Higher Prevalence In Females Research Articles

Identification of CaMK4 as a sex-difference-related gene in knee osteoarthritis.

Osteoarthritis (OA) is a common degenerative joint disease with a higher prevalence in females than in males. Sex may be a key factor affecting the progression of OA. This study aimed to investigate critical sex-difference-related genes in patients with OA and confirm their potential roles in OA regulation. OA datasets GSE12021, GSE55457, and GSE36700 were downloaded from the Gene Expression Omnibus database to screen OA-causing genes that are differentially expressed in the two sexes. Cytoscape was used to construct a protein-protein interaction network and determine hub genes. Synovial tissues of patients (male and female) with OA and female non-OA healthy controls were obtained to confirm the expression of hub genes and screen the key genes among them. Destabilization of the medial meniscus (DMM)-induced OA mice model was established to verify the screened key genes. Hematoxylin and eosin (HE) staining and Safranin O-fast green dye staining were employed to observe synovial inflammation and pathological cartilage status. The abovementioned three datasets were intersected to obtain 99 overlapping differentially expressed genes, of which 77 were upregulated and 22 were downregulated in female patients with OA. The hub genes screened were EGF, AQP4, CDC42, NTRK3, ERBB2, STAT1, and CaMK4. Among them, Ca2+/calmodulin-dependent protein kinase-4 (CaMK4) was identified as a key sex-related gene for OA. It was significantly higher in female OA patients than in the cases of male patients. Moreover, CaMK4 was significantly increased in female patients with OA compared with the female non-OA group. These results suggest that CaMK4 plays an important role in the progression of OA. OA mouse models demonstrated that CaMK4 expression in the mice knee joint synovial tissue elevated after DMM, with aggravated synovial inflammation and significant cartilage damage. Cartilage damage improved after intraperitoneal administration of the CaMK4 inhibitor KN-93. CaMK4 is a key sex-related gene influencing the progression and pathogenesis of OA and may be considered as a new target for OA treatment.

Current management of generalized pustular psoriasis.

Generalized pustular psoriasis (GPP) is a rare subset of psoriasis involving episodes of sterile pustules accompanied by inflammation and, often, systemic involvement. The inflammatory nature of GPP has potential for severe multisystem complications including high-output cardiac failure, infections, digestive system issues, and disfiguring or lethal acute flare episodes. The disease tends to have higher prevalence in females and Asians. The IL-1/IL-36 inflammatory pathway is a critical facet of GPP's pathology. Genetic mutations that are associated with GPP include modifications of Interleukin 36 Receptor Antagonist (IL36RN), Caspase Recruitment Domain Family Member 14 (CARD14), Adaptor Related Protein Complex 1 Subunit Sigma 3 (AP1S3), Myeloperoxidase (MPO) and Serpin Peptidase Inhibitor Clade A Member 3 (SERPINA3) genes. Treatment guidelines for GPP are not well-entrenched. Currently, only one GPP-specific treatment, the interleukin-36 receptor antagonist (IL-36Ra) spesolimab, has been approved for use in the United States. Additional anti-IL-36 pathway therapies are currently being developed. Other treatment options include other biologic therapies such as IL-17 inhibitors, IL-23 inhibitors and TNFα inhibitors. Non-biologic therapeutic options include retinoids, cyclosporine and methotrexate. Treatment options differ throughout the world; most countries utilize retinoids, cyclosporine and methotrexate as first-line non-biologic options. China and United Kingdom have no GPP-specific biologic therapies approved for use, while several biologic therapies are approved for use in Japan. This review aims to serve as an update on the current global management of GPP while also including relevant aspects of disease pathogenesis, diagnosis, clinical presentation, histopathology, aetiology and epidemiology.

