Relationship between patient characteristics and treatment allocation for patients with personality disorders.

Science.gov (United States)

van Manen, Janine G; Andrea, Helene; van den Eijnden, Ellen; Meerman, Anke M M A; Thunnissen, Moniek M; Hamers, Elisabeth F M; Huson, Nelleke; Ziegler, Uli; Stijnen, Theo; Busschbach, Jan J V; Timman, Reinier; Verheul, Roel

2011-10-01

Within a large multi-center study in patients with personality disorders, we investigated the relationship between patient characteristics and treatment allocation. Personality pathology, symptom distress, treatment history, motivational factors, and sociodemographics were measured at intake in 923 patients, who subsequently enrolled in short-term or long-term outpatient, day hospital, or inpatient psychotherapy for personality pathology. Logistic regressions were used to examine the predictors of allocation decisions. We found a moderate relationship (R(2) = 0.36) between patient characteristics and treatment setting, and a weak relationship (R(2) = 0.18) between patient characteristics and treatment duration. The most prominent predictors for setting were: symptom distress, cluster C personality pathology, level of identity integration, treatment history, motivation, and parental responsibility. For duration the most prominent predictor was age. We conclude from this study that, in addition to pathology and motivation factors, sociodemographics and treatment history are related to treatment allocation in clinical practice.

[Medico-social characteristics of patients with chronic pancreatitis].

Science.gov (United States)

Kosyura, S D; Fedorov, I G; Gavrilina, N S; Sedova, G A

2014-01-01

Comparative analysis of the health status of patients with chronic toxic-metabolic pancreatitis (CTMP) and chronic obstructive pancreatitis (COP). The gender and social factors was analysed. 250 patients with chronic pancreatitis examined. On based of the TIGAR-O classification, two groups of patients choosed: the 1-st group included 142 (56.8%) a patient with CTMP, the 2-nd group--108 (43.2%) patients COP. The social characteristics of patients had produced, including assessment of status social (gender, age, educational level, employment, marital status, bad habits). Quality of life was assessed by using the updated questionnaire SF-36. The average age of patients with CP is 53.2 years, male to female ratio is 3:2. At stake is 56.8% of all CTMP patients with CP, the median age is 42.3 years, the male to female ratio is 4:1. The average age of patients with COP is 54.6 years, male to female ratio is 1:4. Do not work, not married, engaged in an anti-social way of life 43% of people working age with CTMP, have a lower education in comparison with patients with COP. Patients with CTMP reduced social significance illustrate reduced social significance as personal (reduction in the level of education, an anti-social way of life), and social (lack of employment, deterioration of demographic indicators).

The association between location, age and advanced colorectal adenoma characteristics

DEFF Research Database (Denmark)

Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

2017-01-01

PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible....... Inclusion criteria for patients were one adenoma of >1 cm in diameter or multiple adenomas of any size, or an adenoma of any size and familial disposition for colorectal cancer. Multivariate regression and propensity score-matched analyses were used to correlate location of adenomas and age with advanced...... adenoma features. RESULTS: In this study, 2149 adenomas were removed in 1215 patients. Advanced colorectal adenomas primarily occurred in the anal part of the colon. Older age was associated with more adenomas and more oral occurrence of adenomas, as well as a higher risk of advanced adenomas...

The use of surgery in the treatment of ER+ early stage breast cancer in England: Variation by time, age and patient characteristics.

Science.gov (United States)

Richards, P; Ward, S; Morgan, J; Lagord, C; Reed, M; Collins, K; Wyld, L

2016-04-01

To assess whether the proportion of patients aged 70 and over with ER+ operable breast cancer in England who are treated with surgery has changed since 2002, and to determine whether age and individual level factors including tumour characteristics and co-morbidity influence treatment choice. A retrospective cohort analysis of routinely collected cancer registration data from two English regions (West Midlands, Northern & Yorkshire) was carried out (n = 17,129). Trends in surgical use over time for different age groups were assessed graphically and with linear regression. Uni- and multivariable logistic regressions were used to assess the effects of age, comorbidity, deprivation and disease characteristics on treatment choice. Missing data was handled using multiple imputation. There is no evidence of a change in the proportion of patients treated surgically over time. The multivariable model shows that age remains an important predictor of whether or not a woman with ER+ operable breast cancer receives surgery after covariate adjustment (Odds ratio of surgery vs no surgery, 0.82 (per year over 70)). Co-morbidity, deprivation, symptomatic presentation, later stage at diagnosis and low grade are also associated with increased probability of non-surgical treatment. Contrary to current NICE guidance in England, age appears to be an important factor in the decision to treat operable ER+ breast cancer non-surgically. Further research is needed to assess the role of other age-related factors on treatment choice, and the effect that current practice has on survival and mortality from breast cancer for older women. Copyright © 2016 Elsevier Ltd. All rights reserved.

New onset status epilepticus in older patients: Clinical characteristics and outcome.

Science.gov (United States)

Malter, M P; Nass, R D; Kaluschke, T; Fink, G R; Burghaus, L; Dohmen, C

2017-10-01

We here evaluated (1) the differential characteristics of status epilepticus (SE) in older (≥60 years) compared to younger adults (18-59 years). In particular, we were interested in (2) the proportion and characteristics of new onset SE in patients with no history of epilepsy (NOSE) in older compared to younger adults, and (3) predictive parameters for clinical outcome in older subjects with NOSE. We performed a monocentric retrospective analysis of all adult patients (≥18years) admitted with SE to our tertiary care centre over a period of 10 years (2006-2015) to evaluate clinical characteristics and short-time outcome at discharge. One-hundred-thirty-five patients with SE were included in the study. Mean age at onset was 64 years (range 21-90), eighty-seven of the patients (64%) were older than 60 years. In 76 patients (56%), SE occurred as NOSE, sixty-seven percent of them were aged ≥60 years. There was no age-dependent predominance for NOSE. NOSE was not a relevant outcome predictor, especially regarding age-related subgroups. Older patients with NOSE had less frequently general tonic clonic SE (GTCSE; p=0.001) and were more often female (p=0.01). Regarding outcome parameters and risk factors in older patients with NOSE, unfavourable outcome was associated with infections during in-hospital treatment (0.04), extended stay in ICU (p=0.001), and generally in hospital (p<0.001). In our cohort, older patients represented the predominant subgroup in patients with SE. Older patients suffered more often from non-convulsive semiology and had a less favourable short-time outcome. NOSE was not a predictive outcome parameter in older patients. Data suggest that avoiding infections should have a priority because higher infection rates were associated with unfavourable outcome. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Clinical characteristics and outcome of patients with upper ...

African Journals Online (AJOL)

Conclusions: The common presentations were haematemesis and melaena, mainly in middle aged men with mortality in one out of seven patients. The high mortality may be due to co-morbidities and poor support services. Keywords: Upper gastrointestinal bleeding, Emergency department, Characteristics, Outcome ...

The relationship between patients' perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics and patient age.

Science.gov (United States)

Kvist, Tarja; Voutilainen, Ari; Mäntynen, Raija; Vehviläinen-Julkunen, Katri

2014-10-18

The relationship between nurses' job satisfaction and their perceptions of quality of care has been examined in previous studies. There is little evidence, however, about relationships between the job satisfaction of nursing staff and quality of care perceived by the patients. The aim of this study was to analyze, how the job satisfaction of nursing staff, organizational characteristics (hospital and unit type), and patients' age relate to patients' perceptions of the quality of care. The study was cross-sectional and descriptive, based on a secondary analysis of survey data acquired during the At Safe study in Finland. The study included 98 units at four acute care hospitals between autumn 2008 and spring 2009. The participants were 1909 patients and 929 nursing staff. Patients' perceptions of quality of care were measured using the 42-item RHCS questionnaire. Job satisfaction of nursing staff was measured with the 37-item KUHJSS scale. Statistical analyses included descriptive statistics, principal component analysis, t-tests, analysis of variance, linear regression, and multivariate analysis of variance. Patients' perceptions of overall quality of care were positively related to general job satisfaction of nursing staff. Adequate numbers of staff appeared to be the clearest aspect affecting quality of care. Older patients were more satisfied with staff number than younger patients. Patients cared for in outpatient departments felt more respected than patients in wards, whereas patients in wards reported better care of basic needs (e.g., hygiene, food) than outpatients. The evaluation of resources by nursing staff is related to patients' perceptions of the adequacy of nursing staff levels in the unit. The results emphasize the importance of considering patients' perceptions of the quality of care and assessments by nurses of their job satisfaction at the hospital unit level when evaluating quality of care.

Second branchial cleft fistulae: patient characteristics and surgical outcome.

Science.gov (United States)

Kajosaari, Lauri; Mäkitie, Antti; Salminen, Päivi; Klockars, Tuomas

2014-09-01

Second branchial cleft anomalies predispose to recurrent infections, and surgical resection is recommended as the treatment of choice. There is no clear consensus regarding the timing or surgical technique in the operative treatment of these anomalies. Our aim was to compare the effect of age and operative techniques to patient characteristics and treatment outcome. A retrospective study of pediatric patients treated for second branchial sinuses or fistulae during 1998-2012 at two departments in our academic tertiary care referral center. Comparison of patient characteristics, preoperative investigations, surgical techniques and postoperative sequelae. Our data is based on 68 patients, the largest series in the literature. One-fourth (24%) of patients had any infectious symptoms prior to operative treatment. Patient demographics, preoperative investigations, use of methylene blue, or tonsillectomy had no effect on the surgical outcome. There were no re-operations due to residual disease. Three complications were observed postoperatively. Our patient series of second branchial cleft sinuses/fistulae is the largest so far and enables analyses of patient characteristics and surgical outcomes more reliably than previously. Preoperative symptoms are infrequent and mild. There was no difference in clinical outcome between the observed departments. Performing ipsilateral tonsillectomy gave no outcome benefits. The operation may be delayed to an age of approximately three years when anesthesiological risks are and possible harms are best avoided. Considering postoperative pain and risk of postoperative hemorrhage a routine tonsillectomy should not be included to the operative treatment of second branchial cleft fistulae. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Colorectal cancer: comparative analysis of clinical and pathological characteristics in patients aged above and below 45 years of age and impact on prognosis

Directory of Open Access Journals (Sweden)

Joana Sofia Gomes Pestana

2016-10-01

Full Text Available Introduction: Colorectal cancer, in Portugal, presents as the second most common cancer and of cancer death cause. CRC is a disease of the elderly; however, there has been an increase of incidence in younger patients and doubts have emerged about its behavior, characteristics and prognosis in this group. Methods: In this study, we have evaluated a sample of 512 patients diagnosed with colorectal cancer submitted to surgical treatment in the period between January 1st, 2005 and January 1st, 2010, through a comparative clinical, pathological and survival analysis of patients under and over 45 years old (Groups I and II respectively. Results: Group I patients accounted for 5.5% of the sample. There was a predominance of males and the most common site was the left colon in both age groups. In the younger group, the histological type presents with a predominance of tumors with a mucinous component and with signet ring cells (p = 0.001, however, there was no difference in terms of overall survival and disease-free survival. Conclusion: In this study, colorectal cancer at younger ages shows similar characteristics to those of older patients. Resumo: Introdução: O Câncer Colorectal (CCR, em Portugal, constitui o segundo câncer mais frequente em termos de incidência e de mortalidade. É uma doença do idoso, no entanto, tem-se observado um aumento da incidência em pacientes mais jovens, tendo surgido dúvidas acerca do seu comportamento, características e prognóstico neste grupo etário. Métodos: 512 pacientes com diagnóstico de CCR operados entre Janeiro de 2005 e Janeiro de 2010 foram avaliados através da análise comparativa das características clínicas, anatomopatológicas e sobrevida em indivíduos com idade inferior e superior a 45 anos (Grupo I e II respetivamente. Resultados: Os pacientes do Grupo I representaram 5,5% da amostra. Houve predomínio do gênero masculino e o local mais frequente foi o cólon esquerdo em ambos os

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups.

Science.gov (United States)

Hasegawa, Masayo; Shinnabe, Akihiro; Kanazawa, Hiromi; Iino, Yukiko; Yoshida, Naohiro

2017-08-01

We aimed to analyze preoperative and intraoperative clinical characteristics of chronic perforated otitis media by patient age. We analyzed 137 tympanoplasties for chronic perforated otitis media in 133 patients. Exclusion criteria were ear adhesions, cholesteatoma, and a history of tympanoplasty. Patients were divided into a younger group (aged 15-39 years), a middle group (40-64 years), and an elderly group (≥65 years). We compared tympanoplasty technique (using Wullstein classification), mastoid air-cell area measured by temporal bone computed tomography, preoperative aeration of the temporal bone, mean preoperative hearing (at 500 Hz, 1000 Hz, and 2000 Hz), and patch effect calculated by the pre- and post-patch air-bone gap at frequencies of 250 Hz and 500 Hz among the three age groups. Although type I tympanoplasty was performed most frequently in all age groups, it was performed significantly less often in the elderly group (pgroup (page groups (pgroups. The mean patch effect was significantly better in the younger group than in middle or elderly groups (p<0.05). The less pneumatized mastoid and ossicular diseases in elderly patients with chronic perforated otitis media suggest that they had longer lasting and more severe childhood middle ear pathologies than did younger patients.

Differential characteristics of bacteraemias according to age in a community hospital.

Science.gov (United States)

Toyas, C; Aspiroz, C; Martínez-Álvarez, R M; Ezpeleta, A I; Arazo, P; Ferrando, J C

To describe the characteristics of bacteraemias, according to age, in a community hospital. A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38.3% in the 65 to 79 age group; and 37.9% in the 80 years or older group). The most common underlying disease in all the groups was diabetes mellitus. In the most elderly patients, the Charlson index was highest, there was a lower proportion of exogenous factors, and almost 25% were severely dependent (Barthel index<20). Escherichia coli was the most common germ, and the main focus was urological. The patients aged 80 years or older had predominantly healthcare-associated infections, less severe symptoms (sepsis) (66.3%) and higher mortality (29.1%) compared with the younger patients. The very elderly patients with bacteraemia presented fewer exogenous factors, greater comorbidity and a poorer functional situation. The most common focus was urological and the origin was healthcare related. Despite their less severe clinical presentation, these patients' mortality was greater, and their degree of dependence was a highly relevant independent risk factor. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Headache Characteristics and Clinical Features of Elderly Migraine Patients.

Science.gov (United States)

de Rijk, Pablo; Resseguier, Noémie; Donnet, Anne

2018-04-01

To investigate the headache characteristics and clinical features of elderly migraine patients at a tertiary headache center. We retrospectively reviewed 239 records of migraine patients, over the age of 64 at the first visit, who had migraine as defined by the International Classification of Headache Disorders 3rd edition (beta version) from 2006 to 2015 based on the Marseille registry at Timone Hospital. 13.8% (33/239) patients had migraine with aura only, 13.0% (31/239) had both diagnoses. Of the patients who presented with migraine with aura, 13.4% (32/239) presented with aura without headache. Unilateral pain location was reported by 58.6% (140/239) of patients and the throbbing type of pain was present in 50.2% (120/239) of our study group. Photo- and phonophobia were observed in 77.4% (185/239) and 79.5% (190/239) of patients. Seventy-nine out of 239 (30.1%) patients were found to have probable medication overuse. Within this group, 31.65% (25/79) overused triptan and 70.9% (56/79) overused combination analgesics. We found higher frequencies of migraine for patients whose age at onset of migraine was younger than 18 years, and low frequency migraine was reported more frequently in the later onset group (P = .0357). We assess the headache characteristics of elderly migraine patients who were seen at our tertiary headache center and report the high frequency of probable medication overuse headache in this study group. Finally, we suggest that age of onset is an important factor in the clinical profile of these patients. © 2017 American Headache Society.

[METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

Science.gov (United States)

Stogov, M V; Ovchinnikov, E N; Sazonova, N V

2015-01-01

This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.

Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

Science.gov (United States)

Wilson, I B; Kaplan, S

2000-12-15

Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (pbetter communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV

Socio-economic characteristics of patients with generalized retinal dystrophy in Denmark

DEFF Research Database (Denmark)

Bertelsen, Mette; Linneberg, Allan; Rosenberg, Thomas

2015-01-01

the Danish Retinitis Pigmentosa Registry and 228,500 control subjects matched by age and gender. Demographic and socio-economic data were retrieved from Statistics Denmark. Differences between cases and controls were estimated using conditional logistic regression. RESULTS: On 1 January 2012, 2285 patients......PURPOSE: To examine socio-economic characteristics of patients with generalized retinal dystrophy in Denmark. METHODS: Cross-sectional population-based study with analysis of socio-economic characteristics including income, education, employment status and civil status in 2285 patients from...... with a Danish civil registration number were registered as having a generalized retinal dystrophy. At the age of 40 years, less patients than controls had a high education (odds ratio (OR), 0.51; 95% confidence interval (CI95), 0.41-0.62), a high income (OR, 0.21; CI95, 0.17-0.26) and were married (OR, 0.39; CI...

The characteristics and mortality risk factors for acute kidney injury in different age groups in China-a cross sectional study.

Science.gov (United States)

Wei, Qing; Liu, Hong; Tu, Yan-; Tang, Ri-Ning; Wang, Yan-Li; Pan, Ming-Ming; Liu, Bi-Cheng

2016-10-01

Age is an independent risk factor for acute kidney injury (AKI). The causes and outcomes of AKI in children, middle-aged, and older patients are different. The objective of this country-based study was to identify the characteristics and mortality factors for AKI in different age groups in China. Using data from 374,286 adult patients (≥18 years) admitted to 44 study hospitals, we investigated the characteristics and mortality risk factors for AKI in four different age groups: 18-39 years of age, 40-59 years of age, 60-79 years of age, and ≥80 years of age. The identification criteria for AKI included the 2012 KDIGO AKI definition and an expanded criterion. The country-based survey included 7604 AKI patients (7604/374,286, 2.03%). The proportions of AKI in the four age groups were 11.52%, 30.79%, 41.03%, and 16.66%, respectively. In any age group, the patients with AKI stage 1 were the majority (43.4%, 42.4%, 46.4%, and 52.2%, respectively), and the most common classification of AKI was pre-renal AKI (44.3%, 51.3%, 52.3%, and 56.4%, respectively). The higher AKI peak stage occurred for the in-hospital mortality factors for AKI in all age groups; except for the AKI stage 2 patients in the 18-39 age group. The characteristics and mortality factors for AKI vary by age in China. Elderly patients were the primary population with AKI, and the most common type of AKI was pre-renal AKI. Special caution should be taken to the old population in hospitalized patients to prevent the pre-renal AKI.

Characteristics of patients with chronic exertional compartment syndrome.

Science.gov (United States)

Davis, Daniel E; Raikin, Steven; Garras, David N; Vitanzo, Peter; Labrador, Hallie; Espandar, Ramin

2013-10-01

Chronic exertional compartment syndrome (CECS) is a condition that causes reversible ischemia and lower extremity pain during exercise. To date there are few large studies examining the characteristics of patients with CECS. This study aimed to present these characteristics by examining the largest published series of patients with a confirmed diagnosis of the disorder. An IRB-approved, retrospective review was undertaken of patients with a suspected diagnosis of CECS undergoing pre- and postexercise compartment pressure testing between 2000 and 2012. Patients were evaluated for gender, age, duration of symptoms, pain level, specific compartments involved, compartment pressure measurements, and participation and type of athletics. Two-hundred twenty-six patients (393 legs) underwent compartment pressure testing. A diagnosis of CECS was made in 153 (67.7%) patients and 250 (63.6%) legs with elevated compartment measurements; average age of the patients was 24 years (range, 13-69 years). Female patients accounted for 92 (60.1%) of those with elevated pressures. Anterior and lateral compartment pressures were elevated most frequently, with 200 (42.5%) and 167 (35.5%) compartments, respectively. One hundred forty-one (92.2%) patients reported participation in sports, with running being the most common individual sport and soccer being the most common team sport. Duration of pain prior to diagnosis averaged 28 months. Although there is ample literature pertaining to the diagnostic criteria and treatment algorithm of the condition, few papers have described the type of patient most likely to develop CECS. This is the largest study to date to evaluate the type of patient likely to present with chronic exertional compartment syndrome. Level III, retrospective review.

Genetic Counselling, BRCA1/2 Status and Clinico-pathologic Characteristics of Patients with Ovarian Cancer before 50 Years of Age

Science.gov (United States)

Cvelbar, Mirjam; Hocevar, Marko; Novakovic, Srdjan; Stegel, Vida; Perhavec, Andraz

2017-01-01

Abstract Background In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC) has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m) within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years. Patients and methods All clinical data have to be interpreted in the light of many changes happened in the field of EOC just in the last few years: new hystology stage classification (FIGO), new hystology types and differentiation grades classification, new therapeutic possibilities (PARP inhibitors available, also in Slovenia) and new guidelines for genetic counselling of EOC patients (National Comprehensive Cancer Network, NCCN), together with next-generation sequencing possibilities. Results Compliance rate at the invitation was 43.1%. In the group of 27 invited or previously tested patients with EOC diagnosed before the age of 45 years, five gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within the group was 18.5%. There were 4 gBRCA1 and 1 gBRCA2 mutations detected. In the extended group of 42 tested patients with EOC diagnosed before the age of 50 years, 14 gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within this extended, partially selected group was 33.3%. There were 11 gBRCA1 and 3 gBRCA2 mutations detected. Conclusions The rate of gBRCA1/2 mutation in tested unselected EOC patients under the age of 50 years was higher than 10%, namely 18.5%. Considering also a direct therapeuthic benefit of PARP inhibitors for BRCA positive patients, there is a double reason to offer genetic testing to

Physician and patient characteristics associated with clinical inertia in blood pressure control.

Science.gov (United States)

Harle, Christopher A; Harman, Jeffrey S; Yang, Shuo

2013-11-01

Clinical inertia, the failure to adjust antihypertensive medications during patient visits with uncontrolled hypertension, is thought to be a common problem. This retrospective study used 5 years of electronic medical records from a multispecialty group practice to examine the association between physician and patient characteristics and clinical inertia. Hierarchical linear models (HLMs) were used to examine (1) differences in physician and patient characteristics among patients with and without clinical inertia, and (2) the association between clinical inertia and future uncontrolled hypertension. Overall, 66% of patients experienced clinical inertia. Clinical inertia was associated with one physician characteristic, patient volume (odds ratio [OR]=0.998). However, clinical inertia was associated with multiple patient characteristics, including patient age (OR=1.021), commercial insurance (OR=0.804), and obesity (OR=1.805). Finally, patients with clinical inertia had 2.9 times the odds of uncontrolled hypertension at their final visit in the study period. These findings may aid the design of interventions to reduce clinical inertia. ©2013 Wiley Periodicals, Inc.

Combining macula clinical signs and patient characteristics for age-related macular degeneration diagnosis: a machine learning approach.

Science.gov (United States)

Fraccaro, Paolo; Nicolo, Massimo; Bonetto, Monica; Giacomini, Mauro; Weller, Peter; Traverso, Carlo Enrico; Prosperi, Mattia; OSullivan, Dympna

2015-01-27

To investigate machine learning methods, ranging from simpler interpretable techniques to complex (non-linear) "black-box" approaches, for automated diagnosis of Age-related Macular Degeneration (AMD). Data from healthy subjects and patients diagnosed with AMD or other retinal diseases were collected during routine visits via an Electronic Health Record (EHR) system. Patients' attributes included demographics and, for each eye, presence/absence of major AMD-related clinical signs (soft drusen, retinal pigment epitelium, defects/pigment mottling, depigmentation area, subretinal haemorrhage, subretinal fluid, macula thickness, macular scar, subretinal fibrosis). Interpretable techniques known as white box methods including logistic regression and decision trees as well as less interpreitable techniques known as black box methods, such as support vector machines (SVM), random forests and AdaBoost, were used to develop models (trained and validated on unseen data) to diagnose AMD. The gold standard was confirmed diagnosis of AMD by physicians. Sensitivity, specificity and area under the receiver operating characteristic (AUC) were used to assess performance. Study population included 487 patients (912 eyes). In terms of AUC, random forests, logistic regression and adaboost showed a mean performance of (0.92), followed by SVM and decision trees (0.90). All machine learning models identified soft drusen and age as the most discriminating variables in clinicians' decision pathways to diagnose AMD. Both black-box and white box methods performed well in identifying diagnoses of AMD and their decision pathways. Machine learning models developed through the proposed approach, relying on clinical signs identified by retinal specialists, could be embedded into EHR to provide physicians with real time (interpretable) support.

Characteristics of Patients Involved in Psychotherapy in Bosnia and Herzegovina

Directory of Open Access Journals (Sweden)

Sabina Alispahić

2014-04-01

Full Text Available Introduction: The aim of this study was to determine the demographic and clinical characteristics of Bosnian and Herzegovinian patients involved in psychotherapeutic treatments in order to explore the current situation of psychotherapy in Bosnia and Herzegovina.Methods: The study included 213 patients (154 women and 47 men undergoing diverse psychotherapeutic treatments. Data about demographic and clinical characteristics were collected by questionnaire. Following characteristics were documented: age, sex, education, employment status, marital status, specific problem that got the client involved in psychotherapy, type of psychotherapy, and use of psychopharmacology.Results: Majority of the patients undergoing psychotherapy are age up to 40 and female. They are by vast majority holding a university degree and are employed. Nearly equal number of patients is living in partnership or marriage compared to single or never been married. Most frequent reasons for getting involved in the psychotherapy treatment are of the intrapersonal nature (depression, anxiety and panic attacks. Majority of the patients were involved in gestalt and cognitive behavioral psychotherapy, and at the same time majority of those were not prescribed medicaments.Conclusions: We point out and overview some of the most prominent socio-demographic traits of patients undergoing psychotherapy, the ones that could be important in the future research with the higher degree of control. In the terms of personal initiative, psychotherapy stops being a taboo in Bosnia and Herzegovina. However, there is still a long path until it reaches integration in daily life of the people.

Clinical Characteristics of Patients with Intradialytic Hypertension.

Science.gov (United States)

Eftimovska-Otovic, Natasa; Grozdanovski, Risto; Taneva, Borjanka; Stojceva-Taneva, Olivera

2015-01-01

Intradialytic hypertension with a prevalence of 15% among hemodialysis patients is with unknown pathophysiology, demographic, laboratoiy and clinical characteristic of patients, and it's influence on longtenn clinical effects (cardiovascular morbidity and mortality, rate of hospitalization). The aim of the study is to present the clinical, laboratoiy and demographic characteristics of patients with intradialytic hypertension in our dialysis center. Out of 110 hemodialysis patients, 17 patients (15,45%) had intradialytic hypertension - started at a systolic pressure greater than 140 nun Hg or had an increase in systolic pressure more than 10 mm Hg during the session, and 17 patients were nonnotensive or had a drop in blood pressure dining the dialysis. HD were performed 3 times per week with a duration of 4-5 hours, on machines with controlled ultrafiltration and high flux syntetic membrane (polyetersulfon) sterilized with gamma rays. A dialysate with standard electrolytes content was used (Na(+) 138 mmol/L, K(+) 2,0 mmol/L, Ca(++) 1,5 mmol/L, Mg (+)1,0 mmol/L, CH(3)COO(-) 3,0 mmol/L, Cl -110 mmol/1, HCO(3)(-) 35 mmol/L). We analysed the following demographic and clinical characteristics: gender, age, BMI, dialysis vintage, vascular acces, cardiovascular comorbidity (cardiomyopathy, ischemic cardiac disease, peripheral artery disease, heart valve disease), number and type of antihypertensive drugs, weekly dose of erythropoesis - stimulating agent, standard monthly, three and six months laboratoiy analyzes, and sp Kt/V and PCR. Statistical analysis was performed using the statistical software SPSS 17.0. hi both groups men were predominant (IDH group 88.23%, control group 64.07%). The IDH group was older (59.00 ± 7.64 versus 49.00 ± 13.91, p = 0.314) and with lower BMI (p = 0.246) compared to the control group. The DDH patients had significantly lower serum sodium and higher sodium gradient (135.75 ± 2.03 versus 137.33 ± 1.97, p = 0.042; 2.25 ± 1.98 versus 0.66 �

Tumor location and patient characteristics of colon and rectal adenocarcinomas in relation to survival and TNM classes

International Nuclear Information System (INIS)

Hemminki, Kari; Santi, Irene; Weires, Marianne; Thomsen, Hauke; Sundquist, Jan; Bermejo, Justo Lorenzo

2010-01-01

Old age at diagnosis is associated with poor survival in colorectal cancer (CRC) for unknown reasons. Recent data show that colonoscopy is efficient in preventing left-sided cancers only. We examine the association of Tumor Node Metastasis (TNM) classes with diagnostic age and patient characteristics. The Swedish Family-Cancer Database has data on TNM classes on 6,105 CRC adenocarcinoma patients. Ordinal logistic regression analysis was performed to model tumor characteristics according to age at diagnosis, tumor localization, gender, socioeconomic status, medical region and family history. The results were compared to results from survival analysis. The only parameters systematically associated with TNM classes were age and tumor localization. Young age at diagnosis was a risk factor for aggressive CRC, according to stage, N and M with odds ratios (ORs) ranging from 1.80 to 1.93 for diagnosis before age 50 years compared to diagnosis at 80+ years. All tumor characteristics, particularly T, were worse for colon compared to rectal tumors. Right-sided tumors showed worse characteristics for all classifiers but M. The survival analysis on patients diagnosed since 2000 showed a hazard ratio of 0.55 for diagnosis before age 50 years compared to diagnosis at over 80 years and a modestly better prognosis for left-sided compared to right-sided tumors. The results showed systematically more aggressive tumors in young compared to old patients. The poorer survival of old patients in colon cancer was not related to the available tumor characteristics. However, these partially agreed with the limited colonoscopic success with right-sided tumors

Age-Related Differences in Clinical Characteristics and Esophageal Motility in Patients with Dysphagia.

Science.gov (United States)

Nakato, Rui; Manabe, Noriaki; Kamada, Tomoari; Matsumoto, Hideo; Shiotani, Akiko; Hata, Jiro; Haruma, Ken

2017-06-01

Dysphagia in elderly patients has a major effect on nutrition and quality of life (QOL). Although several studies have shown that aging itself is associated with changes in esophageal motility, the impact of these changes on dysphagia symptoms and QOL is unknown. This study assessed the manometric diagnoses of elderly patients with dysphagia compared with diagnoses in younger counterparts. Participants included 116 consecutive patients examined for dysphagia from 2007 to 2014. We divided patients into three groups by age: Group A, 66 years and older (24 men, 23 women); Group B, 45-65 years (18 men, 24 women); and Group C, 44 years and younger (15 men, 12 women). The three groups were compared in regard to symptoms, esophageal motility, and health-related QOL (HRQOL). All patients underwent esophageal manometry examination and completed a self-administered questionnaire concerning their symptoms; HRQOL assessment was based on results of the Short Form-8 General Health Survey. Symptoms rated ≥4 points on the Likert scale were defined as significant. Although all patients had dysphagia as a major symptom, more elderly patients reported globus sensation, whereas more young patients reported heartburn as the primary symptom. Manometric diagnoses were generally similar across the three groups. Ineffective esophageal motility was more prevalent in Groups A and C than in Group B, although the difference was not statistically significant. No significant differences in manometric parameters or HRQOL were detected among the three groups. Despite differences in symptom patterns, broad manometric diagnoses and impairment of HRQOL in elderly patients with dysphagia are similar to those in younger counterparts.

Hypertrophy in port-wine stains: Prevalence and patient characteristics in a large patient cohort

NARCIS (Netherlands)

van Drooge, Anne Margreet; Beek, Johan F.; van der Veen, J. P. Wietze; van der Horst, Chantal M. A. M.; Wolkerstorfer, Albert

2012-01-01

Background: Port-wine stains (PWS) may thicken and darken with age. Little is known about the pathogenesis and epidemiology of PWS hypertrophy because of the lack of large studies. Objective: We sought to assess the prevalence and characteristics of patients with hypertrophic PWS. Methods: Medical

Pseudophakic retinal detachment in young-aged patients.

Directory of Open Access Journals (Sweden)

Thomas Laube

Full Text Available To investigate the incidence and risk factors for retinal detachment (RD after cataract surgery or refractive lens exchange (RLE in patients aged below 61 years.Retrospective medical chart review of 7,886 patients (13,925 eyes who underwent cataract surgery or RLE. Patients aged below 61 years were selected. Age, gender, axial length, follow-up times, and the occurrence of RD were recorded. Additional characteristics documented for RD cases were: history of RD, preexisting retinal findings, laser capsulotomy, status of macula at RD, date and details of RD.From a total of 421 patients (677 eyes aged below 61 years 24 cases of RD were identified, resulting in an overall cumulative incidence per eyes of 3.55%. The mean follow-up time was 45 ± 32.8 months. Ninety-two % of all RDs occurred within 3.6 years from surgery. Axial length had a significant effect on the risk of RD after cataract/ RLE surgery (HR = 1.42, P = 0.0001, 95% CI 1.19-1.69. The highest incidence of RD occurred in the subgroup of 25 to 28.9 mm axial length (10.2%. With an increase in age of ten years, the hazard of postoperative RD was not significantly increased by a factor of 1.50 (P = 0.286, 95% CI 0.71-3.15. The highest incidence of RD occurred in patients aged 50-54 years (5.39%. Compared to females, males had an almost twofold not significant risk of postoperative RD (HR = 1.96, P = 0.123, 95% CI 0.83-4.63. None of the RD cases had a history of RD.Axial length is a significant risk factor for pseudophakic RD. The need for cataract surgery or RLE should be carefully considered in patients with axial lengths between 25 and 29 mm, aged 50-54 years, in males, and in case of preexisting retinal findings.

Metabolic Characteristics and Risks Associated with Stone Recurrence in Korean Young Adult Stone Patients.

Science.gov (United States)

Kang, Ho Won; Seo, Sung Pil; Kim, Won Tae; Kim, Yong-June; Yun, Seok-Joong; Kim, Wun-Jae; Lee, Sang-Cheol

2017-08-01

The aim of this study was to assess the metabolic characteristics and risks of stone recurrence in young adult stone patients in Korea. The medical records of 1532 patients presenting with renal or ureteric stones at our stone clinic between 1994 and 2015 were retrospectively reviewed. Patients were grouped according to age (young adult, 18-29 years; intermediate onset, 30-59 years; old age, ≥60 years) at first presentation, and measurements of clinicometabolic characteristics and risks of stone recurrence were compared. Overall, excretion of urinary stone-forming substances was highest in the intermediate onset group, followed by the young adult and old age groups. Importantly, excretion of urinary citrate was lowest in the young adult group. Kaplan-Meier analyses identified a significant difference between the three age groups in terms of stone recurrence (log rank test, p adult stone patients. Younger age (18-29 years) at first stone presentation was a significant risk factor for stone recurrence, and urinary citrate excretion was an independent risk factor affecting recurrence in this group. Metabolic evaluation and potassium citrate therapy should be considered for young adult stone patients to prevent recurrence.

Clinical characteristics of patients with conjunctivochalasis

Directory of Open Access Journals (Sweden)

Balci O

2014-08-01

Full Text Available Ozlem Balci Ophthalmology Department, Kolan Hospitalium Group, Istanbul, Turkey Purpose: To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh. Methods and materials: This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded. Results: The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60% eyes with grade 1 CCh; 15 (30% eyes with grade 2 CCh; and five (10% eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90% eyes, and in the remaining five (10% CCh was located in the superior bulbar conjunctiva. Ten (33.3% patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6% patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients. Conclusion: Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora. Keywords: ocular irritation, epiphora, dryness, eye pain, blurry vision

Clinical Characteristics for 348 Patients with Adrenal Incidentaloma

Directory of Open Access Journals (Sweden)

Jongho Kim

2013-03-01

Full Text Available BackgroundAdrenal incidentaloma is an adrenal neoplasm frequently encountered in clinical practice for which detection rates have recently increased. We describe here the clinical characteristics of adrenal incidentalomas.MethodsA retrospective study was performed examining the age, sex, location, size, function, and the histological findings for 348 patients with an adrenal mass discovered incidentally on computed tomography (CT undertaken for health examination or nonadrenal disease from August 2005 to May 2012.ResultsPatients consisted of 156 males (44.8% and 192 females (55.2%, aged between 20 and 86. Adrenal masses were most commonly found in patients in their sixth decade (32.5%. Regarding the location of the masses, 62.0% were found in the left adrenal gland, 30.2% were found in the right, and 7.8% were found bilaterally. Of all of the masses analyzed, 87.1% were 1 to 4 cm in size, and an adenoma-like appearance was the most common finding (75.3% seen on CT scans. Hormonal analysis showed that 82.2% of the masses were nonfunctioning, 6.0% were diagnosed as subclinical Cushing's syndrome, 4.6% were aldosterone-producing adenomas, and 7.2% were pheochromocytomas. Adrenalectomy was performed in a total of 69 patients having adenoma (50.7%, pheochromocytoma (24.6%, and carcinoma (4.3%.ConclusionThe characteristics of benign, malignant, nonfunctional, and functional adrenal masses that were incidentally found at our hospital were similar to those presented in other studies.

Facial attractiveness judgements reflect learning of parental age characteristics.

Science.gov (United States)

Perrett, David I; Penton-Voak, Ian S; Little, Anthony C; Tiddeman, Bernard P; Burt, D Michael; Schmidt, Natalie; Oxley, Roz; Kinloch, Nicholas; Barrett, Louise

2002-05-07

Mate preferences are shaped by infant experience of parental characteristics in a wide variety of species. Similar processes in humans may lead to physical similarity between parents and mates, yet this possibility has received little attention. The age of parents is one salient physical characteristic that offspring may attend to. The current study used computer-graphic faces to examine how preferences for age in faces were influenced by parental age. We found that women born to 'old' parents (over 30) were less impressed by youth, and more attracted to age cues in male faces than women with 'young' parents (under 30). For men, preferences for female faces were influenced by their mother's age and not their father's age, but only for long-term relationships. These data indicate that judgements of facial attractiveness in humans reflect the learning of parental characteristics.

Contribution of Patient Characteristics to Differences in Readmission Rates

Science.gov (United States)

Barnett, Michael L.; Hsu, John; McWilliams, J. Michael

2016-01-01

Importance Medicare penalizes hospitals with higher than expected readmission rates by up to 3% of annual inpatient payments. Expected rates are adjusted only for patients’ age, sex, discharge diagnosis, and recent diagnoses. Objective To assess the extent to which a comprehensive set of patient characteristics accounts for differences in hospital readmission rates. Design and Setting Using survey data from the nationally representative Health and Retirement Study (HRS) and linked Medicare claims, we assessed 29 patient characteristics from survey data and claims as potential predictors of 30-day readmission when added to standard Medicare adjustments of hospital readmission rates. We then compared the distribution of these characteristics between participants admitted to hospitals with higher vs. lower hospital-wide readmission rates reported by Medicare. Finally, we estimated differences in the probability of readmission between these groups of participants before vs. after adjusting for the additional patient characteristics. Participants HRS participants enrolled in Medicare who were hospitalized from 2009–2012 (n=8,067 admissions). Main Outcomes and Measures All-cause readmission within 30 days of discharge. Results Of the additional 29 patient characteristics assessed, 22 significantly predicted readmission beyond standard adjustments, and 17 of these were distributed differently between hospitals in the highest vs. lowest quintiles of publicly reported hospital-wide readmission rates (p≤0.04 for all). Almost all of these differences (16 of 17) indicated that participants admitted to hospitals in the highest quintile of readmission rates were more likely to have characteristics that were associated with a higher probability of readmission. The difference in the probability of readmission between participants admitted to hospitals in the highest vs. lowest quintile of hospital-wide readmission rates was reduced by 48% from 4.41 percentage points with

Clinician characteristics, communication, and patient outcome in oncology: a systematic review.

Science.gov (United States)

De Vries, A M M; de Roten, Y; Meystre, C; Passchier, J; Despland, J-N; Stiefel, F

2014-04-01

The aim of this study was to review the literature on clinician characteristics influencing patient-clinician communication or patient outcome in oncology. Studies investigating the association of clinician characteristics with quality of communication and with outcome for adult cancer patients were systematically searched in MEDLINE, PSYINFO, PUBMED, EMBASE, CINHAL, Web of Science and The Cochrane Library up to November 2012. We used the preferred reporting items for systematic reviews and meta-analyses statement to guide our review. Articles were extracted independently by two of the authors using predefined criteria. Twenty seven articles met the inclusion criteria. Clinician characteristics included a variety of sociodemographic, relational, and personal characteristics. A positive impact on quality of communication and/or patient outcome was reported for communication skills training, an external locus of control, empathy, a socioemotional approach, shared decision-making style, higher anxiety, and defensiveness. A negative impact was reported for increased level of fatigue and burnout and expression of worry. Professional experience of clinicians was not related to communication and/or to patient outcome, and divergent results were reported for clinician gender, age, stress, posture, and confidence or self-efficacy. Various clinician characteristics have different effects on quality of communication and/or patient outcome. Research is needed to investigate the pathways leading to effective communication between clinicians and patients. Copyright © 2013 John Wiley & Sons, Ltd.

Is There a Characteristic Clinical Profile for Patients with Dementia and Sundown Syndrome?

Science.gov (United States)

Angulo Sevilla, David; Carreras Rodríguez, María Teresa; Heredia Rodríguez, Patricia; Fernández Sánchez, Marisa; Vivancos Mora, José Aurelio; Gago-Veiga, Ana Beatriz

2018-01-01

Sundown syndrome (SS) is the onset or worsening of behavioral symptoms in the evening in patients with dementia. To identify the differential clinical profile of patients with dementia who present SS. A cross-sectional, case-control observational study was conducted by retrospectively reviewing the medical records of patients with dementia in a specialized Memory Unit. We compared the characteristics of patients with and without SS, including sociodemographic variables, etiology, and severity of the dementia, behavioral symptoms, sleep disorders (considering insomnia and hypersomnia), other diseases and treatments employed. We identified the factors related to SS and conducted a logistic regression analysis to establish a predictive nomogram. Of the 216 study patients with dementia, 41 (19%) had SS. There was a predominance of women (2.4:1), advanced age (p = 0.0001), dependence (p patients with dementia, with a predictive capacity of 80.1%. In our study, age, a higher score on the GDS, and the presence of insomnia or hypersomnia are differential clinical characteristics of patients with SS. We defined a nomogram that helps predicting the occurrence of SS in patients with dementia.

Clinicopathological features of patients with breast cancer aged 70 years or over.

Science.gov (United States)

Aytekin, Aydin; Karatas, Fatih; Sahin, Suleyman; Erdem, Gokmen U; Altundag, Kadri

2017-01-01

The risk of breast cancer (BC) increases in parallel with increasing age. Despite the increased disease burden in elderly patients, there is still a great uncertainty regarding "how to manage" BC in aging-population. The purpose of this study was to investigate the clinicopathological features and treatment approaches of patients with BC aged 70 years or over. The medical records of 4413 patients with BC followed between 1994-2015 were retrospectively analyzed. Of the 4413 patients, 238 with stage I to III disease aged 70 years or over at BC diagnosis were enrolled into this study. Patients were divided into 2 groups according to the age as group 1 (70-79 years, N=192) and group 2 (80 or over, N=46). Clinicopathological features of patients including tumor histology, grade, estrogen (ER) and progesterone receptor (PgR) status, human epidermal growth factor receptor 2 (HER2) status, tumor size, lymph node involvement (LNI), lymphovascular invasion (LVI), perineural invasion (PNI), clinical stage, type of surgery, treatments and comorbid diseases were evaluated. The median age was 74 for group 1 (range 70-79) and 82 for group 2 (range 80-92). Excluding tumor size and grade, no statictically significant difference was found between the two groups according to histopathological characteristics. Patients in group 2 had more commonly larger T stage (T4), and less frequently presented with grade I tumor (p=0.014 and p=0.044, respectively). Modified radical mastectomy and adjuvant chemotherapy were more commonly performed in group 1 (p=0.001 and p=0.001, respectively). In contrast, neoadjuvant treatment was more frequently applied in group 2 (p=0.003). There was no difference in disease-free survival (DFS) between the groups (p=0.012), however, median overall survival (OS) was significantly higher in group 1 (p=0.03). Excluding the tumor grade and tumor size, both groups had similar histopathological features. However, patients aged between 70-79 years were likely to

Clinical characteristics of reticular pseudodrusen in Korean patients.

Science.gov (United States)

Lee, Mee Yon; Yoon, Jaemoon; Ham, Don-Il

2012-03-01

To clarify the clinical characteristics of reticular pseudodrusen in Korean patients. Retrospective, observational, consecutive case series. A total of 255 eyes of 130 patients diagnosed with reticular pseudodrusen were evaluated. Reticular pseudodrusen were diagnosed by characteristic fundus findings using ophthalmoscopy, color fundus photography with blue-channel examination, near-infrared photography, red-free photography, autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography. Age-related macular degeneration (AMD) was determined by the International Classification and Grading System. The mean age was 72.6 ± 9.0 years (range, 43 to 92 years). Most reticular pseudodrusen patients had bilateral disease (97.7%), with a female preponderance (86.2%). All 3 patients who showed unilateral reticular pseudodrusen had neovascular AMD in the eye with no reticular pseudodrusen. AMD was found in 183 eyes (71.8 %), among which early AMD was found in 115 eyes (45.1%), geographic atrophy was found in 41 eyes (16.1%), and neovascular AMD was found in 27 eyes (10.6%). The mean age of patients with AMD and with no AMD was 73.7 ± 9.2 years (range, 58 to 92 years) and 69.9 ± 11.7 years (range, 43 to 90 years), respectively, and there was a statistical difference between these 2 groups (P < .05). Classic choroidal neovascularization was found in 13 eyes (48.1%), and occult choroidal neovascularization was found in 14 eyes (51.9%) in the neovascular AMD group. Reticular pseudodrusen occurs in Koreans, and clinical manifestations of reticular pseudodrusen in Koreans did not differ significantly from those described in white persons. However, our study demonstrated a higher rate of bilaterality compared with those previously reported, and geographic atrophy was found to be associated more commonly with reticular pseudodrusen than with neovascular AMD. Ethnical differences may be associated with these

Seizure characteristics in multiple sclerosis patients

Directory of Open Access Journals (Sweden)

Vahid Shaygannejad

2013-01-01

Full Text Available Background: To evaluate seizure characteristic among multiple sclerosis patients with coexistent seizure activity compared to control group. Materials and Methods : This study is a cross-sectional study which was conducted by reviewing the clinical records of patients with definite diagnosis of MS according to McDonald′s criteria from March 2007 to June 2011, who referred to the MS clinic of the university. Results : A total of 920 patients with a diagnosis of MS were identified, among whom 29 patients (3.15% with seizure activity (case due to MS with the mean age of 32.6 ± 6.23 years were analyzed. Also, fifty MS patients without any seizure occurrence with the mean age of 33.7 ± 7.4 years were used as our control group. In case group, seizure was general tonic clonic in 23 patients (79.3%, complex partial in four (13.8%, and simple partial in two (5.9%. The 26 available interictal EEGs in MS patients showed abnormal EEG pattern in 22 (84.6% of them, including focal epileptic form discharge or focal slowing in 10 (38.5%, generalized discharge (spike-wave, polyspike, or general paroxysmal fast activity in 10 (38.5%, and general slowing activity in 10 record (38.5%. MRI reviews of the 26 available brain MRIs showed subcortical white mater lesions in 22 (84.6% of patients with seizure. All MRIs were performed within one month after the first seizure episode. Amongst 48 available MRIs in our control group, 91.7% (44 cases showed periventricular lesions and in 8.3% (4 cases subcortical white matter lesions were reported. Conclusion : The result of this study demonstrated the higher rate of subcortical whit matter lesion in MS patients with seizure occurrence compared to control group.

Medico-social characteristics of patients treated in rehabilitation centres

Directory of Open Access Journals (Sweden)

Shapovalenko T.V.

2013-12-01

Full Text Available Aim: analysis of the medical social characteristics of patients of rehabilitation center. Material and methods. The data that had been got by extracting from medical records of patients of the Center of restorative medicine and rehabilitation «Medical rehabilitation center» MOH of Russia on a specially developed «Patient card» were analyzed. Results. Among the majority of patients (who got treatment in the center with diseases of the musculoskeletal system and connective tissue (44,9%, almost 1/3 (29,2% were patients with diseases of the circulatory system, in the third place — patients with injuries (14,1 %. Conclusion. As a result of the peculiarities of a patient health condition of different age and social position had been revealed.

Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan

Science.gov (United States)

Sakitani, Kosuke; Enooku, Kenichiro; Kubo, Hirokazu; Tanaka, Akifumi; Arai, Hisakatsu; Kawazu, Shoji; Koike, Kazuhiko

2017-01-01

Objective The leading cause of liver injuries in diabetes mellitus may be associated with fatty liver. We aimed to elucidate the relationship between fatty liver and diabetes characteristics. Methods Retrospectively, 970 patients with diabetes were analysed. Fatty liver was diagnosed when the liver/spleen Hounsfield unit ratio by computed tomography was below 0.9. Clinical diabetes characteristics were compared between patients with and without fatty liver. Results Of 970 patients (717 male and 253 female; mean age 64.4 years), 175 males (24.4%) and 60 females (23.7%) had fatty liver. None of the 28 patients with type 1 diabetes had fatty liver. In male patients with type 2 diabetes, age, visceral adipose tissue (VAT), albumin, alanine amino-transferase (ALT), and triglycerides were independently associated with fatty liver. In females, age and bilirubin were associated with fatty liver. Conclusions Fatty liver is associated with type 2 diabetes characteristics, including younger age and elevated VAT, albumin, ALT, and triglycerides in males and younger age and elevated bilirubin levels in females. PMID:28553763

Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan.

