Clinical Characteristics Of Adults Research Articles

Patient Demographics and Clinical Characteristics of Adults With Spinal Muscular Atrophy (SMA): An Assessment of Patients Receiving Risdiplam Treatment and Untreated Patients With SMA (P2-11.004)

Patient Demographics and Clinical Characteristics of Adults With Spinal Muscular Atrophy (SMA): An Assessment of Patients Receiving Risdiplam Treatment and Untreated Patients With SMA (P2-11.004)

Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story.

International studies show that adults with intellectual and developmental disabilities (IDD) are disproportionately represented in the criminal justice and forensic mental health systems; however, it is difficult to capture their involvement across systems in any one jurisdiction. The current study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD. This project utilised administrative data to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care and community mental health programmes. Questions were driven by and results were contextualised by a project advisory group and people with lived experience from the different sectors studied, resulting in a series of recommendations. Adults with IDD were over-represented in each of the four settings, ranging from 2.1% in federal corrections to 16.7% in forensic inpatient care. Between 20% (forensic inpatient) and 38.4% (provincial corrections) were under the age of 25 and between 34.5% (forensic inpatient) and 41.8% (provincial corrections) resided in the lowest income neighbourhoods. Medical complexity and rates of co-occurring mental health conditions were higher for people with IDD than those without IDD in federal and provincial corrections. Establishing a population-based understanding of people with IDD within these sectors is an essential first step towards understanding and addressing service and care needs. Building on the perspectives of people who work in and use these systems, this paper concludes with intervention recommendations before, during and after justice involvement.

Clinical characteristics, treatment course and outcome of adults treated for avoidant/restrictive food intake disorder (ARFID) at a tertiary care eating disorders program

BackgroundAvoidant/restrictive food intake disorder (ARFID) is now recognized as a feeding/eating disorder that affects individuals across the lifespan, but research on ARFID in general and particularly in adults remains limited. The purpose of this study was to describe the demographic and clinical characteristics of adults with ARFID seeking treatment at a tertiary care eating disorders program, and to describe the course and outcomes of treatment at three levels of care—inpatient, intensive outpatient, and outpatient individual therapy.MethodThis retrospective chart review study examined the charts of 42 patients who received treatment for ARFID between April 2020 and March 2023. Following diagnostic assessment, patients were referred to either inpatient treatment, intensive outpatient treatment, or outpatient individual therapy. All three levels of care involved individual cognitive behaviour therapy. Inpatients typically transitioned to one of the outpatient treatments as part of a continuous care plan. We examined demographic and clinical characteristics, treatment length and completion, and changes in key indicators during treatment.ResultsPatients were diverse with respect to demographics (e.g., 62% cisgender women; 21% cisgender men; 17% transgender, non-binary, or other gender) and comorbid concerns (e.g., 43% had neurodevelopmental disorders; > 50% had mood and anxiety disorders; 40% had posttraumatic stress disorder [PTSD]; 35% had medical conditions impacting eating/digestion). Most patients presented with more than one ARFID maintaining mechanism (i.e., lack of appetite/interest, sensory sensitivities, and/or fear of aversive consequences of eating). Treatment completion rates and outcomes were good. On average, patients showed significant improvement in impairment related to their eating disorder, and those who were underweight significantly improved on BMI and were not underweight at end of treatment.DiscussionThese findings add to the literature by indicating that ARFID patients are commonly male or have diverse gender identities, and have high rates of neurodevelopmental, mood, anxiety, and gastrointestinal disorders. We also found high rates of PTSD. The findings show promise for treatment outcomes across the continuum of care. Next steps in ARFID treatment and research include incorporating ARFID-specific assessments into routine care, and ongoing research investigating the efficacy and effectiveness of treatments such as CBT-AR.

Factors associated with psychiatric and physical comorbidities in bipolar disorder: a nationwide multicenter cross-sectional observational study.

