Younger Categories Research Articles

The radiographic diversity of dental patterns among 7219 young individuals-a contribution to disaster victim identification.

The diversity of dental patterns is a fundamental topic in disaster victim identification. The current scientific literature, however, is scarce of data regarding young individuals. This study aimed to assess the radiographic diversity of dental patterns, considering missing, unrestored, and filled teeth in young individuals. The sample consisted of 7219 panoramic radiographs of individuals between 12 and 22.9 years. The permanent teeth, except third molars, were coded as missing, unrestored, or filled and odds ratios (OR) were calculated based on sex, dental arch, and age. The sex-combined sample had 1.116 distinctive dental patterns. "All unrestored" teeth was the most common pattern (OR: 0.437) followed by the sequence of unrestored teeth except restored mandibular first molars (OR: 0.021). Females had more distinctive dental patterns than males (p < .001), while males had more unrestored teeth (p < .001). In the age category of 12-12.9 years, the OR for finding a distinctive dental pattern was 11%, while in the age category of 22-22.9 years it increased to 58%. On the other hand, the OR for "all unrestored" gradually decreased according to age (74% in the younger category, and 23% in the older age category). The distinctiveness of dental patterns among young individuals is affected by the predominance of unrestored teeth. However, registering a single filled tooth in a remaining unrestored dentition can reduce exponentially the probability of finding an identical pattern of missing, unrestored and filled teeth.

Sex disparities in outcome of medication-assisted therapy of opioid use disorder: Nationally representative study.

The opioid epidemic causes massive morbidity, and males have substantially greater overdose mortality rates than females. It is unclear whether there are sex-related disparities at different stages in the trajectory of opioid use disorders, in "real world" settings. To determine sex disparities in non-medical opioid use (NMOU) at the end of outpatient medication-assisted treatment (MAT), using nationally representative data. Observational epidemiological study of publicly funded outpatient MAT programs in the national "Treatment episode data set-discharges" (TEDS-D) for 2019. Persons aged ≥18 in their first treatment episode, in outpatient MAT for use of heroin or other opioids (N=11,549). The binary outcome was presence/absence of NMOU. In univariate analyses, males had significantly higher odds of NMOU, compared to females (odds ratio=1.27; Chi2 [df:1]=39.08; uncorrected p<0.0001; p=0.0041 after Bonferroni correction). A multivariable logistic regression detected a male>female odds ratio of 1.19 (95%CI=1.09-1.29; p<0.0001), adjusting for socio-demographic/clinical variables. Several specific conditions were revealed in which males had greater odds of NMOU compared to females (e.g., at ages 18-29 and 30-39; corrected p=0.012, or if they used opioids by inhalation; corrected p=0.0041). This nationally representative study indicates that males have greater odds of NMOU in their first episode of MAT, indicating more unfavorable outcomes. The study reveals specific socio-demographic and clinical variables under which this sex disparity is most prominent.

The resistance of domestic canine skin-derived fibroblasts to oxidative and non-oxidative chemical injury: implications of breed and body size.

Small-breed dogs live significantly longer lives than large-breed dogs, while having higher mass-specific metabolic rates and faster growth rates. Underlying this observed physiological difference across domestic dogs, there must also be differences at other levels of organization that could lead to elucidating what accounts for the disparity in aging rates and life span within this species. At the cellular level, a clear mechanism underlying whole animal traits has not been fully elucidated. Here, we cultured dermal fibroblasts from large and small breed dogs from both young and old age categories and examined the degree of resistance to multiple sources of cytotoxic stress. This included heat (42°C), paraquat, cadmium, and hydrogen peroxide for increasing amounts of time (heat) or increasing concentrations (chemical stressors). We hypothesized that small breed dogs, with longer lifespans, would have greater cellular resistance to stress compared with large breed dogs. Final sample sizes include small puppies (N = 18), large puppy (N = 32), small old (N = 11), and large old (N = 23) dogs. Using a 2 (donor size) by 2 (donor age) between-subjects multivariate analysis of variance, we found that the values for the dose that killed 50% of the cells (LD50) were not significantly different based on donor size (p = 0.45) or donor age (p = 0.20). The interaction was also not significant (p = 0.47). Interestingly, we did find that the degree of resistance to cadmium toxicity was significantly correlated with the degree of resistance to both heat and hydrogen peroxide, but not paraquat (p < 0.01 for both). These data suggest that cellular stress resistance does not differ among domestic dogs as a function of size or age, pointing to other cellular pathways as the mechanistic basis for the observed differences in lifespan.