Science.gov (United States)

Sakitani, Kosuke; Enooku, Kenichiro; Kubo, Hirokazu; Tanaka, Akifumi; Arai, Hisakatsu; Kawazu, Shoji; Koike, Kazuhiko

2017-06-01

Objective The leading cause of liver injuries in diabetes mellitus may be associated with fatty liver. We aimed to elucidate the relationship between fatty liver and diabetes characteristics. Methods Retrospectively, 970 patients with diabetes were analysed. Fatty liver was diagnosed when the liver/spleen Hounsfield unit ratio by computed tomography was below 0.9. Clinical diabetes characteristics were compared between patients with and without fatty liver. Results Of 970 patients (717 male and 253 female; mean age 64.4 years), 175 males (24.4%) and 60 females (23.7%) had fatty liver. None of the 28 patients with type 1 diabetes had fatty liver. In male patients with type 2 diabetes, age, visceral adipose tissue (VAT), albumin, alanine amino-transferase (ALT), and triglycerides were independently associated with fatty liver. In females, age and bilirubin were associated with fatty liver. Conclusions Fatty liver is associated with type 2 diabetes characteristics, including younger age and elevated VAT, albumin, ALT, and triglycerides in males and younger age and elevated bilirubin levels in females.

Clinical characteristics differentiating bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia.

Science.gov (United States)

Toyota, M; Yasuda, N; Koda, S; Ohara, H; Enkhbat, S; Tsogt, G

1998-06-01

The objective of this study is to clarify clinical characteristics which differentiate bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia. The subjects include 338 patients aged 16 years and older who had undergone bacteriological examinations. Of them, 107 patients (31.7%) were confirmed bacteriologically. The proportion of bacteriological positive results increased significantly among patients who had cavities in the roentgenographic examination, cough at diagnosis and the family history of tuberculosis. Addressing these clinical characteristics will contribute to raising not only the sensitivity of the sputum examination, but also the specificity of the roentgenographic examination in the diagnostic process of tuberculosis.

Dysthymic disorder: clinical characteristics in relation to age at onset.

Science.gov (United States)

Barzega, G; Maina, G; Venturello, S; Bogetto, F

2001-09-01

The variability in the clinical presentation of dysthymia has given rise to a rich debate in literature, and various hypotheses have been proposed. One is that the clinical presentation differs in relation to age at onset. The aim of the study was to evaluate differences in socio-demographic and clinical characteristics in a sample of patients with dysthymia (DSM-IV), in relation to age at onset. 84 consecutive outpatients with a diagnosis of dysthymia (DSM-IV) were studied. All subjects were evaluated by a semistructured clinical interview and the following rating scales: HAM-A, HAM-D, MADRS, Paykel's Interview for Recent Life Events. 23.8% of the sample had early-onset (dysthymia. Patients with early-onset disorder were significantly younger at the observation, more frequently female and single. They had a significantly longer duration of illness and in a significantly higher percentage had already received a specialist treatment before admission in the present trial. No differences in the frequency of symptoms were observed. A significantly higher percentage of patients with late-onset disease reported at least one stressful event in the year preceding the onset of dysthymia. A positive history of major depression was significantly more common among the early-onset group; social phobia, panic disorder and conversive disorder were also more frequent in this group. The late-onset patients frequently presented generalized anxiety disorder, substance abuse and somatization disorder. The study is retrospective and enrolls a limited number of cases. The present study agrees with other reports on the differences in clinical presentation of dysthymia according to age at onset. Although they are not actually related to age at onset, some interesting findings emerged in the symptomatological characterization of the disorder, referring to the diagnostic criteria proposed in DSM-IV.

Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy.

Science.gov (United States)

Leffert, Lisa R; Clancy, Caitlin R; Bateman, Brian T; Cox, Margueritte; Schulte, Phillip J; Smith, Eric E; Fonarow, Gregg C; Schwamm, Lee H; Kuklina, Elena V; George, Mary G

2015-10-01

Hospitalizations for pregnancy-related stroke are rare but increasing. Hemorrhagic stroke (HS), ie, subarachnoid hemorrhage and intracerebral hemorrhage, is more common than ischemic stroke in pregnant versus nonpregnant women, reflecting different phenotypes or risk factors. We compared stroke risk factors and outcomes in pregnant versus nonpregnant HS in the Get With The Guidelines-Stroke Registry. Using medical history or International Classification of Diseases-Ninth Revision codes, we identified 330 pregnant and 10 562 nonpregnant female patients aged 18 to 44 years with HS in Get With The Guidelines-Stroke (2008-2014). Differences in patient and care characteristics were compared by χ(2) or Fisher exact test (categorical variables) or Wilcoxon rank-sum (continuous variables) tests. Conditional logistic regression assessed the association of pregnancy with outcomes conditional on categorical age and further adjusted for patient and hospital characteristics. Pregnant versus nonpregnant HS patients were younger with fewer pre-existing stroke risk factors and medications. Pregnant versus nonpregnant subarachnoid hemorrhage patients were less impaired at arrival, and less than half met blood pressure criteria for severe preeclampsia. In-hospital mortality was lower in pregnant versus nonpregnant HS patients: adjusted odds ratios (95% CI) for subarachnoid hemorrhage 0.17 (0.06-0.45) and intracerebral hemorrhage 0.57 (0.34-0.94). Pregnant subarachnoid hemorrhage patients also had a higher likelihood of home discharge (2.60 [1.67-4.06]) and independent ambulation at discharge (2.40 [1.56-3.70]). Pregnant HS patients are younger and have fewer risk factors than their nonpregnant counterparts, and risk-adjusted in-hospital mortality is lower. Our findings suggest possible differences in underlying disease pathophysiology and challenges to identifying at-risk patients. © 2015 American Heart Association, Inc.

Age-dependent Characteristics in Women with Breast Cancer: Mastectomy and Reconstructive Trends at an Urban Academic Institution.

Science.gov (United States)

Rodby, Katherine A; Robinson, Emilie; Danielson, Kirstie K; Quinn, Karina P; Antony, Anuja K

2016-03-01

Breast reconstruction is an important aspect of treatment after breast cancer. Postmastectomy reconstruction bears a significant impact on a woman's postsurgical confidence, sexuality, and overall well-being. Previous studies have inferred that women under age 40 years have unique characteristics that distinguish them from an older cohort. Identifying age-dependent trends will assist with counseling women on mastectomy and reconstruction. To identify age-dependent trends, 100 consecutive women were sampled from a prospectively maintained breast reconstruction database at an urban academic institution from June 2010 through June 2013. Women were placed into two cohorts mastectomy, reconstructive and symmetry procedures were evaluated. Statistical analysis was performed using SAS software. In 100 patients of the sample study cohort, 151 reconstructions were performed. Increasing age was associated with one or more comorbidities [odds ratio (OR) = 1.07, P = 0.005], whereas younger age was associated with metastatic disease (OR = 0.88, P = 0.006), chemotherapy (OR = 0.94, P = 0.01), and radiation (OR = 0.94, P = 0.006); split cohorts demonstrated similar trends (P Mastectomy and reconstructive characteristics associated with younger age included bilateral mastectomy (OR = 0.94, P = 0.004), tissue expander (versus autologous flap) (OR = 0.94, P = 0.009), extra high implant type (OR = 0.94, P = 0.049), whereas increasing use of autologous flaps and contralateral mastopexy symmetry procedures (OR = 1.09, P = 0.02) were associated with an aging cohort. Increasing age was not associated with an increasing likelihood of complications (P = 0.75). Age-related factors play a role in the treatment of patients with breast cancer. Younger women typically present with more aggressive features requiring oncologic treatment including chemotherapy and radiation. Mastectomy and reconstructive choices also demonstrate age-dependent characteristics. Women in younger age groups are more

Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.

Science.gov (United States)

Strassle, Paula D; Williams, Felicia N; Napravnik, Sonia; van Duin, David; Weber, David J; Charles, Anthony; Cairns, Bruce A; Jones, Samuel W

Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.

Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam

Directory of Open Access Journals (Sweden)

Lauritsen Jens M

2011-05-01

Full Text Available Abstract Background The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Objectives Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. Methods A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007 were obtained for comparison. Results A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively. The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Conclusions Characteristics of patients

Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam.

Science.gov (United States)

Hoa, Nguyen B; Wei, Chen; Sokun, Chay; Lauritsen, Jens M; Rieder, Hans L

2011-05-23

The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007) were obtained for comparison. A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively.The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Characteristics of patients greatly differed between countries and between patient categories. In Cambodia

Physical activity and body mass index: the contribution of age and workplace characteristics.

Science.gov (United States)

Nelson, Candace C; Wagner, Gregory R; Caban-Martinez, Alberto J; Buxton, Orfeu M; Kenwood, Christopher T; Sabbath, Erika L; Hashimoto, Dean M; Hopcia, Karen; Allen, Jennifer; Sorensen, Glorian

2014-03-01

The workplace is an important domain for adults, and many effective interventions targeting physical activity and weight reduction have been implemented in the workplace. However, the U.S. workforce is aging, and few studies have examined the relationship of BMI, physical activity, and age as they relate to workplace characteristics. This paper reports on the distribution of physical activity and BMI by age in a population of hospital-based healthcare workers and investigates the relationships among workplace characteristics, physical activity, and BMI. Data from a survey of patient care workers in two large academic hospitals in the Boston area were collected in late 2009 and analyzed in early 2013. In multivariate models, workers reporting greater decision latitude (OR=1.02, 95% CI=1.01, 1.03) and job flexibility (OR=1.05, 95% CI=1.01, 1.10) reported greater physical activity. Overweight and obesity increased with age (pworkplace characteristics. Sleep deficiency (OR=1.56, 95% CI=1.15, 2.12) and workplace harassment (OR=1.62, 95% CI=1.20, 2.18) were also associated with obesity. These findings underscore the persistent impact of the work environment for workers of all ages. Based on these results, programs or policies aimed at improving the work environment, especially decision latitude, job flexibility, and workplace harassment should be included in the design of worksite-based health promotion interventions targeting physical activity or obesity. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Seminal characteristics and sexual behavior in men of different age groups: is there an aging effect?

Science.gov (United States)

Zavos, Panayiotis M; Kaskar, Khalied; Correa, Juan R; Sikka, Suresh C

2006-05-01

To assess the seminal characteristics as well as the sexual behavior of men of various age groups to establish the presence of an aging effect on those characteristics. Semen samples were collected from men (n = 792) undergoing in vitro fertilization or intrauterine insemination in cases of female factor infertility only. Samples were collected using a seminal collection device at intercourse and evaluated manually according to World Health Organization (WHO) standards. Men were divided into four groups according to their ages: (i) 20-30, (ii) 31-40, (iii) 41-50 and (iv) 51-60 years, and their seminal characteristics and responses to a sexual behavior questionnaire were compared. The data showed statistically significant differences in the seminal characteristics tested, most notably in the sperm concentration, motility, grade of motility, hypo-osmotic swelling and normal sperm morphology. Furthermore, the decline in normal sperm morphology with age was more pronounced when using strict criteria rather than WHO standards. There were also differences in total sperm count, total motile sperm and total functional sperm fraction (assessed by both WHO and strict criteria). Significant differences were also observed in the sexual behavior patterns in older men in terms of the number of years they have been trying to conceive, sexual frequency and sexual satisfaction. The data clearly illustrate an aging effect on semen characteristics and sexual behavior in men as they age. It is suggested that the aging effect be taken into consideration when proposing normal standard values for semen characteristics in routine semen analysis as outlined by WHO standards.

Clinical decision making in cancer care: a review of current and future roles of patient age.

Science.gov (United States)

Tranvåg, Eirik Joakim; Norheim, Ole Frithjof; Ottersen, Trygve

2018-05-09

Patient age is among the most controversial patient characteristics in clinical decision making. In personalized cancer medicine it is important to understand how individual characteristics do affect practice and how to appropriately incorporate such factors into decision making. Some argue that using age in decision making is unethical, and how patient age should guide cancer care is unsettled. This article provides an overview of the use of age in clinical decision making and discusses how age can be relevant in the context of personalized medicine. We conducted a scoping review, searching Pubmed for English references published between 1985 and May 2017. References concerning cancer, with patients above the age of 18 and that discussed age in relation to diagnostic or treatment decisions were included. References that were non-medical or concerning patients below the age of 18, and references that were case reports, ongoing studies or opinion pieces were excluded. Additional references were collected through snowballing and from selected reports, guidelines and articles. Three hundred and forty-seven relevant references were identified. Patient age can have many and diverse roles in clinical decision making: Contextual roles linked to access (age influences how fast patients are referred to specialized care) and incidence (association between increasing age and increasing incidence rates for cancer); patient-relevant roles linked to physiology (age-related changes in drug metabolism) and comorbidity (association between increasing age and increasing number of comorbidities); and roles related to interventions, such as treatment (older patients receive substandard care) and outcome (survival varies by age). Patient age is integrated into cancer care decision making in a range of ways that makes it difficult to claim age-neutrality. Acknowledging this and being more transparent about the use of age in decision making are likely to promote better clinical decisions

Clinical characteristics of patients with facial psoriasis in Malaysia.

Science.gov (United States)

Syed Nong Chek, Sharifah Rosniza; Robinson, Suganthy; Mohd Affandi, Azura; Baharum, Nurakmal

2016-10-01

Psoriasis involving the face is visible and can cause considerable emotional distress to patients. Its presence may also confer a poorer prognosis for the patient. This study sought to evaluate the characteristics of facial psoriasis in Malaysia. A cross-sectional study conducted using data from the Malaysian Psoriasis Registry from 2007 to 2011. Specific risk factors, i.e., age, age of onset, gender, duration of disease, obesity group, body surface area, Dermatology Life Quality Index (DLQI), family history of psoriasis, nail involvement, psoriatic arthritis, phototherapy, systemic therapy, clinic visit, days of work/school, and hospital admission due to psoriasis in the last 6 months were analyzed. A total of 48.4% of patients had facial psoriasis. Variables significantly associated with facial psoriasis are younger age, younger age of onset of psoriasis of ≤ 40 years, male, severity of psoriasis involving >10% of the body surface area, higher DLQI of >10, nail involvement, and history of hospitalization due to psoriasis. This study found that facial psoriasis is not as rare as previously thought. Ambient ultraviolet light, sebum, and contact with chemicals from facial products may reduce the severity of facial psoriasis, but these factors do not reduce the prevalence of facial psoriasis. The association with younger age, younger age of onset, higher percentage of body surface area involvement, higher DLQI of > 10, nail involvement, and hospitalization due to psoriasis support the notion that facial psoriasis is a marker of severe disease. © 2016 The International Society of Dermatology.

Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects.

Science.gov (United States)

Niederer, Daniel; Vogt, Lutz; Wilke, Jan; Rickert, Marcus; Banzer, Winfried

2015-03-01

The present study aims to develop age-dependent cutoff values in a quasi-experimental, cross-sectional diagnostic test study. One hundred and twenty (120) asymptomatic subjects (n = 100, 36♀, 18 75 years, for normative values; n = 20, 23-75 years, 15♀, for selectivity analyses) and 20 patients suffering from idiopathic neck pain (selectivity analyses, 22-71 years, 15♀) were included. Subjects performed five repetitive maximal cervical flexion/extension movements in an upright sitting position. Cervical kinematic characteristics (maximal range of motion (ROM), coefficient of variation (CV) and mean conjunct movements in rotation and flexion (CM)) were calculated from raw 3D ultrasonic data. Regression analyses were conducted to reveal associations between kinematic characteristics and age and gender and thus to determine normative values for healthy subjects. Age explains 53 % of the variance in ROM (decrease 10.2° per decade), 13 % in CV (increase 0.003 per decade) and 9 % in CM (increase 0.57° per decade). Receivers operating characteristic (ROC) analyses were conducted for differences between individual values of the kinematic characteristics and normative values to optimise cutoff values for distinguishing patients from unimpaired subjects (20 patients and 20 healthy). Cutoff values distinguished asymptomatic subjects' and chronic nonspecific neck patient's movement characteristics with sufficient quality (sensitivity 70-80 %, specificity 65-70 %). By including such classifications, the present findings expand actual research stating an age-related decrease in kinematic behaviour only using categorising span widths across decades. Future study is warranted to reveal our results' potential applicability for intervention onset decision making for idiopathic neck pain patients.

Metabolic characteristics and renal dysfunction in 65 patients with tophi prior to gout.

Science.gov (United States)

Lu, Chuan-Chin; Wu, Shyi-Kuen; Chung, Wei-Sheng; Lin, Liang-Hung; Hung, Ta-Wei; Yeh, Chih-Jung

2017-08-01

Tophi typically occur many years after uncontrolled gout. Therefore, their development before gout remains unusual. Such patients might exhibit some characteristic differences compared with typical tophaceous gout patients. In this study, 65 tophaceous gout patients with tophi as the first sign of gout (tophi-first group) were enrolled. Their clinical characteristics were compared with those of 1421 patients whose tophi occurred after gout (tophi-after group). Compared with the tophi-after group, the tophi-first group had a significantly higher percentage of female patients and patients with elderly onset of disease and a lower percentage of patients with a positive family history; these patients had lower body mass indices, serum urate levels, and estimated glomerular filtration rates (eGFRs). Female sex and negative family history were identified as the principal determinants of tophi development before gout. The decreasing eGFR among the tophi-first group was not due to the group per se but was a result of older age, longer tophi duration, and hyperuricemia. The most common site of initial tophi occurrence in both groups was the toe. In the tophi-first group, the occurrence rates for initial tophi sites were significantly higher at the finger but were lower at the ankle. The tophi-first group exhibited distinct characteristics of age, gender, family history, BMI, serum urate levels, and initial tophi site. This group had fewer comorbidities but similar renal dysfunction compared with the tophi-after group. Thus, patients presenting with tophi should be treated promptly, even if they have no history of gout symptoms.

Characteristics and clinical aspects of patients with spinal cord injury undergoing surgery

Directory of Open Access Journals (Sweden)

João Simão de Melo-Neto

Full Text Available ABSTRACT OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery. Individuals undergoing surgery were associated with complications after treatment. The authors assessed whether age influenced the characteristics of patients submitted to surgery. Subjects with <60 years of age were associated with motorcycle accidents and the morphologies of injury were fracture-dislocation. Elderly individuals were associated to fall, SCI in the lower cervical spine and the morphology of injury was listhesis. Subsequently, the authors analyzed the gender characteristics in these patients. Women who suffered car accidents were associated to surgery. Women were associated with paraparesis and the morphologic diagnosis was fracture-explosion, especially in the thoracolumbar transition and lumbosacral regions. Men who presented traumatic brain injury and thoracic trauma were related to surgery. These individuals had a worse neurological status and were associated to complications. Men and the cervical region were most affected, thereby, these subjects were analyzed separately (n= 92. The presence of complications increased the length of hospital stay. The simultaneous presence of morphological diagnosis, worst neurological status, tetraplegia, sensory, and motor alterations were associated with complications. Pneumonia and chest trauma were associated with mortality. CONCLUSION: These factors enable investments in prevention, rehabilitation, and treatment.

Characteristics Predicting Dyslipidemia in Drug-naïve Type 2 Diabetes Patients

Directory of Open Access Journals (Sweden)

Shi-Dou Lin

2006-09-01

Conclusion: We recommend a more intensive monitoring of lipid levels in drug-naïve diabetic patients who possess the characteristics of alcohol consumption or older age (men, long duration of diabetes (women, and higher BMI or WHR (both genders.

Clinical characteristics of reticular pseudodrusen in the fellow eye of patients with unilateral neovascular age-related macular degeneration.

Science.gov (United States)

Hogg, Ruth E; Silva, Rufino; Staurenghi, Giovanni; Murphy, George; Santos, Ana R; Rosina, Chiara; Chakravarthy, Usha

2014-09-01

To describe associations between reticular pseudodrusen, individual characteristics, and retinal function. Cohort study. We recruited 105 patients (age range, 52-93 years) who had advanced neovascular age-related macular degeneration (AMD) in only 1 eye from 3 clinical centers in Europe. Minimum follow-up was 12 months. The eye selected for study was the fellow eye without advanced disease. Clinical measures of vision were distance visual acuity, near visual acuity, and results of the Smith-Kettlewell low-luminance acuity test (SKILL). Fundus imaging included color photography, red-free imaging, blue autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography using standardized protocols. These were used to detect progression to neovascular AMD in the study eye during follow-up. All imaging outputs were graded for the presence or absence of reticular pseudodrusen (RPD) using a multimodal approach. Choroidal thickness was measured at the foveal center and at 2 other equidistant locations from the fovea (1500 μm) nasally and temporally. Metrics on retinal thickness and volume were obtained from the manufacturer-supplied automated segmentation readouts. Presence of RPD, distance visual acuity, near visual acuity, SKILL score, choroidal thickness, retinal thickness, and retinal volume. Reticular pseudodrusen was found in 43 participants (41%) on 1 or more imaging method. The SKILL score was significantly worse in those with reticular drusen (mean score ± standard deviation [SD, 38±12) versus those without (mean score ± SD, 33±9) (P = 0.034). Parafoveal retinal thickness, parafoveal retinal volume, and all of the choroidal thickness parameters measured were significantly lower in those with reticular drusen than in those without. The presence of RPD was associated with development of neovascular AMD when corrected for age and sex (odds ratio, 5.5; 95% confidence interval, 1.1-28.8; P = 0.042). All participants

Do Physician Recommendations for Colorectal Cancer Screening Differ by Patient Age?

Directory of Open Access Journals (Sweden)

Maida J Sewitch

2007-01-01

Full Text Available Colorectal cancer screening is underutilized, resulting in preventable morbidity and mortality. In the present study, age-related and other disparities associated with physicians’ delivery of colorectal cancer screening recommendations were examined. The present cross-sectional study included 43 physicians and 618 of their patients, aged 50 to 80 years, without past or present colorectal cancer. Of the 285 screen-eligible patients, 45% received a recommendation. Multivariate analyses revealed that, compared with younger nonde-pressed patients, older depressed patients were less likely to receive fecal occult blood test recommendations, compared with no recommendation (OR=0.31, 95% CI 0.09 to 1.02, as well as less likely to receive colonoscopy recommendations, compared with no recommendation (OR=0.14; 95% CI 0.03 to 0.66. Comorbidity and marital status were associated with delivery of fecal occult blood test and colonoscopy recommendations, respectively, compared with no recommendation. In summary, patient age and other characteristics appeared to influence physicians’ delivery of colorectal cancer screening and choice of modality.

The characteristics of the patients with Rett syndrome: Case series

Directory of Open Access Journals (Sweden)

Dutina Aleksandra

2016-01-01

Full Text Available Rett syndrome is a neurodevelopmental disorder caused by mutation in the gene MECP2 on the X chromosome. The main clinical characteristics are breathing disorders, epileptic seizures, scoliosis, walking disability and constipation with frequent growth failure and malnutrition. Our transversal study included 29 female patients with Rett syndrome treated in the Institute for Mother and Child Health Care ''Dr Vukan Čupić'' in Belgrade. The patients were anthropometrically measured by their height and weight and caluculating body mass index. The degree of scolisios, the frequency of epileptic seizures, walking ability and grade of respiratory dysfunction were assessed based on the clinical scales for disease severity estimation. The statistical data analysis was done in the software package PASW Statistics 18. The average age of the patients was 145.5±90.1 months. The average height was 125.2±22.1cm, the average weight 27.6±12.3kg, and the average body mass index was 16.6±3.5kg/m2. The average z scores for height, weight and BMI-for-age were statistically significantly lower in comparison to general population, which is given with negative z scores. There was the statistically significant negative coorelation between the age of patients and the average z scores for height-for-age (r=-0.464 p=0.011, weight-for-age (r=-0.433 p=0.019 and BMI-for-age (r=-0.433 p=0.019. The statistically significant negative coorelation was found between the degree of scoliosis and the average z scores for height and weight-for-age, but not with the average z score for BMI-for-age. The growth failure and malnutrition represent significant problems which are found in Rett syndrome. The detection of factors affecting the growth and nutrition in patients with Rett syndrome could greatly contribute to the improvement of the quality of life in the patients with Rett syndrome and perhaps lead to the correction of the approach of symptomatic and supportive therapy.

Patient characteristics and cancer prevalence in the Danish cancer patient pathway for patients with serious non-specific symptoms and signs of cancer-A nationwide, population-based cohort study

DEFF Research Database (Denmark)

Moseholm, E; Lindhardt, B Ø

2017-01-01

of included patients who were diagnosed with cancer after completing a NSSC-CPP diagnostic course. Associations between patient characteristics and cancer diagnosis were estimated in a multivariate logistic regression model. RESULTS: The mean age of the 23,934 patients included in the analysis was 64.6 years...

Age-Specific Patient Navigation Preferences Among Adolescents and Young Adults with Cancer.

Science.gov (United States)

Pannier, Samantha T; Warner, Echo L; Fowler, Brynn; Fair, Douglas; Salmon, Sara K; Kirchhoff, Anne C

2017-11-23

Patient navigation is increasingly being directed at adolescent and young adult (AYA) patients. This study provides a novel description of differences in AYA cancer patients' preferences for navigation services by developmental age at diagnosis. Eligible patients were diagnosed with cancer between ages 15 and 39 and had completed at least 1 month of treatment. Between October 2015 and January 2016, patients completed semi-structured interviews about navigation preferences. Summary statistics of demographic and cancer characteristics were generated. Differences in patient navigation preferences were examined through qualitative analyses by developmental age at diagnosis. AYAs were interviewed (adolescents 15-18 years N = 8; emerging adults 19-25 years N = 8; young adults 26-39 years N = 23). On average, participants were 4.5 years from diagnosis. All age groups were interested in face-to-face connection with a navigator and using multiple communication platforms (phone, text, email) to follow-up. Three of the most frequently cited needs were insurance, finances, and information. AYAs differed in support, healthcare, and resource preferences by developmental age; only adolescents preferred educational support. While all groups preferred financial and family support, the specific type of assistance (medical versus living expenses, partner/spouse, child, or parental assistance) varied by age group. AYAs with cancer have different preferences for patient navigation by developmental age at diagnosis. AYAs are not a one-size-fits-all population, and navigation programs can better assist AYAs when services are targeted to appropriate developmental ages. Future research should examine fertility and navigation preferences by time since diagnosis. While some navigation needs to span the AYA age range, other needs are specific to developmental age.

Characteristics and outcomes of patients with multiple myeloma aged 21-40years versus 41-60years

DEFF Research Database (Denmark)

Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit

2016-01-01

We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 pati...

Ocular biometric characteristics of cataract patients in western China.

Science.gov (United States)

Huang, Qing; Huang, Yongzhi; Luo, Qu; Fan, Wei

2018-04-17

We aimed to measure ocular biometric characteristics in older cataract patients from western China. Ocular biometry records were retrospectively analyzed for 6933 patients with cataracts (6933 eyes) at least 50 years old who were treated at West China Hospital of Sichuan University. Partial coherence laser interferometry gave the following population averages: axial length (AL), 24.32 ± 2.42 mm; anterior chamber depth (ACD), 3.08 ± 0.47 mm; keratometric power (K), 44.23 ± 1.66 diopters; and corneal astigmatism (CA), 1.00 ± 0.92 diopters. The percentage of individuals with AL > 26.5 mm was 13.66%, while the percentage with CA > 1.0 diopters was 35.54%. Mean AL and ACD showed a trend of decrease with increasing age (P biometric characteristics as other populations. The high prevalence of severe axial myopia warrants further investigation.

Occupational Characteristics and Cognitive Aging in the Glostrup 1914 Cohort

DEFF Research Database (Denmark)

Gow, Alan J; Avlund, Kirsten; Mortensen, Erik L

2014-01-01

Objectives.The effect of occupational characteristics on cognitive change over 20 years was examined.Method.Occupational characteristics-intellectual challenge, physical hazards, and psychological demands-were assessed in the Glostrup 1914 Cohort when aged 60 years, and cognitive ability...... was assessed by 4 cognitive ability tests at ages 60, 70, and 80. RESULTS: Individuals in more intellectually challenging occupations had higher cognitive ability (r = .27-.38, p occupations performed more poorly (r = -.12 and -.13 at ages 50 and 60, p ..., the one in the more intellectually challenging occupation had lower subsequent cognitive ability. The association of physical hazards with lower cognitive ability level did not remain after adjustment for the basic demographics, and none of the occupational characteristics were associated with cognitive...

Characteristics of choroidal neovascularization in the complications of age-related macular degeneration prevention trial.

Science.gov (United States)

Maguire, Maureen G; Alexander, Judith; Fine, Stuart L

2008-09-01

To describe the characteristics of incident choroidal neovascularization (CNV) in observed and treated eyes in the Complications of Age-related Macular Degeneration Prevention Trial (CAPT). Cross-sectional descriptive study within a multicenter, randomized clinical trial. Patients who developed CNV during CAPT follow-up. Inclusion criteria for CAPT specified bilateral large drusen (>or=10 drusen at least 125 micro), visual acuity >or=20/40 in each eye, and age >or=50. Exclusion criteria included CNV and geographic atrophy >1 Macular Photocoagulation Study (MPS) disc area or within 500 micro of the foveal center. One eye of each person was selected randomly for low-intensity laser treatment and the contralateral eye was observed. Fluorescein angiography was performed at baseline, annually for >or=5 years, and whenever there were symptoms of CNV. Trained readers at the CAPT Photograph Reading Center assessed color stereo photographs and angiogram negatives to identify CNV. Choroidal neovascularization was classified by type (predominantly classic CNV, minimally classic CNV, occult only CNV, or scar), location, and area. Visual acuity was measured by certified examiners. Symmetry of characteristics between eyes of bilaterally affected patients was examined. Choroidal neovascularization developed in 282 eyes of 225 patients. At the time of detection, 192 (68%) of the lesions were occult only, 153 (54%) were subfoveal, and 157 (56%) were or=20/40 in 123 (69%) of 179 eyes with visual acuity measured at the time of detection. Choroidal neovascularization developed in both eyes in 57 patients (25%) during CAPT follow-up. Lesions in eyes of bilaterally affected patients were no more similar to each other than affected eyes in 2 different patients. When patients are monitored closely, many CNV lesions can be detected outside of the fovea and when they are relatively small. Early detection may lead to improved long-term visual acuity.

Characteristics of breast cancer patients with central nervous system metastases: a single-center experience.

Science.gov (United States)

Harputluoglu, Hakan; Dizdar, Omer; Aksoy, Sercan; Kilickap, Saadettin; Dede, Didem S; Ozisik, Yavuz; Guler, Nilufer; Barista, Ibrahim; Gullu, Ibrahim; Hayran, Mutlu; Selek, Ugur; Cengiz, Mustafa; Zorlu, Faruk; Tekuzman, Gulten; Altundag, Kadri

2008-05-01

The aim of this study was to assess the characteristics of breast cancer patients with central nervous system (CNS) metastases and factors associated with survival after development of CNS metastasis. One-hundred-forty-four patients with brain metastases were retrospectively analyzed. Median age at the time of brain metastasis diagnosis was 48.9. Median time between initial diagnosis and development of brain metastasis was 36 months. Fourteen cases had leptomeningeal involvement. Twenty-two patients (15.3%) had single metastasis. Ten percent of the patients had surgery, 94% had radiotherapy and 63% had chemotherapy. Median survival after development of brain metastasis was 7.4 months. Survival of patients with single metastasis was significantly longer than those with multiple metastases (33.5 vs. 6.5 months, p = 0.0006). Survival of patients who received chemotherapy was significantly longer than those who received radiotherapy alone (9.9 vs. 2 months, p < 0.0001). In multivariate Cox regression analyses, presence of single metastasis and application of chemotherapy were the only significant factors associated with better survival (p = 0.047 and p < 0.0001, respectively). Age at initial diagnosis or at the time of brain metastasis, time from initial diagnosis to development of brain metastasis, menopausal status, tumor stage, grade, hormone receptor or HER2 status individually were not associated with survival. In this study, survival after the diagnosis of CNS metastases appeared to be affected by patient characteristics rather than biologic characteristics of the tumor. This is probably secondary to the lack of effective treatment options in these patients and overall poor prognosis.

Medical Cannabis in Arizona: Patient Characteristics, Perceptions, and Impressions of Medical Cannabis Legalization.

Science.gov (United States)

Troutt, William D; DiDonato, Matthew D

2015-01-01

Many advances have been made toward understanding the benefits of medical cannabis. However, less is known about medical cannabis patients themselves. Prior research has uncovered many important patient characteristics, but most of that work has been conducted with participants in California, who may not represent medical cannabis patients throughout the United States. Furthermore, it is unknown if medical cannabis legalization, which typically imposes strict regulations on cannabis cultivation and sale, impacts patients' experiences acquiring and using cannabis. The goal of this study was to address these limitations by (1) examining the characteristics, perceptions, and behaviors of medical cannabis patients in Arizona; and (2) questioning participants with a history of cannabis use regarding their experiences with cannabis before and after legalization. Patients in Arizona share many characteristics with those in California, but also key differences, such as average age and degree of cannabis consumption. Participants also had positive perceptions of the effect of medical cannabis legalization, reporting that feelings of safety and awareness were higher after legalization compared to before. The results are discussed in relation to evidence from patients in other states and in terms of their potential policy implications.

Characteristics and prognosis of Japanese female breast cancer patients: The BioBank Japan project

Directory of Open Access Journals (Sweden)

Koshi Nakamura

2017-03-01

Full Text Available Background: Breast cancer is currently the most common type of cancer in Japanese females. Unlike most other types of cancer, breast cancer develops more frequently in middle-aged females than in elderly females. Methods: Of all Japanese female breast cancer patients aged ≥20 years whom the BioBank Japan Project originally enrolled between 2003 and 2008, 2034 were registered within 90 days after their diagnosis. We described the lifestyle and clinical characteristics of these patients at study entry. Furthermore, we examined the effect of these characteristics on all-cause mortality. Results: In the female patients registered within 90 days after diagnosis, the frequency of stage 0 or unclassified, stage I, II, III and IV were 11.4%, 47.9%, 37.0%, 2.9% and 0.8%, respectively. The proportion of histological types was 12.9% for non-invasive carcinoma (ductal carcinoma and lobular carcinoma, 81.0% for invasive carcinoma (papillotubular carcinoma, solid tubular carcinoma, scirrhous carcinoma and special types, 0.2% for Paget’s diseases and 5.8% for others. Those positive for the estrogen and progesterone receptors accounted for 75.8% and 62.1% of all patients, respectively. Among 1860 female participants registered within 90 days, 218 participants died during 144,54 person-years of follow-up. More advanced stage, elevation of serum carcinoembryonic antigen and carbohydrate antigen 15-3 levels and absence of the estrogen receptor at study entry were crudely associated with an increased risk of all-cause mortality after adjustment for age. Conclusions: This study showed the association of several clinical characteristics with all-cause mortality in female breast cancer patients.

Characteristics of positive-interaction parenting style among primiparous teenage, optimal age, and advanced age mothers in Canada.

Science.gov (United States)

Kim, Theresa H M; Connolly, Jennifer A; Rotondi, Michael; Tamim, Hala

2018-01-08

Positive-interaction parenting early in childhood is encouraged due to its association with behavioural development later in life. The objective of this study was to examine if the level of positive-interaction parenting style differs among teen, optimal age, and advanced age mothers in Canada, and to identify the characteristics associated with positive-interaction parenting style separately for each age group. This was a cross-sectional secondary analysis of the National Longitudinal Survey of Children and Youth. First-time mothers with children 0-23 months were grouped into: teen (15-19 years, N = 53,409), optimal age (20-34 years, N = 790,960), and advanced age (35 years and older, N = 106,536). The outcome was positive-interaction parenting style (Parenting Practices Scale); maternal socio-demographics, health, social, and child characteristics were considered for backward stepwise multiple linear regression modeling, stratified for each of the age groups. Teen, optimal age, and advanced age mothers reported similar levels of positive- interaction parenting style. Covariates differed across the three age groups. Among optimal age mothers, being an ever-landed immigrant, childcare use, and being devoted to religion were found to decrease positive-interaction parenting style, whereas, higher education was found to increase positive-interaction parenting style. Teen mothers were not found to have any characteristics uniquely associated with positive-interaction parenting. Among advanced age mothers, social support was uniquely associated with an increase in positive-interaction parenting. Very good/excellent health was found to be positively associated with parenting in teens but negatively associated with parenting in advanced age mothers. Characteristics associated with positive-interaction parenting varied among the three age groups. Findings may have public health implications through information dissemination to first-time mothers, clinicians

Characteristics and Outcomes of Elderly Patients Refused to ICU

Directory of Open Access Journals (Sweden)

María-Consuelo Pintado

2013-01-01

Full Text Available Background. There are few data regarding the process of deciding which elderly patients are refused to ICU admission, their characteristics, and outcome. Methods. Prospective longitudinal observational cohort study. We included all consecutive patients older than 75 years, who were evaluated for admission to but were refused to treatment in ICU, during 18 months, with 12-month followup. We collected demographic data, ICU admission/refusal reasons, previous functional and cognitive status, comorbidity, severity of illness, and hospital and 12-month mortality. Results. 338 elderly patients were evaluated for ICU admission and 88 were refused to ICU (26%. Patients refused because they were “too ill to benefit” had more comorbidity and worse functional and mental situation than those admitted to ICU; there were no differences in illness severity. Hospital mortality rate of the whole study cohort was 36.3%, higher in patients “too ill to benefit” (55.6% versus 35.8%, P<0.01, which also have higher 1-year mortality (73.7% versus 42.5%, P<0.01. High comorbidity, low functional status, unavailable ICU beds, and age were associated with refusal decision on multivariate analysis. Conclusions. Prior functional status and comorbidity, not only the age or severity of illness, can help us more to make the right decision of admitting or refusing to ICU patients older than 75 years.

Patient-reported access to primary care in Ontario: effect of organizational characteristics.

Science.gov (United States)

Muggah, Elizabeth; Hogg, William; Dahrouge, Simone; Russell, Grant; Kristjansson, Elizabeth; Muldoon, Laura; Devlin, Rose Anne

2014-01-01

To describe patient-reported access to primary health care across 4 organizational models of primary care in Ontario, and to explore how access is associated with patient, provider, and practice characteristics. Cross-sectional survey. One hundred thirty-seven randomly selected primary care practices in Ontario using 1 of 4 delivery models (fee for service, established capitation, reformed capitation, and community health centres). Patients included were at least 18 years of age, were not severely ill or cognitively impaired, were not known to the survey administrator, had consenting providers at 1 of the participating primary care practices, and were able to communicate in English or French either directly or through a translator. Patient-reported access was measured by a 4-item scale derived from the previously validated adult version of the Primary Care Assessment Tool. Questions were asked about physician availability during and outside of regular office hours and access to health information via telephone. Responses to the scale were normalized, with higher scores reflecting greater patient-reported access. Linear regressions were used to identify characteristics independently associated with access to care. Established capitation model practices had the highest patient-reported access, although the difference in scores between models was small. Our multilevel regression model identified several patient factors that were significantly (P = .05) associated with higher patient-reported access, including older age, female sex, good-to-excellent self-reported health, less mental health disability, and not working. Provider experience (measured as years since graduation) was the only provider or practice characteristic independently associated with improved patient-reported access. This study adds to what is known about access to primary care. The study found that established capitation models outperformed all the other organizational models, including reformed

Tuberculous Pleural Effusion: Clinical Characteristics of 320 Patients.

Science.gov (United States)

Bielsa, Silvia; Acosta, Cristina; Pardina, Marina; Civit, Carmen; Porcel, José M

2018-05-22

To analyze the clinical and radiological characteristics and features of pleural fluid (PF) in patients with tuberculous pleural effusion (TPE). Retrospective analysis of TPEs treated in our clinic over the last 23years. We included 320 patients with TPE (70% men; median age 33years). Mycobacterium tuberculosis was identified in the sputum or PF of 36% of the patients by microscopic examination, solid and liquid media cultures, or nucleic acid amplification tests. The greatest percentage of positive microbiological findings were associated with human immunodeficiency virus (HIV) co-infection (OR: 3.27), and with the presence in PF of proteins 60% (OR: 3.23), and glucose Pleural adenosine deaminase <35U/L was associated with TPEs that occupied less than half of the hemithorax (OR: 6.36) and with PF lactate dehydrogenase levels <500U/L (OR: 8.09). Radiological pulmonary opacities (30%) were more common in TPE occupying less than half of the hemithorax (OR: 2.73), in bilateral TPE (OR: 4.48), and in older patients (OR: 1.02). Factors predicting mortality were: HIV co-infection (OR: 24), proteins in PF <5g/dL (OR: 10), and greater age (OR: 1.05). Patients with TPE and HIV co-infection and those with lower concentrations of proteins in PF had higher rates of positive microbiological results and death. Moreover, older patients had more pulmonary opacities and a higher incidence of death. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Characteristic adverse events and their incidence among patients participating in acute ischemic stroke trials.

Science.gov (United States)

Hesse, Kerrick; Fulton, Rachael L; Abdul-Rahim, Azmil H; Lees, Kennedy R

2014-09-01

Adverse events (AE) in trial populations present a major burden to researchers and patients, yet most events are unrelated to investigational treatment. We aimed to develop a coherent list of expected AEs, whose incidence can be predicted by patient characteristics that will inform future trials and perhaps general poststroke care. We analyzed raw AE data from patients participating in acute ischemic stroke trials. We identified events that occurred with a lower 99% confidence bound greater than nil. Among these, we applied receiver operating characteristic principles to select the fewest types of events that together represented the greatest number of reports. Using ordinal logistic regression, we modeled the incidence of these events as a function of patient age, sex, baseline National Institutes of Health Stroke Scale, and multimorbidity status, defining Ppatients, reporting 21 217 AEs. Among 756 types of AEs, 132 accounted for 82.7%, of which 80% began within 10 days after stroke. Right hemisphere (odds ratio [OR], 1.67), increasing baseline National Institutes of Health Stroke Scale (OR, 1.11), multimorbidity status (OR, 1.09 per disease), patient age (OR, 1.01 per year), height (OR, 1.01 per centimeter), diastolic blood pressure (OR, 0.99 per mm Hg), and smoking (OR, 0.82) were independently associated with developing more AEs but together explained only 13% of the variation. A list of 132 expected AEs after acute ischemic stroke may be used to simplify interpretation and reporting of complications. AEs can be modestly predicted by patient characteristics, facilitating stratification of patients by risk for poststroke complications. © 2014 American Heart Association, Inc.

Is Older Age Associated with Higher Self- and Other-Rated ASD Characteristics?

Science.gov (United States)

Lever, Anne G; Geurts, Hilde M

2018-06-01

Autism spectrum disorder (ASD) characteristics seem to abate over time, but whether this protracts until late adulthood is largely unknown. We cross-sectionally investigated self- and other-reported ASD characteristics of adults with (ASD: N max-self  = 237, N max-other  = 130) and without ASD (COM: N max-self  = 198, N max-other  = 148) aged 19-79 years. Within the ASD group, self-reported ASD characteristics, and sensory sensitivities were highest in middle adulthood, while age was not associated to empathy. Sex differences were also found. However, age-and sex-related differences were not revealed by others and self- and other-report were poorly concordant. These results show that ASD characteristics in adulthood are differently perceived across age, sex, and informants and suggest that it is important to repeatedly assess self-reported ASD characteristics during adulthood.

PHYSICAL EDUCATION AND INDIVIDUAL CHARACTERISTICS OF THE AGE SPECIFIC DEVELOPMENT

Directory of Open Access Journals (Sweden)

Е. М. Revenko

2017-01-01

Full Text Available The aim of this paper is scientific substantiation of the importance of the individual characteristics of the age specific youth development which will result in the rational modelling of students’ physical education.Methodology and research methods. The methods involve collection of experimental data carried out by means of evaluation of motor abilities and general intelligence of students. Motor abilities of students were studied by measuring of strength (dead lift dynamometry, strength endurance (pull-up, speed and power abilities (standing jump, as well as speed ability (running 30, 60 or 100 m, depending on age, aerobic endurance (running 1000 or 3000 m, depending on age. The dynamics of integral physical preparedness (DIPP of each student was calculated by calculation the arithmetic mean values of the growth rates of the development of motor abilities. Assessment of General Intelligence (GI of the 8th, 10th and 11th-grades school pupils as well as the 1st to 3rd year students was carried out through the test of R. Amthauer in the adaptation of L. A. Yazykova, and school pupils of the 6th grade were assessed through the Intelligent Test (GIT.Results. Discrepancies in the dynamics of the mental and motor areas development of maturing personality, which are interpreted as individual characteristics of the age specific development are experimentally revealed. Individual psychological differences leading to the different susceptibility to the development of motor and intellectual abilities appearing in adolescence and early adolescence are analysed. A leading role of activity in formation of the individual characteristics of the age specific development is substantiated. The conclusion of necessity to formulate to the students differing in individual characteristics of the age specific development differentiated in the complexity requirements and motor tasks in the course of physical training is made.Scientific novelty. For the first time

Characteristic and Outcome of Psoriatic Arthritis Patients with Hyperuricemia.

Science.gov (United States)

AlJohani, Roa'A; Polachek, Ari; Ye, Justine Yang; Chandran, Vinod; Gladman, Dafna D

2018-02-01

To determine the characteristics of patients with psoriatic arthritis (PsA) who have hyperuricemia (HUC) and their outcomes, especially cardiovascular (CVD) and kidney diseases. Patients have been followed prospectively at the PsA clinic according to a standard protocol at 6- to 12-month intervals. We defined HUC in men > 450 µ mol/l or women > 360 µ mol/l. We matched patients with HUC based on sex and age ± 5 years with normal uric acid patients. Demographics information and disease characteristics were reviewed. Outcomes of patients with HUC, especially CVD and kidney diseases, were recorded. Conditional logistic regression was performed to determine factors independently associated with HUC in patients with PsA. There were 325 (31.9%) out of 1019 patients with PsA who had HUC. Of these, 318 cases were matched to 318 controls. There were 11 (3.4%) out of 325 patients with HUC who had gout. Patients with HUC had longer disease duration and a higher Psoriasis Area and Severity Index. They had more concurrent comorbidities, including CVD and metabolic diseases, as well as higher prevalence of kidney stones and higher creatinine. Only 1 patient with HUC was treated with allopurinol at first evaluation visit and 7 patients during followup. Over the followup, 163 of the 318 patients had persistent HUC (pHUC) for more than 2 visits. Patients with pHUC developed more myocardial infarction, heart failure, and renal impairment. Multivariate analysis showed an association between pHUC, PsA disease duration, and obesity. HUC is common in patients with PsA, especially in those with longer disease duration and obesity. Proper control of HUC and metabolic diseases may play a preventive role in improving PsA outcomes.

Do clinical characteristics and outcome in nonagenarians with a hip fracture differ from younger patients?

NARCIS (Netherlands)

Vochteloo, Anne J.H.; Borger van der Burg, Boudewijn L.S.; Tuinebreijer, Wim E.; de Vries, Mark R.; Niggebrugge, Arthur H.P.; Bloem, Rolf M.; Maier, Andrea B.; Nelissen, Rob G.H.H.; Pilot, Peter

Aim: To compare clinical characteristics and outcome of nonagenarian hip fracture patients with younger patients aged 65-89years. Methods: This was a cohort follow-up study of admissions for a hip fracture between 2005-2010 (mean follow up of 3.5years) in two teaching hospitals in the Netherlands;

Service provision patterns by main diagnoses and characteristics of patients.

Science.gov (United States)

Brennan, D S; Spencer, A J; Szuster, F S

2000-06-01

Service provision patterns may be influenced not only by clinical oral health status leading to a diagnosis and treatment plan, but also by other variables such as patient characteristics. The main aim of this study was to investigate whether associations between services provided and patient factors would persist after controlling for the main presenting diagnosis or condition. A random sample of dentists surveyed in 1993-94 provided a response rate of 74%. Private general practitioners recorded service provision data from logs of 1-2 typical days of practice. Caries (26.5%) was the most prevalent diagnosis, followed by recall/maintenance care (19.0%), pulpal/periapical infection (10.9%), and failed restorations (10.4%). Diagnoses were associated with variation in the percentage of patients receiving services in main areas of service, and also with insurance status, sex and age distributions of patients, and type of visit (chi-square; Pservices indicated statistically significant associations with patient characteristics and diagnosis categories. Controlling for diagnosis, uninsured patients and those visiting for emergencies had less favourable service patterns (e.g., higher odds of extractions, but lower odds of preventive and crown and bridge services) compared to patients who had dental insurance or visited for check-ups or other non-emergency dental problems. The influence of these factors on services provided has implications of public health importance in terms of appropriateness of care and social inequality.

TNM and Modified Dukes staging along with the demographic characteristics of patients with colorectal carcinoma

Science.gov (United States)

Akkoca, Ayşe Neslin; Yanık, Serdar; Özdemir, Zeynep Tuğba; Cihan, Fatma Gökşin; Sayar, Süleyman; Cincin, Tarık Gandi; Çam, Akın; Özer, Cahit

2014-01-01

Aim: Colon adenocarcinoma, is the most common cancer in gastrointesinal system (GIS). The whole world is an important cause of morbidity and mortality. TNM and modified Dukes classification which has great importance in the diagnosis and treatment of Colorectal cancer (CRC). TNM and Modified Dukes classification results of histopathological examination and the demographic characteristics of patients and their relation were investigated. Materials and methods: Lower gastrointestinal operation results of 85 patients were examined accepted to clinical Pathology between January 1997-November 2013. Colon cancer had been diagnosed at 85 patients with pathology materials and staging was done according to the TNM and Modified Duke classification. The demographic characteristics of patients, differentiation grade, lymph node involvement, serous involvement were evaluated retrospectively. Results: In this study 37 patients (43.52%) were men and 48 (56.47%) were women. Ages of patients were between 19 and 87 with a mean age of 57.31 ± 15.31. Lymph node, differentiation, serosa involvement, Modified Dukes and TNM classification was assessed according to sex and age. TNM classification by sex was not statistically significant (p > 0.05). There was no statistically significant relationship between age and differentiation (p = 0.085). Value of differentiation increased towards from 1 to 3 inversely proportional to age. So young patients defined as well-differentiated at the conclusion. Negative relationship was evaluated between age and TNM Class variables. As a result, the relationship between age and TNM was not significant (p > 0.05). However, with increasing age the degree of staging was also found to increase. TNM classification was associated with the differentiation and it was significant (p = 0.043). Conclusion: Colon cancer, when contracted at an early stage, it is suitable for surgery and curative treatment can be done with minimal morbidity and mortality. However

The association of patient characteristics and spinal curve parameters with Lenke classification types.

