Prevalence Of Significant Findings Research Articles

Electrocardiographic findings in pediatric versus young-adolescent athletes: A comparative analysis using general international criteria

BackgroundThe inclusion of electrocardiogram (ECG) in medical examinations for sports practice serves as a valuable tool for identifying potential life-threatening conditions during physical exercise. However, its applicability in young individuals remains a subject of controversy, primarily due to relatively high rates of false positives and the associated costs of further investigations. Furthermore, the validation of International Criteria for athletes below 12 years of age in optimizing pre-participation screening for young athletes is yet to be established. In light of these considerations, this study aims to describe the prevalence of ECG findings in a sample of children and young-adolescent athletes aged 11–16 years, employing refined Seattle interpretation criteria. Additionally, we seek to compare these findings based on age group and sex. MethodsThis was a retrospective and observational study of 3747 athletes 11–16 year-olds. Evaluation included interviewer-administered questionnaires for relevant history, physical examination and resting 12 - lead ECG for each participant. The primary outcome measure was abnormal ECG findings according to the International Recommendations for Electrocardiographic Interpretation in Athletes. ResultsAmong the evaluated population of pediatric and young adolescent athletes (77.5% boys; >99% Caucasian), the vast majority exhibited normal electrocardiogram (ECG) results, with adaptive findings related to sports participation being more frequent among young adolescents and males. The presence of significant ECG abnormalities in young-adolescent athletes was uncommon (2.05%; 1.92% children and 2.32% young-adolescent) and required additional examinations. 0.27% of the total population were diagnosed with a previously unknown cardiac pathology only through the ECG. ConclusionsThis study provides valuable insights into the prevalence of normal, borderline, and abnormal electrocardiogram (ECG) findings in a large population of pediatric and young-adolescent athletes. These findings serve as guidance in detecting potentially serious cardiac alterations within this specific group, considering variations based on age and sex. The study confirms that ECG screening is a useful tool for identifying cardiac abnormalities in pediatric and young-adolescent athletes, even though the prevalence of significant findings in this population is relatively low. Furthermore, our findings support the utilization of the refined Seattle criteria as a sensitive and specific technique for screening pediatric and young-adolescent athletes, further enhancing the accuracy of ECG-based evaluations.

Age Matters: The Impact of Ageism on Health, Cognitive Impairment, Work Lives, and Anti-Ageist Interventions

Age is a social constructions. The treatment of people on the basis of their age, imposes serious psycho-emotional, social and economic costs on society and older people. The experiences of ageism may be exacerbated when other forms of acute and chronic forms of oppression are experienced due to racism, sexism, etc. The first paper looks at the impact of ageism on older people’s health. Their systematic review of studies showed that ageism detrimentally and consistently impacted older individuals in 11 health domains, with the prevalence of significant findings increasing over time. Informed by NIA’s Health Disparities Framework, the second paper examines the relationships between discrimination and protective factors on cognitive functioning. Their analyses of the Health and Retirement Survey data reveal, among other things, that everyday experiences of ageism significantly worsen older adults cognitive functioning. Using survey data of adults throughout the life-span, our third presenter examines how multiple identities (such as age and gender) influence employees’ perspectives on workplace fairness in hypothetical situations. The findings are informative to human resource departments in ensuring workplace fairness within the context of a multigenerational workforce. The final paper examines two efforts to disrupt ageism, specifically interventions that target students in an intergenerational program and staff members of senior living communities. Results from these evaluations point to an increase in positive attitudes among students and a reduction in ageist behaviors among staff members. All presenters will discuss policy, practice and research implications of their studies.

Ageism and Its Impact on Older Persons’ Health

Ageism has been called a silent epidemic. The extent to which ageism impacts the health of older persons in different countries was not well understood. In this presentation we will focus on the reach of ageism including negative age beliefs, on older individuals’ health. In an exhaustive systematic review, we found that ageism influenced older individuals in 45 countries and 11 health domains, with the prevalence of significant findings increasing over time (p < .001). In this presentation, we will also explore the mechanism by which this impact occurs and steps that can be taken to address this epidemic.

Incidental Non-cardiac Findings in Coronary Computed Tomography Angiography: Is it Worth Reporting?

