Different Ages Of Patients Research Articles

Performance of ACR-TIRADS in assessing thyroid nodules does not vary according to patient age.

A few studies have evaluated the performance of the American College of Radiology Thyroid Imaging Reporting And Data System (ACR-TIRADS) in pediatric and elderly patients and found differences between the latter two age groups and middle adulthood. Thus, the present study was undertaken to explore the possible variation of ACR-TIRADS performance across different ages of patients. A retrospective population undergoing thyroidectomy was selected to use histology as the reference standard. Ultrasound images were reviewed, and alignment of ACR-TIRADS with the corresponding histological diagnosis was made afterwards. Results of the age groups were compared. The ACR-TIRADS diagnostic performance was calculated considering the assessment of nodules across risk categories (i.e., from TR1 to TR5), rate of unnecessary FNAC (UN-FNAC), and rate of necessary but non-performed FNAC (NNP-FNAC). Overall, 114 patients with a total of 220 nodules (46 carcinomas) were included. The rate of UN-FNAC was 66.3%, being 93.1% in TR3, 82.1% in TR4, and 31.4% in TR5. There were 15 NNP-FNACs. No significant difference was observed between age groups in terms of sample size, nodule, cancer, and FNAC. The nodule assessment according to ACR-TIRADS categories did not vary across ages. Sensitivity and specificity recorded in three age tertiles were not significantly different. The present study shows that the performance of ACR-TIRADS is not significantly influenced by patient age.

Associations and attributable burden between risk factors and all-cause and cause-specific mortality at different ages in patients with hypertension.

It remains unclear the age-specific associations of risk factors with deaths and mortality burden attributable across age. In a territory-wide retrospective cohort, 1,012,228 adults with hypertension were identified. Comorbidities including diabetes, chronic kidney disease (CKD), cardiovascular disease (CVD), heart failure, and cancer, and risk factors including current smoking and suboptimal control of blood pressure (BP), glucose and low-density lipoprotein cholesterol were defined. Associations of comorbidities/risk factors with all-cause and cause-specific mortality across age groups (18-54, 55-64, 65-74, and ≥75 years) were assessed. Population attributable fractions were also quantified. During a median follow-up of 10.7 years, 244,268 (24.1%) patients died, with pneumonia (7.2%), cancer (5.1%), and CVD (4.2%) being the leading causes. Despite increasing deaths with age, relative risk of mortality related to comorbidities/risk factors decreased with age; similar patterns were found for cause-specific mortality. The assessed risk factors accounted for 24.0% (95% CI 22.5%, 25.4%) deaths, with highest proportion in the youngest group (33.5% [28.1%, 38.5%] in 18-54 years vs 19.4% [17.0%, 21.6%] in ≥75 years). For mortality burden, CKD was the overall leading risk factor (12.7% [12.4%, 12.9%]) with higher proportions in older patients (11.1-13.1% in ≥65 years), while diabetes was the leading risk factor in younger patients (15.9-13.5% in 18-54 years). The association of comorbidities or risk factors with mortality is stronger in younger patients with hypertension, despite lower absolute mortality in young patients than in the elderly. Leading risk factors differed across age, highlighting the importance of targeted and precise risk management.

Long-term re-intervention after USgHIFU and prediction of NPVR in different ages of patients with uterine fibroids

Objective Long-term re-intervention after ultrasound-guided high intensity focused ultrasound (USgHIFU) ablation was reported, and the prediction of non-perfusion volume ratio (NPVR) in differently aged patients with uterine fibroids (UFs) was explored. Materials and Methods Patients with UFs who underwent USgHIFU ablation from January 2012 to December 2019 were enrolled and divided into < 40-year-old and ≥ 40-year-old groups. Cox regression was used to analyze the influencing factors of re-intervention rate, and receiver operating characteristic (ROC) curve was used to analyze the correlation between NPVR and re-intervention rate. Results A total of 2141 patients were enrolled, and 1558 patients were successfully followed up. The 10-year cumulative re-intervention rate was 21.9%, and the < 40-year-old group had a significantly higher rate than the ≥ 40-year-old group (30.8% vs. 19.1%, p < 0.001). NPVR was an independent risk factor in both two groups. When the NPVR reached 80.5% in the < 40-year-old group and 75.5% in the ≥ 40-year-old group, the risk of long-term re-intervention was satisfactory. Conclusion The long-term outcome of USgHIFU is promising. The re-intervention rate is related to NPVR in differently aged patients. Young patients need a high NPVR to reduce re-intervention risk.

