Higher Proportion Of Females Research Articles

Risk Factors for Symptomatic Cyclops Lesion Formation after Anterior Cruciate Ligament Reconstruction.

Objective To evaluate the incidence of symptomatic cyclops lesions requiring surgical treatment after anterior cruciate ligament (ACL) reconstruction and to establish possible intraoperative risk factors related to it. Methods Three hundred and eighty-nine patients aged between 18 and 50 years who underwent primary ACL reconstruction were retrospectively evaluated. Patients were divided into groups according to the presence or absence of symptomatic cyclops lesions, and their characteristics were compared. Patients with associated lesions that required additional surgical procedures (except anterolateral extra-articular procedures) were not included. The rate of symptomatic cyclops lesions was recorded and the following parameters were evaluated: age, gender, time from injury to surgery, graft type and diameter, femoral tunnel perforation technique, fixation type, presence of knee hyperextension, preservation of the ACL remnant, associated anterolateral extra-articular procedure, associated meniscal injury and participation in sports. Results 389 patients were evaluated and 26 (6.7%) patients developed cyclops. The patients with and without cyclops lesions did not differ in age, time from injury to surgery, graft type or diameter, surgical technique, femoral fixation method, presence of knee hyperextension, remnant preservation and associated meniscal injury. The group with cyclops lesion had a higher proportion of females (10 (38.4%) vs 68 (18.7%); OR = 2.7; p = 0.015), higher proportion of extra-articular reconstruction (18 (11.8%) vs 8 (3.4%); OR = 3.8; p = 0.001) and higher proportion of sports practice (23 (8.6%) vs 3 (2.5%); OR = 3.6; p = 0.026). Conclusion In our series, 6.7% of the patients required arthroscopic removal of cyclops lesions. Female gender, associated extra-articular reconstruction and sports practice were factors related to this lesion. Remnant preservation had no relationship with cyclops lesion formation.

Prevalence and Predictors of Sexual Dysfunction (SD) after Treatment of Localized Rectal and Anal Cancer (LRAC)

SD is possible after treatment of LRAC and is associated with distress and impaired quality of life. We report the prevalence of SD in our LRAC patients treated with curative intent. We also evaluate patient/treatment-related factors associated with SD. LRAC patients from 2010-2022 were identified. Consented patients were surveyed and patient/treatment factors were collated from medical records. Sexual function (SF) was measured using the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). The impact of disease/treatment on SF since treatment was measured using the SF Questionnaire Medical Impact Scale (SFQ-MIS). FSFI ≤ 19.2 and IIEF ≤ 32.2 were considered SD based on the mean scores of SD patients in the primary literature. SFQ-MIS ≥ 15.5 was used to dichotomize responses into "at least some impact" versus "at least no impact." Spearman rank correlations examined correlations between FSFI/IIEF and factors. Comparisons involving componential domains and factors were based on a two-sided Mann-Whitney test. RT dose, surgery, the extent of lymphadenectomy, T stage, and time since treatment were factors assessed in all patients. In females, dilator use during RT, tumor distance (TD) from the anterior vaginal wall and whole vagina, and V25Gy, V45Gy, and mean dose to the anterior vaginal wall and whole vagina were other factors assessed. In males, TD from the neurovascular bundle (NVB), V25Gy, V45Gy, and mean dose to NVB was used. Forty-five patients (13.5% response rate) completed study surveys (62% males; 80% white; 71% rectal cancer patients). The median age and time since treatment were 63 and 4 yrs. respectively. RT doses ranged from 25 - 54Gy. The overall prevalence of SD was 58% (71% in females; 50% in males). The proportion of patients who reported at least some SF impact was 56% (53% in females; 57% in males). There was a marginal association between higher total IIEF and receipt of surgery (p = 0.059). A correlation of 0.44 was seen between total IIEF and TD from upper NVB-the strongest among all comparisons. In the domains of IIEF, statistically significant associations were found between intercourse satisfaction (ISAT) and TD from upper NVB (p = 0.004), overall satisfaction (OSAT) and TD from lower NVB (p = 0.040), and ISAT and T stage (p = 0.047). There were marginal associations between TD from upper NVB and OSAT (p = 0.052), orgasm (p = 0.063), and erectile dysfunction (p = 0.097). There was a marginal association between V25Gy to the anterior vaginal wall and pain during penetrative sex (p = 0.095). No other association with FSFI or its domains was significant. SD is prevalent in a large majority of patients studied (58%). In males, higher TD from NVB was associated with better overall SF, better intercourse, and overall satisfaction. While a higher proportion of females had SD, no significant associations were found in females likely due to their small sample size.

