Patient Demographic Characteristics Research Articles

Demographic, Clinical and Language Characteristics of Malaysian Patients with Aphasia: A Retrospective Study

Limited research has been conducted in Malaysia on the characteristics of patients with aphasia. To address this gap, a retrospective study was conducted at Hospital Rehabilitasi Cheras (HRC). The study aimed to profile the demographic, clinical, and language characteristics of patients who underwent speech therapy for aphasia. Medical records from 2014 to 2017 were reviewed, focusing on 1,259 adult patients who were referred to the Speech Therapy Unit. Analysis included demographics, clinical aspects, and linguistic features. The Western Battery of Aphasia-Revised (WAB-R), a comprehensive assessment tool, was used to evaluate the language abilities. Among the patients' files analysed, a total of 211 contained WAB-R test results. The demographic profile revealed a higher proportion of male patients compared to females, with Malay patients comprising the majority, followed by Chinese and Indians. Age distribution included 41.7% older adults (aged 55 and above), 37.9% middle-aged (aged 36-55), and 20.4% younger adults (aged 18- 35). Notably, 44.5% had completed high school education. Clinically, right- sided hemiparesis was prevalent as noted with 67.8% of patients, while 14.7% had left-sided hemiparesis. The primary cause of aphasia was stroke, accounting for 71.1% of cases, with ischemic stroke being the dominant subtype (56.9%). Fluent aphasia was presented in 50.2% of the cases, compared to 49.3% of non-fluent aphasia. Anomic aphasia was the most common subtype (35.5%), followed by global aphasia (27.5%) and Broca’s aphasia (17.5%). The language profile provided a detailed description, encompassing linguistic aspects relevant to different aphasia types. These preliminary findings yielded valuable insights and hold significant implications for the clinical management of aphasia patients in Malaysia.

Controlled and uncontrolled arterial hypertension: comparison of clinical and demographic characteristics in patients (according to the National Registry of Hypertension, 2019-2022)

Aim: to study the clinical and demographic characteristics of patients in a sample of patients with arterial hypertension observed in primary healthcare (20192022). To compare data from patients with uncontrolled and controlled hypertension.Materials and methods. An analysis of medical data of 4543 patients was carried out (history, clinical and laboratory data, concomitant cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, revascularization (coronary bypass grafting, transluminal balloon angioplasty of the coronary arteries). For statistical data processing, the SPSS statistical software package was used.Results. The patients in the study sample were middle-aged and elderly. 51,5% of patients did not achieve target blood pressure values. More than 90% of patients in the studied sample are high and very high risk patients. The ratio of groups of patients with controlled and uncontrolled arterial hypertension among patients of different ages did not differ. Higher values of low-density lipoprotein cholesterol, a higher frequency (1,3 times) of failure to achieve target values of low-density lipoprotein cholesterol <2,6 mmol/l, and obesity (1,3 times) were identified in patients with uncontrolled arterial hypertension. More than 80% of patients had low-density lipoprotein cholesterol values higher than recommended. Patients with controlled arterial hypertension were more likely to have coronary heart disease, myocardial infarction and a history of coronary angioplasty and coronary artery bypass grafting.Сonclusions. In hypertensive patients, more careful monitoring of cardiovascular risk factors is required, including blood pressure levels and achieving target LDL cholesterol levels. The association of a higher incidence of obesity, type 2 diabetes mellitus and the severity of dyslipidemia with uncontrolled hypertension may indicate less adherence of patients to both drug and non-drug treatment methods. While the presence of coronary heart disease, surgical interventions performed on the coronary arteries can serve as an illustration of increased adherence to therapy when hypertension is combined with coronary heart disease.

Clinical and Demographic Characteristics of Patients Diagnosed with Polycystic Ovary Syndrome: A Cross-Sectional Observational Study

Objective: The aim of this study was to investigate the clinical and demographic characteristics of patients diagnosed with polycystic ovary syndrome (PCOS) who were followed up in our hospital. Material and Methods: We conducted a retrospective, case-controlled observational study of patients treated at the PCOS Clinic of University of Health Sciences Etlik Zubeyde Hanim Women’s Health Training and Research Hospital between November 2023 and January 2024. The gynecologic history, demographic characteristics, and biochemical parameters of each patient were obtained from the hospital records. Results: The number of patients who presented to our PCOS outpatient clinic and were enrolled in the study was 48, and the mean age of the patients was 23±5.6 years. The mean body mass index was 26.1± 4.9 kg/m2. The most common reason for presentation to the PCOS outpatient clinic was irregular menstruation (83.3%). The most frequently observed phenotypic group was group A (47.9%). The preferred treatment was lifestyle modification (75.0%), the second most common treatment was oral contraceptives (45.8%). Conclusion: PCOS is one of the most common endocrine disorders worldwide and can affect women of all ages. In our study, the most common phenotype in our clinic was found to be group A. In addition to oral contraceptives, which are the treatment of first choice, lifestyle changes are also among the treatments used in patients.