Epidemiological characteristics of paediatric burn patients in China from 2016 to 2019: a retrospective study

BackgroundEpidemiological characteristics of paediatric burn can help to protect children from burn injuries. Most of the previous studies have been conducted on small scale and single centre in China. This...

Depression in Chinese Patients with Cleft Lip and/or Palate: A Preliminary Study

(1) Objectives: To investigate the difference in prevalence of depression between patients with CL/P (cleft lip and/or palate) and analyze the possible demographic factors that affect the prevalence of depression in Chinese patients with CL/P. (2) Methods: Patients with CL (cleft lip only), CP (cleft palate), and CLP (cleft lip and palate) were included in the study group. Non-CL/P individuals were included in the control group. The Patient Health Questionnaire (PHQ-9) was used to screen the depression of Chinese patients with CL/P. The different proportions of different depression groups between the CL/P group and the control groups were tested by the Fisher-Freeman-Halton test and Bonferroni correction. The scores between the study groups and the control group were analyzed by one-way ANOVA. In the study groups, demographic and clinical data of the patients, including diagnosis (CL, CP, CLP), gender, age, the only child or not, and region were collected to analyze whether they were the possible factors affecting depression through one-way independent-samples t-test. Pearson correlation analysis was used to analyze the correlation between monthly family income and depression. (3) Results: 111 and 80 valid questionnaires were collected from the study and control groups, respectively. The mean PHQ-9 score of the study group (5.459 ± 6.082) was relatively higher than the control group (4.362 ± 3.384), and the difference in proportions of depression groups was statistically significant between the CL/P group and the control group (p = 0.01), especially in the mild depression (p < 0.05) and moderately severe depression groups (p < 0.05). Statistically significant differences in PHQ-9 scores were observed between the individuals of different genders (p = 0.036) and ages (p = 0.007) in patients with CL/P, the individuals who were the only child or not in patients with CL (p = 0.007), and the individuals of different ages in patients with CP (p = 0.016). (4) Conclusions: The prevalence of depression in Chinese patients with CL/P was different compared with those without CL/P, while gender, age, the only child or not, and region played significant roles in affecting depression psychology.

Isolation and Identification of bacteria with heart disease and detection of some Immunological Cytokine in patients

The current study was conducted to detect the accompanying bacterial causes in people with heart disease of both sexes and of different ages of patients. Collected 150 blood samples of the people who visited Marjan Specialized Hospital, and the results of the transplantation were shown through the study of the appearance of pathogens the people who visited Marjan Specialized Hospital, and the results of the transplants were revealed through the study of the appearance of the flora, 193 were positive for the transplant out of 150 and 11 no growth culture. The positive bacteria included the highest percentage of the positive bacterial isolates is Staphylococcus aureus if the isolation percentage was 34.75%As for the negative bacteria, Enterococcus it was the highest isolation rate was 31.97%.the level of interleukin was measured IL10 Which showed an increase in its concentration in patient samples, especially in the 70-61 group, reaching (381.6667±16.56301pg/ml) compared to control in the same group reaching (299.0000±31.51190pg/ml). And IL35 which showed an increase in its concentration in patient samples, especially in the (70-61) group, reaching (1722.6667±2067.59796pg/ml) Compared to its value in healthy subjects while the age group (41-50) (45.08141±26.02776pg/ml) showed the lowest concentration of this interleukin and it was compared to the healthy and the same group.

P-694 Dosage of exogenous gonadotropins is not related to blastocyst aneuploidy or cumulative live-birth rates in PGT-A cycles