Changes in Nutrition, Physical Activity, and Body Weight among Lithuanian Students during and after the COVID-19 Pandemic.

The long-term effect of the COVID-19 pandemic on lifestyle changes remains understudied. This cross-sectional study aimed to assess changes in nutrition, physical activity, and body weight among Lithuanian students during the pandemic and their post-pandemic persistence. Data were collected from 1430 first-year students (325 males, 1105 females) through an online self-administered questionnaire. The students indicated an increase in the consumption of snacks, fast food, home-made confectionery, and sweets. A decrease in physical activity during the pandemic was reported by 34.9% of males and 33.2% of females. Lifestyle changes during the pandemic were associated with post-pandemic habits. A higher proportion of females (38.7%) than males (31.1%) indicated an increase in BMI, which was more pronounced among students with overweight. A multivariate logistic regression analysis revealed that reduced physical activity; the increased consumption of red meat, snacks, fast food, and home-made confectionery during the pandemic; and post-pandemic BMI were linked with weight gain. After the pandemic, weight gain persisted in 40.9% of students who continued to follow unhealthy nutrition habits and had reduced physical activity. The study emphasizes that the promotion of a healthy diet and regular physical activity among university students is essential for developing lifelong habits that contribute to a healthy body weight and overall well-being.

Intersectionality and depression symptoms in Mexican adults aged ≥50, MHAS 2001 and 2012

Objective. To analyze, from the perspective of intersectionality, the association of social inequality dimensions (occupation, poverty, and educational level) and socio-demographic and health characteristics with the proportion of depressive symptoms among males and females aged 50 years and older who participated in the 2001 and 2012 waves of the Mexican Health and Aging Study (MHAS). Materials and methods. Descriptive analysis and logistic regression models stratified by sex were performed, including interaction terms between poverty, educational level, and employment conditions on the presence of depressive symptoms. Results. The proportion of females with depressive symptoms was significantly higher than that of males in both waves. A high proportion of older females in poverty, with five years or less of education and manual occupational activities, reported depressive symptoms in the MHAS-2001. The interactions evaluated between occupation, poverty, and educational level were not statistically significant under adjusted models; however, disability and comorbidities were associated with depressive symptoms in both sexes. Conclusion. A higher proportion of females have depressive symptoms under conditions of inequality; however, the effect of the intersection between employment and socio-demographic characteristics on depressive symptoms was not observed under adjusted models.

Hospitalization and Healthcare Resource Utilization of Omidubicel-Onlv versus Umbilical Cord Blood Transplantation for Hematologic Malignancies: Secondary Analysis from a Pivotal Phase 3 Clinical Trial

A phase 3 trial (ClincialTrials.gov identifier NCT02730299) of omidubicel-onlv, a nicotinamide-modified allogeneic hematopoietic progenitor cell therapy manufactured from a single umbilical cord blood (UCB) unit, showed faster hematopoietic recovery, reduced rate of infections, and shorter hospital stay compared with patients randomized to standard UCB. This prospective secondary analysis of the phase 3 trial characterized resource utilization in the first 100 days post-transplantation with omidubicel-onlv compared with UCB. This analysis examined resource utilization, including hospital length of stay, hospital care setting, visits by provider type, rate of transfusions, and readmissions, among the 108 treated patients (omidubicel-onlv, n = 52; UCB, n = 56) from day 0 to day 100 post-transplantation. Demographics were generally balanced between the 2 arms, except a higher proportion of females (52% versus 37%) and older median age (40 years versus 36 years) were noted in the omidubicel-onlv arm. Compared with patients receiving UCB transplantation, patients receiving omidubicel-onlv had a shorter average total hospital length of stay (mean, 41.2 days versus 50.8 days; P = .027) in the first 100 days post-transplantation and more days alive and out of the hospital (mean, 55.8 days versus 43.7 days; P = .023). Fewer patients died in the omidubicel-onlv arm compared with the UCB arm (12% vs 16%) before day 100 post-transplantation. During primary hospitalization (ie, time from transplantation to discharge), fewer patients receiving omidubicel-onlv required intensive care unit (ICU) admission (10% versus 23%) and spent fewer days in the ICU (mean, .4 day versus 4.7 days; P = .028) and transplant unit (mean, 25.3 days versus 32.9 days; P = .022) compared with those receiving UCB. Patients receiving omidubicel-onlv required fewer outpatient consultant and nonconsultant visits and fewer platelet or other transfusions within 100 days from transplantation. Our findings suggest that faster hematopoietic recovery in omidubicel-onlv patients is associated with significantly shorter hospital stay and reduced healthcare resource use compared with UCB.

