Greater Age Research Articles

The level of kinesiophobia in breast cancer women undergoing surgical treatment.

Lifestyle-associated factors like physical activity (PA) play an important role in cancer prevention and oncology treatment outcomes. The aim of the study is to investigate the level of kinesiophobia (fear of movement) in breast cancer (BC) patients undergoing surgical treatment depending on socio-demographic variables, lifestyle before cancer diagnosis, stage and type of BC and comorbidities. We interviewed 285 women (132 patients from Greater Poland Cancer Center - age: 55.7 ± 12.4; BMI: 26.7 ± 4.7 and 153 healthy women from control group - age: 49.0 ± 15.7; BMI: 25.7 ± 4.0) using Polish adaptation of the Tampa Scale of Kinesiophobia (TSK). Research results show that women with BC suffer from kinesiophobia (>37 points) signi!cantly. Approximately 3/4 of the surveyed women with BC did not know the World Health Organization (WHO) recommendations regarding the weekly dose of PA for healthy people and for people with cancer. Before cancer diagnosis more than a half of women (60%) performed PA in accordance with WHO recommendations. 7% less women performed PA during oncology treatment. Almost a half of patients are not physically active during cancer treatment and 1/5 of the respondents declared that they do not know yet if they will be physically active after oncology treatment. The level of kinesiophobia in BC women with comorbidities was the same as in the group of BC women without comorbidities. However, the highest levels of fear of movement have been observed among women with BC suffering also from osteoporosis, obesity and diabetes. In general, higher levels of kinesiophobia were reported among women in less advanced stages of the disease. There were no differences in the level of kinesiophobia depending on the type of BC (hormonally dependent luminal cancers vs. other types). The level of kinesiophobia did not differ between women who were physically active before BC diagnosis and women who were not. In terms of socio- demographic variables, we found one direct association between the level of kinesiophobia (pain) with age - the greater age, the higher level of pain kinesiophobia. Research on fear of movement in female oncology requires further research (including also chemotherapy, radiotherapy, immunotherapy and hormonal therapy) and in order to effectively eliminate hypokinetic attitudes at every stage of cancer treatment.

Frequency of Hypomagnesemia in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Objective: The purpose of this study is to assess the prevalence of hypomagnesemia among COPD patients (COPD). Study design: A cross sectional study. Place and duration of study: I have been offered a position in the Medicine & Pulmonology Department at Nishtar Hospital in Multan, Pakistan, which I will begin in March 2016 and remain in until February 2018. Methodology: The non-probabilistic sequential sampling technique used to choose the final pool of 137 cases. Quantitative variables' means and standard deviations were determined. Quantitative evaluation included frequency counts and percentages for qualitative factors. Several effect modifiers have been taken into consideration via stratification, including age, diabetes, body mass index, COPD, high blood pressure, smoking, socioeconomic status, place of residence (race/ethnicity), and gender. A chi-square test for stratification was used to examine the data, and a P value of 0.05 was considered statistically significant. Results: 30.81±14.74 Nearly eighty-one percent of the sample had illnesses that lasted more than 18 months, and the median duration of illness was also months (112). Fifty patients, or 36.5% of the total, were found to have low magnesium levels, with a mean blood magnesium level of 1.520.54 meq/liter. Practical Implementation: There is a lack of data on the function of magnesium in preventing COPD exacerbations. Hypomagnesemia may prove to be helpful in establishing COPD exacerbation as a predictive factor, according to the research that is now being conducted. This could lead to the development of COPD intervention strategies other than the standard treatments, enhancing COPD patients' life quality, morbidity, and mortality. Conclusion: Our results provide evidence that hypomagnesemia is common among people with COPD. Male gender, greater age, lower socioeconomic status, diabetes, hypertension, tobacco use, and longer disease duration were all associated with low magnesium levels. Keywords: Chronic Obstructive pulmonary disease (COPD), frequency, hypomagnesemia.

Does loss to follow-up lead to an overestimation of treatment success? Findings from a spine surgery registry of over 15,000 patients.

