Upper gastrointestinal bleeding in Scotland 2000‐2015: trends in demographics, aetiology and outcomes
Sardar ChaudharyDaniel MackayJill P. PellJohn MorrisNicholas I. ChurchAndrew FraserAdrian J. Stanley
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Abstract:
Summary Background Upper gastrointestinal bleeding (UGIB) remains a common cause of presentation and admission to hospital in the UK, with the incidence in Scotland one of the highest in the world. Aims To investigate the difference in demographics, deprivation quintiles, aetiology of bleeding and clinical outcomes in patients presenting with UGIB to hospitals across Scotland over a 16‐year period Methods Data were collected using the National Data Catalogue and analysed retrospectively using the National Safe Haven. Results We included 129 404 patients. The annual number of patients presenting with UGIB remained similar over the 16‐year period. Mean age at admission increased from 59.2 to 61.4 years. There was a significant drop in variceal bleeding over time from 2.2% to 1.7% ( P < 0.001). The incidence of UGIB was highest in the more deprived quintiles. There was a significant decrease in 30‐day case‐fatality from 10.1% in 2000 to 7.9% in 2015 ( P < 0.001), which was observed across all deprivation quintiles. Mean length of stay fell from 3.9 to 2.1 days. There was no difference in 30‐day case‐fatality or mean length of stay between patients presenting on weekdays or at weekends. Conclusions In this national study, we demonstrated that case‐fatality and mean length of stay after presentation with UGIB in Scotland has fallen over the past 16 years, despite a rise the in mean age of patients. There is a positive correlation between the incidence of UGIB and deprivation. We found no evidence of worse outcomes among patients presenting at weekends.Keywords:
Etiology
Demographics
Upper Gastrointestinal Bleeding
Case fatality rate
I have been promising (or threatening, depending on your point of view) for some time to write on the subject of SEG's demographics and now is the time. One could say that it is SEG's most important issue because our demographic profile says a lot about our society and deeply influences our future. Yet, I have been slow to bring the issue to the fore because I have been puzzled by some aspects of our demographics and also needed to collect some hard data. I think you may find the results interesting.
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This paper examines the impact that demographics have on policy outcomes. The impact that aldermanic ward‐level demographics have on the number of liquor licenses is measured in two US cities. In one city there is a great deal of direct resident involvement in the issuance process, while in the other city, issuance decisions are handled by elected representatives. This research does find that demographics have a significant impact on policy outcomes. However, the paper does not find a significant difference in outcomes between decisions made by elected representatives and those made by the community.
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102 children with uveitis were followed up in both an ophthalmological clinic and in private practice. These cases were studied, using the same criteria for the anatomical and etiological classification. For each etiology arguments for certitude and probability were cautiously defined. The etiology could be ascertained in about 36.5% of the cases. Arguments for a presumptive etiology were found in about 23.1% more cases. The first cause was toxoplasmosis; the second cause was streptococcic hypersensitivity. An etiology was rarely found for intermediate uveitis.
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Aim: To investigate whether severe acute respiratory syndrome coronavirus is involved in the etiology of acute pancreatitis.
Material and Methods: This study was conducted in Çiğli Educational Hospital, Bakırçay Univesity. The study included 2060 patients with AP admitted to hospital between March, 2020 and August, 2023. The patients were assigned into 2 groups based on presence of COVID-19 infection. Ethiological factors for AP were determined in all patients.
Results: Gallstone was the etiological factor in 614 patients (32.9%) who were COVID (-) but it was the etiological reason in only 19 patients (19%) in COVID (+) group. No etiology was identified in 217 (11.6%) of COVID (-) patients who were diagnosed as idiopathic pancreatitis. Idiopathic pancreatitis was diagnosed in 107 cases (54%) in COVID (+) group. There was significant difference presence of the diagnosis, which was made according to etiological factor, between groups.
Conclusion: There was no definitive etiological link between COVID-19 and AP; however, the fact that same team diagnosed such a different idiopathic AP in the same hospital with same diagnostic facilities implies an etiological role for SARS-CoV-2 virus in AP.
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Etiology and pathogenesis of MCA/MR in 1,023 patients (618 male; 405 female) with mental retardation were studied. Of 1,023 patients, there were 563 cases (317 male; 246 female) with MCA (55%). Among the MCA patients, there were 303 (156 male; 147 female) whose primary etiology was clarified (53.8%). Among the 260 patients with MCA/MR of unknown etiology, there were 23 with recognizable syndromes of unknown etiology and 7 previously reported by us as possibly having a new malformation syndrome. We had 569 patients with mental retardation of unknown etiology including 236 (41.5%) who were involved with MCA.
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One hundred cases of urticaria were studied to find out the etiology and to detect any co-relation between etiology and clinical manifestation. In 59% cases an etiological factor could be detected and the diagnosis was more certain in acute cases. In more than two-third of cases of chronic utricaria, the etiology could not be detected. Type and distribution of the lesions did not suggest any particular etiology except in the cases of physical and cholinergic urticaria.
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