Gender, racial, and socioeconomic disparity of preoperative optimization goals in ventral hernia repair.

Preoperative optimization cut-offs are frequently utilized to determine eligibility for elective ventral hernia repair. Our objective was to assess the relationship between gender, race, and socioeconomic status and preoperative optimization goals. We queried our institutional database for adults with ventral hernia diagnoses between 2016 and 2021. Demographics, comorbidities, laboratory, and operative data were collected and analyzed. The following cut-offs were used to determine eligibility for elective repair: body mass index (BMI) < 40kg/m2, no active smoking, and glycated hemoglobin (HbA1c) < 8%. Socioeconomic status was assessed using the Distressed Communities Index. A total of 5638 patients were included [Whites = 4321 (77%), Blacks = 794 (14%), Hispanics = 318 (6%), and other/unknown 205 (4%)]. Median age was 61years and 50% were male. Most common hernia types were umbilical (36%) and incisional (20%). 10% had BMI > 40kg/m2, 9% were active smokers and 4% had HbA1c > 8%. 21% of all patients did not meet the preoperative optimization cut-offs at time of diagnosis and those were less likely to undergo hernia repair during the study timeframe compared to those who did (OR 0.50; 95% CI [0.42-0.60]). There was a higher proportion of females (21%) and Blacks (22%) with BMI > 40kg/m2 compared to males (11%) and other races (11-15%), p = 0.002. As the level of socioeconomic distress increased, there was a corresponding increase in the proportion of patients who did not meet preoperative optimization cut-offs from 16% in prosperous communities to 25% in distressed communities (p < 0.0001). Nearly 1 of 5 patients with ventral hernias is affected by commonly used arbitrary preoperative optimization cut-offs. These cut-offs disproportionately impact females, Black patients and those with higher socioeconomic distress. These disparities need to be considered when planning preoperative optimization protocols and resource allocation to ensure equitable access to elective ventral hernia repair.

Biological characteristics and distribution of the glowbelly Acropoma japonicum, a dominant fish in the Beibu Gulf, China

In the 1990s, a rapid increase in fishing intensity in the Beibu Gulf, disrupted the demersal ecosystem, wherein the dominant species shifted to smaller-sized individuals. Among the smaller-sized species, Acropoma japonicum was the most prominent. We examined the biological characteristics, distribution and environmental factors of this species to better understand its population status and sustained dominance. The dominant body length group was 50–55 mm (18.98%), and the dominant body weight group was 4–5 g (15.69%). The exponent b value was 2.55 for both sexes. The ratio of females to males was 1.33:1. Gonadal maturity was mainly at stages III (20.21%), IV (34.10%) and V (28.27%). Size at first maturity (L50) was 39.40 mm for females and 63.16 mm for males. The mean CPUE and proportion of A. japonicum in the survey catches decreased from 2006 to 2018, but increased thereafter. Redundancy analysis indicated that water depth is the most important factor affecting the species' distribution, followed by bottom water temperature. The overall results indicate that long-term dominance by A. japonicum in the Beibu Gulf is likely attributable to early sexual maturity, a high proportion of females and long reproductive time, as well as a suitable environment in the ecosystem.

Key participant characteristics influencing completion of a phase II cardiac rehabilitation program: A cross-sectional analysis

Study objectiveCardiac rehabilitation (CR) programs are effective at reducing cardiovascular disease risk factors, yet programs in the United States (US) have poor participation and completion. The current study evaluates characteristics related to completion and drop-out for CR participants. DesignA cross-sectional study design compared participants who completed the program (finishers) and those did not finish (non-finishers). Variables were compared to determine differences between the dichotomous groups included demographic data, initial six-minute walk test, Zung Depression Index, and Quality of Life Measure (QLM). Logistical regression using variables with differences between groups determined impact on program completion. SettingPhase two outpatient hospital based cardiac rehabilitation program. ParticipantsNinety-seven participants were part of the sample; 61 completed the program, and 36 dropped out. Main outcome measureCompletion of CR. ResultsNinety-seven participants are included; 61 (63 %) were finishers and 36 (37 %) were non-finishers. Finishers were older, had a higher proportion of females and Medicare insurance recipients, had lower depression scores, and reported higher quality of life. Results of the final logistic regression revealed finishers were more likely to have Medicare (odds ratio (OR) = 5.215, confidence interval (CI) 1.897–14.338), be female (OR = 4.597, 95 % CI 1.532–13.795) and have higher QLM Family Sub scores (OR = 1.129, 95 % CI 1.023–1.246). The model correctly classified 71.9 % of cases. ConclusionThe analysis highlights Medicare insurance and family support are associated with program completion. Interventions to increase family and social support, and to provide financial assistance for those with financial burden through lack of insurance or high co-pays may increase cardiac rehabilitation completion rates.