Bipolar disorder (BD) is a chronic and disabling affective disorder with significant morbidity and mortality. Despite the high rate of psychiatric and physical health comorbidity, little is known about the complex interrelationships between clinical features of bipolar illness and comorbid conditions. The present study sought to examine, quantify and characterize the cross-sectional associations of psychiatric and physical comorbidities with selected demographic and clinical characteristics of adults with BD. A nationwide multicenter cross-sectional observational epidemiological study conducted from October 2015 to March 2017 in Slovakia. Out of 179 study participants [median age 49 years (interquartile range IQR 38-58); 57.5% females], 22.4% were free of comorbidity, 42.5% had both psychiatric and physical comorbidities, 53.6% at least one psychiatric comorbidity, and 66.5% at least one physical comorbidity. The most prevalent were the essential hypertension (33.5%), various psychoactive substance-related disorders (21.2%), specific personality disorders (14.6%), obesity (14.5%), and disorders of lipoprotein metabolism (14%). The presence of an at least one physical comorbidity, atypical symptoms of BD, and unemployed status were each associated with an at least one psychiatric comorbidity independent of sex, early onset of BD (age of onset <35 years), BD duration and pattern of BD illness progression (p < 0.001). The presence of various psychoactive substance-related disorders, BD duration, atypical symptoms of BD, unemployed status, pension, female sex, and not using antipsychotics were each associated with an at least one physical comorbidity independent of the pattern of BD illness progression (p < 0.001). In several other multiple regression models, the use of antipsychotics (in particular, olanzapine) was associated with a decreased probability of the essential hypertension and predicted the clinical phenotype of comorbidity-free BD (p < 0.05). This cross-national study has reported novel estimates and clinical correlates related to both the comorbidity-free phenotype and the factors associated with psychiatric and physical comorbidities in adults with BD in Slovakia. The findings provide new insights into understanding of the clinical presentation of BD that can inform clinical practice and further research to continue to investigate potential mechanisms of BD adverse outcomes and disease complications onset.

Clinical characteristics of adults with self-reported diagnosed asthma and/or COPD: data from the BOLD Australia Study.

Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in the community is variable, often without spirometry. Some studies report that adults with both diagnostic labels (asthma+COPD) have worse health outcomes than those with asthma or COPD only, but data for Australian adults are limited. We investigated the relationship between clinical characteristics and self-reported diagnoses of asthma, COPD and both. We used data from the BOLD Australia study, which included randomly selected adults aged ≥40 years from six study sites. The BOLD questionnaires and spirometry test were used in all sites. Participants were grouped by self-reported diagnosis. Demographic and clinical characteristics and lung function were compared between groups. Of the study sample (n=3522), 336 reported asthma only, 172 reported COPD only, 77 reported asthma+COPD and 2937 reported neither. Fewer than half of participants with a COPD diagnosis (with or without asthma) had airflow limitation. Participants with asthma+COPD had more respiratory symptoms and greater airflow limitation than those with either diagnosis alone. Having asthma+COPD was independently associated with a higher probability of having clinically important breathlessness (modified Medical Research Council score ≥2) than asthma only (adjusted OR 3.44, 95% CI 1.86-6.33) or COPD only (adjusted OR 3.28, 95% CI 1.69-6.39). Airflow limitation (Global Initiative for Chronic Obstructive Lung Disease 2 or higher, using post-bronchodilator forced expiratory volume in 1 s/forced vital capacity ratio <0.7) was similar between asthma only and COPD only, but twice as prevalent in asthma+COPD (adjusted OR 2.18 and 2.58, respectively). Adults with diagnoses of asthma+COPD have a higher symptom and disease burden than those with diagnoses of asthma only or COPD only. These patients should receive regular comprehensive reviews because of the substantially increased burden of having both diagnoses.

