Males Average Age Research Articles

Clinical Outcomes in Terminally Ill Patients Admitted to Hospice Care: Diagnostic and Therapeutic Interventions

This study's aim was to determine the impact of medical technologies on patient comfort and survival time, through retrospective review of the clinical course, symptom profile, and illness trajectory in 102 consecutive patients (50 males and 52 females), and of diagnostic and therapeutic interventions delivered to them. The average age of males was 72.3 years and of females 73.1 years. Ninety-four patients were admitted for palliation of symptoms due to malignant disease and eight other patients for non-malignant diseases. The median survival time was 12 days. On admission, higher univariate hazard risks for survival were significantly associated with male gender, metastatic disease, and dyspnea. Higher adjusted Charlson comorbidity scores were associated with significantly decreased survival time, while de novo symptoms and diagnostic interventions were associated with lower univariate risk rates and increased survival times. Palliative therapeutic interventions were not significantly associated with increased patient survival. A multivariate analysis showed that pain, dyspnea, immobility, and adjusted Charlson comorbidity scores were independent risks for shorter patient survival times. Diagnostic interventions were significant for increased patient survival. No requests for euthanasia had been recorded, which may, in part, reflect the significant family support most of these patients had received.

Effects of central corneal thickness on measurement of intra-ocular pressure in keratoconus and post-keratoplasty.

To measure and compare central corneal thickness (CT) and intraocular pressure (IOP) in keratoconus and post-keratoplasty subjects and examine the CT-IOP relationship. 22 keratoconus (category I: six female sixteen male, average age 27.0 range 12-47) and 19 post-keratoplasty (category II: ten female nine male average age 34.6 range 16-54) patients without other anterior segment conditions were recruited. Only one, non-contact lens wearing, eye of the patient was included for analysis. Cornea was anaesthetised with non-preserved 0.4% Benoxinate Hydrochloride. Using a randomised approach, CT was measured using a standard ultrasonic pachymeter. IOP was then measured using a standard Goldmann tonometer. At all times the tonometrist remained unaware of the corneal thickness values. The mean (+/- s.d.) values for CT and IOP respectively in the two categories were: (I), 445 (45) mu and 9.8 (2.3) mmHg, (II), 564(44) microns and 15.8 (3.9) mmHg. Differences between I and II for both CT and IOP were significant (t-test, p = 0.01). Within each category, a significant correlation between CT and IOP was not found. Pooling all pairs of data (n = 41) a significant relationship between CT and IOP was detected (r = 0.635, p = 0.0001). The results confirm the hypothesis that an eye with a thicker cornea tends to present with a higher measured IOP. In the management of keratoconus and other corneal surgical procedures, changes in CT will contribute to any apparent changes in measured IOP.

タイにおける地方レベルでの死亡登録の実態とその要因

While the reporting system of death cases in Thailand looks working properly at the national level, there still is a problem that "unknown causes of death" amount to half of the total number of deaths. For improving the quality of the system, the situation of registration at a local level needs to be analyzed. In Khonkaen province, one of the major provinces in the northeast Thailand, copies of deathregistration were summarized by the Provincial Health Office. In the present research, data inJanuary (dry season) and July (rainy season) in 1996 were investigated. The total number ofdeath reports was 1, 632 (976 males, 619 females and 37 unknown gender) for the two months . The two months being compared, there was no significant difference in terms of sex ratio.The average age at death was 53.9 years as a whole. The average age of males was 49.7 yearsand that of females was 60.6 years, showing about 10 years difference. It was 1, 607 examples that their places of death were mentioned: 1, 000 (62.4%) at home, 541 (33.8%) in medical facilities and 66 (4.1%) in other places, mostly outside, which includedunexpected accidents such as traffic accidents.Deaths at home amounted to almost two thirds of the entire death cases. Of the total number of 1, 461 cases, only 601 (41.1 %) were attached with death certificates; there were 860death reports (58.9%) without medical certificate. In 974 cases which received medical care before death, 506 (52.0%) died in hospitals and456 (46.8%) died at home. Almost all the cases (99.2%) for deaths in medical facilities wereattached with death certificates. However, up to 95.7% of persons who once received medicaltreatment but eventually died at home were not attached with death certificates . In addition, 390 cases (90.1 %) in the group who did not have medical treatment before death died at home . It is necessary to extend opportunities of medical services to elder people. But, even if medial services became available, it is not enough just to increase access to medical services, con sidering that only half of the people eventually received medical certificates.