Impact of headache frequency and preventive treatment failure on quality of life, disability, and direct and indirect costs among individuals with episodic migraine in the United States.

To evaluate unmet needs among individuals with episodic migraine (EM) in the United States (US). Data are limited on the impact of headache frequency (HF) and preventive treatment failure (TF) on the burden of migraine in the US. A retrospective, cross-sectional analysis of 2019 National Health and Wellness Survey (NHWS) data was conducted from an opt-in online survey that identified respondents (aged ≥18 years) in the US with self-reported physician-diagnosed migraine. Participants were stratified by HF (low: 0-3 days/month; moderate-to-high: 4-14 days/month) and prior preventive TF (preventive naive; 0-1 TF; ≥2 TFs). Comparisons were conducted between preventive TF groups using multivariable regression models controlling for patient demographic and health characteristics. Among individuals with moderate-to-high frequency EM, the NHWS identified 397 with ≥2 TFs, 334 with 0-1 TF, and 356 as preventive naive. The 36-item Short-Form Health Survey (version 2) Physical Component Summary scores were significantly lower among those with ≥2 TFs, at a mean (standard error [SE]) of 41.4 [0.8] versus the preventive-naive 46.8 [0.9] and 0-1 TF 44.5 [0.9] groups; p < 0.001 for both). Migraine Disability Assessment Scale scores were significantly higher in the ≥2 TFs, at a mean (SE) of 37.7 (3.9) versus preventive-naive 26.8 (2.9) (p < 0.001) and 0-1 TF 30.1 (3.3) (p = 0.011) groups. The percentages of time that respondents experienced absenteeism (mean [SE] 21.6% [5.5%] vs. 13.4% [3.6%]; p = 0.022), presenteeism (mean [SE] 55.0% [8.3%] vs. 40.8% [6.5%]; p = 0.015), overall work impairment (mean [SE] 59.4% [5.6%] vs. 45.0% [4.4%]; p < 0.001), and activity impairment (mean [SE] 56.8% [1.0%] vs. 44.4% [0.9%]; p < 0.001) were significantly higher in the ≥2 TFs versus preventive-naive group. Emergency department visits (preventive-naive, p = 0.006; 0-1 TF, p = 0.008) and hospitalizations (p < 0.001 both) in the past 6 months were significantly higher in the ≥2 TFs group. Direct and indirect costs were significantly higher in the ≥2 TFs (mean [SE] $24,026 [3460]; $22,074 [20]) versus 0-1 TF ($10,897 [1636]; $17,965 [17]) and preventive-naive ($11,497 [1715]; $17,167 [17]) groups (p < 0.001 for all). Results were similar in the low-frequency EM group. In this NHWS analysis, individuals with more prior preventive TFs experienced significantly higher humanistic and economic burden regardless of HF.

Evaluation of Outcome after Total Hip Arthroplasty for Femoral Neck Fracture: Which Factors Are Relevant for Better Results?

Background: Femoral neck fractures (FNFs) are frequent orthopedic injuries in elderly patients. Despite improvements in clinical monitoring and advances in surgical procedures, 1-year mortality remains between 15% and 30%. The aim of this study is to identify variables that lead to better outcomes in patients treated with total hip arthroplasty (THA) for FNFs. Methods: All patients who underwent cementless THA for FNF from January 2018 to December 2022 were identified. Patients aged more than 80 years old and with other post-traumatic lesions were excluded. Patient data and demographic characteristics were collected. The following data were also registered: time trauma/surgery, surgical approach, operative time, intraoperative complications, surgeon arthroplasty-trained or not, and anesthesia type. In order to search for any predictive factors of better short- and long-term outcomes, we performed different logistic regression analyses. Results: A total of 92 patients were included. From multivariable logistic regression models, we derived that a direct anterior surgical approach and an American Society of Anesthesiologists (ASA) classification < 3 can predict improved short-term outcomes. Moreover, THAs performed by surgeons with specific training in arthroplasty have a lower probability of revision at 1 year. Mortality at 1 year was ultimately influenced by the ASA classification. Conclusions: A direct anterior approach and specific arthroplasty training of the surgeon appear to be able to improve the short- and long-term follow-up of THA after FNF.