The association between tissue doppler-derived E/(e′s′) ratio and coronary atherosclerosis severity measured by the SYNTAX score in patients with non-ST elevation-acute coronary syndrome

BackgroundThe prognosis of patients hospitalized with non-ST elevation-acute coronary syndrome (NSTE-ACS) is typically determined by the existence and severity of myocardial necrosis and left ventricular (LV) remodeling.AimThe present study was to assess the association between the E/(e′s′) ratio and the coronary atherosclerosis severity, measured by the SYNTAX score, in patients with NSTE-ACS.MethodsUtilizing a descriptive correlational research design, this study was prospectively conducted on 252 patients with NSTE-ACS, undergoing an echocardiography to determine the left ventricular ejection fraction (LVEF), the left atrial (LA) volume, the pulsed-wave (PW) Doppler-derived transmitral early (E) and late (A) diastolic velocities, and the tissue Doppler (TD)-derived mitral annular early diastolic (e′) and peak systolic (s′) velocities. After that, a coronary angiography (CAG) was performed, and the SYNTAX score was calculated.ResultsThe patients were divided into two groups, viz., those with the E/(e′s′) ratio < 1.63 and the cases with the ratio ≥ 1.63. The results revealed that the patients with a high ratio were older, had a higher prevalence of females, a SYNTAX score ≥ 22, and a lower glomerular filtration rate than those with a low ratio (p-value < 0.001). Besides, these patients had larger indexed LA volume and lower LVEF than others (p-value: 0.028 and 0.023, respectively). Furthermore, the multiple linear regression outcomes established a positive independent association between the E/(e′s′) ratio ≥ 1.63 (B = 5.609, 95% CI 2.324–8.894, p-value = 0.001) and the SYNTAX score.ConclusionThe study results demonstrated that the patients hospitalized with NSTE-ACS and the E/(e′s′) ratio ≥ 1.63 had worse demographic, echocardiographic, and laboratory profiles and a higher prevalence of a SYNTAX score ≥ 22 than those with a lower ratio.

Retrospective study of transmissible venereal tumor in dogs in the city of Dourados, Mato Grosso do Sul - Brazil

The Transmissible Venereal Tumor (TVT) is a neoplasm contagious and sexually transmitted, also known as infectious sarcoma, venereal lymphosarcoma, and Sticker Tumor. The general objective of this article was to verify the occurrence of TVT cases in dogs in the city of Dourados, in the State of Mato Grosso do Sul, in relation to gender, age, areas affected and cytology. The results showed a higher prevalence in females 116 (67%) than males 57 (33%), adults and in relation to the location, presented a greater occurrence in the genital region, followed by other localities. In cytology, the presence of round cells with round nucleus, some in the periphery, containing loose chromatin and evident nucleolus. Thus, it is important to emphasize that prevention campaigns should be performed with the purpose of clarify to the owners the importance of not let loose animals on the streets, as they act as potential reservoir for TVT.

Investigating the Relationship between Gallbladder Malignancy and Various Factors in Surgically Treated Gallbladder Disease Patients

Introduction: Gallbladder cancer is a rare but aggressive disease with a poor prognosis. Factors that may contribute to the development of gallbladder cancer include chronic inflammation, gallstones, and obesity. This study will examine the prevalence of these factors in patients who have undergone surgery for gallbladder disease, and determine if there is a correlation with the development of gallbladder cancer. This information will be valuable in identifying high-risk individuals and developing strategies for the early detection and prevention of gallbladder cancer. Methods: This prospective cross-sectional and observational study was carried out in the Department of General Surgery and Hepato-Biliary-Pancreatic surgery, BIRDEM General Hospital, Dhaka from August 2019 to February 2021. Patients admitted to the General Surgery and Hepato-Biliary-Pancreatic Surgery Department of BIRDEM hospital who underwent gallbladder surgery were recruited for this study. Consecutive sampling was done in this study. Result: The present study findings showed that the majority (65.45%) of the participants were between the age of 50-59 years, with 38.18% being male and 61.82% being female. The most common comorbidities were diabetes (62.73%), hypertension (43.64%) and anaemia (40%). The most common clinical presentation was abdominal pain (76.36%) and the most common histopathological diagnosis was chronic calculous cholecystitis (49.09%), while 20% of participants had gallbladder carcinoma. The study found an association between age, gallbladder wall thickness and gallbladder malignancy. Participants who were 60 years or older were 4.865 times more likely to have gallbladder carcinoma and those with severe wall thickness (&gt;10mm) were 13.32 times more likely to have gallbladder carcinoma. Conclusion: The present study found that the majority of participants were between the age of 50-59 years, with a higher female prevalence. The most common comorbidities were diabetes, ..........

