Males Average Age Research Articles

Association between serum vitamin D levels and gastric cancer: A retrospective chart analysis.

AIMTo determine whether there is an increased risk of gastric adenocarcinoma associated with vitamin D deficiency (VDd).METHODSA retrospective case control study was performed of all patients diagnosed with gastric adenocarcinoma between 2005 and 2015. After we excluded the patients without a documented vitamin D level, 49 patients were included in our study.RESULTSThe average age of patients with gastric adenocarcinoma and documented vitamin D level was 64 years old (95%CI: 27-86) and average vitamin D level was 20.8 mg/dL (95%CI: 4-44). Compared to a matched control group, the prevalence of VDd/insufficiency in patients with gastric adenocarcinoma was significantly higher than normal vitamin D levels (83.7% vs 16.3%). Forty-one patients (83.7%) with adenocarcinoma showed VDd/insufficiency compared to 18 (37%) patients with normal vitamin D level without gastric cancer (OR: 8.8, 95%CI: 5-22, P value < 0.0001). The average age of males with gastric adenocarcinoma diagnosis was 60 years old vs 68 years old for females (P = 0.01). Stage II gastric adenocarcinoma was the most prevalent in our study (37%).CONCLUSIONWe reported a positive relationship between VDd and gastric adenocarcinoma, that is to say, patients with decreased VDd levels have an increased propensity for gastric adenocarcinoma.

Surgical treatment of intrahepatic cholangiocarcinoma: A retrospective cohort study

BackgroundIntrahepatic cholangiocarcinoma (IHCC) is the second most frequently developed primary carcinoma of liver, after hepatocellular carcinoma (HCC). They are biologically aggressive and they are frequently discovered in late study. Surgical removal is the only curative therapeutic method for treatment of such tumors. Patients and methodsFrom 1.1.2004 to 31.12.2014, at the Department of Surgery, University Hospital Martin and Jessenius Medical Faculty of Comenius University in Martin, we operated 411 patients with benign, primary, metastatic tumors of liver, where in 33 patients (8%) the histology confirmed the primary intrahepatic cholangiocarcinoma of liver. In the group, we evaluated the 1-year and 5-year survival of the patients according to radical resections, the degree of differentiation of tumor (grading), and according to positivity of lymph node. The results were statistically analyzed by the Student t-test and Kaplan–Meier curves of survival. ResultsThe average age of the patients was 59.6 ± 11.4 years, the males represented 46.2%, the females represented 53.8%. The average age of males was 58 ± 13.2, and females 61 ± 9.8 years. Large anatomic resections of 3 and more segments of liver were performed in 24 patients, anatomic resections and metastasectomies were performed in 6 patients, two patients had radiofrequency ablation of tumor. R0 resection was achieved in 20 patients, R1 resection in 8 patients, and R2 resection in 5 patients. One-year survival in the R0 group was 65%, in the R1 group 62%, and in the R2 resections group it was only 20%; five-year survival after R0 resections was 52%, and in R1 and R2 it was zero, which proved to be statistically significant. The median of survival in R0 resections was 12 months (interval 1–87 months), in R1 resections it was 12 months (interval 1–36 months), and after R2 resections it was 7 months (interval 1–12 months). One-year and five-year survival, depending on the degree of differentiation, was statistically non-significant; however, the five-year survival of G1 tumors is on the level of being statistically significant – the 5-year survival expressed in percentage G1/G2/G3 was 50%/12%/0% respectively. Positive lymph nodes were found in 16 patients (48%) from the group of 33 patients. The one-year and five-year survival was not statistically significant; however, 5 years of survival was recorded in 30% patients with negative lymph node and 0% patients with positivity of lymph node. ConclusionResection of tumor is the optional method; it should be attempted to achieve R0 resection and at the same time to preserve sufficient volume of residual functional parenchyma. Radical R0 resection is considered by us as the only possible method of surgical treatment for survival of patients with IHCC.