Abstract Study question Does dosage of gonadotropins affect aneuploidy rate rates or cumulative live birth rates (CLBRs) after the transfer of euploid embryos? Summary answer We did not find evidence that dosage gonadotropin influenced significantly the rate of aneuploidy and CLBRs after transfer of euploid embryos. What is known already Aneuploidy rates increase steadily with age, reaching &amp;gt;80% in women &amp;gt;42 years old. The goal of controlled ovarian stimulation obtaining more embryos to biopsy through the recruitment of several follicles, reaching more euploid embryos. However, several studies have suggested that a high response to stimulation might be embryotoxic and/or increase aneuploidy rates by enhancing the abnormal segregation of chromosomes during meiosis. Furthermore, a study on young donors showed differences in the euploidy rates, suggesting an iatrogenic etiology resulting from different stimulation methods. Study design, size, duration A multicenter retrospective study, with the preimplantation genetic test for aneuploidy (PGT-A) between January 2013 and January 2020 collected from clinics IVIRMA in Europe. 6832 cycles of in vitro fertilization (IVF) with PGT-A were included in the study Participants/materials, setting, methods A total of 62131 embryos were analyzed for ploidy status. Embryos that were subjected to chromosomal analysis were performed blastomere by aCGH (array Comparative Genomic Hybridization) or NGS (Next-Generation Sequencing) analysis. The embryos were biopsied on days 5 and 6. Women were divided into two age groups (&amp;lt;37 and ≥37 years old). Outcomes were compared between different total gonadotropin dosages (&amp;lt;3000 and ≥3000 IU), the dosage of hMG, and numbers of oocytes retrieved. Main results and the role of chance The total number of aneuploid embryos was 28336 of the 62131 embryos genetically screened using PGT-A. The embryonic aneuploidy rate was 59.4% (95%CI 58.5-60.3). In the group of women with gonadotropins dosage &amp;lt;3000 IU the embryonic aneuploidy rate was 59.7% (95%CI 58.7-60.8) and in the group with gonadotropins dosage ≥3000 IU was 58.7% (95%CI 57.1-60.3) with no significant difference between them (P = 0.279). In the group of younger patients (&amp;lt;37 y.o) the aneuploidy rate demonstrated no significant differences between patients who received low gonadotropin dosages and patients with high gonadotropin dosages (P = 0.06). Aneuploidy rates in the group of older patients (≥37 y.o) were similar regardless of gonadotropin dosing (P = 0.21). Dividing the according to the number of oocytes retrieved (10, 11-15, &amp;gt;15), the analysis of aneuploidy rate revealed no association between the gonadotropin dosages administrated depending on the total number of retrieved oocytes and age. The aneuploidy rate was also analyzed considering the administration of hMG, there was no statistical difference in the aneuploidy rate with low or high hMG dosages also when it was stratified by age. The cumulative live-birth rate in the groups of different gonadotropins dosage and different ages of patients was similar across the group. Limitations, reasons for caution The retrospective nature is the major limitation of this study, also patients included in the study received PGT-A using NGS and CGH arrays technology. The aCGH analysis used is less sensitive than more recent NGS technology. Wider implications of the findings Our study demonstrated that gonadotropin dosage did not affect aneuploidy rate or cumulative live-birth rates suggesting that the high doses of gonadotropins used in ART cycles may be safe. Trial registration number not applicable

CARDIOVASCULAR RISK FACTORS IN TYPE 1 DIABETES MELLITUS: ANY DIFFERENCE BETWEEN ADOLESCENTS AND YOUNG ADULTS FOR SUBCLINICAL ATHEROSCLEROSIS?

Objective: Atherosclerosis is one of the most dangerous complications of type 1 diabetes mellitus (T1DM) leading to cardiovascular (CV) diseases. There are only a few data about the relative burden of the other CV risk factors apart from DM in determining subclinical atherosclerosis at different ages in patients with T1DM. Thus, the aim of the present study was to compare adolescents and young adults with T1DM about the association of the different CV risk factors with subclinical vascular damage. Design and method: In sixty children and sixty adults with T1DM matched for sex and glycated haemoglobin [HbA1c] level, carotid intima-media thickness (cIMT), carotid coefficient of distensibility (cDC) and Pulse Wave Velocity (PWV) were measured by carotid ultrasonography and the SphygmoCor XCel device. Peripheral and central systolic/diastolic blood pressure (pSBP/pDBP; cSBP/cDBP), body mass index (BMI), HbA1c, nonHDL/HDL-cholesterol ratio were also analyzed. Demographic and hemodynamic variables are shown in Table-1. The relationship between risk factors and markers of subclinical vascular damage was assessed in each group by linear regression models using as covariates: gender, BMI, age, HbA1c, nonHDL/HDL-cholesterol ratio, and either pBP or cBP. Results: cIMT was associated neither with hemodynamic parameters nor with metabolic risk factor in both adolescents and adults. In adolescents, cDC was associated with pSBP (±SEM -017 ± 0.09 p-value = 0.013) whereas PWV showed an association with cSBP (±SEM 0.37 ± 0.008; p-value:0.003), cDBP (±SEM 0.46 ± 0.02; p-value:0.000), pDBP (±SEM 0.35 ± 0.01; p-value:0.003), and non-HDL/HDL ratio (±SEM 0.35 ± 0.12; p-value:0.007). In young adults, cDC was associated with cDBP (±SEM -0.28 ± 0.13; p-value:0.005) and pDBP (±SEM -0.26 ± 0.15 p-value = 0.02) whereas PWV was associated with cDBP (±SEM 0.36 ± 0.009; p-value:0.02), pSBP (±SEM 0.37 ± 0.01; p-value:0.002) and pDBP (±SEM 0.37 ± 0.02; p-value: 0.004). Conclusions: Subclinical vascular damages in T1DM are associated especially with hemodynamic factors, such as SBP and DBP, both in adolescents and young adults. Our findings suggest that BP control may be paramount starting early in patients with T1DM.