Psychosis in adults with autism spectrum disorder and attention deficit hyperactivity disorder at acute psychiatric wards

Background and objectivesPsychotic symptoms, such as delusions and hallucinations, in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have been increasingly reported in recent literature. In the present study, the prevalence and duration of psychotic symptoms, comorbid psychotic disorders, and clinical characteristics of adults with ASD and ADHD were retrospectively examined via a chart review. MethodsThe participants were 98 adults (mean age, 28.5 years; 72 men) who were admitted to the psychiatric emergency wards of Showa University Karasuyama Hospital, and who were diagnosed with ASD and/or ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. ResultsAmong 69 individuals with ASD, 21 (30.4%) experienced psychotic symptoms, and among 29 individuals with ADHD, 5 (17.2%) exhibited psychosis. While all psychotic symptoms were classified as transient and none had comorbidity with schizophrenia and other psychotic disorders in adults with ADHD, 38.1% of psychosis was classified as prolonged and 10.3% had comorbidity with schizophrenia and other psychotic disorders in adults with ASD. ConclusionThe results showed that a significant proportion of adults with ASD and ADHD experience psychosis during their course of illness, and provide evidence for the existence of a shared etiology between neurodevelopmental and psychotic disorders.

Sociodemographic and clinical characteristics of adults with ADHD enrolled in a adult neurodevelopmental disorders clinic of a university hospital

Sociodemographic and clinical characteristics of adults with ADHD enrolled in a adult neurodevelopmental disorders clinic of a university hospital

Factors Associated with Depression, Anxiety, and Stress in Men and Women: Findings from a Population-Based Study in Iran

Background: This study aimed to investigate the relationship between personal and clinical characteristics of adults in the Tehran Lipid and Glucose Study (TLGS) with depression, anxiety, and stress. Methods: Data of 2272 adults participating in the 6th phase of TLGS were used for univariate analysis to investigate the association between socio-demographic, behavioral, and clinical characteristics and participants’ emotional states. Thereupon, the predictors with a P value&lt;0.20, at least for one of depression, anxiety, and stress in the primary analysis, were included in the model for multivariate modeling. Results: The mean age of participants was 47.23±14.87. The mean scores of depression, anxiety, and stress were higher in women (P value:&lt;0.001,&lt;0.001, and 0.004) than in men. Higher age was associated with lower anxiety (β=-0.04, P=0.004) and stress (β=-0.13, P&lt;0.001) in men, but only lower stress in women (β=-0.07, P=0.001). Highly educated participants experienced lower depression (β=-2.26, P=0.01, β=-2.26, P=0.003). Although married men robustly experienced lower depression than others (β=-1.69, P=0.009), a less powerful relationship existed between being married and depression in women (β=-1.37, P=0.05). All cigarette smokers experienced higher depression, anxiety, and stress, but only female hookah smokers had higher anxiety and stress. Physical activity and chronic disorders had no relationship with emotional states. Obesity was associated with stress in women (β=1.95, P=0.001). Conclusion: This study provides an update on factors associated with mental health outcomes in a large general population. Examining the factors associated with depression, anxiety, and stress through a sex-sensitive lens could help clinicians diagnose and plan the best preventive and therapeutic approach.

Epidemiological and Clinical Characteristics of Adults with Coronavirus Disease 2019 Complicated with Pneumothorax.