Work and the Adolescent in Medieval England ad 900–1550: The Osteological Evidence

WHAT WAS IT LIKE to be a teenager in medieval England? Despite the fact that medieval society often singled young apprentices and workers out for comment, their study has been largely neglected in medieval archaeology. The skeletal remains of 4940 children and adolescents (6.6–25 years) from 151 sites in medieval England were compiled from a combination of primary data collection and secondary data from published and unpublished skeletal reports and online databases. The aim was to explore whether apprentices could be identified in the archaeological record and, if so, at what age they started work and what impact occupation had on their health. The data were divided into urban and rural groups, dating from before and after the Black Death of ad 1348–49, and before the Industrial Revolution. A shift in the demographic pattern of urban and rural adolescents was identified after the Black Death, with a greater number of young females residing in urban contexts after 14 years. The average age of males in urban contexts increased from 12 years to 14 years after the plague years, contrary to what we might expect with the greater opportunities for work after the Black Death. There were higher rates of spinal and joint disease in the urban adolescents, and before the age of 18 years, their injuries were more widespread than their rural counterparts. Domestic service was the potential cause of greater strain on the knees and backs of urban females, with interpersonal violence evident in young urban males. Overall, it was the urban females that carried the burden of respiratory and infectious diseases, suggesting they may have been the most vulnerable group. This study has demonstrated the value of adolescent skeletal remains in revealing information about their health and working life, before and after the Black Death.

Sexuality in Older Couples: Individual and Dyadic Characteristics.

Sexuality is a key component of health and functioning that changes with age. Although most sexual activity takes place with a partner, the majority of research on sexuality has focused on individuals. In this paper, we focused on the sexual dyad. We proposed and tested a conceptual model of the predictors of partnered sexual activity in older adulthood. This model began with the personality of each of the partners, which affects individuals' views of sex and characteristics of the partnership, which in turn affected sexual expression in the couple. We measured a key feature of personality, Positivity, which reflected the individual's tendency to present his or herself positively in social situations. This trait, we posited, increased frequency of sex through increased desire for sex, and the subjective importance of sex to each member of the couple. In this model, Positivity also impacted characteristics of the relationship that promoted dyadic sexual behavior. These processes differed for men and women in the model. We tested this model with data from the National Social Life, Health and Aging Project, which conducted personal interviews with both partners in 940 American dyads (average male age 72; average female age 69). We found that couples in which the husbands' (but not wives') were high in Positivity show higher levels of sexual activity, and that this association was partially mediated by dimensions of relationship quality, but more so by individual factors such as thinking about sex and believing sex is important.

De Novo Anemia and Relationship with Vitamin C Deficiency and Zinc Deficiency in a Southern Delaware Population, a Retrospective Analysis