Patient-reported outcome measures (PROMs) are integral to the assessment of treatment success, but loss to follow-up (attrition) may lead to bias in the results reported. We sought to evaluate the extent, nature and implications of attrition in a long-established, single-centre spine registry. The registry contained the data of 15,264 consecutive spine surgery patients. PROMs included the Core Outcome Measures Index (COMI) and a rating of the Global Treatment Outcome (GTO) and Satisfaction with Care. Baseline characteristics associated with returning a 12-month PROM (= "responder") were analysed (logistic regression). The 3-month outcomes of 12-month responders versus 12-month non-responders were compared (ANOVA and Chi-square). In total, 14,758/15,264 (97%) patients (60 ± 17y; 46% men) had consented to the use of their registry data for research. Preoperative, 3-month post-operative and 12-month post-operative PROMs were returned by 91, 90 and 86%, respectively. Factors associated with being a 12-month responder included: greater age, born in the country of the study, no private/semi-private insurance, better baseline status (lower COMI score), fewer previous surgeries, less comorbidity and no perioperative medical complications. 12-month non-responders had shown significantly worse outcomes in their 3-month PROMs than had 12-month responders (respectively, 66% vs 80% good GTO ("treatment helped/helped a lot"); 77% vs 88% satisfied/very satisfied; and 49% vs 63% achieved MCIC on COMI). Although attrition in this cohort was relatively low, 12-month non-responders displayed distinctive characteristics and their early outcomes were significantly worse than those of 12-month responders. If loss to follow-up is not addressed, treatment success will likely be overestimated, with erroneously optimistic results being reported.

Is Helicobacter pylori Infection Prevalent in Middle East Countries?

Background: Helicobacter pylori is a pathogenic bacteria found in the gastric mucosa of both children and adults. Our goal was to use an endoscopic method to look at the prevalence of H. pylori in children with gastrointestinal complaints. Methods: This cross-sectional research was conducted in 2022 on pediatric patients who received gastric or duodenal biopsies by endoscopy. We collected data from medical reports regarding patients' age, gender, location of residence, type of gastrointestinal problems, and frequency of H. pylori infection. Results: A total of 2030 pediatric patients participated in the study. Helicobacter pylori infection was found in 259 cases (12.76%). There were no significant differences between the two genders regarding the prevalence of H. pylori infection (P = 0.094). This infection was more common in patients aged > 10 years (P < 0.001) and in residents of the Isfahan suburb (P < 0.001). Conclusions: In comparison to other locations, we found a similar incidence rate of H. pylori infection in children. According to our findings, greater ages are associated with a higher detection rate of H. pylori infection.

A normative database of wide-field swept-source optical coherence tomography angiography quantitative metrics in a large cohort of healthy adults.

Data from healthy eyes is needed to interpret optical coherence tomography angiography (OCTA) findings. However, very little normative data is available for wide-field swept-source OCTA (WF SS-OCTA), particularly 12 × 12-mm and disc-centered angiograms. Therefore, we aim to report quantitative metrics in a large sample of control eyes. In this cross-sectional observational study, 482 eyes of 375 healthy adults were imaged on the 100kHz Zeiss PLEX® Elite 9000 using protocols centered on the fovea (3 × 3, 6 × 6, and 12 × 12-mm) and optic disc (6 × 6 and 12 × 12-mm) between December 2018 and January 2022. The ARI Network (Zeiss Portal v5.4) was used to calculate vessel density (VD) and vessel skeletonized density (VSD) in the superficial capillary plexus, deep capillary plexus, and whole retina, as well as foveal avascular zone (FAZ) parameters. Mixed-effect multiple linear regression models were used for statistical analysis. The subjects' median age was 55 (38-63) years, and 201 (53.6%) were female. Greater age and worse best-corrected visual acuity (BCVA) were associated with significantly lower VD and VSD (p < 0.05). VD and VSD differed based on race and cataract status, but not sex, on some scan protocols (p < 0.05). FAZ circularity decreased with age, and FAZ dimensions differed based on race and ethnicity in certain scan protocols. We report a large database of parafoveal and peripapillary vascular metrics in several angiogram sizes. In referencing these values, researchers must consider characteristics such as age, race, and BCVA, but will have a valuable point of comparison for OCTA measurements in pathologic settings.