The Effect of Adolescent Idiopathic Scoliosis on Natural Delivery and Epidural Use in Pregnant Females: A Matched Cohort Study.

Retrospective matched cohort study. The aim of this study was to determine whether females with idiopathic scoliosis (IS), both with and without spine fusion, experience different rates of cesarean section (CS) and epidural anesthesia (EA) than females without scoliosis. IS is a common spine condition with a higher prevalence in females. It is unclear whether females with scoliosis, treated nonoperatively or operatively, have different rates of cesarean delivery or EA. Patients with IS who delivered in our integrated health care system during a 6-year period were identified (N = 1810). They were matched with a group without scoliosis who delivered during the same period (N = 1810). Rates and relative risk (RR) of CS and EA between cohorts and subgroups were calculated. The scoliosis cohort had significantly higher rates and RR of EA ( P = 0.002 and P = 0.004, respectively). Scoliosis patients treated nonoperatively had an 8% greater RR of EA ( P = 0.004) and had a significantly lower rate of CS (23.2% vs . 26%, P = 0.048) compared with the control group. Among only scoliosis patients, those treated with spine fusion had a 38% decreased RR of EA ( P < 0.001). Distal fusion level did not seem to influence the RR of EA or CS. Females with scoliosis were significantly more likely to receive EA at delivery compared with females without scoliosis. Rates and RR of cesarean delivery were not significantly lower among women with scoliosis, but females treated nonoperatively for scoliosis had a significantly lower CS rate than those without scoliosis. Females treated with spine fusion for scoliosis were far less likely to receive EA than both females without scoliosis and females with scoliosis treated nonoperatively.

Association of Admission Systolic Blood Pressure on long-Term Outcomes after ST-Segment Elevation Myocardial Infarction.

Hypertension is widely known as a significant factor in the development of cardiovascular diseases. However, there is increasing interest in the potential link between low admission systolic blood pressure (SBP) and higher mortality rates. Therefore, this study aimed to investigate the relationship between admission SBP and the probability of one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI). This study, which used data from registries, focused on patients diagnosed with STEMI between July 2018 and December 2019. The patients were divided into three groups based on their admission SBP: normal (< 112 mm Hg), elevated (112-140 mm Hg), and hypertension (≥140 mm Hg), and were followed for one year. The researchers used Cox proportional models to analyze the data, which allowed them to estimate crude and fully adjusted hazard ratios, along with their corresponding 95% confidence intervals (HR, 95% CI). This study, which included 1159 patients with a mean age of 60.71±12.19, 914 (78.86%) were male, and 108 (9.32%) died within one year. Among the patients, 276 had a normal admission SBP, 338 had elevated SBP, and 545 had hypertension. Those with hypertension had a higher-risk profile, including factors such as hyperlipidemia, BMI, LDL levels, anterior myocardial infarction, and a higher prevalence of females. The crude and fully adjusted hazard ratios (HR) for the relationship between elevated admission SBP and mortality were calculated as 0.36 (95% CI: 0.23-0.56) and 0.43 (95% CI: 0.23-0.81), respectively. The study's findings indicate a connection between increased admission SBP and a decreased probability of one-year mortality among patients with STEMI. Unlike the general population, where there is a direct linear correlation between SBP and the risk of future cardiovascular events, this research demonstrates an inverse relationship between SBP and one-year mortality.