Background:Vitamin C is an essential dietary nutrient. It is a water soluble vitamin that exists in the body primarily in the reduced form Ascorbic acid. It's deficiency leads to a disease called Scurvy which is rare in developed countries. The relationship between anemia, Iron deficiency and Vitamin C deficiency is not clear and not evidence-based although many hematologists recommend Vitamin C intake to help Iron absorption.Method:We reviewed the data from a single institution where cases of de novo anemia underwent diagnostic workup. The study was approved by the hospital IRB and it was a retrospective analysis of data from October 2007 through July 2014. In addition to checking patient's CBC, iron studies, ferritin, b12, folic acid all patients (pts) went through testing for Vitamin C, Copper and Zinc. All reference labs were send to Mayo medical laboratories for consistency and standardization. Vitamin C level was determined by a High-Performance Liquid Chromatography (HLPC) and samples were collected after a 12-14 hour fasting-overnight. The normal range for Vitamin C is 0.6-2.0 mg/dL. We divided patients into 5 categories Severe deficiency (<0.1 mg/dL), Moderate deficiency (0.1-0.3 mg/dL), Mild deficiency (0.4-0.6 mg/dL), Low normal or Borderline values (0.7-0.8 mg/dL) and Normal results (0.9-2.0 mg/dL).Results: Of the 482 pts with de novo anemia tested, 273 subjects were found to have a Vitamin C deficiency (56.6% of population). Of those 30 pts (10.9%) had severe Vit C deficiency, 96 (35.1%) had moderate deficiency, 84 (30.7%) mild deficiency and 63 (23%) had low normal or borderline values and 209 (43.3%) had normal results. In pts with Vitamin C deficiency, iron studies indicated a serum iron saturation below 20% (range 20-50%) in 115 out of 212 subjects tested giving an incidence of 54.2%. Pts who had Vitamin C deficiency about 212 of those pts were tested for zinc levels and 103 pts (48.5%) were found to have Zinc deficiency that's value below 0.66 mcg/ml (Normal range being 0.66-1.1 mcg/ml). Of the group with severe Vitamin C deficiency or undetectable levels (30 pts), average hemoglobin for that group was 8.8 gm/dl range being 11.3-15.5 (CI 5.5-14.9), average iron saturation was 31% range (20-50%)(CI 3-92%), average Zinc levels were 0.49 mcg/ml range 0.66-1.1 (CI 0.19-0.79) average copper value 1.26 mcg/ml range 0.75-1.45 mcg/ml (CI 0.77-1.74), average Ferritin value 1048 ng/ml range 22-322 ng/ml (CI 13.8-5621). This means that in pts with severe anemia and severe vitamin C deficiency we see a profile where 77% pts also present with Zinc deficiency, their copper values are normal, iron saturation is normal but Ferritin which is a marker of inflammation is elevated (66.6%). Taking all of Vitamin C deficiency cases in our study(#273) the average age of females was 57.35 years (CI 15-97) 67.3% of study group & average age for males was 59.61 years (CI 25-90) which is 32.7%Pts who were found to have Vitamin C deficiency were given Vitamin C tablet 500 mg orally daily and if they have Zinc deficiency also supplemented with Zinc 50 mg orally daily. We have data on 67 of those 212 pts who had significant C deficiency (severe, moderate or mild). The average improvement in Vitamin C level for the group was 0.43 mg with average hemoglobin improvement of 0.96 gm.Conclusion: Vitamin C deficiency appears to play an important role in pathogenesis of nutritional anemia and it's incidence was more common than any other identifiable cause in our group. It can present as anemia regardless of the iron status and there appears to be a very strong correlation between Vit C deficiency and Zinc deficiency in patients with anemia. It also causes an Inflammatory response with elevation of Ferritin. Diet appears to play a major role in this type of anemia regardless of the body habitus. Malabsorption of Vitamin C and Zinc can be a reason as well. It is more common in females. Patients may or may not have other signs and symptoms of scurvy but in our population gum disease, bone pain, impaired wound healing and some degree of psychosis and mood disorder (scorbutic psychosis) was common. We believe that Vitamin C Deficiency is very common and under recognized cause of anemia. The exact pathophysiology needs to be established. Further studies need to be done to validate this important clinical finding but we recommend adding a fasting Vitamin C level and Zinc level as part of de novo anemia workup. DisclosuresNo relevant conflicts of interest to declare.

Study on the difference of corresponding age at cervical vertebral maturation stages among different skeletal malocclusions

To compare the difference of corresponding age at cervical vertebral maturation (CVM) stages among different skeletal malocclusions and provide clinic guideline on optimal treatment timing for skeletal malocclusion. Based on ANB angle, 2 575 cephalograms collected from Department of Orthodontics, Peking University School and Hospital of Stomatology from May, 2006 to November, 2014 were classified into skeletal Class I (ANB 0°~5°, 1 317 subjects), Class II (ANB > 5°, 685 subjects) and Class III (ANB < 0°, 573 subjects) groups. CVM stages were evaluated with the modified version of CVM method. Independent sample t test was performed to analyze the difference of age at different CVM stages among various skeletal groups. Significant gender difference of age was found at CS3 to CS6 for skeletal Class I group (P < 0.05), at CS5 and CS6 for skeletal Class II group (P < 0.05), and at CS3 and CS5 for skeletal Class III group (P < 0.05). At CS3 stage, the average age of male in skeletal Class II and skeletal Class III groups was (11.6 ± 1.5) years old and (10.3 ± 1.9) years old, respectively; the average age of females in those two groups was (11.7 ± 1.3) years old and (9.3 ± 1.5) years old, respectively, and significant difference was found in both comparisons (P < 0.05). Compared average age at CS5 and CS6 between skeletal Class II and skeletal Class III groups [the ages of male was (15.1 ± 1.7) and (16.8 ± 1.6) years old, the ages of male was (14.6 ± 1.2) and (15.7 ± 2.5) years old], significant difference was also found (P < 0.05). Significant gender differences were found when evaluated CVM stage and age in skeletal Class I, II and III groups. Significant differences of age at different CVM stage was noted when skeletal Class II was compared with skeletal Class III groups.