The burden of preoperative fear-avoidance beliefs in workers after thoracic and lumbar spine surgery: a 2-year follow-up study.

Spinal disorders are the main reasons for sick leave and early retirement among the working population in industrialized countries. When "red flags" are present, spine surgery is the treatment of choice. However, the role of psychosocial factors such as fear-avoidance beliefs in spine surgery outcomes is still debated. The study aims to investigate whether patients presenting high or low levels of fear-avoidance thoughts before the spine surgery reported different surgical results and return-to-work rates over 2 years. From an institutional spine surgery registry, workers surgically treated with a preoperative score in the Oswestry Disability Index (ODI) higher than 20/100 and provided ODI questionnaires, return-to-work status at 3-, 6-, 12-, and 24-month follow-ups were analyzed. A total of 1769 patients were stratified according to the work subscale of the Fear-Avoidance Beliefs Questionnaire (FABQ-W) in high fear (FABQ-W ≥ 34/42) or low fear (FABQ-W < 34/42). Multivariate regression was used to search for preoperative factors, which might interact with FABQ-W. The higher-fear group showed a different recovery pattern, with higher levels of disability according to the ODI (total score, absolute change, frequency of clinically relevant change, and disability categories) and lower return-to-work ratios over the 24-month follow-up. High fear, high disability, greater age, female gender, smoking, and worse physical status at baseline were associated with worse ODI outcomes 2 years after the surgery. In summary, fear-avoidance beliefs significantly influence the speed and the entity of surgical outcomes in the working population. However, the contribution of FABQ-W in predicting long-term disability levels was limited.

Combined Cognitive Training and Vortioxetine Mitigates Age-Related Declines in Functional Brain Network Integrity

ObjectiveAge-related cognitive decline is common and potentially modifiable with cognitive training. Combining cognitive training with pro-cognitive medication offers an opportunity to modify brain networks to mitigate age-related cognitive decline. We tested the hypothesis that the efficacy of cognitive training could be amplified by combining it with vortioxetine, a pro-cognitive and pro-neuroplastic multimodal antidepressant. MethodsWe evaluated the effects of 6 months of computerized cognitive training plus vortioxetine (versus placebo) on resting state functional connectivity in older adults (age 65+) with age-related cognitive decline. We first evaluated the association of functional connectivity with age and cognitive performance (N = 66). Then we compared the effects of vortioxetine plus cognitive training versus placebo plus cognitive training on connectivity changes over the training period (n = 20). ResultsAt baseline, greater age was significantly associated with lower within-network strength and network segregation, and poorer cognitive function. Cognitive training plus vortioxetine over 6 months positively impacted the relationship between age to mean network segregation. These effects were not observed in the placebo group. In contrast, vortioxetine did not modify the relationship of age to change in mean within-network strength. Exploratory analyses identified the cingulo-opercular network as the network most affected by cognitive training plus vortioxetine. ConclusionThis preliminary study provides evidence that combining cognitive training with pro-cognitive medication may modulate the effects of aging on functional brain networks. Results indicate that for older adults experiencing age-related cognitive decline, vortioxetine has a potentially beneficial effect on the correspondence between aging and functional brain network segregation. These results await replication in a larger sample.

Characteristics of patients resuscitated after burn related out-of-hospital cardiac arrest

