scholarly journals SUN-625 The Impact of Age on Outcomes of Hyperosmolar Hyperglycemia Among Adult Patients with Diabetes. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Middle Age ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Older Age ◽  
National Inpatient Sample ◽  
Total Cost ◽  
Patients With Diabetes ◽  
The Mean ◽  
Secondary Outcomes ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of age on outcomes hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of the study was to evaluate the effect of age on the outcome of patients admitted for the management of HHS. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of HHS during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV) length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age was 55.9, standard error of the mean (SEM): 0.1. Majority were of middle age. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Young age was defined as age ≤ 35 years, middle age was > 35 and ≤ 65 years, old age was > 65 years. Mortality was 0.3 %, 0.6%, 2.5% in young, middle and older aged groups respectively. Similarly, higher age correlated with increased risk for MI, stroke and all secondary outcomes. On multivariable analysis, age was an independent predictor for all adverse outcomes. Compared to young patients, middle and older age groups had higher odds for mortality with adjusted odds ratio (aOR) 2.23 [95%CI:1.10-4.52], p=0.03 and aOR 7.35 [95%CI: 3.27-16.53], p<0.001 respectively, higher risk for stroke with aOR 9.32 [95%CI: 2.92-29.7], p<0.001 and aOR 17.46 [95%CI:5.23-58.3], p<0.001 and higher risk for MI aOR 5.18 [95%CI:2.15-12.51], p<0.00 and aOR 5.80 [95%CI:2.27-14.80], p<0.00 for middle and older age groups respectively. In addition, compared to the younge age group, the risk for rhabdomyolysis, AKI, ARF, MV, total cost and LOS was significantly higher among middle and older age groups respectively. Conclusion: Age is an important determinant for adverse outcomes among patients with hyperosmolar hyperglycemic sate.

scholarly journals SUN-620 Gender Difference in the Outcome of Patients with Diabetes Admitted for Hyperosmolar Hyperglycemia. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Lower Risk ◽  
Female Gender ◽  
Secondary Outcome ◽  
National Inpatient Sample ◽  
Patients With Diabetes ◽  
Hyperosmolar Hyperglycemic State ◽  
The Mean ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of gender on outcomes of hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of this study was to evaluate the effect of gender on the outcome of these patients. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of hyperosmolar hyperglycemic state (HHS) during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV), length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age of males was 53.7, standard error of the mean (SEM: 0.13), and of females was 58.5 (SEM: 0.15), p<0.001. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Both males and females had equivalent rates of mortality, stroke, ARF and need for mechanical ventilation. Compared to males, females had significantly higher risk for MI 1.6% vs 1.1%, p<0.001, lower risk for AKI 29.3% vs 32.9%, p<0.001, lower risk for rhabdomyolysis 1.1% vs 2%, p<0.001 and higher LOS 4.3 vs 3.9 days, p<0..01 and higher total costs 8165.6 $ vs 7669.3 $, p < 0.001. On multivariable analysis, female gender was independently predictive for higher risk for MI with adjusted odds ratio (aOR) 1.34 [95%CI: 1.08-1.67] p=0.01 and lower risk for rhabdomyolysis with aOR 0.52 [95%CI: 0.42-0.63] p<0.001 and lower risk for AKI with aOR 0.74 [95%CI: 0.7-0.78] p<0.001. In addition, female gender correlated with higher cost and length of stay. Conclusion: Females with hyperosmolar hyperglycemic state are at higher risk for MI and lower risk for AKI and rhabdomyolysis.

65Utilization of percutaneous left atrial appendage closure in patients with atrial fibrillation in the United States: analysis from national inpatient sample 2016

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Wu ◽  
K Ho
Keyword(s):  
Length Of Stay ◽  
Left Atrial Appendage ◽  
National Inpatient Sample ◽  
Left Atrial Appendage Closure ◽  
Total Cost ◽  
The Us ◽  
Comorbidity Index ◽  
The Mean ◽  
Mean Time ◽  
Related Mortality