The major brunt of coronavirus disease-2019 (COVID-2019) is borne by the lungs. The major cause of morbidity and mortality in COVID-19 patients is a compromise of the respiratory system. Pneumothorax is noted as an insignificant proportion of patients suffering from COVID-19, but it jeopardizes the clinical recovery significantly. We, in the case series of 10 patients, will be summarizing the epidemiological, demographic, and clinical characteristics of COVID-19 patients who also developed pneumothorax. All the confirmed cases of COVID-19 pneumonia diagnosed between May 1, 2020 and August 30, 2020, admitted at our center meeting the inclusion criteria and whose clinical course was complicated by pneumothorax were made part of our study. Their clinical records were studied, and epidemiological, demographic, and clinical data of these patients were collected and compiled in this case series. All the patients in our study required ICU care, and 60% received non-invasive mechanical ventilation, while 40% of the patients progressed to intubation and invasive mechanical ventilation. A total of 70% of the patients in our study had a successful outcome, while 30% succumbed to the disease and expired. Epidemiological, demographic, and clinical characteristics of COVID-19 patients complicated with pneumothorax were evaluated. Our study showed that pneumothorax also developed in some patients who had not received mechanical ventilation, indicating that pneumothorax could be a secondary complication of SARS-CoV-2 infection. Our study also emphasizes the fact that even the majority of patients whose clinical course was complicated by pneumothorax had a successful outcome emphasizing the need for timely and adequate intervention in such cases. Singh NK. Epidemiological and Clinical Characteristics of Adults with Coronavirus Disease 2019 Complicated with Pneumothorax. Indian J Crit Care Med 2022;26(7):833-835.

Receipt of Baseline Laboratory Testing Recommended by the HIV Medicine Association for People Initiating HIV Care, United States, 2015-2019.

BackgroundThe HIV Medicine Association of the Infectious Disease Society of America publishes Primary Care Guidance for Persons with Human Immunodeficiency Virus. We assessed receipt of recommended baseline tests among newly diagnosed patients initiating HIV care.MethodsThe Medical Monitoring Project is a Centers for Disease Control and Prevention survey designed to produce nationally representative estimates of behavioral and clinical characteristics of adults with diagnosed HIV in the United States. We analyzed data for 725 participants in the 2015–2019 data collection cycles who received an HIV diagnosis within the past 2 years and had ≥1 HIV provider visit. We estimated the prevalence of having recommended tests after the first HIV provider visit and between 3 months before and 3/6 months after the first HIV provider visit and estimated prevalence differences of having 4 combinations of tests by sociodemographic and clinical characteristics.ResultsWithin 6 months of care initiation, HIV monitoring tests were performed for 91.3% (95% CI, 88.7%–93.8%) of patients; coinfection blood tests, 27.5% (95% CI, 22.5%–32.4%); site-based STI tests, 59.7% (95% CI, 55.4%–63.9%); and blood chemistry and hematology tests, 50.8% (95% CI, 45.8%–55.8%). Patients who were younger, gay, or bisexual were more likely to receive site-based STI tests, and patients receiving care at Ryan White HIV/AIDS Program (RWHAP)–funded facilities were more likely than patients at non-RWHAP-funded facilities to receive all test combinations.ConclusionsReceipt of recommended baseline tests among patients initiating HIV care was suboptimal but was more likely among patients at RWHAP-funded facilities. Embedding clinical decision support in HIV provider workflow could increase recommended baseline testing.

1261-P: Is Glycemic Control Better in Adults with Type 1 Diabetes When Office Visits are Supplemented with Telehealth Visits?

Objective: Since the COVID-pandemic began, instead of in-office care alone, many institutions implemented hybrid care (in-office + telemedicine) . It is not known if hybrid care is as effective as in-office visits in regards to achieving glycemic goals. Methods: Clinical characteristics of adults with type 1 diabetes (T1D) (age ≥40 years) were retrieved from electronic health records from two periods: in-office model before the pandemic (April 2019-March 2020) and hybrid-care model during the pandemic (September 20pril 2021) . Patients were stratified by age. Results: Overall, 1,820 patients were evaluated, 66% younger (40-64 years: mean age 52±7yrs, 52% female, 53% CGM users, 56% pump users) and 34% older (≥65 years: mean age 72±5yrs, 55% female, 53% CGM users, 38% pump users) . A1c using hybrid-care improved in both younger (7.8±1.2 vs. 7.6±1.2%; p=0.005) and older adults (7.6±0.9 vs. 7.4±1%; p=0.02) , compared to in-office care. Within the hybrid-care model period, poor glycemic control was associated with a higher number of hybrid visits, and more in-office missed appointments, while pump use was associated with lower A1c. Conclusion: Compared with in-office care, hybrid care was effective at maintaining glycemic control in both younger and older adults with T1D. Prospective studies are needed to understand the use of hybrid-care for the management of adults with T1D. Disclosure E.Toschi: Consultant; Medtronic. A.Adam: None. C.Slyne: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc. M.Munshi: Consultant; Sanofi.