Higher Risk of Incident Hyperthyroidism in Patients With Atrial Fibrillation.

Atrial fibrillation (AF) has been linked to increased hyperthyroidism risk, but contributing factors are unclear. We aimed to investigate whether AF could predict hyperthyroidism and related risk factors. This retrospective cohort study was conducted in a tertiary medical institution and included patients aged 18 years or older with AF but without hyperthyroidism at diagnosis. The endpoint was defined as newly diagnosed hyperthyroidism during the follow-up period. The study cohort included 8552 participants. Patients who developed new hyperthyroidism were younger and the proportion of females was higher. They had fewer comorbidities, including diabetes (26% vs 29%, P = .121), hypertension (51% vs 58%, P < .001), coronary artery disease (17% vs 25%, P < .001), stroke (16% vs 22%, P < .001), and end-stage renal disease (ESRD) (6% vs 10%, P = .001). The CHADS2 score was lower in patients with hyperthyroidism (1.74 vs 2.05, P = .031), but there was no statistically significant difference in the CHA2DS2-VASc and HAS-BLED score. Cox regression analysis identified younger age, female gender, history of congestive heart failure, hypertension, diabetes, non-ESRD status, and lower CHADS2 score but not CHA2DS2-VASc as independent predictors of incident hyperthyroidism during follow-up. We also propose a novel, simple risk stratification score (SAD HEC2 score) with excellent predictive power for incident hyperthyroidism during follow-up. Our results provide insight into clinical risk factors for the development of hyperthyroidism in AF patients, as identified by the novel SAD HEC2 score. AF appears to be a common precursor of hyperthyroidism.

Comparison of Corvis ST Parameters between Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma.

We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). A retrospective analysis was performed on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. CST parameters were compared between eyes with POAG and those with PACG using a linear mixed model (LMM). No differences were observed in age, central corneal thickness, intraocular pressure, or use of antiglaucoma eye drops between the two groups. Patients with PACG had a significantly shorter axial length (AL), a higher proportion of females, CST parameters, longer applanation 2 (A2) time, deeper A2 deformation amplitude, shorter peak distance, longer whole eye movement, and longer whole eye movement time than patients with POAG. The highest concavity (HC) length and PD showed a significant positive correlation with AL. However, A1 length, A1 deformation amplitude, A2 time, A2 velocity, A2 length, A2 deformation amplitude, HC time, whole eye movement, and whole eye movement time were negatively correlated with AL. The biomechanical properties of the cornea differed between POAG and PACG. In some parts, AL differences between the POAG and PACG groups might contribute to the variation in CST parameters.

Clinical comparative analysis of bacterial keratitis according to contact lens use: a retrospective study in a tertiary referral center of South Korea.

To compare the clinical aspects and treatment outcomes of contact lens-related bacterial keratitis (CLBK) and non-CLBK patients. Altogether 217 patients of bacterial keratitis (CLBK; 62, non-CLBK; 155) hospitalized between January 2012 and December 2020 were retrospectively analyzed for epidemiology, microbiological profiles, predisposing factors, clinical characteristics, and treatment outcomes. Poor treatment outcomes (PTO) were defined as a final BCVA < 0.3 (Snellen), a decreased visual acuity after treatment, complications, or surgical intervention. Relative importance of the initial clinical features leading to PTO was assessed using the random forest model and two-proportion Z-test. The most common predisposing factors were sleeping with wearing CL (51.6%) in the CLBK group and trauma (55.5%) in the non-CLBK group. There were significant differences between the two groups in mean age (35.1:55.1years, p < 0.001), female sex (56.5:34.8%, p = 0.003), symptom duration (6.2:6.9days, p = 0.019), gram-negative organisms (83.3:48.3%, p = 0.008), epithelial healing time (8.5:14.1days, p = 0.004), final BCVA (0.15:0.46 logMAR, p = 0.015), and PTO (9.7:21.9%, p = 0.035). For the entire group, the initial BCVA < 0.1 (27.9%), symptom duration ≥ 5days (19.4%), age ≥ 60years (16.4%), and hypopyon (14.0%) were important initial clinical features leading to PTO in the random forest model. In CLBK group, the type of CL or CL-related history was not significantly related to PTO. CLBK patients had a higher proportion of females, younger age, gram-negative bacteria, and better treatment outcomes than those of non-CLBK patients. There were no significant risk factors leading to PTO in either the type of CL or CL-related history.

