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 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.

Attachment points, team identification and sponsorship outcomes: evidence from the Indian Premier League

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Giridhar B. Kamath ◽  
Shirshendu Ganguli ◽  
Simon George
Keyword(s):  
Structural Equation ◽  
Group Analysis ◽  
Age Groups ◽  
Team Identification ◽  
Age And Gender ◽  
Content Type ◽  
Behavioural Intentions ◽  
Premier League ◽  
And Gender ◽  
The Impact

PurposeThis paper tests and validates a conceptual model linking the attachment points, team identification, attitude towards the team sponsors and the behavioural intentions in the context of Indian Premier League (IPL), while testing for the moderating effects of age and gender.Design/methodology/approachData were collected from 1,053 participants through both online and offline survey and then analyzed using exploratory factor analysis (EFA) and structural equation modelling (SEM).FindingsAttachment points influence the formation of team identification, which, in turn, affect the attitude towards the team sponsors. Attitude towards the team sponsors influence the behavioural intentions. Player attachment influences team identification the most. Age and gender have a moderating effect on the constructs of the study. Team identification in females is stronger because of attachment to sports, whereas males have stronger team identification based on player attachment. Males have a stronger intention to spread positive word of mouth (WOM) about sponsor products as compared to the female respondents. The younger age group of less than 21 years has more intention to spread positive WOM compared to the other age groups considered in the study.Practical implicationsThis study contributes towards sports sponsorship research and the paradigms of social identity and attachment theories. Moreover, it will also help the marketers (sponsors) in IPL to strategically market their brands.Originality/valueThis is the first study to investigate the impact of attachment points on sponsorship outcomes in the context of IPL. Further, it is also the first to investigate the purchase intentions and WOM for the team sponsors in IPL. The multi-group analysis results will provide insights into marketers to better understand IPL viewers' segments and their behaviour.

scholarly journals Who Should Rather Undergo Transesophageal Echocardiography to Determine Stroke Etiology: Young or Elderly Stroke Patients?

2020 ◽  
Vol 11 ◽  
Author(s):  
Christoph Strecker ◽  
Felix Günther ◽  
Andreas Harloff
Keyword(s):  
Secondary Prevention ◽  
Transesophageal Echocardiography ◽  
Treatment Guidelines ◽  
Age Groups ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Old Patients ◽  
Stroke Etiology ◽  
Risk Sources ◽  
The Impact

Introduction: The indication of transesophageal echocardiography (TEE) in acute stroke is unclear. Thus, we systematically studied the impact of TEE on determining stroke etiology and secondary prevention in patients of different age-groups with cryptogenic stroke.Methods: Four hundred and eighty five consecutive patients with acute retinal or cerebral ischemia were prospectively included and underwent routine stroke workup including TEE. Stroke etiology was identified according to the TOAST classification and patients were divided in those with determined and cryptogenic stroke etiology without TEE results. Then, the frequency of high- and potential-risk sources in TEE was evaluated in &lt;55, 55–74, and ≥75 year-old patients with cryptogenic stroke etiology.Results: Without TEE, stroke etiology was cryptogenic in 329(67.8%) patients and TEE determined possible etiology in 158(48.4%) of them. In patients aged &lt;55, 55–74, ≥75, TEE detected aortic arch plaques ≥4 mm thickness in 2(1.2%), 37(23.0%), and 33(40.2%) and plaques with superimposed thrombi in 0(0.0%), 5(3.1%), and 7(8.5%); left atrial appendage peak emptying flow velocity ≤30cm/s in 0(0.0%), 1(0.6%), and 2(2.4%), spontaneous echo contrast in 0(0.0%), 1(0.6%), and 6(7.3%), endocarditis in 0(0.0%), 0(0.0%), and 1(1.2%) and patent foramen ovale (PFO) plus atrial septum aneurysm (ASA) in 18(20.9%), 32(19.9%), and 14(17.1%), respectively. TEE changed secondary prevention in 16.4% of these patients following guidelines of 2010/11 and still 9.4% when applying the guidelines of 2020.Conclusions: TEE was highly valuable for determining stroke etiology and influenced individual secondary prevention based on available treatment guidelines and expert opinion in most cases. In young patients the impact of TEE was limited to the detection of septal anomalies. By contrast, in older patients TEE detected high numbers of complex aortic atheroma and potential indicators of paroxysmal atrial fibrillation.

