ◽

Cross Sectional Study ◽

University Teaching ◽

University Hospital ◽

Pathological Examination ◽

Hiv Positive ◽

Cross Sectional ◽

History Of ◽

Early Miscarriage ◽

The University

Background: Describe the epidemiological and diagnostic of spontaneous aspects of early miscarriage in the department of the Gynecology Obsteric of Treichville University Teaching Hospital of Treichville in Abidjan.Methods: A cross-sectional study was performed from January 2016 to March 2017 on patients received for an early miscarriage (gestational age less than 14 weeks of amenorrhea).Results: We recorded 337 cases of miscarriage and it shows that miscarriage was frequently estimated at 58 percent. Our patients had a average age of 32.9 years, 60.4 percent of them with primary education and 48 percent are housewives. The patients were paucigestes in 46 percent and the majority of them were nulliparous (62 percent). 6 percent with history of high blood pressure; diabetes (3 percent) and 31 percent of patients were HIV positive. Patients had pelvic pain at the admission in (55 percent). A miscarriage appears before 10 weeks of amenorrhea (76.1 percent) of cases. Ultrasound showed ovular debris (47 percent) of patients and (55.4 percent) were chromosomal abnormalities on anatomy-pathological examination.Conclusions: Spontaneous abortions are common and pathological examination is essential for diagnosis.

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Factors Associated with Nonattendance to a Geriatric Clinic among Mexican Older Adults

Gerontology ◽

10.1159/000517919 ◽

2021 ◽

pp. 1-9

Author(s):

Juan Pablo Negrete-Najar ◽

Yoselin Juárez-Carrillo ◽

Jimena Gómez-Camacho ◽

Nancy R. Mejía-Domínguez ◽

Enrique Soto-Perez-de-Celis ◽

...

Keyword(s):

Older Adults ◽

Geriatric Medicine ◽

Health Resources ◽

Public Health Problem ◽

Time Frame ◽

Cross Sectional Study ◽

Multinomial Regression ◽

Cross Sectional ◽

History Of ◽

The Impact

Introduction: Outpatient appointment nonattendance (NA) represents a public health problem, increasing the risk of unfavorable health-related outcomes. Although NA is significant among older adults, little is known regarding its correlates. This study aimed to identify the correlates (including several domains from the geriatric assessment) of single and repeated NA episodes in a geriatric medicine outpatient clinic, in general and in the context of specific comorbidities. Methods: This is a cross-sectional study including data from 3,034 older adults aged ≥60 years with ≥1 scheduled appointments between January 1, 2016, and December 31, 2016. Appointment characteristics as well as sociodemographic, geographical, and environmental information were obtained. Univariate and multivariate multinomial regression analyses were carried out. Results: The mean age was 81.8 years (SD 7.19). Over a third (37.4%) of participants missed one scheduled appointment, and 14.4% missed ≥2. Participants with a history of stroke (OR 1.336, p = 0.041) and those with a greater number of scheduled appointments during the study time frame (OR 1.182, p < 0.001) were more likely to miss one appointment, while those with Parkinson’s disease (OR 0.346, p < 0.001), other pulmonary diseases (OR 0.686, p = 0.008), and better functioning for activities of daily living (ADL) (OR 0.883, p < 0.001) were less likely to do so. High socioeconomic level (OR 2.235, p < 0.001), not having a partner (OR 1.410, p = 0.006), a history of fractures (OR 1.492, p = 0.031), and a greater number of scheduled appointments (OR 1.668, p < 0.001) increased the risk of repeated NA, while osteoarthritis (OR 0.599, p = 0.001) and hypertension (OR 0.680, p = 0.002) decreased it. In specific comorbidity populations (hypertension, type 2 diabetes mellitus, and cancer), better ADL functioning protected from a single NA, while better mobility functioning protected from repeated NA in older patients with hypertension and cancer. Discussion/Conclusion: Identifying geriatric factors linked to an increased probability of NA may allow one to anticipate its likelihood and lead to the design and implementation of preventive strategies and to an optimization of the use of available health resources. The impact of these factors on adherence to clinical visits requires further investigation.

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