On the question of the frequency of mechanical eye trauma in senile patients in Azerbaijan

The article presents the results of the trauma of the eyes for a period of 10 years (2000-2009) in 601 hospitalized patients of 50 (min)-92 years (max) years old. By the age criteria, the eye injury most often occurred in senile patients (50.9%), the proportion of senile patients over time decreases due to the increase of middle-aged patients. By decades of age groups, there is a slight excess of the frequency injury index at the age of 51 to 60 compared with age from 61 to 70. As potential risk factors for injury the age-related changes in quality of vision cannot be excluded. Men were 438 (72.9%), women 163 (27.1%) with an average age of males 63.4 +/- 0.4 years, females--67.1 +/- 0.8. Timely provision of expert care, as a visual criterion, reflected the time factor of patients' addressing to the hospital. The analysis of the causes of eye injuries confirmed their diversity. The traumas received by the patients while falling (14.5 +/- 1.4) including--frequent due to the aggravation factor of the patient that determines both the injury and delayed treatment are noteworthy. According to addressing to the hospital, primary emergency aid was rendered on the first day only to 15.3 +/- 1.5% patients, within 1 to 3 days 34.9 +/- 1.9% were hospitalized, 4-7 days--10.5 +/- 1.2%, 8-14 days--7.5 +/- 1.1%. The problem of eye injury in senile patients remains topical, given the frequency of eye injuries in senile patients, given the high probability of somatic aggravation of the patients as a potential risk factor for injury, delayed treatment, which makes the problem of eye trauma in senile patients the one that demands increased and due attention.

CRANIAL BASE SYMMETRIC AND NORMAL LOWER JAW ROTATION

Understanding the complexities of cranial base development, function, and architecture is important for testing hypotheses about many aspects of craniofacial variation and evolution. Architecturally, the cranial base provides the platform upon which the brain grows and around which the face grows. In addition, the cranial base connects the cranium with the rest of the body: it articulates with the vertebral column and the mandible, provides conduits for all the vital neural and circulatory connections between the brain, the face and the neck, houses and connects the sense organs in the skull, and forms the roof of the nasopharynx. The shape of the cranial base is therefore a multifactorial product of numerous phylogenetic, developmental, and functional interactions. Aim. The aim of this research is to perform a morphometric analysis of the skull base to investigate the symmetry between the two hemibases of the cranial fossa with each other in adult patients with normal type of lower jaw rotation using cone beam copmuted tomography CBCT in transversal plane. Materials and methods. In result of radiographic study, 35 Caucasian adult patients with no prior orthodontics treatment were selected (16 males, 19 females) from 16 to 27 years (mean age of 20.02 years: females average age was 20.15 years; males average age was 21.84 years) of age with normal type of lower jaw rotation according to the sum of Björk. Pearson’s Correlation Coefficient was calculated to investigate the symmetry between the two hemibases of the cranial fossa with each other. Results. A difference was found amongst the two genders of the sample subjects in the strength of the correlation between the CBCT angular measurements evaluating the two hemibases of the cranial base symmetry. Conclusion. A difference was found amongst the two genders. This study found no exact symmetry between the samples, but it was in high level for adult females.

Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study

The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.

P102 Why do patients attend as rebook attendees in sexual health clinics?

