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Seasonal Variation in Diverticulitis: Evidence From Both Hemispheres.

ABSTRACT: Diverticulitis is a common and morbid disease with incompletely understood risk factors and pathophysiology. Geographic and, recently, seasonal trends in diverticulitis have been described in the United States.The purpose of this study was to investigate and compare seasonal trends in urgent hospital admission for diverticulitis in geographically distinct populations in the northern and southern hemispheres.Inpatient, urgent admissions for diverticulitis were identified within the Dr Foster Intelligence Global Comparators Dataset, a global benchmarking collaborative.Admissions to participating hospitals in the United Kingdom, Australia, and the United States were identified between 2008 and 2013.A total of 18,672 urgent admissions for diverticulitis were identified among 5.5-million admissions.Four separate hypothesis testing methods were used to identify seasonal trends in diverticulitis admissions among international patient populations.Seasonal trends were present in all 3 countries. A summer peak was observed in both hemispheres using multiple statistical testing methods. Logistic regression analyses identified summer months as significantly associated with diverticulitis admission in all 3 countries.This study is limited by restriction to inpatient admissions, reliance on administrative data, and participation of select hospitals within the database.These data suggest a shared seasonal risk factor among geographically distinct populations for diverticulitis.

SUBMITTER: Adler JT

PROVIDER: S-EPMC6136646 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Seasonal Variation in Diverticulitis: Evidence From Both Hemispheres.

Adler Joel T JT Chang David C DC Chan Andrew T AT Faiz Omar O Maguire Lillias H LH

Diseases of the colon and rectum 20160901 9

<h4>Background</h4>Diverticulitis is a common and morbid disease with incompletely understood risk factors and pathophysiology. Geographic and, recently, seasonal trends in diverticulitis have been described in the United States.<h4>Objective</h4>The purpose of this study was to investigate and compare seasonal trends in urgent hospital admission for diverticulitis in geographically distinct populations in the northern and southern hemispheres.<h4>Design</h4>Inpatient, urgent admissions for dive ...[more]

PMID: 27505116

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Project description:BackgroundDisambiguation of embolus pathogenesis in embolic strokes is often a clinical challenge. One common source of embolic stroke is the carotid arteries, with emboli originating due to plaque buildup or perioperatively during revascularization procedures. Although it is commonly thought that thromboemboli from carotid sources travel to cerebral arteries ipsilaterally, there are existing reports of contralateral embolic events that complicate embolus source destination relationship for carotid sources. Here, we hypothesize that emboli from carotid sources can travel to contralateral hemispheres and that embolus interactions with collateral hemodynamics in the circle of Willis influence this process.Methods and resultsWe use a patient-specific computational embolus-hemodynamics interaction model developed in prior works to conduct an in silico experiment spanning 4 patient vascular models, 6 circle of Willis anastomosis variants, and 3 different thromboembolus sizes released from left and right carotid artery sites. This led to a total of 144 different experiments, estimating trajectories and distribution of approximately 1.728 million embolus samples. Across all cases considered, emboli from left and right carotid sources showed nonzero contralateral transport (P value <-0.05). Contralateral movement revealed a size dependence, with smaller emboli traveling more contralaterally. Detailed analysis of embolus dynamics revealed that collateral flow routes in the circle of Willis played a role in routing emboli, and transhemispheric movement occurred through the anterior and posterior communicating arteries in the circle of Willis.ConclusionsWe generated quantitative data demonstrating the complex dynamics of finite size thromboembolus particles as they interact with pulsatile arterial hemodynamics and traverse the vascular network of the circle of Willis. This leads to a nonintuitive source-destination relationship for emboli originating from carotid artery sites, and emboli from carotid sources can potentially travel to cerebral arteries on contralateral hemispheres.

Dataset Information

Seasonal Variation in Diverticulitis: Evidence From Both Hemispheres.

Publications

Seasonal Variation in Diverticulitis: Evidence From Both Hemispheres.

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