AimThis study’s objective was to describe the characteristics of burn injury patients who were resuscitated after burn related out-of-hospital cardiac arrest (OHCA). MethodWe conducted a retrospective cohort study and examined characteristics of burn related OHCA using data from a Japanese nationwide burn registry that was collected between April 1, 2011 and March 31, 2020. First, we compared the characteristics of burn patients with and without OHCA. Second, among burn patients with OHCA, we compared the characteristics of survivors with non-survivors. ResultsIn the database, there were 16,995 hospitalised burn patients and 256 burn related OHCA. Thirty-two of the 256 burn patients (13%) survived after admission. Among patients with burns who also had OHCA, flames were the most common injury mechanism (74%); in comparison to all other injury mechanisms, the rate of flame burn was significantly higher in burn patients with OHCA than in burn patients without OHCA. The most common cause of death for burn related OHCA is carbon-monoxide poisoning (46%). Compared with survivors, non-survivors had a larger burn area, greater age and more complications. such as inhalation injuries and perineal burn injuries. Compared to other mechanisms of burn injury, electrical burn injuries were more common among survivors. In twelve patients with electrical burns, eight patients survived (67%) OHCA; of those eight patients, six (50%) could be discharged home. ConclusionPatients with burn related OHCA have a poor prognosis; however, patients who sustain electrical shock injuries may do better.

Uptake of community pharmacist prescribing over a three-year period

ObjectivesPharmacists in Nova Scotia have had legislated authority to prescribe since 2011. This study aimed to describe the prescribing activities of pharmacists and the characteristics of patients who used pharmacist prescribing services. MethodsUsing provincial health administrative databases we identified all community pharmacists who prescribed during the study period (October 2016 to March 2020) and correspondingly patients who had medications prescribed by a pharmacist during this period. Differences in, and predictors of the quantity of pharmacist prescribing over three fiscal years (April 2017 to March 2020) were described. Pharmacist prescribing activity was compared across the fiscal years of the study period with One-way Analysis of Variance. Negative binomial regression examined patient factors associated with use of pharmacist prescribing services. Analysis was carried out using SAS ENTERPRISE GUIDE v.8.2 (SAS Institute Cary, NC, USA). Key findingsA total of 1182 pharmacist prescribers were identified, who on average prescribed 24.6, 26.3, and 32.5 (p < 0.001) times per month in fiscal years 2018, 2019, 2020, respectively. The patient cohort contained 372,203 Nova Scotians over the 3-year period. For approved common and minor ailment prescribing in Nova Scotia, gastroesophageal reflux disease, vaccines (non-travel), contraceptive management, herpes zoster treatment, and allergic rhinitis had the highest number of prescriptions over the study period. Patient factors most strongly related to receiving more prescribing services by a pharmacist included receiving income assistance without copay (Incidence rate ratio (IRR) = 1.70), having >2 comorbidities (IRR = 1.51), male sex (IRR = 1.03), and greater age (IRR = 1.01). Those from an urban area (IRR = 0.92) or having a higher income (IRR = 0.95) received fewer pharmacist prescribing services (all p < 0.0001). ConclusionsPharmacist prescribing increased over the 3-year period. Patients who were older and those with multiple comorbidities used pharmacist prescribing services most often. Prescribing activities represent an increasingly utilized role for pharmacists in primary care.

Outcomes of Patients With Atrial Fibrillation Following Thrombectomy for Stroke

Patients with atrial fibrillation (AF) treated with mechanical thrombectomy (MT) for acute ischemic stroke (AIS) have been reported to experience worse outcomes compared with patients without AF. To assess differences between patients with AF and their counterparts without AF treated with MT for AIS, focusing on safety outcomes, clinical outcomes, and baseline characteristics in both groups. A systematic literature review of the English language literature from inception to July 14, 2022, was conducted using Web of Science, Embase, Scopus, and PubMed databases. Studies that focused on patients with and without AF treated with MT for AIS were included. Multiple reviewers screened studies to identify studies included in analysis. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline to ensure accuracy. Data were pooled using a random-effects model. The primary outcome of interest was rate of modified Rankin Scale (mRS) scores of 0 to 2 at 90 days. Secondary outcomes of interest included rates of successful reperfusion, defined as thrombolysis in cerebral infarction (TICI) scores of 2b to 3, 90-day mortality, symptomatic intracranial hemorrhage (SICH), and baseline patient characteristics. Of 1696 initially retrieved studies, 10 studies were included, with 6543 patients. Patients with AF were a mean of 10.17 (95% CI, 8.11-12.23) years older (P < .001) and had higher rates of hypertension (OR, 1.89 [95% CI, 1.57-2.27]; P < .001) and diabetes (OR, 1.16 [95% CI, 1.02-1.31]; P = .02). Overall, there were comparable rates of mRS scores of 0 to 2 between patients with AF and patients without AF (odds ratio [OR], 0.72 [95% CI, 0.47-1.10]; P = .13), with significant heterogeneity among the included studies. After sensitivity analysis, the rate of mRS scores of 0 to 2 was significantly lower among patients with AF (OR, 0.65 [95% CI, 0.52-0.81]; P < .001). Successful reperfusion rates were similar between the groups (OR, 1.11 [95% CI, 0.78-1.58]; P = .57). The rate of SICH was similar between groups (OR, 1.05 [95% CI, 0.84-1.31]; P = .68). Mortality was significantly higher in the AF group (OR, 1.47 [95% CI, 1.12-1.92]; P = .005). In this systematic review and meta-analysis, patients with AF experienced worse 90-day outcomes, even in the setting of similar rates of successful reperfusion. This was likely associated with greater age and greater rates of comorbidities among patients with AF.