Intraductal papillary mucinous neoplasm of pancreas: Clinicopathological features and long-term survival after surgical resection

IntroductionIntraductal papillary mucinous neoplasm (IPMN) of the pancreas can progress from low-grade dysplasia to high-grade dysplasia and invasive carcinoma. MethodsIn this single-center retrospective series, we analyze the clinicopathological features and long-term follow up of patients who underwent pancreatic resection for IPMN, from January 2009 to December 2019. Results31 patients were diagnosed with IPMN: 9 males and 22 females. Mean age was 67 years. Twenty-seven patients (87%) were symptomatic. Seven patients had main duct IPMN, 11 branch-type IPMN and 13 mixed-type IPMN. High-risk stigmata were found in 20 patients (64.5%) and worrisome features in 10 patients (32.2%). Thirteen patients (41.9%) had an associated invasive carcinoma, 4 (12.9%) high-grade dysplasia and 14 (45.2%) low-grade dysplasia. The follow-up was from 2 to 12 years. Median survival for patients with IPMN and associated invasive carcinoma was 45.8 months, and disease-free survival was 40.8 months. ConclusionsIPMN had a higher prevalence in females, mostly symptomatic and high incidence of associated invasive carcinoma with branch type. The 5-year survival was good even with associated invasive carcinoma.

Iron deficiency in whole blood donors in a resource-poor setting: A cross-sectional study in Uganda.

Blood donation is known to result in iron deficiency (ID), with a higher prevalence in females. There is little published data on the frequency of ID among blood donors in resource-poor settings. We determined the prevalence of ID in blood donors in Uganda. We conducted a descriptive cross-sectional study at the Uganda Blood Transfusion Service, Kampala from December 2021 to February 2022. A sample of 500 whole blood donors was enrolled. The evaluation included demographic characteristics, donation history, nutritional history, complete blood count, and serum ferritin. The primary outcome was the proportion of donors with serum ferritin <15 μg/L. The median (IQR) serum ferritin was 25 (12-47) μg/L and 89 (52-133) μg/L among female and male donors respectively. The prevalence of iron deficiency (serum ferritin <15 μg/L) among donating individuals was 11.5% (8.7-14.9), while among low haemoglobin deferrals, 61.5% (50.9-71.1). The prevalence was high among females [33.0% (27.9-38.6)] compared with males [2.5% (1.0-5.8)], but even higher among females younger than 24 years [35.4% (29.2-42.1)]. Factors associated with ID (adjusted odds ratio, 95% Cl, and significance) were; female donors (15.81, 5.17, 48.28, p < 0.001) and a high RDW (6.89, 2.99, 15.90, p < 0.001). We found a moderate correlation between serum ferritin and RDW (r=-0.419 and -0.487 for males and females respectively). Iron deficiency is common among blood donors in Uganda, affecting mostly young female donors. Considerations to adopt evidence-based strategies to prevent and manage ID among blood donors-such as serum ferritin monitoring and iron supplementation are highly recommended.

RELAÇÃO ENTRE A PANDEMIA DA COVID-19 E OS RESULTADOS DOS EXAMES DE LESÃO CORPORAL E CAUTELARES. O ANTES E O DURANTE

Introduction: The covid-19 pandemic revealed the world’s vulnerability in dealing not only with an unknown disease, but also with socio-economic and violent difficulties and consequences, quite harmful to society. Objectives: To analyze the reports of the forensic examinations of personal injuries and precautionary measures carried out at IML Estácio de Lima – Maceió/AL, from 2018 to 2021, considering the changes that could be observed before and during the Covid-19 pandemic. Material and methods: Documentary, epidemiological, descriptive, and analytical study through sampling. The variables considered were: gender, age group, origin, verification of the occurrence of bodily harm, the instrument and means used in the aggression, in addition to the answers to the official questions related to bodily harm. Results: Of a total of 2208 reports, 743 were investigations resulting from bodily injury and 1465 were precautionary investigations. The highest percentage of the analyzed reports was of precautionary expertise, constituting 66.34% of the total, with a prevalence of males, representing 92.01%. Regarding the body injury expertise, there was a higher prevalence of females in the age group from 21 to 30 years. Discussion: It was observed that there was no relevant change in the expertise in the previous period and during the pandemic, as precautionary expertise was already predominant, maintaining the predominance of male, young adults. Regarding the body injury expertise, the female gender was more prevalent, representing 63.52% of the reports analyzed during the study. The most evident injuries were those produced by blunt instruments without associations, in a total of 1048, with mild bodily injuries predominating. Conclusion: In view of the findings the authors conclude that there was no significant quantitative or qualitative change related to the analyzed expertise, before and during the Covid-19 pandemic. Keywords: covid-19, personal injury, violence, medico-legal expertise.