Функціональна матриця в розвитку лицевого скелета в дітей

The aim of the study. Identifying the relationship between the presence of a bad habit and the violation of the formation of the facial skeleton in children. Improving the effectiveness of comprehensive treatment of patients with pathological occlusion and existing bad habits through orthodontic treatment and elimination of bad habits. Research methods. Examined and treated 15 patients aged 9–12 years (group I) and 15 patients aged 12–15 years (group II) with dental and maxillary anomalies and disorders of the architecture of the mouth against the background of bad habits. All patients underwent rehabilitation of the oral cavity, orthodontic treatment with removable and non-removable structures, surgical correction of violations of the architecture of the oropharynx (freneloplasty, plastic connective tissue plastics). Conducted a clinical study, where the main point was the detection of abnormally attached bridles of the lips and tongue, the presence of connective tissue strands in the lateral group of teeth, changes in the dental-maxillary system due to bad habits. Computed tomography – to detect changes in the position of teeth and their rudiments, density and thickness of the bony structure of the jaw bones. We performed the following 3D-modeling of the facial skull and studied the cephalometric parameters of McNamara, the thickness of symmetrical masticatory muscles, analyzed the relationship between muscle thickness and bone thickness. We compared the changes in the photoprotocol before treatment, after treatment. Scientific novelty. Clinical studies have shown that 96.6 % of the examined patients (29 people) have bad habits. Patients who were able to overcome the bad habit were more likely to receive the desired therapeutic effect from the treatment based on the results of clinical and radiological examination, cephalometric analysis and photoprotocol. All patients before treatment had violations of the architecture of the oropharynx, manifested by highly attached strands in the area of the canines, premolars and bridle of the lip on the lower jaw (less than 5 mm); low-attached strands in the area of the canines, premolars and bridle of the lip on the upper jaw (less than 5 mm). Computed tomography data showed changes in the density and thickness of the bony structure of the jaw bones in areas where they were able to eliminate the bad habit. An increase in the thickness of the bony structure of the facial skull and an increase in the thickness of the masticatory muscles on the side where they managed to eliminate the bad habit were observed. Patients in groups I and II had a significant difference in cephalometric parameters according to McNamara before treatment and one year after the start of active treatment (p ≤ 0.05). The indicators in groups I and II did not differ significantly before treatment (p ≥ 0.05), but differed significantly one year after treatment (p ≤ 0.05), which is associated with the properties of bone structure at different ages of patients. Conclusions. Bad habits progress regardless of the patient's age, manifested in 96.6 % of patients.The results of clinical and radiological studies, analysis of cephalometric parameters and data on the thickness of the masticatory muscles confirm the relationship between chronic bad habits and the development of musculoskeletal system. The results indicate the ability of bone tissue to change its thickness, shape after the elimination of bad habits and confirm the presence of a functional matrix of bone structure. Bad habit is often one of the etiological factors in the development of pathological occlusion and only with its conscious elimination the patient achieves the desired therapeutic effect. Key words: bad habits, bone structure, orthodontic treatment.