Science.gov (United States)

Sponseller, Paul D; Flynn, John M; Newton, Peter O; Marks, Michelle C; Bastrom, Tracey P; Petcharaporn, Maty; McElroy, Mark J; Lonner, Baron S; Betz, Randal R

2012-06-01

Retrospective review. To determine the association of patient characteristics and spinal curve parameters with Lenke curve types. The Lenke curve classification may be used for surgical planning and clinical research. We retrospectively reviewed the records of 1912 patients with adolescent idiopathic scoliosis who underwent initial surgery at 21 years of age or younger; collected data on patient's age, patient's sex, primary curve magnitude (Society (SRS) outcomes questionnaire (SRS-22) score; and compared that data by Lenke curve type. Analysis of variance and χ tests were used as appropriate (significance level, P ≤ 0.005). RESULTS.: Lenke types vary by sex: male patients had more major thoracic (types 1-4) than major thoracolumbar/lumbar (types 5 and 6) curves, fewer lumbar C-modifiers (32% vs. 44%), and less apical lumbar translation (1.1 vs. 1.7 cm). Lenke types vary by frequency: the most common type was 1 (50%); the least common, 4 (4%). Lenke types vary by magnitude: type 4 had the greatest percentage of large curves (52% of curves .75°), most smaller curves were types 1 and 5, and type 4 had the largest mean magnitude (78° ± 17°). Lenke types vary by patient age: type 5 curves occurred in the oldest patients (average age at surgery: 15.4 ± 2.2 vs. 14.3 ± 14.6 years for all others) despite having the lowest mean magnitude (P = 0.001); curve size was negatively correlated with age at surgery (r = -0.16, P = 0.001). Lenke types vary by patient self-image: patients with type 4 curves had lower preoperative SRS outcome scores for self-image than did patients with type 1 curves (P = 0.005). Lenke types vary by sex, frequency magnitude, patient age, and patient self-image, which should be considered in designing studies.

Demographic characteristics of MS patients in Poland's upper Silesia region.

Science.gov (United States)

Pierzchala, Krystyna; Adamczyk-Sowa, Monika; Dobrakowski, Pawel; Kubicka-Baczyk, Katarzyna; Niedziela, Natalia; Sowa, Pawel

2015-05-01

In Poland, no national registry of MS patients has yet been introduced. So far, no demographic studies have been conducted in patients with MS in Upper Silesia. The aim of the present study was to evaluate, for the first time, a selected demographic and clinical parameters in MS patients from the Upper Silesia region and compare these characteristics with previously published data from other regions of Poland. 640 patients with clinically defined MS, were prospectively and randomly selected for the study. Social, socio-economic, and demographic data were obtained through a questionnaire study. All subjects performed a self-assessment of their health condition using EQ-5D and EQ-VAS version questionnaires. The ratio of women to men was 2.18. The average age of onset was 29.6 ± 11.1 years; the disease duration was 7.9 ± 4.5 years. The relapsing-remitting form of MS was diagnosed in 73.12%. In 71.25% the onset was monofocal and in 28.75% multifocal disease onset was observed. Among the studied population 339 (52.97%) patients were still employed. A mean EQ-VAS score of 66.11 ± 20.12 was calculated. Results from our study identify for the first time the demographic and clinical characteristics of the Upper Silesia MS population.

Characteristics of Cytomegalovirus Uveitis in Immunocompetent Patients.

Science.gov (United States)

Woo, Jyh Haur; Lim, Wee K; Ho, Su L; Teoh, Stephen C

2015-01-01

To present the clinical characteristics of patients with anterior uveitis who had evidence of cytomegalovirus (CMV) infection on polymerase chain reaction PCR-based assays for viral DNA in aqueous samples. This was a retrospective observational case series of 16 patients with CMV infection on qualitative polymerase chain reaction PCR-based assays for viral DNA in aqueous samples. Case records of 16 patients were reviewed and relevant clinical information was collected using a standardized data sheet. There were 10 male and 6 female patients, with 16 eyes included. The median age at the first attack was 52 years (range 27-77 years). Thirteen patients (81.3%) presented with an initial BCVA of 20/40 or better. Eleven eyes (68.8%) had anterior chamber inflammation of 1+ cells or less. Eight eyes (50.0%) had concomitant sectoral iris atrophy, while 2 eyes were noted to have heterochromic irides. Eleven patients (68.8%) presented with an elevated intraocular pressure. Seven patients (43.8%) had clinical features that led to a presumptive diagnosis of Posner-Schlossman syndrome, while 3 patients (18.8%) were initially diagnosed with Fuchs heterochromic iridocyclitis. Six patients were initially treated for uveitic glaucoma or anterior uveitis of unknown cause. There is a spectrum of clinical manifestations of CMV anterior uveitis. A high index of suspicion of a possible viral etiology, especially CMV, and subsequent accurate identification of the virus involved are fundamental to the overall therapeutic approach.

Variation in guideline adherence in non-Hodgkin’s lymphoma care: impact of patient and hospital characteristics

International Nuclear Information System (INIS)

Stienen, Jozette J.C.; Hermens, Rosella P.M.G.; Wennekes, Lianne; Schans, Saskia A.M. van de; Maazen, Richard W.M. van der; Dekker, Helena M.; Liefers, Janine; Krieken, Johan H.J.M. van; Blijlevens, Nicole M.A.; Ottevanger, Petronella B.

2015-01-01

The objective of this observational study was to assess the influence of patient, tumor, professional and hospital related characteristics on hospital variation concerning guideline adherence in non-Hodgkin’s lymphoma (NHL) care. Validated, guideline-based quality indicators (QIs) were used as a tool to assess guideline adherence for NHL care. Multilevel logistic regression analyses were used to calculate variation between hospitals and to identify characteristics explaining this variation. Data for the QIs regarding diagnostics, therapy, follow-up and organization of care, together with patient, tumor and professional related characteristics were retrospectively collected from medical records; hospital characteristics were derived from questionnaires and publically available data. Data of 423 patients diagnosed with NHL between October 2010 and December 2011 were analyzed. Guideline adherence, as measured with the QIs, varied considerably between the 19 hospitals: >20 % variation was identified in all 20 QIs and high variation between the hospitals (>50 %) was seen in 12 QIs, most frequently in the treatment and follow-up domain. Hospital variation in NHL care was associated more than once with the characteristics age, extranodal involvement, multidisciplinary consultation, tumor type, tumor aggressiveness, LDH level, therapy used, hospital region and availability of a PET-scanner. Fifteen characteristics identified at the patient level and at the hospital level could partly explain hospital variation in guideline adherence for NHL care. Particularly age was an important determinant: elderly were less likely to receive care as measured in the QIs. The identification of determinants can be used to improve the quality of NHL care, for example, for standardizing multidisciplinary consultations in daily practice

Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar district, Kedah, Malaysia

Directory of Open Access Journals (Sweden)

Wei Leong Tan

2015-07-01

Full Text Available OBJECTIVES: This study explored the demographic characteristics of hepatitis C patients in the Kota Setar (KS district, Kedah, Malaysia, the prevalence of intravenous drug use (IVDU as a risk factor among these patients, and the associations between IVDU and demographic characteristics. METHODS: Retrospective data pertaining to 713 patients from January 2009 to December 2013 were retrieved from hospital and disease notification records for analysis. The risk factors for hepatitis C virus (HCV infection were grouped into IVDU and non-IVDU risk factors for analysis using multiple logistic regression. RESULTS: Of the hepatitis C patients included in this study, the most common age group was 31 to 40 years (30.2%, and male patients (91.2% made up the overwhelming majority. Ethnic Malays constituted approximately 80.4% of the patients, and IVDU was the main risk factor (77.8% for HCV infection. Multiple logistic regression showed that male patients were 59 times more likely to have IVDU as a risk factor for HCV infection. Single patients were 2.5 times more likely to have IVDU as a risk factor. Patients aged ≥71 years were much less likely than patients aged ≤30 years to have IVDU as a risk factor for HCV infection. CONCLUSIONS: IVDU was found to be an important risk factor for HCV infection among patients in the KS district. The factors associated with IVDU included age, sex, and marital status. Appropriate preventive measures should be developed to target the groups in which IVDU is most likely to be a risk factor for HCV infection.

Effects of age and body mass index on breast characteristics: A cluster analysis.

Science.gov (United States)

Coltman, Celeste E; Steele, Julie R; McGhee, Deirdre E

2018-05-24

Limited research has quantified variation in the characteristics of the breasts among women and determined how these breast characteristics are influenced by age and body mass. The aim of this study was to classify the breasts of women in the community into different categories based on comprehensive and objective measurements of the characteristics of their breasts and torsos, and to determine the effect of age and body mass index (BMI) on the prevalence of these breast categories. Four breast characteristic clusters were identified (X-Large, Very-ptotic & Splayed; Large, Ptotic & Splayed; Medium & Mildly-ptotic; and Small & Non-ptotic), with age and BMI shown to significantly affect the breast characteristic clusters. These results highlight the difference in breast characteristics exhibited among women and how these clusters are affected by age and BMI. The breast characteristic clusters identified in this study could be used as a basis for future bra designs and sizing systems in order to improve bra fit for women.

Personality characteristics in patients with somatized disorder

Directory of Open Access Journals (Sweden)

Ekaterina Anatolyevna Tolkach

2010-01-01

Full Text Available Objective: to study personality characteristics, behavioral style, and modes of relations with their people in patients with somatized disorder. Subjects and methods. Eighty-six patients diagnosed as having somatized disorder were examined using Leary's interpersonal diagnosis system. Results. The author revealed the following personality characteristics and behavioral styles: a depressed need for authoritarianism, dominance, autonomy, aggressiveness, a display of qualities, such as superfriendliness, benevolence, submissiveness, dependency, and suspiciousness. These characteristics give an insight into the development of somatization in patients with somatized disorder.

Characteristics of patients with rheumatoid arthritis presenting for physiotherapy management: a multicentre study.

Science.gov (United States)

Kennedy, Norelee; Keogan, Fiona; Fitzpatrick, Martina; Cussen, Grainne; Wallace, Lorraine

2007-03-01

To describe the characteristics of patients with rheumatoid arthritis (RA) attending for physiotherapy management in Ireland. Managers of physiotherapy departments in the 53 hospitals in Ireland were invited to participate in a multi-centre observational study over a 6-month period. Data on patients with RA the day of presentation for physiotherapy management were recorded. These data related to patient demographic details, disease management, aids and appliances, splint and orthoses usage and occupational issues. The Health Assessment Questionnaire was also recorded for each patient. A total of 273 patients from eight physiotherapy departments participated in the survey (n = 199; 73% female). Mean age of the participants was 59.3 (SD 12.5) years with mean disease duration of 13.8 (SD 10.6) years. The majority of the patients were inpatients (n = 170, 62%). Sixty-eight per cent of patients had attended for previous physiotherapy treatment and 98% were under current rheumatologist care. Biologic therapies were prescribed to 11% of patients. Use of splint and foot orthoses was high with 133 patients (49%) wearing splints and 75 (31%) wearing foot orthoses. The majority of patients had moderate (n = 119, 44%) or severe (n = 94, 35%) disability as per Health Assessment Questionnaire (HAQ) score. Mean HAQ score was 1.5, with HAQ scores showing increasing disability with increasing age, disease duration and erythrocyte sedimentation rate (ESR) levels. Patients with RA attending for physiotherapy management present with varied profiles. This study provides valuable information on the characteristics of patients with RA attending for physiotherapy management which will contribute to physiotherapy service planning and delivery and will optimize patient care.

Clinical characteristics in focal cortical dysplasia: a retrospective evaluation in a series of 120 patients.

Science.gov (United States)

Fauser, Susanne; Huppertz, Hans-Juergen; Bast, Thomas; Strobl, Karl; Pantazis, Georgios; Altenmueller, Dirk-Matthias; Feil, Bertram; Rona, Sabine; Kurth, Christoph; Rating, Dietz; Korinthenberg, Rudolf; Steinhoff, Bernhard J; Volk, Benedikt; Schulze-Bonhage, Andreas

2006-07-01

Focal cortical dysplasias (FCDs) are increasingly diagnosed as a cause of symptomatic focal epilepsy in paediatric and adult patients. However, little is known about the clinical characteristics of epilepsy in these patients. In order to elucidate the clinical characteristics of their epilepsy, 120 pharmacoresistant patients including children and adults with histologically proven FCD were studied retrospectively. Age at seizure onset was analysed in the total group and compared between subgroups with different localization and different histological subtypes of FCD. The role of febrile seizures with respect to dual pathology was investigated. Seizure semiology was analysed focusing on initial seizure type and change of seizure semiology during the course of disease. Finally, transient responsiveness to antiepileptic drug therapy was studied. In the majority of patients, epilepsy began in the first 5 years of life. However, onset of epilepsy could also occur in the second or third decade until the age of 60. Age at epilepsy onset was not significantly different between temporal, extratemporal and multilobar localization of FCD. Patients without cytoarchitectural abnormalities (mild malformations of cortical development, FCD 1a according to Palmini) had significantly later epilepsy onset (P= 0.001) compared with patients with cytoarchitectural abnormalities (FCD 1b, 2a and 2b according to Palmini). In patients with additional hippocampal sclerosis (dual pathology) febrile seizures were significantly more frequently reported (P = 0.02) than in patients without dual pathology. Moreover, patients with dual pathology and febrile seizures significantly more frequently presented with severe hippocampal sclerosis (Wyler Grade 3-4) as compared with patients with dual pathology in the absence of febrile seizures (P = 0.03). First observed seizures were mainly tonic or generalized tonic-clonic. A change of seizure semiology seemed to be age-dependent and occurred between the

Age-Relevance of Person Characteristics: Persons' Beliefs about Developmental Change across the Lifespan

Science.gov (United States)

Gruhn, Daniel; Gilet, Anne-Laure; Studer, Joseph; Labouvie-Vief, Gisela

2011-01-01

The authors investigated normative beliefs about personality development. Young, middle-aged, and older adults indicated the age-relevance of 835 French adjectives by specifying person characteristics as typical for any age decade from 0 to 99 years. With this paradigm, the authors determined age-relevance (How typical is a characteristic for a…

Pressure Ulcer Risk Evaluation in Critical Patients: Clinical and Social Characteristics.

Science.gov (United States)

de Azevedo Macena, Mônica Suêla; da Costa Silva, Rayanne Suely; Dias Fernandes, Maria Isabel Da Conceição; de Almeida Medeiros, Ana Beatriz; Batista Lúcio, Kadyjina Daiane; de Carvalho Lira, Ana Luisa Brandão

2017-01-01

Pressure ulcers increase hospital stays and treatment costs due to their complications. Therefore, recognizing factors that contribute to pressure ulcer risk are important to patient safety. To evaluate the association between the scores of the Waterlow, Braden, and Norton scales and clinical and social characteristics in critically ill patients. A cross-sectional study of 78 patients in an adult intensive care unit of a university hospital in Northeastern Brazil was conducted from July to December 2015. Data included social and clinical information and the risk factors of the Braden, Norton and Waterlow scales. Data were analysed by the descriptive and inferential statistics. Most of the participants were female, adults and elderly people with brown skin colour, low education levels and insufficient income. Most of them showed a high risk for developing pressure ulcers using the three evaluated scales. Age, smoking status, diabetes and hypertension were associated with scores on the Waterlow, Braden and Norton scales. Age, use of the tobacco, diabetes and hypertension were associated with the risk of pressure ulcers in ICU patients.

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

Science.gov (United States)

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P arthroscopy should be considered a valid treatment option when treating hip pain in patients aged 50 years or older with a Tönnis arthritic grade of 0 or 1. Older patients

Brain cortical characteristics of lifetime cognitive ageing.

Science.gov (United States)

Cox, Simon R; Bastin, Mark E; Ritchie, Stuart J; Dickie, David Alexander; Liewald, Dave C; Muñoz Maniega, Susana; Redmond, Paul; Royle, Natalie A; Pattie, Alison; Valdés Hernández, Maria; Corley, Janie; Aribisala, Benjamin S; McIntosh, Andrew M; Wardlaw, Joanna M; Deary, Ian J

2018-01-01

Regional cortical brain volume is the product of surface area and thickness. These measures exhibit partially distinct trajectories of change across the brain's cortex in older age, but it is unclear which cortical characteristics at which loci are sensitive to cognitive ageing differences. We examine associations between change in intelligence from age 11 to 73 years and regional cortical volume, surface area, and thickness measured at age 73 years in 568 community-dwelling older adults, all born in 1936. A relative positive change in intelligence from 11 to 73 was associated with larger volume and surface area in selective frontal, temporal, parietal, and occipital regions (r cognitive ageing and a thinner cortex for any region. Interestingly, thickness and surface area were phenotypically independent across bilateral lateral temporal loci, whose surface area was significantly related to change in intelligence. These findings suggest that associations between regional cortical volume and cognitive ageing differences are predominantly driven by surface area rather than thickness among healthy older adults. Regional brain surface area has been relatively underexplored, and is a potentially informative biomarker for identifying determinants of cognitive ageing differences.

Changes in preoperative characteristics in patients undergoing radical prostatectomy

DEFF Research Database (Denmark)

Røder, Martin Andreas; Brasso, Klaus; Christensen, Ib Jarle

2014-01-01

of a shift in attitude with increasing opportunistic PSA testing. This had led to an increasing number of RPs being performed in Denmark. The objective of this study was to analyze changes in preoperative characteristics over time for the complete cohort of 6489 men who underwent RP between 1995 and 2011....... Our hypothesis was that an increasing amount of men undergo RP for lower risk PCa. MATERIAL AND METHODS: All patients operated from 1995 to 2011 were identified via patient files and registries. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS......, especially after 2005. Biopsy GS = 7 was found in 20.2% of the patients in 2005 compared to 57.1% in 2011. The proportion of T1 disease increased from 32% to 56%. Significant changes in percentage of patients according to the D'Amico classification were found. After 2005 the proportion of intermediate...

Warfarin dose requirement in Turkish patients: the influences of patient characteristics and polymorphisms in CYP2C9, VKORC1 and factor VII.

Science.gov (United States)

Yildirim, E; Erol, K; Birdane, A

2014-01-01

To determine the contribution of cytochrome P4502C9 (CYP2C9), vitamin K epoxide reductase (VKORC1) and factor VII genotypes, age, body mass index (BMI), international normalized ratio (INR) and other individual patient characteristics on warfarin dose requirements in an adult Turkish population. Blood samples were collected from 101 Turkish patients. Genetic analyses for CYP2C9*2 and *3, VKORC1 -1639 G>A and factor VII -401 G>T polymorphisms were performed. Age, INR, BMI values and other individual patient characteristics were also recorded. The mean daily warfarin dosage was significantly higher in patients with the CYP2C9*1/*1 genotype than in the CYP2C9*2/*2 and CYP2C9*1/*3 groups (p ≤ 0.05). With respect to the VKORC1 -1639 G>A polymorphism, the mean warfarin daily dose requirement was higher in the wild type group compared to the heterozygous group (p≤0.001). The mean daily dose requirement for patients with the GG form of factor VII was significantly higher than that of patients with the TT genotype (p ≤ 0.05). Age, gender, BMI, INR had no statistically significant correlation with warfarin dose (p ≥ 0.05). Polymorphisms in CYP2C9, VKORC1 and factor VII did partially affect daily warfarin dose requirements, while age, gender, BMI and INR do not. However, further case-control studies with a larger study size and different genetic loci are needed to confirm our study.

Characteristics of Keratoconus Patients at a Tertiary Eye Center in India

Directory of Open Access Journals (Sweden)

Vinay B Agrawal

2011-01-01

Full Text Available Purpose: To evaluate the presentation and characteristics of patients with keratoconus at a tertiary eye care center in Mumbai, India. Methods: This single center, non-comparative, retrospective cohort analysis was performed on patients with keratoconus who presented to the Clear Vision Eye Center clinic from April 2007 to March 2009. Data was collected to characterize correlations among visual acuity, corneal biomicroscopic findings, and refractive and topographic findings in keratoconus. Results: Records of 274 patients including 189 male and 85 female subjects with mean age of 20.1±3.5 (range, 13 to 29 years at the time of diagnosis were assessed. There was history of skin allergy in 73 (26.6%, symptomatic ocular allergy in 67 (24.45% and asthma in 31 (11.31% patients. The most frequent corneal sign was Fleischer′s ring which was observed in 81% of cases. Corneal topography revealed mean simK (simulated keratometry of 53.3±6.1 (range, 41.2 to 69.0 diopters. Corneal topography analysis with the Cone Location Magnitude Index disclosed the presence of inferior cones in 93% of patients. Conclusion: This group of patients had younger age at presentation and more severe keratoconus as compared to western populations; contact lenses were used only in a minority of patients.

Comparison of influence of ageing on low-temperature characteristics of asphalt mixtures

Science.gov (United States)

Vacková, Pavla; Valentin, Jan; Benešová, Lucie

2017-09-01

Ability of relaxation of asphalt mixtures and thus its resilience to climate change and traffic load is decreasing by influence of aging - in this case aging of bituminous binder. Binder exposed to climate and UV ages and becomes more fragile and susceptible to damage. The results of the research presented in this paper are aimed to finding a correlation between low-temperature properties of referential and aged asphalt mixture specimens and characteristics (not low-temperature) of bituminous binders. In this research there were used conventional road binders, commonly used modified binders and binders additionally modified in the laboratory. The low-temperature characteristics were determined by strength flexural test, commonly used in the Czech Republic for High Modulus Asphalt Mixtures (TP 151), and semi-cylindrical bending test (EN 12697-44). Both of the tests were extended by specimens exposed to artificial long-term aging (EN 12697-52) - storing at 85° C for 5 days. The results were compared with characteristics of binders for finding a suitable correlation between characteristics of binders and asphalt mixtures.

Characteristics of lumbar spondylolysis in elementary school age children.

Science.gov (United States)

Sakai, Toshinori; Goda, Yuichiro; Tezuka, Fumitake; Takata, Yoichiro; Higashino, Kosaku; Sato, Masahiro; Mase, Yasuyoshi; Nagamachi, Akihiro; Sairyo, Koichi

2016-02-01

Lumbar spondylolysis, a stress fracture of the pars interarticularis in the lumbar spine, is often precipitated by trauma, but there may be a congenital predisposition to this condition. There have been few studies on spondylolysis in young children, despite their suitability for studies on congenital defects. The aim of this study was to identify the clinical features of lumbar spondylolysis in elementary school age children in order to elucidate its pathogenesis. Thirty lumbar spondylolysis patients (23 boys, 7 girls, including a pair of twins; mean age 9.5 years, age range 5-12 years) were studied. Patient data on history of athletic activity, symptoms at first consultation, and radiological findings such as spinal level, stage of the stress fracture, and skeletal age were collected. Among the 30 patients, 27 (21 boys, 6 girls) had L5 spondylolysis (90.0 %). Only 2 patients had no history of athletic activity at the first consultation. All patients, except for 2 whose diagnosis was incidental, complained of low back pain. In the 27 patients with L5 spondylolysis, 17 (63.0 %) had terminal-stage fracture and 25 (92.6 %) had spina bifida occulta (SBO) involving the S1 lamina. Sixteen of the 27 (59.3 %) had SBO involving the affected lamina (L5) and S1 lamina. In contrast, the 3 patients with L3 or L4 spondylolysis had no evidence of SBO. With respect to skeletal age, 23 of the 27 L5 spondylolysis patients (85.2 %) were in the cartilaginous stage while the remaining 4 patients were in the apophyseal stage. Lumbar spondylolysis in elementary school age children was commonly a terminal-stage bone defect at L5, which was not necessarily related to history of athletic activity and was sometimes asymptomatic. It was often associated with SBO, indicating a possible congenital predisposition. These findings may provide further insight into the pathogenesis of lumbar spondylolysis.

A comparison of physical characteristics between patients seeking treatment for neck pain and age-matched healthy people

DEFF Research Database (Denmark)

Jordan, A; Mehlsen, J; Ostergaard, K

1997-01-01

To compare physical characteristics of the cervical musculature, including maximal isometric strength of the flexors and extensors, relative isometric endurance of the extensors and the active range of motion (ROM) in extension in a group of patients seeking treatment for chronic neck pain...

Psychological characteristics of patients with asthma.

Science.gov (United States)

Bulcun, Emel; Turkel, Yakup; Oguztürk, Omer; Dag, Ersel; Visal Buturak, S; Ekici, Aydanur; Ekici, Mehmet

2018-01-01

Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory). Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma introvert. Patients with long-standing asthma have less psychological distress, suggesting that learned to cope with his illness. © 2016 John Wiley & Sons Ltd.

Primary pulmonary cryptococcosis: evaluation of CT characteristics in 26 immunocompetent Chinese patients

Energy Technology Data Exchange (ETDEWEB)

Qu, Yanjuan; Liu, Guobing; Ghimire, Prasanna; Liao, Meiyan; Xu, Liying [Dept. of Radiology, Zhongnan Hospital of Wuhan Univ., Wuhan (China)], E-mail: leometeor123@gmail.com; Shi, Heshui [Dept. of Radiology, Union Hospital affiliated to Tongji Medical College of Huazhong Univ. of Science and Technology, Wuhan (China); Yang, Guifang [Dept. of Pathology, Zhongnan Hospital of Wuhan Univ., Wuhan (China); Wang, Guanliang [Dept. of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou (China)

2012-07-15

Background. Discrepancies still exist in the diagnosis of primary pulmonary cryptococcosis in immunocompetent patients. Purpose. To describe and evaluate radiological manifestations of pulmonary cryptococcosis in immunocompetent patients. Material and Methods. Twenty-six histopathologically confirmed cases of pulmonary cryptococcosis were analyzed for clinical, pathological, and CT characteristics. Necessary statistical tests for differences in CT presentations and correlation analysis between clinical and CT characteristics were performed. Results. The patients' ages ranged from 24 to 79 years, with 20 men and six women. Eighteen patients were symptomatic, with cough as the most common symptom (n = 14, 53.8%). Nodules (n = 21, 80.8%) were the most common CT findings. Eight cases presented with solitary and nine with multiple nodules, while 13 cases presented with irregular and 19 with ill-defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients. Lesions were mainly localized in the lower lobes of the lungs (n = 15, 57.7%) with peripheral distribution (n = 18, 69.2%). Ground-glass opacities (GGOs) were more easily detected in older patients (66.7%, P <0.01). No significant differences in CT abnormalities were found between male and female patients. Conclusion. Primary pulmonary cryptococcosis in immunocompetent patients exhibits certain CT characteristics. The typical presentation includes multiple nodules with the halo sign scattered in the peripheral field in the lower lobes of the bilateral lungs. This could contribute to diagnosis of the disease entity. However, vigilance should be exercised when facing GGOs, with or without nodules, in older patients.

Patient and Physician Characteristics Associated with the Provision of Weight Loss Counseling in Primary Care

Science.gov (United States)

Dutton, Gareth R.; Herman, Katharine G.; Tan, Fei; Goble, Mary; Dancer-Brown, Melissa; Van Vessem, Nancy; Ard, Jamy D.

2013-01-01

Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians. PMID:24743007

Characteristics of Patients With Satisfactory Functional Gain Following Total Joint Arthroplasty in a Postacute Rehabilitation Setting.

Science.gov (United States)

Hershkovitz, Avital; Vesilkov, Marina; Beloosesky, Yichayaou; Brill, Shai

2017-01-10

Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA. This was a retrospective study of 180 patients with TJA admitted during 2010-2013. The main outcome measures were the Functional Independence Measure (FIM), the Montebello Rehabilitation Factor Score (MRFS) on the motor FIM, and the Timed Get Up and Go Test. Satisfactory functional gain was defined as an mFIM MRFS score above median score. Comparisons of clinical and demographic characteristics between patients who achieved a satisfactory functional gain versus those who did not were performed by the Mann-Whitney U test and the χ test. The proportion of patients who achieved a satisfactory functional gain was similar in the total knee arthroplasty and total hip arthroplasty (THA) groups. The most significant characteristic of patients who achieved a satisfactory functional gain was their admission functional ability. Age negatively impacted the ability to achieve a satisfactory functional gain in patients with THA. Functional level on admission is the best predictive factor for a better rehabilitation outcome for patients with TJA. Age negatively affects functional gain in patients with THA.

Peritoneal membrane characteristics in patients on peritoneal dialysis

Directory of Open Access Journals (Sweden)

Jamal Al-wakeel

2011-01-01

Full Text Available Peritoneal dialysis (PD is a well-established modality for treatment of patients with end-stage renal disease, giving excellent patient and technique survival rates. In Saudi Arabia, data collected by the Saudi Center for Organ Transplantation showed that in 2008, patients on PD accounted for a mere 4.8% of total patients on renal replacement therapy, including hemodialysis and renal transplantation. This study was conducted to identify the characteristics of membrane per-meability in the Saudi population and to assess the role of various factors affecting solute transport across the peritoneal membrane. We followed up a total of 52 patients on Continuous Ambulatory Peritoneal Dialysis (CAPD as well as Automated Peritoneal Dialysis (APD, being treated in the PD unit of the King Khalid University Hospital, Riyadh. There were 30 female and 22 male patients; 14 patients were using CAPD while 38 patients were on APD. The mean age of the patients was 50.5 years, with a range of 14-86 years. The average body mass index (BMI was 27.1 kg/m 2 and the mean body surface area (BSA of the study patients was 1.71 m 2 . A standardized PET test was performed on all patients, 4-6 weeks after initiation of regular PD. The Kt/V and creatinine clearance measured 6-8 weeks after initiation of dialysis were 1.96 and 56.59 L/week, respectively. Residual renal function was assessed on the basis of daily urine output, using 24-hour urine collection. The mean serum urea con-centration was 16.91 mmol/L and mean serum creatinine was 702 μmol/L. According to the Peritoneal Equiliberation Test (PET, 8% of the subjects belonged to the high trans-porter category, 44% patients belonged to the high-average transport group, 46% to the low-average category and 2% came in the low transporter category. Our study suggests that the patient characteristics and demographic para-meters seen in the Saudi population are comparable to those seen in other studies from the Middle East and

Characteristics of the patients undergoing surgical treatment for pneumothorax: A descriptive study.

Science.gov (United States)

Cakmak, Muharrem; Yuksel, Melih; Kandemir, Mehmet Nail

2016-05-01

To identify the characteristic features of pneumothorax patients treated surgically. The retrospective study was conducted at Gazi Yasargil Education and Research Hospital Thoracic Surgery Clinic, Diyarbakir, Turkey and comprised records of pneumothorax patients from January 2004 to December 2014. They were divided into two groups as spontaneous and traumatic. Patients who had not undergone any surgical intervention were excluded. Mean age, gender distribution, location of the disease, type of pneumothorax, and treatment method were noted. Among patients with spontaneous pneumothorax, age and months distribution, smoking habits, pneumothorax size, and treatment method were assessed. The effect of gender, location, comorbid disease, smoking, subgroup of disease, and pneumothorax size on surgical procedures were also investigated. The mean age of the 672 patients in the study was 34.5±6.17 years. There were 611(91%) men and 61(9%) women. Disease was on the right side in 360(53.6%) patients, on the left side in 308(45.8%), and bilateral in 4(0.59%). Besides, 523(77.8%) patients had spontaneous, and 149(22.7%) had traumatic pneumothorax. Overall, 561(83.5%) patients had been treated with tube thoracostomy, whereas 111(16.5%) were treated with thoracotomy/thoracoscopic surgery. The presence of comorbid diseases, being primary, and being total or subtotal according to partial were found to create predisposition to thoracotomy/ thoracoscopic surgery (ppneumothorax being total, the presence of comorbid diseases, and the increase in pneumothorax size, thoracotomy or thoracoscopic surgery is preferred.

Prediction of an excessive response in in vitro fertilization from patient characteristics and ovarian reserve tests and comparison in subgroups: an individual patient data meta-analysis

NARCIS (Netherlands)

Broer, Simone L.; Dólleman, Madeleine; van Disseldorp, Jeroen; Broeze, Kimiko A.; Opmeer, Brent C.; Bossuyt, Patrick M. M.; Eijkemans, Martinus J. C.; Mol, Ben Willem; Broekmans, Frank J. M.; Broer, S. L.; Dólleman, M.; van Disseldorp, J.; Eijkemans, M. J. C.; Broekmans, F. J. M.; Aflatoonian, A.; Anderson, R. A.; Ashrafi, M.; Bancsi, L.; Caroppo, E.; Copperman, A. B.; Ebner, T.; Eldar-Geva, T.; Erdem, M.; Freour, T.; Gnoth, C.; Greenblatt, E. M.; Jayaprakasan, K.; Raine-Fenning, N.; Klinkert, E.; Kwee, J.; La Marca, A.; Lambalk, C. B.; McIlveen, M.; Mohiyiddeen, L.; Merce, L. T.; Muttukrishna, S.; Nardo, L. G.; Nelson, S. M.; Ng, H. Y.; Popovic-Todorovic, B.; Smeenk, J. M. J.; Tomás, C.; van der Linden, P. J. Q.; van Rooij, I. A.; Vladimirov, I. K.

2013-01-01

To evaluate whether ovarian reserve tests (ORTs) add prognostic value to patient characteristics, such as female age, in the prediction of excessive response to ovarian hyperstimulation in patients undergoing IVF, and whether their performance differs across clinical subgroups. Authors of studies

SOFC: Processes and characteristics of ageing behaviour

International Nuclear Information System (INIS)

Gerganov, T.; Grigorov, S.; Kozhukharov, S.

2005-01-01

The high-temperature solid oxide fuel cell (SOFC) is convenient for the environmental friendly and efficient conversion of chemical into electric energy. During the last decade the development of planar SOFC stacks with metallic interconnects has made considerable progress in both size and power density. The improvement of durability in long-term operation of planar SOFC components is one of the main fields for stationary applications. Ageing of stacks can be caused by various processes, e.g. corrosion of metallic plates, degradation of ceramic parts and chemical interactions on electrodes/electrolyte or interconnect/electrode interface. Namely, these processes are object of the overview in the present work. The most important characteristics of ageing behavior are subjected to analysis and discussion, as well. Moreover a correlation between ageing process and single cell performance will be given

Seasonal distribution and demographical characteristics of carpal tunnel syndrome in 1039 patients.

Science.gov (United States)

Gomes, Irênio; Becker, Jefferson; Ehlers, João Arthur; Kapczinski, Flávio; Nora, Daniel Bocchese

2004-09-01

To describe the demographic characteristics of gender, age, and presence of repetitive movements, intake of alcohol and non-steroid anti-inflammatories (NSAI), medical specialties that referred patients to nerve conduction studies and electromyography (NCS-EMG), school attainment, and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome (CTS) in the State of Rio Grande do Sul, Brazil. A series of 1039 patients (1549 hands) with neurophysiologically defined CTS was studied. Patients were referred for NCS-EMG in 3 universities and 2 private services, from August 2001 to January 2003. All patients completed a questionnaire containing demographic information. The diagnosis of CTS was established following a pre-established protocol, with defined diagnostic criteria. Around one fourth of patients had already performed NCS-EMG; the greatest frequency of CTS was observed in women (5.6:1) and in patients above the age of 40. Most patients reported performing repetitive movements in their daily routine (69.7%); 12.9% reported use of NSAI and 14.9% regular intake of alcoholic beverages. A greater frequency of CTS was observed in the months of July and August, when compared to the other months of the year. Around 2/3 of the study population had completed at least secondary school. Most requests of nerve conduction studies did not provide a diagnostic hypothesis (59.9%) and neurophysiologic studies were requested mostly by traumatology/orthopedics (71.1%). We have concluded that, in our environment, CTS shows some demographical characteristics that are similar to what the literature describes. Also, we have found that most of our sample concluded at least secondary school, and was referred to neurophysiologic studies by orthopedists. To be pointed out is the seasonal distribution of CTS, which demonstrates a significant association with winter months.

Correlation of CA-125 serum level and clinico-pathological characteristic of patients with endometriosis.

Science.gov (United States)

Karimi-Zarchi, Mojgan; Dehshiri-Zadeh, Najmeh; Sekhavat, Leili; Nosouhi, Fahime

2016-11-01

Cancer antigen 125 (CA-125) is a glycoprotein biomarker that is used in women with pelvic masses such as endometriosis and maybe is useful in practice of patients suspicious to endometriosis. The aim of this study was to evaluate the association between preoperative serum CA-125 levels and clinic pathological characteristic in women with endometriosis, and find out the best serum CA-125 levels cut-off in pre and post menopause women. Serum CA-125 levels in 87 women aged 21-54 years suspected to endometriosis with pelvic pain, dysmenorrhea, or dyspareunia were measured preoperatively. Also the association between clinic pathological characteristic and serum CA-125 level were analyzed. The mean age of women was 32.22±6.91. The mean serum CA-125 level was 49.93±4.30 U/mL. There was a significant correlation between the endometriosis stage, lesion size, adhesion score and preoperative CA-125 plasma concentration. However, we did not found significant differences in age, marital status, patient's complaints, and pelvic pain associated to Ca125 serum level. The suggested preoperative serum cut-off levels in premenopausal and postmenopausal patients were 37 U/ml and 35 U/ml, respectively. According to the results, preoperative serum CA-125 is an important predictor for patients with endometriosis and it should be taken into consideration when surgical management is suspected, especially if stage of disease, lesion size and adhesion score are undertaken.

Research Article. Characteristics of Sleep Apnea Assessed Before Discharge in Patients Hospitalized with Acute Heart Failure

Directory of Open Access Journals (Sweden)

Kocsis Ildikó

2017-03-01

Full Text Available Objectives. Evaluation of the characteristics of sleep apnea (SA in patients hospitalized with acute heart failure, considering that undiagnosed SA could contribute to early rehospitalization. Methods. 56 consecutive patients (13 women, 43 men, mean age 63.12 years with acute heart failure, in stable condition, underwent nocturnal polygraphy before hospital discharge. The type and severity of SA was determined. Besides descriptive statistics, correlations between the severity of SA and clinical and paraclinical characteristics were also analyzed (t-test, chi-square test, significancy at alpha 30/h. The apnea was predominantly obstructive (32 cases vs. 12 with central SA. Comparing the patients with mild or no SA with those with severe SA, we did not find statistically significant correlations (p>0.05 between the severity of SA and the majority of main clinical and paraclinical characteristics - age, sex, BMI, cardiac substrates of heart failure, comorbidities. Paradoxically, arterial hypertension (p=0.028 and atrial fibrillation (p=0.041 were significantly more prevalent in the group with mild or no SA. Conclusions. Before discharge, in the majority of patients hospitalized with acute heart failure moderate and severe SA is present, and is not related to the majority of patient related factors. Finding of significant SA in this setting is important, because its therapy could play an important role in preventing readmissions and improving prognosis.

A review of patient and skin characteristics associated with skin tears.

Science.gov (United States)

Rayner, R; Carville, K; Leslie, G; Roberts, P

2015-09-01

Skin tears are the most common wound among the elderly and have the potential to cause infection, form chronic wounds, reduce quality of life and increase health-care costs. Our aim was to identify studies that reviewed patient and skin characteristics associated with skin tears. A review of skin tear studies reported in the English literature between 1980 and 2013 was undertaken using the following electronic databases: PubMed, Medline, CINAHL, Embase, Scopus, Evidence Based and Medicine Reviews (EBM). Search terms included aged, skin, tears or lacerations, skin tearing, geri tear, epidermal tear and prevalence. There were 343 articles found with using the search terms. After abstract review nine were found to be relevant to the search. The principle findings from these eight published articles and one unpublished study revealed that the most common patient characteristics were a history of skin tears, impaired mobility and impaired cognition. Skin characteristics associated with skin tears included senile purpura, ecchymosis and oedema. This review provides an overview of identified patient and skin characteristics that predispose the elderly to skin tears and exposes the lack of research within this domain. R. Rayner is a recipient of a 2013 Australian Postgraduate Award, Curtin University Postgraduate Scholarship and a Wound Management Cooperative Research Centre (CRC) PhD stipend. The School of Nursing, Midwifery and Paramedicine, Curtin University and the Silver Chain Group, Western Australia are participants in the Wound Management Innovation CRC. No conflict of interest exists among the authors.

Clinical characteristics of depressed patients with a history of suicide attempts: results from the CRESCEND study in South Korea.

Science.gov (United States)

Park, Min-Hyeon; Kim, Tae-Suk; Yim, Hyeon-Woo; Jeong, Seung Hee; Lee, Chul; Lee, Chang-Uk; Kim, Jae-Min; Jung, Sung-Won; Lee, Min-Soo; Jun, Tae-Youn

2010-10-01

South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.

Impact of acetylsalicylic Acid on the clinicopathological characteristics and prognosis of patients with invasive breast cancer.

Science.gov (United States)

Sendur, Mehmet A N; Aksoy, Sercan; Ozdemir, Nuriye Y; Zengin, Nurullah; Altundag, Kadri

2014-04-01

The impact of acetylsalicylic acid (ASA) on the clinicopathological characteristics of breast cancer has not yet been elucidated in detail; we therefore aimed to investigate the effects of ASA on the clinicopathological characteristics of patients with breast cancer. Patients diagnosed with breast cancer were retrospectively analyzed. Breast cancer patients who were taking ASA at the time of breast cancer diagnosis were enrolled as ASA users (n = 84); matching patients with the same age who were not taking ASA were included as control group (n = 890). The median age was 56 (range 34-82) years in both groups. ASA users had a significantly lower incidence of grade II-III tumors compared to non-users (P = 0.02). The other clinicopathological characteristics and treatment histories were similar in both groups. In patients using ASA, the disease-free survival (DFS) rate was 97.3%, 89.4%, and 79.9% and in non-users it was 94.1%, 81.8%, and 70.9% in the 1rst, 3rd, and 5th year, respectively (P = 0.01). In aspirin users, the overall survival rate was 95.0%, 90.6%, and 87.6% and in non-users it was 98.1%, 91.2%, and 85.5% in the 1rst, 3rd, and 5th year, respectively (P = 0.50). Using ASA at the time of breast cancer diagnosis was associated with significantly improved DFS in breast cancer patients.

Patient and clinical characteristics that heighten risk for heart failure readmission.

Science.gov (United States)

Bradford, Chad; Shah, Bijal M; Shane, Patricia; Wachi, Nicole; Sahota, Kamalpreet

2017-11-01

Within 30 days of hospital discharge, heart failure (HF) readmission rates nationally accumulate to more than 20%. Due to this high rate of unplanned re-hospitalization, predictive models are needed to identify patients who pose the highest readmission risk. To evaluate the diagnosis and timing and to identify patient and clinical characteristics associated with 30 day readmissions among HF patients. A retrospective analysis of electronic health records was conducted to study HF admissions during the period October 2008 to November 2014. Patients with a primary discharge diagnosis consistent with HF were included. Descriptive statistics were used to compare the readmitted and non-readmitted cohorts. Logistic regression was used to develop a predictive model to determine patient and clinical variables associated with 30 day readmission. Characteristics of the study cohort (n = 2420) are: a mean age of 72, predominantly male (55%), white (55%), currently not employed (91%), and utilizing Medicare as a payer (68%). Overall, 42% were married. Over the study time period there were 394 (16.3%) 30 day readmissions after 2420 hospitalizations. The 3 most common reasons for readmission were HF (36.0%), renal disorders (8.4%), and other cardiac diseases (6.9%). Analysis showed that 11.9% of patients readmitted during days 0-3, 15.2% during days 4-7, 31.5% during days 8-15, and 41.4% during days 16-30. The final multivariate predictive model included 5 variables that were associated with an increased risk for 30-day readmission: employment status as retired or disabled, > 1 emergency department visit in the past 90 days, length of stay >5 days during index visit, and a BUN value > 45 mg/dL. This study provides a deeper understanding of patient and clinical characteristics that are associated with readmission in HF. Evaluation of these characteristics will provide additional information to guide strategies meant to reduce HF readmission rates. Copyright © 2016 Elsevier

Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure

DEFF Research Database (Denmark)

Gustafsson, Finn; Torp-Pedersen, Christian; Seibaek, Marie

2004-01-01

function the RR was 1.57 (1.43-1.72, multivariate analyses). CONCLUSION: The clinical characteristics of CHF patients vary considerably with age. Elderly patients hospitalised with CHF face a very grave prognosis, particularly if their heart failure symptoms are caused by LV systolic dysfunction....... dysfunction, were under treated with ACE-inhibitors and were more often female. The prevalence of hypertension, diabetes and ischaemic heart disease increased with age, until the oldest age group (>80 years). Age was an independent predictor of short-term mortality (risk ratio (RR) per 10-year increase was 1...

Effect of brachytherapy technique and patient characteristics on cervical cancer implant dosimetry

Energy Technology Data Exchange (ETDEWEB)

Anker, Christopher J., E-mail: chris.anker@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); O' Donnell, Kristen [Department of Radiation Oncology, The University of Arizona, Tucson, AZ (United States); Boucher, Kenneth M. [Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States); Gaffney, David K. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States)

2013-01-01

Our purpose was to evaluate the relationship between brachytherapy technique and patient characteristics on dose to organs-at-risk (OARs) in patients undergoing high dose rate (HDR) brachytherapy for cervical cancer. From 1998 to 2008, 31 patients with cervical cancer with full dosimetric data were identified who received definitive external-beam radiation and HDR brachytherapy with tandem and ovoid applicators. Doses were recorded at point A, the International Commission on Radiation Units and Measurements (ICRU)-38 rectal point, the ICRU-38 bladder point, the vaginal surface, and the pelvic sidewall. Generalized estimating equations were used to determine the significance of changes in OAR to point A dose ratios with differences in brachytherapy technique or patient characteristics. Patients underwent a median of 5 brachytherapy procedures (range, 3 to 5), with a total of 179 procedures for 31 patients. For all brachytherapy treatments, the average ratios between the doses for the rectal, bladder, vaginal surface, and pelvic sidewall reference points to those at point A were 0.49, 0.59, 1.15, and 0.17, respectively. In general, decreased OAR dose was associated with a lower stage, younger age, increased ovoid size, increased tandem length, and earlier implant number. Increased tandem curvature significantly increased bladder dose and decreased rectal dose. Intravenous anesthesia usage was not correlated with improved dosimetry. This study allowed identification of patient and procedure characteristics influencing OAR dosing. Although the advent of 3-dimensional (3D) image-guided brachytherapy will bring new advances in treatment optimization, the actual technique involved at the time of the brachytherapy implant procedure will remain important.

Characteristics and Associated Comorbidities of Pediatric Dental Patients Treated under General Anesthesia.

Science.gov (United States)

Delfiner, Alexandra; Myers, Aaron; Lumsden, Christie; Chussid, Steve; Yoon, Richard

To describe characteristics and identify common comorbidities of children receiving dental treatment under general anesthesia at Children's Hospital of New York-Presbyterian. Electronic medical records of all children that received dental treatment under general anesthesia through the Division of Pediatric Dentistry from 2012-2014 were reviewed. Data describing patient characteristics (age, sex, race/ethnicity, insurance carrier, and American Society of Anesthesiologists physical status classification system), medical history, and justification for treatment were collected. Descriptive statistics, including frequencies, percentages and t-tests, were calculated. A total of 298 electronic medical records were reviewed, of which 50 records were excluded due to missing information. Of the 248 electronic medical records included, the average age was 5-years-old and 58% were male. The most common reason for dental treatment under general anesthesia was extent and severity of dental disease (53%), followed by significant medical history (47%) and behavior/pre-cooperative age (39%). Those who were ASA III or IV were older (6.6-years) (p<.001). Common medical comorbidities appear evenly distributed: autism (12%), cardiac anomalies (14%), developmental delay (14%), genetic syndromes/chromosomal disorders (13%), and neurological disorders (12%). Younger age groups (1 to 2 years and 3 to 5 years) had a high percentage of hospitalizations due to the extent and severity of the dental disease (83%) and behavior (77%) (p<0.001). No single comorbidity was seen more often than others in this patient population. The range of medical conditions in this population may be a reflection of the range of pediatric specialty services at Children's Hospital of NewYork-Presbyterian.

The Ahmed Versus Baerveldt study: design, baseline patient characteristics, and intraoperative complications.

Science.gov (United States)

Christakis, Panos G; Tsai, James C; Zurakowski, David; Kalenak, Jeffrey W; Cantor, Louis B; Ahmed, Iqbal I K

2011-11-01

To report the design, baseline patient characteristics, and intraoperative complications of the Ahmed Versus Baerveldt (AVB) Study. Multicenter, randomized, clinical trial. Patients were recruited from 7 international clinical sites and treated by 10 surgeons between 2005 and 2009. Inclusion criteria required that patients be at least 18 years of age and have uncontrolled glaucoma refractory to medicinal, laser, and surgical therapy. Eligible patients were randomized to undergo implantation of an Ahmed-FP7 valve (New World Medical, Inc., Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc., Santa Ana, CA) using standardized surgical technique, to be followed for 5 years. The primary outcome measure was failure, defined as intraocular pressure (IOP) out of target range (5-18 mmHg with ≥ 20% reduction from baseline) for 2 consecutive visits after 3 months, vision-threatening complications, additional glaucoma procedures, or loss of light perception. Secondary outcome measures included IOP, medication use, visual acuity, complications, and interventions. A total of 238 patients were enrolled in the study; 124 received the Ahmed-FP7 valve implant and 114 received the Baerveldt-350 implant. The 2 treatment groups did not differ in any baseline characteristics with the exception of sex. The mean age of the study group was 66 ± 16 years, and 55% were women, with a greater proportion in the Baerveldt group (P=0.01). The mean baseline IOP of the study group was 31.4 ± 10.8 on a mean of 3.1 ± 1.0 glaucoma medications. The median Snellen visual acuity was 20/100, mean number of previous laser therapies was 0.9 ± 1.1, and mean number of previous surgeries was 1.7 ± 1.2. Five (4%) patients in the Ahmed group and 4 (4%) patients in the Baerveldt group experienced significant intraoperative complications. Aqueous drainage devices are being increasingly used for glaucoma refractory to conventional treatment, and the AVB Study compares the 2 most

Age-related effects of job characteristics on burnout and work engagement.