P.0058 Socio-demographic and clinical characteristics of adults with ID attending the ID clinic: Preliminary findings

P.0058 Socio-demographic and clinical characteristics of adults with ID attending the ID clinic: Preliminary findings

Real-World Study of CPX-351 Treatment Outcomes for Acute Myeloid Leukemia (AML) in England

Introduction: CPX-351 (US: Vyxeos ®; Europe: Vyxeos ® Liposomal) is a dual-drug liposomal encapsulation of daunorubicin and cytarabine in a synergistic 1:5 molar ratio. Since November 2018, the National Institute for Health and Care Excellence (NICE) has recommended its use for adults with newly diagnosed, therapy-related AML (t-AML) or AML with myelodysplasia-related changes (AML-MRC) due to either prior myelodysplastic syndrome (MDS)/chronic myelomonocytic leukemia (CMML) or de novo AML with myelodysplasia-related cytogenetic changes. The key aims of this study were to utilize the Cancer Analysis System (CAS) database available through the National Cancer Registration and Analysis Service (NCRAS) to describe the demographics and clinical characteristics of adults with AML in England who have received CPX-351, as well as to estimate overall survival (OS) and survival within stratifications of interest.Methods: The NCRAS systematically collects and curates population-level data about cancer diagnoses, treatments, and outcomes across England. Adults (aged ≥18 years) diagnosed with AML and treated with CPX-351 were included in this study. A diagnosis of t-AML or AML-MRC between January 2013 and March 2020 was determined either directly using International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes or indirectly using non-specific ICD-O-2, ICD-O-3, or ICD-10 AML codes in combination with either prior systemic anticancer therapy or radiotherapy (t-AML) or a prior diagnosis of MDS or CMML (AML-MRC; other AML-MRC subtypes could not be specifically identified and are included within the de novo AML subgroup). OS was measured from the date of diagnosis; a separate analysis of OS landmarked from the date of hematopoietic cell transplant (HCT) was also performed. Within this preliminary analysis, no OS adjustments have been made to account for any COVID-19-related deaths.Results: A total of 172 patients with AML who were treated with CPX-351 were identified: 37 (22%) had t-AML, 57 (33%) had AML-MRC, and 78 (45%) had de novo AML. At diagnosis, the mean (standard deviation) age was 62.8 years (10.1), with 49/172 (28%) patients aged <60 years; 66% of patients were male; 87% were white; and most had an Eastern Cooperative Oncology Group performance status of 0 or 1 (68%). Six (3%) patients had received azacitidine treatment for a prior malignancy. To date, 43/172 (25%) patients had undergone HCT overall, including 43/97 (44%) patients with ≥3 months of follow-up.The cut-off date for OS was December 31, 2020, giving a median (interquartile range) follow-up of 11.2 months (3.6, 16.9). Overall, 91 patients had died, with an estimated median OS (95% confidence interval [CI]) of 16.6 months (11.0, not estimable) and probability of survival (95% CI) at 1 and 2 years of 0.54 (0.47, 0.62) and 0.39 (0.30, 0.50), respectively (Figure 1). Early mortality rates were 7% at 30 days and 15% at 60 days. When OS was landmarked from the date of HCT, median OS was not reached, with a probability of survival (95% CI) at 1 year of 0.74 (0.62, 0.89; Figure 2). When stratified by age, estimated median OS (95% CI) was not reached for patients aged <60 years and 12.8 months (8.9, 17.6) for patients aged ≥60 years. In a treatment patterns analysis that evaluated second-line treatments after CPX-351, 68 patients died without salvage therapy and 64 were alive without receiving subsequent therapy by the end of the study period. The most common salvage treatments were fludarabine, cytarabine, idarubicin, and granulocyte-colony stimulating factor (FLAG-Ida; n = 15), daunorubicin plus cytarabine (DA)-based therapy (n = 6), and azacitidine alone (n = 7). Of the 43 patients who received an HCT, 6 (14%) underwent HCT following salvage therapy.Conclusions: This is the largest study to date examining the real-world outcomes for patients with AML who were treated with CPX-351. The estimated median OS of 16.6 months is consistent with reported real-world outcomes for CPX-351 in French and Italian studies. Median OS has not been reached in patients aged <60 years or when landmarked from the date of HCT. Once the CAS database has been updated, these analyses will be repeated to increase follow-up and patient numbers and to determine the impact of COVID-19 on OS following CPX-351 treatment. [Display omitted] DisclosuresLegg: Jazz Pharmaceuticals: Current Employment, Current equity holder in publicly-traded company. Doubleday: IQVIA Inc., which was contracted by Jazz Pharmaceuticals for the conduct of this analysis: Current Employment. Reich: IQVIA Inc., which was contracted by Jazz Pharmaceuticals for the conduct of this analysis: Current Employment. Lambova: IQVIA Inc., which was contracted by Jazz Pharmaceuticals for the conduct of this analysis: Current Employment. Medalla: Jazz Pharmaceuticals: Current Employment, Current equity holder in publicly-traded company.

