Changes in the architectonics of the lower jaw in children depending on age.

Multiplicity 1: Subgroup analyses

Introduction. The degree of mineralization of bone tissue depends on the macro elements content in it and on the course of metabolic processes in the body, which are the catalysts of microelements. The purpose of our work was to investigate the characteristics of calcium and strontium content in bone tissue of the lower jaw of collar part, their relationship and age dynamics in preschool children. Material and methods. To achieve this goal were conducted atomic absorption spectral analysis of 70 fragments of bone tissue of collar apophysis mandible of the lower jaw in children under 6 years (post extraction material and material obtained during surgery on the injury of lower jaw), obtained in pediatric wards of dental clinics of Lviv. All material was divided into 5 age groups – up to 6 months, to 1 year, to 2 years, to 4 years and 6 years, 7 fragments in each group (boys and girls, respectively). In the investigated fragments of bone tissue the content of calcium (Ca) and strontium (Sr) were determined. Research was carried out on atomic absorption spectrophotometer C-115, the concentration of the search elements in samples of bone tissue were indicated in mg/g. Results. Conducted atomic absorption spectral analysis collar of bone tissue of the lower jaw in children of different sexes of preschool age allowed to determine the content of calcium and strontium. It was set up that regardless of gender, the content of calcium in bone tissue of the jaw in children is gradually increasing to 4 years of age and slightly reduced to 6 years. Minimum indices of calcium content is in the 6-month, and the maximum – in 4 years. Herewith in all age groups the absolute levels of calcium in bone tissue are higher in girls than in boys. The content of strontium also has a similar age dynamics of boys and girls. Indicators strontium content increases in children 1 year of age, compared with a 6-month, slightly lower in the 2-years, sharply increasing (more than into 2 times) in the 4-years and continue to rise to 6 years. It was established that during the investigated age interval, the minimum content of strontium is 2 years of age, and a maximum at 6 years. In contrast to calcium, strontium content indexes in bone tissue of mandible in boys are higher than in girls exception in children 2 and 4 years of age, where the difference in terms of the two sexes were not found. Conclusions. This age dynamics of calcium and strontium content provides a balance of resorption and aposition processes in the bone tissue of the lower jaw in preschool children and with the result that an intensive and well-coordinated restructuring of the jaws associated with the development of dental germs of both generations, and functioning eruption of primary teeth that must be considered when planning dental treatment for children in this age group.

Objective Hysterectomy rates have fallen over recent years and there remains debate whether salpingectomy should be performed to reduce the lifetime risk of ovarian cancer. We examined trends in adnexal removal and route of hysterectomy in Australia between 2001 and 2015. Methods Data were obtained from the national procedural dataset for hysterectomy approach (vaginal, VH; abdominal, AH; and, laparoscopic, LH) and rates of adnexal removal, as well as endometrial ablation. The total female population in two age groups (“younger age group,” 35 to 54 years, and “older age group,” 55 to 74 years) was obtained from the Australian Bureau of Statistics. Results The rate of hysterectomy fell in both younger (61.7 versus 45.2/10000/year, p < 0.005) and older (38.8 versus 33.2/10000/year, p < 0.005) age groups. In both age groups there were significant decreases in the incidence rates for VH (by 53% in the younger age group and 29% in the older age group) and AH (by 53% and 55%, respectively). The rates of LH increased by 153% in the younger age group and 307% in the older age group. Overall, the proportion of hysterectomies involving adnexal removal increased (31% versus 65% in the younger age group, p < 0.005; 44% versus 58% in the older age group, p < 0.005). The increase occurred almost entirely after 2011. Conclusion Hysterectomy is becoming less common, and both vaginal and abdominal hysterectomy are being replaced by laparoscopic hysterectomy. Removal of the adnexae is now more common in younger women.

We aimed to elucidate the factors for the decision-making process in the treatment of adult spinal deformity (ASD), including sagittal parameters, that impact health-related quality of life (HRQOL). A multicenter prospective ASD database was retrospectively reviewed. The demographic data, HRQOL, and radiographic measures were analyzed using multivariate analyses in younger (≤ 50years) and older (> 50years) age groups. This study included 414 patients (134 surgical and 280 nonsurgical; mean age 30.7years) in the younger age group and 575 patients (323 surgical and 252 nonsurgical; mean age 65.8years) in the older age group. Worse HRQOL measures drove surgical treatment, both in younger and older patients. The SRS-22 self-image score was the most differentiating domain, both in the younger and older age groups, and an additional significant factor in the older age group was pain and disability. Coronal deformity drove surgical treatment for the younger age group; however, older surgical patients were less likely to have coronal malalignment. Sagittal parameters were associated with the decision-making process. Greater pelvic incidence minus lumbar lordosis mismatch in the younger age group and smaller lumbar lordosis index in the older age group were most correlated with the decision to undergo surgery. Aside from the HRQOL measures and coronal deformity, sagittal parameters were identified as significant factors for the decision-making process in the ASD population, and the lack of lumbar lordosis in relation to pelvic incidence was a strong driver to pursue surgical treatment. These slides can be retrieved under Electronic Supplementary Material.

Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: A systematic review

Late-life depression is a prevalent mental health problem among older adults. Variations may exist in the intensity of chronic stressors experienced by people in different older age groups and their effects on depressive symptoms. To examine differences among older adults by age group in the experienced intensity of chronic stressors in relation to coping strategies and depressive symptoms. Participants were 114 older adults. The sample was divided into three age groups: 65-72, 73-81, and 82-91. The participants completed questionnaires on coping strategies, depressive symptoms, and chronic stressors. Moderation analyses were conducted. The lowest levels of depressive symptoms were in the young-old age group and the highest levels were in the oldest-old age group. The young-old age group used more engaged and less disengaged coping strategies than the two other groups. The association between intensity of chronic stressors and depressive symptoms was stronger in the two older age groups compared to the youngest (moderating effect of age groups). Differences exist in the relationships among chronic stressors, coping strategies, and depressive symptoms by age groups in the older adult population. Professionals should be aware of the possible differences between age groups in depressive symptoms and the impact of stressors on depressive symptoms in different older adult age groups.

PurposeGastric cancer has a high incidence and mortality rate in Korea. Despite a growing older population and an increase in the number of older patients with gastric cancer, the older patients are not willing to undergo surgery due to their operative risks. Hence, to determine the clinical characteristics and outcomes of gastric cancer surgery for them, we investigate factors influencing the treatment decision.Materials and MethodsBetween January 1996 and December 2005, a total of 1,519 patients were classified into two groups; the younger age group between 41 and 69 years of age, and the older age group of 70 years or older. The analysis conducted included patient characteristics, accompanying disorders, related American Society of Anesthesiologists (ASA) grade, pathological characteristics and survival rate for each age group.ResultsSignificant differences were found in the ASA grade (P<0.001) and the number of accompanying disorders (P<0.001) between the two groups. The average length of hospital stay after surgery was 14.5 days in the younger age group, and 13.3 days in the older age group (P=0.065). The average survival time was 47.5 months in the younger age group, and 43.2 months in the older age group (P<0.001).ConclusionsThis study demonstrated that there was more number of accompanying disorders with a high surgical risk in the older age group. However, there was no significant difference between the older and younger age groups in terms of the incidence of complications, under the given disease conditions and if proper management was provided.

Purpose We investigated associations of blood pressure (BP) with albuminuria and left ventricular hypertrophy (LVH) in young, middle and older aged patients with hypertension and/or diabetes mellitus. Materials & Methods Study participants were treated patients with hypertension or diabetes, enrolled in a China nationwide registry. The 2510 patients were classified into young (<45 years, n = 345), middle (45–64 years, n = 1383) and older (≥65 years, n = 782) age groups. Clinic BP was measured three times consecutively on each of the two clinic visits. These six readings were averaged for analyses. Albuminuria was defined as a urinary albumin-to-creatinine ratio of ≥30 mg/g. LVH was assessed by the electrocardiogram (ECG) Cornell product and voltage methods. Results The prevalence of albuminuria and ECG-LVH was 17.8 and 6.5%, respectively. Mean (±SD) systolic/diastolic BP was 132.0 ± 16.5/85.2 ± 11.9 mmHg, 136.8 ± 17.9/81.7 ± 11.2 mmHg, and 139.8 ± 16.7/75.8 ± 10.4 mmHg in the young, middle and older age groups. In the young age group, the prevalence of albuminuria increased from 8.8% in systolic/diastolic BP <120/80 mmHg to 14.6, 16.0% and 16.5% in 120–129/80–84, 130–139/85–89 and ≥140/90 mmHg, respectively. The corresponding values were 8.9, 7.0, 18.1 and 22.2%, respectively, in the middle age group, and 21.2, 15.5, 16.4 and 24.4%, respectively, in the older age group. Adjusted analyses confirmed the J-shaped relation between BP and albuminuria in the older but not young age group. The prevalence of ECG-LVH was significantly (p for trend ≤0.04) higher with increasing BP similarly in all age groups. Conclusions The association between BP and organ damage seems to differ in young, middle and older aged patients for albuminuria but not ECG-LVH.