Adjuvant chemotherapy (AC) initiation and early discontinuation in elderly patients (EPs) with stage III colon cancer (CC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6014-6014
Author(s):  
Jenny J Ko ◽  
Hagen F. Kennecke ◽  
Howard John Lim ◽  
Sharlene Gill ◽  
Ryan Woods ◽  
...  
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Advanced Age ◽  
Stage Iii ◽  
Early Discontinuation ◽  
Cancer Specific Survival ◽  
Entire Cohort ◽  
Stage Iii Colon Cancer ◽  
The Impact ◽  
To Receive

6014 Background: Research suggests that EPs with cancer are commonly undertreated, but the precise reasons for this observation are unclear. Our aims were to 1) evaluate the impact of advanced age on AC use (none vs capecitabine vs FOLFOX) for stage III CC, 2) determine the specific reasons for selecting and discontinuing a particular regimen, and 3) examine if the effect of AC on outcomes is modified by age. Methods: Patients diagnosed with stage III CC from 2006 to 2008 and referred to any 1 of 5 cancer centers in British Columbia, Canada were identified. Descriptive statistics were used to summarize treatment patterns in young patients (YPs) aged <70 vs EPs aged >/=70 years. Logistic regression was used to evaluate the association between AC and cancer-specific survival (CSS) in YPs and EPs. Results: We identified 810 patients: 51% men, 52% YPs and 48% EPs, and 74% received AC in the entire cohort. When compared to YPs, EPs had worse ECOG and more comorbidities (both p<0.01). EPs were less likely than YPs to receive AC (57 vs 91%, p<0.01). Frequent reasons for no treatment included age, comorbidities and perceived minimal benefit from AC. Among those treated with AC, EPs were less likely to receive FOLFOX (32 vs 74%, p<0.01) in favor of capecitabine due to patient preference, age and comorbidities. Once started on AC, EPs had similar rates of early treatment discontinuation as YPs (70 vs 62%, p=0.08). Reasons for early discontinuation were comparable between EPs and YPs (Table). Receipt of either FOLFOX or capecitabine was correlated with improved CSS, compared to surgery alone. Age did not modify CSS, irrespective of AC choice (interaction p for capecitabine and age=0.26; interaction p for FOLFOX and age=0.40). Conclusions: EPs with stage III CC frequently received either no adjuvant treatment or capecitabine monotherapy due to advanced age and comorbidities. The treatment effect of AC on CSS is similar across age groups, with comparable side effects and rates of discontinuation between EPs and YPs. AC should not be withheld from CC patients based on advanced age alone. [Table: see text]

Impact of Young Age and Gender on Outcomes of Transradial Versus Transfemoral Access Coronary Angiography

Angiology ◽  
2020 ◽  
pp. 000331972096194
Author(s):  
Kuljit Singh ◽  
Rosanna Tavella ◽  
Tracy Air ◽  
Matthew Worthley ◽  
Ajay Sinhal ◽  
...  
Keyword(s):  
Age Groups ◽  
South Australia ◽  
Female Gender ◽  
Primary Objective ◽  
Young Age ◽  
Adverse Cardiovascular Event ◽  
Entire Cohort ◽  
Median Split ◽  
And Gender ◽  
The Impact