Interaction between thrombin potential and age on early clinical outcome in patients hospitalized for COVID-19

Patients with Coronavirus Disease-2019 (COVID‐19) have haemostatic dysfunction and are at higher risk of thrombotic complications. Although age is a major risk factor for outcome impairment in COVID-19, its impact on coagulative patterns here is still unclear. We investigated the association of Endogenous Thrombin Potential (ETP) with thrombotic and haemorrhagic events according to different ages in patients admitted for COVID-19. A total of 27 patients with COVID‐19-related pneumonia, without need for intensive care unit admission or mechanical ventilation at hospital presentation, and 24 controls with non-COVID-19 pneumonia were prospectively included. ETP levels were measured on admission. Patients were evaluated for major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, stroke, transient ischemic attack, venous thromboembolism) and bleeding complications [according to Bleeding Academic Research Consortium (BARC) definition] during in-hospital stay. COVID-19 patients had similar ETP levels compared to controls (AUC 93 ± 24% vs 99 ± 21%, p = 0.339). In the COVID-19 cohort, patients with in-hospital MACE showed lower ETP levels on admission vs those without (AUC 86 ± 14% vs 95 ± 27%, p = 0.041), whereas ETP values were comparable in patients with or without bleeding (AUC 82 ± 16% vs 95 ± 26%, p = 0.337). An interaction between age and ETP levels for both MACE and bleeding complications was observed, where a younger age was associated with an inverse relationship between ETP values and adverse event risk (pint 0.018 for MACE and 0.050 for bleeding). Patients with COVID-19 have similar thrombin potential on admission compared to those with non-COVID-19 pneumonia. In younger COVID-19 patients, lower ETP levels were associated with a higher risk of both MACE and bleeding.

Oral atenolol treatment for infantile hemangiomas: clinical analysis of 133 consecutive patients.

BackgroundInfantile hemangiomas (IHs) are the most frequently occurring pediatric lesions. Oral propranolol has been shown to be safe and effective in infants with IHs. Side effects such as sleep disturbances have been associated with propranolol. Atenolol is a hydrophilic, selective β1-blocker and therefore may be not associated with side effects attributable to β2-adrenergic receptor blockade and lipophilicity. However, the efficacy of atenolol in the treatment of IHs is poorly understood. The aim of this study was to evaluate the efficacy of atenolol in the treatment of proliferating IHs in a clinical cohort including 133 consecutive patients.MethodsIn this study, we enrolled 133 patients diagnosed as proliferating IHs from the routine clinical and referral practices of the authors. The procedures followed were in accordance with the ethical standards of the Institute Review Board of Shanghai Ninth People’s Hospital and Helsinki Declaration. Clinical characteristics, including demographic data and clinical morphology, were collated. Responses to oral atenolol therapy were graded as: excellent, good, fair and poor. According to the reaction to atenolol treatment, additional medications or therapy were used for IH patients to achieve satisfactory clinical results.ResultsIn this study, 128 (96.2%) of 133 IH patients responded to oral atenolol, and the response rate (RR) was significantly different for different ages of patients (P<0.05), with the youngest patients having the highest RR. The mean time of treatment was 4.9 months. Forty-one patients who exhibited residual hyperpigmentation or telangiectasia were further treated with timolol maleate cream (n=32) or pulsed dye laser (n=9). All the 41 patients showed positive response. No life-threatening complications were noted during and after oral atenolol. Only 4 (3.0%) of 133 patients developed minor complications including diarrhea. No agitation and bronchospasm were noted in our study.ConclusionsThis study demonstrated that atenolol was effective in the treatment of IHs. Compared to propranolol, atenolol seems to have a similar effect on IHs. Furthermore, atenolol seems to be less frequently associated with potentially life-threatening side effects.

Natural History of Serum Enzyme Levels in Duchenne Muscular Dystrophy and Implications for Clinical Practice.

In Duchenne muscular dystrophy, creatine kinase and transaminases are released into the circulation, indicating muscle injury. Their usefulness in monitoring muscle injury or disease progression has not yet been fully evaluated. Thus, this study examined serum creatine kinase and transaminase concentrations at different ages in patients with Duchenne muscular dystrophy and evaluated their association with muscle injury. This is a prospective cohort study that included 110 patients with Duchenne muscular dystrophy categorized by age groups. Creatine kinase and transaminases were quantified in the serum; the Vignos scale evaluated the muscle function. Creatine kinase and transaminase levels were higher in ambulatory than that in nonambulatory patients, which significantly decreased as age increased. Serum creatine kinase and transaminase concentrations were elevated in all ages, and those aged 3-4 yrs had the highest concentrations. Age and Vignos Scale were significantly correlated with creatine kinase and transaminase concentrations. Age, creatine kinase, and transaminases explained the 42.5% of loss of muscle function. This study added the knowledge on the natural history of Duchenne muscular dystrophy at different ages and confirmed that creatine kinase and transaminases decrease with age and loss of muscle function, making them generally inappropriate for monitoring response to therapy, although they are useful for the clinical diagnosis.