<h3>Background/introduction</h3> Locally commissioners have raised concerns as regards the number of patients re-attending as a new episode of care (rebook) at the countywide sexual health clinics, rebook patients accounting for 54% of new/rebook attendances over a three month period. Commissioning concerns focussed on whether re attendance for recurrent bacterial sexually transmitted infections (STIs) due to previous suboptimal health prevention/promotion. Are there any grounds for these concerns? <h3>Aim(s)/objectives</h3> To ascertain the reasons why patients re-attend clinics as rebook patients. <h3>Methods</h3> A retrospective analysis of 150 case notes of rebook patients was undertaken with respect to age, gender and reasons for attendance. In addition a questionnaire survey was administered prospectively to 172 rebook patients as regards reasons for re-attendance. <h3>Results</h3> In the retrospective study, 106/150 (71%) were female, the average age of males was 30.4, the average age of female was 23.9. 56% (84/150) of patients attended three times or more related to genital warts, genital herpes, pelvic pain, contraception or recurrent bacterial vaginosis. In the prospective survey. 24% stated that they had re-attended because of genital warts, recurrent genital soreness or pelvic pain. 73/172(42%) were asymptomatic. Between 48–63% stated they preferred to attend because of the expertise, friendliness and confidentiality of the clinic. <h3>Discussion/conclusion</h3> In one study, 56% of attendees had attended with recurrent issues not related to recurrent bacterial STIs. Between 48–63% had attended related to friendliness, expertise and confidentiality of the clinic inferring that quality of care and confidentiality are important factors in reasons for re-attendance.

Modified Posterior Vertebral Column Resection for the Treatment of Vertebral Infections in Elderly Patients

Introduction Modified posterior vertebral column resection (PVCR) technique described in this study enables resection of infected material, decompression of the spinal canal, restoration of the anterior column, and posterior stabilization at the same time. Multilevel resections (two or more) can be performed with low-complication rates. Patients and Methods A total of 24 elderly patients (16 females and 8 males average age of 73.8 years [range, 68–83 years]) with pulmonary comorbidity were included. Etiologic diagnoses were spinal tuberculosis in 10 patients and nonspecific spondylodiscitis in 14 patients. Surgical technique included placement of fenestrated titanium pedicle screws, followed by hemilaminectomy, unilateral pediculectomy, decompression of the spinal canal by subtotal vertebrectomy, and anterior column support by expandable cage. One level above and one level below prophylactic vertebroplasty were performed. Results There were 6 single level, 17 two level, and 1 four level resections. The mean operation time was 2.5 hours and the average blood loss was 670 mL. Average follow-up was 47 months (range, 14–80 months). Average resected level was 1.9 (range, 1–4). The mean preoperative local kyphosis angle 32.7∞ was decreased by 67.8%. Overall, 14 patients with partial neurologic deficit (10 patients ASIA grade D and 4 patients ASIA grade C) had significant improvement. The major complications were post-op deep infection in three patients (12.5%) and death because of the cardiac failure in one (4%) patient. The minor complication rate was 29.1% with three hematomas and four dural tears. None of the remaining patients required revision surgery for recurrence of infection or implant failure or pseudoarthrosis. Conclusion Modified PVCR seems to be good alternative to anterior or combined A + P approaches in treatment of vertebral infections in elderly patients with pulmonary comorbidity, as technique enables multilevel resections (two or more) with low-recurrence and low-complication rates.

Radiographic Outcomes Following Lateral Column Lengthening With a Porous Titanium Wedge.

