ABSTRACT
Introduction Public figures, namely celebrities, are highly influential people whose actions and thoughts are often emulated, especially regarding healthcare. Understanding trends in public interest may provide an opportunity for further patient education. Given the changes of the COVID-19 pandemic along with the highly publicized death of actor Chadwick Boseman, who died from complications of colon cancer, we analyzed trends in colon cancer searches over a 15-month period. Methods Google Trends (Google, Mountain View, California) was used to access search histories in the United States from January 1, 2020, through April 30, 2021. Four search terms were analyzed: "colon cancer", "colonoscopy", "Cologuard", and "virtual colonoscopy". Google Trends reports data as relative search volume (RSV), a scaled number from 0-100 reflecting interest in a particular search term over a set time. Search terms were analyzed on the same RSV scale with one-way ANOVAs comparing search volumes during four eight-week blocks. Results Google Trends data was reported weekly. Search volume for colon cancer was higher (17.3, p=0.00) over the eight weeks following Boseman's death, while search volume for colonoscopy returned to normal (21.5, p=0.95) when compared to pre-pandemic levels. Conclusion The peak in colon cancer searches in late August of 2020 corresponds to the death of Chadwick Boseman on 8/28/2020. Colonoscopy interest decreased during the COVID-19 pandemic before returning to previous levels around the time of Boseman's death without experiencing the same spike in interest. This discrepancy represents a missed opportunity for patient education on this preventable disease.
ABSTRACT
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver disease with increasing prevalence worldwide. Clostridioides difficile infection (CDI) remains the most common cause of nosocomial diarrhea in developed countries. AIM: To assess the impact of NAFLD on the outcomes of hospitalized patients with CDI. METHODS: This study was a retrospective cohort study. The Nationwide Inpatient Sample database was used to identify a total of 7239 adults admitted as inpatients with a primary diagnosis of CDI and coexisting NAFLD diagnosis from 2010 to 2014 using ICD-9 codes. Patients with CDI and coexisting NAFLD were compared to those with CDI and coexisting alcoholic liver disease (ALD) and viral liver disease (VLD), individually. Primary outcomes included mortality, length of stay, and total hospitalization charges. Secondary outcomes were in-hospital complications. Multivariate regression was used for outcome analysis after adjusting for possible confounders. RESULTS: CDI with NAFLD was independently associated with lower rates of acute respiratory failure (2.7% vs 4.2%, P < 0.01; 2.7% vs 4.2%, P < 0.05), shorter length of stay (days) (5.75 ± 0.16 vs 6.77 ± 0.15, P < 0.001; 5.75 ± 0.16 vs 6.84 ± 0.23, P <0.001), and lower hospitalization charges (dollars) (38150.34 ± 1757.01 vs 46326.72 ± 1809.82, P < 0.001; 38150.34 ± 1757.01 vs 44641.74 ± 1660.66, P < 0.001) when compared to CDI with VLD and CDI with ALD, respectively. CDI with NAFLD was associated with a lower rate of acute kidney injury (13.0% vs 17.2%, P < 0.01), but a higher rate of intestinal perforation (P < 0.01) when compared to VLD. A lower rate of mortality (0.8% vs 2.7%, P < 0.05) but a higher rate of intestinal obstruction (4.6% vs 2.2%, P = 0.001) was also observed when comparing CDI with NAFLD to ALD. CONCLUSION: Hospitalized CDI patients with NAFLD had more intestinal complications compared to CDI patients with VLD and ALD. Gut microbiota dysbiosis may contribute to the pathogenesis of intestinal complications.
ABSTRACT
OBJECTIVES: We aimed to examine the clinical characteristics and outcomes of patients admitted for acute pancreatitis (AP) in the population with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). METHODS: The National Inpatient Sample from 2010 to 2014 was used to identify adult patients admitted with AP. Patients were grouped based on the HIV status. Primary outcomes were mortality, length of stay (LOS), disposition and total hospitalization charges. Secondary outcomes included acute kidney injury, septic shock, respiratory failure and pancreatic procedures. RESULTS: After matching and weighting, a total of 14,152 HIV-positive patients (6904 with AIDS and 7248 with asymptomatic HIV [aHIV]) with AP were identified. Acute pancreatitis with AIDS were associated with a higher rate of acute kidney injury, longer LOS, higher hospitalization charges, and less routine disposition compared with HIV-negative AP. Patients with aHIV had less septic shock, shorter LOS, and less hospitalization charges compared with HIV-negative patients and less respiratory failure, shorter LOS, and less hospitalization charges compared with AIDS patients. CONCLUSIONS: Patients admitted for AP with AIDS have worse outcomes. On the contrary, aHIV status was not only associated with better outcomes when compared with AIDS, but to HIV-negative status as well.