Abstract Introduction/Background In recent years, the percutaneous left atrial appendage closure (LAAC) has been gaining its popularity in the US. However its use in the US in recent years has not been well described. Purpose To provide an updated cross-sectional survey of performance of percutaneous LAAC in the US at national database level. Methods We use ICD-10 disease and procedure code to identify all the percutaneous LAAC performed in 2016 in US from national inpatient sample database. The demographic feature, comorbidity, mean time to procedure, mortality, complication rate, length of stay, total cost were described. Procedure related complication Including any vascular, cardiac, respiratory, neurologic and renal complications defined by AHRQ as patient safety indicators. Results There is approximately a total of 7550 percutaneous LAAC performed in the US in 2016. The majority of the patients were elderly (mean age 66.83±0.34), white (80.41%) male (59.04%). The mean Charlson Comorbidity Index score is 1.74, with hypertension (76.75%), diabetes (29.23%) being the most common comorbidity. The mean time to procedure is 1.98±0.11 days. The procedure related mortality is 2.06%, whereas the complication rate is 19.6%. The average length of stay is 10.77 day, with an average total cost of 239.67 thousand dollars. Baseline characterlistisc and outcomes Total percutaneous LAAC (estimated from sample) 7550 Age, years 66.83±0.34 Male, % 59.04 White, % 80.41 Mean Charlson Comorbidity Index 1.74±0.31 Hypertension, % 76.75 Diabetes, % 29.23 CKD, % 21.42 Mean Time to procedure, days 1.98±0.11 Mortality, % 2.06 Length of Stay, days 10.77±0.25 Any Complication, % 19.6 Total Cost, thousand dollars 239.67±10.01 Values are reported as mean ± SD. Categorical variables are represented as frequency. Conclusion A total of 7550 percutaneous LAAC was performed in US in 2016. The procedure related mortality is 2.06%, with an average time to procedure of 1.98 days and a length of stay of 10.77 days.

scholarly journals The Impact of COVID-19 on Risky Behaviors and Health Changes in African-American Smokers Who Are Eligible for LDCT Screening

2021 ◽  
Vol 9 ◽  
Author(s):  
Tung-Sung Tseng ◽  
Mirandy Li ◽  
Yu-Hsiang Kao ◽  
Lei-Shih Chen ◽  
Hui-Yi Lin
Keyword(s):  
African American ◽  
Risky Behaviors ◽  
Adverse Outcomes ◽  
Health Changes ◽  
The Us ◽  
The Mean ◽  
Vegetables And Fruits ◽  
Control And Management ◽  
Low Dose Computed Tomography ◽  
The Impact

The COVID-19 pandemic has disrupted much of day-to-day life in the US and around the world. Smokers have a higher risk of adverse outcomes due to COVID-19. This study investigated the impact of COVID-19 on risky behaviors and health changes in lower income African-American smokers eligible for Low dose computed tomography (LDCT) screening, who may be more adversely impacted by the COVID-19 pandemic. A total of 22 African-American daily smokers who were eligible for LDCT screening participated in this study. The mean age of participants was 61.2 years old (SD = 4.7), 77.3% of the smokers were female, all participants had an income below $20,000, and 63.6% were on Medicaid. Descriptive statistics were used to provide summary information on demographics, COVID-19, and health status. Results showed that participants increased cigarette smoking, spent more time on screens, increased sugary drink consumption, consumed more vegetables and fruits, and engaged in more gardening activities during the COVID-19 pandemic. However, participants also decreased physical activity time and slept less during the pandemic. In general, more than one-third of participants gained more body weight and reported increased stress and anxiety. Our results suggest that African-American smokers who qualify for LDCT screening should be encouraged to consider strategies not only for smoking cessation, but also risky behavior control and management.

​Impact of Extreme Hot Environmental Temperature Period on Marker Enzymes of Carbohydrate Metabolism in Non-descript Sheep from Arid Tracts of Rajasthan

2021 ◽  
Author(s):  
Anandita Srivastava ◽  
Nalini Kataria
Keyword(s):  
Carbohydrate Metabolism ◽  
Environmental Temperature ◽  
Age Groups ◽  
Extreme Temperature ◽  
Mean Value ◽  
Marker Enzymes ◽  
Mean Values ◽  
The Mean ◽  
The Impact ◽  
Enzymes Of Carbohydrate Metabolism

Background: The present investigation was envisaged to find out the impact of extreme hot environmental temperature period (ETP) on marker enzymes of carbohydrate metabolism in male and female non-descript sheep of various age groups i.e. 4 to 13 months from arid tracts of Rajasthan. Glucose-6-phosphate dehydrogenase (G-6-PDH) and malate dehydrogenase (MDH) marker enzymes of carbohydrate metabolism were considered for study. Methods: During the period October 2016-June 2017 blood samples were collected to harvest sera for spectrophotometric method from 240 healthy animals selected from private slaughter house during moderate and extreme hot environmental temperature periods (ETPs). The mean values of markers attained during moderate ETP were reckoned as the control. It was 10.00 ± 0.10 UL-1 and 42.00±1.00 respectively. Conclusion: The mean value of MDH was significantly (p≤0.05) higher while G-6-PDH significantly (p≤0.05) lowers during extreme hot temperature in comparison to moderate period. Therefore, it could be concluded that variations in enzyme markers were associated with changes in environmental temperatures. Probably ETP were able to produce a profound effect on carbohydrate metabolism in sheep. Therfore it can be suggested that during the period of extreme temperature balanced ration must be provided to the animal along with proper management to decrease the severity of temperature impact.