The differential impact of young age and female gender on transradial access (TRA) outcomes remains to be confirmed. The primary objective was to assess the impact of young age and female gender on in-hospital net adverse cardiovascular events (NACE). Among 12 346 patients from the Coronary Angiogram Database of South Australia (CADOSA) Registry, the impact of gender; men (transfemoral access [TFA] 1995, TRA 6168) and women (TFA 1249, TRA 2934), and a median split of age, ≤63 years (TFA 1617, TRA 4727) and >63 years (TFA 1627, TRA 4375) were analyzed on in-hospital outcomes by creating 5 separate propensity-matched cohorts (entire cohort, men, women, ≤63 and > 63 years). Net adverse cardiovascular event reduction with TRA was limited to the >63 years old cohort (odds ratio [OR] = 0.56, 95% CI: 0.34-0.93, P = .02) and women (OR = 0.37, 95% CI: 0.18-0.76, P = .007). In both the age groups and genders, TRA was associated with a lower risk of bleeding and all-cause mortality. On multivariate logistic regression, TRA was associated with a significant reduction in NACE, major bleeding, and mortality in the overall cohort. In conclusion, a reduction in bleeding and mortality was noted with TRA in all the subgroups in this observational study.

Efficacy of palliative chemotherapy in elderly patients with colorectal cancer

2019 ◽  
Vol 57 (04) ◽  
pp. 484-490
Author(s):  
Wolfram Bohle ◽  
Amelie Pachlhofer ◽  
Wolfram Zoller
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumor ◽  
Palliative Chemotherapy ◽  
Age Groups ◽  
Chemotherapeutic Agents ◽  
Old Patients ◽  
The Impact

Abstract Background The number of old patients suffering from colorectal cancer rises. In clinical trials, old patients are underrepresented, and chemotherapy is significantly less often performed in elderly patients. We analyzed the impact of elder age for palliative chemotherapy in patients suffering from metastatic colorectal cancer, according to therapeutic drugs used, intensity of treatment performed, and therapeutic results. Materials and methods We analyzed consecutive patients with metastatic colorectal cancer treated in palliative intention in our department. Assessed data included age (</> 75 years), sex, comorbidity, site of primary tumor, k-ras-status, site and amount of metastasis, number and kind of chemotherapeutic agents used, number of consecutive therapy lines performed, dose intensity, toxicity, time between start and end of palliative chemotherapy, and overall survival. Prognostic variables were tested in uni- and multivariate analysis. Results Ninety-seven patients (69 < 75, 18 > 75 years) were included. Age groups were well balanced according to site of primary tumor, k-ras-mutational status, localization, and number of metastatic sites. Cardial and renal comorbidity was more frequent in elderly patients. The median number of chemotherapeutic drugs used and lines of therapy performed did not differ between age groups, except of oxaliplatin, which was significantly less often used in old patients. Median survival did not differ between age groups (23.4 vs. 23.5 months). In multivariate analysis, only left-sided primary tumor and more than 3 lines of therapy performed were prognostic positive variables. Conclusion Old patients can profit from palliative chemotherapy to the same extent as younger ones.

scholarly journals The impact of young age (< 40 years) on the outcome of a cohort of patients with primary non-metastatic breast cancer: analysis of 10-year survival of a prospective study

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Youssef Bouferraa ◽  
Yolla Haibe ◽  
Andrea Chedid ◽  
Elio Jabra ◽  
Maya Charafeddine ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prospective Study ◽  
Age Groups ◽  
Metastatic Breast ◽  
Young Age ◽  
Survival Outcomes ◽  
Tumor Characteristics ◽  
Younger Age ◽  
The Impact