A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection

Aims/hypothesisThe aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK.MethodsA retrospective cohort study was performed using data collected through a nationwide audit of people admitted to hospital with diabetes and COVID-19, conducted by the Association of British Clinical Diabetologists from March to October 2020. Prespecified demographic, clinical, medication and laboratory data were collected from the electronic and paper medical record systems of the participating hospitals by local clinicians. The primary outcome of the study, severe COVID-19, was defined as death in hospital and/or admission to the adult intensive care unit (AICU). Logistic regression models were used to generate age-adjusted ORs.ResultsForty UK centres submitted data. The final dataset included 196 adults who were admitted to hospital and had both type 1 diabetes and COVID-19 on admission (male sex 55%, white 70%, with mean [SD] age 62 [19] years, BMI 28.3 [7.3] kg/m2 and last recorded HbA1c 76 [31] mmol/mol [9.1 (5.0)%]). The prevalence of pre-existing microvascular disease and macrovascular disease was 56% and 39%, respectively. The prevalence of diabetic ketoacidosis on admission was 29%. A total of 68 patients (35%) died or were admitted to AICU. The proportions of people that died were 7%, 38% and 38% of those aged <55, 55–74 and ≥75 years, respectively. BMI, serum creatinine levels and having one or more microvascular complications were positively associated with the primary outcome after adjusting for age.Conclusions/interpretationIn people with type 1 diabetes and COVID-19 who were admitted to hospital in the UK, higher BMI, poorer renal function and presence of microvascular complications were associated with greater risk of death and/or admission to AICU. Risk of severe COVID-19 is reassuringly very low in people with type 1 diabetes who are under 55 years of age without microvascular or macrovascular disease.In people with Type 1 diabetes and COVID-19 admitted to hospital in the UK, BMI and one or more microvascular complications had a positive association and low serum creatine levels had a negative association with death/admission to intensive care unit after adjusting for age.

Glycemic control status, diabetes management patterns, and clinical characteristics of adults with type 1 diabetes in Japan: Study of Adults' Glycemia in T1DM subanalysis.