Science.gov (United States)

Ramos, R; Jenny, G; Bauer, G

2016-04-01

In light of an ageing and age-diverse workforce, it is imperative to understand how psychosocial aspects of work might influence health throughout working life. Recently, there has been an implicit call to differentiate job characteristics beyond the two factors of job demands and job resources. As needs, abilities and motivation fluctuate with age, different job characteristics might yield differential benefits. Additionally, markers beyond chronological age should be considered. To explore systematically interactions between different job characteristics, age and age covariates (i.e. job tenure and position type) and their relationship with work-related health outcomes. An online survey of workers in Switzerland, Austria and Germany, recruited through a panel data service provider. We excluded participants working fewer than 30 hours a week, trainees, self-employed people and senior managers. We assessed seven areas of psychosocial risks at work, burnout, work engagement and demographics. Of the 6000 workers contacted, 1916 responded (31%). After applying exclusion criteria, we analysed data from 1417 respondents. We found that age barely had a moderating effect between psychosocial factors and health outcomes, but its three-way interaction with age covariates had more explanatory potential. Young workers with high job tenure showed particular vulnerability to job demands and the lack of certain job resources. Older workers with managerial positions were more resilient. Age and its covariates, such as job tenure and position type, should be considered in developing age-sensitive occupational health models. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparison of road traffic injury characteristics between local versus floating migrant patients in a tertiary hospital between 2007 and 2010.

Directory of Open Access Journals (Sweden)

Chungui Xu

Full Text Available BACKGROUND: The aim of this study is to give a description of the road traffic injuries (RTIs characteristics of floating migrant population by comparing with those of local residents in a harbor city of China. METHODS: A population-based descriptive study was carried out between 2007 and 2010 with RTI patient records from the Fifth Center Hospital of Tianjin. Inpatient diagnoses of RTI patients were defined using the International Classification of Diseases, Tenth Revision (ICD-10 codes. We analyzed the demographics and general characteristics of RTI patients that were in the hospital during the four years. In order to compare the group differences between local resident patients and floating migrant patients, the distribution of their ages, diagnoses, severity of injuries, duration of inpatient stays, hospitalization cost were analyzed. RESULTS: People between the ages of 16 and 55 were the most likely to suffer RTIs. The floating migrant patients between the ages of 16 and 45 had a higher incidence of accidents, while local resident patients between 46 and 55 had a higher incidence of accidents. Compared to local resident patients, floating migrant patients were more vulnerable to open injuries and severe traffic injuries. With the severity of injuries ranked from mild to severe, floating migrant patients had lower duration of inpatient stay, but higher hospitalization costs compared to local resident patients. CONCLUSIONS: Floating migrant patients had a different age distribution, severity of injuries, diseases, inpatient duration and hospitalization cost compared with local resident patients. Compared to local resident patients, floating migrants had a higher risk to RTIs and were more vulnerable to severer traffic accidents at lower ages.

Characteristics of electronic patient-provider messaging system utilisation in an urban health care organisation

Directory of Open Access Journals (Sweden)

Sean Patrick Mikles

2014-12-01

Full Text Available Introduction Research suggests that electronic messaging can improve patient engagement. Studies indicate that a ‘digital divide’ may exist, where certain patient populations may be using electronic messaging less frequently. This study aims to determine which patient characteristics are associated with different levels of usage of an electronic patient-provider messaging system in a diverse urban population.Methods Cross-sectional electronic health record data were extracted for patients 10 years of age or older who live in New York City and who visited a set of clinics between 1 July 2011 and 30 June 2012. Regression analyses determined which participant characteristics were associated with the sending of electronic messages.Results Older, female, English-speaking participants of white race who received more messages, had any diagnoses, more office visits and a provider who sent messages were more likely to send more messages. Non-Millennial, non-white participants who received fewer messages, had more office visits, any diagnoses, a provider who saw fewer patients with patient portal accounts, lived in a low socioeconomic status neighbourhood, and did not have private insurance were more likely to send zero messages.Conclusion This study found significant differences in electronic messaging usage based on demographic, socioeconomic and health-related patient characteristics. Future studies are needed to support these results and determine the causes of observed associations.

Medical home characteristics and the pediatric patient experience.

Science.gov (United States)

Burnet, Deborah; Gunter, Kathryn E; Nocon, Robert S; Gao, Yue; Jin, Janel; Fairchild, Paige; Chin, Marshall H

2014-11-01

The patient-centered medical home (PCMH) has roots in pediatrics, yet we know little about the experience of pediatric patients in PCMH settings. To examine the association between clinic PCMH characteristics and pediatric patient experience as reported by parents. We assessed the cross-sectional correlation between clinic PCMH characteristics and pediatric patient experience in 24 clinics randomly selected from the Safety Net Medical Home Initiative, a 5-state PCMH demonstration project. PCMH characteristics were measured with surveys of randomly selected providers and staff; surveys generated 0 (worst) to 100 (best) scores for 5 subscales, and a total score. Patient experience was measured through surveying parents of pediatric patients. Questions from the Consumer Assessment of Healthcare Providers and Systems-Clinician and Group instrument produced 4 patient experience measures: timeliness, physician communication, staff helpfulness, and overall rating. To investigate the relationship between PCMH characteristics and patient experience, we used generalized estimating equations with an exchangeable correlation structure. We included 440 parents and 214 providers and staff in the analysis. Total PCMH score was not associated with parents' assessment of patient experience; however, PCMH subscales were associated with patient experience in different directions. In particular, quality improvement activities undertaken by clinics were strongly associated with positive ratings of patient experience, whereas patient care management activities were associated with more negative reports of patient experience. Future work should bolster features of the PCMH that work well for patients while investigating which PCMH features negatively impact patient experience, to yield a better patient experience overall.

Establishment and baseline characteristics of a nationwide Danish cohort of patients with Ehlers-Danlos syndrome

DEFF Research Database (Denmark)

Kulas Søborg, Marie-Louise; Leganger, Julie; Quitzau Mortensen, Laura

2017-01-01

at any given time between 1 January 2000 and 31 December 2012, based upon longitudinal Danish national registers. All patients with EDS were identified, and the cohort was described by disease prevalence, basic demographic characteristics, mean age at death and mortality for the observational period...

Clinical characteristics of inflammation-associated depression: Monocyte gene expression is age-related in major depressive disorder.

Science.gov (United States)

Grosse, Laura; Carvalho, Livia A; Wijkhuijs, Annemarie J M; Bellingrath, Silja; Ruland, Tillmann; Ambrée, Oliver; Alferink, Judith; Ehring, Thomas; Drexhage, Hemmo A; Arolt, Volker

2015-02-01

Increased inflammatory activation might only be present in a subgroup of depressed individuals in which immune processes are especially relevant to disease development. We aimed to analyze demographic, depression, and trauma characteristics of major depressive disorder (MDD) patients with regard to inflammatory monocyte gene expression. Fifty-six naturalistically treated MDD patients (32 ± 12 years) and 57 healthy controls (HC; 31 ± 11 years) were analyzed by the Inventory of Depressive Symptomatology (IDS) and by the Childhood Trauma Questionnaire (CTQ). We determined the expression of 38 inflammatory and immune activation genes including the glucocorticoid receptor (GR)α and GRβ genes in purified CD14(+) monocytes using quantitative-polymerase chain reaction (RT-qPCR). Monocyte gene expression was age-dependent, particularly in MDD patients. Increased monocyte gene expression and decreased GRα/β ratio were only present in MDD patients aged ⩾ 28 years. Post hoc analyses of monocyte immune activation in patients depression (recurrent type, onset depression, onset ⩾15 years) - additionally characterized by the absence of panic symptoms - that exhibited a strongly reduced inflammatory monocyte activation compared to HC. In conclusion, monocyte immune activation was not uniformly raised in MDD patients but was increased only in patients of 28 years and older. Copyright © 2014 Elsevier Inc. All rights reserved.

Do Neighborhood Characteristics in Amsterdam Influence Adiposity at Preschool Age?

Directory of Open Access Journals (Sweden)

E. Jessica Hrudey

2015-05-01

Full Text Available Background: Neighborhood characteristics may contribute to adiposity in young children, but results in the current literature are inconsistent. This study aimed to investigate whether objective (socioeconomic status (SES and subjective (perceived safety, satisfaction with green spaces and perceived physical disorder neighborhood characteristics directly influence child adiposity (as measured by BMI, percent body fat (%BF and waist-to-height ratio (WHtR. Methods: Data on child BMI, %BF and WHtR were obtained from the Amsterdam Born Children and their Development cohort at 5–6 years of age. Three thousand four hundred and sixty nine (3469 children were included in the analyses. Mixed models, using random intercepts for postal code area to account for neighborhood clustering effects, were used to analyze the relationships of interest. Results: Associations were observed for both perceived safety and neighborhood SES with %BF after adjustment for maternal education and ethnicity. All relationships were eliminated with the inclusion of individual covariates and parental BMI into the models. Conclusions: In general, child adiposity at age 5–6 years was not independently associated with neighborhood characteristics, although a small relationship between child %BF and both neighborhood SES and perceived safety cannot be ruled out. At this young age, familial and individual factors probably play a more important role in influencing child adiposity than neighborhood characteristics.

Clinical characteristics and long-term response to mood stabilizers in patients with bipolar disorder and different age at onset

Science.gov (United States)

Dell’Osso, Bernardo; Buoli, Massimiliano; Riundi, Riccardo; D’Urso, Nazario; Pozzoli, Sara; Bassetti, Roberta; Mundo, Emanuela; Altamura, A Carlo

2009-01-01

Introduction Bipolar disorder (BD) is a prevalent, comorbid, and impairing condition. Potential predictors of response to pharmacological treatment are object of continuous investigation in patients with BD. The present naturalistic study was aimed to assess clinical features and long-term response to mood stabilizers in a sample of bipolar subjects with different ages at onset. Methods The study sample included 108 euthymic patients, diagnosed as affected by BD, either type I or II, according to the DSM-IV-TR, who were started on mood stabilizer treatment. Patients were followed-up for 24 months and the occurrence of any mood episode collected. At the end of the follow-up, patients were divided in 3 subgroups according to the age at onset (early-onset ≤30 years, middle-onset >30–≤45 years, and late-onset >45 years, respectively) and the long-term response to mood stabilizers was compared between them along with other clinical features. Results The three subgroups showed significant differences in terms of clinical and demographic features and, with respect to long-term response to mood stabilizers, the early-onset subgroup showed a better outcome in terms of reduction of major depressive episodes during the 24-month follow-up compared to the other subgroups (one way ANOVA, F = 3.57, p = 0.032). Conclusions Even though further controlled studies are needed to clarify the relationship between age at onset and outcome in BD, the present follow-up study suggests clinical peculiarities and different patterns of response to mood stabilizers across distinct subgroups of patients with BD and different ages at onset. PMID:19649214

Patient-physician agreement on tobacco and alcohol consumption: a multilevel analysis of GPs' characteristics.

Science.gov (United States)

Thebault, Jean-Laurent; Falcoff, Hector; Favre, Madeleine; Noël, Frédérique; Rigal, Laurent

2015-03-18

Data about tobacco and alcohol consumption are essential in many types of studies. These data can be obtained by directly questioning patients or by using the information collected from physicians. Agreement between these two sources varies according to the characteristics of patients but probably also those of physicians. The purpose of this study was to analyze the characteristics of general practitioners (GPs) associated with agreement between them and their patients about the patients' consumption of alcohol and tobacco. Data came from an observational survey among GPs who were internship supervisors in the Paris metropolitan area. Fifty-two volunteer GPs completed a self-administered questionnaire about the organization of their practice and their training. For each GP, a random sample of 70 patients, aged 40 to 74 years, answered questions about their personal tobacco and alcohol consumption. GPs simultaneously answered similar questions about each patient. We used a mixed logistic model to assess the association between physicians' characteristics and agreement for patients' smoking status and alcohol consumption. Data were collected from both patient and physician for 2599 patients. The agreement between patients and their physicians was 60.4% for smoking status and 48.7% for alcohol consumption. Physicians with continuing medical education in management of smokers and those reporting specific skill in managing hypertension had the best agreement for smoking. Physicians who taught courses at the university medical school and those reporting specific skill in managing alcoholism had the best agreement for alcohol consumption. Agreement increases with physicians' training and skills in management of patients with tobacco and alcohol problems. It supports the importance of professional training for improving the quality of epidemiologic data in general practice. Researchers who use GPs as a source of information about patients' tobacco and alcohol consumption

Postoperative cognitive dysfunction in middle-aged patients

NARCIS (Netherlands)

Johnson, T.; Monk, T.; Rasmussen, L.S.; Abildstrom, H.; Houx, P.J.; Korttila, K.; Kuipers, H.M.; Hanning, C.D.; Siersma, V.D.; Kristensen, D.; Canet, J.; Ibanaz, M.T.; Moller, J.T.

2002-01-01

Background: Postoperative cognitive dysfunction (POCD) after noncardiac surgery is strongly associated with increasing age in elderly patients; middle-aged patients (aged 40-60 yr) may be expected to have a lower incidence, although subjective complaints are frequent. Methods: The authors compared

Age dependency of primary tumor sites and metastases in patients with Ewing sarcoma.

Science.gov (United States)

Worch, Jennifer; Ranft, Andreas; DuBois, Steven G; Paulussen, Michael; Juergens, Heribert; Dirksen, Uta

2018-06-01

The median age of patients with Ewing sarcoma (EwS) at diagnosis is around 14-15 years. Older age is associated with a worse outcome. The correlation of age at diagnosis on sites of disease has not been fully described. The goal of this study was to evaluate the differences in sites of primary tumor and metastatic tumor involvement according to age groups. EwS data from the Gesellschaft für Pädiatrische Onkologie und Hämatology (GPOH) database of the Cooperative Ewing Sarcoma Study (CESS) 81/86 and the European Intergroup Cooperative Ewing's Sarcoma Study EICESS 92 and the EUROpean Ewing tumor Working Initiative of National Groups-99-Protocol (EURO-E.W.I.N.G.-99) study were analyzed. Patient and tumor characteristics were evaluated statistically using chi square tests. The study population included 2,635 patients with bone EwS. Sites of primary and metastatic tumors differed according to the age groups of young children (0-9 years), early adolescence (10-14 years), late adolescence (15-19 years), young adults (20-24 years), and adults (more than 24 years). Young children demonstrated the most striking differences in site of disease with a lower proportion of pelvic primary and axial tumors. They presented less often with metastatic disease at diagnosis. Site of primary and metastatic tumor involvement in EwS differs according to patient age. The biological and developmental etiology for these differences requires further investigations. © 2018 Wiley Periodicals, Inc.

Characteristic sonographic and follow up features of thyroid nodules according to children age groups

International Nuclear Information System (INIS)

Nam, Bo Da; Chang, Yun Woo; Hong, Seong Sook; Hwang, Ji Young; Lim, Hyun Kyung; Lee, Jeong Ho; Lee, Dong Hwan

2016-01-01

We analyzed the spectrum and the significance of pediatric thyroid nodules depicted on sonography and evaluated the follow-up change according to the age group. We retrospectively reviewed the sonographic features of 82 nodules in 69 patients (6.6%) among 1282 children less than 13 years of age without a palpable lesion, from January 2006 to January 2013. Patients were divided into three age groups; infants, preschoolers, and schoolers. Thyroid nodules were evaluated according to their sonographic characteristics (simple cyst, colloid cyst, solid mass, or intrathyroid thymus) and the changes detected at follow-up (disappearance, decrease in size, no change or increase in size) were reported. There was a significant difference in the nodule patterns among the age groups (p < 0.001). The nodules in infants included a simple cyst (n = 12), a solid mass (n = 12), or an intra-thyroid thymus (n = 9). The preschoolers had a simple cyst (n = 11), a colloid cyst (n = 5), a solid mass (n = 3) or an intra-thyroid thymus (n = 5). However, the schoolers had a simple cyst (n = 2), a colloid cyst (n = 18), and a solid mass (n = 5), but there was no case of intra-thyroid thymus. Follow-up of 38 cases revealed significant differences among the age groups (p = 0.018). The nodules in infants showed findings such as disappearance of nodules (n = 9) and no change (n = 10) on follow-up sonography. In preschoolers, the nodules had disappeared (n = 2), decreased in size (n = 1), and showed no change (n = 11). However, the nodules in schoolers were found to be decreased in size (n = 1), show no change (n = 2), and increased in size (n = 2). The proven pathologic finding was benign in four patients. There were significant differences in the prevalence and the interval change of thyroid nodules among infants, preschoolers, and schoolers. A large series of intrathyroid thymus was seen in infants and preschoolers, and masses did not increase in size in these age groups. The frequency of a

Clinical and angiographic characteristics of young adult patients recovered from acute myocardial infarction

Directory of Open Access Journals (Sweden)

Miljković Dušan

2015-01-01

Full Text Available Introduction. Occurrence of acute myocardial infarction in young adults is a relatively rare. In majority of the studies, age of 45 years is used as cut-off line in definition of the young patients with coronary artery disease or myocardial infarction. Studies have shown that younger population aged less than 40 years represents only 2-8% of all patients with myocardial infarction. Objective. The aim of this study was to examine the specificities of clinical and angiographic characteristics of the patients recovered from acute myocardial infarction, younger than 45 years at the moment of attack, by comparing their clinical and angiographic characteristics with those of patients older than 65 years, who recovered from acute myocardial infarction. Method. The study included 78 patients recovered from acute myocardial infarction, 33 patients were younger than 45 years (40.7 ± 3.9 years, 25 (75.7% men and eight (24.2% female, and 45 patients were older than 65 years (68.2 ± 4.2 years, 32 (71.3% men and 13 women. Detailed history taking, physical examination, permanent ECG monitoring, laboratory analyses, X-ray examination, echocardiography and selective coronarography of all patients were performed. Results. Patients younger than 45 years had a significantly higher incidence of STEMI (p 0.05 Multivessel disease existed at 54.5% under the age of 45 and 77.8% older than 65 years (p0.05. The disease of left main coronary artery had 6.1% of patients younger than 45 and 22.2% of patients older than 65 years (p0.05 Were without significant coronary artery stenosis Comparing risk factors for coronary artery disease in patients younger than 45 years and older than 65 years, we find: hypertension in 48.5% vs. 88.9% (p0.05, diabetes mellitus in 21.2% vs. 55.5% (p 0.05, and stress in 18.2% vs. 2.2% (p <0.01. Conclusion. Patients with myocardial infarction younger than 45 years are predominantly male and have a significantly higher incidence of infarction

Establishment and baseline characteristics of a nationwide Danish cohort of patients with Ehlers-Danlos syndrome.

Science.gov (United States)

Kulas Søborg, Marie-Louise; Leganger, Julie; Quitzau Mortensen, Laura; Rosenberg, Jacob; Burcharth, Jakob

2017-05-01

The aim of this study was to investigate national prevalence, general demographic characteristics and survival of Danish patients with Ehlers-Danlos syndrome (EDS). A population-based cohort study was conducted using a database consisting of the entire Danish population alive at any given time between 1 January 2000 and 31 December 2012, based upon longitudinal Danish national registers. All patients with EDS were identified, and the cohort was described by disease prevalence, basic demographic characteristics, mean age at death and mortality for the observational period of 13 years. The cohort held 1427 unique persons with EDS, giving a national prevalence of 0.02%. The EDS population had a mean ( s . d .) age of 34.9 (18.6) years and comprised 73.9% females and 26.1% males. Of the cohort, 95.9% originated from Denmark and 57% were unmarried. We found that 31.6% of the cohort received state-granted subsidies, of which 77% were in the form of early retirement pension. Regarding educational status, 28.1% of the EDS cohort had completed primary education (⩽10th grade) as their highest educational level, while 71.9% had completed a higher level. During the observation period, 42 patients died, with a mean ( s . d .) age at death of 53.6 (21.7) years. This study confirmed a small national prevalence of patients diagnosed with EDS and showed that the majority of patients diagnosed are female. The EDS cohort had a lower educational level, mean age and life expectancy compared with the background population and showed a predisposition for receiving state-granted subsidies. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Aging characteristic and mechanical properties of TiC/2618 composite

Institute of Scientific and Technical Information of China (English)

龙春光; 张厚安; 庞佑霞; 刘厚才

2001-01-01

TiC/2618 composite was prepared by XD method . The constituent and microstructure of the composite have been investigated by X-ray diffraction and TEM technique. The aging characteristics and mechanical properties at high and room temperatures were studied. The results show that: 1 ) it is possible to prepare multiple alloy matrix TiC/2618composite by XD method; 2) the TiC particles in TiC/2618 composite have the characteristics of fine size, clean appearance and a good bond with the matrix; 3) the aging law of the TiC/2618 composite has been changed by the addition of TiC particles. Two-peak value phenomenon has been observed when it was aged at 190 ℃; 4) TiC/2618 composite has better mechanical properties than those of the matrix both at room and high temperatures.

A goods characteristics model of the hedonic ageing equation: evidence from a French marriage bureau

OpenAIRE

Sam Cameron; Nicolas Vaillant

2005-01-01

The present paper adopts a modelling perspective derived from goods characteristics analysis [Lancaster (1971)] and the general ideas of transactions costs. This is implemented in estimated equations, which feature the age of partner sought as the dependent variable and own age and various other personal characteristics, and characteristics desired in a partner, as the right-hand side variables. The results show a very strong relationship between age and desired partner age. More interestingl...

Cost of management in epistaxis admission: Impact of patient and hospital characteristics.

Science.gov (United States)

Goljo, Erden; Dang, Rajan; Iloreta, Alfred M; Govindaraj, Satish

2015-12-01

To investigate patient and hospital characteristics associated with increased cost and length of stay in the inpatient management of epistaxis. Retrospective cross-sectional study of the 2008 to 2012 National (Nationwide) Inpatient Sample. Patient and hospital characteristics of epistaxis admissions were analyzed. Multiple linear regression analysis was used to ascertain variables associated with increased cost and length of hospital stay. Variables significantly associated with high cost were further analyzed to determine the contribution of operative intervention and total procedures to cost. A total of 16,828 patients with an admitting diagnosis of epistaxis were identified. The average age was 67.5; 52.3% of the patients were male; 73.3% of the patients were Caucasian; and 70.7% of the hospital stays were government funded. The average length of stay was 3.24 days, and average hospitalization cost was $6,925. Longer length of stay was associated with black race, alcohol abuse, sinonasal disease, renal disease, Medicaid, and care at a northeastern U.S. hospital. Increased hospitalization costs of > $1,000 were associated with Asian/Pacific Islander race; sinonasal disease; renal disease; top income quartile; and care at urban teaching, northeastern, and western hospitals in the United States. High costs were predicted by procedural intervention in patients with comorbid alcohol abuse, sinonasal disease, renal disease, patients with private insurance, and patients managed at large hospitals. Although hospitalization costs are complex and multifactorial, we were able to identify patient and hospital characteristics associated with high costs in the management of epistaxis. Early identification and intervention, combined with implementation of targeted hospital management protocols, may improve outcomes and reduce financial burden. 2C. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

[Influence of social support and personality traits on psychological characteristic of patients with chronic cervicodynia and lumbodynia].

Science.gov (United States)

Wei, Jie; Zhao, Ping; Chen, Li-Jun; Qin, Hui-Qing; Shi, Wang-Hong; Guo, Wei; Zhen, Ying

2012-03-01

To explore the effects of social support and personality traits on psychological characteristic of patients with chronic cervicodynia and lumbodynia and improve the level of diagnosis and treatment. From August 2009 to April 2010, 231 patients (obtained 217 effective responses) with chronic cervicodynia and lumbodynia were recruited. Among the patients, there were 123 males and 94 females, with an average age of (38.00 +/- 5.67) years (ranged from 15 to 66 years). Social Support Rating Scale (SSRS), Cattell Sixteen Personality Factor Questionnaire (16PF) and Symptom Checklist 90 (SCL-90) were used to test social support and psychological characteristic and compared the difference of psychological, personality traits and norm, then analyzed the effect of social support and personality traits on psychological characteristic. Two hundred and seventeen (93.9%) patients completed the questionnaire. Compared with normal 16PF scores, there were significant differences in factor scores of intelligence, stability, excitability, perseverance,social boldness, vigilance, sophistication, experimental, independence and tonicity (P characteristic between patients with chronic cervicodynia and lumbodynia and norms. Improving social support level and optimizing personality traits can improve psychological profile of these patients.

The Relationship between Attention Deficit Hyperactivity Disorder and Personality Characteristics in Migrainous Patients

Directory of Open Access Journals (Sweden)

Abdol Reza Sabahi

2014-08-01

Full Text Available Background: World Health Organization reports described migraine as one of the 4 most disabling chronic medical disorders. A day with migraine is as disabling as a day with quadriplegia, schizophrenia, or dementia in who is view 87% of people with migraine has some degree of disability. Migraine headaches are associated with psychological factors and personality characteristics. This study compares the personality characteristics of migraine patients with Attention Deficit Hyperactivity Disorder (ADHD and without ADHD. Materials and Methods: Eighty patients with migraine were evaluated in this cross sectional study with simple sampling method. All participants were assessed with semi structured clinical interview, adult ADHD self-report scale (ASRS and Millone clinical multiaxial inventory questionnaire. The migraine patients were divided into two groups, with and without ADHD. The correlation of variables was tested by χ2 test and t-test with 0.05 significance with the use of software SPSS-20. Results: Our participants were 80% female, 56% married and 36.2% with at least graduation from high school. Patients with migraine and ADHD were younger and their first headache experience had occurred in lower age compared with non-ADHD patients (p<0.05. In current study, we showed that there is a significant correlation between ADHD and depressive and independent personality traits and dysthymic clinical syndrome in migraine patients (p<0.05. Conclusion: Our results demonstrate that personality characteristics in migraine patients may be affected by some other mental disorders such as ADHD. These findings might be helpful in early treatment and prevention of dysfunctioning in patients with migraine.

[Characteristics of falls producing hip fracture in an elderly population. Differences according to age and gender].

Science.gov (United States)

Formiga, F; Ruiz, D; López-Soto, A; Duaso, E; Chivite, D; Pérez-Castejón, J M

2006-01-01

The majority of hip fractures are produced because of a fall. We examined the characteristics associated with falls causing hip fracture in elderly patients. Characteristics of falls owing to hip fracture were analyzed in 410 consecutive patients admitted in 6 hospitals during the 2004. We evaluated the location, time and the possible cause of fall: intrinsic risk factor, extrinsic or combined. We evaluated 316 women (77%) and 94 men, mean age 81.9 years. Previous to the hip fracture, the mean BI was 77.5. The mean value of falls during the last year was 1.9. Previously to the fall that caused hip fracture, we found that 24% of the patients had fallen repeatedly (more than two falls). Usually falls were at home (68%) and during daytime (80%). In 45% of patients an intrinsic risk factor was considered the most likely cause, in 33% an extrinsic risk factor and in 22% a combination. The majority of falls owing to hip fracture in elderly people happen in daytime, at home and due to intrinsic risk factors. Efforts to identify elderly people at risk of fall should be stressed in order to establish preventive measures.

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs).

Science.gov (United States)

Sun, Xin; Xue, Min; Deng, Xinliang; Lin, Yun; Tan, Ying; Wei, Xueli

2018-01-01

Intrauterine devices (IUDs) are the most popular form of contraception used worldwide; however, IUD is not risk-free. IUD migrations, especially uterine perforations, were frequently occurred in patients. The aim of this study was to investigate the clinical characteristics and intraoperative findings in patients with migrated IUDs. 29 cases of uterine perforation associated with migrated IUDs and 69 control patients were followed between January 2008 to March 2015. Patients who used IUDs within first 6 months from the last delivery experienced a characteristically high rate of the perforation of the uterine wall. A significantly larger number of IUD insertion associated with uterine perforation were performed in rural hospitals or operated at a lower level health care system. There was no clear difference in the age and presented symptoms in patients between two groups. Majority of contraceptive intrauterine devices was the copper-releasing IUDs. Furthermore, patients who used V-shaped IUD showed significantly higher incidence of pelvic adhesions when compared with the users of O-shaped IUDs. Unique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system.

Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age-related macular degeneration: a prospective study from a long-term observational data set. The Fight Retinal Blindness! Project.

Science.gov (United States)

Nguyen, Vuong; Daien, Vincent; Guymer, Robyn H; McAllister, Ian L; Morlet, Nigel; Barthelmes, Daniel; Gillies, Mark C

2018-04-01

Identifying variables that influence presenting visual acuity (VA) in patients with neovascular age-related macular degeneration (nAMD) is important because it is a strong predictor of long-term outcomes. To assess the clinical and social characteristics associated with low presenting VA in nAMD patients. The present study is a cross-sectional analysis from a prospective, observational database. We identified 3242 treatment-naïve patients from 54 Australian practices in the Fight Retinal Blindness! registry. Age, gender, ethnicity and VA were recorded at the baseline visit. Socio-economic status was determined using the Australian Bureau of Statistics socio-economic indexes for areas. Association between clinical and socio-economic characteristics with presenting VA was identified. Poor VA (≤35 letters) in the presenting eye was associated with older age (adjusted odds ratio [AOR]: 1.33 for patients aged ≥80 years vs. <80 years [95% confidence interval, CI: 1.04, 1.71]), treatment at a public practice (AOR: 1.91 for public vs. private practices [95% CI: 1.46, 2.50]) and intermediate (36-69 letters) VA in the fellow eye (AOR: 0.67 [95% CI: 0.47, 0.95] and 0.64 [95% CI: 0.48, 0.85] for poor [≤35 letters] and good [≥70 letters] VA vs. intermediate VA in the fellow eye). Gender, ethnicity and socio-economic status were not independently associated with VA at presentation. Poor presenting vision is detrimental to the long-term outcomes of nAMD. Poor presentation of nAMD in Australia may not be related to socio-economic circumstances, but due to systems of care. Further research is warranted to determine why patients at public practices present with worse vision compared with private practices in Australia. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

Coping strategies and socio-demographic characteristics among Jordanian caregivers of patients receiving hemodialysis

Directory of Open Access Journals (Sweden)

Eman Alnazly

2016-01-01

Full Text Available Individuals who care for family members receiving chronic hemodialysis (HD are likely to experience burdens that may adversely impact their patients. Effective coping strategies are shaped by various factors, including sociodemographic characteristics. To assess the relationship between caregivers and their patients, we studied 225 family-member caregivers of chronic HD patients through answering the Ways of Coping Questionnaire-Revised. Sociodemographic data, including caregiver age, gender, educational level, relationship to the patients, length of care time and weekly hours of caregiving were analyzed using the t-test, analysis of variance and least-significant difference post hoc test. Of the eight coping strategies investigated, seven were significantly related to at least one of the analyzed sociodemographic variables; these were confrontive coping, distancing, self-controlling, seeking social support, accepting responsibility, planful problem solving and positive reappraisal. The findings of the present study may be useful for administering dialysis by nurses for identifying coping strategies among caregivers and for establishing plans of care that would promote coping strategies in relation to the caregiver′s sociodemographic characteristics.

Clinicopathological characteristics of renal cell carcinoma in a dialysis patient

International Nuclear Information System (INIS)

Hayashida, Yushi; Sumitani, Haruo

2009-01-01

In order to clarify the clinicopathological features of renal cell carcinoma (RCC) occurring in chronic hemodialysis patients, we analyzed patient demographics, hemodialysis duration, pathological characteristics of the tumors and prognosis of these patients. We retrospectively reviewed the record of 16 patients who had undergone radical nephrectomy for RCC at Kawashima Hospital between November 1994 and December 2007. They ranged in age from 32 to 82 years old (mean age, 55.0), and comprised 14 males and 2 females. All the patients were clinical stage I. As for the underlying disease which caused renal failure, chronic glomerulonephritis was noted in 12 patients and diabetes mellitus was noted in 1 patient. The causes in 3 patients were unknown. The duration of hemodialysis ranged from 1 to 226 months, (90 months on average). As for the main diagnostic methods, CT was performed in 14 cases. Two patients demonstrated macroscopic hematuria Acquired cystic disease of the kidney (ACDK) was present in 10 patients (68.8%). Patients were divided two groups; patients who had undergone open surgery (group 1, N=7) and patients who had undergone retroperitoneoscopic surgery (group 2, N=9). The following factors were analyzed: operation time, bleeding volume, postoperative complications, hospitalization. Nephrectomy was performed for the right kidney in 8 patients, and for the left kidney in 8 patients. Operation time ranged from 90 to 150 minutes (average, 111 min), in group 1, and from 80 to 284 minutes (average, 146 min), in group 2. Bleeding volume ranged from 10 to 170 ml (average, 72 ml), in group 1, and from 10 to 50 ml (average, 15 ml), in group 2. Complications of nephrectomy were observed in 6 patients, but all were minor problems. As for hospitalization, in group 1 it was 20 days and in group 2 it was 12 days. Fifteen patients survived and are tumor free. One patient died of causes unrelated to RCC. (author)

Seizure threshold and the half-age method in bilateral electroconvulsive therapy in Japanese patients.

Science.gov (United States)

Yasuda, Kazuyuki; Kobayashi, Kaoru; Yamaguchi, Masayasu; Tanaka, Koichi; Fujii, Tomokazu; Kitahara, Yuichi; Tamaoki, Toshio; Matsushita, Yutaka; Nunomura, Akihiko; Motohashi, Nobutaka

2015-01-01

Seizure threshold (ST) in electroconvulsive therapy (ECT) has not been reported previously in Japanese patients. We investigated ST in bilateral ECT in Japanese patients using the dose-titration method. The associations between demographic and clinical characteristics and ST were analyzed to identify the predictors of ST. Finally, the validity of the half-age method for the stimulus dose was evaluated. Fifty-four Japanese patients with mood disorder, schizophrenia, and other psychotic disorders received an acute course of bilateral ECT using a brief-pulse device. ST was determined at the first session using a fixed titration schedule. ST was correlated with age, sex, body mass index, history of previous ECT, and psychotropic drugs on multiple regression analysis. Furthermore, the rate of accomplished seizures was calculated using the half-age method. Mean ST was 136 mC. ST was influenced by age, sex, history of previous ECT, and medication with benzodiazepines. The accomplished seizure rate using the half-age method was 72%, which was significantly lower in men and subjects on benzodiazepines. ST in Japanese patients was equal to or slightly higher than that previously reported in other ethnic groups, which might be attributable, at least in part, to high prevalence of and large-dose benzodiazepine prescription. Higher age, male gender, no history of ECT, and benzodiazepines were related to higher ST. The half-age method was especially useful in female patients and subjects without benzodiazepine medication. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Patient characteristics associated with false arrhythmia alarms in intensive care

Directory of Open Access Journals (Sweden)

Harris PR

2017-04-01

Full Text Available Patricia R Harris,1,2 Jessica K Zègre-Hemsey,3,4 Daniel Schindler,5 Yong Bai,6 Michele M Pelter,2,7 Xiao Hu2,8 1Department of Nursing, School of Health and Natural Sciences, Dominican University of California, San Rafael, 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, 3School of Nursing, 4Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC, 5Intensive Care Unit, The Neuroscience Center, Sutter Eden Medical Center, Castro Valley, 6Hu Research Laboratory, Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 7ECG Monitoring Research Lab, Department of Physiological Nursing, School of Nursing, 8Physiological Nursing and Neurological Surgery, Affiliate Faculty of Institute for Computational Health Sciences Core Faculty UCB/UCSF Joint Bio-Engineering Graduate Program, University of California, San Francisco, CA, USA Introduction: A high rate of false arrhythmia alarms in the intensive care unit (ICU leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. Objective: The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. Methods: This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds at an urban medical center over a period of 31 days in 2013. All monitor alarms and continuous waveforms were stored on a secure server. Nurse scientists with expertise in cardiac monitoring used a standardized protocol to annotate six clinically important types of arrhythmia alarms (asystole, pause, ventricular fibrillation, ventricular tachycardia, accelerated ventricular rhythm, and

[Clinical, neurophysiological and psychological characteristics of neurosis in patients with panic disorders].

Science.gov (United States)

Tuter, N V

2008-01-01

Forty-eight patients with panic disorders (PD), aged 31,5 years, 17 men, 31 women, were studied. The results were analyzed in comparison to a control group which comprised 16 healthy people, 6 men, 10 women, mean age 29,5 years. A traditional clinical approach, including somatic, neurologic and psychiatric examination, was used in the study. Also, a neurophysiological study using compression and spectral analyses, EEG, cognitive evoked potentials, skin evoked potentials, was conducted. A psychological examination included assessment of personality traits (Cattell's test), MMPI personality profile, mechanisms of psychological defense, the "Life style index" and Sondy test. A decrease of - and -rhythms was found that implied the reduction of activation processes. The psychological data mirror as common signs characteristic of all PD, as well as psychological features characteristic of neurotic disorders. The results obtained confirm the heterogeneity of PD in nosological aspect that demands using differential approach to the problems of their diagnostics and treatment.

Malignant oral tumors in iran: ten-year analysis on patient and tumor characteristics of 1042 patients in Tehran.

Science.gov (United States)

Sargeran, Katayoun; Murtomaa, Heikki; Safavi, Seyed Mohammad Reza; Vehkalahti, Miira; Teronen, Olli

2006-11-01

This study analyzed characteristics of oral cancer patients from Tehran, Iran, and their tumors. Data came from the patient records of 30 major hospitals in Tehran. Patients (n = 1042), diagnosed with invasive oral cancer in 1993-2003, were classified by primary tumor site according to ICD-10 (C00-C10). Data were analyzed separately for lip, oral cavity and salivary gland tumors. Statistical evaluation included chi and t-test. Of all cases, 59% were male. Age for all cases ranged from 6-103 years, mean age was 58.8 years (SD 16; median 62); 89% were older than 40. Tumor site breakdown was 65% oral cavity, 21% major salivary glands and 14% lip. A clear gender difference (P dominated in oral cavity cancers and men in lip cancers. The most common cancer site was the tongue (32%), accounting for 50% of the oral cavity cancers. Histologically, 88% of all oral cavity and lip cancers were squamous cell carcinomas, 10% of those were in age /= age 65. At the time of diagnosis, 59% of oral cavity cancers and 29% of lip cancers were at stage III or IV (P < 0.001). The results emphasize an urgent need for a national program focusing on early detection of oral cancers, including educational information addressed to oral health professionals.

Endodontics and the ageing patient.

Science.gov (United States)

Johnstone, M; Parashos, P

2015-03-01

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. © 2015 Australian Dental Association.

Characteristics and Long-Term Outcome of Patients with Systemic Immunoglobulin Light-Chain Amyloidosis

DEFF Research Database (Denmark)

Nelson, Lærke Marie; Gustafsson, Finn; Gimsing, Peter

2015-01-01

Background/Aims: Immunoglobulin light-chain (AL) amyloidosis is a systemic disorder that causes progressive organ dysfunction. The optimal treatment strategy requires accurate patient stratification with an emphasis on the extent of cardiac involvement. Reports on its prognosis are sparse...... and predominantly originate from highly selected centers. We aimed to evaluate patient characteristics and outcomes in a cohort treated at a single center. Methods: This is a single-center retrospective study of 63 consecutive patients diagnosed with AL amyloidosis between January 2000 and December 2012. Patients...... were evaluated by treatment strategy and cardiac involvement. Results: The mean age at diagnosis was 61.4 years (±8.9), and 39 patients (62%) were male. Thirty-two (51%) patients presented with cardiac amyloid involvement (CA) and the remaining 31 (49%) had noncardiac amyloidosis (NCA). The median...

Clinical characteristics of pleomorphic adenoma of salivary glands among Jordanian patients

International Nuclear Information System (INIS)

Khtoum, N. A.; Qubilat, A. R.; Zaidaneen, S. A.; Sarhan, M. A.; Qudah, A. A.

2013-01-01

Objective: To evaluate the incidence of salivary gland pleomorphic adenoma in Jordanian patients. Methods: The retrospective study involved histopathological reports of 62 patients diagnosed to have pleomorphic adenoma from salivary glands between 2000 and 2008 at King Hussein Medical Centre and the peripheral military hospitals of the Royal Medical Services, Jordan. The files were evaluated. Special attention was given to the distribution of the tumour to major and minor categories. Age, gender and treatment pattern were also noted. Quantitative and categorical variables were worked out for statistical analysis. Results: Out of the 62 cases, 32 (51.6%) occurred in men, with a male-to-female ratio of 1.06:1. The mean age was 40.4+-12 years (range: 8 to 80 years) with peak incidence in the 4th decade of life. The primary tumours were predominantly located in the parotid gland (n=40; 64%), followed by pleomorphic adenoma of the minor salivary glands (n=11; 17%), the submandibular gland (n=10; 16.12%) and the sublingual gland (n=1; 1.6%). Painless swelling was the first finding in 49 (79%), followed by pressure sensation in 10 (16%) and pain in 3 (5%) patients. Conclusion: Pleomorphic adenoma of salivary glands had similar characteristics with patients of most previously published research studies in other countries except that there was no significant difference regarding gender distribution in Jordanian patients. (author)

Usefulness of ultrasonography for detection of breast cancer in patients under 30 years of age

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Hyung; Oh, Ki Keun; Yoon, Sang Wook [Yongdong Severance Hospital, Seoul (Korea, Republic of)

1995-04-15

The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. Authors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast sonography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. In breast cancer patients under 30 years of age who have palpable breast mass as a initial, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.

Usefulness of ultrasonography for detection of breast cancer in patients under 30 years of age

International Nuclear Information System (INIS)

Kim, Ji Hyung; Oh, Ki Keun; Yoon, Sang Wook

1995-01-01

The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. Authors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast sonography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. In breast cancer patients under 30 years of age who have palpable breast mass as a initial, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients

Younger age is an independent predictor of worse prognosis among Lebanese nonmetastatic breast cancer patients: analysis of a prospective cohort

Directory of Open Access Journals (Sweden)

El Chediak A

2017-06-01

Full Text Available Alissar El Chediak,1 Raafat S Alameddine,1 Ayman Hakim,1 Lara Hilal,2 Sarah Abdel Massih,1 Lana Hamieh,3 Deborah Mukherji,1 Sally Temraz,1 Maya Charafeddine,1 Ali Shamseddine1 1Division of Hematology/Oncology, Department of Internal Medicine, 2Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon; 3Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA Background: Several retrospective studies have reported that younger age at presentation is associated with a worse prognosis for nonmetastatic breast cancer patients. In this study, we prospectively assessed the association between different baseline characteristics (age, tumor characteristics, mode of treatment, etc and outcomes among newly diagnosed nonmetastatic Lebanese breast cancer patients.Methods: We recruited a sample of 123 women newly diagnosed with nonmetastatic breast cancer presenting to American University of Beirut Medical Center. Immunohistochemical, molecular (vitamin D receptor, methylene tetrahydrofolate reductase polymorphisms, and genetic assays were performed. Patient characteristics were compared by age group (<40 and ≥40 years. A Cox regression analysis was performed to evaluate the variables affecting the disease-free survival (DFS. Outcome data were obtained, and DFS was estimated.Results: Among the 123 patients, 47 were 40 years of age or younger, and 76 were older than 40 years. Median follow-up duration was 58 months. Nine out of 47 patients <40 years (19.1% experienced disease relapse in contrast to four out of 76 patients >40 years (5.2%. A wide immunohistochemical panel included Ki-67, cyclin B1, p53, platelet-derived growth factor receptor, and vascular endothelial growth factor receptor, and did not reveal any significant difference in these markers between the two age groups. Older patients had a larger percentage of Luminal A than younger patients. On multivariate analysis

Cardiovascular risk factors and TIA characteristics in 19,872 Swedish TIA patients.

Science.gov (United States)

Ström, J O; Tavosian, A; Appelros, P

2016-12-01

Transient ischemic attack (TIA) constitutes a major risk factor for stroke, making TIA patients an important group for secondary intervention. The aim of this study was to account for risk factor prevalence in TIA patients and analyze the association between TIA characteristics and risk factors. We included 20,871 TIA events in 19,872 patients who were registered in the Swedish Riksstroke registry during the years 2010 through 2012. Data from other Swedish registers were used for comparison. The following variables were analyzed: age, sex, diabetes mellitus, atrial fibrillation (AF), cigarette smoking, and antihypertensive treatment. Compared to the general population (based on data retrieved from Sweden's national public health survey 'Health on equal terms'), TIA patients more often had diabetes mellitus (prevalence ratio, PR = 2.3), AF without oral anticoagulants (OAC) (PR = 2.8), and AF on OAC (PR = 1.6). Blood pressure medication was less prevalent among TIA patients than in the general population (PR = 0.57). Increasing age was associated with longer attacks. The fact that diabetes mellitus, atrial fibrillation, and smoking are more common in TIA patients than in the general population suggests that these factors are risk factors for TIA, even if causal relations cannot be proven. The relation between increasing age and longer attacks possibly reflects an increased proportion of embolic TIAs, or impaired recovery ability. Our results also suggest a significant proportion of untreated hypertension cases in the population. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Radiation therapy in aged lung cancer patients

International Nuclear Information System (INIS)

Ohtake, Eiji; Tobari, Chitose; Matsui, Kengo; Iio, Masahiro.

1982-01-01

The results and problems of radiotherapy were analyzed in 57 lung cancer patients more than 65 years of age (average age: 74.8 years). Of these, 45 (79%) were irradiated with a total dose exceeding 40 Gy. In these patients, the median survival was 13 months for Stages I and II, 6.5 months for Stage III, and 5 months for Stage IV. The results of combined radiotherapy and chemotherapy were better than those of radiotherapy alone. Also, slightly better results were obtained in patients treated with split-course than continuous-course irradiation. In aged lung cancer patients the prognosis was highly influenced by their respiratory function. Double cancers were present in 9 (16%) of the 57 patients. (author)

Pretreatment Serum Cystatin C Levels Predict Renal Function, but Not Tumor Characteristics, in Patients with Prostate Neoplasia

Directory of Open Access Journals (Sweden)

Feilong Yang

2017-01-01

Full Text Available To evaluate the role of Cystatin C (Cys-C in tumorigenesis and progression of prostate cancer (PCa, we retrospectively collected the clinical information from the records of 492 benign prostatic hyperplasia (BPH, 48 prostatic intraepithelial neoplasia (PIN, and 173 PCa patients, whose disease was newly diagnosed and histologically confirmed. Pretreatment serum Cys-C levels were compared across the various groups and then analyzed to identify relationships, if any, with clinical and pathological characteristics of the PCa patient group. There were no significant differences in serum Cys-C levels among the three groups (P > 0.05. In PCa patients with normal SCr levels, patient age was correlated with serum Cys-C level (P ≤ 0.001 but did not correlate with alkaline phosphatase (AKP, lactate dehydrogenase (LDH, prostate specific antigen (PSA, Gleason score, or bone metastasis status (P > 0.05. Age and SCr contributed in part to the variations in serum Cys-C levels of PCa patients (r = 0.356, P ≤ 0.001; r = 0.520, P ≤ 0.001. In conclusion, serum Cys-C levels predict renal function in patients with prostate neoplasia, but were not a biomarker for the development of prostate neoplasia, and were not correlated with the clinicopathological characteristics of PCa.

Clinical Characteristics in Patients with Triple Negative Breast Cancer

Directory of Open Access Journals (Sweden)

Janet Yeh

2017-01-01

Full Text Available Purpose. The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC and non-TNBC patients, with a particular focus on genetic susceptibility and risk factors prior to diagnosis. Methods. Our institutional database was queried for all patients diagnosed with invasive breast cancer between January 2010 and May 2016. Results. Out of a total of 1964 patients, 190 (10% patients had TNBC. The median age for both TNBC and non-TNBC was 59 years. There was a significantly higher proportion of African American and Asian patients with TNBC (p=0.0003 compared to patients with non-TNBC. BRCA1 and BRCA2 were significantly associated with TNBC (p<0.0001, p=0.0007. A prior history of breast cancer was significantly associated with TNBC (p=0.0003. There was no relationship observed between TNBC and a history of chemoprevention or patients who had a history of AH or LCIS. Conclusions. We found that having Asian ancestry, a prior history of breast cancer, and a BRCA1 or BRCA2 mutation all appear to be positively associated with TNBC. In order to develop more effective treatments, better surveillance, and improved prevention strategies, it is necessary to improve our understanding of the population at risk for TNBC.

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

Science.gov (United States)

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients

Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.

Science.gov (United States)

Franklin, Patricia D; Miozzari, Hermes; Christofilopoulos, Panayiotis; Hoffmeyer, Pierre; Ayers, David C; Lübbeke, Anne

2017-01-11

Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample. Data included age, sex, education level, BMI, diagnosis, medical co-morbidities, PROMs (WOMAC pain/function), global health (SF-12). Six thousand six hundred eighty primary TKAs (US) and 823 TKAs (Swiss) were evaluated. US vs. Switzerland TKA patients were younger (mean age 67 vs. 72 years.), more obese (BMI ≥30 55% vs. 43%), had higher levels of education, more cardiac disease. Swiss patients had lower preoperative WOMAC pain scores (41 vs. 52) but pre-operative physical disability were comparable. 4,647 primary THAs (US) and 1,023 THAs (Swiss) were evaluated. US vs. Switzerland patients were younger (65 vs. 68 years.), more obese (BMI ≥30: 38% vs. 24%), had higher levels of education, more diabetes. Swiss patients had lower preoperative WOMAC pain scores (40 vs. 48 points). Physical disability was reported comparable, but Swiss patients indicated lower mental health scores. We found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes. Reports from national registries lack detailed patient information while these data suggest the need for adequate risk adjustment of patient factors.