Lateral column lengthening (LCL) is commonly utilized in treating stage II posterior tibialis tendon dysfunction. This study aimed to analyze the outcomes of LCL with porous titanium wedges compared to historic controls of iliac crest autograft and allograft. We hypothesized that the use of a porous titanium wedge would have radiographic improvement and union rates similar to those with the use of autograft and allograft in LCL. Between May 2009 and May 2014, 28 feet in 26 patients were treated with LCL using a porous titanium wedge. Of the 26 patients, 9 were males (34.6%). The average age for males was 43 years (range, 17.9-58.7), 48.7 years (range, 21-72.3) for females. Mean follow-up was 14.6 months. Radiographs were examined for correction of the flatfoot deformity and forefoot abduction. All complications were noted. Radiographically, the patients had a significant deformity correction in the anteroposterior talo-first metatarsal angle, talonavicular coverage angle, lateral talo-first metatarsal angle, and calcaneal pitch. All but 1 patient (96%) had bony incorporation of the porous titanium wedge. The average preoperative visual analog scale pain score was 5; all patients but 3 (12%) had improvements in their pain score, with a mean change of 3.4. LCL with porous titanium had low nonunion rates, improved radiographic correction, and pain relief. Level IV, case series.

Body size and age in three populations of the northern banded newt Ommatotriton ophryticus (Berthold, 1846) from Turkey

We measured body size (snout-vent length, SVL) for three populations of Ommatotriton ophryticus newts in Turkey and estimated age using the skeletochronological method. Age was determined by counting the lines of arrested growth in cross-sections taken from phalanges. SVL was similar among populations and ranged between 58.41 and 85.78 mm in males and 50.33 and 71.56 mm in females. Males were significantly larger than females in all populations. Age at maturity was 4-6 years in males and 5-6 years in females. The average age of males and females did not differ significantly. Maximum age ranged from 9 to 12 years in males and from 9 to 11 years in females. Positive correlation was found between SVL and age for both sexes in all populations. A significant difference was observed among populations in terms of both age and body size (6-, 7-, and 8-year-old age classes). The demographic traits of the studied populations are the result of the interaction of multiple factors, including altitude, geographical location, and ecological factors.

Role of heritable connective tissue diseases phenotypes in assessing the risk for internal diseases

Aim. To identify the prevalence of main phenotypes of polygenic heritable connective tissue diseases in patients with internal diseases and to assess the prevalence of different internal diseases in such patients. Methods. The study involved 600 patients (254 males, 346 females) aged 18 to 64 years. Average age of males was 52±3.8 years, females - 47±2.2 years. Patients were examined to reveal the signs of different phenotypes of heritable connective tissue diseases in patients with internal diseases, as well as the severity of connective tissue diseases, and possibilities for it screening using the wrist and thumb hypermobility tests. Results. Signs of heritable connective tissue diseases were revealed in 147 (24.5%) patients with internal diseases. In females, those signs were observed in 104 (30.0%) cases, of which 44 (42.3%) were graded as mild, 35 (33.7%) - moderate, 25 (24.0%) - severe. In males, signs of heritable connective tissue diseases were revealed in 43 cases (16.9%), including mild - 17 (39.5%), moderate - 14 (32.5%) and severe - 12 (28.0%). Ehlers-like phenotype was the most common (52.0%), Marfan-like phenotype was observed in 14.0% of cases, primary mitral valve prolapse was diagnosed in 7.0% of patients, unclassifiable phenotype was observed in 11.0% of cases. Joint hypermobility syndrome was revealed in 31.0% of patients, presenting both as specific phenotypes (Marfan-like, Ehlers-like) and as a self-phenotype (31.9% of all the patients with heritable connective tissue diseases phenotype). Benign joint hypermobility was observed in 6.1% of cases. Symptoms of heritable connective tissue diseases were more frequent in patients with gastrointestinal and musculoskeletal diseases. Conclusion. The most common phenotype of heritable connective tissue diseases is Ehlers-like with skin, bone and systemic manifestations. Presence of heritable connective tissue diseases was most commonly associated with gastrointestinal and musculoskeletal diseases.