The Effect of Three Different Ages of Patients with Hip Fracture on their Quality of Life Comparative Study

Abstract Background: Hip fractures are serious injuries that can lead to immobility and dependency, disability, mortality and negatively impact on patients’ quality of life. Aim: To compare the effect of three different ages of patients with hip fracture on their quality life. Research design: Descriptive (comparative research) design was utilized to conduct this study. Subjects: The sample compromised from three different adult ages from patients with hip fracture. Thirty patients for each group. The first age group represents young adult (18 04 > ), the second middle age adult (40 > 04), and the third older age adult (≥60). Setting: Trauma department at Assiut University Hospital. Tools: (I) Patient assessment sheet, (II) Rand Short Form 36-Items questionnaire. Result: The mean score of quality of life of the first age group (95.63±1.299) was more than the second and third age group (93.36±2.370, 83.46±18.024 respectively). Conclusion: quality of life of the first age group was better than the second and third age groups. Recommendation: rehabilitation program should be developed and applied for older adult patients with hip fracture to improve their quality of life.

Molecular &amp; Antibiotic Sensitivity Pattern Study of Acute Otitis Media, Tonsillitis &amp; Periodontitis among Different Ages of Patients of Al-Hashmia General Hospital, Primary Care Centers &amp; Private Clinic in Babylon Province

A total of 89 specimens have included 34 swabs of periodontitis(13male, 21 female), 28 swabs of Otitis Media & 27 swabs of Tonsillitis. These samples were brought from patients consulted to Alhashmia Hospital, primary care centers & private clinic of Babylon province during the period from 5 October 2017 to 11December 2017. They were appeared (72.17)% positive cases for Streptococcus pyogenes which have gotten from patients within age ranged, which suffered from Ear infection (3 to 39 years), Tonsillitis(1 to 60 years) & periodontitis inflammation(from less than 3years to 60 years). Biochemical examinations have included oxidase, catalase & Antibiotics sensitivity test. Results of bacterial genetics detection of sic as responsible for virulence agents of isolates bacteria, which is responsible for damage host cell components. 50 patterns (55.3%) of S. pyogenes cases of otitis media, tonsillitis & gingivitis have positive exclude 39(44.7) isolates were negative on 3% agarose gel. The volume of sic gene was 150 bp of the DNA, ladder (100–1000)bp. This gene of S. pyogenes specimens has amplified by PCR utilizing specific forward & reverse primers have appeared that 50 Streptococcus isolates detection of Otitis Media., Tonsillitis & periodontitis infections have negative 27 (90%) except 2 (10%) isolates were positive.

Comparison of incidence of perioperative deep venous thrombosis and D-dimer level between different ages in patients with lower limb fracture in Northwest China

Objective To compare the perioperative incidence of deep venous thrombosis (DVT) and level of plasma D-dimer between different ages in patients with lower limb fracture in Northwest China. Methods The data were retrospectively analyzed of the 1,185 patients with lower limb fracture in 5 provinces in Northwest China from July 2014 to March 2017. They were 583 males and 602 femals, with an average of 60.3 years(from 18 to 102 years). Of them, 723 were from Shaanxi Province, 148 from Gansu Province, 137 from Qinghai Province, 128 from Ningxia Hui Nationality Autonomous Regions and 49 from Xinjiang Uygur Autonomous Region. They were divided into a young group (≤44 years old) (n=288), a middle-aged group (from 45 to 59 years old) (n=256), a junior elderly group (from 60 to 74 years old) (n=263), and a senior elderly group (≥75 years old) (n=378). The incidences of perioperative deep venous thrombosis (DVT) and levels of plasma D-dimer were compared between the 4 age groups. Results The DVT incidences before and after operation in the young group were significantly lower than in the other 3 groups (P<0.05); the DVT incidence after operation in the middle-aged group was significantly lower than that in the junior elderly group (P<0.05). The pre- and post-operative levels of plasma D-dimer increased with the age of the patients; the pre- and post-operative levels of plasma D-dimer in the senior elderly group were significantly higher than in the other 3 groups (P<0.05). Conclusions The perioperative incidence of DVT was high in the elderly patients with lower limb fracture in Northwest China, peaking in the age range from 60 to 74 years old. The pre- and post-operative levels of plasma D-dimer increased with the age of the patients. Key words: Bones of lower extremity; Fractures, bone; Thrombosis; Age distribution

Psychosocial Problems and Physical Activity at Different Ages in Patients with Epilepsy