Type 1 diabetes is rare in the general Japanese population, but becoming more common in adults with increased longevity owing to advancements in treatment. We aimed to examine the current state of glycemic control and diabetes management using real-world data on Japanese adults with type 1 diabetes in different age groups. This was a subanalysis of Japanese participants from a multinational, cross-sectional, observational study of adults with type 1 diabetes aged ≥ 26years conducted in 2018 (Study of Adults' Glycemia in T1DM). Glycemic control achievement rate and goal setting, incidence of hypoglycemia, and diabetes management of individuals aged 26‒44years, 45‒64years, and ≥ 65years were summarized. The data on 528 participants were analyzed. The mean glycated hemoglobin (HbA1c) value was 7.8% (61.3mmol/mol). Of the participants, 25.8% achieved an HbA1c level of < 7.0% (26-44years, 33.7%; 45‒64years, 18.9%; and ≥ 65years, 24.3%). In total, 71.4% participants reported ≥ 1 symptomatic hypoglycemic episode within the last 3months, and 5.5% participants reported ≥ 1 severe hypoglycemic episode within the last 6months. A less stringent individualized goal was set for participants aged ≥ 65years; they had the lowest incidence of ≥ 1 symptomatic hypoglycemic episode. Insulin pumps and continuous glucose monitoring were used in 23.5% and 33.9% participants, respectively. Glycemic control was suboptimal; the low incidence of severe hypoglycemia suggests careful glycemic control, balancing benefits and risks, particularly in Japanese adults aged ≥ 65years with type 1 diabetes. The online version contains supplementary material available at 10.1007/s13340-021-00504-7.

Socio-Demographic and Clinical Characteristics of Adults With Psychotic Symptomatology Under Involuntary Admission and Readmission for Compulsory Treatment in a Referral Psychiatric Hospital in Cyprus.

Socio-demographic and clinical characteristics of adults under compulsory psychiatric treatment, have not been reported adequately in Southern European countries. We investigated the socio-demographic and clinical characteristics of adults with psychotic symptomatology who were involuntarily treated in the acute Mental Health Services in Cyprus. A descriptive cross-sectional study was applied. Data collection (December 2016 to February 2018) achieved via a structured questionnaire including demographic and clinical variables. Census sampling was applied in Cyprus referral center for compulsory psychiatric treatment. The sample included 406 individuals (262 males, 144 females). Approximately 86.2% were single, 77.6% were unemployed, and 24.9% held a bachelor's degree. The most frequent clinical diagnosis was schizophrenia or a relevant psychotic disorder (86.4%). The most frequent admission cause was non-adherence to pharmacotherapy along with disorganized behavior (agitation and/or self-care deficit, and/or aggressive behavior, and/or suicidal behavior) (53.6%). Moreover, 70.7% of the sample reported a positive personal history of mental health problems, while 42.1% reported a positive family history of mental health disorders. Half of the participants (52%) were previously involuntarily admitted for compulsory treatment. Adjusted associations of readmission status were reported with Cypriot ethnicity (OR: 4.40, 95%CI: 2.58–7.50), primary education only (OR: 3.70, 95%CI: 1.64–8.37), readmission due to disorganized behavior along with non-adherence to pharmacotherapy (OR: 10.84, 95%CI: 2.69–43.72), as well as along with substance use (OR: 6.39, 95%CI: 1.52–26.82). Readmission was almost five times more likely to occur due to suicidal behavior (OR: 5.01, 95%CI: 1.09–22.99) compared to disorganized behavior not otherwise specified. Additionally, those with a diagnosis of schizophrenia were more than 12 times more frequently readmitted for compulsory treatment compared to other diagnoses (OR 12.15, 95%CI: 1.04–142). Moreover, the participants with higher secondary education had 54.6% less odds to be involuntarily re-admitted compared to Bachelor degree holders (OR 0.442, 95%CI: 0.24–0.79). A high percentage of involuntary treatment was noted due to non-adherence to pharmacotherapy and substance use. Re-evaluation of the effectiveness of relevant community interventions is suggested, as well as implementation of structured educational programs on therapy adherence during psychiatric hospitalization.