Safety, Efficacy and Pharmacokinetics of Nonacog Beta Pegol (N9-GP) in Prophylaxis and Treatment of Bleeding Episodes in Previously Treated Pediatric Hemophilia B Patients

The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry

We report the bone attenuation of ankle joint measured on computed tomography (CT) and the cause of injury in patients with ankle fractures. The results showed age- and gender-dependent low bone attenuation and low-energy trauma in elderly females, which suggest the osteoporotic features of ankle fractures. This study was performed to investigate the osteoporotic features of ankle fracture in terms of bone attenuation and cause of injury. One hundred ninety-four patients (mean age 51.0 years, standard deviation 15.8 years; 98 males and 96 females) with ankle fracture were included. All patients underwent CT examination, and causes of injury (high/low-energy trauma) were recorded. Mean bone attenuations of the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis were measured on CT images. Patients were divided into younger age (<50 years) and older age (≥50 years) groups, and mean bone attenuation and causes of injury were compared between the two groups in each gender. Proportion of low-energy trauma was higher in the older age group than in the younger age group, but the difference was only significant in female gender (p = 0.011). The older age group showed significantly lower bone attenuation in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis than the younger age group in both genders. The older age group showed more complex pattern of fractures than the younger age group. With increasing age, bone attenuations tended to decrease and the difference of bone attenuation between the genders tended to increase in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis. Ankle fracture had features of osteoporotic fracture that is characterized by age- and gender-dependent low bone attenuation. Ankle fracture should not be excluded from the clinical and research interest as well as from the benefit of osteoporosis management.

Objective: We investigated the association of blood pressure with albuminuria and left ventricular hypertrophy (LVH) in young, middle and older age groups of patients. Design and method: Our study participants were treated patients with hypertension or diabetes, enrolled in a China nationwide registry. The 2510 patients were classified into young (&lt;45 years, n = 345), middle (45–65 years, n = 1383) and older (&gt;65 years, n = 782) age groups. Clinic blood pressure was measured three times consecutively on each of the two planned clinic visits. These six readings were averaged for statistical analysis. Albuminuria was defined as a urinary albumin-to-creatinine ratio of &gt; 30 mg/g. LVH was assessed by the electrocardiogram (ECG) Cornell product method. Results: The prevalence of albuminuria and ECG-LVH was 17.8% and 3.7%, respectively, in all patients and 18.1% and 4.2%, respectively, in 2026 (80.7%) patients on antihypertensive medication. The mean (±SD) systolic/diastolic blood pressure was 132.0 ± 16.5/85.2 ± 11.9 mmHg, 136.8 ± 17.9/81.7 ± 11.2 mmHg, and 139.8 ± 16.7/75.8 ± 10.4 mmHg in young, middle and older age groups. In the young age group, the prevalence of albuminuria increased from 8.8% in blood pressure &lt; 120/80 mmHg to 14.6%, 16.0% and 16.5% in blood pressure at 120–130/80–85, 130–140/85–90 and &gt; 140/90 mmHg. The corresponding values were 8.9%, 7.0%, 18.1% and 22.2%, respectively, in the middle age group, and 21.2%, 15.5%, 16.4% and 24.4%, respectively, in the older age group. The prevalence of ECG-LVH was slightly but non-significantly (P for trend &gt; 0.09) higher with increasing blood pressure similarly in all age groups. Conclusions: The relationship between blood pressure and organ damage seems to be age-dependent for albuminuria but not ECG-LVH.

The European Youth Heart Study (EYHS) addresses cardiovascular disease risk factors and their determinants in European children and adolescents. The Swedish part of the study began with cross-sectional data collection in 9- and 15-year-old schoolchildren in 1998–1999 (EYHS-I). Repeated observations of the key indicators were performed in 2004–2005 (EYHS-II). The purpose of this study was to assess potential dropout effects in EYHS-II. Participants in both EYHS-I and EYHS-II (n=459) were compared with dropouts who participated only in the EYHS-I (n=678) in relation to baseline physical activity, cardiorespiratory fitness and socioeconomic and anthropometric characteristics. Bivariate comparisons were performed using chi-square tests and gamma tests for nominal and ordinal data, respectively. Continuous data were compared by t tests and Mann−Whitney tests depending on the distribution. The Bonferroni correction was used to control for multiple hypothesis testing. Multiple logistic regression with backward elimination of variables was applied to study independent effects of variables on the probability of becoming a dropout. Analyses were performed separately for the younger and older age groups. The dropout proportion in EYHS-II was 60%. Subjects from the older age group were less likely to participate in the follow-up study (32% vs. 50%, p<0.001). In bivariate analyses, only maternal education was associated with dropout rates in the younger age group after Bonferroni correction. Males were more likely to drop out in both younger [odds ratio (OR)=1.72; 95% confidence interval (CI): 1.10, 2.96] and older (OR=1.96; 95% CI: 1.09, 3.54) age groups while basic maternal education was associated with outcome only in the younger group (OR=4.31; 95% CI: 1.78, 2.95) in regression analysis. The Swedish EYHS-II had high dropout rate after EYHS-I, but the dropouts did not differ from the participants in relation to physical activity, physical fitness, and anthropometric indices. Males were more likely to drop out than were females in both age groups. Differential dropout in relation to maternal education was observed in the younger age group.