The occurrence of Leptospira spp. serogroup Pomona infections in wild boars

Leptospirosis is a worldwide zoonosis caused by different pathogenic serovars of the genus Leptospira, with very complex aetiology and epidemiology. Recent publications suggest that wild boar (Sus scrofa) has an important role in the epizootiology of leptospirosis, representing a potential source of infection. Wild boar populations in urban environments are increasing, posing not only agricultural and ecosystem concerns, but also a public health concern. The aim of this study was to assess the prevalence, temporal patterns and risk factors of Pomona infection in wild boars from areas with pronounced human activity. A total of 159 wild boar serum samples were collected within a health monitoring project in Medvednica Nature Park over a period of six hunting seasons (2012–2016; 2018) and 25.2% samples tested positive. Seropositivity against seven different serogroups was observed, with the highest number of positive reactions to the serogroup Pomona. Annual variation in Pomona reactivity was also detected, and positive reactions were five times more common in females than in males. In most of studies, adults had a higher seroprevalence than younger categories; however, in this study,seroprevalence against Pomona was higher in piglets and subadults. The results indicate that wild boar has the potential of maintaining serovars from the serogroup Pomona in certain natural foci. Due to the expansion of wild boar populations and their intrusion into urban areas, they should be considered a potentially important source of infection for humans and domestic animals.

IMPACTS OF TOBACCO USE AND EXPOSURE TO TOBACCO SMOKE ON HEALTH, SOCIETY, ECONOMY, AND ENVIRONMENT

Smoking represents a significant global public health challenge and is the primary preventable cause of disease and death. This problem is accentuated by the fact that a substantial 80% of adult smokers worldwide come from low- or middle-income countries. The aim of this paper is twofold: first, to highlight the health impacts associated with tobacco use, and second, to delineate the indirect damage caused to the environment during the life cycle of tobacco products - from production and distribution to consumption and waste generation. The reluctance of some countries to take decisive action, together with intense pressure from tobacco corporations, is hindering progress towards reducing the number of adult smokers and curbing tobacco use among minors. State interventions, supported by strict laws, are necessary to enforce the ban on indoor smoking, the ban on the sale of tobacco to minors, and the establishment of permanent interstate cooperation in the fight against cigarette smuggling. Educational initiatives aimed at raising awareness of the dangers of smoking and tobacco consumption are key to fostering a smoke-free culture. A strong media campaign, supported by state measures, could contribute to faster and more comprehensive targeting of target groups, especially younger age categories.

Misconduct of Spanish grassroots soccer coaches through referees’ reports: Variability by match format, age category, sex, and severity

This study aimed to describe and analyse the disciplinary sanctions received by grassroots soccer coaches in the Valencian Community (Spain) over five seasons. Specific objectives included determining the influence of format (8-a-side or 11-a-side), age (U7, U9, U11, U13, U15, and U18), sex category (male or female), and sanction severity (mild [one to four matches] or serious [five matches to a full season]). A study was conducted based on referees’ records from 275,844 games played in 1401 league competitions during five subsequent seasons between 2014 and 2019 in Valencia (Spain). A total of 3563 sanctions were recorded by matchday referees, with the majority being minor offences (92.93%) and most being imposed on 11-a-side soccer coaches (87%). The most frequent reasons for sanctions pertained to protests to referees (28%); dismissal due to double reprimands (26.40%); contemptuous and inconsiderate attitudes towards referees, including insults and threats (19.53%); and direct sending-offs (8.84%). Significantly more mild sanctions were found than serious ones, with more sanctions emerging in the 11-a-side soccer than in the 8-a-side soccer and the men's category compared to the women's category. Finally, we found significantly more sanctions in the U18 men's category compared to all other younger age categories and in the U15 men's category compared to the U7, U9 and U9-U11 female categories (p &lt; .05).

A pediatric and young adult case of unclassified renal cell carcinoma with medullary phenotype (RCCU-MP): Clinical course and treatment

Renal cell carcinoma (RCC) is the most common kidney tumor in adults. RCC is rare in children, although its incidence increases in the second decade of life. Renal medullary carcinoma (RMC) is a rare and often aggressive RCC subtype characterized by complete loss of SMARCB1/INI1, predominantly diagnosed in patients with sickle cell disease or -trait. Here, we describe a pediatric and a young adult patient with clinicopathological characteristics similar to RMC but without hemoglobinopathies. These tumors are currently classified as “RCC unclassified with medullary phenotype” (RCCU-MP). Both our patients had an infiltrating, rather small kidney tumor with SMARCB1/INI1 deficiency. Remarkably, the aggressiveness and clinical course and treatment differed greatly between these two cases. So far, only nine patients, predominantly adults, have been reported. In a literature overview, most cases were metastatic and progressed or relapsed after varying treatment approaches, with low survival. Whereas the classification of these tumors remains a topic of debate, case reports add to the current knowledge of RMCs without hemoglobinopathies, stressing the importance of sharing experience concerning rare renal neoplasms with often poor outcomes, also concerning younger age categories.