Hemiagenesis of the Thyroid in a Seven-year-old Child: A Case Report

Thyroid Hemiagenesis (TH) is a rare condition characterised by developmental abnormalities of the thyroid, often observed on the left-side, with a higher prevalence in females. It is commonly associated with a lack of the isthmus. A seven-year-old boy presented to the Ear Nose Throat (ENT) Department with chief complaints of bilateral ear block sensation and dull aching earache persisting for two months, for which syringing was performed. No family history of TH or any past surgeries related to the neck, thyroid, or parathyroid were reported. In recent laboratory tests, his Thyroid Stimulating Hormone (TSH) level was 7.23 μIU/mL, free tetraiodothyronine was 8.91 mcg/dL, free triiodothyronine was 75.06 ng/dL, and Antithyroid Peroxidase (TPO) was 2.0 IU/ mL. The neck ultrasound revealed the absence of the left thyroid lobe and isthmus. He was diagnosed with congenital TH and hypothyroidism and was treated with a dosage of 25 mcg of levothyroxine. TH can be incidentally discovered and may manifest in later stages of life. Patients with TH are more prone to developing hypothyroidism compared to individuals with a complete thyroid, as they have lower reserves of thyroid hormones.

Descriptive study of reported cases of sexual violence and specialized care services in the state of Minas Gerais, Brazil, 2019.

to describe the sociodemographic profile of reported cases of sexual violence (SV) and the distribution of care services for this health condition in the state of Minas Gerais, Brazil, 2019. this was a descriptive study of the cases of sexual violence reported on the Notifiable Health Conditions Information System and care services registered in the National Health Establishment Registry. a total of 4,418 notifications of SV were identified during the study period, representing more than 12 notifications per day; the majority of notifications were among females (87.0%) and among children and adolescents (72.0%); the distribution of care services showed care gaps in four of the 14 health macro-regions of the state of Minas Gerais; the maximum distances traveled to access referral services ranged from 93 to 327 km. the scarcity of care services for people subjected to sexual violence in the micro-regions and macro-regions of Minas Gerais highlights the need for planning public policies aimed at increasing access to these services. Over 12 notifications of sexual violence were reported per day in the state of Minas Gerais in 2019, with a higher prevalence in females, children and adolescents, mixed-race/Black people. Care gaps were identified in four macro-regions of the state. There was a need for victims to travel long distances to receive care in municipalities with referral services for comprehensive care for sexual violence, which may hinder access and timely care. It is expected that the results can contribute to improving public policies, considering the need to strategically plan the location of specialized services for people subjected to sexual violence.

The peripheral blood inflammatory markers in Ménière's disease patients with and without migraine