Introduction Cardiac magnetic resonance (CMR) radiomics use voxel-level data to derive quantitative indices of myocardial tissue texture, which may provide complementary risk information to traditional CMR measures. Purpose In this first stage of our work, establishing the performance characteristics of CMR radiomics in relation to disease outcomes, we aimed to elucidate differences in radiomic features by sex and age in apparently healthy adults. Methods We defined a healthy cohort from the first 5,065 individuals completing the UK Biobank Imaging Enhancement, limiting to white Caucasian ethnicity, and excluding those with major co-morbidities, or cardiovascular risk factors/symptoms. We created evenly distributed age groups: 45–54 years, 55–64 years, 65–74 years. Radiomics features were extracted from left ventricle segmentations, with normalisation to body surface area. We compared mean values of individual features between the sexes, stratified by age and separately between the oldest and youngest age groups for each sex. Results We studied 657 (309 men, 358 women) healthy individuals. There were significant differences between radiomics features of men and women. Different features appeared more important at different age groups. For instance, in the youngest age group “end-systolic coarseness” showed greatest difference between men and women, whilst “end-diastolic run percentage” and “end-diastolic high grey level emphasis” showed most variation in the oldest and middle age groups. In the oldest age groups, differences between men and women were most predominant in the texture features, whilst in the younger groups a mixture of shape and texture differences were observed. We demonstrate significant variation between radiomics features by age, these differences are exclusively in texture features with different features implicated in men and women (“end-diastolic mean intensity” in women, “end-systolic sum entropy in men”). Conclusions There are significant age and sex differences in CMR radiomics features of apparently healthy adults, demonstrating alterations in myocardial architecture not appreciated by conventional indices. In younger ages, shape and texture differences are observed, whilst in older ages texture differences dominate. Furthermore, texture features are the most different features between the youngest and oldest hearts. We provide proof-of-concept data indicating CMR radiomics has discriminatory value with regard to two characteristics strongly linked to cardiovascular outcomes. We will next elucidate relationships between CMR radiomics, cardiac risk factors, and clinical outcomes, establishing predictive value incremental to existing measures. Funding Acknowledgement Type of funding source: Other. Main funding source(s): European Union's Horizon 2020 research and innovation programme (825903),British Heart Foundation Clinical Research Training Fellowship (FS/17/81/33318)

Background: ACS-STEMI in young adults may have some characteristics such clinical, novel CVRF’s & angiographic proile that are different from those in older patients. Objective: To assess the frequency, risk factors, presenting symptoms, treatment in-hospital outcomes of young patients with STEMI compared with those of older patients Material and Method: The present study had 242 cases of acute ST elevation MI of both the sex, aged below and above 40 years treated in Cardiology department. Risk factors including hsCRP, Lp(a) and homocystiene; presenting symptoms, in two age groups were analyzed. Results: Acute ST elevation MI patients in age group below 40 years were 18.6% and in above 40 years age group were 81.4%. Overall mean age of presentation of STEMI is 54.31 years. STEMI was more common in younger age group 88.9% than in older age group 76.6%. STEMI was more common in male (78.9%) than female (21.1%). Overall most common symptom was breathlessness (72.3%), in younger age group chest pain was common (71.1%). The prevalence of hypertension and DM much or less equally distributed in both age groups. Prevalence of smoking in younger age group was 64.4% and in older age group 53.3%. A family history of CAD in younger age group was 35.6% and in older age group 24.9%. Lipoprotein (a) level was higher in younger age group which is statistically significant. hsCRP levels was increased above the normal range in older age group patients which was statistically significant. Conclusion: Acute ST elevation MI patients in age group below 40 years were 18.6% and in above 40 years age group were 81.4%. Acute STEMI was more common in male than female. Most common symptom was breathlessness. Lipoprotein (a) was significantly higher in younger age group; hsCRP was significantly higher in older age group.