Abstract 5095: Characteristics of patients with advanced renal cell carcinoma (aRCC) who received first-line (1L) nivolumab plus cabozantinib (NIVO+CABO), pembrolizumab plus lenvatinib (PEM+LEN), or nivolumab (NIVO) monotherapy in the real-world (RW) setting

Abstract Background: Recent advances in immunotherapy have introduced new treatment modalities for aRCC. In absence of guideline recommendations, it is unclear what factors drive providers in selecting 1L treatments for aRCC. To address this gap, we described the baseline demographic and clinical characteristics of patients with aRCC who received 1L NIVO+CABO, PEM+LEN, or NIVO monotherapy in the RW setting. Methods: In this retrospective cohort study, treating oncologists from a US nationally representative network abstracted electronic health record data from patients with aRCC who initiated 1L NIVO+CABO or NIVO monotherapy (off-label in the US) between 2/1/2021 and 6/12/2023, or PEM+LEN between 9/1/2021 and 6/12/2023. Patient demographic and clinical characteristics were summarized descriptively. Results: Compared with patients who received NIVO+CABO (n = 200) or PEM+LEN (n = 100), patients who received NIVO (n = 147) were relatively older at 1L initiation (Table). Sex, race, and region of residence were comparable across cohorts. Patients who received NIVO were more likely to have an ECOG PS score of ≥ 2 (59.2%) compared with NIVO+CABO (14.5%) or PEM+LEN (20%) cohorts. The distribution of MSKCC or IMDC risk scores at 1L initiation was comparable across cohorts . Grade 3 or 4 tumors were reported among 56.5%, 41.0%, and 43.5% of those who received NIVO+CABO, PEM+LEN, and NIVO, respectively. Conclusions: This study suggests that 1L treatment for aRCC using IO monotherapy may be more likely to be considered than IO-TKI therapy for older patients and those with poorer ECOG PS, possibly reflecting perceived tolerability of TKI combinations in these patient populations. Further research is needed to understand the impact of these 1L treatment selection patterns on outcomes. Table: Key patient characteristics at 1L initiation. PEM+LEN NIVO+CABO NIVO n = 100 n = 200 n = 147 Mean age, year (standard deviation) 64.4 (7.9) 66.3 (7.4) 74.1 (9.6) Male, n (%) 93 (63.3) 122 (61.0) 93 (63.3) Race, n (%) White 61 (61.0) 127 (63.5) 91 (61.9) Non-white/unknown 39 (39.0) 73 (36.5) 56 (38.1) Region of residence, n (%) Northeast 23 (23.0) 44 (22.0) 37 (25.2) Midwest 22 (22.0) 53 (26.5) 27 (18.4) South 20 (20.0) 34 (17.0) 33 (22.4) West 35 (35.0) 69 (34.5) 50 (34.0) MSKCC or IMDC risk score, n (%) Favorable 13 (13.0) 28 (14.0) 22 (15.0) Intermediate 57 (57.0) 100 (50.0) 74 (50.3) Poor 28 (28.0) 68 (34.0) 41 (27.9) ECOG-PS, n (%) 0 or 1 80 (80.0) 171 (85.5) 60 (40.8) ≥2 20 (20.0) 29 (14.5) 87 (59.2) Grade of tumor differentiation, n (%) Grade 1 3 (3.0) 10 (5.0) 16 (10.9) Grade 2 56 (56.0) 77 (38.5) 67 (45.6) Grade 3 36 (36.0) 98 (49.0) 55 (37.4) Grade 4 5 (5.0) 15 (7.5) 9 (6.1) Citation Format: Kevin K. Zarrabi, Benjamin Miron, Xin Yin, Lisa Rosenblatt, Sarah B. Guttenplan, William John, Taavy A. Miller, Parisa Asgarisabet, Prathamesh Pathak, Monica Ahlquist, Yul Brian Gash, Daniel M. Geynisman. Characteristics of patients with advanced renal cell carcinoma (aRCC) who received first-line (1L) nivolumab plus cabozantinib (NIVO+CABO), pembrolizumab plus lenvatinib (PEM+LEN), or nivolumab (NIVO) monotherapy in the real-world (RW) setting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5095.