Sociodemographic and clinical characteristics of patients with recurrent aphthous stomatitis

Directory of Open Access Journals (Sweden)

Anıl Gülsel Bahalı

2014-12-01

Full Text Available Background and Design: The purpose of this study was to obtain data that may provide an insight into the etiopathogenesis of recurrent aphtous stomatitis (RAS by the way of analysing the sociodemographic and clinical characteristics of patients who had been diagnosed with RAS. Materials and Metods: The patients, who were diagnosed with RAS in the dermatology outpatient clinic, between May 2007 and May 2010, were evaluated retrospectively. The data including sociodemografic and clinical characteristics, and treatment options were recorded. Results: A hundred patients (68 women, 32 men were included in this study. The average age was 40±13.6 years. RAS was more common in patients with middle-income and low education. The most common type of RAS was minor aphtous ulcers (88%. The lesions were most frequently seen on the lateral side of the tongue (34% and cheek (34%. Sixty percent of patients had a positive family history. Some factors such as biting (12%, tooth brushing (18%, dental disease presence (82%, food (39%, menstruation (10.3%, stress (76%, iron deficiency (16.7%, vitamin B12 deficiency (22.4%, low serum ferritin levels (18%, and seasonal variability (32% showed positive correlation with RAS. A negative correlation was found between RAS and smoking. Forty-nine percent of patients had used alternative therapies in addition to drug therapy. The most frequently used alternative method was consumption of sumac (26.5%. Conlucions: In contrast to the literature, our study found that RAS is started in the third decade of life and, approximately 50% of patients prefered alternative treatment methods, particularly sumac. Nowadays, discussions about the etiopathogenesis of RAS continue. In this study, we found that different sociodemographic and clinical factors may be associated with the etiopathogenesis of the disease. Our study will be followed by further studies using prospective design to identify the the etiopathogenesis of RAS.

[The influence of procaine electrophoresis and mesotherapy on the indices of body components and biochemical characteristics in the subjects above 30 years of age].

Science.gov (United States)

Turova, E A; Konchugova, T V; Balaban, E I; Fadeeva, N I; Golovach, A V; Teniaeva, E A

2013-01-01

This study has demonstrated the effectiveness of a 2% procaine solution given with a view to improving metabolic parameters of aging, such as the body weight and composition along with the lipid profile in the patients varying in age from 30 years to 75 years. The study involved 95 patients treated with a 2% procaine solution that was administered by different methods (electrophoresis and mesotherapy) into several points of the collar region and upper back. The control group was comprised of the patients who received placebo by means of galvanization and mesotherapy. The results of the study indicate that the introduction of a 2% procaine solution in the treatment of metabolic disorders effectively improves selected metabolic characteristics of ageing and thereby helps to reduce the biological age in comparison with the control patients treated with placebo.

Survival after out-of-hospital cardiac arrest in relation to age and early identification of patients with minimal chance of long-term survival

DEFF Research Database (Denmark)

Wissenberg, Mads; Folke, Fredrik; Hansen, Carolina Malta

2015-01-01

.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.......7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all Pworking-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients......, from 4.0% to 15.0% (all Pworking-age patients, 5.8% to 22.0% (Psenior patients, 2.7% to 8.4% (Psenior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day...

Pre- and Postoperative Body Composition and Metabolic Characteristics in Patients with Acromegaly: A Prospective Study

Science.gov (United States)

Gao, Lu; Li, Hailong; Wang, Qiang; Wang, Zihao

2018-01-01

Objective To investigate the preoperative body composition, metabolic characteristics, and postoperative changes in patients with active acromegaly and analyze the effects of gender and age. Methods We included 36 patients with untreated acromegaly and 37 patients with nonfunctional pituitary adenomas. Adipose tissue (AT), the visceral fat index (VFI), sclerotin, protein, skeletal muscle, total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were measured using bioelectrical impedance analysis (BIA). Total energy expenditure (TEE) and basal metabolism (BM) were measured with a cardiopulmonary and metabolic analyzer (CMA). Tricep skinfold thickness (TST), bicep circumference, waistline, hipline, and calf circumference were measured with a skinfold caliper and tape. These indices were measured before surgery and 3 months and 1 year after surgery. Results Overall, AT, VFI, and TST were lower, whereas sclerotin, protein, skeletal muscle, TBW, ICW, ECW, TEE, and BM were higher in acromegaly patients. Postoperatively, TST rose initially and then decreased, the waistline increased, and sclerotin, skeletal muscle, TEE, and BM decreased. Changes in these indices differed with gender and age in unique patterns. Conclusions Body composition and metabolism in acromegaly patients changed after surgery, and gender and age influenced these changes. PMID:29531529

Headache among patients with HIV disease: prevalence, characteristics, and associations.

Science.gov (United States)

Kirkland, Kale E; Kirkland, Karl; Many, W J; Smitherman, Todd A

2012-03-01

Headache is one of the most common medical complaints reported by individuals suffering from human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), but limited and conflicting data exist regarding their prevalence, prototypical characteristics, and relationship to HIV disease variables in the current era of highly active antiretroviral therapy (HAART). The aims of the present cross-sectional study were to characterize headache symptoms among patients with HIV/AIDS and to assess relations between headache and HIV/AIDS disease variables. Two hundred HIV/AIDS patients (49% female; mean age = 43.22 ± 12.30 years; 74% African American) from an internal medicine clinic and an AIDS outreach clinic were administered a structured headache diagnostic interview to assess headache characteristics and features consistent with International Classification of Headache Disorders (ICHD)-II diagnostic semiologies. They also completed 2 measures of headache-related disability. Prescribed medications, most recent cluster of differentiation (CD4) cell count, date of HIV diagnosis, possible causes of secondary headache, and other relevant medical history were obtained via review of patient medical records. One hundred seven patients (53.5%) reported headache symptoms, the large majority of which were consistent with characteristics of primary headache disorders after excluding 4 cases attributable to secondary causes. Among those who met criteria for a primary headache disorder, 88 (85.44%) met criteria for migraine, most of which fulfilled ICHD-II appendix diagnostic criteria for chronic migraine. Fifteen patients (14.56%) met criteria for episodic or chronic tension-type headache. Severity of HIV (as indicated by CD4 cell counts), but not duration of HIV or number of prescribed antiretroviral medications, was strongly associated with headache severity, frequency, and disability and also distinguished migraine from TTH. Problematic headache is highly prevalent

Epidemiologic characteristics of oral cancer: single-center analysis of 4097 patients from the Sun Yat-sen University Cancer Center.

Science.gov (United States)

Zhang, Ji; Gao, Fan; Yang, An-Kui; Chen, Wen-Kuan; Chen, Shu-Wei; Li, Huan; Zhang, Xing; Yang, Zhong-Yuan; Chen, Xin-Lin; Song, Ming

2016-03-03

Oral cancer is a common type of head and neck cancers. Knowing its epidemiologic characteristics is crucial to preventing, diagnosing, and treating this cancer. This study aimed to explore the epidemiologic characteristics of oral cancer in South China. We retrospectively analyzed data from 4097 oral cancer patients treated at the Sun Yat-sen University Cancer Center between 1960 and 2013. We compared the age of onset, sex ratio, pathologic type, and primary tumor location among three subcultural areas (Guangfu, Hakka, and Chaoshan) and between an economically developed region and a less-developed one in Guangdong. Overall, oral cancer had a male-to-female ratio of approximately 2:1, and this ratio decreased over time. Oral cancer occurred mostly in patients of 45-64 years old (54.5%), and the percentage of older patients gradually increased over time. The most common tumor location was the tongue. Squamous cell carcinoma was the predominant pathologic type. The percentage of blood type O in oral cancer patients was lower than that in the healthy population. The male-to-female ratio in the Chaoshan area was higher than that in the Guangfu and Hakka areas, whereas the age of disease onset in Guangfu was higher than that in Hakka and Chaoshan. The male-to-female ratio was lower and the age of disease onset was higher in the economically developed region than in the less-developed region. The incidence of oral cancer in South China presents typical characteristics to which doctors should pay attention when diagnosing and treating oral cancer patients.

Clinical characteristics of disabling attacks at onset in patients with neuromyelitis optica spectrum disorder.

Science.gov (United States)

Seok, Jin Myoung; Cho, Eun Bin; Lee, Hye Lim; Cho, Hye-Jin; Min, Ju-Hong; Lee, Kwang Ho; Kim, Byoung Joon

2016-09-15

Individual attacks of neuromyelitis optica (NMO) are generally severe enough to cause disability even after the onset attack. We aimed to elucidate the clinical characteristics of disabling attacks at the onset of NMO. We investigated the clinical characteristics at onset and at first relapse in patients with NMO or NMO spectrum disorder with seropositive for the anti-aquaporin-4 antibody. A disabling attack at onset (DAO) was defined as an onset attack in which, at best recovery (allowing up to one year), patients were unable to walk without assistance or were left functionally blind in at least one affected eye. Fifty-seven patients were enrolled (53 females; onset age, 41.9±14.8years). Ten patients (17.5%) had a DAO; four had become unable to walk without assistance following myelitis, and six had severe visual impairment following optic neuritis despite rescue treatments. Attack severity at nadir was the only clinical factor predicting a DAO (odds ratio, 2.120; 95% CI, 1.162-3.869; P=0.014). The use of immunosuppressants delayed the interval to the first relapse (P=0.003). Our study showed characteristics of NMO onset attacks that caused severe disability. However, no clinically modifiable factors predicted disabling attacks, except attack severity. Copyright © 2016 Elsevier B.V. All rights reserved.

Characteristics of children under 6 years of age treated for early childhood caries in South Africa.

Science.gov (United States)

Mohamed, Nadia; Barnes, Jo

2008-01-01

This retrospective survey highlighted the characteristics of children less than six years of age presenting with early childhood caries (ECC) who had two or more teeth extracted under intravenous sedation at the Tygerberg Oral Health Centre in Cape Town, South Africa. This survey was carried out in order to plan a community-appropriate intervention strategy. Records of 140 patients kept by the pediatric Dentistry Division met the inclusion criteria and were included in this survey. Most of the patients originate from economically disadvantaged areas. Diet, feeding and oral hygiene habits were shown to be the most significant factors that contributed to the development of ECC in these patients. All the children were either breast- or bottle-fed past one year of age. 93.6% of the children went to sleep with the bottle or while on the breast and 90% of them were fed on demand during the night. On average, breastfeeding was stopped at 9 months of age compared to bottle-feeding that, on average, was stopped at a much later mean age of 23 months. Where oral hygiene practices were concerned, 52.6% of children brushed their own teeth without supervision. Frequency of brushing varied between subjects. The results of this study have demonstrated that there is a need for culturally appropriate education campaigns to inform parents (especially those in disadvantaged communities) about the importance of oral health and the prevention of oral disease.

Patient characteristics and treatment outcome in functional anorectal pain.

Science.gov (United States)

Atkin, Gary K; Suliman, Amna; Vaizey, Carolynne J

2011-07-01

Functional anorectal pain occurs in the absence of any clinical abnormality. It is common and disabling; it has previously been reported in only a few studies involving small patient numbers. This study aimed to report the clinical characteristics and treatment outcomes for patients with functional anorectal pain. Patient demographics, clinical history, and tests results for all referrals for anorectal physiological testing between 1997 and 2009 were prospectively recorded. For patients with functional anorectal pain, further information was gained from clinical notes. Clinical history, anorectal physiology, and radiological imaging data were recorded for all patients; treatment outcome was noted for patients treated and followed up at the present unit. One hundred seventy patients, 99 female, with a median age of 48 years (range, 18-86), were studied. Patients were classified as having chronic proctalgia (pain duration ≥20 min, 158 patients) or proctalgia fugax (pain duration proctalgia fugax had a higher internal anal sphincter thickness and resting pressure than patients with chronic proctalgia, whereas patients with a family history of similar symptoms were more likely to have proctalgia fugax and higher resting pressures and internal anal sphincter thickness compared with those without a family history of these symptoms. Patients referred for treatment underwent a range of interventions including biofeedback (29 patients, 17 improved), tricyclic antidepressants (26 patients, 10 improved), Botox injection (9 patients, 5 improved), and sacral nerve stimulation (3 patients, 2 improved). Biofeedback had the greatest treatment effect, especially in patients with defecatory dysfunction. Biofeedback is beneficial in the subset of patients with functional anorectal pain and difficulty with defecation. Tricyclic antidepressants, Botox, and sacral nerve stimulation may also have a role.

Relationship between the clinical characteristics of osteomyelitis and the finding of extraosseous fat on MRI in pediatric patients

Energy Technology Data Exchange (ETDEWEB)

Mattis, Tod A. [Spectrum Health Helen Devos Children' s Hospital, Grand Rapids, MI (United States); Michigan State University, College of Human Medicine, Radiology, Grand Rapids, MI (United States); Grand Rapids Medical Education Partners, Grand Rapids, MI (United States); Borders, Heather L.; Ellinger, Doug M.; Junewick, Joseph J. [Spectrum Health Helen Devos Children' s Hospital, Grand Rapids, MI (United States); Michigan State University, College of Human Medicine, Radiology, Grand Rapids, MI (United States); Advanced Radiology Services, Grand Rapids, MI (United States)

2011-10-15

MRI is frequently utilized to evaluate patients for osteomyelitis. The findings of intramedullary and extramedullary fat globules as well as extramedullary fat-fluid levels can help improve the specificity of MRI for this diagnosis. To correlate these MRI findings with the clinical characteristics in children with osteomyelitis. A retrospective electronic medical record search for pediatric patient charts from March 2004 to November 2009 that contained the word ''osteomyelitis'' in the ''principal diagnosis'' portion of the international classification of disease (ICD) billing code. Each electronic chart was reviewed. MRI examinations of selected children were reviewed by a pediatric radiologist, a general radiologist and a transitional year resident. A total of 10 patients/11 MRI studies were included. Five of the 11 had the MRI finding of extramedullary globular fat signal. There was a significantly increased likelihood of seeing this finding in children of pubertal or postpubertal age compared to those of prepubertal age (p < 0.05). This study provides evidence that the MRI finding of extramedullary fat globules in children with acute osteomyelitis is associated with the clinical characteristic of being within or above the age range for puberty. (orig.)

New-Onset Status Epilepticus in Pediatric Patients: Causes, Characteristics, and Outcomes.

Science.gov (United States)

Jafarpour, Saba; Hodgeman, Ryan M; De Marchi Capeletto, Carolina; de Lima, Mateus Torres Avelar; Kapur, Kush; Tasker, Robert C; Loddenkemper, Tobias

2018-03-01

Many pediatric patients presenting with status epilepticus have no history of seizures. We retrospectively analyzed the clinical characteristics of patients aged one month to 21 years who presented during six consecutive years with convulsive status epilepticus and without a history of seizures. New-onset refractory status epilepticus was defined as status epilepticus refractory to two lines of treatment, without an identified cause in the first 48 hours. Of 460 patients with status epilepticus, 79 (17.2%) presented with new-onset status epilepticus, including four (0.9%) with new-onset refractory status epilepticus. Of those patients, 54.4% were female, and the median age was 3.5 years (IQR: 1.08 to 6.75). The median seizure duration was 20 minutes (IQR: 10 to 40 minutes). Etiology was unknown in 36.7%, symptomatic in 30.3%, provoked in 16.5%, and provoked with an existing symptomatic etiology in 16.5%. Patients were followed for a median duration of 63 months (IQR: 21 to 97). The mortality rate was 3.8%. Of 55 patients who were developmentally normal at baseline, 29.1% had a significant cognitive impairment at the last follow-up, and 20% had academic difficulties or behavioral problems. Patients with symptomatic etiology had greater odds of having cognitive and behavioral problems compared with patients with unknown etiology (odds ratio = 3.83, P = 0.012). Patients with new-onset status epilepticus are at risk for recurrent seizures, recurrent status epilepticus, death, and subsequent cognitive-behavioral impairment. Specific monitoring and care interventions might be required in this high-risk population. Copyright © 2017 Elsevier Inc. All rights reserved.

Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder.

Science.gov (United States)

Pagel, Tobias; Baldessarini, Ross J; Franklin, Jeremy; Baethge, Christopher

2013-05-01

Information on basic demographic and clinical characteristics of schizoaffective disorder is sparse and subject to sampling bias and low diagnostic reliability. In the present study we aimed to: (i) estimate the demographic and clinical descriptors in schizoaffective disorder patients and (ii) compare the findings with those with schizophrenia and bipolar disorder. To minimize sampling bias and low reliability, we systematically reviewed studies that simultaneously compared schizoaffective, schizophrenia, and bipolar disorder patients. We estimated demographic, clinical, and psychometric characteristics based on weighted pooling, and compared disorders by meta-analysis. We also estimated whether schizoaffective disorder is closer to schizophrenia or to bipolar disorder. We identified 50 studies that included 18312 patients. Most characteristics of the 2684 schizoaffective disorder patients fell between those of 4814 diagnosed with bipolar disorder and 10814 with schizophrenia. However, the schizoaffective group had the highest proportion of women (52%), had the youngest age at illness onset (23.3 ± 3.8 years), and had the highest standardized ratings of psychosis and depression. Differences in pooled parameters between schizoaffective versus schizophrenia and versus bipolar disorder subjects were similar. Values for patients with schizoaffective disorders mostly were intermediate between schizophrenia and bipolar disorder. However, the majority of studies showed schizoaffective patients to be more like schizophrenia than bipolar disorder patients in seven out of nine demographic and clinical categories as well as in five out of eight psychometric measures. These results remained similar when we restricted the analyses to studies with psychotic bipolar disorder patients only or to studies using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR and DSM-IV only. The present study provided estimates of important characteristics of schizoaffective

A systematic review of patient and health system characteristics associated with late referral in chronic kidney disease

Directory of Open Access Journals (Sweden)

Aloudat Sarah

2008-02-01

Full Text Available Abstract Background To identify patient and health system characteristics associated with late referral of patients with chronic kidney disease to nephrologists. Methods MEDLINE, CENTRAL, and CINAHL were searched using the appropriate MESH terms in March 2007. Two reviewers individually and in duplicate reviewed the abstracts of 256 articles and selected 18 observational studies for inclusion. The reasons for late referral were categorized into patient or health system characteristics. Data extraction and content appraisal were done using a prespecified protocol. Results Older age, the existence of multiple comorbidities, race other than Caucasian, lack of insurance, lower socioeconomic status and educational levels were patient characteristics associated with late referral of patients with chronic kidney disease. Lack of referring physician knowledge about the appropriate timing of referral, absence of communication between referring physicians and nephrologists, and dialysis care delivered at tertiary medical centers were health system characteristics associated with late referral of patients with chronic kidney disease. Most studies identified multiple factors associated with late referral, although the relative importance and the combined effect of these factors were not systematically evaluated. Conclusion A combination of patient and health system characteristics is associated with late referral of patients with chronic kidney disease. Overall, being older, belonging to a minority group, being less educated, being uninsured, suffering from multiple comorbidities, and the lack of communication between primary care physicians and nephrologists contribute to late referral of patients with chronic kidney disease. Both primary care physicians and nephrologists need to engage in multisectoral collaborative efforts that ensure patient education and enhance physician awareness to improve the care of patients with chronic kidney disease.

Characteristics of ocular pain complaints in patients with idiopathic dry eye symptoms

Science.gov (United States)

Kalangara, Jerry P.; Galor, Anat; Levitt, Roy C.; Covington, Derek B.; McManus, Katherine T.; Sarantopoulos, Constantine D.; Felix, Elizabeth R.

2016-01-01

Objective The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Methods Subjects with clinically-relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared to similar measures from published data in other chronic pain populations. Results The study sample consisted of 154 subjects, of which 91% were male and ranged in age from 27 to 89 (mean age = 61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale (NRS) ≥ 4), with specific characteristics (i.e., “burning” spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57 to 0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. Conclusions A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with the majority endorsing descriptors commonly used by patients with non-ocular neuropathic pain conditions. Identifying sub-groups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye sub classification and better individualize treatment strategies. PMID:26925537

Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

Directory of Open Access Journals (Sweden)

Đorđević Biljana

2008-01-01

Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

Cancer patients' perceptions of quality-of-care attributes-Associations with age, perceived health status, gender and education.

Science.gov (United States)

Suhonen, Riitta; Stolt, Minna; Berg, Agneta; Katajisto, Jouko; Lemonidou, Chryssoula; Patiraki, Elisabeth; Sjövall, Katarina; Charalambous, Andreas

2018-01-01

The aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient-centred quality and individuality in care and trust in nurses for those education were not related to their assessments of care quality attributes: person-centred care quality, individuality in care and trust in nurses. Subgroup analysis of the older adults and those of working age showed clear associations with patients' assessments of quality-of-care attributes and perceived health status. The lower the perceived health status, the lower the assessment of care quality attributes. The results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient-centred, individualised care strategies alongside a stronger focus on people instead of cancer-care-related processes and duties. Health status was the only factor associated with cancer patients' assessments of care quality attributes. Cancer itself may be the strongest determinant of the care quality perceptions, rather than any patient characteristics. The findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care. © 2017 John Wiley & Sons Ltd.

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury.

Science.gov (United States)

Vall, Janaína; Costa, Carlos Mauricio de Castro; Santos, Terezinha de Jesus Teixeira; Costa, Samuel Bovy de Castro

2011-02-01

This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8%). Another 20 patients (18.3%) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.

Neuropathic pain characteristics in patients from Curitiba (Brazil with spinal cord injury

Directory of Open Access Journals (Sweden)

Janaína Vall

2011-02-01

Full Text Available This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients. The nociceptive pain presented was classified as musculoskeletal pain (nine patients, visceral pain (four patients and mixed pain (one patient, thus totaling 14 patients (12.8%. Another 20 patients (18.3% showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.

clinical characteristics of cataract patients with pseudoexfoliation

African Journals Online (AJOL)

User

the clinical characteristics of pseudoexfoliation syndrome among cataract patients examined at ... CONCLUSION: A significant number of patients with PEX had poor zonular integrity and high IOP ... Poor zonular integrity may give rise to.

Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

Science.gov (United States)

Kozlowski, Piotr; Lennmyr, Emma; Ahlberg, Lucia; Bernell, Per; Hulegårdh, Erik; Karbach, Holger; Karlsson, Karin; Tomaszewska-Toporska, Beata; Åström, Maria; Hallböök, Heléne

2017-08-01

Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012. Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status ≥2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count ≤35×10 9 /L and age ≥75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

Characteristics of positive-interaction parenting style among primiparous teenage, optimal age, and advanced age mothers in Canada

OpenAIRE

Kim, Theresa H. M.; Connolly, Jennifer A.; Rotondi, Michael; Tamim, Hala

2018-01-01

Background Positive-interaction parenting early in childhood is encouraged due to its association with behavioural development later in life. The objective of this study was to examine if the level of positive-interaction parenting style differs among teen, optimal age, and advanced age mothers in Canada, and to identify the characteristics associated with positive-interaction parenting style separately for each age group. Methods This was a cross-sectional secondary analysis of the National ...

Trends and Characteristics of Pediatric Dentistry Patients Treated under General Anesthesia.

Science.gov (United States)

Rudie, Maxwell N; Milano, Michael M; Roberts, Michael W; Divaris, Kimon

2018-05-11

The aims of this study were to describe the demographic characteristics of pediatric dentistry patients undergoing dental rehabilitation under general anesthesia (DRGA) at UNC-Chapel Hill during the last 13 years and identify factors associated with multiple (1 versus 2 or more) DRGA visits during that timeframe. Administrative claims data were used to identify children and adolescents (age <18 years) who underwent DRGA between 1/1/2002 and 12/31/2014 at the UNC Hospitals system. Information on children's age, sex and all treatment-associated CDT codes were collected. Descriptive statistics and bivariate tests of association were used for data analyses. There were 4,413 DRGAs among 3,973 children (median age=4 years 8 months, males=55%) during the study period. The annual rate of DRGAs increased over time, peaking (n=447) in 2013. Overall, 9% of children had ≥2 visits with repeat rates up to 18%. There was no association between children's sex and receipt of one versus multiple DRGAs; however, craniofacial cases were more likely (p<0.0005) to have multiple DRGAs compared to non-craniofacial ones. DRGAs are on the increase-with the exception of craniofacial and special health care needs patients, multiple DRGAs may be reflective of sub-optimal adherence to preventive and continuing care recommendations.

Characteristics and experience of the patient in psychotherapy and the psychotherapy's effectiveness. A structural approach.

Science.gov (United States)

Szymańska, Agnieszka; Dobrenko, Kamila; Grzesiuk, Lidia

2017-08-29

The study concerns the relationship between three groups of variables presenting the patient's perspective: (1) "patient's characteristics" before psychotherapy, including "expectations of the therapy"; (2) "experience in the therapy", including the "psychotherapeutic relationship"; and (3) "assessment of the direct effectiveness of the psychotherapy". Data from the literature are the basis for predicting relationships between all of these variables. Measurement of the variables was conducted using a follow-up survey. The survey was sent to a total of 1,210 former patients of the Academic Center for Psychotherapy (AOP) in which the therapy is conducted mainly with the students and employees of the University of Warsaw. Responses were received from 276 people. 55% of the respondents were women and 45% were men, under 30 years of age. The analyses were performed using structural equations. Two models emerged from an analysis of the relationship between the three above-mentioned groups of variables. One concerns the relationship between (1) the patient's characteristics (2) the course of psychotherapy, in which -from the perspective of the patient - there is a good relationship with the psychotherapist and (3) psychotherapy is effective. The second model refers to (2) the patient's experience of poor psychotherapeutic relationship and (3) ineffective psychotherapy. Patient's expectations of the psychotherapy (especially "the expectation of support") proved to be important moderating variablesin the models-among the characteristics of the patient. The mathematical model also revealed strong correlation of variables measuring "the relationship with the psychotherapist" and "therapeutic interventions".

The clinical characteristics of neuropathic pain in patients with spinal cord injury.

Science.gov (United States)

Celik, E C; Erhan, B; Lakse, E

2012-08-01

The aim of the study was to evaluate the characteristics of neuropathic pain and observe intensity alterations in pain with regard to time during the day in spinal cord injury (SCI) patients. A total of 50 SCI patients (M/F, 40/10; mean age, 35±12 years) with at-level and below-level neuropathic pain were included in the study. All patients were examined and classified according to the ASIA/ISCoS 2002 International Neurologic Examination and Classification Standards. The history, duration, localization and characteristics of the pain were recorded. Neuropathic pain of patients was evaluated with the McGill-Melzack Pain Questionnaire and LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) Pain Scale. Visual analog scale (VAS) was used to measure the severity of pain four times during the day. Quality of life was analyzed with Short Form 36. Out of 50 patients, 10 were tetraplegic and 40 were paraplegic. In all, 28 patients had motor and sensory complete injuries (AIS A), whereas 22 patients had sensory incomplete (AIS B, C and D) injuries. The most frequently used words to describe neuropathic pain were throbbing, tiring, hot and tingling. Pain intensity was significantly higher in the night than in the evening, noon and morning (PNeuropathic pain is a serious complaint in SCI patients and affects their quality of life. Neuropathic pain intensity was higher in the night hours than other times of day. This situation reinforces the need for a continued research and education on neuropathic pain in SCI.

Characteristics of Older Adults and the Aging: Some Comments.

Science.gov (United States)

Kowalski, Cash J.; Cangemi, Joseph P.

1978-01-01

Asserting that both humanistic and manpower considerations dictate that we address the aging process, this article describes the characteristics of older adults and illustrates the way in which they may be allowed to remain productive. Maslow's "Need Hierarchy" and Thorndike's "Theory of Developmental Tasks" are applied to the…

Clinical characteristics of pigment dispersion syndrome in Chinese patients.

Science.gov (United States)

Qing, G; Wang, N; Tang, X; Zhang, S; Chen, H

2009-08-01

To report clinical findings and characteristics of pigment dispersion syndrome (PDS) in Chinese patients. PDS suspects with any one of the following signs: corneal endothelial pigmentation, iris transillumination defects (ITDs), pigment granule dusting on anterior iris surface, posterior iris bowing, trabecular meshwork (TM) pigmentation, and lenticular or zonular pigmentation were evaluated for PDS at the glaucoma specialty clinic at Beijing Tongren Eye Centre. Diagnosis of PDS required at least two of the following signs: Krukenberg spindle, moderate-to-heavy TM pigmentation (>or=Scheie II) and any degree of lenticular and/or zonular pigmentation. Eighteen patients (12 males and six females) were identified as having PDS during a 1-year period, with mean age of 35.5+/-7.0 years (range, 22-49). All but two eyes from two patients had myopia of -0.5 D or greater, with mean spherical equivalent power of -5.20+/-5.80 D (range, -24.75+/-0.5). The average IOP at initial diagnosis was 33.7+/-10.5 mm Hg (range, 16-56). Fifteen patients (83.3%) were found to have pigmentary glaucoma at their initial diagnosis. All patients showed homogenous increased TM pigmentation as well as lenticular and/or zonular pigmentation. 61.1% of patients (11 of 18) had Krukenberg spindle. None of the patients exhibited spoke-like midperipheral ITDs except for trace-isolated transillumination in both eyes of the two patients. The most common clinical findings in Chinese PDS patients include homogeneous TM pigmentation and pigment granule dusting on lens zonules and/or posterior peripheral lens surface. ITDs are uncommon in Chinese patients with PDS.

Clinical characteristics of Japanese patients with severe hypertriglyceridemia.

Science.gov (United States)

Tada, Hayato; Kawashiri, Masa-Aki; Nakahashi, Takuya; Yagi, Kunimasa; Chujo, Daisuke; Ohbatake, Azusa; Mori, Yukiko; Mori, Shunsuke; Kometani, Mitsuhiro; Fujii, Hiroshi; Nohara, Atsushi; Inazu, Akihiro; Mabuchi, Hiroshi; Yamagishi, Masakazu; Hayashi, Kenshi

2015-01-01

Although of interest, few data exist on the clinical characteristics of Japanese patients with an extremely high triglyceride level (≥ 1000 mg/dL). We assessed the clinical characteristics of Japanese patients with an extremely high triglyceride level. We investigated the presence of coronary artery disease, history of pancreatitis, the presence of fatty liver, and the potential causes of elevated triglyceride in Japanese subjects with an extremely high level of fasting triglyceride (≥ 1000 mg/dL) among 70,368 subjects whose serum triglyceride was measured for any reason at Kanazawa University Hospital from April 2004 to March 2014. We identified 215 (0.31%) subjects (mean age, 46 years; male, 170, mean body mass index, 25 kg/m(2)) with severe hypertriglyceridemia. Among them, 4 (1.9%) subjects were classified as type I, 97 (45.1%) subjects were type IV, and 114 (53.0%) subjects were type V hyperlipidemia, according to Fredrickson's classification. Among 215 subjects, 116 subjects (54.0%) drank alcohol, 58 (27.0%) showed heavy intake (≥ 60 g/d), and 64 (29.8%) subjects had diabetes. In total, 59 (27.4%) subjects had transient severe hypertriglyceridemia caused by corticosteroids (N = 19), antidepressant (N = 18), l-asparaginase and steroids for acute lymphoid leukemia (N = 15), hormone replacement therapy for breast cancer (N = 9), β-blocker (N = 5), hypothyroidism (N = 4), pregnancy (N = 4), and panhypopituitarism (N = 2). As many as 119 (55.3%) subjects exhibited fatty liver. Moreover, 12 (5.6%) and 17 (7.9%) subjects had a history of pancreatitis and coronary artery disease, respectively. A variety of situations can cause severe hypertriglyceridemia. We suggest that potential secondary causes should be carefully assessed for such patients. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

The Relationship between Stroke Patients Characteristics and Family Support with Compliance Rehabilitation

Directory of Open Access Journals (Sweden)

Irma Okta Wardhani

2015-01-01

Full Text Available Stroke is a cerebrovascular disease, it is brain function disorders associated with the disease of the blood vessels that supply the brain. The impact of stroke is paralysis. Family support is things that are needed to be considered in the treatment of stroke patients. It is very involved in the compliance rehabilitation of patients to prevent the re-occurrence of stroke. Characteristics of stroke patients may also affect the compliance rehabilitation. The purpose of this research is to determine the relationship between stroke patients characteristics and family support to compliance rehabilitation at the Medical Rehabilitation Unit RSU Haji Surabaya. This research was an analytic observational research with cross sectional design. The subjects of this research are taken using total population technique. The independent variables in this research is family support. The dependent variable is compliance rehabilitation. The results of this research are presented in the form of frequency distributions and calculate the strength of the relationship with Phi coefficient. The result of this research shows that there is a strong relationship between family support and compliance rehabilitation (r=0.582. There are weak relationship between ages (r=-0,027, gender (r=0,092, level of education (r= -0,295, work (r=0,098, and marital status (r=0,319. The conclusion is family support may affect compliance rehabilitation of stroke patients. It is recommended for health workers to provide counseling to improve family support in curing stroke patients. Keywords: depression, family support, compliance rehabilitation

Risk of Developing Second Cancer From Neutron Dose in Proton Therapy as Function of Field Characteristics, Organ, and Patient Age

International Nuclear Information System (INIS)

Zacharatou Jarlskog, Christina; Paganetti, Harald

2008-01-01

Purpose: To estimate the risk of a second malignancy after treatment of a primary brain cancer using passive scattered proton beam therapy. The focus was on the cancer risk caused by neutrons outside the treatment volume and the dependency on the patient's age. Methods and Materials: Organ-specific neutron-equivalent doses previously calculated for eight different proton therapy brain fields were considered. Organ-specific models were applied to assess the risk of developing solid cancers and leukemia. Results: The main contributors (>80%) to the neutron-induced risk are neutrons generated in the treatment head. Treatment volume can influence the risk by up to a factor of ∼2. Young patients are subject to significantly greater risks than are adult patients because of the geometric differences and age dependency of the risk models. Breast cancer should be the main concern for females. For males, the risks of lung cancer, leukemia, and thyroid cancer were significant for pediatric patients. In contrast, leukemia was the leading risk for an adult. Most lifetime risks were <1% (70-Gy treatment). The only exceptions were breast, thyroid, and lung cancer for females. For female thyroid cancer, the treatment risk can exceed the baseline risk. Conclusion: The risk of developing a second malignancy from neutrons from proton beam therapy of a brain lesion is small (i.e., presumably outweighed by the therapeutic benefit) but not negligible (i.e., potentially greater than the baseline risk). The patient's age at treatment plays a major role

Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital.

Science.gov (United States)

Flabeau, O; Laurendeau, G; Laksir, H; Castaings-Pelet, S; Harston, S; Bourdel-Marchasson, I

2013-02-01

Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles. to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital. Prospective observational study in day hospital. Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics. Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066). Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.

Experimental research on the structural characteristics of high organic soft soil in different deposition ages

Science.gov (United States)

Liu, Fei; Lin, Guo-he

2018-03-01

High organic soft soil, which is distributed at Ji Lin province in China, has been studied by a lot of scholars. In the paper, structural characteristics with different deposition ages have been researched by experimental tests. Firstly, the characteristics of deposition age, degree of decompositon, high-pressure consolidation and microstructure have been measured by a series of tests. Secondly, structural strengths which were deposited in different ages, have been carried out to test the significant differences of stress-strain relations between remoulded and undisturbed high organic soft soil samples. Results showed that high organic soft soil which is deposited at different ages will influence its structural characteristics.

Culture-proven bacterial meningitis in elderly patients in southern Taiwan: clinical characteristics and prognostic factors.

Science.gov (United States)

Chang, Chia-Chen; Lu, Chen-Hsien; Huang, Chi-Ren; Chuang, Yao-Chung; Tsai, Nai-Wen; Chen, Shu-Fang; Chang, Hsueh-Wen; Chang, Wen-Neng

2006-06-01

The epidemiologic landscape of causative pathogens and clinical characteristics of bacterial meningitis varies with several clinical factors including preceding/pre-existent medical and/or surgical conditions, modes of contraction, geographic distributions, status of vaccinations, the study time periods and differences among age groups. In order to delineate the epidemiology of bacterial meningitis in senior adults (ages > or =60 y/o) in southern Taiwan, we analyzed the clinical characteristics and therapeutic outcomes of 64 senior adults (42 men and 22 women, aged 60-80 years) with bacterial meningitis collected over a period of 13 years at our hospital. The prognostic factors between fatal and non-fatal groups of patients were compared. Twenty-seven of the 64 patients belonged to a nosocomial infection group, and the other 37 comprised a community-acquired infection group. Sixty percent (39/64) of the patients had a post-neurosurgical state as the most preceding event prior to infection. Liver disease (13) and diabetes mellitus (6) were the most common underlying conditions of the other 25 patients with spontaneous meningitis. Of these 64 patients, Klebsiella (K.) pneumoniae (18), Acinetobacter baumannii (5), Escherichia coli (5), and Enterobacter species (5) were the most commonly implicated Gram-negative pathogens. Staphylococcus (S.) aureus infection was increasing during the study period. The therapeutic results of this group of patients showed a mortality rate of 38% (24/64). The presence of septic shock was the most significant prognostic factor. In conclusion, for this study group, a post-neurosurgical state was the single most important preceding event for senior adults developing bacterial meningitis. Of the implicated pathogens, K. pneumoniae and S. aureus were the most common gram-negative and gram-positive pathogens, respectively. The therapeutic result of this specific group of patients showed a high mortality rate; however, the small case number and

Cholecystectomy in Sweden 2000 – 2003: a nationwide study on procedures, patient characteristics, and mortality

Directory of Open Access Journals (Sweden)

Stenlund Hans

2007-08-01

Full Text Available Abstract Background Epidemiological data on characteristics of patients undergoing open or laparoscopic cholecystectomy are limited. In this register study we examined characteristics and mortality of patients who underwent cholecystectomy during hospital stay in Sweden 2000 – 2003. Methods Hospital discharge and death certificate data were linked for all patients undergoing cholecystectomy in Sweden from January 1st 2000 through December 31st 2003. Mortality risk was calculated as standardised mortality ratio (SMR i.e. observed over expected deaths considering age and gender of the background population. Results During the four years of the study 43072 patients underwent cholecystectomy for benign biliary disease, 31144 (72% using a laparoscopic technique and 11928 patients (28% an open procedure (including conversion from laparoscopy. Patients with open cholecystectomy were older than patients with laparoscopic cholecystectomy (59 vs 49 years, p Conclusion Laparoscopic cholecystectomy is performed on patients having a lower mortality risk than the general Swedish population. Patients with open cholecystectomy are more sick than patients with laparoscopic cholecystectomy, and they have a mortality risk within 90 days of admission for cholecystectomy, which is four times that of the general population. Further efforts to reduce surgical trauma in open biliary surgery are motivated.

Computed tomographic study of aged schizophrenic patients

International Nuclear Information System (INIS)

Seno, Haruo; Fujimoto, Akihiko; Ishino, Hiroshi; Shibata, Masahiro; Kuroda, Hiroyuki; Kanno, Hiroshi.

1997-01-01

The width of interhemispheric fissure, lateral ventricles and third ventricle were measured using cranial computed tomography (CT; linear method) in 45 elderly inpatients with chronic schizophrenia and in 28 age-matched control subjects. Twenty-three patients were men and 22 were women. In addition, Mini-Mental State Examination, Brief Psychiatric Rating Scale (BPRS) and a subclass of BPRS were undertaken in all patients. There is a significant enlargement of the maximum width of the interhemispheric fissure (in both male and female) and a significant enlargement of ventricular system (more severe in men than in women) in aged schizophrenics, as seen with CT, compared with normal controls. These findings are consistent with previous studies of non-aged schizophrenic patients. Based upon the relation between psychiatric symptoms and CT findings, the most striking is a significant negative correlation between the third ventricle enlargement and the positive and depressive symptoms in all patients. This result suggests that the advanced third ventricle enlargement may decrease these symptoms in aged schizophrenics. (author)

[Clinical characteristic of patients with acute kidney injury complicated severe cardio-vascular diseases].

Science.gov (United States)

Wróbel, Paweł; Wyrwicz-Zielińska, Grażyna; Krzysztonek-Weber, Izabela; Sułowicz, Władysław

2016-01-01

Patients with cardiovascular diseases are a group of increased risk of acute kidney injury (AKI). Mortality in this group of patients with AKI, especially treated in intensive care units, is very high. The aim of this study was to evaluate the clinical characteristic of patients with AKI complicated severe cardiovascular diseases. Retrospective evaluation of 246 questionnaire of patients with AKI in the course of severe cardiovascular diseases treated in the wards of nephrological profile from the malopolska and podkarpackie voivodships in the years 2000-2011 was performed. The group of patients consisted of 157 men and 89 women, with mean age 67.9 ± 14.8 years. The most common cause of AKI were: acute decompensated heart failure--24 (9.8%), chronic decompensated heart failure--94 (38.2%), cardiac arrest--29 (11.8%), myocardial infarction--48 (19.5%), CABG--12 (4.9%), cardiac valve implantation--14 (5.7), heart transplantation--4 (1.6%) and aortic aneurysm--21 (8.5%). Age distribution of patients with AKI revealed that most numerous group had 71-80 years. The most of patients (95.9%) with AKI were treated with hemodialysis. The mortality rate in the study group was very high (69.5%). Recovery of renal function was observed in 39 (27.3%) of patients. Signs of kidney disease before AKI was noted in 116 (47.2%) of patients. Patients with severe cardiovascular complications and AKI had high mortality rate instead of performed hemodialysis treatment.

Clinical characteristics of patients with tinnitus evaluated with the Tinnitus Sample Case History Questionnaire in Japan: A case series.

Directory of Open Access Journals (Sweden)

Takashi Kojima

Full Text Available The Tinnitus Sample Case History Questionnaire was determined as a standardized questionnaire for obtaining patient case histories and for characterizing patients into subgroups at the Tinnitus Research Initiative in 2006. In this study, we developed a Japanese version of this questionnaire for evaluating the clinical characteristics of patients with tinnitus. The Japanese version of the questionnaire will be available for evaluating treatments for tinnitus and for comparing data on tinnitus in research centers.To evaluate the clinical characteristics of patients with tinnitus in Japan using a newly developed Japanese version of Tinnitus Sample Case History Questionnaire.This was a prospective study based on patient records.University hospitals, general hospitals, and clinics.We collected patient data using a Japanese translated version of the Tinnitus Sample Case History Questionnaire. In total, 584 patients who visited our institutions in Japan between August 2012 and March 2014 were included (280 males and 304 females; age 13-92 years; mean age, 60.8. We examined patients after dividing them into two groups according to the presence or absence of hyperacusis. The collected results were compared with those from the Tinnitus Research Initiative database.Compared with the TRI database, there were significantly more elderly female patients and fewer patients with trauma-associated tinnitus. There was a statistically lower ratio of patients with hyperacusis. We found that patients with tinnitus in addition to hyperacusis had greater tinnitus severity and exhibited higher rates of various complications.The Japanese version of the Tinnitus Sample Case History Questionnaire developed in this study can be a useful tool for evaluating patients with tinnitus in Japan. The results of this multicenter study reflect the characteristics of patients with tinnitus who require medical care in Japan. Our data provides a preliminary basis for an international

Consensus statement on essential patient characteristics in systemic treatment trials for metastatic colorectal cancer: Supported by the ARCAD Group.

Science.gov (United States)

Goey, Kaitlyn K H; Sørbye, Halfdan; Glimelius, Bengt; Adams, Richard A; André, Thierry; Arnold, Dirk; Berlin, Jordan D; Bodoky, György; de Gramont, Aimery; Díaz-Rubio, Eduardo; Eng, Cathy; Falcone, Alfredo; Grothey, Axel; Heinemann, Volker; Hochster, Howard S; Kaplan, Richard S; Kopetz, Scott; Labianca, Roberto; Lieu, Christopher H; Meropol, Neal J; Price, Timothy J; Schilsky, Richard L; Schmoll, Hans-Joachim; Shacham-Shmueli, Einat; Shi, Qian; Sobrero, Alberto F; Souglakos, John; Van Cutsem, Eric; Zalcberg, John; van Oijen, Martijn G H; Punt, Cornelis J A; Koopman, Miriam

2018-06-21

Patient characteristics and stratification factors are key features influencing trial outcomes. However, there is substantial heterogeneity in reporting of patient characteristics and use of stratification factors in phase 3 trials investigating systemic treatment of metastatic colorectal cancer (mCRC). We aimed to develop a minimum set of essential baseline characteristics and stratification factors to include in such trials. We performed a modified, two-round Delphi survey among international experts with wide experience in the conduct and methodology of phase 3 trials of systemic treatment of mCRC. Thirty mCRC experts from 15 different countries completed both consensus rounds. A total of 14 patient characteristics were included in the recommended set: age, performance status, primary tumour location, primary tumour resection, prior chemotherapy, number of metastatic sites, liver-only disease, liver involvement, surgical resection of metastases, synchronous versus metachronous metastases, (K)RAS and BRAF mutation status, microsatellite instability/mismatch repair status and number of prior treatment lines. A total of five patient characteristics were considered the most relevant stratification factors: RAS/BRAF mutation status, performance status, primary tumour sidedness and liver-only disease. This survey provides a minimum set of essential baseline patient characteristics and stratification factors to include in phase 3 trials of systemic treatment of mCRC. Inclusion of these patient characteristics and strata in study protocols and final study reports will improve interpretation of trial results and facilitate cross-study comparisons. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Analysis of clinical characteristics of 187 patients with Marjolin's ulcers].

Science.gov (United States)

Liu, Zan; Zhou, Yuxiang; Zhang, Pihong; Zhang, Minghua; Ren, Licheng; Zeng, Jizhang; Zhou, Jie; Liang, Pengfei; Huang, Xiaoyuan

2016-05-01

To analyze the etiology and clinical characteristics of Marjolin's ulcer, and to explore its prevention and treatment. Medical records of 187 patients with Marjolin's ulcers admitted to the Department of Burns and Reconstructive Surgery of Xiangya Hospital of Central South University from January 1998 to May 2015 were retrospectively analyzed, including gender, age of onset of initial injury or primary disease, age of onset of Marjolin's ulcer, initial injury or primary disease, length of latency, lengths of pre- and post-ulceration periods, lesion site, lesion type, lesion area, local scar tension, histopathological type, degree of carcinoma cell differentiation, bone invasion and lymphadenopathy, treatment, and prognosis. The relationships between the age of onset of initial injury or primary disease and the length of latency, and the length of pre-ulceration period and the length of post-ulceration period were assessed by Spearman correlation analysis. The recurrence rates were processed with Fisher's exact test. (1) Among the patients, the ratio of male to female was nearly 1.6:1.0. The age of onset of initial injury or primary disease was 0.17-78.00 (17±18) years, and the age of onset of Marjolin's ulcers was 18-84 (49±14) years. (2) The most common initial injury among the patients was flame burn. The length of latency was 0.25-74.00 (32±16) years, and the lengths of pre- and post-ulceration periods were 0-73.00 (26±19) years and 0.08-59.00 (6±11) years respectively. The common lesion sites were the lower limbs and head and face. The rodent ulcer was the most common lesion type, and the lesion area was 1-625 (69±110) cm(2). There were obviously negative correlations between the age of onset of initial injury or primary disease and the length of latency, as well as the length of pre-ulceration period and the length of post-ulceration period (with r values respectively -0.71 and -0.50, P values below 0.01). The pathological scars of strong tension around

Characteristics of stress-coping behaviors in patients with bipolar disorders.

Science.gov (United States)

Moon, Eunsoo; Chang, Jae Seung; Choi, Sungwon; Ha, Tae Hyon; Cha, Boseok; Cho, Hyun Sang; Park, Je Min; Lee, Byung Dae; Lee, Young Min; Choi, Yoonmi; Ha, Kyooseob

2014-08-15

Appropriate stress-coping strategies are needed to improve the outcome in the treatment of bipolar disorders, as stressful life events may aggravate the course of the illness. The aim of this study was to compare stress-coping behaviors between bipolar patients and healthy controls. A total of 206 participants comprising 103 bipolar patients fulfilling the Diagnostic and Statistical Manual for Axis I disorder fourth edition (DSM-IV) diagnostic criteria for bipolar I and II disorders and controls matched by age and sex were included in this study. Stress-coping behaviors were assessed using a 53-item survey on a newly-designed behavioral checklist. The characteristics of stress-coping behaviors between the two groups were compared by using t-test and factor analysis. Social stress-coping behaviors such as 'journey', 'socializing with friends', and 'talking something over' were significantly less frequent in bipolar patients than controls. On the other hand, pleasurable-seeking behaviors such as 'smoking', 'masturbation', and 'stealing' were significantly more frequent in bipolar patients than controls. These results suggest that bipolar patients may have more maladaptive stress-coping strategies than normal controls. It is recommended to develop and apply psychosocial programs to reduce maladaptive stress-coping behaviors of bipolar patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Clinical characteristics of patients with serrated polyposis syndrome in Korea: comparison with Western patients

Directory of Open Access Journals (Sweden)

Eun Ran Kim

2017-07-01

Full Text Available Background/Aims: Serrated polyposis syndrome (SPS has been shown to increase the risk of colorectal cancer (CRC. However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.Methods: This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.Results: Twenty patients (67% were male. The median patient age at diagnosis was 56 years (range, 39–76 years. A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months. Serrated polyps were noted more frequently in the distal colon (298/702, 55%. However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively; 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients, but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.Conclusions: The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.

Characteristics of patients with measles admitted to allied hospital rawalpindi

International Nuclear Information System (INIS)

Sultana, A.; Sabir, S.A.; Awan, A.

2015-01-01

Measles, a virus borne droplet infection, is one of the leading causes of death among young children worldwide despite presence of a safe and cost-effective vaccine. Objective of our study was to identify the characteristics of measles patients admitted to Allied Hospitals, Rawalpindi. Methods: This cross-sectional study was conducted amongst patients admitted with measles in paediatric units of Rawalpindi Medical College Allied Hospitals, Rawalpindi. A standard proforma was used to collect data from the respondents. Results: A total of 55 patients (mean age-29.36 months) with measles were included in the study. 65.5% children were vaccinated while 34.5% were not vaccinated. Among those vaccinated 14 were male. Out of the vaccinated children 52.6% were residents of middle class areas, 31.6% lower middle class area, 10.5% upper middle class areas and 5.3% rural areas. In 55.0% of patients who were vaccinated with at least one dose of measles at nine month of age the estimated calendar months of vaccination was March to April while in 30% the overall climatic period of vaccination was of summer (May to September). Twenty one study subjects were exposed to a case of measles in the family and thirty five out of all developed at least one known complication of the disease. Pneumonia was the most common complication reported in patients (63.6%) followed by diarrhoea (27.3%). Conclusion: Majority of the patients suffering from measles were not vaccinated and the most common reason for failure to immunize children was lack of awareness. Educated and well off fathers were more likely to get their children immunized. The vaccinated children who developed measles majority were vaccinated during months of March, April and May. (author)

Characterization of patients aged 45 or under admitted with hypertensive emergencies in the Hospital do Prenda.