Thirty day postoperative outcomes following laparoscopic adrenalectomy for functional adrenal tumors.

Functional adrenal tumors (FATs) are rare and if left untreated, there is a substantial risk of morbidity and mortality due to uncontrolled excess hormone secretion. The three most common FATs are cortisone-producing tumors (hypercortisolism), aldosterone-producing tumors (hyperaldosteronism), and catecholamines-producing tumors (pheochromocytomas). The study aims to evaluate demographic characteristics and 30-day outcomes after laparoscopic adrenalectomy of FATs. Patients who underwent laparoscopic adrenalectomy for FATs were selected from the ACS-NSQIP database (2015-2017), and divided into three groups (hyperaldosteronism, hypercortisolism, and pheochromocytoma). Preoperative demographics, medical comorbidities, and 30-day postoperative outcomes among the three groups were analyzed using the chi-squared test, analysis of variance (ANOVA) and Kruskal-Wallis one-way analysis of variance. Multivariable logistic regression was performed to assess the effects independent variables on the likelihood of increased overall morbidity. Of a total of 2410 patients who underwent laparoscopic adrenalectomy, 345 (14.3%) patients with FATs were included. Patients in the hypercortisolism group were younger, had higher proportion of females, had higher BMI, had a higher proportion of White ethnicity and had a higher proportion of diabetes. The hyperaldosteronism group had a higher proportion of Black ethnicity and a higher proportion of hypertension (HTN) requiring medication. Thirty day postoperative outcomes showed that the pheochromocytoma group had a higher rate of serious morbidity, overall morbidity, and highest readmission rates. There were three deaths, 1 in the pheochromocytoma and 2 in the hypercortisolism groups. Operative time (in minutes) was longer in the hypercortisolism group. Median length of stay was higher in hypercortisolism (2days) and pheochromocytoma (1.5day) groups. Functional adrenal tumors show distinct variations in patient demographics and postoperative outcomes. It is essential to use this information during the preoperative period to optimize patients prior to intervention and counsel patients about potential postoperative outcomes.

Food Security as a Predictor of Global Pediatric Postburn Mortality.

Food security (FS) is defined as access to sufficient and nutritious food. Children, especially those in low- and middle- income countries (LMICs), are disproportionately affected by low FS. We hypothesized high FS would be predictive of decreased pediatric postburn mortality in LMICs. Publicly-available, deidentified datasets were obtained from the World Health Organization's Global Burn Registry (GBR) and Economist Intelligence Unit's Global FS Index (GFSI). The GFSI calculates FS scores annually from intergovernmental organization data reviewed by a panel of experts. FS scores are reported on a 0-100 scale with 100 indicating the highest FS. Patients aged 0-19 years were included; after linking GBR and GFSI datasets, countries with <100 burn patients were excluded. Data were analyzed with descriptive statistics and bivariate analyses. Multiple logistic regression controlling for confounders was used to quantify associations between mortality and FS score. Significance was set at p<0.05. From 2016-2020, there were 2,246 cases including 259 deaths (11.5%) over nine countries. Those who died had a higher median age (7 [IQR 2, 15] vs. 3 [2, 6] years, p<0.001), higher proportion of females (48.6% vs. 42.0%, p=0.048), and lower median FS score (55.7 [IQR 45.3, 58.2] vs. 59.8 [IQR 46.7, 65.7], p<0.001). Increasing FS score was associated with decreased odds of postburn mortality [multivariable odds ratio 0.78 (0.73-0.83), p<0.001]. Increasing FS score was associated with decreased pediatric postburn mortality. International efforts to increase FS in LMICs may help improve pediatric burn patient survival.

Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia.