Abstract Background The role of young age (< 40 years) at diagnosis as an independent risk factor for adverse outcomes in female patients with breast cancer has been highlighted in several studies. In this prospective study, we assessed the difference in 10-year survival between two groups of patients diagnosed with non-metastatic breast cancer based on an age cutoff of 40 years. We also assessed the impact of factors including tumor characteristics, molecular markers and immunohistochemical markers on survival outcomes, highlighting the interaction of those variables with age. Methods A total of 119 female patients with newly diagnosed non-metastatic breast cancer were recruited at the American University of Beirut Medical Center (AUBMC) between July 2011 and May 2014. Patients were recruited and divided into 2 age groups (< 40 and ≥ 40 years). In addition to clinical characteristics, we assessed immunohistochemistry including estrogen, progesterone and HER2 receptors, p53, cyclin B1, vascular endothelial growth factor receptor (VEGFR), and ki-67. Germline BRCA mutations were also performed on peripheral blood samples. Patient and tumor characteristics were compared between the age groups. 10-year overall survival (OS) and disease-free survival (DFS) were estimated accordingly. Cox regression analysis was performed in order to assess the effect of the different variables on clinical outcomes. Results After a median Follow-up of 96 (13–122) months, the estimated 10-year OS was 98.6% for patients ≥40 as compared to 77.6% in patients < 40 (p = 0.001). A similar trend was found for 10-year DFS reaching 90% for patients ≥40 and 70.4% for those < 40 (p = 0.004). On multivariate analysis for DFS and OS, only younger age (< 40 years), higher stage and triple negative phenotype among other parameters assessed significantly affected the outcome in this cohort. Conclusion This prospective study confirms the association between younger age and adverse survival outcomes in patients with non-metastatic breast cancer. Future studies of the whole genome sequences may reveal the genomic basis underlying the clinical differences we have observed.

scholarly journals RISK FACTORS PROFILE FOR MYOCARDIAL INFARCTION: FOCUS AT A YOUNG AGE

2021 ◽  
pp. 160-166
Author(s):  
I.A. Novikova ◽  
◽  
O.V. Khlynova ◽  
L.A. Nekrutenko ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Age Groups ◽  
Young Patients ◽  
Young Age ◽  
Ischemic Heart ◽  
Cardiac Infarction ◽  
Regional Center ◽  
Male Sex

The paper focuses on examining peculiarities of risk factors causing cardiac infarction at a young age. Although car- diac infarction primarily occurs among patients older than 45, its frequency at a young age has been growing recently. Risk factors that cause cardiac infarction at a young and old age are quite different. Examining risk factors profiles in different age groups provides wider opportunities for implementing primary and secondary prevention strategies aimed at reducing frequency and negative outcomes of ischemic heart disease.108 patients aged from 18 to 45 and 35 patients aged from 60 to 75 took part in the research; they all had confirmed cardiac infarction with or without rise in ST segment and were treated in a regional center for cardiovascular pathology treatment in a period from January 01, 2017 to January 01, 2019. Basic risk factors of cardiac infarction were assessed when a patient was admitted to a clinic for treatment. The research results indicate high prevalence of risk factors that could cause ischemic heart disease among young pa- tients. 92.2 % young patients have dyslipidemia, 70.2 % smoke, 68.5 have low physical activity, 68.2 % suffer from over- weight and obesity, 58.8 % have arterial hypertension, 7.4 % suffer from type II pancreatic diabetes, and disorders in toler- ance to carbohydrates was reveled in 15.7 % cases. Such factors as male sex (85.2 vs. 37.1 %, р=0,000), smoking (70.2 vs. 20.6 %, р=0.000) and burdened heredity as per early ischemic heart disease occurrence (54.6 vs. 16.0 %, р=0.001) were significantly more frequent among young patients than among older ones. Data obtained via the present research allowed creating risk factors profile for cardiac infarction associated with car- diac infarction occurrence at a young age; this profile included such factors as male sex, early ischemic heart disease occur- rence in family history, and smoking

scholarly journals Comparison of Risk of Metachronous Advanced Colorectal Neoplasia in Patients with Sporadic Adenomas Aged < 50 Versus ≥ 50 years: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (2) ◽  
pp. 120
Author(s):  
Yoon Suk Jung ◽  
Jung Ho Park ◽  
Chan Hyuk Park
Keyword(s):  
Colorectal Neoplasia ◽  
Meta Analysis ◽  
Age Groups ◽  
Young Patients ◽  
Colorectal Adenomas ◽  
Significant Heterogeneity ◽  
Age Group ◽  
Advanced Colorectal Neoplasia ◽  
Surveillance Interval ◽  
The Impact