Socio-Demographic and Clinical Characteristics of Adults with Sars-Cov-2 Infection in Two Hospitals in Bogota, Colombia

This study is a retrospective cohort of 122 adult patients with SARS-CoV-2 diagnosed and managed at two mediumsized, tertiary private hospitals. The analysis includes demographic and socio-economic information, symptoms, comorbidities, laboratory test results, therapeutic management, clinical outcomes and complications.

Population-based study on the prevalence and clinical profile of adults with cerebral palsy in Northern Ireland

ObjectivesThis study aimed to report the prevalence and clinical characteristics of adults with cerebral palsy (CP) in a geographically defined region of the UK.Design and settingCross-sectional study using the Northern...

Racial/Ethnic and Income Disparities in the Prevalence of Comorbidities that Are Associated With Risk for Severe COVID-19 Among Adults Receiving HIV Care, United States, 2014-2019.

Health inequities among people with HIV may be compounded by disparities in the prevalence of comorbidities associated with an increased risk of severe illness from COVID-19. Complex sample survey designed to produce nationally representative estimates of behavioral and clinical characteristics of adults with diagnosed HIV in the United States. We estimated the prevalence of having ≥1 diagnosed comorbidity associated with severe illness from COVID-19 and prevalence differences (PDs) by race/ethnicity, income level, and type of health insurance. We considered PDs ≥5 percentage points to be meaningful from a public health perspective. An estimated 37.9% [95% confidence interval (CI): 36.6 to 39.2] of adults receiving HIV care had ≥1 diagnosed comorbidity associated with severe illness from COVID-19. Compared with non-Hispanic Whites, non-Hispanic Blacks or African Americans were more likely [adjusted PD, 7.8 percentage points (95% CI: 5.7 to 10.0)] and non-Hispanic Asians were less likely [adjusted PD, -13.7 percentage points (95% CI: -22.3 to -5.0)] to have ≥1 diagnosed comorbidity after adjusting for age differences. There were no meaningful differences between non-Hispanic Whites and adults in other racial/ethnic groups. Those with low income were more likely to have ≥1 diagnosed comorbidity [PD, 7.3 percentage points (95% CI: 5.1 to 9.4)]. Among adults receiving HIV care, non-Hispanic Blacks and those with low income were more likely to have ≥1 diagnosed comorbidity associated with severe COVID-19. Building health equity among people with HIV during the COVID-19 pandemic may require reducing the impact of comorbidities in heavily affected communities.

The burden of chronic disease, multimorbidity, and polypharmacy in adults with Down syndrome.

Data on clinical characteristics of adults with Down syndrome (DS) are limited and the clinical phenotype of these persons is poorly described. This study aimed to describe the occurrence of chronic diseases and pattern of medication use in a population of adults with DS. Participants were 421 community dwelling adults with DS, aged 18 years or older. Individuals were assessed through a standardized clinical protocol. Multimorbidity was defined as the occurrence of two or more chronic conditions and polypharmacy as the concomitant use of five or more medications. The mean age of study participants was 38.3 ± 12.8 years and 214 (51%) were women. Three hundred and seventy-four participants (88.8%) presented with multimorbidity. The most prevalent condition was visual impairment (72.9%), followed by thyroid disease (50.1%) and hearing impairment (26.8%). Chronic diseases were more prevalent among participants aged >40 years. The mean number of medications used was 2.09 and polypharmacy was observed in 10.5% of the study sample. Psychotropic medications were used by a mean of 0.7 individuals of the total sample. The high prevalence of multimorbidity and the common use of multiple medications contributes to a high level of clinical complexity, which appears to be similar to the degree of complexity of the older non-trisomic population. A comprehensive and holistic approach, commonly adopted in geriatric medicine, may provide the most appropriate care to persons with DS as they grow into adulthood.