Racial disparities in initiation of chemotherapy among breast cancer patients with discretionary treatment indication in the state of Georgia

PurposeThe majority of breast cancer patients are diagnosed with early-stage estrogen receptor (ER) positive disease. Despite effective treatments for these cancers, Black women have higher mortality than White women. We investigated demographic and clinical factors associated with receipt of chemotherapy among those with a discretionary indication who are at risk for overtreatment.MethodsUsing Georgia Cancer Registry data, we identified females diagnosed with ER positive breast cancer who had a discretionary indication for chemotherapy (2010–2017). We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) associating patient demographic and clinical characteristics with chemotherapy initiation overall, and comparing non-Hispanic Black (NHB) with non-Hispanic White (NHW) women within strata of patient factors.ResultsWe identified 11,993 ER positive breast cancer patients with a discretionary indication for chemotherapy. NHB patients were more likely to initiate chemotherapy compared with NHW women (OR = 1.41, 95% CI: 1.28, 1.56). Race differences in chemotherapy initiation were pronounced among those who did not receive Oncotype DX testing (OR = 1.47, 95% CI: 1.31, 1.65) and among those residing in high socioeconomic status neighborhoods (OR = 2.48, 95% CI: 1.70, 3.61). However, we observed equitable chemotherapy receipt among patients who received Oncotype DX testing (OR = 0.90, 95% CI: 0.71, 1.14), were diagnosed with grade 1 disease (OR = 1.00, 95% CI: 0.74, 1.37), and those resided in rural areas (OR = 1.01, 95% CI: 0.76, 1.36).ConclusionWe observed racial disparities in the initiation of chemotherapy overall and by sociodemographic and clinical factors, and more equitable outcomes when clinical guidelines were followed.

Abstract 2237: Determinants of time to cancer treatment initiation at a comprehensive cancer center

Abstract Background: Delays in treatment initiation adversely impact cancer mortality and survival. To inform potential enhancements and targets for our existing oncology patient navigation program, we examined characteristics associated with timely treatment initiation among patients at a tertiary comprehensive cancer center that serves four diverse counties in Southern California. Methods: We performed a retrospective analysis of patients newly diagnosed with non-hematological cancers between January 2020 and June 2023. Using electronic medical record data, we used a multivariable Cox proportional model to examine the association between patient demographic and clinical characteristics and time to treatment initiation (time between first encounter and start of definitive treatment) within a clinical benchmark of 3 months. A hazard ratio (HR)&amp;gt;1 indicates shorter (faster) time to treatment initiation while a HR&amp;lt;1 indicates a longer (slower) time. Results: Our sample included 9,148 patients, who were predominantly &amp;lt;65 years (57%), female (61%), married or with a partner (64%), and retired or unemployed (56%); 50% were non-White. In multivariable analyses, patient’s age, primary language, employment status, cancer diagnosis type, and first treatment type were significant determinants of time to treatment initiation. Faster treatment initiation was observed among patients ages &amp;gt;=75 vs &amp;lt;65 years (HR=1.36, 95% CI 1.23 - 1.52). Among the primary languages spoken in our sample (Spanish, Chinese, Korean, Vietnamese, among others), patients who spoke Armenian vs English also had shorter time to treatment (HR=1.64, 95% CI 1.32 - 2.04). By contrast, longer time to treatment initiation was associated with patients who were retired or disabled vs employed full-time (HR=0.85, 95% CI 0.78 - 0.94, and HR=0.70, 95% CI 0.59 - 0.83, respectively) and underwent radiation or oral chemotherapy vs chemo-infusion (HR=0.65, 95% CI 0.57 - 0.74, and HR=0.82, 95% CI 0.76 - 0.89, respectively). With the exception of melanoma, all diagnoses had a longer time to treatment compared with neuro-oncology. In our multivariable model, sex, marital status, race and ethnicity, and receipt of at least one navigation encounter were not significant determinants. Conclusions: In our study, which overlapped the early stages of the COVID-19 pandemic, findings highlight opportunities to enhance navigation delivery, especially for certain subpopulations, diagnoses, and treatment types with complex scheduling and coordination needs. Future research will explore navigation intensity and other process and clinical outcomes modifiable through navigation. Citation Format: Narissa J. Nonzee, Marianne Razavi, William Dale, Lauren Cai, Annette Mercurio, Lorena Gaytan, Deborah Lefkowitz, Chrissy Kim, Terry Hernandez, Steven Morales, Danilo Duque, Ana I. Tergas. Determinants of time to cancer treatment initiation at a comprehensive cancer center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2237.

The effect of advanced age on peri- and post-operative complications following pelvic floor repair surgeries.