Research background and hypothesis. Physical inactivity of patients with epilepsy is associated with the course of the disease, treatment, preconceived attitudes and myths that their physical activity might be dangerous and cause seizures (Steinhoff et al., 1996; Nakken, 2001 ).The aim of our research was to examine the links between the psychosocial problems of patients’ with epilepsy, their hysical activity, self-reported quality of life as well as their connection with patients’ age. Research methods. The participants were 209 patients with epilepsy from three different regions (Šiauliai, Panevėžys and Pasvalys) of Lithuania. The subjects were selected with the help of quantitative closed-type survey – QOLIE-89 and IPAQ international questionnaire. The research findings were compared between two age groups: younger (20–39 years of age) and senior (40–59 years of age) subjects. Research results. The main psychosocial problems for patients with epilepsy were concerns about possible injuries during the seizures, experience of shame and other social restraint, health problems that might occur as a result of taking antiepileptic drugs for a long period of time, negative effects of antiepileptic drugs and memory impairments. These problems were more common among younger respondents (p &lt; 0.05). Physical activity levels in patients with epilepsy were inadequate and different. The main factor that contributed to these differences was patients’ age. Younger respondents trained more in their leisure time, while seniors spent more time reading or sleeping (p = 0.002).Younger patients lacked knowledge about the most appropriate types of physical activities, senior respondents were inactive were to the disapproval of medical professionals and their health problems (p = 0.006). Younger respondents evaluated their lifestyle as good enough more often than seniors. Discussion and conclusion. Psychosocial problems and physical inactivity of patients with epilepsy were connected with their age. Younger respondents more often than seniors were physically active and their self-reported quality of life was good.Keywords: age of patients with epilepsy, social problems, physical activity, evaluation of lifestyle.

Neurobiology of Mood Disorders

Mood disorders (major depressive disorders [MDDs] and bipolar disorders [BDs]) are common psychiatric conditions and major causes of morbidity and mortality worldwide. Their neurobiology is extensively studied, and major advances have been made in understanding the neuroanatomic, neurochemical, synaptic plasticity, and genetic correlates. In this review, we discuss the major neuroanatomic regions in the brain affected in mood disorders and brain structural and functional alterations, the main hypotheses for the neurobiology, the major neurotransmitters and neuromodulators implicated, the synaptic plasticity changes, the role of stress and the hypothalamic-pituitary-adrenal axis, the importance of circadian rhythms, and the role of genetics. We discuss differences in the neurobiology between MDDs and BDs and connect the knowledge of neurobiology to therapeutics. We discuss the main classes of medications, such as antidepressants for treatment of MDD and mood-stabilizing drugs for treatment of BD, and neuromodulation therapies such as transcranial magnetic stimulation. We point to unanswered questions and future directions, such as elucidation of the role of atypical neurotransmitters in mood disorders, the need for better understanding of the genetics and interactions between the immune and central nervous systems, and the development of biomarkers and personalized therapeutics based on the neurobiology. Notably, there are discrepancies in the current scientific knowledge and many unanswered questions in the neurobiology due to the different ages of patients, disease stage, presence of medications, and other comorbidities. It is notable, however, that mood disorders have a clearly established biological basis with alterations in the immune and central nervous systems that affect synaptic plasticity, neural circuits, and larger-scale brain networks and communicate with the autonomic nervous system. This review contains 5 figures, 4 tables and 62 references Key words: antidepressant, bipolar disorder, epigenetics, hypothalamic-pituitary-adrenal axis, immune system, limbic system, major depressive disorder, mood stabilizer, neurotransmitter, synaptic plasticity, transcranial magnetic stimulation