Objectives:The objectives of this study were to estimate the prevalence and significance of incidental non-cardiac findings (INCFs) in coronary computed tomography angiography (CCTA) using a dual-source multidetector computed tomography.Materials and Methods:Retrospective review of all CCTA studies performed over a time period for various indications was included in the study. After exclusions, CCTA of 1713 patients was evaluated by two experienced cardiac radiologists for non-cardiac abnormalities in the full field-of-view limited contrast chest series. The scans were acquired from the level of the carina to just below the diaphragm. INCFs were classified into three categories: Significant, indeterminate, and insignificant findings based on their clinical impact and availability of prior imaging and clinical details.Results:The study cohort consisted of 1123 males (mean age of 58 years) and 590 females (mean age of 64 years). INCFs were seen in 600 patients of 1713 patients. A total of 812 INCFs (47.5%) were found in 1713 patients. Of those, 568 (70%) were considered insignificant, 205 (25.2%) indeterminate, and 39 significant findings (4.9%). The prevalence of significant findings was 2.3%. Among the 39 significant findings, after correlating with clinical details and other imaging, nine were really significant findings (0.5%) and out of this, four turned out to be cancers (0.2%).Conclusion:Large number of INCFs can be found in CCTA with majority of them being insignificant or of minimal clinical impact. Although the proportion of significant findings is small and may not be cost beneficial, it is prudent to evaluate all the available data and to make appropriate classification of INCFs which can help in further management.

Prevalence of significant neoplasia in FOBT-positive patients on warfarin compared with those not on warfarin.

The fecal occult blood test (FOBT) is widely used for colorectal cancer screening. However, the impact of warfarin use on FOBT sensitivity and specificity remains unclear. This study compares the relative risk of neoplasia in FOBT-positive patients stratified by warfarin use. The Clinical Outcomes Research Initiative database was used to identify patients with positive FOBT as the only indication for colonoscopy during 2005-2006. Patients were categorized on the basis of documented warfarin status within a 30-day period before FOBT. We compared the demographics and prevalence of significant colon findings (defined as polyp >9 mm or suspected malignant tumor) among the two groups. After adjusting for confounding variables, logistic regression was used to estimate the odds ratio of significant findings in warfarin-positive vs. warfarin-negative patients. Of 10,266 patients with positive FOBT, 372 used warfarin, 9,265 did not use warfarin, and 629 were excluded because of missing warfarin status. Warfarin-positive patients were more likely male (65 vs. 50%; P<0.0001), Caucasian (88 vs. 80%; P<0.0001), and veterans (53 vs. 33%; P<0.0001). The prevalence of a significant finding was greater in the warfarin group, 16 vs. 11.4% (P<0.01). After adjusting for age and sex, the relative risk of significant colon findings among warfarin-positive patients was not significantly different from warfarin-negative patients (odds ratio 1.1, 95% confidence interval: 0.81-1.44). No increased risk for significant colonic findings among FOBT-positive patients according to warfarin use was identified. These findings suggest that continuing warfarin before FOBT will not affect the positive predictive value of this screening test.

Diagnostic yield of colonoscopy based on symptoms

Objective. There are only a few data on the diagnostic yield of colonoscopy in different symptoms. The aim of this study was to assess the outcome of colonoscopy in patients with various gastrointestinal symptoms and to estimate the relation between the findings and the presenting symptoms. Material and methods. 1121 consecutive colonoscopies were registered during 1 year. Asymptomatic subjects and patients with known inflammatory bowel disease (IBD) were excluded, leaving 767 eligible for the study. Symptoms, findings and clinical judgement about their relation were recorded. Results. In patients with bleeding symptoms (n=405), serious colonic pathology – cancers and adenomas >1 cm, IBD and angiodysplasia – was found in 54 (13.3%), 83 (20.5%) and 20 (4.9%) patients, respectively; 162 (40%) patients had findings that could be related to the symptom. In 173 subjects with non-bloody diarrhoea, the diagnostic yield was 31.2%, i.e. mostly IBD and microscopic colitis. In 189 subjects with other gastrointestinal symptoms, the diagnostic yield was 13.2%. Serious colonic pathology was found in 8 of 362 (2.2%) subjects examined because of non-bleeding symptoms. Conclusion. The diagnostic yield of colonoscopy is high in patients with bleeding symptoms or diarrhoea, while the prevalence of significant findings is equal to a screening population in patients with other symptoms.