Objective: To investigate the peripheral blood inflammatory markers including white blood cell count (WBC), monocytes, neutrophils, lymphocytes, platelets, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), high-density lipoprotein(HDL-C), low-density lipoprotein and fibrinogen (FIB) in Ménière's disease (MD) patients with and without migraine, and to explore the relationship between the inflammatory response with MD and migraine. Methods: The general physical condition, clinical manifestations, pure-tone audiometry, and peripheral blood inflammatory markers of 92 unilateral MD patients who were hospitalized in Peking University People's Hospital for surgical treatment from January 2017 to January 2021 were continuously collected. Meanwhile, 50 healthy controls matched with age and sex were included, and their general physical conditions and peripheral blood inflammatory markers were also collected. This study consisted of two parts. First, the differences in epidemical characteristics and peripheral blood inflammatory markers between MD patients and healthy controls were compared by univariate analysis. Second, all 92 MD patients were divided into two subgroups according to whether they were accompanied by migraine. The clinical characteristics and peripheral blood inflammatory markers of MD patients with and without migraine were compared by univariate analysis. Thereafter, binary Logistic regression was used to analyze the related factors of whether MD patients were accompanied with migraine. Results: Compared with the healthy control group, the peripheral blood WBC, neutrophils and FIB of MD patients were significantly increased (all P<0.05). Compared with MD patients without migraine, MD patients with migraine had higher female prevalence, longer disease history, lower low-frequency hearing threshold, higher frequency of vertigo attacks and higher HDL-C levels (all P<0.05), meanwhile, female, frequency of vestibular attacks and HDL-C were independent related factors of whether MD patients were accompanied with migraine. Conclusion: The occurrence of MD and migraine may be related to the inflammatory response. The level of anti-inflammatory factors in the blood of MD patients with migraine are higher, suggesting that the inflammatory response status of MD patients with and without migraine is different.

Analysis of Surgical Resection of Non-Melanoma Skin Cancer in The Head and Neck of Elderly Population in a Public Hospital of São Paulo

Introduction: Skin cancer is among the most frequent neoplasms worldwide. It is divided into two major groups: non-melanoma skin cancer (NMSC) and melanoma skin cancer (MSC), with NMSC still classified into several subtypes, with the most prevalent being basal cell carcinoma subtype (BCC), followed by squamous cell carcinoma (SCC). Although NMSC does not present high mortality rates, it can involve high morbidity on the functional, aesthetic, and emotional levels. There is a divergence in the literature regarding decision-making in the cases of elderly (patients above 65 years of age) and super elderly patients (starting at 80 years of age). Objectives: This study aims to: 1. Identify the complications of surgical resection of the NMSC of the face and neck in the elderly population. 2. Demonstrate that surgical resection can be used as a therapeutic option in the elderly population without a significantly higher risk of morbidities. Method: This is a transversal, retrospective single-center study of quantitative nature. After the approval of the Research Ethics Committees, analysis was performed on the electronic records of 34 patients who underwent surgery at the Carapicuíba General Hospital between August 2017 and November 2019. The descriptive analysis of the results was performed employing absolute and relative frequency of the qualitative variables; mean and standard deviation were used for the quantitative variables. Analysis of group differences was done through the Fisher's Exact, Student's, or Mann-Whitney T-tests, to evaluate the factors associated with the complications of the procedure. Results: The results showed a mean age of 85.1 years; higher prevalence in females (61.8%); higher prevalence of BCC (76.5%); higher involvement in the nasal (23.5%), periauricular (23.5%), and malar regions (17.7%); hypertension (55.9%), and diabetes mellitus (35.3%) as the main comorbidities; 8 (23.5%) patients had post-surgical complications, and 0 patients had intraoperative complications. Conclusion: It was concluded that surgical resection was a good therapeutic method for the patients approached in the study. It is suggested that the therapeutic choice should be individualized, with the evaluation of the patient as a whole and taking into account aspects other than age group and comorbidities. Moreover, it is necessary to develop new studies and clinical trials with a more significant sample.

Anaesthethetic management of craniotomy for recurrent astrocytoma in case of large atrial septal defect with severe pulmonary hypertension: A case report