To assess whether advanced age is a risk factor for complications following pelvic organ prolapse (POP) repair surgeries using the Clavien-Dindo classification system. In this retrospective cohort study, 260 women who had undergone POP repair surgery at the Soroka University Medical Center (SUMC) between the years 2014-2019 were included. A univariate analysis was conducted to compare the demographical, clinical, obstetrical and operative characteristics of patients by age group (younger or older than 70years). We performed a similar analysis to assess for the possible association between several variables and post-operative complications. Variables that were found to be associated with post-operative complications (P < 0.2) were included in a multivariate analysis along with advanced age. During the 12months follow-up period, more than half of the women had experienced at least one post-operative complication. Minor complications (grades 1-2 according to the Clavian-Dindo classification system) were the most common. One woman had died during the follow-up period, and none had experienced organ failure (grade 4). Hysterectomy, as part of POP surgery, was found to be significantly associated with post-operative complications. Additionally, grandmultiparity (> 5 births) showed a tendency towards an increased risk for post-operative complications, however this reached only borderline significance. We found no association between advanced age and post-operative complications. POP repair surgeries are safe for women of all ages. Major complications (grades 3-5) are rare in all age groups. Although advanced age was associated with a higher prevalence of comorbidity and a higher grade of prolapse, no significant difference in the post-operative complications was found between age groups. Concomitant hysterectomy at the time of POP repair surgery is a risk factor for post-operative complications.

Measure of Social Support and Its Relevance to the Clinical and Demographic Characteristics of Patients Going to the Hemophilia Center

Background: Social support has been considered one of the factors that facilitate health behaviors, and there is some evidence related to the subordination of the treatment of hemophilia patients according to various factors. Therefore, the present study was conducted with the aim of determining the measure of social support and its relevance to the clinical and demographic characteristics of patients going to the hemophilia center. Methods: This cross-sectional study was conducted at Sanandaj Hemophilia Center in Sanandaj, Kurdistan, Iran, in 1402. A total of 120 patients were voluntarily selected as samples based on inclusion criteria. The data collection tool included the registration form of demographic and clinical characteristics and the Social Support Questionnaire of Vaux et al. To analyze the data of the study, independent t-student statistical tests and unilateral analysis of variance in STATA software version 12 were used. Results: In this study, the dimensions of social support were examined: Family support, support from others, and support from friends. Family support, with an average of 4.36 out of 5, was considered the highest value, compared to other dimensions. Conclusions: Based on the results of this study, the average social support of hemophilia patients was appropriate. In the case of increasing the social support of hemophilia patients through creating job opportunities, increasing income, access to urban treatment facilities and services, material and moral coverage of organizations, and social support, the improvement of the health level of hemophilia patients can be expected.

Can Baseline Patient Clinical and Demographic Characteristics Predict Response to Early Posttraumatic Stress Disorder Interventions After Physical Injury?

Objective A growing evidence base supports stepped care interventions for the early treatment of posttraumatic stress disorder (PTSD) after physical injury. Few investigations have examined the characteristics of patients who do and do not respond to these interventions. Method This investigation was a secondary analysis that used previously collected data from three randomized clinical trials of stepped care interventions (patient N = 498). The study hypothesized that a subgroup of patients would manifest persistent PTSD symptoms regardless of randomization to intervention or control conditions, and that characteristics present at the time of baseline injury hospitalization could distinguish patients who would develop persistent symptoms from potential treatment responders. Regression analyses identified baseline patient clinical and demographic characteristics that were associated with persistent PTSD symptoms over the 6-months post-injury. Additional analyses identified treatment attributes of intervention patients who were and were not likely to demonstrate persistent symptoms. Results A substantial subgroup of patients (n = 222, 44.6%) demonstrated persistent PTSD symptoms over time. Greater numbers of pre-injury trauma, pre-injury PTSD symptoms, elevated early post-injury PTSD symptoms, unemployment, and non-White race identified patients with persistent symptoms. Patients with ≥3 of these baseline risk characteristics demonstrated diminished treatment responses when compared to patients with <3 characteristics. Intervention patients with ≥3 risk characteristics were less likely to engage in treatment and required greater amounts of interventionist time. Conclusions Injured trauma survivors have readily identifiable characteristics at the time of hospitalization that can distinguish responders to PTSD stepped care interventions versus patients who may be treatment refractory.

High-density lipoprotein (HDL) as an indicator for alcohol use in a psychiatrically ill population.