Resistant Starch Supplementation Improves Bifidobacteria Colonization and Lipid Profile in Adult Obese Subjects Residing in Urban Vadodara

2018 ◽  
Vol 55 (4) ◽  
pp. 432
Author(s):  
Mini Sheth ◽  
Aanchal Johari ◽  
Isha Shah
Keyword(s):  
Lipid Profile ◽  
Resistant Starch ◽  
Age Groups ◽  
Randomised Control Trial ◽  
Control Group ◽  
Obese Adults ◽  
Obese Subjects ◽  
The Mean ◽  
The Impact ◽  
Experimental Group

Obesity continues to be a growing problem globally among all age groups, further associated with life threatening co-morbidities. Resistant Starch (RS) as a dietary component has been recently recognized as a prebiotic with potential role in improving the bacterial ecology of human gut. The present study was undertaken to evaluate the impact of resistant starch supplementation by the obese adults in urban Vadodara on microbial changes in gut flora with respect to Bifidobacteria and Enterobacteria. Using a non randomised control trial study design, 60 obese adults were enrolled from the free living population of urban Vadodara. Baseline information was collected and subjects were classified into control (n=30) and experimental group (n=30). Experimental group was supplemented with 10 g of RS daily for the period of two months (60 days). The control group were not given anything during this period. Blood and stool samples were analysed for lipid profile and the presence of Bifidobacteria and pathogenic Enterobacteria, respectively both at baseline and after the intervention period. Results revealed a significant increase in the mean log counts of Bifidobacteria by 11.7% with no significant reduction in the mean log counts of enteric pathogens and lipid profile of subjects. Hence study concludes that a daily supplementation of 10 grams of RS for 60 days to the obese subjects improved colonization of beneficial gut microbiota in terms of Bifidobacteria, but had little effect on obesity.

scholarly journals OR30-01 Real-World Minimed™ 670G System Use and Glycemic Outcomes of Pediatric and Adult Individuals Living with Type 1 Diabetes (T1D) in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Robert Alan Vigersky ◽  
Michael Stone ◽  
Pratik Agrawal ◽  
Alex Zhong ◽  
Kevin Velado ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Real World ◽  
Adult Population ◽  
Age Groups ◽  
The United States ◽  
System Use ◽  
System Data ◽  
The Mean ◽  
The Impact ◽  
The U.S

Abstract Introduction: The MiniMed™ 670G system was FDA-approved in 2016 for adults and adolescents ≥14yrs, and in 2018 for children ages 7-13yrs with T1D. Since then, use of the system has grown to over 180,000 people in the U.S. The glycemic control benefits of real-world MiniMed™ 670G system Auto Mode use in the U.S. were assessed. Methods: System data (aggregated five-minute instances of sensor glucose [SG]) uploaded from March 2017 to July 2019 by individuals (N=118,737) with T1D and ≥7yrs of age who enabled Auto Mode were analyzed to determine the mean % of overall time spent <54mg/dL/<70mg/dL (TBR); between 70-180mg/dL (TIR); and >180mg/dL/>250mg/dL (TAR). The impact of Auto Mode was further assessed in a sub-group of individuals (N=51,254) with, at least, 7 days of SG data for both Auto Mode turned ON and turned OFF. The % of TIR, TBR and TAR, and the associated glucose management indicator (GMI) were evaluated for the overall OFF (2,524,570 days) and ON (6,308,806 days) periods, and across different age groups. Results: System data TIR was 71.3%; TBR was 0.4% and 1.9%, respectively; and TAR was 26.8% and 6.2%, respectively. User-wise data of Auto Mode OFF versus ON showed a mean of 70.3% of the time spent in Auto Mode, that TIR increased from 60.9% to 69.9%; and that both TBR and TAR decreased. For those 7-13yrs (N=1,417), TIR increased from 48.7% to 61.5%; TBR increased from 0.5% to 0.6% and from 2.0% to 2.2%, respectively; and TAR decreased from 49.3% to 36.3% and from 20.5% to 13.0%, respectively. For those 14-21yrs (N=4,194), TIR increased from 51.0% to 61.5%; TBR decreased from 0.7% to 0.6% and from 2.3% to 2.0%, respectively; and TAR decreased from 46.7% to 36.5% and from 18.5% to 12.5%, respectively. For those ≥22yrs (N=45,643), TIR increased from 62.2% to 70.9%; TBR decreased from 0.7% to 0.5% and from 2.6% to 1.9%, respectively; and TAR decreased from 35.2% to 27.3% and from 9.9% to 6.3%, respectively. The mean GMI decreased by 0.23% (overall), 0.48% (7-13yrs), 0.35% (14-21yrs), and 0.22% (≥22yrs), respectively, with Auto Mode ON versus OFF. Discussion: In over 6 million days of real-world MiniMed™ 670G system Auto Mode use in the U.S., TIR of a large pediatric and adult population with T1D improved by 9% compared to when Auto Mode was OFF, which was comparable to or exceeded the TIR observed in the smaller pivotal trials. These results further support outcomes of the pivotal trials and increased glycemic control with system use.