Neurobiology of Mood Disorders

Mood disorders (major depressive disorders [MDDs] and bipolar disorders [BDs]) are common psychiatric conditions and major causes of morbidity and mortality worldwide. Their neurobiology is extensively studied, and major advances have been made in understanding the neuroanatomic, neurochemical, synaptic plasticity, and genetic correlates. In this review, we discuss the major neuroanatomic regions in the brain affected in mood disorders and brain structural and functional alterations, the main hypotheses for the neurobiology, the major neurotransmitters and neuromodulators implicated, the synaptic plasticity changes, the role of stress and the hypothalamic-pituitary-adrenal axis, the importance of circadian rhythms, and the role of genetics. We discuss differences in the neurobiology between MDDs and BDs and connect the knowledge of neurobiology to therapeutics. We discuss the main classes of medications, such as antidepressants for treatment of MDD and mood-stabilizing drugs for treatment of BD, and neuromodulation therapies such as transcranial magnetic stimulation. We point to unanswered questions and future directions, such as elucidation of the role of atypical neurotransmitters in mood disorders, the need for better understanding of the genetics and interactions between the immune and central nervous systems, and the development of biomarkers and personalized therapeutics based on the neurobiology. Notably, there are discrepancies in the current scientific knowledge and many unanswered questions in the neurobiology due to the different ages of patients, disease stage, presence of medications, and other comorbidities. It is notable, however, that mood disorders have a clearly established biological basis with alterations in the immune and central nervous systems that affect synaptic plasticity, neural circuits, and larger-scale brain networks and communicate with the autonomic nervous system. This review contains 5 figures, 4 tables and 62 references Key words: antidepressant, bipolar disorder, epigenetics, hypothalamic-pituitary-adrenal axis, immune system, limbic system, major depressive disorder, mood stabilizer, neurotransmitter, synaptic plasticity, transcranial magnetic stimulation

The treatment of facial asymmetry: Review.

Some degree of congenital or acquired asymmetry is normal and universal. Significant facial asymmetry, however, causes both aesthetic, as well as functional problems. The comprehensive management of facial symmetry is scarcely addressed.1-5 Differing etiologies, heterogeneous material, and different ages of patients tend to produce fragmentary reports, the more so as evidence-based evaluation of outcomes is almost impossible. Therefore, a presentation of the general rules of treatment, illustrated by our own material collected from the Hospital and Clinic of Plastic Surgery in Polanica-Zdrój and from private surgical and orthodontic practice, could be regarded as useful and justified. Special attention has been given to both functional and cosmetic problems encountered in severe congenital and acquired asymmetries. The management of selected craniofacial malformations in so-called rare clefts, cleft lip and palate, and craniofacial microsomia (CFM), as well as large hemangiomas and neurofibromas, have been discussed. Additionally, the treatment of extensive and asymmetrical post-traumatic deformities and defects is discussed with particular attention given to problems related to ankylosis of the temporomandibular joints. Numerous examples of one-stage procedures, as well as combined, multidisciplinary treatments are presented.

Propranolol therapy for infantile hemangioma: our experience.

ObjectiveHemangiomas are the most common benign vascular tumors of infancy. Although most infantile hemangiomas (IHs) have the ability to involute spontaneously after initial proliferation and resolve without consequence, intervention is required in a subset of IHs, which develop complications resulting in ulceration, bleeding, or aesthetic deformity. The primary treatment for this subset of IHs is pharmacological intervention, and propranolol has become the new first-line treatment for complicated hemangiomas. Here, we evaluated the efficacy of propranolol on proliferation IH in a clinical cohort including 578 patients.MethodsWe retrospectively reviewed a total of 578 IH patients who were treated with oral propranolol from January 2010 to December 2012. Responses to the propranolol treatment were graded as: excellent, good, poor, or no response. Based on the response to propranolol treatment (once daily at a dose of 1.0 mg/kg for patients younger than 2 months; twice daily at daily total dose of 2 mg/kg for patients older than 2 months), additional pharmacotherapies or surgery were used for IH patients for satisfactory clinical outcome.ResultsFive hundred and sixty (96.9%) of 578 IH patients in our study responded to oral propranolol treatment, and the response rate was significantly different for different ages of patients (P<0.05), with the youngest patients having the highest response rate. The mean time of treatment was 6 months (range, 3–12 months). For example, response rate to propranolol was 98.1% in patients younger than 2 months, compared with 93.3% in patients older than 2 months and younger than 8 months, and 73.7% in patients older than 8 months. One hundred and thirty one patients who exhibited incompletely involuted hemangiomas were further treated with timolol maleate (n=89) or pulsed dye laser (n=42). One hundred and seventeen (89.3%) of 131 patients showed a positive response. There were no instances of life-threatening complications after propranolol. However, minor side effects were observed including 10 (1.73%) cases of sleep disturbance, 7 (1.21%) cases of diarrhea, and 5 (0.86%) cases of bronchospasm.ConclusionIH requires early intervention. During the involution phase, tapering propranolol dosage can be done to minimize side effects before discontinuing treatment. For patients exhibiting telangiectasia and chromatosis after propranolol treatment, administration of a 0.5% solution of timolol maleate or pulse dye laser is an effective therapeutic approach for complete involution.