Science.gov (United States)

García, Geovedy Martínez; Miúdo, Venâncio; Manuel Lopes, Conceição da Graça Alves; Vassuelela Gomes, Juliana

2014-01-01

The incidence and prevalence of hypertensive emergency have been little addressed in the literature. However, over the last decade increasing numbers of young patients with different forms of hypertensive crisis have been observed in emergency departments. We performed this study to ascertain the clinical and epidemiological characteristics of patients aged ≤ 45 years admitted with a diagnosis of hypertensive emergency. We conducted an observational, descriptive, cross-sectional prospective study of 123 patients hospitalized for hypertensive emergency in the Hospital do Prenda, Luanda, between May 2011 and June 2012. Mean age was 36.62 ± 5.49 years, and most were male (52.85%). The main risk factor was hypertension (65.9%), with 17.3% complying with therapy. The most frequent forms of presentation were hypertensive encephalopathy and hemorrhagic stroke (9.8% and 82.1%, respectively). The main drugs used were diuretics, angiotensin-converting enzyme inhibitors and calcium channel blockers. Mortality during hospitalization was 25.2% (31 patients), hemorrhagic stroke being the most common cause. There was a significant association between age and in-hospital mortality. Of patients admitted with hypertensive emergency, 30.1% were aged ≤ 45 years. Hemorrhagic stroke was the most common presentation. There was a significant relationship between mode of presentation, age and in-hospital mortality. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Clinical characteristics of patients with thyrotropin-secreting pituitary adenoma.

Science.gov (United States)

Wu, Yung-Yen; Chang, Hung-Yu; Lin, Jen-Der; Chen, Kwang-Wen; Huang, Yu-Yao; Jung, Shih-Ming

2003-03-01

Thyroid-stimulating hormone (thyrotropin, TSH)-secreting pituitary adenoma is a very rare cause of hyperthyroidism. Diagnosis of this condition is often delayed due to lack of availability of TSH radioimmunoassay (RIA), the failure to recognize the utility of RIA and the incorrect attribution of the condition to other causes of thyrotoxicosis. This retrospective study analyzed the clinical characteristics of patients with this disorder treated from 1991 to 2002. Seven patients (6 females, 1 male; mean age, 48 years; range, 33 to 72 years) with a diagnosis of TSHsecreting pituitary adenoma based on detectable TSH levels with high serum free thyroid hormone or triiodothyronine concentrations and pituitary lesions found on neuroimaging were included in this study. Patient records including clinical features, endocrine studies, immunohistochemistry studies, and response to treatment were reviewed. All 7 patients had hyperthyroidism, elevated free thyroxine or triiodothyronine levels, and unsuppressed levels of TSH. Imaging studies demonstrated a pituitary mass or lesion in all patients. Six patients had macroadenomas and 1 patient had a microadenoma. One of the patients had coexisting acromegalic features and hypersecretion of growth hormone was diagnosed. All of the patients had been treated with thionamides or thyroidectomy for presumed primary hyperthyroidism. Serum alpha-subunit level was uncharacteristically normal in 2 patients and elevated in 1 patient. Alpha-subunit/TSH molar ratios were elevated in 3 patients. Five patients underwent transsphenoidal adenomectomy but only one of them remained well-controlled at follow-up. Three patients received administration of somatostatin analogs and they achieved normalization of serum TSH and free thyroid hormones during the period of therapy. TSH immunoassay has an important role in the evaluation of hyperthyroid patients to determine the presence of inappropriate secretion. TSH-secreting pituitary adenoma exhibits

Characteristics of cancer patients presenting to an integrative medicine practice-based research network.

Science.gov (United States)

Edman, Joel S; Roberts, Rhonda S; Dusek, Jeffery A; Dolor, Rowena; Wolever, Ruth Q; Abrams, Donald I

2014-09-01

To assess psychosocial characteristics, symptoms and reasons for seeking integrative medicine (IM) care in cancer patients presenting to IM clinical practices. A survey of 3940 patients was conducted at 8 IM sites. Patient reported outcome measures were collected and clinicians provided health status data. This analysis compares 353 participants self-identified as cancer patients with the larger noncancer cohort. Mean age of the cancer cohort was 55.0 years. Participants were predominantly white (85.9%), female (76.4%), and well educated (80.5% completed college). For 15.2% of cancer patients, depression scores were consistent with depressive symptoms, and average scores for perceived stress were higher than normal, but neither were significantly different from noncancer patients. The most prevalent comorbid symptoms were chronic pain (39.8%), fatigue (33.5%), and insomnia (23.3%). In the cancer cohort, perceived stress was significantly associated with depression, fatigue, insomnia, pain, and QOL. Cancer patients who chose an IM clinical practice "seeking healthcare settings that address spirituality as an aspect of care" had significantly higher levels of perceived stress, depression, and pain than those not selecting this reason. Demographic characteristics, depression scores, perceived stress scores, and reasons for seeking integrative cancer care were not significantly different between cancer patients and noncancer patients. Perceived stress may be an important indicator of QOL. The association of perceived stress, depression and pain with seeking spirituality suggests that providing IM interventions, such as effective stress management techniques and pastoral or spiritual counseling, may be helpful to patients living with cancer. © The Author(s) 2014.

Nasopharyngeal carcinomas: analysis of patient, tumor and treatment characteristics determining outcome

International Nuclear Information System (INIS)

Erkal, Haldun S.; Serin, Meltem; Cakmak, Ahmet

2001-01-01

Purpose: The present study reviews the experience in treatment of 447 patients with nasopharyngeal carcinomas, analyzing patient, tumor and treatment characteristics determining outcome. Materials and methods: There were 322 males and 125 females, their ages ranging from 7 to 85 years (median, 45 years). Two-hundred and seventy-two patients had World Health Organization (WHO) type 3 carcinomas, 123 patients had T4 tumors and 320 patients had metastatic cervical lymph nodes. Three-hundred and eight patients were treated with radiation therapy alone and 139 patients with chemotherapy in combination with radiation therapy. Cumulative radiation dose to primary tumor ranged from 50 to 76 Gy (median, 70 Gy) and radiation dose to metastatic cervical lymph nodes ranged from 46 to 74 Gy (median, 66 Gy). Results: Follow-up ranged from 0.1 to 19.5 years (mean, 7.6 years). Local complete response was achieved in 357 patients. In multivariate analysis, T-classification, cumulative radiation dose to primary tumor and treatment with chemotherapy in combination with radiation therapy predicted local response. Nodal complete response was achieved in 272 patients. In multivariate analysis, N-classification and radiation dose to metastatic cervical lymph nodes predicted nodal response. Local failure was observed in 70 patients, nodal failure in 35 patients and systemic failure in 114 patients. Overall survival, disease-free survival and disease-specific survival were 33, 32 and 37%, respectively, at 10 years. In multivariate analysis, age, T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted overall survival whereas T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted both disease-free survival and disease-specific survival. Conclusions: Radiation therapy alone appears to be an adequate and viable treatment for patients with early

Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

Science.gov (United States)

Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

2001-01-01

Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

PSYCHOLOGICAL CHARACTERISTICS OF PATIENTS INFLUENCING ON THE COMMITMENT TO IMPLEMENT THE RECOMMENDATIONS OF DENTISTS

Directory of Open Access Journals (Sweden)

E. V. Sitkina

2017-01-01

Full Text Available The psychological peculiarities of dental patients with periodontal disease are summarized here. Also, the article presents the description of patients with positive and negative dynamics of treatment.Objective  – to identify relationships between the characteristics of the patient’s personality and their implementation to the recommendations of dentist.Materials  and Methods. 45 people were examined, an average age of 43 years. The following psychodiagnostic methods were used: 1 the multidimensional questionnaire on health; 2 the test «Diagnosis of interpersonal relationships»; 3 characterological questionnaire by K. Leonhard&T. Shmishek; 4 individually-typological questionnaire by Sobchik L.N.; 5 the questionnaire of self-evaluation status;  6 personality Inventory of Bekhterev Institute. These dental indexes of oral health were measured: 1 CPITN; 2 PMA; 3 Saxer & Muhlemann; 4 Silness & Loe; 5 OHI-S.Results.  According to the results of two measurements of dental indexes, 3 groups of patients were identified: 1 with good oral hygiene; 2 with poor hygiene and positive dynamics (improving dental health index; 3 with poor hygiene and negative dynamics (deterioration indexes. The interrelation of the recommendations  of a dentist with the personal characteristics of patients was found.Summary.  Most patients have tried to follow the dentist’s recommendations for oral care, as evidenced by the decline in dental health indexes in the second survey. Differences in personal characteristics of patients, following and not following the recommendations were revealed, also, the gender differences in the groups with improvement and deterioration indexes were found.

Age-Differential Effects of Job Characteristics on Job Attraction: A Policy-Capturing Study.

Science.gov (United States)

Zacher, Hannes; Dirkers, Bodil T; Korek, Sabine; Hughes, Brenda

2017-01-01

Based on an integration of job design and lifespan developmental theories, Truxillo et al. (2012) proposed that job characteristics interact with employee age in predicting important work outcomes. Using an experimental policy-capturing design, we investigated age-differential effects of four core job characteristics (i.e., job autonomy, task variety, task significance, and feedback from the job) on job attraction (i.e., individuals' rating of job attractiveness). Eighty-two employees between 19 and 65 years ( M age = 41, SD = 14) indicated their job attraction for each of 40 hypothetical job descriptions in which the four job characteristics were systematically manipulated (in total, participants provided 3,280 ratings). Results of multilevel analyses showed that the positive effects of task variety, task significance, and feedback from the job were stronger for younger compared to older employees, whereas we did not find significant age-differential effects of job autonomy on job attraction. These findings are only partially consistent with propositions of Truxillo et al.'s (2012) lifespan perspective on job design.

Patient Characteristics and Patient Behavior as Predictors of Outcome in Cognitive Therapy and Exposure Therapy for Hypochondriasis.

Science.gov (United States)

Richtberg, Samantha; Jakob, Marion; Höfling, Volkmar; Weck, Florian

2017-06-01

Psychotherapy for hypochondriasis has greatly improved over the last decades and cognitive-behavioral treatments are most promising. However, research on predictors of treatment outcome for hypochondriasis is rare. Possible predictors of treatment outcome in cognitive therapy (CT) and exposure therapy (ET) for hypochondriasis were investigated. Characteristics and behaviors of 75 patients were considered as possible predictors: sociodemographic variables (sex, age, and cohabitation); psychopathology (pretreatment hypochondriacal symptoms, comorbid mental disorders, and levels of depression, anxiety, and somatic symptoms); and patient in-session interpersonal behavior. Severity of pretreatment hypochondriacal symptoms, comorbid mental disorders, and patient in-session interpersonal behavior were significant predictors in multiple hierarchical regression analyses. Interactions between the predictors and the treatment (CT or ET) were not found. In-session interpersonal behavior is an important predictor of outcome. Furthermore, there are no specific contraindications to treating hypochondriasis with CT or ET. © 2016 Wiley Periodicals, Inc.

Patient and practitioner characteristics predict brief alcohol intervention in primary care.

Science.gov (United States)

Kaner, E F; Heather, N; Brodie, J; Lock, C A; McAvoy, B R

2001-10-01

The effectiveness of an evidence-based health care intervention depends on it being delivered consistently to appropriate patients. Brief alcohol intervention is known to be effective at reducing excessive drinking and its concomitant health and social problems. However, a recent implementation trial reported partial delivery of brief alcohol intervention by general practitioners (GPs) which is likely to have reduced its impact. To investigate patient-practitioner characteristics influencing brief alcohol intervention in primary care. Cross-sectional analysis of 12,814 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires. Eighty-four GPs who had implemented a brief alcohol intervention programme in a previous trial based in the Northeast of England. GPs were requested to screen all adults (aged over 16 years) presenting to their surgery and follow a structured protocol to give a brief intervention (five minutes of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of the screening questionnaire were collected from all practices after a three-month implementation period. Although AUDIT identified 4080 'risk' drinkers, only 2043 (50%) received brief intervention. Risk drinkers that were most likely to receive brief intervention were males (58%), unemployed (61%), and technically-trained patients (55%). Risk drinkers that were least likely to receive brief intervention were females (44%), students (38%), and university educated patients (46%). Logistic regression modelling showed that patients' risk status was the most influential predictor of brief intervention. Also, GPs' experience of relevant training and longer average practice consultations predicted brief intervention. However, personal characteristics relating to patients and GPs also predicted brief intervention in routine practice. Interpersonal factors relating to patients and practitioners contributed to the selective provision of brief

Impacts of patient characteristics on hospital care experience in 34,000 Swedish patients

Directory of Open Access Journals (Sweden)

Wolf Axel

2012-06-01

Full Text Available Abstract Background Standardized patient surveys are widely used for assessing quality of healthcare from the patient perspective. An important purpose of such surveys is to identify disparities in care among different patient groups. The purpose of this study was to 1. evaluate aspects of the validity of the adapted Swedish version of the Picker Patient Care Experience -15 (PPE-15 survey and 2. examine the explanatory value of various socio-demographic and health characteristics in predicting patients’ care experiences. Methods A retrospective cross-sectional study design was used. Patients discharged from internal medicine wards at regional and university hospitals in different parts of Sweden during 2010 were invited to participate in the regularly administered national care-experience survey for hospital care. The internal validity of the PPE-15 was assessed with Cronbach’s alpha and item-scale correlations. Pearson product–moment correlation coefficients were used to compare PPE-15 total scores with overall care satisfaction ratings and Spearman correlation coefficients were used to compare PPE-15 total scores with various patient characteristics. Multiple linear regression analysis was performed to examine the influence of various patient characteristics on PPE-15 scores. Results The response rate was 66% (n = 34 603. Cronbach’s alpha was 0.87. The correlation between the PPE-15 total score and overall care satisfaction was high (0.62, p  Conclusions Our results supported the internal validity of the Swedish adapted version of the PPE-15. The explanatory value of the examined patient socio-demographic and health characteristics was low, suggesting the need for exploring other patient-related determinants of care experiences. Our findings also suggest a care paradox: patients in greatest need of hospital care are least satisfied with the quality of the care they receive.

[Detection and analysis of the characteristic expression of microRNAs of anal fistula patients].

Science.gov (United States)

Qiu, Jianming; Yu, Jiping; Yang, Guangen; Xu, Kan; Tao, Yong; Lin, Ali; Wang, Dong

2016-07-01

To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance. The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(Pcharacteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.

Characteristics of patients contacting a center for undiagnosed and rare diseases.

Science.gov (United States)

Mueller, Tobias; Jerrentrup, Andreas; Bauer, Max Jakob; Fritsch, Hans Walter; Schaefer, Juergen Rolf

2016-06-21

Little is known about the characteristics of patients seeking help from dedicated centers for undiagnosed and rare diseases. However, information about their demographics, symptoms, prior diagnoses and medical specialty is crucial to optimize these centers' processes and infrastructure. Using a questionnaire, structured information from 522 adult patients contacting a center for undiagnosed and rare diseases was obtained. The information included basic sociodemographic data (age, gender, insurance status), previous hospital admissions, primary symptoms of complaint and previously determined diagnosis. The majority of patients completing the questionnaire were female, 300 (57 %) vs. 222 men (43 %). The median age was 52 years (range 18-92). More than half, 309 (59 %), of our patients had never been admitted to a university hospital. Common diagnoses included other soft tissue disorders, not classified elsewhere (ICD M79, n = 63, 15.3 %), somatoform disorders (ICD F45, n = 51, 12.3 %) and other polyneuropathies (ICD G62, n=36, 8.7 %). The most frequent symptoms were general weakness (n = 180, 36.6 %) followed by arthralgia (n = 124, 25.2 %) and abdominal discomfort (n = 113, 23.0 %). The majority of patients had either internal medicine (81.3 %) and/or neurologic (37.6 %) health problems. Pain-associated diagnoses and the typical "unexplained" medical conditions (chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome) are frequent among people contacting a center dedicated to undiagnosed diseases. The chief symptoms are mostly unspecific. An interdisciplinary organizational approach involving mainly internal medicine, neurology and psychiatry/psychosomatic care is needed.

Merkel cells carcinoma of the aged patient

International Nuclear Information System (INIS)

Levy, A.; Assouline, A.; Mazeron, J.J.; Chargari, C.; Krzisch, C.

2009-01-01

The carcinoma at Merkel cells is a rare and aggressive skin cancer, principally of the aged adult. The surgery is the fundamental treatment. The interest of the adjuvant radiotherapy is discussed for the aged patient. In the limits of this retrospective analysis, the postoperative radiotherapy appeared to bring a similar benefit as for younger patients. (N.C.)

The incidence and characteristics of supraventricular tachycardia in left atrial isomerism: a high incidence of atrial fibrillation in young patients.

Science.gov (United States)

Miyazaki, Aya; Sakaguchi, Heima; Ohuchi, Hideo; Yamamoto, Tetsuya; Igarashi, Takehiro; Negishi, Jun; Toyota, Naoki; Kagisaki, Koji; Yagihara, Toshikatsu; Yamada, Osamu

2013-06-20

In left atrial isomerism (LAI), both atria show left atrial morphology. Although bradyarrhythmias are frequent and highly complex in LAI patients, previous studies have reported a low incidence of supraventricular tachycardia (SVT). To evaluate the incidence and characteristics of SVT in LAI, we retrospectively evaluated the clinical characteristics of SVTs in 83 patients with LAI (age at last follow-up, 15.3±10.5 years). There were 27 SVTs in 19 patients (23%), including nine episodes of atrial fibrillation (AF) and eight non-reentrant SVTs. Sixteen of the 19 patients with SVT had histories of atriotomy, but the three patients with AF or non-reentrant tachycardia had no history of atriotomy. The rates of freedom from SVT were 66% and 59% at ages of 20 and 30 years, respectively; the corresponding rates for freedom from AF were 89% and 74%. In multivariate analysis, the predictors of SVT were age (OR, 1.14; 95% CI, 1.06-1.26; p=0.003) and sinus node dysfunction (SND) (OR, 3.88; 95% CI, 1.57-13.34; p=0.01). In patients with LAI, SVTs are common, and AF and non-reentrant SVTs are the major type of SVTs. The incidence of AF was high in young patients with LAI. The lack of anatomical barriers in the atria that allow the formation of macro-reentrant circuits may account for the higher incidence of AF and non-reentrant SVT than macro-reentrant tachycardia. Moreover, the increasing prevalence of SND with age should contribute to a higher incidence of SVT. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Advanced Glaucoma Intervention Study (AGIS): 3. Baseline characteristics of black and white patients.

Science.gov (United States)

1998-07-01

The purpose of this report is to examine the differences at baseline in demographic, medical, and ophthalmic characteristics between blacks and whites enrolled in the Advanced Glaucoma Intervention Study (AGIS), a multicenter, randomized, clinical trial. Multicenter, randomized, controlled trial. A total of 332 black patients (451 eyes), 249 white patients (325 eyes), and 10 patients of other races (13 eyes) with open-angle glaucoma that could not be controlled by medical therapy alone participated. There was no intervention performed. The investigators compare the baseline demographic, medical, and ophthalmic characteristics of black and white patients, adjusting the comparisons for age and gender. Blacks in the study were younger than whites and had more systemic hypertension and diabetes than whites. The visual field defects of blacks on average were substantially more severe than those of whites. Intraocular pressures and visual acuity scores were similar in the two groups. Blacks were more hyperopic and had relatively fewer disk rim hemorrhages than whites. The findings of the current study concur with those of previous clinical studies of open-angle glaucoma that visual field defects are more severe in blacks than whites.

Socio-demographic characteristics and risk factors among HIV/AIDS patients in Kano, Northern Nigeria.

Science.gov (United States)

Iliyasu, Z; Arotiba, J T; Babashani, M

2004-01-01

There has been no description of the characteristics of HIV/AIDS patients that are referred to this antiretroviral treatment centre. The information could be useful in planning for prevention, care and support of people living with HIV/AIDS (PLWHA) and people affected by AIDS (PABA). To describe the socio-demographic characteristics and identify risk factors among HIV/AIDS patients presenting to Aminu Kano Teaching Hospital. Analysis of a prospectively collected data on 205 consecutive patients presenting to Aminu Kano Teaching Hospital from May 2002 to June 2003. Out of the 205 HIV positive patients seen, there were 112 (54.6%) males and 93 (45.4%) females giving a sex ratio of 1.2:1. The age range was 18 to 61 years with an overall mean S.D of 33.7 +/- [corrected] 8 years. The mean for males was 37.3 +/- [corrected] 7.8 years compared to 29.56 years for females. This difference was statistically significant (t = 8.1 DF = 201 P homosexuality. The need for a sustained multi-sectoral preventive effort and the scaling up of treatment and community care initiatives were stressed.

Obesity paradox in heart failure patients - Female gender characteristics-KAMC-single center experience.

Science.gov (United States)

Khaled, Sheeren; Matahen, Rajaa

2017-09-01

The correlation between low body mass index (BMI) and congestive heart failure (obesity paradox) has been described in the literature; However, the association between BMI and clinical outcome measures is not well characterized. Little is known about CHF in the Middle Eastern female population; most of the gender-specific information on heart failure comes from higher income "Western" countries. We aimed to identify the correlation between heart failure patients especially those with low BMI and clinical/safety outcome measures with focusing on female patients subgroup characteristics. We performed group comparisons of statistically relevant variables using prospectively collected data of HFrEF patients hospitalized over a 12 month period. The 167 patients (Group I) enrolled by this study with mean age of 59.64 ± 12.9 years, an EF score of 23.96 ± 10.14, 62.9% had ischemic etiology, 12.5% were smoker, 18% had AF, 31.1% had received ICD/CRT-D and an estimated 8.85 ± 9.5 days length of stay (LOS). The low BMI group of patients (Group II) had means age of 58.7 ± 14.5 years, a significant lower EF score of 20.32 ± 8.58, significantly higher 30, 90 days readmission rates and in-house mortality (22%, 36.6% and 17.1% vs 10.2%, 20.4% and 6.6% respectively) and higher rates of CVA, TIA and unexplained syncope (19.5% vs 7.2%). Similarly, female patients with low BMI (Group IV) had lower EF score of 22.0 ± 53, higher 30,90 days readmission rates and in-house mortality (34.4%,43.8% and 25% vs 13.5%,21.6% and 5.4% respectively) and higher rates of CVA, TIA and unexplained syncope(10% vs 0%). Our findings showed that heart failure patients with low BMI had poor adverse clinical outcome measures (poor EF, recurrent readmission, mortality and composite rates of CVA, TIA and unexplained syncope) which reflect the effect of obesity paradox in those patients with HFrEF. Female patient subgroup showed similar characteristic findings which also might reflect the

Dynamic characteristic of gastro-oesophageal reflux in ambulatory patients with gastro-oesophageal reflux disease and normal control subjects

NARCIS (Netherlands)

Weusten, B. L.; Akkermans, L. M.; vanBerge-Henegouwen, G. P.; Smout, A. J.

1995-01-01

BACKGROUND: The aim of the study was to investigate the dynamic characteristics of pathologic gastro-oesophageal reflux. METHODS: Five-channel ambulatory 24-h oesophageal pH monitoring was performed in 19 gastro-oesophageal reflux disease patients (age, 21-74 years) and in 19 healthy volunteers

Age as a moderator in the relationship between work-related characteristics, job dissatisfaction and need for recovery.

Science.gov (United States)

Bos, Judith Teresa; Donders, Nathalie Charlotte Gerarda Maria; Schouteten, Roel Leonardus Joseph; van der Gulden, Joost Willem Johannes

2013-01-01

Job dissatisfaction and need for recovery are associated with voluntary turnover, absenteeism and diminished health. In the light of encouraging working longer, this study investigated whether the relationships between various work characteristics and job dissatisfaction and need for recovery are dependent on age. Cross-sectional questionnaire data from 591 university employees were divided into four age groups: job dissatisfaction and Task variety with need for recovery were influenced by age group. The salience of specific work characteristics within the age groups varied: for job dissatisfaction, Task variety ( job dissatisfaction and need for recovery in four age groups. Although the moderating effect of age group was rather limited, the salience of specific work characteristics within the age groups varied.

Proportion and characteristics of patients who measure their blood pressure at home: Nationwide survey in Slovenia

Directory of Open Access Journals (Sweden)

Petek-Šter Marija

2009-01-01

Full Text Available Introduction. Home blood pressure monitoring has several advantages over blood pressure monitoring at a physician's office, and has become a useful instrument in the management of hypertension. Objective. To explore the rate and characteristics of patients who measure their blood pressure at home. Methods. A sample of 2,752 patients with diagnosis of essential arterial hypertension was selected from 12596 consecutive office visitors. Data of 2,639 patients was appropriate for analysis. The data concerning home blood pressure measurement and patients' characteristics were obtained from the patients' case histories. Results 1,835 (69.5% out of 2,639 patients measured their blood pressure at home. 1,284 (70.0% of home blood pressure patients had their own blood pressure measurement device. There were some important differences between these two groups: home blood pressure patients were more frequently male, of younger age, better educated, from urban area, mostly non-smokers, more likely to have diabetes mellitus and ischemic heart disease and had higher number of co-morbidities and were on other drugs beside antihypertensive medication. Using the logistic regression analysis we found that the most powerful predictors of home blood pressure monitoring had higher education level than primary school OR=1.80 (95% CI 1.37-2.37, non-smoking OR=2.16 (95% CI 1.40-3.33 and having a physician in urban area OR=1.32 (95% CI 1.02-1.71. Conclusion. Home blood pressure monitoring is popular in Slovenia. Patients who measured blood pressure at home were different from patients who did not. Younger age, higher education, non-smoking, having a physician in urban area and longer duration of hypertension were predictors of home blood pressure monitoring.

Clinical and immunological characteristics of hemorrhagic fever with renal syndrome in women of different age groups

Directory of Open Access Journals (Sweden)

Kutdusova A.M.

2012-09-01

Full Text Available Objective: To evaluate the clinical and immunological features of the hemorrhagic fever with renal syndrome in women of different age groups. Materials and methods: Clinical and laboratory characteristics of hemorrhagic fever with renal syndrome in 148 women aged 17 to 65 years old have been investigated. Patients have been divided into two groups: group I included 101 patients with normal menstrual rhythm, group II included 47 female patients with menopause. In 57 women (36 from group I, 21 — from group II the content of CD3+, CD4+, CD8+, CD16+, CD19+ — sub-populations of peripheral blood lymphocytes has been determined. Results: In compared groups significant differences in structure and frequency of complications of the disease have been revealed. Unidirectional tendency to increase significantly reduced absolute rates of investigated lymphocyte subpopulations in dynamics of the disease has been identified. It also has been stated that by the time of early convalescence in case of severe form of HFRS the indices did not reach the standard level. In an older group of women deeper damage and long-term recovery of immune system have been marked. Conclusion: According to the results of clinical and immunological studies the research work has revealed that in young women the response of the immune system to HFRS has developed faster and stronger than that in patients during the menopause period.

Comparison of methodologies to define hemodialysis patients hyporesponsive to epoetin and impact on counts and characteristics

Directory of Open Access Journals (Sweden)

Gilbertson David T

2013-02-01

Full Text Available Abstract Background Some hemodialysis patients require large doses of erythropoiesis-stimulating agents (ESAs to manage anemia. These patients, termed “ESA hyporesponsive,” have been characterized using various definitions. We applied three definitions of hyporesponsiveness to a large, national cohort of hemodialysis patients to assess the impact of definition on counts and on characteristics associated with hyporesponsiveness. Methods We studied point-prevalent hemodialysis patients on May 1, 2008, with Medicare as primary payer, who survived through December 31, 2008. Included patients received recombinant human erythropoietin (EPO in each month, August-December. Hyporesponsiveness definitions were: above the ninetieth percentile of total monthly EPO dose; above the ninetieth percentile of total monthly EPO dose divided by weight in kg; above the ninetieth percentile of total monthly EPO dose divided by hemoglobin level. Hyporesponsiveness was further classified as chronic, acute, or other. Comorbid conditions were assessed before and concurrent with the hyporesponsive period. Results Women, African Americans, and patients aged Conclusions As associations were similar between patient characteristics and three methods of characterizing EPO hyporesponsiveness, the simplest definition using EPO dose can be used.

Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study.

Directory of Open Access Journals (Sweden)

Orla M Smith

Full Text Available Little is known about homeless patients in intensive care units (ICUs.To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17 had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001 and illicit drug(46% vs 8%,p<0.001 use and less documented hypertension (16% vs 40%,p = 0.005 or prescription medications (48% vs 67%,p<0.05. Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001 and nicotine (38% vs 14%,p = 0.004 prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005. Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality.Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians, have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes in this vulnerable population.

Evaluation of glycemic control, quality of life and psychological characteristics in patients with type 1 diabetes mellitus

Directory of Open Access Journals (Sweden)

Yuliya Andreevna Shishkova

2013-12-01

Full Text Available Aim. To identify psychological characteristics associated with better glycemic control and higher quality of life (QoL in patients with type 1 diabetes mellitus (T1DM. Materials and Methods.  The study included 140 T1DM patients (47 males aged 18 to 28 years. Assessment of the QoL and associated emotional state (ES was performed by validated localized questionnaires, supplemented with the inventories for evaluation of psychological characteristics. Based on the acquired data we performed a trilateral analysis of glycemic control, QoL and ES, followed by testing of these parameters for correlation with certain psychological characteristics, including disease attitude, mindfulness, self-attitude and self-assessment, coping strategies, autoregulation parameters and the locus of control. Results.  In the studied sample, better glycemic control was associated with higher QoL and more favourable ES. We also identified several psychological characteristics associated with an improvement in all three primary parameters, namely: higher level of mindfulness, internal locus of control and ergopathic attitude. Conclusion.  The diagnostic inventory for QoL and ES evaluation used in the present study may be helpful for psychological testing in patients with T1DM.

Evaluation of glycemic control, quality of life and psychological characteristics in patients with type 1 diabetes mellitus

Directory of Open Access Journals (Sweden)

Yuliya Andreevna Shishkova

2013-12-01

Full Text Available Aim. To identify psychological characteristics associated with better glycemic control and higher quality of life (QoL in patients with type 1 diabetes mellitus (T1DM.Materials and Methods. The study included 140 T1DM patients (47 males aged 18 to 28 years. Assessment of the QoL and associated emotional state (ES was performed by validated localized questionnaires, supplemented with the inventories for evaluation of psychological characteristics. Based on the acquired data we performed a trilateral analysis of glycemic control, QoL and ES, followed by testing of these parameters for correlation with certain psychological characteristics, including disease attitude, mindfulness, self-attitude and self-assessment, coping strategies, autoregulation parameters and the locus of control.Results. In the studied sample, better glycemic control was associated with higher QoL and more favourable ES. We also identified several psychological characteristics associated with an improvement in all three primary parameters, namely: higher level of mindfulness, internal locus of control and ergopathic attitude.Conclusion. The diagnostic inventory for QoL and ES evaluation used in the present study may be helpful for psychological testing in patients with T1DM.

Patient Characteristics, Treatment Patterns and Prognostic Factors in Squamous Cell Bladder Cancer.

Science.gov (United States)

Zahoor, Haris; Elson, Paul; Stephenson, Andrew; Haber, Georges-Pascal; Kaouk, Jihad; Fergany, Amr; Lee, Byron; Koshkin, Vadim; Ornstein, Moshe; Gilligan, Timothy; Garcia, Jorge A; Rini, Brian; Grivas, Petros

2018-04-01

Squamous cell carcinoma (SCC) is an uncommon histologic subtype of bladder cancer with limited data on treatment patterns, outcomes, and prognostic factors. "Real world" information might inform decision-making, prognostic estimates, and clinical trial designs. A retrospective review of patients with tissue-confirmed bladder SCC treated at Cleveland Clinic from 2007 to 2016 was performed. Data on patient characteristics, treatment patterns, and clinical follow-up were extracted. Univariate analysis was used to identify predictors of overall survival (OS), recurrence-free survival (RFS) and time to recurrence. Of 58 identified patients, 42 had complete data available. Median age at diagnosis was 67 years (range, 37-90). Hematuria was the most common (71%) presenting symptom; 32 patients had pure SCC and 10 predominant/extensive squamous differentiation without major differences noted in clinicopathologic variables or outcomes among those 2 groups. Overall, 35 patients underwent cystectomy with 5 receiving neoadjuvant and 1 adjuvant chemotherapy, whereas 3 had chemotherapy for recurrent disease. Of patients with cystectomy, most had locally advanced disease (75% pT3/4, 35% pN+). Overall, 10 patients progressed and 14 died; median OS was not reached. The 2-year estimated OS, RFS, and cumulative incidence of recurrence were 61% ± 9%, 50% ± 9%, and 32% ± 9%, respectively. Hydronephrosis, older age (70 years or older), lymphovascular invasion, nodal metastases, and advanced T stage were associated with 1 or more poor outcomes. In patients with resectable bladder SCC, radical cystectomy remains the main treatment modality. The role of perioperative chemotherapy remains unclear. The identified prognostic factors might be helpful for prognostication, treatment discussion, and trial eligibility/stratification. Copyright © 2017 Elsevier Inc. All rights reserved.

NUTRITIONAL STATUS OF MAINTENANCE HEMODIALYSIS PATIENTS WITH DIFFERENT AGES

Directory of Open Access Journals (Sweden)

Wenling Ye

2012-06-01

Full Text Available To investigate nutritional status and body composition in different ages of maintaining hemodialysis (HD patients. 129 patients (male 62, female 67 with the mean age 56.33±14.14 years on HD were divided into four groups with age under 40, 40-69, 60-69 and over 70 years. Body composition was evaluated with Multi-frequency bioelectric impedance analysis (BIA and 83 healthy subjects, matched for age and sex, were as the control. In all patients, about 6.2% were underweight with body mass index (BMI less than 18.5 Kg/m2. The incidence of underweight were 0%, 6.2%, 4.8% and 11.1% in groups under 40, 40-59, 60-69 and over 70 years respectively. Serum Creatinine, ALB, pre-ALB and normalized protein catabolic rate (nPCR were significantly decreased in patients over 70 years. The young patients under 40 years also displayed lower nPCR and CHO value compared with that of group 40-59 years. Body cell mass, lean tissue mass, lean tissue index and relative lean tissue mass in HD patients were significantly lower than that in age and sex matched control group. Meanwhile, fat mass, fat tissue index and relative fat were increase 20% than the control. They were less different between HD patients and controls in age of 40-59 years, however, difference significantly increased in other three groups and changes were most obvious in patients over 70 years. In conclusion, our study showed that nutritional status was significantly associated with the age in HD patients. Patients under 40 years and over 70 years old displayed much severer protein wasting and more fat tissue storage.

Physical Therapy and Manual Physical Therapy: Differences in Patient Characteristics.

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, Rob A B; van Berkel, Lonneke M.; Scholten-Peeters, Gwendolijne G M; Pool, Jan J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

Physical therapy and manual physical therapy: Differences in patient characteristics

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, R.A.B.; van Berkel, Lonneke M.; Scholten-Peeters, G.G.M.; Pool, J.J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

Physical Therapy and Manual Physical Therapy: Differences in Patient Characteristics

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, Rob A B; van Berkel, Lonneke M.; Scholten-Peeters, Gwendolijne G. M.; Pool, Jan J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

Demographic And Histopathological Characteristics Of Colorectal Polyps: A Descriptive Study Based On Samples Obtained From Symptomatic Patients

Directory of Open Access Journals (Sweden)

Cekodhima Genta

2016-06-01

Full Text Available Colorectal polyps (CP are common among individuals older than 50 years. Some polyp types can precede colorectal cancer (CRC. This study aimed at describing histopathological characteristics of colorectal polyps in relation to age and gender among symptomatic patients referred for a colonoscopy examination during 2011-2014 in Tirana, Albania.

The Digital Divide and Patient Portals: Internet Access Explained Differences in Patient Portal Use for Secure Messaging by Age, Race, and Income.

Science.gov (United States)

Graetz, Ilana; Gordon, Nancy; Fung, Vick; Hamity, Courtnee; Reed, Mary E

2016-08-01

Online access to health records and the ability to exchange secure messages with physicians can improve patient engagement and outcomes; however, the digital divide could limit access to web-based portals among disadvantaged groups. To understand whether sociodemographic differences in patient portal use for secure messaging can be explained by differences in internet access and care preferences. Cross-sectional survey to examine the association between patient sociodemographic characteristics and internet access and care preferences; then, the association between sociodemographic characteristics and secure message use with and without adjusting for internet access and care preference. One thousand forty-one patients with chronic conditions in a large integrated health care delivery system (76% response rate). Internet access, portal use for secure messaging, preference for in-person or online care, and sociodemographic and health characteristics. Internet access and preference mediated some of the differences in secure message use by age, race, and income. For example, using own computer to access the internet explained 52% of the association between race and secure message use and 60% of the association between income and use (Sobel-Goodman mediation test, Pdifferences in portal use remained statistically significant when controlling for internet access and preference. As the availability and use of patient portals increase, it is important to understand which patients have limited access and the barriers they may face. Improving internet access and making portals available across multiple platforms, including mobile, may reduce some disparities in secure message use.

MODEL OF EMERGENCY DEPARTMENT NURSE PERFORMANCE IMPROVEMENT BASED ON ASSOCIATION OF INDIVIDUAL CHARACTERISTIC, ORGANIZATION CHARACTERISTIC AND JOB CHARACTERISTIC

Directory of Open Access Journals (Sweden)

Maria Margaretha Bogar

2017-04-01

Full Text Available Introduction: Nursing care is integral part of health care and having important role in management of patient with emergency condition. The purpose of this research was to develop nurse performance improvement model based on individual, organization and job characteristics association in Emergency Department of RSUD dr TC Hillers Maumere. Method: This was an explanative survey by cross sectional approach held on July -August 2012. Respondents in this study were 22 nurses and 44 patients were obtained by purposive sampling technique. Data were analyzed by partial least square test and signi fi cant t value > 1.64 (alpha 10%. Result: Results showed that individual characteristic had effect on nurse performance (t = 7.59, organization characteristic had effect on nurse performance (t = 2.03 and job characteristic didn’t have effect on nurse performance (t = 0.88. Nurse performance had effect on patient satisfaction (t = 6.54 but nurse satisfaction didn’t have effect on nurse performance (t = 1.31, and nurse satisfaction didn’t have effect either on patient satisfaction (t = 0.94. Discussion: This research concluded that individual characteristics which in fl uence nurse performance in nursing care were ability and skill, experience, age, sex, attitude and motivation. Organization characteristic that influence nurse performance was reward while job characteristic that include job design and feedback didn’t influence nurse performance in nursing care. Nurse performance influenced patient satisfaction but nurse satisfaction didn’t influence patient satisfaction and nurse performance.

Resistant hypertension, patient characteristics, and risk of stroke.

Directory of Open Access Journals (Sweden)

Chen-Ying Hung

Full Text Available Little is known about the prognosis of resistant hypertension (RH in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes.Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6% patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years. Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events] in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years. There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09-1.26; p<0.001. Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08-1.27; p<0.001, especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20-1.48; p<0.001, but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95-1.19; p = 0.312 or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99-1.39; p = 0.070 were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients.Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and elderly patients than in male or young

Resistant Hypertension, Patient Characteristics, and Risk of Stroke

Science.gov (United States)

Hung, Chen-Ying; Wang, Kuo-Yang; Wu, Tsu-Juey; Hsieh, Yu-Cheng; Huang, Jin-Long; Loh, El-Wui; Lin, Ching-Heng

2014-01-01

Background Little is known about the prognosis of resistant hypertension (RH) in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes. Methods and Results Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6%) patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years). Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events]) in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years). There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years) patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09–1.26; p<0.001). Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08–1.27; p<0.001), especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20–1.48; p<0.001), but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95–1.19; p = 0.312) or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99–1.39; p = 0.070) were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients. Conclusions Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and

Digitized Speech Characteristics in Patients with Maxillectomy Defects.

Science.gov (United States)

Elbashti, Mahmoud E; Sumita, Yuka I; Hattori, Mariko; Aswehlee, Amel M; Taniguchi, Hisashi

2017-12-06

Accurate evaluation of speech characteristics through formant frequency measurement is important for proper speech rehabilitation in patients after maxillectomy. This study aimed to evaluate the utility of digital acoustic analysis and vowel pentagon space for the prediction of speech ability after maxillectomy, by comparing the acoustic characteristics of vowel articulation in three classes of maxillectomy defects. Aramany's classifications I, II, and IV were used to group 27 male patients after maxillectomy. Digital acoustic analysis of five Japanese vowels-/a/, /e/, /i/, /o/, and /u/-was performed using a speech analysis system. First formant (F1) and second formant (F2) frequencies were calculated using an autocorrelation method. Data were plotted on an F1-F2 plane for each patient, and the F1 and F2 ranges were calculated. The vowel pentagon spaces were also determined. One-way ANOVA was applied to compare all results between the three groups. Class II maxillectomy patients had a significantly higher F2 range than did Class I and Class IV patients (p = 0.002). In contrast, there was no significant difference in the F1 range between the three classes. The vowel pentagon spaces were significantly larger in class II maxillectomy patients than in Class I and Class IV patients (p = 0.014). The results of this study indicate that the acoustic characteristics of maxillectomy patients are affected by the defect area. This finding may provide information for obturator design based on vowel articulation and defect class. © 2017 by the American College of Prosthodontists.

Outcomes of surgery in patients aged ≥90 years in the general surgical setting.

Science.gov (United States)

Sudlow, A; Tuffaha, H; Stearns, A T; Shaikh, I A

2018-03-01

Introduction An increasing proportion of the population is living into their nineties and beyond. These high risk patients are now presenting more frequently to both elective and emergency surgical services. There is limited research looking at outcomes of general surgical procedures in nonagenarians and centenarians to guide surgeons assessing these cases. Methods A retrospective analysis was conducted of all patients aged ≥90 years undergoing elective and emergency general surgical procedures at a tertiary care facility between 2009 and 2015. Vascular, breast and endocrine procedures were excluded. Patient demographics and characteristics were collated. Primary outcomes were 30-day and 90-day mortality rates. The impact of ASA (American Society of Anesthesiologists) grade, operation severity and emergency presentation was assessed using multivariate analysis. Results Overall, 161 patients (58 elective, 103 emergency) were identified for inclusion in the study. The mean patient age was 92.8 years (range: 90-106 years). The 90-day mortality rates were 5.2% and 19.4% for elective and emergency procedures respectively (p=0.013). The median survival was 29 and 19 months respectively (p=0.001). Emergency and major gastrointestinal operations were associated with a significant increase in mortality. Patients undergoing emergency major colonic or upper gastrointestinal surgery had a 90-day mortality rate of 53.8%. Conclusions The risk for patients aged over 90 years having an elective procedure differs significantly in the short term from those having emergency surgery. In selected cases, elective surgery carries an acceptable mortality risk. Emergency surgery is associated with a significantly increased risk of death, particularly after major gastrointestinal resections.

Characteristics and demographics of reversible cerebral vasoconstriction syndrome: A large prospective series of Korean patients.

Science.gov (United States)

Choi, Hyun Ah; Lee, Mi Ji; Choi, Hanna; Chung, Chin-Sang

2018-04-01

Objectives To report demographics and characteristics of reversible cerebral vasoconstriction syndrome (RCVS) in the Korean cohort. Methods We prospectively recruited patients with definite (imaging-proven) RCVS and probable (imaging-negative) RCVS who visited Samsung Medical Center between June 2012 and September 2016. Clinical manifestations, neuroimaging, treatment, and clinical outcomes were evaluated in all patients. Characteristics of RCVS without typical causes ("idiopathic RCVS") were compared with those of RCVS with identifiable causes ("secondary RCVS"). International Classification of Headache Disorders (ICHD)-3 beta criteria for 6.7.3 RCVS and 6.7.3.1 probable RCVS were tested. Results A total of 138 patients (104 definite and 34 probable RCVS) were included in this study. Patients with definite RCVS were predominantly female (85.6%) and middle-aged (mean, 50.7 [range, 23-82] years). Probable RCVS was associated with less female predominance (70.6%, p = 0.049), more typical manifestations ( p < 0.001), and none of neurological complications. One-hundred and one (97.1%) patients with definite RCVS had headache, but the typical "recurrent and/or triggered" thunderclap headache was reported in only 83 (82.2%). In most patients with definite RCVS (84.6%), RCVS was idiopathic, while only 16 (15.4%) had secondary causes. Compared to those with secondary RCVS, patients with idiopathic RCVS were older (52.8 ± 11.42 vs. 39.1 ± 9.55 years, p < 0.001). Patients with secondary RCVS had more complications than those with idiopathic RCVS (40.5% vs. 12.5%, p = 0.018). Among idiopathic RCVS patients, 33 (37.5%) reported a preceding event or a change in lifestyle, environment, health, or medication within one month before onset. Conclusion In our cohort, RCVS was benign and idiopathic in most patients, and occurred frequently in middle-aged women. Manifestations of RCVS were more diverse than previously recognized, and forms without any

Age patterns and transmission characteristics of hand, foot and mouth disease in China

Directory of Open Access Journals (Sweden)

Jijun Zhao

2016-11-01

Full Text Available Abstract Background Hand, foot and mouth disease (HFMD has circulated in China and caused yearly outbreak. To understand the transmission of the disease and to assess the spatial variation in cases reported, we examined age-specific transmission characteristics and reporting rates of HFMD for 31 provinces in mainland China. Methods We first analyzed incidence spatial patterns and age-specific incidence patterns using dataset from 2008 to 2012. Transmission characteristics were estimated based on catalytic model. Reporting rates were estimated using a simple mass action model from “Time Series Susceptible Infectious Recovered” (TSIR modeling. Results We found age-specific spatial incidence patterns: age-specific proportions of HFMD cases varied geographically in China; larger case percentage was among children of 3–5 years old in the northern part of China and was among children of 0–2 years old in the southern part of China. Our analysis results revealed that: 1 reporting rates and transmission characteristics including the average age at infection, the force of infection and the basic reproduction number varied geographically in China; 2 patterns of the age-specific force of infection for 30 provinces were similar to that of childhood infections in developed countries; the age group that had the highest infection risk was 3–5 years old in 30 provinces, and 10–14 years old in Tibet; 3 a large difference in HFMD transmission existed between northwest region and southeast region; 4 transmission characteristics determined incidence patterns: the higher the disease transmission in a province, the earlier the annual seasonality started and the more case percentage was among children 0–2 years old and less among 3–5 years old. Conclusion Because HFMD has higher transmission than most childhood infections reported, high effective vaccine coverage is needed to substantially reduce HFMD incidence. Control measures before the vaccine

Characteristics and outcomes of older HIV-infected patients receiving antiretroviral therapy in Malawi: A retrospective observation cohort study.

Directory of Open Access Journals (Sweden)

Hannock Tweya

Full Text Available To estimate patients enrolling on antiretroviral therapy (ART over time; describe trends in baseline characteristics; and compare immunological response, loss to follow-up (LTFU, and mortality by three age groups (25-39, 40-49 and ≥50 years.A retrospective observation cohort study.This study used routine ART data from two public clinics in Lilongwe, Malawi. All HIV-infected individuals, except pregnant or breastfeeding women, aged ≥ 25 years at ART initiation between 2006 and 2015 were included. Poisson regression models estimated risk of mortality, stratified by age groups.Of 37,378 ART patients, 3,406 were ≥ 50 years old. Patients aged ≥ 50 years initiated ART with more advanced WHO clinical stage and lower CD4 cell count than their younger counterparts. Older patients had a significantly slower immunological response to ART in the first 18 months on ART compared to patients aged 25-39 years (p = 0.04. Overall mortality rates were 2.3 (95% confidence Interval (CI 2.2-2.4, 2.9 (95% CI 2.7-3.2 and 4.6 (95% CI 4.2-5.1 per 100 person-years in patients aged 25-39 years, 40-49 years and 50 years and older, respectively. Overall LTFU rates were 6.3 (95% CI 6.1-6.5, 4.5 (95% CI 4.2-4.7, and 5.6 (95% CI 5.1-6.1 per 100 person years among increasing age cohorts. The proportion of patients aged ≥ 50 years and newly enrolling into ART care remained stable at 9% while the proportion of active ART patients aged ≥50 years increased from 10% in 2006 to 15% in 2015.Older people had slower immunological response and higher mortality. Malawi appears to be undergoing a demographic shift in people living with HIV. Increased consideration of long-term ART-related problems, drug-drug interactions and age-related non-communicable diseases is warranted.

An update on the characteristics of patients attending the Kooyong Low Vision Clinic.

Science.gov (United States)

Chong, Mae Fa; Jackson, A Jonathan; Wolffsohn, James S; Bentley, Sharon A

2016-11-01

Since 1972, the Australian College of Optometry has worked in partnership with Vision Australia to provide multidisciplinary low-vision care at the Kooyong Low Vision Clinic. In 1999, Wolffsohn and Cochrane reported on the demographic characteristics of patients attending Kooyong. Sixteen years on, the aim of this study is to review the demographics of the Kooyong patient cohort and prescribing patterns. Records of all new patients (n = 155) attending the Kooyong Low Vision Clinic for optometry services between April and September 2012 were retrospectively reviewed. Median age was 84.3 years (range 7.7 to 98.1 years) with 59 per cent female. The majority of patients presented with late-onset degenerative pathology, 49 per cent with a primary diagnosis of age-related macular degeneration. Many (47.1 per cent) lived with their families. Mean distance visual acuity was 0.57 ± 0.47 logMAR or approximately 6/24. The median spectacle-corrected near visual acuity was N8 (range N3 to worse than N80). Fifty patients (32.3 per cent) were prescribed new spectacles, 51 (32.9 per cent) low vision aids and five (8.3 per cent) were prescribed electronic magnification devices. Almost two-thirds (63.9 per cent) were referred for occupational therapy management and 12.3 per cent for orientation and mobility services. The profile of patients presenting for low-vision services at Kooyong is broadly similar to that identified in 1999. Outcomes appear to be similar, aside from an expected increase in electronic devices and technological solutions; however, the nature of services is changing, as treatments for ocular diseases advance and assistive technology develops and becomes more accessible. Alongside the aging population and age-related ocular disease being the predominant cause of low vision in Australia, the health-funding landscape is becoming more restrictive. The challenge for the future will be to provide timely, high-quality care in an economically efficient model. © 2016

Characteristics of prescribers whose patients shop for opioids: results from a cohort study.