To examine the cross sectional and longitudinal associations between the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) and differences in high-density lipoprotein (HDL) in a psychiatrically ill population. Retrospective observational study using electronic health record data from a large healthcare system, of patients hospitalized for a mental health/substance use disorder (MH/SUD) from 1 July 2016 to 31 May 2023, who had a proximal AUDIT-C and HDL (N= 15915) and the subset who had a repeat AUDIT-C and HDL 1year later (N= 2915). Linear regression models examined the association between cross-sectional and longitudinal AUDIT-C scores and HDL, adjusting for demographic and clinical characteristics that affect HDL. Compared with AUDIT-C score = 0, HDL was higher among patients with greater AUDIT-C severity (e.g. moderate AUDIT-C score = 8.70[7.65, 9.75] mg/dl; severe AUDIT-C score = 13.02 [12.13, 13.90] mg/dL[95% confidence interval (CI)] mg/dl). The associations between cross-sectional HDL and AUDIT-C scores were similar with and without adjusting for patient demographic and clinical characteristics. HDL levels increased for patients with mild alcohol use at baseline and moderate or severe alcohol use at follow-up (15.06[2.77, 27.69] and 19.58[2.77, 36.39] mg/dL[95%CI] increase for moderate and severe, respectively). HDL levels correlate with AUDIT-C scores among patients with MH/SUD. Longitudinally, there were some (but not consistent) increases in HDL associated with increases in AUDIT-C. The increases were within range of typical year-to-year variation in HDL across the population independent of alcohol use, limiting the ability to use HDL as a longitudinal clinical indicator for alcohol use in routine care.

Exploring Factors Influencing Cancer Patients' Understanding of Diagnosis, Prognosis, and Emotional Well-being under Palliative Care: A Cross-sectional Investigation

Introduction: The demographic characteristics of cancer patients correlate with their awareness of diagnosis, prognosis, and the psychological distress associated with their condition. Objectives: The purpose of this study was to evaluate patients' knowledge of psychological distress, diagnosis, and prognosis who were presenting to the palliative medicine department of a tertiary hospital in Bangladesh. Methodology: This cross‐sectional study was conducted among 377 patients living with cancer attending the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Bangladesh from November 2021 and March 2022. Information on the clinical and sociodemographic aspects was gathered through a structured questionnaire and in-person interview, and the degree of distress was measured using a distress thermometer. After information was gathered, descriptive statistics were used to analyze it. Result: Approximately 16.2% of patients were unaware of their diagnosis, with two-thirds (68%) lacking awareness of prognosis. Over half (54.1%) reported significant distress. Gender, education, employment status, and head-and-neck cancer diagnosis were linked to diagnosis awareness, while educational level predicted prognosis awareness. Younger age, head-and-neck or hematological cancer diagnosis and lack of awareness regarding diagnosis and prognosis were associated with distress. Conclusions: Higher education and socioeconomic status correlate with patients' awareness of diagnosis and prognosis. However, distress remains higher among those unaware of prognosis.

Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Objective: In this study, we aimed to contribute to the literature by determining data such as mortality rates, demographic, clinical and radiological characteristics of patients who applied to our hospital's emergency department between January 2011 and December 2020 with the diagnosis of SISH and were operated on in our clinic. Methods:53 patients who were operated on for SISH diagnosis between January 2011 and December 2020 were retrospectively examined. Patients with SISH on brain tomography (CT) were evaluated. Hematoma localization is lobar; those with frontal, parietal, temporal and occipital locations; Those in the thalamic, putaminal and basal ganglia were considered to be deeply located. Patients were divided into three groups according to the Glasgow coma score (GCS): GCS 5–8, GCS 9–12, and GCS 13–15. Results: In our cohort, the patients mean age was 62.8 years (range, 19–92). The overall mortality rate was 62.87%. Age showed no significant association with mortality. Mortality was associated with increased hematoma volume and low GCS score at the first presentation (p &lt; 0.001). In receiver operating characteristic curve analysis, hematoma volume was an important predictor of surgical outcome; the optimal cut-off value of 59.5 cm3 was associated with 84.4% sensitivity and 90.5% specificity (p &lt; 0.001). Similarly, the optimal GCS score cut-off value of 8.5 was associated with a 96.9% sensitivity and 71.4% specificity for predicting mortality (p &lt; 0.001). Conclusions:Low GCS, increased hematoma volume, and especially the presence of concomitant hypertension (HT) are associated with poor prognosis in SISH patients.

A nationwide registry-based observational study of thyroid disease incidence in the Faroe Islands.