118 Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia, a Safe and Effective Procedure

INTRODUCTION: Traditionally, microvascular decompression (MVD) for treating trigeminal neuralgia (TN) has been performed using a microscope. Endoscopic microvascular decompression (E-MVD) is a newly accepted variation of this procedure. The endoscope improves the field of vision, and facilitates an easier dissection and placement of Teflon. It provides the advantage of better visualizing structures within the cerebellopontine angle. In this study, we examined 60 patients who were treated for TN exclusively using an endoscope. METHODS: A retrospective study with a long-term prospective telephone questionnaire for patients who have undergone E-MVD for TN. Patients were given the Brief Pain Inventory (BPI)-Facial 3 times throughout their treatment: preoperatively at baseline, at short-term follow-up, and at long-term follow-up. The BPI-Facial is an adapted version of the BPI, created by senior author J.Y.K. Lee, with 7 questions that pertain to specific facial interference. RESULTS: Sixty patients who received E-MVD were reviewed, 42 females (68%) and 20 males (32%). Average age for males treated was 63.3 years old and 57.3 for females. Fifty-six patients had Type 1 TN. 35 (58%) had right sided TN, while 25 (42%) had left sided TN. Neurolysis was performed in 15 of the 60 (25%). The most common compressions seen were SCA with 19 patients (32%), venous compression with 12 (20%), 10 had an unnamed artery compression, and 10 had a combination of the SCA and venous compression simultaneously. The rest were different combinations of the above. The mean “worst imaginable pain” prior to surgery was 8.3. Upon short-term follow-up, the average was 2.1, with a long-term mean of 2.1. Thirty-two patients reported zero pain during follow-up. One patient required a reoperation for a cerebrospinal fluid leak. CONCLUSION: E-MVD is a safe and effective treatment for TN. Postoperative outcomes produced significantly reduced and long-lasting facial pain. The majority of patients have reported complete facial pain relief.

Molecular genetic analysis and clinical aspects of patients with hereditary hemochromatosis

The purpose of the study was to perform a molecular genetic analysis and to document clinical aspects in patients with hereditary hemochromatosis. The study included 33 outpatients (23 males average age 50.6 years and 10 females average age 60.6 years) with a disorder of iron metabolism (transferrin saturation > 75 %) as confirmation of hemochromatosis who were subjected to molecular genetic and clinical analyses. A homozygous mutation of the hemochromatosis (HFE) gene (C282YY) was detected in 63.6 %, a compound heterozygous mutation (C282Y/H63D) in 30.3% and no mutation of the HFE gene was detected in 6.1 %. The following organ manifestations could be objectified: arthralgia (78.8 %), liver disease (39.9 %), skin hyperpigmentation (30.3 %), osteoporosis (24.2 %), diabetes mellitus (24.2 %) and cardiomyopathy (12.1 %). Comparison between patients with heterozygous and homozygous hemochromatosis revealed the following differences: compound heterozygote patients presented less frequently with osteoarthritis of the metacarpophalangeal (MCP) joints and hands (85.7 %/71.4 % homozygotes vs. 60 %/60 % heterozygotes). Osteoarthritis of the shoulder joints and osteoporosis as well as hypothyroidism were more frequent in compound heterozygote patients, whereas osteoarthritis of the knee and hip joints as well as liver disease were more common in homozygote patients. No differences between both groups were seen with respect to the clinical manifestations of cardiomyopathy and diabetes mellitus. Prevalent causes of death in hereditary hemochromatosis are heart failure, liver disease (cirrhosis and hepatocellular carcinoma) and portal hypertension. Therefore, an early diagnosis, adequate therapy and genetic screening of family members are of great importance. Medicinal treatment will only effectively prevent deleterious organ involvement and subsequent complications if initiated at an early stage. Furthermore, an overview of the current data is given.

Studies of the chronological course of third molars eruption in a northern Chinese population

Dental age estimation is of great importance for individual identification in forensic medicine and many other fields of study. Among them, tooth eruption is a parameter developmental morphology that can be determined by clinical examinations or by dental X-rays. The purpose of present research is to study the chronological course of third molars eruption in a Chinese population and compare that with other ethnic population for age estimation. A total of 1135 conventional orthopantomograms from 506 male and 629 female northern Chinese subjects aged between 11 and 26 years were analyzed. The eruption status of the third molars was assessed using the developmental stages described by Olze et al. Results showed that the third molars 18, 28, 38 and 48 in the stage A showed significant younger average age in males than in females. The Olze's stage A could be used as a reference stage to determine whether a male or female northern Chinese is likely to be equal or above age 16, with 99.6–100% and 97.4–98.1% of correct predictions, respectively. The stage D was found to be a useful marker for diagnosing age under 16 years, with 98.9–100% and 100% of correct predictions in males and females, respectively. There were some significant differences of the chronological course of the third molars eruption in different ethnic groups, which indicated that population-specific standards could enhance the accuracy of forensic age estimation based on third molar eruption.