Measures of Admission Immunocoagulopathy as an Indicator for In-Hospital Mortality in Patients with Necrotizing Fasciitis: A Retrospective Study.

Demographic data, infection characteristics, and laboratory values from 389 confirmed necrotizing fasciitis cases from a single institution were analyzed. A multivariable logistic regression model was built on admission immunocoagulopathy measures (absolute neutrophil, absolute lymphocyte, and platelet counts) and patient age to predict in-hospital mortality. The overall in-hospital mortality rate was 19.8% for the 389 cases and 14.6% for the 261 cases with complete measures of immunocoagulopathy on admission. A multivariable logistic regression model indicated that platelet count was the most important predictor of mortality, followed by age and absolute neutrophil count. Greater age, higher neutrophil count, and lower platelet count led to significantly higher risk of mortality. The model discriminated well between survivors and non-survivors, with an overfitting-corrected C-index of 0.806. This study determined that measures of immunocoagulopathy and patient age at admission effectively prognosticated the in-hospital mortality risk of patients with necrotizing fasciitis. Given the accessibility of neutrophil-to-lymphocyte ratio and platelet count measurements determined from a simple complete blood-cell count with differential, future prospective studies examining the utility of these measures are warranted. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Disordered Eating and Body Image Concerns in Young Adult Women With Scoliosis

Researchers have called for more investigation into disordered eating behaviors in females with scoliosis. The objective of the current study was to assess the associations between body image concerns, disease-specific indicators of scoliosis (ie, age of diagnosis, having undergone bracing treatment, being told by a physician your scoliosis required surgery, having a spinal fusion), quality of life, and disordered eating in a sample of young adult women diagnosed with idiopathic scoliosis during adolescence. This study was cross-sectional in design. Participants were 177 young adult women ages 18 to 30 years diagnosed with idiopathic scoliosis by a physician who completed questionnaires online. Undergoing bracing treatment (r = -.440; P < .001), greater age at scoliosis diagnosis (r = .563; P < .001), being told scoliosis required surgery (r = -.196; P < .050), annual income (r = .306; P < .001), level of education (r = .228; P < .010), and race/ethnicity (r = -.213; P < .050) were associated with the EDE-Q Global Score. The Body Shape Questionnaire Total Score and EDE-Q Global Score (r = .848; P < .001) and EDE-Q Weight Concern Score (r = .813; P < .001) were associated. The strongest correlations between the EDE-Q and the SRS-22-Revised Subscales were generally evidenced on the SRS-22-Revised Mental Health Subscale (rs ranged from -.200 to -.371; P < .001). After controlling for annual income, highest level of education, undergoing bracing treatment, and age of scoliosis diagnosis, the Body Shape Questionnaire Total Score was significantly correlated with the EDE-Q Eating Concern Score (standardized beta coefficient = .618; P < .001). These findings underscore the importance of assessing body image concerns in young adult women with scoliosis experiencing disordered eating as this information may provide valuable information relevant to treatment planning.

