Special Topics

Special Topics

A Work in Process

When ICDs are viewed next to each other, some interesting differences can be noted between ICDs we normally think of as fairly close in behavior to each other.  Likewise, ICDs we think can be used to explain an event can appear so different that the possibility that such a claim is accurate is seriously questionable.  In one case, what is traditionally considered a cardiological ICD has an age gender behavior too distinct from the suspected diagnoses for the old theory to be considered seriously.  Even with a scientific hypothesis designed to back up  that claim is produced, the difference between the actual syndrome or condition, and its theoretical equivalent, is too great for the proposed theory to be credible.  Yet we often ignore the age-gender data placed before us due to the attractiveness and the apparent credibility of the individual proposing the hypothesis in the first place.  The goal for such an individual researcher should be to explain why the age-gender distribution is mismatched to the hypothesis at hand, rather than venture too far with a theory that is most likely going to trigger tremendous opposition by those most loyal to the biostatistics fields.

The following are self-explanatory.  They are demonstrations of how age and gender are interacting with genetics, physiology, psychology, social behavior and the environment to produce these distinct differences between the different groups of ICDs reviewed.  Some of these ICDs are reviewed elsewhere as well, either under the age group upon which they have the greatest influences, or in a special topics page located on the table of contents just beneath this new section chapter page.  Brief reviews of the data accompany many of these pages, to demonstrate how useful they become when trying to interpret otherwise hard to decipher epidemiological issues and concerns.

Cancer

Diabetes

Hypertension

Renal Failure

Injuries

Dislocations [ICD9 830.* to 838.*]

Nine specific joints were reviewed for dislocations.  Their order presented below matches the sequence of the ICD9 identifiers, presented in the following order 830-Jaw, 831-Shoulder, 832-Elbow, 833-Wrist, 834-Finger, 835-Hip, 836-Knee, 837-Ankle, and 838-Foot.

The most foretelling outcome for this review was the implication of the very unique distribution of the elbow dislocation [ICD 832].  These graphs are measures of prevalence by 1-year age-gender increments utilizing a moving windows method to define the prevalence rates per year.  The results of ICD 832 suggest this may be applied as a unique identifier for child abuse cases involving very young children.  Elbow dislocations occur due to falls, and mishandling, suspension of a child or picking up a child by one arm, etc.  The former suggests lack of parental attentiveness or the expected parental care given to a child as part of the daily child raising experience.  It also suggests the possibility of deliberate mishandling of children, and due to its method of identification and notation in the medical records, is perhaps more easy and legally “safe” to document in a medical record than the other indicators of child abuse such as battered child syndrome.

The second unique identifier upon which an alert can be based is the hip dislocation frequency noted for older age groups.  Hip dislocations are expected for this group, along with hip or pelvis-femur neck fractures, and so reappear in the last decades of life.  The higher childhood IP (1-year incidence-prevalence) is due to age and the same reasoning related to elbow dislocations (lack of full joint development); the dislocations noted for later years is in part due to loss of muscular strength but more so due to calcium loss in the bones. 

Also note the opposing appearance of jaw (female > male) versus shoulder (male > female) dislocations.  There are also unique assymetries in the pyramid for ankle and foot dislocations.

Ostomies [V44.*]

The ostomies graphed above imply old-age, very young (childhood development)  and mid-life related events.  The first two are symmetric, but with opposing peak ages.  The difference in peak ages by gender for cystostomies demonstrates a unique aging related health problem.  The reasons for these procedures in the younger population are probably identical for both genders, but for the older ages are more than likely very different.

MVAs  [E810-E819]

The above graphs are for health care received by victims of all of the MVAs, just pedestrians involved in MVAs, and MVAs involving motorcyles.  Gender-age differences are slight but exist in the first two.   The motorcycle related events demonstrate a strong age-gender asymmetry, with two peaks for male patients (older children/young adults and younger working class) and an identical although much smaller set of peaks for females. 

Traumatic Amputations

Conclusion: Young age is a factor for childhood related amputations primarily for Fingers, but perhaps as well any other lower arm part.    Old Age is most directly related to lower limb amputations induced by accidental means, with below the knee loss of parts most linked to old age.  Thumb amputation is the least age-specific amputations, and the least likely to occur for women.  Men received far more amputation related injuries than women, especially regarding fingers loss.

Thumb, Fingers, Arm Hand, Below Elbow, Above Elbow — Toes, Foot, Leg, Below Knee, Above Knee

Heart Valve Diseases (424.*)

Mitral, Aortic, Tricuspid, Pulmonary

Organ Transplants [V42.*]

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Types of questions answered by the above figures:

  • Which organ transplants demonstrate the most age-related limitations for eligibility?
  • Which organ transplants are most likely to be performed on an infant under 6 months of age? 
  • Which organ transplants are allowed even into very old ages (>75 yo)?
  • Which organ transplants are most equally distributed between the two genders?
  • Which transplant demonstrates the greatest difference between genders?
  • For working class populations, which organ transplants appear to demonstrate the greatest gender differences?

Drug Dependence [305.*]

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Social and Behavioral Gender Asymmetry

Mind-Body Relationships

The mindbody relationship some diseases and conditions may demonstrate is a controversial issue.  In the above syndromes in the top row, there are gender inequalities, with male patients reashing their peak in disease incidence-prevalence ten or more years before female patients.     This behavior in general is also seen for a large number of midlife diseases that interfere with the work environment, and to some physicians and researchers, appear to be correlated, such as gastroesophageal reflux and fibromyalgia.   The first condition in the lower row, gambling, is very behavioral in origins and nature.  Even though there is some evidence out there being used to argue that gambling and other obsessions people has some biological neurotransmitter basis for the claim, the cause-effect relationship needed to prove this correlation is lacking.  Assuming gambling is very much a behavioral and psychological condition, it is remarkable how much similarity it has to the first three conditions, with male prevalence much greater than female prevalence during the young working class years (18-40).   The acknowledged psychogenic syndrome psychogenic constipation, has a similar bigender age incidence-prevalence distribution, but with women overall equally influenced as men, although at a much older age.  Compare this with a truly biological ICD, more symmetric, “constipation” (ICD 564.0), entered as a simple biological medical condition.  The two well-known high risk age groups (very young and very old) demonstrate the peaks in this biological problem, versus the midlife sociologically-influenced states of the employed individual with unique mindbody relationships playing their roles in the health status of the body.  This means that asymmetry alone can suggest possible gender-related biological and sociocultural gender related influences, with mindbody influences prevailing during the mid-life years for these conditions or diseases.  This also means that such ICDs may have strong sociocultural influences interfering with the true physiological causes for whatever conditions are being addressed

Adult Abuse versus Child Abuse

More on Gender Differences

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Subjective ICD Applications

Insomnia and Sleep Apnea ICDs – Entries as an Organic Disease versus as a Symptom

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For more on these studies in detail, view any of the following (some may be locked due to controversial nature and related criticisms about this work):