Local control of human papillomavirus infection after anal condylomata acuminata eradication

To verify whether the eradication of anal condylomata acuminata was effective for local control of HPV infection using anal colposcopy and anal brush cytology. We evaluated 147 patients treated for anal margin and/or anal canal condyloma, with 108 HIV-positive and 39 HIV-negative individuals. The average age for males was 40 years for HIV-positive and 27.5 for HIV-negative. In females, the mean age was 37.5 years for HIV-positive and 31.5 for HIV-negative. Twenty-four patients (16.3%) had normal cytology and anal colposcopy, 16 (10.9%) normal cytology and altered anal colposcopy, 52 (35.4%) normal anal colposcopy and altered cytology, and 55 (37.4%) had altered cytology and anal colposcopy. the eradication of clinical lesions failed to locally control HPV infection.

Epidemiology of ameloblastomas of the jaws; a report from the Netherlands.

Objectives: To provide epidemiological data of ameloblastomas of the jaws in the Netherlands over a 25-year time period (1985-2010) and to compare these data with data from other parts of the world. Material and Methods: The data of all patients diagnosed with a primary ameloblastoma of the jaws in the Netherlands in the period 1985-2010 have been retrieved from the nationwide histopathology and cytopathology network and registry in the Netherlands (PALGA). The pathology reports were screened and only those cases were included in which a distinct diagnosis of primary, histopathologically benign, intraosseous ameloblastoma was rendered. The average population in The Netherlands during this period amounted approximately 15 million people. Results: An annual incidence rate was approximately 1,5 per million population, the male-female ratio being 1.4: 1. The age at the time of diagnosis was 44.1 years. The average age in males was 46.3 years compared to an average age in females of 41.3 years, the difference being significant (p≤ 0.05). The results were compared with those available in only a small number of publications worldwide. Conclusions: There is no strong evidence for significant differences of the true incidence of ameloblastomas worldwide, neither for a gender predilection. The diagnosis is generally made at a somewhat lower age in women; this phenomenon is even much stronger in the Black population, irrespective of gender. No proper explanation for this finding can be provided. Key words:Odontogenic tumor, ameloblastoma, epidemiology.

Cost-Effectiveness of Renin-Guided Treatment of Hypertension

A plasma renin activity (PRA)-guided strategy is more effective than standard care in treating hypertension (HTN). However, its clinical implementation has been slow, presumably due in part to economic concerns. We estimated the cost effectiveness of a PRA-guided treatment strategy compared with standard care in a treated but uncontrolled HTN population. We estimated costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) of PRA-guided therapy compared to standard care using a state-transition simulation model with alternate patient characteristic scenarios and sensitivity analyses. Patient-specific inputs for the base case scenario, males average age 63 years, reflected best available data from a recent clinical trial of PRA-guided therapy. Transition probabilities were estimated using Framingham risk equations or derived from the literature; costs and utilities were derived from the literature. In the base case scenario for males, the lifetime discounted costs and QALYs were $23,648 and 12.727 for PRA-guided therapy and $22,077 and 12.618 for standard care, respectively. The base case ICER was $14,497/QALY gained. In alternative scenario analyses varying patient input parameters, the results were sensitive to age, gender, baseline systolic blood pressure, and the addition of cardiovascular risk factors. Univariate sensitivity analyses demonstrated that results were most sensitive to varying the treatment effect of PRA-guided therapy and the cost of the PRA test. Our results suggest that PRA-guided therapy compared with standard care increases QALYs and medical costs in most scenarios. PRA-guided therapy appears to be most cost effective in younger persons and those with more cardiovascular risk factors.