The occurrence of thyroid disease varies among populations. While the iodine nutrition level of the Faroese seems to have been decreasing over the past decades, there is no systematic evaluation of the thyroid disease pattern in the Faroe Islands. Such knowledge of thyroid disease occurrence in the North Atlantic region may support healthcare planning and prevention. To investigate incidence rates, including subtypes of thyroid diseases, and demographic characteristics of thyroid disease patients in the Faroe Islands, to improve understanding of the patterns and trends of these disorders. A registry-based observational study was conducted over 10 years, encompassing all adult Faroese individuals. Health records from general practitioners and hospitals were used to identify incident cases of thyroid diseases. Validation was performed using multiple data sources. The incidence rates were standardised using population data from the middle of the study period 2006-2018. Among the 1152 individuals diagnosed with thyroid disease, the standardised incidence rates per 100,000 person-years were 55 for hyperthyroidism and 112 for hypothyroidism, and around four times higher in women than in men. Hashimoto's thyroiditis was the dominant cause of hypothyroidism, while Graves' disease was the leading cause of hyperthyroidism. The incidence of hypothyroidism increases with age. A decreasing trend was observed over time for both hypothyroidism and hyperthyroidism. Considering the decrease in iodine nutrition levels over the past decades, we were surprised by the high incidence of autoimmune thyroid disease. The findings highlight the need for continuous monitoring of thyroid disease occurrence in coastal areas of the North Atlantic Ocean.

Status Epilepticus after mechanical thrombectomy: The role of early EEG assessment in Stroke Unit, clinical and radiological prognostication

BackgroundConvulsive (CSE) and non-convulsive (NCSE) Status Epilepticus are a complication in 0.2–0.3% ischemic strokes. Large stroke and cortical involvement are the main risk factors for developing SE. This study evaluates the prevalence of SE in patients treated with endovascular thrombectomy (EVT) through EEG recording within 72- h from admission. Moreover, we compared clinical, radiological, and outcome measures in SE and no-SE patients. Materials and MethodsWe collected retrospectively demographical and clinical characteristics of acute ischemic stroke patients who underwent EVT, admitted in the Stroke Unit (SU) of the University Hospital of Trieste between January 2018 and March 2020 who underwent EEG recording within 72- h from the symptoms’ onset. ResultsOut of 247 EVT patients, 138 met the inclusion criteria, of whom 9 (6.5%) showed SE with median onset time of 1 day (IQR 1–2). No difference was found between the two groups as for age, sex, risk factors, grade of recanalization, etiology of stroke, and closed vessel. The no-SE group presented higher NIHSS improvement rate (p=0.025) compared to the SE group. The sum of the lobes involved in the ischemic lesion was significantly higher in SE group (p=0.048). ConclusionSE after EVT in large strokes is a non-rare complication, with most being NCSE. Performing a rapid EEG assessment in a Stroke Unit setting may allow for a prompt recognition and treatment of SE in the acute/hyper-acute phase. SE may be correlated with worse clinical outcomes in patients with large vessel occlusion.

Thyroid Eye Disease: Pilot Study Comparison Between Patients in United States-Based and India-Based Practices

PurposeThyroid eye disease (TED) phenotype varies by ethnicity/race and genetic/environmental factors. This study compared demographic and clinical characteristics of TED patients from the US and India. DesignObservational pilot study Methods64 patients with TED ages ≥18 years old with active disease (onset of symptoms ≤18 months or presenting clinical activity score (CAS) ≥4) were recruited between March and October 2021 from clinical practices in the United States (Philadelphia, PA) (n= 30) and India (Hyderabad, India) (n=34). Data collection at baseline and 3 months included clinical measurements, thyroid disease history, and photographs. Ocular symptoms and quality of life data were obtained by phone interview. CAS was calculated using the standard 7-point scale. ResultsThere was no statistically significant difference in age, TED duration, or smoking status between patient groups. Both groups had good vision, a low rate of optic neuropathy, and comparable exophthalmometry. US patients were predominantly female (86.7% (26/30)), with a history of hyperthyroidism (96% 29/30). In comparison, Indian patients were 52.9% (18/34, p=0.004) female; underlying thyroid disease was distributed between hyperthyroidism (52%), hypothyroidism (17.6%) and euthyroid (9.7%). Mean (SD) CAS in the US cohort was double the score in the India cohort (4.2 (1.7) vs 1.65 (1.7), respectively) (P<0.0001). However, patients at both sites experienced subjective symptoms of TED at a similar frequency. ConclusionsObserved differences in TED between US and Indian patients warrant further investigation to elucidate differences in pathogenesis, disease expression, or other factors that may influence TED in diverse populations.

Comparing Rates of Undiagnosed Hypertension and Diabetes in Patients With and Without Substance Use Disorders.