Severe COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective observational study, 18 critically ill COVID-19 patients who were treated using V-V ECMO during an 11-month period in a tertiary COVID-19 hospital were analyzed. Biomarkers of inflammation and clinical features were compared between survivors and non-survivors. Survival rates were compared between patients receiving ECMO and propensity matched mechanically ventilated controls. There were 7 survivors and 11 non-survivors. The survivors were significantly younger, with a higher proportion of females, higher serum procalcitonin at ICU admission, and before initiation of ECMO they had significantly lower Murray scores, PaCO2, WBC counts, serum ferritin levels, and higher glomerular filtration rates. No significant difference in mortality was found between patients treated with ECMO compared to patients treated using conventional lung protective ventilation. Hypercapnia, leukocytosis, reduced glomerular filtration rate, and increased serum ferritin levels prior to initiation of V-V ECMO in patients with severe COVID-19 pneumonia may be early warning signs of reduced chance of survival. Further multicentric studies are needed to confirm these findings.

Predictive value of total psoas muscle index for postoperative physical functional decline in older patients undergoing emergency abdominal surgery

BackgroundOlder individuals increasingly require emergency abdominal surgeries. They are susceptible to surgical stress and loss of independence in performing daily activities. We hypothesized that the psoas muscle volume would be significantly associated with postoperative functional decline (FD) in older patients undergoing emergency abdominal surgery and aimed to evaluate the use of the psoas muscle volume on computed tomography (CT) scans.MethodsA retrospective, single-center study of patients aged ≥ 65 years who had undergone emergency abdominal surgery between January 2019 and June 2021 was performed. We assessed patients’ activities of daily living using the Barthel Index. FD was defined as a ≥ 5-point decrease between preoperative and 28-day postoperative values. The psoas muscle volume was measured by CT, which was used for diagnosis, and normalized by height to calculate total psoas muscle index (TPI). We evaluated associations between FD and TPI using receiver operating characteristics (ROC) analysis and multiple logistic regression analysis.ResultsOf 238 eligible patients, 71 (29.8%) had clinical postoperative FD. Compared to the non-FD group, the FD group was significantly older and had a higher proportion of females, higher Charlson Comorbidity Index, lower body mass index, higher American Society of Anesthesiology score, lower serum albumin level, and lower TPI. ROC analyses revealed that TPI had the highest area under the curve (0.802; 95% confidence interval [CI], 0.75–0.86). A multivariable logistic regression model revealed that low TPI was an independent predictor of postoperative FD (odds ratio, 0.14; 95% CI, 0.06–0.32).ConclusionsTPI can predict postoperative FD due to emergency abdominal surgery. Identification of patients who are at high risk of FD before surgery may be useful for enhancing the regionalized system of care for emergency general surgery.

1135-P: Screening for Disordered Eating Behaviors in Youth with Type 1 Diabetes—Feasible and Necessary

The American Diabetes Association (ADA) recommends screening adolescents with type 1 diabetes (T1D) for disordered eating behaviors (DEB) using the Diabetes Eating Problem Survey-Revised (DEPS-R) tool, however this is not routinely done in clinical practice. We implemented screening for DEB in a large academic pediatric diabetes center as part of clinical care as well as to evaluate the prevalence of DEB and identify clinical factors (in particular, use of pumps and continuous glucose monitors (CGM)) associated with a positive screen. Youth with T1D between 13-19 years, seen in our pediatric diabetes clinic from 02/09/2022 - 06/07/2022, were given the survey. A total of 580 subjects were eligible for the screening, 368 (64%) completed it and 282 (~50%) had analyzable data (49% female, 83% white, 11% black, 3% reporting food insecurity (FI), mean (SD) age 16.4±1.9 years, HbA1c 8.2±1.9%, BMI percentile 71.2±26.9). The majority were on CGM (77%) and 45% on pump therapy (including 5% on hybrid close loop systems). A total of 43 (15%) had a positive screen (score≥ 20) for DEB. There was a higher proportion of females, (67 vs 45%, p=0.007) lower proportion of white (70 vs 85%) and higher proportion of black youth (20 vs 8%) (p=0.02) in those that screened positive vs negative. Those with a positive screen also had a higher HbA1c (9.9±2.1 vs 8±1.7, p&amp;lt;0.001) and BMI percentile (83.1±21.1 vs 68.9±27.3, p&amp;lt;0.001). There was no difference in age (16.5±1.9 vs 16.4±1.9 years, p=0.82), report of FI (4.6 vs 2.1%, p=0.76), use of CGM (72 vs 78%, p=0.35), or pump therapy (35 vs 44%, p-0.26) between the two groups. None of those on hybrid close loop had a positive screen, however the numbers were small (n=7). Almost 1 in 5 adolescents with T1D had a positive screen for DEB. There was no difference in the use of diabetes technology. Our findings stress the importance of screening for DEB in youth with T1D and implementation of strategies to improve response rate in order to make timely referrals to reduce associated morbidity. Disclosure S.Sastry: None. M.Coren: None. J.Schreiber: None. I.Libman: Advisory Panel; Novo Nordisk.