In adult population after bicuspid aortic valve, atrial septal defect (ASD) is the most common congenital acyanotic heart disease, with high prevalence in females. Large ASD with pulmonary hypertension (PAH) posted for non-cardiac surgery poses a challenge to anaesthesiologists because intraoperative hypercarbia, hypoxemia, and hyperthermia can result in increased pulmonary vascular resistance (PVR), which can result in shunt reversal, congestive heart failure, and fatal arrhythmias. We report successful anaesthetic management of 48yrs female case of recurrent astrocytoma posted for craniotomy. Patient was having large ostium secundum ASD (35 mm in diameter), with severe PAH having PASP 75mmhg by TR jet, with dilated RA/RV, moderate TR and LVEF 55% under GA, with titrated induction, avoiding rise in PVR and maintaining systemic vascular resistance (SVR) with vasopressors intraoperatively to avoid shunt reversal.:To concludepatients with severe PHT due to large ASD, require meticulous intraoperative management to prevent any rise in PAH, and maintenance of systemic vascular resistance with optimal oxygen delivery and excellent postoperative analgesia for excellent outcome.

Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults—two case reports and a review of literature

BackgroundDisordered eating behaviour including binge-eating often results in significant medical conditions, which are at times fatal. It can result in acute gastric dilatation which can lead to ischemic necrosis and stomach rupture. Dyspepsia and bloating are common symptoms following binge eating. Patients commonly use over-the-counter medications like sodium bicarbonate or home remedies for relief. However, in very rare, reported cases, sodium bicarbonate has been attributed to cause acute gastric dilatation and spontaneous gastric rupture instead.MethodsWe report two cases of spontaneous gastric rupture following consumption of sodium bicarbonate containing antacids after a large meal, and a review of the literature of similar cases.ResultsA total of 36 cases were identified. Approximately half of the cases (47.2%) were correlated with eating disorders, with higher prevalence in females (69%) and a very high mortality rate (41.6%). Amongst the 36 cases, sodium bicarbonate ingestion was associated with 10 cases. The lesser curvature (36.1%) and anterior wall (33.3%) are the most common sites of rupture. Associated causes include binge-eating, gas release from sodium bicarbonate, gastric content fermentation, proximal and distal outlet obstruction, and muscular atony.DiscussionSudden distension and impaired emptying mechanism of the stomach is necessary for spontaneous gastric rupture to occur. Acute gastric dilatation with perforation requires definitive surgical management. There should be a low threshold of suspicion for patients presenting with severe abdominal pain and abdominal distension following an episode of binge-eating. There is a need for patient education around the use of over-the-counter medications or home remedies.

A cross-sectional study on the impact of parental educational level and gender differences on emotional and behavioural difficulties in adolescents in Qatar

ABSTRACT Heterogeneous findings on the prevalence of emotional and behavioural difficulties (EBD) have been reported in Middle Eastern countries. Moreover, the prevalence of EBD among adolescents in Qatar is unknown, making it difficult to implement the necessary educational or psychosocial programs. This study used a cross-sectional methodology to assess emotional and behavioural problems among 533 high school students from the public government schools. Only 10.6% of the students were found to have EBD, and the prevalence varied significantly in different EBD subscales, as identified using the Strengths and Difficulties Questionnaire (SDQ). The reliability of the scales was good. The population of this study had lower mean EBD scores than those reported in three other Middle Eastern countries. There were significant differences in EBD between males and females, with a higher prevalence in females. No effect of parental education was observed, suggesting that in a society with high economic stability and an excellent social structure, parental education may not be an independent factor influencing the EBD in adolescents. More studies are needed to confirm this hypothesis; however, the findings of the current study will be of importance in establishing the use of the SDQ as a tool for gauging EBD and prioritising necessary interventions.

Evaluation of Haller's Cells Prevalence in a Sample of Polish Population Assessed Using Panoramic Radiographs