Association of fasting glucose and fasting insulin levels: Insights into the mechanisms of pre-diabetes

Background: Pre-diabetes is a critical stage with a risk of developing Type 2 diabetes mellitus and it is there is solid evidence of impaired glucose metabolism among the patients. Insulin resistance is the frequent finding and is a key factor in pre-diabetes but its specific relationship with fasting glucose and fasting insulin levels requires further exploration. Aims and Objectives: This study aimed to investigate the correlation of fasting glucose and fasting insulin levels in subjects with pre-diabetes. Materials and Methods: A total of 86 individuals with pre-diabetes (subjects having a level of fasting blood sugar of 100–125 mg/dL) were recruited for this cross-sectional study. Fasting glucose and fasting insulin levels were measured with an 8-h fasting for all the participants of the study who had been diagnosed as pre-diabetes. The Pearson correlation was carried out to evaluate the relationships between fasting glucose and fasting insulin levels. Results: This study included 86 people (56 male and 30 female) with an average age of 42.57 ± 7.58 years. Males had a greater age, height, weight, and BMI. Similarly, no gender differences in blood sugar or insulin levels were seen. FBS and serum insulin levels had a positive connection (r = 0.19, P = 0.038). Conclusion: Our study revealed a robust positive correlation between fasting blood sugar and fasting insulin levels in individuals with pre-diabetes. These findings emphasize the need for early intervention and tailored strategies to address insulin resistance in pre-diabetic individuals to mitigate the risk of progressing to Type 2 diabetes.

Distribution, determinants and normal reference values of aortic arch width: Thoracic aortic geometry in the Framingham Heart Study

Study objectiveAortic arch geometry changes with age, including an increase in aortic arch width (AAW). High AAW is a predictor of incident adverse cardiovascular disease (CVD) events, but its distribution and determinants are unknown. We hypothesized that traditional CVD risk factors, in addition to age, are associated with increased AAW in community-dwelling adults. Study designFramingham Offspring and Third Generation cohort participants (N = 3026, 52 % men) underwent thoracic multidetector computed tomography (MDCT). A referent group (733M, 738W) free of clinical CVD, hypertension, dyslipidemia, smoking, and diabetes was used to generate sex and 10-year age-group specific upper 90th percentile (P90) cut-points for AAW. AAW was measured as the distance between the cross-sectional centroids of the ascending and descending thoracic aorta. Multivariable logistic regression models were used to identify clinical correlates of high AAW (≥referent P90) in the overall study group. ResultsAmong referent participants, AAW increased with greater age-group, p for trend <0.0001 in each sex. Overall and within each age group, AAW was greater in men than women, p < 0.0001 all comparisons. Across all participants, high AAW was associated with greater age (odds ratio, OR = 1.34/10 years; 95 % confidence interval 1.20–1.50), body surface area (OR = 1.97/SD; 1.62–2.40), diastolic blood pressure (OR = 1.59/10 mm Hg; 1.40–1.81), pack-years smoked (OR = 1.07; 1.02–1.13), and prevalent CVD (OR = 1.64; 1.08–2.49). ConclusionAAW increases with greater age, body size, diastolic blood pressure and burden of smoking. High AAW (≥referent P90) is also associated with prevalent (clinically apparent) CVD. AAW is often seen on and easily measured from tomographic thoracic images and has prognostic value.

Lower-extremity muscle wasting in patients with peripheral arterial disease: quantitative measurement and evaluation with CT.