A COMPARISON OF FIVE-YEAR MORTALITY RATES FOLLOWING REVISION HIP ARTHROPLASTY FOR PERIPROSTHETIC FRACTURE, ASEPTIC LOOSENING, OR INFECTION AT A TERTIARY REFERRAL CENTRE

Mortality following revision hip surgery for periprosthetic fracture (PPF) has been reported to be as high as 60% at 5 years. The aim of this study was to determine the mortality rate for PPF revisions, compared to revision for aseptic loosening or infection at our tertiary referral centre.Revision arthroplasty procedures performed for PPF, aseptic loosening or infection between January 2014 and December 2015 at our institution were identified using a prospectively collected PPF referral database and locally collected NJR data. Comparisons were made between the 3 groups for baseline demographics, admission to higher-level care, length of stay, complications, and Kaplan-Meier failure (mortality) at 1 &amp; 5 years post-operative (with log-rank test for equality).There were 37 PPF, 71 infected and 221 aseptic revisions. PPF had a higher proportion of females (65% vs. 39% in infection and 53% in aseptic; p = 0.031) and grade 3 and 4 ASA patients (p = 0.006). Median time to surgery from injury for PPF was 8 days (95% CI, 6–16). Single-stage procedures were performed in 84% of PPF, 42% of infection and 99% of aseptic revisions (p &lt; 0.001). 19% of PPF revisions required HDU admission, 1% in the aseptic group and none in the infection group (p&lt;0.001). Median length of stay was significantly different (PPF 10; infection 14; aseptic 8 days (p &lt; 0.001). The Kaplan-Meier estimate of 1-year mortality were: PPF = 0%; infection = 2.8% (0.7–11.1%); aseptic = 0.9% (0.2–3.5%). 5-year mortality estimates were: PPF = 17.1% (8–34%), infection = 8.7% (4–18.3%), aseptic = 12% (8.4–17%). Log-rank test of equality was not significant, p=0.833.Despite the PPF group having an average delay to surgery of 8 days, higher ASA grades and more admissions to HDU there was no significant difference in mortality rates between the groups at 1 and 5 years postoperatively. Using a coherent MDT approach with dedicated healthcare professionals this service demonstrates a low post operative mortality rate which merits further investment and development.

Examining the effect of dementia on hospitalization outcome for GI cancer: A nationwide retrospective analysis.

e16336 Background: Dementia is a debilitating condition affecting a significant fraction of the elderly, with far-reaching consequences. It is an active field of research, with current emphasis on modifiable risk factors as well as treatment. Considering the limitations that dementia imposes on the management of other medical conditions, we attempt to study its association with, and impact on hospitalizations for gastrointestinal (GI) cancers. Methods: We queried the National Inpatient Sample databases for the years 2016 through 2020, using International Classification of Diseases, tenth revision (ICD-10) codes to include all adult admissions with esophageal, gastric, colorectal, biliary Tract, liver, and pancreatic cancers. We further stratified this cohort based on the presence of a secondary diagnosis of dementia. STATA 17 was used to perform a multivariate regression analysis to compare outcomes in the two cohorts, while adjusting for potential confounders. Results: The study identified 280,180 patients with GI cancer, of whom 4.7% (13,135) had a secondary diagnosis of dementia. The cohort with dementia was found to have a higher proportion of females (47.0%) compared to the non-dementia cohort (40.8%) and a higher median age (77.9 years vs 66.9 years). Additionally, this cohort had a higher prevalence of other medical comorbidities, with 98.2% having a Charlson comorbidity index (CCI) greater than 3 compared to 87.8% in the non-dementia cohort. The primary outcome of the study was in-patient mortality, which was stratified by age groups. In the 41-65 years old group, the mortality rate was higher in the dementia cohort (16.3%) compared to the non-dementia cohort (8.6%), with an adjusted odds ratio (aOR) of 1.96 (95% CI: 1.10-3.48, P&lt;0.05). In the 65-75 years old subgroup, the mortality rate was also higher in the dementia cohort (13.1%) compared to the non-dementia cohort (8.6%), with an aOR of 1.48 (95%CI: 1.14-1.93, P&lt;0.05). In the above-75-year-old subgroup, the mortality was higher in the dementia cohort (11.7%) compared to the non-dementia cohort (8.5%) (aOR: 1.35; 95%CI: 1.16-1.58, P&lt;0.05). Conclusions: Hospitalizations with GI cancer, with a secondary diagnosis of dementia, have higher odds of in-patient mortality compared to those without dementia. This was observed across all age groups. The dementia cohort also had a higher proportion of females and a higher median age, along with a higher prevalence of multiple comorbidities. These findings suggest that individuals with gastrointestinal cancer and dementia face a higher risk of in-patient mortality, highlighting the importance of considering dementia as a part of care planning in patients with GI cancer. [Table: see text]

