Mild Clinical Behaviour of Crohn Disease in Elderly Patients in a Latin American Country: A Case-Control Study

Yamamoto-Furusho, Jesús K.; Sarmiento-Aguilar, Andrea

doi:10.1155/2015/473726

Cited by 6 publications

(10 citation statements)

References 46 publications

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“…[23] Another study by Yamamoto-Furusho et al found that elderly patients with CD had a mild clinical course characterized by long-term remission and no escalation to immunosuppressive and anti-tumor necrosis factor therapy. [49] Of interest, a cohort analysis of 184 cases in Mexico found that pancolitis, hypoalbuminemia and previous hospitalizations were the strongest predictors of procto-colectomy. [50]One study found a higher prevalence of left-sided colitis, higher mortality, and higher usage of biological agents in Mexican population than in Mexican-American population, supporting the role of environmental factors on clinical characteristics of IBD.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

et al. 2020

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Background and aims Ulcerative Colitis (UC) and Crohn's Disease (CD) have a major impact on quality of life and medical costs. The aim of the study was to estimate the prevalence, incidence and clinical phenotypes of Inflammatory Bowel Disease (IBD) cases in Mexico and Colombia. Methods We analyzed official administrative and health databases, used mathematical modelling to estimate the incidence and complete prevalence, and performed a case-series of IBD patients at a referral center both in Mexico and Colombia. Results The age-adjusted complete prevalence of UC per 100,000 inhabitants for 2015/2016 ranged from 15.65 to 71.19 in Mexico and from 27.40 to 69.97 in Colombia depending on the model considered. The prevalence of CD per 100,000 inhabitants in Mexico ranged from 15.45 to 18.08 and from 16.75 to 18.43 in Colombia. In Mexico, the age-adjusted incidence of UC per 100,000 inhabitants per year ranged from 0.90 to 2.30, and from 0.55 to 2.33 in Colombia. The incidence for CD in Mexico ranged from 0.35 to 0.66 whereas in Colombia, the age-adjusted incidence of CD ranged from 0.30 to 0.57. The case-series included 200 IBD patients from Mexico and 204 patients from Colombia.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

et al. 2020

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“… 8 9 11 14 16 The prevalence of extraintestinal manifestations is also lower, varying from 0% to 7% ( Table 3 ). 8 9 10 11 14 15 16 23 24 25 The frequency of thromboembolic complications, however, is much higher in elderly patients, possibly due to hypercoagulable states, relative immobility, and dehydration associated with illness.…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

“…In elderly patients with CD, most studies have reported a higher female to male ratio, with the proportion of females varying from 47% to 67% ( Table 3 ). 8 9 10 12 24 25 Elderly-onset patients with CD tend to have more rectal bleeding but less abdominal pain, fever, or weight loss at presentation. 2 …”

Section: Diagnostic Considerationsmentioning

confidence: 99%

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Management of inflammatory bowel disease in older persons: evolving paradigms

2018

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The incidence and prevalence of inflammatory bowel disease (IBD) is increasing, and considering the aging population, this number is set to increase further in the future. The clinical features and natural history of elderly-onset IBD have many similarities with those of IBD in younger patients, but with significant differences including a broader differential diagnosis. The relative lack of data specific to elderly patients with IBD, often stemming from their typical exclusion from clinical trials, has made clinical decision-making somewhat challenging. Treatment decisions in elderly patients with IBD must take into account age-specific concerns such as comorbidities, locomotor and cognitive function, and polypharmacy, to set realistic treatment targets in order to enable personalized treatment and minimize harm. Notwithstanding paucity of clinical data, recent studies have provided valuable insights, which, taken together with information gleaned from previous studies, can broaden our understanding of IBD. These insights may contribute to the development of paradigms for the holistic and, when possible, evidence-based management of this potentially vulnerable population and are the focus of this review.

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“…Strongly agreeing and agreeing responses were combined to represent positive perspectives by the study participants, while strongly disagreeing and disagreeing responses were combined to represent negative perspectives by the participants. All analyses were conducted using IBM SPSS Statistics version 22 [18].…”

Section: Discussionmentioning

confidence: 99%

Building a Patient-Centered Medical Home in an Integrated Healthcare System: A Survey of Patient Preferences and Needs

Forjuoh¹,

Embry²,

Reis³

2016

Int J Community Fam Med

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Background: While the transformation of a primary care practice into a patient-centered medical home (PCMH) has the potential to improve care, there is a dearth of data on patient perspectives. This study was conducted to assess patients' opinions related to current patient-centeredness, focusing on aspects of coordinated care, communication, accessibility, and management of care. Methods: A cross-sectional survey of English-speaking patients aged >18 years who had a scheduled appointment to see a primary care provider (PCP) at four Baylor Scott & White Health (BSWH) primary care clinics was conducted. The survey instrument included Likert-scale questions based on 5-item choices and data analysis focused on descriptive statistics. The study was approved by the BSWH Institutional Review Board. Results: Of 316 patients approached, 204 (64.6%) returned completed surveys. Their mean age was 47.4 years (SD=16.0; range 18-89) and they were predominantly white (84.4%), female (67.0%), employed (60.2%), and married (57.0%). More than half had at least some college education. Most of the positive responses pertained to patient-provider communication (e.g., provider and staff treating patient with courtesy and respect; provider and staff listening to patient's questions and answering them directly) and management of patient healthcare (e.g., patient thinking it is important to be proactive in their own healthcare; patient belief in playing an active role in their healthcare). Conclusions:A PCMH model appears to be an attainable goal that can better meet the needs of our patients in the ambulatory setting of our integrative healthcare system. Our patient sample endorsed survey items related to satisfactory patient-provider communication as well as those related to quality of participation in their treatment planning and self-management, concepts compatible with the tenants of the PCMH model. In addition, the study suggests that eliciting patient opinions can provide guidance for the initial planning and execution of PCMHs specific to a patient population.

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Mild Clinical Behaviour of Crohn Disease in Elderly Patients in a Latin American Country: A Case-Control Study

Abstract: Elderly patients with Crohn disease had a mild clinical course characterized by the lack of escalation to immunosuppressive and anti-tumour necrosis factor therapy, as well as long-term remission.

Cited by 6 publications

References 46 publications

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

Management of inflammatory bowel disease in older persons: evolving paradigms

Building a Patient-Centered Medical Home in an Integrated Healthcare System: A Survey of Patient Preferences and Needs

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