scholarly journals Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

2019 ◽  
Vol 16 (19) ◽  
pp. 3720 ◽  
Author(s):  
Mona Abdo ◽  
Isabella Ward ◽  
Katelyn O’Dell ◽  
Bonne Ford ◽  
Jeffrey Pierce ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Wildfire Smoke ◽  
Secondary Outcomes ◽  
Adverse Pregnancy ◽  
The Impact ◽  
Zip Code

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m3)−1 [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m3)−1 [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m3) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed.

Nuclear War: Fear of Children and Adolescents

1990 ◽  
Vol 7 (1) ◽  
pp. 2-4
Author(s):  
Neville J King ◽  
Kate Ollier ◽  
Eleonora Gullone
Keyword(s):  
Children And Adolescents ◽  
Middle Age ◽  
Age Groups ◽  
Psychological Development ◽  
Age Group ◽  
Nuclear War ◽  
Fear Survey Schedule ◽  
The Impact

ABSTRACTUsing an extended fear survey schedule, 72 per cent of a sample of 8 to 16 year old children and adolescents in Australia reported a lot of fear of nuclear war. Although a high proportion of respondents in all age groups expressed a lot of fear of nuclear war, significantly more respondents in the middle age group (11-13 years) were found to be afraid. Consistent with the findings on children's fears in general, significantly more females than males reported fear of nuclear war. Further research should be undertaken on the impact of the fear of nuclear war on the psychological development of children and adolescents.

Maternal Age and Preeclampsia Outcomes during Delivery Hospitalizations

2019 ◽  
Vol 37 (01) ◽  
pp. 044-052 ◽  
Author(s):  
Jean-Ju Sheen ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
Jason D. Wright ◽  
Dena Goffman ◽  
...  
Keyword(s):  
Older Women ◽  
Maternal Age ◽  
Primary Outcome ◽  
Temporal Trends ◽  
Adverse Outcomes ◽  
Dependent Manner ◽  
Age Group ◽  
National Inpatient Sample ◽  
Secondary Outcomes ◽  
Dose Dependent

Abstract Objective To characterize risk and temporal trends for preeclampsia and related outcomes by maternal age. Study Design Deliveries to women aged 15 to 54 years in the 1998 to 2014 National Inpatient Sample who had a diagnosis of preeclampsia, eclampsia, or both were included in the analysis. Age was categorized as 15 to 17, 18 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, and 45 to 54 years. The primary outcome was temporal trends in preeclampsia based on maternal age. Secondary outcomes analyzed included risk for severe maternal morbidity. Results The proportion of women with preeclampsia aged 15 to 24 years decreased from 42.3% in 1998 to 30.1% in 2014, while preeclampsia among those 30 to 54 years increased from 32.9 to 43.7%. Preeclampsia risk increased for all groups over the study period. Risk for severe morbidity by age group with and without transfusion was “U-shaped,” with risk highest for women 18 to 24 and 40 to 54 years. The risk for abruption, acute renal failure, acute heart failure or pulmonary edema, and stroke was lowest for women aged 15 to 24 years and increased in a “dose-dependent” manner with increasing maternal age. In contrast, eclampsia risk was highest for women aged 15 to 17 years. Conclusion With a changing demographic profile of preeclampsia, older women accounted for an increasing proportion of preeclampsia and related adverse outcomes.

scholarly journals Predicting the number of public projects in the region as an indicator of economic stability

2019 ◽  
Vol 65 ◽  
pp. 06001
Author(s):  
Olha Dupliak ◽  
Olena Ovchynnikova ◽  
Oksana Zamazii
Keyword(s):  
Middle Age ◽  
Age Groups ◽  
Older Age ◽  
Government Agencies ◽  
Economic Stability ◽  
Community Based ◽  
Demographic Situation ◽  
The Public ◽  
Public Projects ◽  
Community Projects

The article examines the issues of submitting applications and receiving funding for public projects depending on the demographic situation in the region. It is shown that the activity of the population in submitting applications for community projects contributes to the effectiveness of investing in the development of cities and regions. The dynamics of project submission in connection with the permanent population of Khmelnytskyi region is analyzed. In the course of the analysis, it was found that women make up the largest share among both the population and those who submit social projects. According to age characteristics, in spite of an increase in the proportion of the older age groups, mainly younger and middle age groups of the population develop community-based projects. The gender trend identified during the study indicates that women are more active in local processes than men who more closely coordinate these projects with government agencies. According to these statistics, a forecast is provided as to allocation of funds for the public projects’ financing.

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