Temporary Unilateral Amaurosis with Pneumosinus Dilatans of the Sphenoid Sinus

Pneumosinus dilatans (PSD), first described by Meyes in 1898, is an abnormal dilatation of one or more of the paranasal sinuses without bony erosion. The term sinus pneumocele indicates the presence of bony erosion. Review of the literature from 1968 to 1992 revealed 24 cases of idiopathic PSD and 17 cases of pneumocele of various paranasal sinuses. PSD occurred most commonly in the frontal sinus. Males were more often affected than females. The average age for males ranged from 16.5 for the maxillary sinus to 35.5 years for the sphenoid sinus. Pneumoceles occurred most commonly in the maxillary sinus. The average age for males ranged from 29 years for the frontal sinus and 47 years for the ethmoid sinus. Two patients (1 pneumocele and 1 PSD) had a temporary loss of vision. We report the case of a 37-year-old mountain climber who experienced temporary loss of vision in his left eye above 3000 m. Vision returned below 2000 m. High resolution computed tomography scan revealed pneumosinus dilatans of the sphenoid sinus with dehiscence of the optic canal on the left side. Endonasal microendoscopic resection of the anterior wall of the left sphenoid sinus was performed. The patient has remained symptom-free after 2 years of follow-up. Pneumosinus dilatans should always be considered in the differential diagnosis of sudden visual loss associated with atmospheric pressure changes.

Lower-Lung-Field Tuberculosis in Saudi Arabia

One hundred sixty-one patients were found to have lower-lung-field tuberculosis in a retrospective study of 1566 cases of pulmonary tuberculosis admitted to Sahary Chest Hospital, Riyadh. This repr...

半導体レーザーによる除痛効果に対する私見 (第VI報)

The sixth report in this series follows reports already presented at the 5th, 6th, 7th and 9th meetings of the JSLMS, and continues to show the efficacy of the GaAlAs diode laser in LLLT for pain attenuation. The present study shows results obtained with a new LLLT system, the Luketron®,(Mochida, Tokyo) developed jointly by the Japan Medical Laser Laboratory and Matsushita Electric Company, a second generation model of the Panalas 4000® used in the previous trials. The present study brings the total number of patients treated to 4,442 (m=1,845, f=2,597), with a total of 8,073 treated conditions, and 107,200 treatment sessions. The period of the present study is 1 year, from March 1988 to March 1989, with a patient population of 807, average age 51 y. o. (m=365, average age 51.3 y. o.; f=442, average age 50.7 y. o.). This study is the first with the average male age greater than the female. The largest age group was of patients in the 5th decade, with smaller groups of both younger and older patients. The population average age is slightly lower than in the previous reports, which may account for the slightly shorter treatment times. 1468 conditions were treated, an average of 1.8 per patient: this is the same as the previous reports. Efficacy of pain removal is 83%, similar to the previous studies. Greatest efficacy was achieved with multiple treatments, peaking at the 16th-20th treatment with no significant improvement thereafter. This is in accord with the previous study, where we reported the greatest treatment efficacy at an average of 16.8 treatments. The data reinforce our previous conclusions, that LLLT with the GaAlAs diode laser system provides safe and effective alleviation of chronic pain.

Kaposi's sarcoma in the Bantu of Mozambique.

Kaposi's sarcoma in the Bantu of Mozambique is relatively common (2.11% of all tumors for both sexes), with an incidence of 2.2 cases per 100,000 population per annum. The adjusted sex ratio is low (3.5 males to 1 female). Although the average age of males is 50 to 54 years (with 35.6% of the diagnoses made before 40 years), there is a real tendency towards an increasing incidence with aging. In only one patient did a malignant lymphoma occur simultaneously with a Kaposi's sarcoma. The extraordinary low frequency of this association in Africa is discussed. In seven cases there was histologically proven nodal involvement, and, in one autopay, there were metastases in the spleen considered to be suggestive of an intimate relationship with the reticuloendothelial system. The autopsies demonstrated the existence of blood-borne metastases besides the systematic and multicentric nature of the disease.

Orality, impulsivity and cigarette smoking in men: further findings in support of a theory.

JACOBS, MARTIN A. Ph.D; ANDERSON, LULEEN S. Ph.D; CHAMPAGNE, EMILY M.D.; KARUSH, NATHANIEL M.D.; RICHMAN, STEPHEN J. M.D.; KNAPP, PETER H. M.D.