Individuals with substance use disorders (SUDs) have increased risk for developing chronic conditions, though few studies assess rates of diagnosis of these conditions among patients with SUDs. To compare rates of undiagnosed hypertension and diabetes among patients with and without an SUD. Cross-sectional analysis using electronic health record (EHR) data from 58 primary care clinics at a large, urban, healthcare system in New York. Patients who had at least two primary care visits from 2019-2022 were included in our patient sample. Patients without an ICD-10 hypertension diagnosis or prescribed hypertension medications and with at least two blood pressure (BP) readings ≥ 140/90mm were labeled 'undiagnosed hypertension,' and patients without a diabetes diagnosis or prescribed diabetes medications and with A1C/hemoglobin ≥ 6.5% were labeled 'undiagnosed diabetes.' We calculated themean number of patients with and without an ICD-10 SUD diagnosis who were diagnosed and undiagnosed for each condition. We used multivariate logistic regression to assess the association between being undiagnosed for each condition, and having an SUD diagnosis, patient demographic characteristics, clinical characteristics (body mass index, Elixhauser comorbidity count, diagnosed HIV and psychosis), the percentage of visits without a BP screening, and the total number of visits during the time period. The percentage of patients with undiagnosed hypertension (2.74%) and diabetes (22.98%) was higher amongst patients with SUD than patients without SUD. In multivariate models, controlling for other factors, patients with SUD had significantly higher odds of having undiagnosed hypertension (OR: 1.81; 95% CI: 1.48, 2.20) and undiagnosed diabetes (OR: 1.93; 1.72, 2.16). Being younger, female, and having an HIV diagnosis was also associated with significantly higher odds for being undiagnosed. We found significant disparities in rates of undiagnosed chronic diseases among patients with SUDs, compared with patients without SUDs.

Demographic Profiling of Patients on Drug Dependence Admitted in Punjab Institute of Mental Health, Addiction Treatment Centre, Lahore

Objective: Drug dependence is a global public health concern, affecting millions and contributing to widespread negative consequences. This research delves into the demographic characteristics of drug abuse patients at the Punjab Institute of Mental Health (PIMH) Addiction Treatment Center in Lahore, Pakistan. Materials and Methods: Utilizing a cross-sectional research-based descriptive design, the study employs purposive sampling and a comprehensive questionnaire to collect data from 100 drug abusers. The analysis considered age, gender, socioeconomic status, residential area, occupation, education, marital status, and family system, shedding light on the diverse factors contributing to the drug dependence of the patients. Results: The results revealed a diverse age range (18-80 years) among participants (M=33,4, SD=10.3), most of them belonging to lower (34%) and middle class (39%); 67 respondents residing in the urban region and 32 from the rural areas. Heroin (32.3%) was reported to be the most consumed substance while cannabis (25.8%) and crystal methamphetamine (16.4%) were the second and third respectively taken mostly through sniffing. Among the reasons for using drugs, peer pressure came out to be the most reported cause. Conclusion: The findings underscored the complexity of drug dependence, necessitating targeted interventions that consider demographic variations that are crucial for effective treatment and prevention strategies. The study contributed valuable knowledge to the existing scientific understanding of drug dependence, paving the way for more informed public health initiatives.

Patient Characteristics and Adherence to Antidepressant Medication Treatment at PsychiatricOutpatient Department of Mardan Medical Complex, Pakistan

Background: Adherence to antidepressant treatment is an important factor in the treatment and effective management of depressed patients. Characteristics of patients can help in determining compliance to treatment protocols. In order to find link between compliance and demographic characteristics of patients, insight can be obtained through exploration of these variables.Objectives: To determine the association between patient characteristics and antidepressant medication adherence. To identify characteristics of patients that may improve or worsen compliance to antidepressant medication. Material and Methods: This study was a descriptive, cross-sectional study aiming to find the link between personal characteristics and adherence to anti-depressant medications. The study was conducted at Psychiatry outpatient department of a tertiary care hospital, Mardan Medical Complex, Mardan Pakistan, from 05th September 2018 to 08th February 2021. Data was collected from 660 patients who presented with depressive symptoms to Psychiatry OPD. The main objective was to identify characteristics of patients leading to poor compliance to antidepressant medication. Results: Total study population was 660. Majority of the study population 82.9 % (n-549) were female. Uneducated were, 56.6 % (375), 81.1 % (n-537) were unemployed, and 65.9 % (n-436) were married. Follow up interviews were conducted in 316 (47.7 %) patients at 3rd week, 186 (28.1 %) patients at 6th week, 130 (19.6 %) patients at 9th week, 96 (14.5 %) patients at 12th week, and 31 (4.7 %) patients at 6 months. There was no significant difference found on the basis of patient characteristics and adherence. However, compliance was better among patients who had longer duration of illness. Conclusion: Medication adherence is a common problem among depressed patients and leads to impaired daily life functioning. Our study could not found any significant difference regarding patient characteristics among compliant and non compliant patients. Educating patients regarding the use of antidepressant medication treatment should be added to routine practice. Keywords: Anti depressants, Depression, Non-adherence, Poor compliance.