No specific recommendations are available for the surveillance of young patients aged <50 years undergoing polypectomy. We aimed to compare the risk of metachronous advanced colorectal neoplasia (ACRN) between patients aged ≥50 years and those aged <50 years who underwent polypectomy. Studies published between January 1980 and June 2020 that examined the risk of metachronous ACRN were searched. We performed a meta-analysis for the metachronous ACRN risk in patients with sporadic colorectal adenomas according to the age groups (≥50 vs. <50 years). Eight individual studies were included in the meta-analysis. The risk of metachronous ACRN was higher in patients aged ≥50 years than in those aged <50 years without significant heterogeneity (odds ratio (OR) (95% CI): 1.62 (1.34–1.96), I2 = 14%). The impact of the age group on the risk of metachronous ACRN was identified in both the low-risk (LRA) and high-risk (HRA) adenoma groups (≥50 vs. <50 years: LRA, OR 1.88 (95% CI 1.30–2.70); HRA, OR 1.50 [95% CI 1.13–2.00]). In conclusion, patients aged <50 years had a lower risk of metachronous ACRN than older patients. Young patients with sporadic adenomas do not require more intensive surveillance; rather, the surveillance interval may be extended in these patients.

scholarly journals Efficient Ways to Combat Doping in a Sports Education Context!? A Systematic Review on Doping Prevention Measures Focusing on Young Age Groups

2021 ◽  
Vol 3 ◽  
Author(s):  
Katharina Pöppel
Keyword(s):  
School Context ◽  
Age Groups ◽  
Young Age ◽  
Added Value ◽  
Prevention Measures ◽  
Target Groups ◽  
Eligibility Criteria ◽  
Screening Process ◽  
The Impact

Youth is characterized by testing and crossing natural boundaries, sometimes with the help of performance-enhancing substances. In this context, doping prevention measures play a crucial role to protect individuals both within and outside the context of elite sport. Based on the PRISMA guidelines, a systematic literature search was conducted in the databases ProQuest (ERIC), Scopus, PSYNDEX/PsychInfo, PubMed, and Web of Science Core Collection to provide an overview of the impact of doping prevention measures, with particular attention to the underlying understanding of learning. As a result of the screening process, 30 of the initial 5,591 articles met the previously defined and recorded eligibility criteria. The analysis led to heterogeneous results regarding content, implementation, target group, or outcome variables considered relevant. Two-thirds of the studies related to the competitive sports context. Nevertheless, there has been a growing interest in studying doping prevention and its effects on non-elite athlete target groups in recent years. In terms of effectiveness, many measures did not achieve long-term changes or did not collect any follow-up data. This contrasts with understanding learning as sustained change and reduces the intended long-term protection of prevention measures, especially for adolescent target groups. Even young age groups from 10 years upwards benefited from doping prevention measures, and almost all doping prevention measures enabled their participants to increase their physical and health literacy. No conclusion can be drawn as to whether doping prevention measures based on constructivist ideas are superior to cognitivist approaches or a combination of both. Nevertheless, programs that actively engage their participants appear superior to lecture-based knowledge transfer. Most of the prevention measures offered a benefit-orientation so that participants can achieve added value, besides trying to initiate health-promoting change through rejection. Because of the lack of sustained changes, a further modification in doping prevention seems necessary. The review results support the value of primary prevention. Doping prevention measures should enable tailored learning and development options in the sense of more meaningful differentiation to individual needs. The implementation in a school context or an online setting is promising and sees doping as a problem for society. The review highlights the importance of accompanying evaluation measures to identify efficient prevention components that promote health and protect young people.

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