Lower-extremity peripheral arterial disease (PAD) results in limb ischemia and is strongly associated with sarcopenia. This study aimed to retrospectively evaluate the association between the quantity of muscle mass in the lower extremities and the severity of vascular stenosis in PAD patients. Between January 2018 and August 2021, 128 patients with PAD and 53 individuals without PAD, diagnosed by computed tomography, were enrolled. The severity of stenosis of lower-extremity arteries was measured using a grading system. The muscle and fat mass areas were calculated in the abdomen at the L3 or L4 level, mid-thigh, and lower leg. Multivariable logistic regression was conducted to clarify the risk associated with low muscle mass. The difference in muscle mass between PAD and non-PAD patients was evaluated by using propensity score matching. A strong positive correlation between the abdomen muscle area and leg muscle area was observed. The muscle area and muscle index of the leg were lower in PAD patients. These changes occurred earlier than in the abdomen muscle area. The group with more severe artery stenosis had more muscle wasting in the lower extremities. Greater age, female, lower BMI, and PAD were associated with low muscle mass. After propensity score matching, the leg muscle area was still lower in PAD patients. There is a direct association between PAD and regional muscle wasting. This occurs earlier regionally in the lower extremities than in central muscles. Early diagnosis of PAD might prevent progressive muscle loss, improving disease outcome and quality of life. • Peripheral arterial disease is strongly associated with sarcopenia. • Muscle wasting in the lower extremities is earlier and more prominent than that in the abdomen. • More severe arterial stenoses are associated with higher muscle wasting in the lower extremities.

RACE AND AGE DIFFERENCES IN DEPRESSION AND ANXIETY DURING COVID-19: A LONGITUDINAL STUDY

Abstract The COVID-19 pandemic has negatively affected the physical and mental health of many. It remains unclear whether such impacts differ across diverse races or age groups, or along the course of the pandemic. This study assessed trends in levels of depression and anxiety symptoms among U.S. adults during COVID-19 and whether differences emerged across race and age. Data were drawn from the Understanding America Study (UAS) COVID-19 survey, a longitudinal panel survey of a nationally representative sample of over 6,000 individuals. A mixed effect linear model was conducted to assess the influence of race and age on the level of depression and anxiety over time during the pandemic, controlling for covariates such as marital status, employment status, and household income. Results indicate that greater age was associated with lower levels of depression and anxiety. Additionally, trends in levels of depression and anxiety vary across races (e.g., minority populations generally reported lower or comparable levels of depression and anxiety comparing to the White). Findings further suggest significant interactions between age and race, especially among minoritized adults. Study findings underscore the importance of future research and tailored strategies to improve culturally sensitive and age-appropriate mental health services targeting diverse populations.

1056. Correlates of Omicron SARS-CoV-2 viral load: diagnostic and clinical implications

Abstract Background Omicron SARS-CoV-2 infections are associated with less frequent olfactory sensory loss and a predominance of pharyngitis symptoms compared to prior variants, with proposed diagnostic implications. We examined whether such symptomology predicts a higher RNA abundance in the oropharynx. We further investigated how age, symptom-day, vaccination history and clinical severity correlate with viral load to inform clinical prognostication and transmission modeling. Methods The EPICC study is a longitudinal cohort of COVID-19 cases enrolled through U.S military medical treatment facilities. Demographic and clinical characteristics were measured with interviews and surveys. Nasopharyngeal (NP), oropharyngeal (OP) and nasal swabs (NS) were collected for SARS-CoV-2 qPCR and sequence genotyping. Multivariable linear regression models were fit to estimate the effect of anatomical site on SARS-CoV-2 RNA abundance (a proxy for viral load), adjusting for sampling time, vaccine history and host age. Results We analyzed 77 sequence-confirmed Omicron cases; no BA.2 cases were detected. The median age was 38.8 years. 81.8% were vaccinated and 15.6% cases were hospitalized. 80.0%, 21.8%, and 65.5% reported nasal congestion, loss of smell or taste, and sore throat, respectively. The median RNA abundance was lowest in OP swabs (p &amp;lt; 0.001) (Fig 1). Linear regression confirmed that OP sampling was associated with lower viral load (p &amp;lt; 0.001). We further noted that greater age and symptom-day were independent correlates of viral load (Table 1). By bivariate analysis there was a trend toward lower RNA abundance in vaccinated subjects (p = 0.35). RNA abundance (at any site) was substantially higher in hospitalized (10634 N2 genome equivalents [GE]/reaction) versus outpatient cases (1419 N1 GE/reaction) but this was not statistically significant (p = 0.26). Fig 1.RNA abundance by upper respiratory swab anatomical location of collection (n = 142 swabs from n = 77 subjects) Conclusion We noted prevalent sore throat symptoms and infrequent sensory loss in Omicron cases. Despite this, viral load was highest in NP/NS collected swabs as has been noted in prior variants. We note an age correlation with RNA abundance, and provide a viral load decay rate which may be useful for transmission modeling. Vaccination and clinical severity may also correlate with Omicron viral load, as noted with prior SARS-CoV-2 variants. Disclosures Simon Pollett, MBBS, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Julia S. Rozman, n/a, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response David Tribble, MD, DrPH, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Mark P. Simons, PhD, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Timothy Burgess, MD, MPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response.