Introduction: Haller's cells are air structures with variable presence in individuals. They are situated in the anterior part of the ethmoid bone on the inferior and medial walls of the orbits. Their presence can be symptomatic and they may also be an impediment in surgical procedures. A panoramic radiograph commonly used in dental diagnostics allows visualization of their presence. The aim of the study is characteristics and estimation of Haller's cell prevalence in a sample of the Polish population based on panoramic radiographs. Materials and Methods: The study consisted of 467 panoramic radiographs including patients of both genders (303 females and 164 males), aged 17–23 years with a mean of 20.2 years. All radiographs have been evaluated for Haller's cells' presence, shape, number, and location with gender predilection. Results: Haller's cells were found in 72 cases, which comprised 15.4% of the studied group, with a slightly higher prevalence in females (17.82% in females and 10.97% in males). The most predominant shape was oval. Unilateral distribution of the cells outnumbered bilateral variants. One to three Haller's cells were found on one side, in the own material. Conclusions: Panoramic radiograph revealed a relatively low prevalence of Haller's cells in a sample of the Polish population. It is possible to assess the shape and determine the exact number of these cells. Based on the panoramic examination, we can state that they are located more often unilaterally with a slightly higher prevalence in females.

Anatomical Variations of the Maxillary Sinus – A Cone Beam Computed Tomography Study

Abstract Objectives: The knowledge of the normal morphology of the maxillary sinuses and their variations is important for maxillofacial radiologists to achieve a better evaluation and delineation of pathologies and for pre-implant evaluation of the maxilla. The aim of our study was to evaluate anatomical variations of maxillary sinuses using Cone Beam Computed Tomography (CBCT). Materials and methods: 150 CBCT images where bilateral maxillary sinuses were scanned were included in the study following the inclusion and exclusion criteria. 75 CBCT scans each of males and females were studied using the Planmeca Romexis software (Version 4.6.2). Multiplanar images were searched for the presence of anatomical variations such as septae, haller cells and ethmomaxillary sinus. The data were subjected to Chi square test using SPSS software to compare and relate gender and site based differences in the occurrence of the anatomical variations. Results: Sinus septa was the predominant variation in both males and females with significantly higher prevalence in females and on the right side. An ethmomaxillary sinus was seen significantly more often in males, while Haller cells did not show any gender based differences in their occurrence. Ethmomaxillary sinus and Haller cells showed no difference in occurrence on the right and left side. Conclusions: Anatomic variations of the maxillary sinuses are a common finding. It necessary for the clinicians to be familiar with these variations to avoid clinical complications especially in cases of implant placements.

The association between functional status and physical pain with depressive symptoms after a stroke event: A cross-sectional analysis of the China Health and Retirement Longitudinal Study 2018.

BackgroundStroke is a major cause of mortality and long-term physical and cognitive impairment. This study aims to: (1) examine the prevalence of depressive symptoms, disability and pain among Chinese adults with stroke; (2) test the associations of functional limitations and body pain with occurrence of depressive symptoms; (3) investigate gender and urban-rural disparities in these associations.MethodsThis study utilized the data from the China Health and Retirement Longitudinal Study in 2018, involving 969 patients with stroke among 17,970 participants aged ≥ 45 years. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression (CES-D) Scale. We performed multivariable logistic regression models to estimate the associations between activities of daily life (ADL), instrumental activities of daily life (IADL) and pain with depressive symptoms.ResultsDepressive symptoms were found among 40.2% of stroke patients, with a higher prevalence in females (48.2%) than males (32.7%). Prevalence of ADL limitations, IADL limitations and pain among stroke patients were 39.2, 49.8 and 14.0%, respectively. ADL and IADL limitations and pain were more prevalent among females and residents in rural areas. Multivariable regression analyses showed a significant association between ADL limitation (OR = 1.535, 95% CI = 1.168, 2.018), IADL limitation (OR = 1.666, 95% CI = 1.260, 2.203) and pain (OR = 2.122, 95% CI = 1.466, 3.073) with depressive symptoms. Stratified analyses revealed stronger associations among urban residents. Females had a higher association of ADL and IADL with depressive symptoms but similar in that of pain to the males. The impact of ADL and IADL in male patients is higher than in females, but the impact of pain on depressive symptoms is higher in female patients.ConclusionDepressive symptoms are common amongst post-stroke patients in China and are significantly associated with functional disability and physical pain. Our findings have implications for practitioners on the early assessment of pain and depression after stroke. Future research should explore effective intervention measures for physical-mental stroke complications.