Differences in rate of change of retinal structural and microvasculature parameters in parkinson’s disease compared to controls

AbstractBackgroundPrior cross‐sectional studies have revealed decreased macular perfusion density (PFD) and increased peripapillary PFD in Parkinson’s disease (PD). We assess longitudinal rate of change of retinal microvascular and structural parameters in PD vs controls with normal cognition.MethodSubjects were imaged using Zeiss Cirrus HD‐5000 AngioPlex. Those with confounding medical or ocular comorbidities were excluded. Superficial capillary plexus (SCP) PFD and vessel density (VD) were assessed within ETDRS 6×6 circle, inner ring, outer ring and 3×3 circle and inner ring. SCP foveal avascular zone (FAZ) area was assessed. PFD, VD, FAZ, peripapillary retinal nerve fiber layer (RNFL), ganglion cell‐inner plexiform layer (GCIPL), and central subfield thickness (CST) were measured at 2 time points 1 year apart. Rate of change per year was calculated. Generalized estimating equations analyzed associations between rate of change of imaging parameters and PD.Result74 eyes of 40 patients with PD (60% male, mean age 67.47.9 years) &amp; 149 eyes of 78 controls (28% male, mean age 70.35.8 years) were included. No demographic differences were observed between groups except higher proportion of females in controls (p = 0.001). PD had a greater decline in PFD in 6×6 circle (mean change per year = 0.021, control = 0.00, p = 0.001), 6×6 inner ring (PD = 0.018, control = 0.001, p = .007), 6×6 outer ring (PD = 0.022, control = 0.00, p = 0.001), 3×3 circle (PD = 0.016, control = 0.002, p&lt;.001), 3×3 inner ring (PD = 0.016, control = 0.002, p&lt;0.001). PD had greater decline in VD in 6×6 circle (mean change per year in PD = 0.72/mm, control = 0.054/mm, p = 0.006), 6×6 inner ring (PD = 0.636/mm, control = 0.048/mm, p = 0.03), 6×6 outer ring (PD = 0.746/mm, control = 0.054/mm, p = 0.005), 3×3 circle (PD = 0.939/mm, control = 0.006/mm, p&lt;0.001), 3×3 inner ring (PD = ‐0.942/mm, control = 0.013/mm, p&lt;0.001). PD had greater decrease in GCIPL (mean change per year in PD = 0.403µm, control = 0.128µm control, p = 0.01). There were no significant differences in rate of change in FAZ area, RNFL thickness, CST, and no significant differences in rate of change when stratified by PD severity.ConclusionPD may be associated with more rapid loss of retinal microvascular perfusion and vessel densities and more rapid thinning of GCIPL compared to normal aging in controls with normal cognition.

Cone- beam computed tomography study of morphologic and morphometric characteristics of mental foramen in an Eastern Indian population

In light of imaging evidence on the differences in several characteristics of anatomical foramina in the mandible, the current study evaluates the morphologic and morphometric characteristics of Mental foramen (MF) by Cone-Beam Computed Tomography (CBCT) in an Eastern Indian population as well as the effect(s) of age and gender on the same. CBCT images of 200 adult individuals aged 18–60 years were examined for the position, opening angle, dimensions of MF; vertical distance from the superior border of the foramen to alveolar crest and inferior border to base of the mandible; and the prevalence of the accessory mental foramen (AMF). The characteristics of MF and AMF were compared across the gender and age groups at p < 0.05 level of significance. The MF was positioned in between the roots of premolars in 48.0% and 44.0% of males and females, respectively. In a higher proportion of females (98.0%, p = 0.006), the vertical position of MF on the left-side was below the root apex. The vertical (3.64 millimeter; p < 0.001) and horizontal (3.64 millimeter; p < 0.001) diameters of MF and occurrence of AMF (16.0%, p = 0.046) on the left-side were higher in males. The opening angle of MF (right-side: 24.13 degrees, p = 0.001; left-side: 24.21 degrees, p < 0.001) was higher in females. Significant variations in certain parameters of the MF across gender were revealed with marked prevalence of AMF that may be of value in forensic investigation.