Impact of Age, Body Mass Index, and Resection Weight on Postoperative Complications in Reduction Mammaplasty.

The authors seek to evaluate the impact of age, body mass index (BMI), and resection weight, on postoperative complications in women undergoing primary bilateral reduction mammaplasty. A retrospective review of all primary bilateral reduction mammaplasties between February of 2014 and August of 2018 was performed. Patient demographics, medical comorbidities, tobacco use, BMI, operative technique, operative time, resection weight, and complications were reviewed. Two hundred seventy-seven women were included. Mean age was 35.71 years, and BMI was 30.17 kg/m 2 . An inferior pedicle (53.07%) with Wise pattern resection (53.43%) was used most commonly. The minor complication rate was 49.1%, with superficial wounds (42.1%) occurring most commonly. Thirty-three women (11.9%) required greater than 2 months to heal. The major complication rate was 4.31%. BMI was not associated with minor or major complications on univariate analysis ( P = 0.1003 and P = 0.6163), but was associated with wound healing requiring greater than 2 months ( P = 0.0009), longer operative times ( P = 0.0002), and higher resection weights ( P < 0.00001). Greater age was associated with higher minor complication rates ( P = 0.0048). On multivariate analysis, BMI was associated with wound healing requiring greater than 2 months ( P = 0.0137), and age with minor complications ( P = 0.0180). No factors impacted major complication rates. Women with higher BMI are more likely to require larger resections, longer operative times, and are at higher risk for wound healing requiring greater than 2 months. Although BMI is an important consideration for determining operative candidacy, the benefits of reduction may outweigh these risks in carefully selected patients. Risk, III.

Prevalence and distribution of aortic plaque by sex and age group among community-dwelling adults

Rationale and objectivesAtherosclerosis of the aorta is associated with increased risk of cardiovascular mortality and vascular events. We aim to describe the prevalence and distribution of non-calcified atherosclerotic plaque in the descending aorta as quantified by noncontrast cardiovascular magnetic resonance (CMR) in a community-dwelling cohort of adults. Materials and methodsWe used CMR to quantify noncalcified aortic plaque in 1726 participants (aged 65 ± 9 years, 46.7% men) from the Cohort Study Offspring cohort. ECG-gated, fat-suppressed, T2-weighted, black blood turbo spin echo sequence was used to acquire 36 transverse slices covering the descending aorta from just below the arch to the aortoiliac bifurcation. Plaque was defined as discrete luminal protrusions ≥1 mm; these were manually traced, then summed to determine total descending aortic plaque (DAP) and segmental thoracic and abdominal aortic plaque (TAP, AAP). Participants were stratified by sex and age group (<55, 55–64, 65–74, ≥75y). A healthy referent group (without clinical cardiovascular disease, smoking, diabetes, impaired renal function; (N = 768, 43.8% men) was used to determine upper 90th percentile cutpoints for DAP and AAP which were then applied to the overall study cohort. ResultsPrevalence of DAP was similar between men (47.3%) and women (48.9%), p = 0.50, as was AAP prevalence (men: 44.5%, women: 46.7%, p = 0.16); TAP was less prevalent in both sexes (men: 8.9%, women: 7.1%, p = 0.15). Both prevalence and burden of DAP, AAP and TAP increased with advancing age. ConclusionNoncalcified plaque prevalence, visualized on CMR, in community-dwelling adults is similar between the sexes, and both prevalence and burden of aortic plaque increase with greater age.

Introduction

Introduction