Science.gov (United States)

Cepeda, M Soledad; Fife, Daniel; Berlin, Jesse A; Mastrogiovanni, Gregory; Yuan, Yingli

2012-01-01

Little is known about the prevalence of opioid shoppers in clinical practices and the relation between prescriber characteristics and the risk of having opioid shoppers. Describe the prevalence of opioid shoppers in prescribers' practices. Assess the relation between prescribers' characteristics and patient opioid shopping behavior. Retrospective cohort study using a large US retail prescription database. Patients with ≥1 opioid dispensing were followed 18 months. These patients' prescribers are the focus of the study. A patient was a "shopper" if he or she had opioid prescriptions written by ≥1 prescriber with ≥1 day of overlap filled at ≥3 pharmacies and a "heavy shopper" if he or she had ≥5 shopping episodes. The proportions of shoppers by prescriber and the proportion of prescribers with ≥1 shopper or heavy shopper were calculated. Among 858,290 opioid prescribers, most (87 percent) had no shoppers and 98 percent had no heavy shoppers. Prescribers who were aged 70-79 years, male, or who prescribed schedule II opioids had an increased likelihood of having shoppers. As the number of patients for whom a prescriber prescribed opioids increased, the proportion of shoppers also increased. Prescribers with 66 or more patients receiving opioids, who represented 25 percent of prescribers, prescribed for 82 percent of all shoppers. The great majority of opioid prescribers appear to have no shoppers in their practice. Any educational program will be more cost effective if targeted to prescribers of schedule II opioids with a large volume of patients requiring opioids.

Relationship of bony trabecular characteristics and age to bone mass

International Nuclear Information System (INIS)

Choi, Dong Hoon; Song, Young Han; Yoon, Young Nam; Lee, Wan; Lee, Byung Do

2006-01-01

Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony mass and bony trabecular characteristics. Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bony mineral density (BMD, grams/cm 2 ) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass

The clonic phase of seizures in patients treated with electroconvulsive therapy is related to age and stimulus intensity

Directory of Open Access Journals (Sweden)

Chih-Chieh eTseng

2013-12-01

Full Text Available Background: Electroconvulsive therapy (ECT is effective in the treatment of major depressive disorder and schizophrenia in patients who are drug-naïve or less-receptive to antipsychotic drugs. Several studies have discussed the correlation between patient characteristics, input current volume and seizure duration. According to the present principle of ECT guidelines, the therapeutic effect of ECT mostly correlates with seizure duration. As the tonic phase is different from the clonic phase with respect to brain function and activity, it is informative to analyse both the tonic and clonic phases. Thus, this study sought to clarify the relationship between the features of the two phases, and to re-examine and refine guidelines regarding ECT treatment.Method: ECT-course data from 44 schizophrenia patients were recollected, including the number of treatments that they had received, their gender, age, and the association of these characteristics with motor seizure duration was analysed. A two-factor correlation was employed to test the relationship between each of the two factors.Result: The meta-analysis results indicate that seizure duration and age are significantly correlated. Older patients had relatively short seizure durations after ECT-treatment. Notably, a negative correlation was only found between age and the clonic phase of the seizure, not between age and the tonic phase. Furthermore, this study also found an inverse relationship between ECT-intensity and the clonic phase, but not between ECT-intensity and the tonic phase.Conclusion: This study demonstrated that age and ECT-intensity are negatively correlated with seizure duration, particularly in the clonic phase. The present observations are not fully consistent with the basic guidelines of the APA-ECT practical manual. Accordingly, the predictions regarding the therapeutic effect of ECT can be based on both the seizure duration and the clonic phase.

Work characteristics and determinants of job satisfaction in four age groups: university employees' point of view.

NARCIS (Netherlands)

Bos, J.T.; Donders, N.C.G.M.; Bouwman-Brouwer, K.M.; Gulden, J.W.J. van der

2009-01-01

PURPOSE: To investigate (a) differences in work characteristics and (b) determinants of job satisfaction among employees in different age groups. METHODS: A cross-sectional questionnaire was filled in by 1,112 university employees, classified into four age groups. (a) Work characteristics were

Clinicopathological characteristic and clinical handling of the patients with 2 cm or less gastric GISTs.

Science.gov (United States)

Kataoka, Mikinori; Kawai, Takashi; Ikemiyagi, Hidekazu; Fujii, Takashi; Fukuzawa, Mari; Fukuzawa, Masakatsu; Kubota, Keisuke; Yoshida, Masashi; Suzuki, Shinji; Kitajima, Masaki

2013-01-01

We previously reported that safety and efficacy of mucosal cutting biopsy for diagnosing included 2 cm or less gastric GISTs. However, there have been no reports stating the clinicopathological characteristic and clinical handling of the patients with 2 cm or less gastric GISTs. The aim of our study is to investigate the clinicopathological characteristic and clinical handling of the patients with 2 cm or less gastric GISTs. The 19 patients diagnosed with GIST by mucosal cutting biopsy were divided into 2 groups: Group I; subjects were GISTs with 2 cm or less, Group II; subjects were GISTs >2 cm. We compared the 2 groups in terms of mean age, tumor size, tumor site, histopathological risk grade. In cases that underwent surgery with a diagnosis of GIST, we compared the pre- and postoperative histopathological diagnosis, and the histopathlogical risk grade within each group. The mean age and tumor size were significantly higher in Group I than in Group II. Meanwhile, there were no significant differences between the 2 groups, sex ratio, tumor site. All lesions were at histopathological risk grade at very low risk and low risk respectively. In 17 patients with GIST who underwent surgery, the histopathological diagnoses, immunostaining were in agreement with those from the mucosal cutting biopsy specimens in all cases, but mitotic count of one patient was not in agreement in group II. The 2 cm or less gastric GISTs diagnosed with histpathlogical very low risk can be considered acceptable to follow-up.

Impact of aging on cardiac sympathetic innervation measured by {sup 123}I-mIBG imaging in patients with systolic heart failure

Energy Technology Data Exchange (ETDEWEB)

Rengo, Giuseppe; Ferrara, Nicola [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Pagano, Gennaro; Formisano, Roberto; Komici, Klara; Petraglia, Laura; Parisi, Valentina; Femminella, Grazia Daniela; De Lucia, Claudio; Cannavo, Alessandro; Memmi, Alessia; Leosco, Dario [University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Vitale, Dino Franco [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); Paolillo, Stefania [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Attena, Emilio [Fatebenefratelli Hospital, Department of Cardiology, Naples (Italy); Pellegrino, Teresa [Institute of Biostructures and Bioimages of the National Council of Research, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy); Dellegrottaglie, Santo [Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Division of Cardiology, Acerra, Naples (Italy); Trimarco, Bruno; Filardi, Pasquale Perrone [Federico II University of Naples, Division of Cardiology, Department of Advanced Biomedical Sciences, Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy)

2016-12-15

Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine ({sup 123}I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac {sup 123}I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by {sup 123}I-mIBG scintigraphy, in patients with HF. We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac {sup 123}I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62-72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p < 0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age. Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by {sup 123}I-mIBG imaging. This finding suggests that cardiac {sup 123}I-mIBG uptake in patients with HF might be affected by patient age. (orig.)

Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar.

Science.gov (United States)

Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A

2013-09-01

Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.

EFFECT OF METOPROLOL ON COGNITIVE FUNCTION IN HYPERTENSIVE PATIENTS OF YOUNG TO MIDDLE AGE

Directory of Open Access Journals (Sweden)

S. A. Smakotina

2008-01-01

Full Text Available Aim. To evaluate the effect of metoprolol tartrate on blood pressure (BP and cognitive function in young to middle aged patients with essential hypertension (HT.Material and methods. 40 men (age of 49,0±1,9 y.o. with HT of I-II stage not taking antihypertensive medication regularly were enrolled into the study. All patients were given metoprolol tartrate (start dose 50-100 mg/d. Variables of 24-h BP monitoring and clinic BP, left ventricular mass index (measured by echocardiography and characteristics of cognitive function (memory, attention, thinking and neurodynamic were assessed at the start, after 1 and 6 months of therapy.Results. Good and satisfactory antihypertensive effect was achieved in 75% of hypertensive patients with metoprolol (186,6±13,4mg/d monotherapy. Metoprolol significantly decreased maximum day-time systolic and diastolic BP, maximum night-time diastolic BP, mean day-time systolic and night-time diastolic BP, time-index, load-index and variability-index for night-time diastolic BP, day-time and night-time pulse BP. Left ventricular mass index reduced significantly (p<0,0001. After 6 months of therapy significant improvement of memory, attention, thinking and neurodynamic was observedConclusion. Metoprolol had beneficial effect on cognitive function in hypertensive patients, which demonstrate its cerebroprotective properties in addition to antihypertensive action. Metoprolol can reduce the risk of dementia in young to middle aged patients with HT.

Dementia in middle-aged patients with schizophrenia.

Science.gov (United States)

Nicolas, Gaël; Beherec, Laurène; Hannequin, Didier; Opolczynski, Gaëlle; Rothärmel, Maud; Wallon, David; Véra, Pierre; Martinaud, Olivier; Guillin, Olivier; Campion, Dominique

2014-01-01

Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia. Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia. 96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants. Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized. The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.

SPECT of aged backache patients

International Nuclear Information System (INIS)

Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki

1995-01-01

Single photon emission computed tomography (SPECT) using 99m Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. 99m Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.)

Clinical trial enrollment, patient characteristics, and survival differences in prospectively registered metastatic colorectal cancer patients

DEFF Research Database (Denmark)

Sorbye, Halfdan; Pfeiffer, Per; Cavalli-Björkman, Nina

2009-01-01

BACKGROUND: Trial accrual patterns were examined to determine whether metastatic colorectal cancer (mCRC) patients enrolled in trials are representative of a general cancer population concerning patient characteristics and survival. METHODS: A total of 760 mCRC patients referred for their first...... oncological consideration at 3 hospitals in Scandinavia covering defined populations were registered consecutively during 2003 to 2006. Clinical trial enrollment, patient characteristics, and treatment were recorded prospectively, and the follow-up was complete. RESULTS: Palliative chemotherapy was initiated...

Phenotypic and genotypic characteristics of mastocytosis according to the age of onset.

Directory of Open Access Journals (Sweden)

Fanny Lanternier

Full Text Available Adult's mastocytosis is usually associated with persistent systemic involvement and c-kit 816 mutation, while pediatrics disease is mostly limited to the skin and often resolves spontaneously. We prospectively included 142 adult patients with histologically proven mastocytosis. We compared phenotypic and genotypic features of adults patients whose disease started during childhood (Group 1, n = 28 with those of patients whose disease started at adult's age (Group 2, n = 114. Genotypic analysis was performed on skin biopsy by sequencing of c-kit exons 17 and 8 to 13. According to WHO classification, the percentage of systemic disease was similar (75 vs. 73% in 2 groups. C-kit 816 mutation was found in 42% and 77% of patients in groups 1 and 2, respectively (p<0.001. 816 c-kit mutation was associated with systemic mastocytosis in group 2 (87% of patients with systemic mastocytosis vs. 45% with cutaneous mastocytosis, p = 0.0001. Other c-kit activating mutations were found in 23% of patients with mastocytosis' onset before the age of 5, 0% between 6 and 15 years and 2% at adults' age (p<0.001. In conclusion, pathogenesis of mastocytosis significantly differs according to the age of disease's onset. Our data may have major therapeutic relevance when considering c-kit-targeted therapy.

Patient Characteristics Predicting Readmission Among Individuals Hospitalized for Heart Failure

Science.gov (United States)

O'Connor, Melissa; Murtaugh, Christopher M.; Shah, Shivani; Barrón-Vaya, Yolanda; Bowles, Kathryn H.; Peng, Timothy R.; Zhu, Carolyn W.; Feldman, Penny H.

2015-01-01

Heart failure is difficult to manage and increasingly common with many individuals experiencing frequent hospitalizations. Little is known about patient factors consistently associated with hospital readmission. A literature review was conducted to identify heart failure patient characteristics, measured before discharge, that contribute to variation in hospital readmission rates. Database searches yielded 950 potential articles, of which 34 studies met inclusion criteria. Patient characteristics generally have a very modest effect on all-cause or heart failure–related readmission within 7 to 180 days of index hospital discharge. A range of cardiac diseases and other comorbidities only minimally increase readmission rates. No single patient characteristic stands out as a key contributor across multiple studies underscoring the challenge of developing successful interventions to reduce readmissions. Interventions may need to be general in design with the specific intervention depending on each patient's unique clinical profile. PMID:26180045

[The clinico-epidemiological characteristics of cholera patients in Mexico City].

Science.gov (United States)

Vilchis-Guizar, A E; Uribe-Márquez, S; Pérez-Sánchez, P L

1999-01-01

To compare the clinical and epidemiological characteristics of cholera patients and patients with diarrhea of different etiology (controls), treated at Mexican Institute of Social Security medical units in northeast Mexico City, from 1995 to 1998. Cross-sectional analytical study design. Data were collected using the official form "Immediate Notification of Cholera Cases" that each medical unit reports to the Coordination of Community Health. Statistical analysis consisted of comparisons of means and proportions between both groups. In 4,952 notifications, there were 588 cholera cases and 4,364 controls. The age range of cases was 39 to 51 years and 54% were females. During 1995 and 1997 (years with higher proportion of cases) patients with cholera had a greater frequency of watery evacuations than controls (97% vs. 73%), "rice water" appearance (31% vs. 13%), vomiting (72% vs. 63%), muscular spasms (49% vs. 26%), dehydration (83% vs. 71%), hypovolemic shock (10% vs. 1%) and death (0.85% vs. 0.25%). These differences were statistically significant. Cholera presents a biannual cyclic behavior; greater frequencies are associated with greater severity and complications. It is necessary to increase epidemiologic surveillance and medical efforts for opportune diagnosis and treatment.

[The influence of procaine electrophoresis and mesotherapy on the characteristics of biological age].

Science.gov (United States)

Turova, E A; Konchugova, T V; Balaban, E I; Fadeeva, N I; Golovach, A V; Teniaeva, E A

2012-01-01

The assessment of the biological age is needed to estimate the level of health and the efficacy of measures being undertaken to slow down the ageing processes and prolong the active life of the patients. Earlier studies have demonstrated the improvement of both physical health and psychic status of the elderly patients following intravenous administration of procaine. The objective of the present work was to evaluate effect of various methods of administration of a 2% procaine solution on the biological age. A total of 95 subjects at the age between 30 and 75 years were enrolled in the study. The procaine solutions were applied to the collar region. The patients of group 1 were treated with 2% procaine electrophoresis, those in group 2 with procaine galvanization with the same parameters. Mesotherapy using the 2% procaine solution was given to the patients of group 3. It was substituted by placebo (0.9% physiological solution) in the patients of group 4 (controls). The study revealed the most significant decrease of the biological age (calculated as described by L. M. Belozerova) in the patients treated with procaine electrophoresis (91% improvement). The mesotherapeutic administration of procaine also produced the beneficial effect (59% improvement). Neither procaine galvanization nor placebo mesotherapy caused any significant change of the variables characterizing the biological age.

Characteristics and outcomes of patients with multiple myeloma aged 21-40 years versus 41-60 years: a multi-institutional case-control study.

Science.gov (United States)

Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit; Gozzetti, Alessandro; Niesvizky, Ruben; Yadlapati, Sujitha; Jayabalan, David S; Robak, Paweł; Pika, Tomas; Andersen, Kristian T; Rasche, Leo; Mądry, Krzysztof; Woszczyk, Dariusz; Raźny, Małgorzata; Usnarska-Zubkiewicz, Lidia; Knopińska-Posłuszny, Wanda; Wojciechowska, Małgorzata; Guzicka-Kazimierczak, Renata; Joks, Monika; Grosicki, Sebastian; Ciepłuch, Hanna; Rymko, Marcin; Vesole, David H; Castillo, Jorge J

2016-12-01

We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs. 44%; P < 0·001). Five- and 10-year overall survival (OS) in younger versus older patients was 83% vs. 67% and 56% vs. 39%, respectively (P < 0·001). Similar results were seen when studying the subset of 780 patients who underwent autologous transplantation. Younger patients with ISS stage 1 had a better OS than older patients (P < 0·001). There was no survival difference between younger and older patients with ISS stage 2 or 3. Younger MM patients, aged 21-40 years, treated in the era of novel agents have a better OS than their counterparts aged 41-60 years, but the survival advantage observed in younger patients was lost in more advanced stages of MM. © 2016 John Wiley & Sons Ltd.

Peptide YY induces characteristic meal patterns of aged mice.

Science.gov (United States)

Mogami, Sachiko; Yamada, Chihiro; Fujitsuka, Naoki; Hattori, Tomohisa

2017-11-01

Changes in eating behavior occur in the elderly due to oral and swallowing dysfunctions. We aimed to clarify the difference between basal meal patterns of young and aged mice in relation to appetite regulating hormones. Thirty two of young (7-week-old) and aged (23-25-month-old) C57BL/6 male mice were acclimated to a single housing and then transferred to a highly sensitive automated feeding monitoring device. Feeding behavior was monitored from the onset of the dark phase after habituation to the device. Plasma peptide YY (PYY) levels were assessed under the several feeding status or after treatment of PYY. PYY and its receptor (NPY Y2 receptor, Y2R) antagonist were intraperitoneally administered 30min before the monitoring. Although the basal 24-h meal amounts did not differ by age, the total meal time and frequency of minimum feeding activity (bout) were significantly increased and the average bout size and time per bout were significantly decreased in aged mice. PYY dynamics were abnormal and the temporal reduction in food intake by exogenous PYY was more prominent in aged mice than in young mice. PYY administration to young mice induced aged-like meal patterns, and Y2R antagonist administration to aged mice induced young-like meal patterns. Aged mice exhibited characteristic meal patterns probably due to PYY metabolism dysfunction and/or enhanced PYY-Y2R signaling, suggesting a novel method for assessing eating difficulties in aged animals and a potential target for the remedy. Copyright © 2017 Elsevier Inc. All rights reserved.

Cystic fibrosis - Comparison between patients in paediatric and adult age.

Science.gov (United States)

Santos, V; Cardoso, A V; Lopes, C; Azevedo, P; Gamboa, F; Amorim, A

Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians. Although most cases are diagnosed in childhood, diagnosis in adults is apparently increasing. Evaluate the adult population with CF, comparing patients who were diagnosed before and after 18 years of age. Retrospective analysis of patients followed in three main medical centres in Portugal in 2012. Comparison of two groups: G1 - patients diagnosed at <18 years and G2 - patients diagnosed at ≥18 years. 89 adults were identified: 61.8% in G1, 38.2% in G2. Gender distribution was similar in both groups. Average age in G2 was higher (38.3±8.4 vs. 26.8±6.1 years, p<0.001). Respiratory symptoms most frequently led to CF diagnosis in all patients, mainly in adulthood. There was a greater percentage of patients homozygous for the mutation delF508 in G1 (43.6 vs. 8.8%, p=0.02). Respiratory and pancreatic function, and body mass index (BMI) showed a higher severity in G1 (G1 vs. G2: FEV1: 54.6±27.3 vs. 29.9±64.6%, p=0.177; pancreatic insufficiency 72.7 vs. 26.5%, p<0.001; BMI 20.2±3.4 vs. 22.2±4.8, p=0.018). Pseudomonas aeruginosa and methicillin-sensitive Staphylococcus aureus were the most frequently isolated microorganisms. Lung transplantation rate was higher in G2 (20.6 vs. 10.9%, p=0.231) while mortality rate was higher in G1 (0 vs. 3.6%, p=0.261). Hospital admission rate was higher in G1 as well as mortality rate. The results suggest that patients with CF diagnosed in childhood have characteristics that distinguish them from those diagnosed in adulthood, and these differences may have implications for diagnosis, prognosis and life expectancy. Copyright © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Characteristics and status of Korean medicine use in whiplash-associated disorder patients.

Science.gov (United States)

Kim, Nohyeon; Shin, Byung-Cheul; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Hwang, Eui-Hyoung; Jung, Chan Yung; Ruan, Diana; Ha, In-Hyuk

2018-04-06

Patients are free to choose conventional or Korean medicine treatment under the dual medical system in Korea, and the prevalence of patients who choose Korean medicine treatment for whiplash-associated disorders (WADs) is high. This study analyzed the sociodemographic characteristics and medical service use in this population to provide healthcare providers with basic usage information of complementary and alternative medicine for WAD. A total of 8291 outpatients who registered under automobile insurance coverage and visited the main branch of Jaseng Hospital of Korean Medicine from April 1, 2014 to August 10, 2016 were included. Data on sociodemographic characteristics, symptoms, and accident and treatment-related details were collected from electronic medical records. Univariate and multivariate regression analyses were performed to identify baseline factors predictive of total treatment duration. The most prevalent demographic of patients who chose Korean medicine for WAD treatment was males in their thirties whose initial visit to the hospital was 16.1 ± 94.1 days from the accident. Neck pain accompanied by low back pain (57.0%) was the most common complaint, and for singular pain, neck pain (13.5%) was the most prevalent. Baseline numeric rating scale (NRS) pain levels were generally moderate (4-6) regardless of area. Patients received 7.2 ± 10.2 sessions of treatment for 32.6 ± 55.3 days. The most commonly prescribed treatment modalities in order of highest frequency were acupuncture, cupping, pharmacopuncture, and herbal medicine, which collectively accounted for > 90% of treatments. Acupuncture was administered 29.0 ± 40.8 times, and cupping 14.0 ± 18.7 times as the two highest frequency treatments. In multivariate regression analysis, longer treatment periods were found to be associated with higher NRS, older age, and delayed initial visits at baseline. This study highlights the characteristics and Korean medicine use of WAD

Characteristics of diabetic patients visiting a podiatry practice in Germany.

Science.gov (United States)

Lauterbach, S; Kostev, K; Becker, R

2010-04-01

To describe the foot characteristics of diabetic patients attending a podiatry practice for their first consultation. The objective was to determine how effectively diabetic foot ulcers are being prevented in primary care. All diabetic patients who presented at a podiatry practice between 2006 and 2008 for their first consultation were analysed. Anonymous data were obtained from the standard patient anamnesis sheet completed by the podiatrist. These included results of patient interviews and examinations. A total of 230 diabetic patients (93.9% had type 2 diabetes mellitus and 6.1% had type 1) were analysed. The mean age was 67.7 years (+/- 10.8). Just under half (47.4%) were female. The mean duration of diabetes was 12.6 years (+/- 10.5) years. 70.4% of the patients had diabetic neuropathy (confidence intervals: 64.5-76.3), of whom 73.2% already had resting foot pain or strain foot pain while walking. 58.3% of the patients had toenail mycosis, and of these 38.1% had the infection in all 10 toenails. Most of the patients had at least one foot deformities (89.6% splayfoot and 37.0% flatfoot). 40.2% had no sensation to microfilament testing on either their right or left foot toes. The overall mean vibration sensation test threshold was 3.7 (+/- 2.3). While there is a structure and strategy for the primary and secondary prevention of the diabetic foot ulcers, its delivery is often ineffective. This audit shows that, in Germany, the detection and prevention of diabetic foot problems in podiatric practices happens far too late.

Association between biomarkers and clinical characteristics in chronic subdural hematoma patients assessed with lasso regression.

Directory of Open Access Journals (Sweden)

Are Hugo Pripp

Full Text Available Chronic subdural hematoma (CSDH is characterized by an "old" encapsulated collection of blood and blood breakdown products between the brain and its outermost covering (the dura. Recognized risk factors for development of CSDH are head injury, old age and using anticoagulation medication, but its underlying pathophysiological processes are still unclear. It is assumed that a complex local process of interrelated mechanisms including inflammation, neomembrane formation, angiogenesis and fibrinolysis could be related to its development and propagation. However, the association between the biomarkers of inflammation and angiogenesis, and the clinical and radiological characteristics of CSDH patients, need further investigation. The high number of biomarkers compared to the number of observations, the correlation between biomarkers, missing data and skewed distributions may limit the usefulness of classical statistical methods. We therefore explored lasso regression to assess the association between 30 biomarkers of inflammation and angiogenesis at the site of lesions, and selected clinical and radiological characteristics in a cohort of 93 patients. Lasso regression performs both variable selection and regularization to improve the predictive accuracy and interpretability of the statistical model. The results from the lasso regression showed analysis exhibited lack of robust statistical association between the biomarkers in hematoma fluid with age, gender, brain infarct, neurological deficiencies and volume of hematoma. However, there were associations between several of the biomarkers with postoperative recurrence requiring reoperation. The statistical analysis with lasso regression supported previous findings that the immunological characteristics of CSDH are local. The relationship between biomarkers, the radiological appearance of lesions and recurrence requiring reoperation have been inclusive using classical statistical methods on these data

Clinical characteristics of 138 Chinese female patients with idiopathic hypogonadotropic hypogonadism

Directory of Open Access Journals (Sweden)

Rui-yi Tang

2017-11-01

Full Text Available Objective: To evaluate the clinical features of Chinese women with idiopathic hypogonadotropic hypogonadism (IHH. Methods: We retrospectively reviewed the clinical characteristics, laboratory and imaging findings, therapeutic management and fertility outcomes of 138 women with IHH. All patients had been treated and followed up at an academic medical centre during 1990–2016. Results: Among the 138 patients, 82 patients (59.4% were diagnosed with normosmic IHH and 56 patients (40.6% were diagnosed with Kallmann syndrome (KS. The patients with IHH experienced occasional menses (4.3%, spontaneous thelarche (45.7% or spontaneous pubarche (50.7%. Women with thelarche had a higher percentage of pubarche (P < 0.001 and higher gonadotropin concentrations (P < 0.01. Olfactory bulb/sulci abnormalities were found during the magnetic resonance imaging (MRI of all patients with KS. Most patients with IHH had osteopenia and low bone age. Among the 16 women who received gonadotropin-releasing hormone treatment, ovulation induction or assisted reproductive technology, the clinical pregnancy rate was 81.3% and the live birth rate was 68.8%. Conclusions: The present study revealed that the phenotypic spectrum of women with IHH is broader than typical primary amenorrhoea with no secondary sexual development, including occasional menses, spontaneous thelarche or pubarche. MRI of the olfactory system can facilitate the diagnosis of KS. Pregnancy can be achieved after receiving appropriate treatment.

Job characteristics, core self-evaluations, and job satisfaction: what's age got to do with it?

Science.gov (United States)

Besen, Elyssa; Matz-Costa, Christina; Brown, Melissa; Smyer, Michael A; Pitt-Catsouphes, Martha

2013-01-01

There is a well-established relationship between age and job satisfaction. To date, there is little research about how many well-known predictors of job satisfaction, specifically job characteristics and core self-evaluations, may vary with age. Using a multi-worksite sample of 1,873 employed adults aged 17 to 81, this study evaluated the extent to which several job characteristics and core self-evaluations varied in their relationships with job satisfaction for workers of different ages. Findings suggest that the positive relationships between job satisfaction and skill variety, autonomy, and friendship weaken as employee age increases, while the positive relationships between job satisfaction and dealing with others, task identity, task significance, feedback, and core self-evaluations did not vary with age. The findings extend previous research by examining how the factors important for job satisfaction vary for employees of different ages.

Relevant patient characteristics for guiding tailored integrated diabetes primary care: a systematic review.

Science.gov (United States)

Hertroijs, Dorijn F L; Elissen, Arianne M J; Brouwers, Martijn C G J; Schaper, Nicolaas C; Ruwaard, Dirk

2018-02-06

Aim To identify which patient-related effect modifiers influence the outcomes of integrated care programs for type 2 diabetes in primary care. Integrated care is a widespread management strategy for the treatment of type 2 diabetes. However, most integrated care programs are not tailored to patients' needs, preferences and abilities. There is increasing consensus that such a patient-centered approach could improve the management of type 2 diabetes. Thus far, it remains unclear which patient-related effect modifiers should guide such an approach. PubMed, CINAHL and EMBASE were searched for empirical studies published after 1998. A systematic literature review was conducted according to the PRISMA guidelines. Findings In total, 23 out of 1015 studies were included. A total of 21 studies measured the effects of integrated diabetes care programs on hemoglobin A1c (HbA1c) and three on low-density lipoprotein cholesterol, systolic blood pressure and health-care utilization. In total, 49 patient characteristics were assessed as potential effect modifiers with HbA1c as an outcome, of which 46 were person or health-related and only three were context-related. Younger age, insulin therapy and longer disease duration were associated with higher HbA1c levels in cross-sectional and longitudinal studies. Higher baseline HbA1c was associated with higher HbA1c at follow-up in longitudinal studies. Information on context- and person-related characteristics was limited, but is necessary to help identify the care needs of individual patients and implement an effective integrated type 2 diabetes tailored care program.

The effects of high custom made shoes on gait characteristics and patient satisfaction in hemiplegic gait.

Science.gov (United States)

Eckhardt, Martine M; Mulder, Mascha C Borgerhoff; Horemans, Herwin L; van der Woude, Luc H; Ribbers, Gerard M

2011-10-01

To determine the effects of a temporary high custom made orthopaedic shoe on functional mobility, walking speed, and gait characteristics in hemiplegic stroke patients. In addition, interference of attentional demands and patient satisfaction were studied. Clinical experimental study. University Medical Centre. Nineteen stroke patients (12 males; mean age 55 years (standard deviation (SD) 10 years); mean time post onset 3.6 months (SD 1.4 months)) with a spastic paresis of the lower extremity. Functional mobility was assessed with the timed up and go test, walking speed and gait characteristics were measured with clinical gait analysis and performed with and without a verbal dual task. Patient satisfaction was determined with a questionnaire. Walking with the high orthopaedic shoe resulted in improved functional mobility (22%; pshoes. The dual task interfered with functional mobility during walking. The interference was equally big for normal shoes as for the orthopaedic shoe. Patients evaluated walking with the high orthopaedic shoe as an improvement (psafety, walking distance and walking speed. In the early recovery phase after stroke, when regaining walking ability, a temporary high orthopaedic shoe can improve hemiplegic gait, even with dual task interference. Copyright © 2011 Elsevier B.V. All rights reserved.

Clinical characteristics of patients seizure following the 2016 Kumamoto earthquake.

Science.gov (United States)

Inatomi, Yuichiro; Nakajima, Makoto; Yonehara, Toshiro; Ando, Yukio

2017-06-01

To investigate the clinical characteristics of patients with seizure following the 2016 Kumamoto earthquake. We retrospectively studied patients with seizure admitted to our hospital for 12weeks following the earthquake. We compared the clinical backgrounds and characteristics of the patients: before (the same period from the previous 3years) and after the earthquake; and the early (first 2weeks) and late (subsequent 10weeks) phases. A total of 60 patients with seizure were admitted to the emergency room after the earthquake, and 175 (58.3/year) patients were admitted before the earthquake. Of them, 35 patients with seizure were hospitalized in the Department of Neurology after the earthquake, and 96 (32/year) patients were hospitalized before the earthquake. In patients after the earthquake, males and non-cerebrovascular diseases as an epileptogenic disease were seen more frequently than before the earthquake. During the early phase after the earthquake, female, first-attack, and non-focal-type patients were seen more frequently than during the late phase after the earthquake. These characteristics of patients with seizure during the early phase after the earthquake suggest that many patients had non-epileptic seizures. To prevent seizures following earthquakes, mental stress and physical status of evacuees must be assessed. Copyright © 2017. Published by Elsevier Ltd.

Patient Characteristics and Outcomes in Institutional and Community Long-Term Care.

Science.gov (United States)

Braun, Kathryn L.; And Others

1991-01-01

Examined three-way relationships among patient characteristics, type of care (admission to nursing home or community setting), and 6-month outcomes of 352 long-term care patients. Found that patient characteristics influenced type of care received and that substantial portions of variance in outcomes were attributable to initial differences among…

Patient Characteristics Predicting Readmission Among Individuals Hospitalized for Heart Failure.

Science.gov (United States)

O'Connor, Melissa; Murtaugh, Christopher M; Shah, Shivani; Barrón-Vaya, Yolanda; Bowles, Kathryn H; Peng, Timothy R; Zhu, Carolyn W; Feldman, Penny H

2016-02-01

Heart failure is difficult to manage and increasingly common with many individuals experiencing frequent hospitalizations. Little is known about patient factors consistently associated with hospital readmission. A literature review was conducted to identify heart failure patient characteristics, measured before discharge, that contribute to variation in hospital readmission rates. Database searches yielded 950 potential articles, of which 34 studies met inclusion criteria. Patient characteristics generally have a very modest effect on all-cause or heart failure-related readmission within 7 to 180 days of index hospital discharge. A range of cardiac diseases and other comorbidities only minimally increase readmission rates. No single patient characteristic stands out as a key contributor across multiple studies underscoring the challenge of developing successful interventions to reduce readmissions. Interventions may need to be general in design with the specific intervention depending on each patient's unique clinical profile. © The Author(s) 2015.

Semen analysis in fertile patients undergoing vasectomy: reference values and variations according to age, length of sexual abstinence, seasonality, smoking habits and caffeine intake.

Science.gov (United States)

Sobreiro, Bernardo Passos; Lucon, Antonio Marmo; Pasqualotto, Fábio Firmbach; Hallak, Jorge; Athayde, Kelly Silveira; Arap, Sami

2005-07-07

Recent studies have shown regional and population differences in semen characteristics. The objective was to establish reference values for semen analysis and to verify the effect that age, length of sexual abstinence, seasonality, smoking habits and coffee consumption have on fertile individuals' semen characteristics. Prospective study in the Urology Division, Hospital das Clínicas, Universidade de São Paulo. Between September 1999 and August 2002, 500 fertile men requesting a vasectomy for sterilization purposes were asked to provide a semen sample before the vasectomy. We evaluated the effects of age, sexual abstinence, seasonality, smoking and coffee consumption on semen characteristics. Compared with World Health Organization values, 87.2% of the patients presented sperm morphology below the normal level. A significant decline in semen volume, sperm motility and sperm morphology in patients over 45 years of age was observed. In patients with 5 days or more of abstinence, there was reduced sperm motility. The lowest values for sperm concentration, motility and morphology were observed in summer and the highest in winter. No differences in semen parameters relating to smoking were detected. Patients who drank six or more cups of coffee per day presented higher sperm motility. Our sample had a very low percentage of normal sperm morphology. Only sperm morphology showed a high abnormality rate. Differences in semen parameters with regard to age, length of sexual abstinence, seasonality and coffee consumption were identified. No differences relating to smoking were detected.

The Effect of Patient Characteristics and Sleep Quality on Visual Field Performance Reliability

Directory of Open Access Journals (Sweden)

Swarup S. Swaminathan

2018-01-01

Full Text Available Purpose. To investigate the association of automated visual field (VF reliability indices (false positive [FP], false negative [FN], and fixation loss [FL] and sleep quality, VF experience, and age. Methods. Prospective, cross-sectional study. Adult patients (age ≥ 18 years completing automated VF testing were invited to participate. Baseline participant characteristics were obtained, and all participants were asked to complete the Pittsburgh Sleep Quality Index (PSQI questionnaire. Nonparametric Spearman correlations and logistical regression models were performed. Results. 63 patients were enrolled. Lower PSQI score was correlated with higher percentage (% FL in the right eye (p=0.03. Fewer prior VF was significantly correlated with higher %FP in the right eye (p=0.008. Older age was significantly correlated with higher %FN in the left eye (p=0.01. Greater mean deviation (MD and pattern standard deviation (PSD were strongly correlated with higher %FN in the right (p=0.02 and 0.002, resp. and left eyes (p=0.01 and 0.02, resp.. Conclusion. In this prospective, cross-sectional study, worse MD and PSD are strongly correlated with increased FN in both eyes. Increased FN in the left eye associated with older age might be attributable to test fatigue. Worse sleep quality is associated with decreased FL in the right eye.

Office-Based vs Traditional Operating Room Management of Recurrent Respiratory Papillomatosis: Impact of Patient Characteristics and Disease Severity.

Science.gov (United States)

Tatar, Emel Çadalli; Kupfer, Robbi A; Barry, Jonnae Y; Allen, Clint T; Merati, Albert L

2017-01-01

Management of recurrent respiratory papillomatosis (RRP) in adults has evolved to include office-based laser techniques. To determine whether demographic or disease characteristics differ between patients undergoing office-based (office group) vs traditional operating room (OR group) surgical approaches for RRP. This study was a medical record review of adult patients with RRP treated between January 2011 and September 2013 at a tertiary care center. Patients were divided into 2 groups according to the setting in which the patient had the most procedures during the past 2 years. Demographic and disease characteristics were compared between patients receiving predominantly office-based vs predominantly OR management. Of 57 patients (47 male and 10 female, with a mean [SD] age of 53.5 [16.4] years) treated during the 2-year period, 34 patients underwent predominantly office-based management and 23 patients underwent predominantly OR management. Sex, age, and weight were not statistically significantly different between the 2 groups. Patients in the OR group had a younger age at RRP diagnosis (mean [SD], 28.7 [22.0] years in the OR group and 45.5 [20.5] years in the office group), with a mean difference of 16.8 years (95% CI, -28.3 to -5.4 years). Patients in the OR group also had a significantly higher Derkay score (mean [SD], 15.1 [5.7] in the OR group and 10.7 [5.0] in the office group), with a mean difference of 4.4 (95% CI, 1.6-7.3). No statistically significant differences in comorbidities were observed between the 2 groups except for type 1 or 2 diabetes, which was more common in the OR group. There were 5 patients (22%) with diabetes in the OR group and 1 patient (3%) with diabetes in the office group, with a mean difference of 19% (95% CI, 2.7%-35%). In a subanalysis that excluded patients with juvenile-onset RRP, Derkay score (mean [SD], 13.9 [4.5] in the OR group and 10.8 [5.1] in the office group), with a mean difference of 3.1 (95% CI, 0.5-6.1), and the

[Optimal Operational Definition of Patient with Peptic Ulcer Bleeding for Big Data Analysis Using Combination of Clinical Characteristics in a Secondary General Hospital].

Science.gov (United States)

Lee, Jae Won; Kim, Hyun Ki; Woo, Yong Sik; Jahng, Jaehoon; Jin, Young Ran; Park, Jong Heon; Kim, Yong Sung; Jung, Hwoon Yong

2016-08-25

Peptic ulcer bleeding (PUB) is the most common cause of upper gastrointestinal bleeding in Korea but there has been no research done using big data. This study evaluates the optimal operational definition (OD) for big data research by analyzing clinical characteristics of PUB. We reviewed the clinical characteristics of 92 patients with PUB confirmed on endoscopy in Wonkwang University Sanbon Hospital (January 2013 to December 2014). We calculated sensitivity and positive predictive value (PPV) to detect confirmed PUB patients using ODs developed by combining clinical features of patients with PUB. The mean patient age was 63 years. Men had higher prevalence of PUB than women. Bleeding gastric ulcer was proportionately common in the age range of 40s to 60s in men, while a significantly higher rate of bleeding occurred in women older than 70s. The rate of drug-induced ulcer was 28.2%, whereas the prevalence of Helicobacter pylori was 47.8%. Among the hospitalized patients with diagnostic code of PUB, we ruled out patients with endoscopic removal of gastric adenoma or peritonitis, and selected patients who had been administered intravenous proton pump inhibitor. The sensitivity in this setting was 82.6%, and PPV was 88.4%. PUB was more common in older patients, and there was a clear gender difference in gastric ulcer bleeding by age. With a proper OD using PUB diagnostic codes, we can identify true patients with sufficiently high sensitivity and PPV.

Concurrent chemoradiotherapy for limited-disease small cell lung cancer in elderly patients aged 75 years or older

International Nuclear Information System (INIS)

Shimizu, Toshio; Sekine, Ikuo; Sumi, Minako

2007-01-01

The optimal treatment for limited-disease small cell lung cancer (LD-SCLC) in patients aged 75 years or older remains unknown. Elderly patients with LD-SCLC who were treated with chemoradiotherapy were retrospectively reviewed to evaluate their demographic characteristics and the treatment delivery, drug toxicities and antitumor efficacy. Of the 94 LD-SCLC patients treated with chemotherapy and thoracic radiotherapy at the National Cancer Center Hospital between 1998 and 2003, seven (7.4%) were 75 years of age or older. All of the seven patients were in good general condition, with a performance status of 0 or 1. Five and two patients were treated with early and late concurrent chemoradiotherapy, respectively. While the four cycles of chemotherapy could be completed in only four patients, the full dose of radiotherapy was completed in all of the patients. Grade 4 neutropenia and thrombocytopenia were noted in seven and three patients, respectively. Granulocyte-colony stimulating factor support was used in five patients, red blood cell transfusion was administered in two patients and platelet transfusion was administered in one patient. Grade 3 or more severe esophagitis, pneumonitis and neutropenic fever developed in one, two and three patients, respectively, and one patient died of radiation pneumonitis. Complete response was achieved in six patients and partial response in one patient. The median survival time was 24.7 months, with three disease-free survivors for more than 5 years. Concurrent chemoradiotherapy promises to provide long-term benefit with acceptable toxicity for selected patients of LD-SCLC aged 75 years or older. (author)

Demographic characteristics and visual status of patients undergoing cataract surgery at a tertiary hospital in Kano, Nigeria.

Science.gov (United States)

Kurawa, Musbahu Sani; Abdu, Lawan

2017-01-01

Objective/Purpose: To describe the demographic and baseline ocular characteristics, prevalence of blindness and visual impairment among patients undergoing extracapsular cataract extraction for age related cataract at the study hospital over a one year period. Materials/Patients: All consecutive patients aged 40 years and above identified with age related cataract in one or both eyes who voluntarily agree to participate were included. The study adhered to the tenets of the Helsinki declaration. Written informed consent was obtained from all eligible patients. All patients underwent basic eye examination by the ophthalmologist. Visual impairment was determined for each eye according to the standard WHO categorizations. Information obtained also included age, sex and history of previous cataract surgery. Data were recorded in manual tally sheets and on modified computer Cataract Surgery Record forms. Analyses were done using SPSS (version 16, SPSS Inc., Chicago, USA). The participation rate was 91.2%. There were 495 eyes of 487 consecutive patients. This include 212 males and 275 females (M:F, 1:1.3). The age range was 40 to 99 years with a mean age of 62.76 ± 10.49 years (61.35 ± 9.75 years in men and 63.85±10.9 years in females). Most of the patients (n = 451; 92.6%, 95% CI: 89.9-94.6%) were aged 50 years and above. Sixty patients (12.3%, 95% CI: 9.6-15.5%) had cataract in both eyes, 427 (87.7%, 95% CI: 84.5-90.3%) were in one eye. Among these, preoperatively 16 (3.3%, 95% CI: 2.0-5.3%) had aphakia, 21 (4.3%, 95% CI: 2.8-6.5%) had uniocular pseudophakia. About 63.2% (95% CI: 58.9-67.4%) of patients had normal vision in the better eye (presenting VA ≥6/18). Overall 9.5% (95% CI: 7.3-12.7%) were bilaterally blind. About 96.8% of eyes (95% CI: 94.5-98.0%) undergoing cataract surgery were blind (presenting VAConclusion: The study highlights preponderance of females and high incidence of blinding cataract. Education and early disease awareness may play an important

Characteristic risk factors in cirrhotic patients for posthepatectomy complications: comparison with noncirrhotic patients.

Science.gov (United States)

Itoh, Shinji; Uchiyama, Hideaki; Kawanaka, Hirofumi; Higashi, Takahiro; Egashira, Akinori; Eguchi, Daihiko; Okuyama, Toshiro; Tateishi, Masahiro; Korenaga, Daisuke; Takenaka, Kenji

2014-02-01

There seemed to be characteristic risk factors in cirrhotic patients for posthepatectomy complications because these patients have less hepatic reserve as compared with noncirrhotic patients. The aim of the current study was to identify these characteristic risk factors in cirrhotic patients. We performed 419 primary hepatectomies for hepatocellular carcinoma. The patients were divided into the cirrhotic group (n = 198) and the noncirrhotic group (n = 221), and the risk factors for posthepatectomy complications were compared between the groups. Thirty-six cirrhotic patients (18.2%) experienced Clavien's Grade III or more complications. Tumor size, intraoperative blood loss, duration of operation, major hepatectomy (two or more segments), and necessity of blood transfusion were found to be significant risk factors in univariate analyses. Multivariate analysis revealed that major hepatectomy and intraoperative blood loss were independent risk factors for posthepatectomy complications in patients with cirrhosis. On the other hand, the duration of operation was only an independent risk factor for posthepatectomy complication in noncirrhotic patients. Cirrhotic patients should avoid a major hepatectomy and undergo a limited resection preserving as much liver tissue as possible and meticulous surgical procedures to lessen intraoperative blood loss are mandatory to prevent major posthepatectomy complications.

Patient characteristics associated with measurement of routine diabetes care: an observational study.

Directory of Open Access Journals (Sweden)

Arna L Van Doorn-Klomberg

Full Text Available Non-modifiable patient characteristics, including age, gender, ethnicity as well as the occurrence of multi-morbidities, are associated with processes and outcomes of diabetes care. Information on these factors can be used in case mix adjustment of performance measures. However, the practical relevance of such adjustment is not clear. The aim of this study was to assess the strength of associations between patient factors and diabetes care processes and outcomes.We performed an observational study based on routinely collected data of 12,498 diabetes patients in 59 Dutch primary care practices. Data were collected on patient age, gender, whether the patient lived in a deprived area, body mass index and the co-occurrence of cardiovascular disease, chronic obstructive pulmonary disease, depression or anxiety. Outcomes included 6 dichotomous measures (3 process and 3 outcome related regarding glycosylated hemoglobin, systolic blood pressure and low density lipoprotein-cholesterol. We performed separate hierarchical logistic mixed model regression models for each of the outcome measures.Each of the process measure models showed moderate effect sizes, with pooled areas under the curve that varied between 0.66 and 0.76. The frequency of diabetes related consultations as a measure of patient compliance to treatment showed the strongest association with all process measures (odds ratios between 5.6 and 14.5. The effect sizes of the outcome measure models were considerably smaller than the process measure models, with pooled areas under the curve varying from 0.57 to 0.61.Several non-modifiable patient factors could be associated with processes and outcomes of diabetes care. However, associations were small. These results suggest that case-mix correction or stratification in assessing diabetes care has limited practical relevance.

Psychoneurologic characteristics of patients with type 2 diabetes mellitus and diabetic polyneuropathy

Directory of Open Access Journals (Sweden)

Natalya Alexandrovna Belyakova

2010-12-01

Full Text Available Aim. To study psychologic and neurologic characteristics and their interrelationship in patients with type 2 diabetes mellitus (DM. Materials and methods. The study included 167 women aged 54.2?0.4 years with DM2 9.9?0.51 years in duration. Severity of DM was estimatedfrom the presence of late complications and labile clinical course of the disease. Diabetic peripheral polyneuropathy was diagnosed basedon clinical symptoms, NSS and NDS scales. The psychological status was studied by the Spielberger-Khanin method with the assessment of reactive(situational (PX-1 and personal (PX-2 anxiety. Results. Most CD2 patients presented with moderate (NDS and severe (NSS polyneuropathy. It became aggravated as DM duration increased,with subjective symptomatics prevailing over objective one. The psychologic status of the patients was characterized by moderate depression andfrequent anxiety episodes in which personal anxiety prevailed over situational one. The latter was associated with macroangiopathy and thelatter with severe polyneuropathy. Depression most frequently occurred in patients with CHD, obesity, and decompensated carbohydrate metabolism. Conclusion. The above peculiarities of psychologic and neurologic status of DM2 patients should be taken into account when planning their outandinpatient treatment and education.

SPECT of aged backache patients

Energy Technology Data Exchange (ETDEWEB)

Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki [Prefectural Tajimi Hospital, Gifu (Japan)

1995-12-01

Single photon emission computed tomography (SPECT) using {sup 99m}Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. {sup 99m}Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.).

Age-specific mortality among TB patients in Denmark 1998-2010

DEFF Research Database (Denmark)

Fløe, Andreas; Løkke, Anders; Ibsen, Rikke

Objective: To evaluate the age-specific mortality in a national TB cohort, and to estimate relative age-specific mortality compared with matched controls, in a retrospective case-control study. Methods: Using Danish National Patient Registry, we retrospectively identified TB-patients between 1998...... to matched controls. While the difference in survival is substantial among elderly patients, a high relative risk of dying is particularly of concern among young and middle-aged adult TB patients....

Characteristic Motor and Nonmotor Symptoms Related to Quality of Life in Drug-Naïve Patients with Late-Onset Parkinson Disease.

Science.gov (United States)

Park, Hea Ree; Youn, Jinyoung; Cho, Jin Whan; Oh, Eung-Seok; Kim, Ji Sun; Park, Suyeon; Jang, Wooyoung; Park, Jin Se

2018-01-01

Unlike young-onset Parkinson disease (YOPD), characteristics of late-onset PD (LOPD) have not yet been clearly elucidated. We investigated characteristic features and symptoms related to quality of life (QoL) in LOPD patients. We recruited drug-naïve, early PD patients. The patient cohort was divided into 3 subgroups based on patient age at onset (AAO): the YOPD group (AAO patients, 26 were in the YOPD group, 74 in the MOPD group, and 32 in the LOPD group. Among parkinsonian symptoms, patients in the LOPD group had a lower score on the Korean version of the Montreal Cognitive Assessment than the other groups. Logistic regression analysis showed genitourinary symptoms were related to the LOPD group. Linear regression analysis showed both MS and NMS were correlated with QoL in the MOPD group, but only NMS were correlated with QoL in the LOPD group. Particularly, anxiety and fatigue affected QoL in the LOPD group. LOPD patients showed different characteristic clinical features, and different symptoms were related with QoL for LOPD than YOPD and MOPD patients. © 2018 S. Karger AG, Basel.

Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China.

Science.gov (United States)

Wang, Wanpeng; Zhou, Yalan; Zeng, Jun; Shi, Meng; Chen, Baihua

2017-09-01

Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China. A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system. Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p firework-related ocular trauma occurred during the months adjacent to the Chinese New Year

The effectiveness of SMS Reminders and the impact of patient characteristics on missed appointments in a public dental outpatient clinic

Directory of Open Access Journals (Sweden)

Emilia Bellucci

2017-03-01

Full Text Available This paper reports on the Failure To Attend (FTA rate of appointments as well as patients following the implementation of SMS reminders in a public dental outpatient service.  Given the ineffectiveness of the intervention and a highly representative patient’s profile, this paper identifies the demographic characteristics of patients who miss all of their appointments.  Data on appointment attendance, patient demographics and dental service type was collected over a time period of 46 consecutive months.  Using descriptive and inferential statistics (chi-square, two sample tests and Marascuilo procedure we found the SMS intervention was ineffective in reducing the FTA rates. Further, patients associated with high rates of non-attendance exhibited one or more of the following characteristics: male; age 26 – 44; non-concession card holders; a person of Indigenous, local, Asian or African descent, and of refugee status, persons living in low socio-economic areas; and appointments in General Care and Student Clinics. Whilst the literature overwhelmingly attributes SMS reminders to improving the attendance rate of patients in outpatient clinics, our contradictory findings suggest a more targeted approach in settings whose patients exhibit strong characteristics associated with non-attendance.

Subsolid pulmonary nodule morphology and associated patient characteristics in a routine clinical population

Energy Technology Data Exchange (ETDEWEB)

Mets, Onno M.; Jong, Pim A. de [University Medical Center Utrecht, Radiology, Utrecht (Netherlands); Scholten, Ernst T.; Chung, Kaman; Ginneken, Bram van [Radboud University Nijmegen Medical Centre, Diagnostic Imaging Analysis Group, Nijmegen (Netherlands); Schaefer-Prokop, Cornelia M. [Radboud University Nijmegen Medical Centre, Diagnostic Imaging Analysis Group, Nijmegen (Netherlands); Meander Medical Center, Radiology, Amersfoort (Netherlands)

2017-02-15

To determine the presence and morphology of subsolid pulmonary nodules (SSNs) in a non-screening setting and relate them to clinical and patient characteristics. A total of 16,890 reports of clinically obtained chest CT (06/2011 to 11/2014, single-centre) were searched describing an SSN. Subjects with a visually confirmed SSN and at least two thin-slice CTs were included. Nodule volumes were measured. Progression was defined as volume increase exceeding the software interscan variation. Nodule morphology, location, and patient characteristics were evaluated. Fifteen transient and 74 persistent SSNs were included (median follow-up 19.6 [8.3-36.8] months). Subjects with an SSN were slightly older than those without (62 vs. 58 years; p = 0.01), but no gender predilection was found. SSNs were mostly located in the upper lobes. Women showed significantly more often persistent lesions than men (94 % vs. 69 %; p = 0.002). Part-solid lesions were larger (1638 vs. 383 mm{sup 3}; p < 0.001) and more often progressive (68 % vs. 38 %; p = 0.02), compared to pure ground-glass nodules. Progressive SSNs were rare under the age of 50 years. Logistic regression analysis did not identify additional nodule parameters of future progression, apart from part-solid nature. This study confirms previously reported characteristics of SSNs and associated factors in a European, routine clinical population. (orig.)

Subsolid pulmonary nodule morphology and associated patient characteristics in a routine clinical population

International Nuclear Information System (INIS)

Mets, Onno M.; Jong, Pim A. de; Scholten, Ernst T.; Chung, Kaman; Ginneken, Bram van; Schaefer-Prokop, Cornelia M.

2017-01-01

To determine the presence and morphology of subsolid pulmonary nodules (SSNs) in a non-screening setting and relate them to clinical and patient characteristics. A total of 16,890 reports of clinically obtained chest CT (06/2011 to 11/2014, single-centre) were searched describing an SSN. Subjects with a visually confirmed SSN and at least two thin-slice CTs were included. Nodule volumes were measured. Progression was defined as volume increase exceeding the software interscan variation. Nodule morphology, location, and patient characteristics were evaluated. Fifteen transient and 74 persistent SSNs were included (median follow-up 19.6 [8.3-36.8] months). Subjects with an SSN were slightly older than those without (62 vs. 58 years; p = 0.01), but no gender predilection was found. SSNs were mostly located in the upper lobes. Women showed significantly more often persistent lesions than men (94 % vs. 69 %; p = 0.002). Part-solid lesions were larger (1638 vs. 383 mm"3; p < 0.001) and more often progressive (68 % vs. 38 %; p = 0.02), compared to pure ground-glass nodules. Progressive SSNs were rare under the age of 50 years. Logistic regression analysis did not identify additional nodule parameters of future progression, apart from part-solid nature. This study confirms previously reported characteristics of SSNs and associated factors in a European, routine clinical population. (orig.)

Characteristics of Brain Perfusion in Patients of Parkinson's Disease

International Nuclear Information System (INIS)

Jeong, Young Jin; Park, Min Jung; Kim, Jae Woo; Kang, Young Kang

2008-01-01

It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Two hundred nineteen patients (M: 70, F: 149, mean age: 62.9±6.9 y/o) who were diagnosed as PD without dementia clinically and 55 patients (M: 15, F: 40, mean age: 61.4±9.2 y/o) as normal controls who had no past illness history were performed 99m Tc-HMPAO brain perfusion SPECT and neuropsychological test. At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood

[The characteristics of pathological gambling patients: a study of 105 pathological gamblers treated at a psychiatric institution].

Science.gov (United States)

Ohta, Kensuke

2008-01-01

Although pathological gambling has serious personal and societal consequences, little empirical research has been conducted on this subject in Japan. The purpose of this study was to more fully elucidate the characteristics of pathological gamblers in Japan. A retrospective examination of the medical records of 105 pathological gamblers (mean age: 38.9 years; male: 79%) treated at a psychiatric institution was performed. Several factors were analyzed: sociodemographics; gambling behavior and associated complications; family history; and childhood maltreatment. The mean educational duration was 12.8 years, 18% of the patients were divorced, and 23% were unemployed. Their high education and divorce rates were significantly greater than normal. Furthermore, 30% of the patients suffered from depression, 18% were alcoholics, 48% had a family history of mental illness (addiction, 32%; mood disorder, 12%), 38% grew up in dysfunctional families, and 54% started gambling when they were in their teens. Female patients started gambling significantly later than male patients, but there were no significant differences in the onset of their illness in relation to their duration of gambling between males and females. Over 20% of the patients had lost control over their gambling habits within 2 years of their starting to gamble. In addition, 91% of the patients played pachinko, a Japanese machine which is similar to a slot machine. Additionally, 95% of the patients had debts, and 34% had gone bankrupt. The total amount of debt owed was significantly correlated with the duration of this disorder. This study describes several characteristics of pathological gamblers in Japan. In particular, the author determined that many patients started gambling at a young age, and the duration of pathological gambling was significantly correlated with the amount of debt owed. These findings show the importance of the prevention and early detection of pathological gambling.

Psychological characteristics of systemic sclerosis patients and their correlation with major organ involvement and disease activity.

Science.gov (United States)

Golemati, Christina V; Moutsopoulos, Haralampos M; Vlachoyiannopoulos, Panayiotis G

2013-01-01

The aim of this paper is to assess the psychological characteristics of personality, depression, anxiety, social support and coping strategies of systemic sclerosis (SSc) patients, their inter-correlations and their association with clinical symptoms. Patients with SSc (n=85) were interviewed and compared to rheumatoid arthritis (RA) patients (n=120) and healthy controls (HCs [n=125]). Psychological characteristics were assessed by the following psychometric scales: centre of epidemiological studies of depression (CES-D), hospital anxiety and depression scale (HAD), Eysenck personality questionnaire (EPQ), short form of social support (SSq), life experiences survey (LES) and ways of coping (WoC). Clinical data were collected at the same time of the interview. Both control groups were matched to SSc patients in terms of gender, age and educational status. Data were analysed with SPSS software. Compared to control groups, SSc patients expressed more symptoms of depression and anxiety, showed less extraversion and reported more negative life events. They coped less often with positive reappraisal, problem solving, seeking of support and assertiveness, while they sought more often divine help, and they expressed wishing and denial. Inactive disease was associated with a lower probability of reporting depressive symptoms and negative life events and with a higher probability of positively reevaluating a problem. Lung dysfunction, skin involvement, esophageal problems and oral aperture correlated with psychological features. Complications in psychological well-being characterise patients with SSc. This finding, as well as that of psychological characteristics correlating with organic factors, is an indication for designing supportive psycho-educational programmes as complementary therapies.

Clinical characteristics associated with Borrelia burgdorferi sensu lato skin culture results in patients with erythema migrans.

Directory of Open Access Journals (Sweden)

Franc Strle

Full Text Available Clinical characteristics associated with isolation of Borrelia burgdorferi sensu lato from skin have not been fully evaluated. To gain insight into predictors for a positive EM skin culture, we compared basic demographic, epidemiologic, and clinical data in 608 culture-proven and 501 culture-negative adult patients with solitary EM. A positive Borrelia spp. skin culture was associated with older age, a time interval of >2 days between tick bite and onset of the skin lesion, EM ≥ 5 cm in diameter, and location of the lesion on the extremities, whereas several other characteristics used as clinical case definition criteria for the diagnosis of EM (such as tick bite at the site of later EM, information on expansion of the skin lesion, central clearing were not. A patient with a 15-cm EM lesion had almost 3-fold greater odds for a positive skin culture than patients with a 5-cm lesion. Patients with a free time interval between the tick bite and onset of EM had the same probability of a positive skin culture as those who did not recall a tick bite (OR=1.02; however, the two groups had >3-fold greater odds for EM positivity than patients who reported a tick bite with no interval between the bite and onset of the lesion. In conclusion, several yet not all clinical characteristics used in EM case definitions were associated with positive Borrelia spp. skin culture. The findings are limited to European patients with solitary EM caused predominantly by B. afzelii but may not be valid for other situations.

Characteristics of neuropathic pain in patients with spinal cord injury.

Science.gov (United States)

Jang, Joon Young; Lee, Seung Hoon; Kim, MinYoung; Ryu, Ju Seok

2014-06-01

To characterize neuropathic pain in patients with spinal cord injury (SCI) according to classification used in the study by Baron et al. (Baron classification), a classification of neuropathic pain based on the mechanism. To also compare the patterns of neuropathic pain in SCI patients with those in patients with other etiologies and to determine the differences in patterns of neuropathic pain between the etiologies. This was a descriptive cross-sectional study. We used the Baron classification to investigate the characteristics of neuropathic pain in SCI. Sixty-one SCI patients with neuropathic pain (The Leeds assessment of neuropathic symptoms and signs score ≥12) were enrolled in this study between November 2012 and August 2013, after excluding patients patients with visual analog scale (VAS) score patients, and patients with systemic disease or pain other than neuropathic pain. The most common pain characteristic was pricking pain followed by electrical pain and numbness. The mean VAS score of at-level neuropathic pain was 7.51 and that of below-level neuropathic pain was 6.83. All of the patients suffered from rest pain, but 18 (54.6%) patients with at-level neuropathic pain and 20 (50.0%) patients with below-level neuropathic pain suffered from evoked pain. There was no significant difference in between at-level and below-level neuropathic pains. The result was quite different from the characteristics of post-herpetic neuralgia, but it was similar to the characteristics of diabetic neuropathy as shown in the study by Baron et al., which means that sensory nerve deafferentation may be the most common pathophysiologic mechanism of neuropathic pain after SCI. Since in our study, we included short and discrete symptoms and signs based on diverse mechanisms, our results could be helpful for determining further evaluation and treatment.

Correlation between aging grade of T91 steel and spectral characteristics of the laser-induced plasma

Energy Technology Data Exchange (ETDEWEB)

Li, Jun [Power Electric College in South China University of Technology, Guangzhou 510640 (China); Lu, Jidong, E-mail: jdlu@scut.edu.cn [Power Electric College in South China University of Technology, Guangzhou 510640 (China); Dai, Yuan [Electric Power Research Institute of Guangdong Power Grid Company, Guangzhou 510080 (China); Dong, Meirong [Power Electric College in South China University of Technology, Guangzhou 510640 (China); Zhong, Wanli [Electric Power Research Institute of Guangdong Power Grid Company, Guangzhou 510080 (China); Yao, Shunchun [Power Electric College in South China University of Technology, Guangzhou 510640 (China)

2015-08-15

Highlights: • Laser-induced breakdown spectroscopy (LIBS) was first employed to estimate the aging grade of T91 steel. • The differences from the ionic-to-atomic ratio of the same elements indicated that the grade is the reason to cause the difference of the plasma characteristics. • Good unique value correlations between the peak intensity ratio of CrI/FeI, MoI/FeI and the aging grade were found. • The research indicates that LIBS technique is a potential way to estimate the aging grade of T91 steel. - Abstract: T91 steel with favorable mechanical performance has become the representative heat-resistant steel used as heat exchange surfaces in supercritical and ultra-supercritical boilers. The organizational structure and mechanical properties change during the service period, called material aging, which affects the service life and the equipment safety. To develop a fast and easy aging predictive technique of heat exchange metal surfaces, laser-induced breakdown spectroscopy (LIBS) was applied to investigate the plasma characteristics of T91 steel specimens with different aging grades. The metallographic structure, mechanical properties and spectral characteristics of the specimens were analyzed. Then, the correlations between the spectral characteristics and the aging grade were established. The analysis results show that the martensite substructure disappears, and the dimension of the carbide particles among the crystal lattices increases with aging. At the same time, the hardness of the samples gradually decreases. The peak intensities of both the matrix and the alloying element increases then decreases with aging, owing to the change of the metallography structure and mechanical properties. Furthermore, good unique value correlations between the intensity ratio of CrI/FeI, MoI/FeI and the aging grade are found. This demonstrates that LIBS is a possible new way to estimate the aging grade of metal materials.

Correlation between aging grade of T91 steel and spectral characteristics of the laser-induced plasma

International Nuclear Information System (INIS)

Li, Jun; Lu, Jidong; Dai, Yuan; Dong, Meirong; Zhong, Wanli; Yao, Shunchun

2015-01-01

Highlights: • Laser-induced breakdown spectroscopy (LIBS) was first employed to estimate the aging grade of T91 steel. • The differences from the ionic-to-atomic ratio of the same elements indicated that the grade is the reason to cause the difference of the plasma characteristics. • Good unique value correlations between the peak intensity ratio of CrI/FeI, MoI/FeI and the aging grade were found. • The research indicates that LIBS technique is a potential way to estimate the aging grade of T91 steel. - Abstract: T91 steel with favorable mechanical performance has become the representative heat-resistant steel used as heat exchange surfaces in supercritical and ultra-supercritical boilers. The organizational structure and mechanical properties change during the service period, called material aging, which affects the service life and the equipment safety. To develop a fast and easy aging predictive technique of heat exchange metal surfaces, laser-induced breakdown spectroscopy (LIBS) was applied to investigate the plasma characteristics of T91 steel specimens with different aging grades. The metallographic structure, mechanical properties and spectral characteristics of the specimens were analyzed. Then, the correlations between the spectral characteristics and the aging grade were established. The analysis results show that the martensite substructure disappears, and the dimension of the carbide particles among the crystal lattices increases with aging. At the same time, the hardness of the samples gradually decreases. The peak intensities of both the matrix and the alloying element increases then decreases with aging, owing to the change of the metallography structure and mechanical properties. Furthermore, good unique value correlations between the intensity ratio of CrI/FeI, MoI/FeI and the aging grade are found. This demonstrates that LIBS is a possible new way to estimate the aging grade of metal materials

Correlation between demographic characteristics, cognitive functioning and functional independence in stroke patients

Directory of Open Access Journals (Sweden)

Arsić Slađana

2016-01-01

Full Text Available Introduction. It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. Objective. The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. Methods. The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM test was used. The general cognition was estimated by the Mini-Mental State Examination (MMSE test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and χ2 test. Results. There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p<0.001; There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p<0.001; the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p<0.05; the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p<0.05; More severe cognitive impairment is common among women, the elderly and in persons with lower education (p<0.05. Conclusion. By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be

Tumoral expression on Her-2, E R and P R and its Clinico pathological characteristics relation in Uruguayan and Argentine patients with operable breast cancer

International Nuclear Information System (INIS)

Delgado, L; Richardet, E; Pallotta, G; Fresco, R; Aguiar, S; Camejo, N; Gonzalez, V; Ferrero, L; Heinzen, S; Martinez, A. and others

2010-01-01

Introduction: the study of biological subtype of breast cancer (B C) given by the expression tumor estrogen receptors (E R), progesterone (P R) and growth factor receptor and evolutionary. Objective: To know the profile of tumor expression of HER2, ER and P R and their relation with to characteristics clinico pathological characteristics in Uruguayan and Argentine patients with breast cancer. Material and Methods: The medical records of patients who underwent analyzed C M I-III invasive stages between 03/2006 and 03/2008 and assisted in Oncology Services where the authors are performing, which had selected determination ER, P R and HER2 by immunohistochemistry. The expression profile of these was markers compared with age at diagnosis, type and histological grade (GH) and pathological stage (TNM). Results: 291 patients (197 Uruguayan and 94 Argentine) were included whose characteristics were: mean age: 56 years, ductal carcinoma: 85%, GH 1-2: 55% stage I-II: 70%, metastasis axillary: 51%, ER / P R +: 78% HER2 + 12%. Three subtypes were defined: HER2 ER / P R + (71%), HER2 + (12% Uruguayan patients: 10%, Argentine patients: 17%) and negative Triple (TN) (17%). The joint analysis of the patients in both countries showed that subtypes TN and HER2 is associated with greater histological grade (p <0.05). Furthermore, in the group of patients Uruguayan, TN subtype was associated with younger age at diagnosis (p <0.05) subtype HER2, ER / PR +. Conclusions: The percentage of patients with CM Uruguayan invasive HER2 + subtype (10%) is smaller than that reported by other studies (17-28%) and that observed in our study Argentine group of patients. Consistent with previous studies, TN subtypes and HER2 + correlated with more undifferentiated tumors and in the group of Uruguayan patients TN appeared in younger patients

Do schizophrenia patients age early?

Science.gov (United States)

Shivakumar, Venkataram; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Ravi, Vasanthapuram; Gangadhar, Bangalore N

2014-08-01

The etiopathogenesis of schizophrenia is poorly understood. Within the proposed "neurodegeneration paradigm", observations have been put forth for "accelerated aging" in this disorder. This proposition is largely based on the neuroscience research that demonstrates progressive changes in brain as well as other systemic abnormalities supportive of faster aging process in patients with this disorder. In this review, we have summarized the literature related to the concept of early aging in schizophrenia. These studies include P300 abnormalities & visual motion discrimination, neuroimaging findings, telomere dynamics as well as neuropathology of related brain regions. We also propose a role of vitamin D, neuroimmunological changes and elevated oxidative stress as well as mitochondrial dysfunction in addition to the above factors with 'vitamin-D deficiency' as the central paradox. Put together, the evidence supporting early aging in schizophrenia is compelling and this requires further systematic studies. Copyright © 2014 Elsevier B.V. All rights reserved.

VARIABILITY IN LEVELS OF LOW-DENSITY LIPOPROTEINS CHOLESTEROL IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA DEPENDING ON AGE AND SEX AND ITS IMPORTANCE IN THE DIAGNOSIS OF THIS DISEASE

Directory of Open Access Journals (Sweden)

V. А. Korneva

2017-01-01

Full Text Available Aim. To study the ranges of low density lipoprotein (LDL cholesterol depending on the age and gender of patients with familial hypercholesterolemia (FHC by an example of a sample of patients living in the Republic of Karelia.Material and methods. Parameters of lipid spectrum of 219 patients (aged 52.5±1.7 years; males 38.3% with heterozygous FHC were studied before the start of statin therapy. Definite FHC was diagnosed in 102 patients. Lipid profile was estimated by enzymatic calorimetric method. The diagnosis of FHC was established according to the criteria of The Dutch Lipid Clinic Network.  Genetic analysis was performed in 102 patients (46.6%; pathogenic mutation in the LDL receptor was identified in 21 patients. The control group consisted of 539 people with the excluded diagnosis of FHC (aged 46.8±0.8 years; males 53.8%.Results. We determined the level of LDL cholesterol (LDLC associated with increased frequency of mutations of the LDL receptor in patients with definite FHC; mutation frequency was 3 times higher when LDLC level was more than 6.5 mmol/L. We revealed the following characteristic intervals of the LDLC levels in patients with a definite FHC: up to 20 years old – 4.8-6.2 mmol/l; in patients of 20-29 years old – 5.9-8.2 mmol/l; in the age range of 30-39 years the upper value of the LDLC levels reached 9.6 mmol/l; in individuals of 40-49 years old a stabilization, "plateau", was observed – LDLC level did not differ significantly compared to the previous decade, and was 5.4-9.0 mmol/l. In the age range  of 50-59 years the upper LDLC level was up to 11.4 mmol/l. Similar indicators were identified in patients aged 60-69 years. Patients older than 70 years with a definite FHC an upper level of LDLC was higher and reached 12.5 mmol/l. Tendency to increase in the characteristic values of LDLC with age was observed both in men and in women. Specific age-related trends  for men (an increase from a plateau by the age of 50

Some Characteristics of Patients with Community Acquired ...

African Journals Online (AJOL)

There is a dearth of studies relating the information from the history of patients with community-acquired pneumonia to the mortality of the disease. The relationship between age, sex, occupation, marital status, smoking history, alcohol use, concomitant COPD / bronchial asthma, source of referral and the mortality of patients ...

SPECIFIC CHARACTERISTICS OF BRAIN METASTASIZING IN PATIENTS WITH LUMINAL SUBTYPE OF BREAST CANCER

Directory of Open Access Journals (Sweden)

A. S. Balkanov

2016-01-01

Full Text Available Background: More than half of female patients with breast cancer are diagnosed with a  luminal subtype of the disease; however, specific characteristics of its metastases to the brain have been not well studied, unlike those of HER2 positive and triple negative subtypes. Aim: A  comparative analysis of characteristics of metastatic brain lesions in patients with luminal breast cancer. Materials and methods: The time from surgery for breast cancer to the first recurrence and to metastatic brain lesions (assessed by contrast-enhanced MRI imaging was measured in 41 patients with luminal subtype of breast cancer (median age, 49.5±9.6  years, depending on a  diameter of the primary tumor and numbers of involved axillary lymph nodes. Results: The time interval to occurrence of brain metastases in luminal subtype of breast cancer is not associated with the size of the tumor. If≥4  axillary lymph nodes are involved (N2–3, brain metastases are identified much earlier (p<0.05 than in patients with N0–1 (34.5±23.9 months and 62.7±50 months, respectively. Neither the size nor the involvement of axillary lymph nodes has any impact on the rates of metastatic lesion to the brain during the first recurrence. Conclusion: Brain metastases occur at a much shorter time in those patients of luminal subtype of breast cancer who have metastases in≥4  axillary lymph nodes. Brain metastases develop in 50% of patients with the first recurrence of the luminal subtype of breast cancer.

Age-stratified analysis of tumor markers and tumor characteristics in adolescents and young women with mature cystic teratoma

Directory of Open Access Journals (Sweden)

Huseyin Yesilyurt

2018-06-01

Full Text Available Background: Serum tumor markers are widely used for the preoperative evaluation of an adnexal mass. Elevations of cancer antigen (CA 125 and CA 19-9 have been reported in patients with mature cystic teratoma (MCT. The aim of the study is to investigate the relation of serum tumor markers with tumor characteristics in young women with MCT. Methods: We conducted a retrospective review of 157 patients under the age of 35 who underwent laparoscopic surgery for ovarian MCT. Patients were divided into two age groups: Group I (n = 80: adolescents/young adults (aged 13–25 years and Group II (n = 77: women aged 26–35 years. Data were analyzed for serum tumor markers, tumor size, and bilaterality. Results: The rates of elevated CA 125 and CA 19-9 were 10.7% and 31.5%, respectively, for Group I, and 13.9% and 26.5%, respectively, for Group II. The bilaterality rate was higher in Group II compared to Group I (19.5% vs. 8.8%, respectively, p = 0.04. Serum CA 125 and CA 19-9 elevations were not related to tumor size in Group I. In Group II, elevated levels of CA 125 were also unrelated to tumor size. However, significant elevation in CA 19-9 levels was observed when tumor size was larger than 4 cm in this age group (p = 0.004. Elevated CA 125 and CA 19-9 levels were not significantly associated with the presence of bilateral MCT in either group. Conclusion: The results of our study indicate that elevations of CA 19-9 are associated with larger tumor size in women aged 26–35 years, but not in adolescents/young adults. However, elevated serum CA 125 levels are not related to tumor size in either age group. Keywords: Adolescents, Mature cystic teratoma, Tumor marker, Tumor size, Young women

Age-related in-hospital mortality among patients with acute myocardial infarction

International Nuclear Information System (INIS)

Abid, A.R.; Rafique, S.; Ahmed, R.Z.; Anjum, A.H.; Tarin, S.M.A.

2004-01-01

Objective: To evaluate the in-hospital mortality of acute myocardial infarction among different age groups. Subjects and Methods: The subjects were 460 admitted patients of acute myocardial infarction who fulfilled our inclusion criteria. Patients were divided into four age groups. Group-I included patients in 20-40 years, group-II (41-50 years), group-III (51-60 years) and group-IV (>60 years). Mortality was compared between different age groups by Chi-square and linear-regression models. Results: The total in-hospital mortality was 16.7%. It gradually increased from 5.6% in group-I (20-40 years) patients to 21% in group-IV (>60 years) patients. While mortality in groups group-II (41-50 years) and group-III (51-60 years) patients was 16.7% and 18.6% respectively. A marked increase in mortality was noted with increase in age. Group- IV (>60 years) patients presented 2 hours late to the hospital than the group-I (20-40 years) patients. There was no statistical difference in site of infarction in different age groups. Old age (group-IV i.e. >60 years old) was more associated with heart failure (higher Killip class) on presentation. Lesser number of patients in group-IV received thrombolytic therapy than group-I. Only 31.09% patients in group-IV and 62.5% patients in group-I received streptokinase therapy respectively. Conclusion: In patients with acute myocardial infarction age was a powerful independent predictor of in-hospital mortality and complications. (author)

[Psychological characteristics in patients with allergic rhinitis and its associated factors analysis.].

Science.gov (United States)

Xi, Lin; Han, De-Min; Lü, Xiao-Fei; Zhang, Luo

2009-12-01

To investigate the psychological characteristics of patients with allergic rhinitis (AR) and its associated factors. Three hundred and seventy-seven patients with AR were evaluated by the Symptom Checklist-90 (SCL-90). The results were compared with a standard, obtained from healthy Chinese population, including factors of gender, age, educational level, medical history of AR, presence of complications, type of allergenic sensitizations and nasal symptoms (using logistic regression analysis). An abnormal psychological state was found in 10% of AR patients, 13% with deuto-healthy, and remaining 77% of AR patients were completely healthy. The SCL-90 scores of the 377 patients were significantly higher than those of the normal standard population, including symptoms of somatization, compulsion, anxiety, rivalry and psychosis (t equals 7.128, 3.943, 2.777, 6.423, 7.507, respectively, all P horror were respectively different in different AR case history (F equals respectively 2.379, 2.255, all P types, educational level, allergen types (all P > 0.05). Snuffle, sneeze and snivel had no influence on patient's SCL-90 scores (all P > 0.05). Itchy nose was a major symptom that affect on AR patients' SCL-90 scores of depression (standard regression b = 0.126, t = 2.076, P < 0.05). AR patients' psychological status was worse than that of the healthy adults.

[Characteristics of the diagnosis and treatment of pulmonary tuberculosis in patients with and without diabetes mellitus type 2].

Science.gov (United States)

Carrión-Torres, Omar; Cazorla-Saravia, Patrick; Torres Sales, José William; Yhuri Carreazo, Nilton; De La Cruz Armijo, Frank Enrique

2015-10-01

To determine whether there are demographic, clinical and radiological differences among patients with pulmonary tuberculosis (TB) and patients with TB and type 2 diabetes mellitus (DM2 + TB). Observational retrospective cohort study. We compared the clinical characteristics of patients according to sex, age, time to sputum conversion to negative, presence of cavitation and the cure rate, duration of treatment and the proportion of change of treatment regimen, in patients with and without DM2 served by the Tuberculosis Control Program from 2010 to 2012 in the Rebagliati Healthcare Network of Lima, Peru. 31 patients with TB+DM2 and 144 patients with TB were included. Differences (p<0.05) in the diagnostic method, the average of symptoms and the resistance pattern of TB among patients with and without DM2 were found. The presence of cavitation was more frequent in patients with TB + DM2. Having TB + DM2 delayed the time to sputum smear conversion to negative (RRa 4.16, 95% CI: 1.1-1.6) in the adjusted Cox regression analysis. There are differences in demographic, clinical and radiological characteristics in TB patients with and without DM2.The time to sputum conversion to negative is greater in patients with DM2.

Characteristics,correlates and outcomes of perceived stigmatization in bipolar disorder patients

DEFF Research Database (Denmark)

Nilsson, Kristine Kahr; Kugathasan, Pirathiv; Straarup, Krista Nielsen

2016-01-01

The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD).......The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD)....

Semen analysis in fertile patients undergoing vasectomy: reference values and variations according to age, length of sexual abstinence, seasonality, smoking habits and caffeine intake

Directory of Open Access Journals (Sweden)

Bernardo Passos Sobreiro

Full Text Available CONTEXT AND OBJECTIVE: Recent studies have shown regional and population differences in semen characteristics. The objective was to establish reference values for semen analysis and to verify the effect that age, length of sexual abstinence, seasonality, smoking habits and coffee consumption have on fertile individuals’ semen characteristics. DESIGN AND SETTING: Prospective study in the Urology Division, Hospital das Clínicas, Universidade de São Paulo. METHODS: Between September 1999 and August 2002, 500 fertile men requesting a vasectomy for sterilization purposes were asked to provide a semen sample before the vasectomy. We evaluated the effects of age, sexual abstinence, seasonality, smoking and coffee consumption on semen characteristics. RESULTS: Compared with World Health Organization values, 87.2% of the patients presented sperm morphology below the normal level. A significant decline in semen volume, sperm motility and sperm morphology in patients over 45 years of age was observed. In patients with 5 days or more of abstinence, there was reduced sperm motility. The lowest values for sperm concentration, motility and morphology were observed in summer and the highest in winter. No differences in semen parameters relating to smoking were detected. Patients who drank six or more cups of coffee per day presented higher sperm motility. CONCLUSIONS: Our sample had a very low percentage of normal sperm morphology. Only sperm morphology showed a high abnormality rate. Differences in semen parameters with regard to age, length of sexual abstinence, seasonality and coffee consumption were identified. No differences relating to smoking were detected.

The prognostic value of age for 1030 patients with early stage breast cancer after postoperative radiotherapy

International Nuclear Information System (INIS)

Xu Liming; Li Ruiying; Wang Ping; Xu Liang; Hao Jianlei; Liu Xiaobin; Pang Qingsong; Zhu Li; Cui Yong

2010-01-01

Objective: To analyze the prognostic value of age in patients with early stage breast cancer. Methods: The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage I, n = 227; and stage II , n = 241) received breast conserving surgery (BCS) and 562 (stage I, n =184; and stage II, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35, 136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60, 156 patients). The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results: The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110, 569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6.2%, 8.7% and 10.4% (χ 2 = 1.14, P= 0.567). The 5-year distant metastasis rates were 4.3% , 9.5 % and 2. 5% (χ 2 = 5.31 , P = 0.070) . The 5 - year survival rates were 91.2% , 92.6% and 82.1% (χ 2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ 2 = 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ 2 = 9.97, P = 0.007), and distant metastasis rates were 23%, 25% and 10% (χ 2 =8.51, P=0.014). Conclusions: The age is

Characteristic Processes in Close Peer Friendships of Preterm Infants at Age 12

Directory of Open Access Journals (Sweden)

Mary C. Sullivan

2012-01-01

Full Text Available Close friendships become important at middle-school age and are unexplored in adolescents born prematurely. The study aimed to characterize friendship behaviors of formerly preterm infants at age 12 and explore similarities and differences between preterm and full-term peers on dyadic friendship types. From the full sample of N=186, one hundred sixty-six 12-year-old adolescents (40 born full term, 126 born preterm invited a close friend to a 1.5 hour videotaped laboratory play session. Twenty adolescents were unable to participate due to scheduling conflicts or developmental disability. Characteristic friendship behaviors were identified by Q-sort followed by Q-factoring analysis. Friendship duration, age, and contact differed between the full-term and preterm groups but friendship activities, behaviors, and quality were similar despite school service use. Three Q-factors, leadership, distancing, and mutual playfulness, were most characteristic of all dyads, regardless of prematurity. These prospective, longitudinal findings demonstrate diminished prematurity effects at adolescence in peer friendship behavior and reveal interpersonal dyadic processes that are important to peer group affiliation and other areas of competence.

Quantification of pediatric and adult cervical vertebra-anatomical characteristics by age and gender for automotive application.

Science.gov (United States)

Parenteau, Chantal S; Wang, Nicholas C; Zhang, Peng; Caird, Michelle S; Wang, Stewart C

2014-01-01

The cervical anatomy has been shown to affect injury patterns in vehicle crashes. Characterizing the spine anatomy and changes associated with growth and gender is important when assessing occupant protection. In this study, selected cervical characteristics were quantified. Computed tomography (CT) scans of 750 patients were selected from the University of Michigan trauma database; 314 were children and 436 were adults. Four variables were obtained: the maximum spinal canal radius, vertebral body depth, facet angles, and retroversion angles. The cervical spine measurements varied with age and gender. The body depth increased nonlinearly with age. The average vertebral body depth at C4 was 9.2 ± 0.38 mm in the 0-3 age group, 15.7 ± 0.29 mm in the 18-29 age group, and 17.2 ± 0.46 mm in the 60+ age group. Pediatric and adult males had larger vertebral body depth than females overall, irrespective of vertebral level (P vertebral body depth was 8-9 percent greater in male children and 13-16 percent greater in adult males. The average radius varied with gender, with male children generally having a larger radius than females irrespective of vertebral level (P vertebral level (P maturation by the age of 7. Facet angles decreased with age in children and increased with age in adults. The average facet angles were largest in the 0-3 age group (P cervical anatomical changes associated with age and gender. The information is useful when assessing differences in injury patterns between different segments of the population. Anatomical measurements of the cervical spine should be considered for the development of models used to assess injury mechanisms for various occupant age groups.

[Beta-lactamic antibiotics allergy in cataract surgery. Prevalence and preoperative characteristics of allergic patients].

Science.gov (United States)

Fernández-Rubio, M E; Cuesta-Rodríguez, T; Urcelay-Segura, J L; Cortés-Valdés, C

2014-03-01

To describe the proportion of patients allergic to β-lactam antibiotics and the prevalence of preoperative conjunctival bacteria among those undergoing cataract surgery in our area. Retrospective cross-sectional study of prevalence of β-lactam allergic patients consecutively scheduled for cataract surgery from 11 July 2005 to November 2012. For studying the prevalence of conjunctival bacteria and clinical characteristics in the patients' preoperative examination, those under 18 years and those with cataract surgery combined with other eye surgeries were excluded. Data from the first preoperative examination of the remaining patients were selected. Clinical data were extracted from the database generated in the evaluation made for anesthetic purposes, and the microbiological data from the laboratory database. Both bases were linked through a patient history code. A comparison was made between the prevalence of conjunctival bacteria and clinical characteristics in allergic and non-allergic patients. From 12,409 adults selected for the bacteriological study, 862 (6.96%) were allergic to β-lactams, their mean age (74.45 years) was higher than that of the non-allergic (P=.005). The proportion of women (71.4%) in the allergic patient group was much higher than that of men. The prevalence of pathogenic bacteria (especially Bacillus spp and Pseudomonas aeruginosa), lung disease and heart failure, was higher in allergic patients. The prevalence of allergy to β-lactams in this study is within the range described in other populations. The higher prevalence of pathogenic bacteria and the predominance of women in those allergic to β-lactams are useful data to guide their surgical prophylaxis. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

The Characteristics of Male Patients Diagnosed with Osteoporosis - Original Investigation

Directory of Open Access Journals (Sweden)

İlknur Aktaş

2006-12-01

Full Text Available Aims: Evaluating the characteristics of male osteoporosis cases followed up in outpatient clinic. Material and Methods: The age, education status, alcohol, cigarette and coffee consumption, and nutritive habits of the male cases followed up in outpatient clinic between 2004-2005 were evaluated. Usage of toxic drugs and low energy fracture presence in the patient and his family were recorded. Sexual function was evaluated. Total blood count, comprehensive biochemical analyses, and bone mineral density (BMD measurement (DXA Hologic were applied. Results: The mean age of the 55 study subjects was 61.7 ± 14.69 (age range: 22-85. 49.09% of the cases graduated from university, 29.09% high school, and 21.81% primary school. 78.2% of the cases were not using alcohol at all, 5.5% of them drinks alcohol one glass a day, and 3.6% of them have a few glasses a week. The nonsmokers were 89%, the ones that smokes up to 5 cigarettes a day were 7.3%, and the ones who smokes more than 5 cigarettes a day were 3.7%. The percentage of cases that drinks more than 3 cups of coffee a day were 3.6%, the people who receive calcium-rich food were 69.1%, and the regularly exercising people were 49%. 40% of the cases manifested sexual dysfunction. Secondary diseases were determined in 67.3% of cases and 29.1% of them had a history of toxic drug usage. The percentages of having fracture history in patients and their families were, respectively, 16.4% and 10.9%. Mean total hip densitometry value T-score was -2.19 ± 0.89, and Lumbar 1-4 T-score was -2.63 ± 0.80. Conclusion: We can affirm about osteoporosis that it should be considered in men at advanced ages, secondary diseases and sexual hormones play significant roles as etiologic causes, and it effects especially lumbar region. (Osteoporoz Dünyasından 2006;12:84-6

Characteristics and prognostic factors for pain management in 152 patients with lung cancer

Directory of Open Access Journals (Sweden)

Shi L

2016-04-01

Full Text Available Lei Shi,1,* Yumei Liu,2,* Hua He,1 Cong Wang,1 Hongwei Li,1 Nanya Wang1 1Cancer Center, The First Hospital of Jilin University, Changchun, 2Department of Hematology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China *These authors contributed equally to this work Objective: The objective of this study was to analyze the pain characteristics and factors influencing the outcome of pain control in patients with lung cancer having pain. Methods: Pain characteristics, the effectiveness, and prognostic factors for pain control were analyzed in 152 patients with lung cancer having moderate or severe chronic pain admitted to Cancer Center of The First Hospital of Jilin University, People’s Republic of China, between January 2012 and May 2013. Information about sex, age, pathological type, TNM stage, presence/absence of bone metastases, characteristics of pain, methods, and effectiveness of pain management was recorded. Results: Patients with non-small-cell lung cancer and small-cell carcinoma accounted for 132/152 (86.8% and 20/152 (13.2% cases, respectively. Among them, moderate (72.4% or severe pain (27.6% was reported in 73.7% of the cases at stage IV, chest or back pain was reported in 76.3% of the cases, and pain in other locations in the rest of the cases. Bone metastases were apparent in 44.1% of the patients. Neuropathic pain was noted in 46.7% of the patients, and frequent breakthrough pain was noted in 25.7% of the patients. High pain intensity was associated with frequent breakthrough pain. Pain was adequately controlled in 81.6% of the patients prescribed 3 days of analgesics. More patients reported a KPS higher than or equal to 80 after 3 days of analgesic treatment (P<0.001. Severe pain, frequent breakthrough pain, and presence of bone metastases were independent risk factors for poor pain control. Severe pain, frequent breakthrough pain, or neuropathic pain in the patients using opioids required higher

Impact of early personal-history characteristics on the Pace of Aging: implications for clinical trials of therapies to slow aging and extend healthspan.

Science.gov (United States)

Belsky, Daniel W; Caspi, Avshalom; Cohen, Harvey J; Kraus, William E; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

2017-08-01

Therapies to extend healthspan are poised to move from laboratory animal models to human clinical trials. Translation from mouse to human will entail challenges, among them the multifactorial heterogeneity of human aging. To inform clinical trials about this heterogeneity, we report how humans' pace of biological aging relates to personal-history characteristics. Because geroprotective therapies must be delivered by midlife to prevent age-related disease onset, we studied young-adult members of the Dunedin Study 1972-73 birth cohort (n = 954). Cohort members' Pace of Aging was measured as coordinated decline in the integrity of multiple organ systems, by quantifying rate of decline across repeated measurements of 18 biomarkers assayed when cohort members were ages 26, 32, and 38 years. The childhood personal-history characteristics studied were known predictors of age-related disease and mortality, and were measured prospectively during childhood. Personal-history characteristics of familial longevity, childhood social class, adverse childhood experiences, and childhood health, intelligence, and self-control all predicted differences in cohort members' adulthood Pace of Aging. Accumulation of more personal-history risks predicted faster Pace of Aging. Because trials of anti-aging therapies will need to ascertain personal histories retrospectively, we replicated results using cohort members' retrospective personal-history reports made in adulthood. Because many trials recruit participants from clinical settings, we replicated results in the cohort subset who had recent health system contact according to electronic medical records. Quick, inexpensive measures of trial participants' early personal histories can enable clinical trials to study who volunteers for trials, who adheres to treatment, and who responds to anti-aging therapies. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

Sex Differences in Timeliness of Reperfusion in Young Patients With ST-Segment-Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics.

Science.gov (United States)

Gupta, Aakriti; Barrabes, Jose A; Strait, Kelly; Bueno, Hector; Porta-Sánchez, Andreu; Acosta-Vélez, J Gabriel; Lidón, Rosa-Maria; Spatz, Erica; Geda, Mary; Dreyer, Rachel P; Lorenze, Nancy; Lichtman, Judith; D'Onofrio, Gail; Krumholz, Harlan M

2018-03-07

Young women with ST-segment-elevation myocardial infarction experience reperfusion delays more frequently than men. Our aim was to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. We examined sex differences in initial electrocardiographic characteristics among 1359 patients with ST-segment-elevation myocardial infarction in a prospective, observational, cohort study (2008-2012) of 3501 patients with acute myocardial infarction, 18 to 55 years of age, as part of the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study at 103 US and 24 Spanish hospitals enrolling in a 2:1 ratio for women/men. We created a multivariable logistic regression model to assess the relationship between reperfusion delay (door-to-balloon time >90 or >120 minutes for transfer or door-to-needle time >30 minutes) and electrocardiographic characteristics, adjusting for sex, sociodemographic characteristics, and clinical characteristics at presentation. In our study (834 women and 525 men), women were more likely to exceed reperfusion time guidelines than men (42.4% versus 31.5%; P ST elevation in lateral leads was an inverse predictor of reperfusion delay. Sex disparities in timeliness to reperfusion in young patients with ST-segment-elevation myocardial infarction persisted, despite adjusting for initial electrocardiographic characteristics. Left ventricular hypertrophy by voltage criteria and absence of prehospital ECG are strongly positively correlated and ST elevation in lateral leads is negatively correlated with reperfusion delay. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea

Science.gov (United States)

Kim, Hee Kyung; Yoon, Jee Hee; Jeon, Min Ji; Kim, Tae Yong; Shong, Young Kee; Lee, Min Jin; Kim, Bo Hyun; Kim, In Joo; Joung, Ji Young; Kim, Sun Wook; Chung, Jae Hoon

2015-01-01

Background Antithyroid drugs (ATDs) can lead to the development of agranulocytosis, which is the most serious adverse effect. Characteristics of ATD-induced agranulocytosis (AIA) have seldom been reported due to the rarity. In this study, we characterized the clinical features for AIA in Korean patients. Methods We retrospectively reviewed data from patients with AIA diagnosed between 1997 and 2014 at four tertiary hospitals. Agranulocytosis was defined as an absolute neutrophil count (ANC) below 500/mm3. Results The mean age of the patients (11 males, 43 females) was 38.2±14.9 years. Forty-eight patients (88.9%) with AIA had fever and sore throat on initial presentation, 20.4% of patients developed AIA during the second course of treatment, and 75.9% of patients suffered AIA within 3 months after initiation of ATD. The patients taking methimazole (n=39) showed lower levels of ANC and more frequent use of granulocyte-macrophage colony-stimulating factor than propylthiouracil (n=15) users. The median duration of agranulocytosis was 5.5 days (range, 1 to 20). No differences were observed between the long (≥6 days) and short recovery time (≤5 days) groups in terms of age, gender, ATDs, duration of ATDs, or initial ANC levels. Four patients (7.4%) who were taking ATDs for less than 2 months died of sepsis on the first or second day of hospitalization. Conclusion The majority of AIA incidents occur in the early treatment period. Considering the high fatality rate of AIA, an early aggressive therapeutic approach is critical and patients should be well informed regarding the warning symptoms of the disease. PMID:26394729

Assisted care as a baseline patient risk characteristic affecting the outcome of transcatheter aortic valve insertion.

Science.gov (United States)

Traynor, Megan M; Greason, Kevin L; Nkomo, Vuyisile T; Pochettino, Alberto; Holmes, David R; Rihal, Charanjit S; Reeder, Guy S; Bresnahan, John F; Mathew, Verghese

2017-06-01

Objective measures of frailty have not been well defined as risk factors for a poor outcome after transcatheter aortic valve insertion. We hypothesized that assisted care as a baseline patient characteristic was a simple objective measure of frailty. We reviewed our experience to assess for an association between assisted care and outcome of operation. We retrospectively reviewed the records of 597 patients operated with transcatheter aortic valve insertion from November 2008 through July 2015. The study cohort included patients with a dichotomous baseline characteristic of receiving assisted care (AC group, n = 60, 10.1%) or not receiving assisted care (NC group, n = 537, 89.9%). The endpoints of the study were operative stroke/death and 1-year survival. The age of the patients was 80.6 ± 9.0 years, male sex was present in 349 (58.5%), and STS predicted risk of mortality was 9.2 ± 6.2%. Alternate access was used in 26 (43.3%) patients in the AC care group and in 220 (41.0%) in the NC group (P = 0.724). Operative stroke/death occurred in 4 (6.7%) patients in the AC group and in 25 (4.7%) in the NC group (P = 0.492). Mortality at 1 year in the AC group was 14.8 ± 5.2% and in the NC group was 12.9 ± 1.7%; (P = 0. 250). Assisted care as a baseline patient characteristic does not result in increased operative stroke/death or 1-year mortality in patients following transcatheter aortic valve insertion. Assisted care should not by itself preclude operation. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Epidemiological and Clinical Baseline Characteristics as Predictive Biomarkers of Response to Anti-VEGF Treatment in Patients with Neovascular AMD

Directory of Open Access Journals (Sweden)

Miltiadis K. Tsilimbaris

2016-01-01

Full Text Available Purpose. To review the current literature investigating patient response to antivascular endothelial growth factor-A (VEGF therapy in the treatment of neovascular age-related macular degeneration (nAMD and to identify baseline characteristics that might predict response. Method. A literature search of the PubMed database was performed, using the keywords: AMD, anti-VEGF, biomarker, optical coherence tomography, treatment outcome, and predictor. The search was limited to articles published from 2006 to date. Exclusion criteria included phase 1 trials, case reports, studies focusing on indications other than nAMD, and oncology. Results. A total of 1467 articles were identified, of which 845 were excluded. Of the 622 remaining references, 47 met all the search criteria and were included in this review. Conclusion. Several baseline characteristics correlated with anti-VEGF treatment response, including best-corrected visual acuity, age, lesion size, and retinal thickness. The majority of factors were associated with disease duration, suggesting that longer disease duration before treatment results in worse treatment outcomes. This highlights the need for early treatment for patients with nAMD to gain optimal treatment outcomes. Many of the identified baseline characteristics are interconnected and cannot be evaluated in isolation; therefore multivariate analyses will be required to determine any specific relationship with treatment response.

Clinical and Hormonal Characteristics of Patients with Giant Masses of Sellar-Chiasmatic Region

Directory of Open Access Journals (Sweden)

K.B. Alimova

2016-05-01

Full Text Available Objective: to study the clinical and hormonal characteristics of patients with giant masses of sellar-chiasmatic area. Material and methods. During the period from 2015 to 2016, we have examined 35 adult patients with pituitary macroadenomas, including 48.6 % of men. The average age of men was 37.12 years, women — 38.15 years. The disease duration ranged from 2 months to 25 years. Results. Distribution of patients according to topographic and anatomical classification of pituitary adenoma side growth showed that pituitary adenomas with total growth were (51.4 % most frequent. Patients with giant pituitary adenomas most often had panhypopituitarism (44.4 %, as well as bitemporal hemianopsia (61.1 % and secondary amenorrhea (33.3 %. Such disorders, as a secondary osteopenia, endocrine encephalopathy, delayed physical and sexual development, had been identified only in this group of patients. In addition, a significant decrease in the mean values of basal levels of tropic pituitary hormones (growth hormone (GH, luteinizing hormone (LH, follicle stimulating hormone (FSH, adrenocorticotropic hormone was observed in patients with giant pituitary adenomas. Conclusions. Patients with giant pituitary adenomas have primarily a decrease in GH, FSH, LH levels. The most significant neuroendocrine and ophthalmic disorders occur in patients with giant pituitary adenomas.