A Clinical Framework for Video Head Impulse Testing and Vestibular Evoked Myogenic Potential Assessments in Primary School-Aged Children.

This study aimed to offer normative data and age trends of an age-appropriate vestibular test protocol in a large group (n = 140) of school-aged children (6 to 13 years old) as well as to provide a practical and clinical framework for accurate performance and interpretation of vestibular test results in this specific age group. The typically developing participants (mean age of 9.51 ± 2.04 years) were recruited to provide a representative group of 20 children for each of the seven age groups that were composed of children aged from 6 to 13 years in 1-year intervals. Each age group consisted of 10 boys and 10 girls. The protocol comprises the video head impulse test, and cervical and ocular vestibular evoked myogenic potential assessments to provide a child-friendly, noninvasive, short, and portable test battery, which is equally applicable in the hospital and office-practice, and which provides information on the integrity of all five parts of the peripheral vestibular system. The study demonstrates that all included tests and methods, with an overall test duration of 25 min 12 sec ± 5 min 10 sec, were feasible to perform in primary school-aged children, taking into account some practical adaptations. Concerning the video head impulse test, no clinically relevant sex and age effects were noted. However, t tests revealed significant differences for the mean gain of the horizontal (right > left; t[139] = 14.563; p < 0.001) and posterior semicircular canals (left > right; t[139] = -4.823; p < 0.001) between both sides. For the cVEMP assessment, no laterality differences were observed for any of the parameters, but a significantly shorter N1 latencies in the youngest age categories (<8 years), compared with the oldest groups were observed [F(6,118) = 8.336; p < 0.001; partial ƞ² = 0.298]. For all oVEMP parameters, no laterality, sex, or age differences were seen. On the basis of the presented normative data, cutoff criteria were proposed with accompanying clinical recommendations to perform vestibular function testing in this target population. This is the first study in a large group of school-aged children offering normative data and age trends of an age-appropriate vestibular test protocol that evaluates the integrity of all parts of the peripheral vestibular organ. The reported normative values and clinical cutoff values will enable appropriate and age-specific interpretation of clinical and scientific results. Moreover, in combination with extensive history taking, and additional vestibular testing (e.g., rotatory chair test, caloric testing) when needed, the results of this study may support clinicians in the diagnosis of side-specific and location-specific vestibular deficits, which is required for accurate counseling and referral for further follow-up and/or intervention.

Prevalence of Bovine Schistosomiasis and Associated Risk Factors in and Around Haramaya, Oromia Region, East Ethiopia.

Schistosomiasis is caused by the Schistosoma genus and is transmitted through intermediate hosts, such as snails. A cross-sectional investigation was conducted within and surrounding Haramaya town between December 2022 and May 2023 to estimate the prevalence of schistosomiasis in cattle and associated risk factors. The degree of prevalence was estimated using surveys carried out in slaughterhouses and coprological laboratories. For statistical estimation, chi-square tests and logistic regression were utilized. A total of 390 samples were obtained through simple random sampling. In the survey that was undertaken on abattoirs, a total of 384 samples were chosen through the utilization of a systematic random sampling approach. The recovery of Schistosoma eggs from fecal specimens was achieved by sedimentation. The overall rates of schistosomiasis in cattle were estimated to be 21.28% and 18.23% through coprological and postmortem examinations, respectively. The analysis conducted through multivariable logistic regression indicated that management system, body condition, and age were significant risk factors. Cattle under extensive management (OR = 5.9, 95% CI = 2-17) and those in the young age category (OR = 2.7, 95% CI = 1.0-7.00) were more susceptible to acquiring schistosomiasis than cattle under intensive management and those in the adult age category, respectively. According to the odds ratio, there was a positive association between the incidence rate of schistosomiasis in cattle and poor body condition (OR: 3.048, 95% CI = 1.07-8.68; P = 0.00). Schistosomiasis infection was 3.048 times more likely to manifest in animals in poor physical condition. This affliction has had a profound impact on the livestock industry, as substantiated by the elevated prevalence of schistosomiasis in cattle within the studied region. Consequently, an integrated approach to prevention and control that targets the parasite is needed.

IJCM_191A: A study of awareness regarding harmful effects of tobacco consumption among an urban population of Raipur.

Background: Tobacco consumption has been significantly linked to increased mortality and morbidity. It gives rise to several diseases such as lung cancer, oral cancer, COPD, asthma, and dental problems as well as aggravates other diseases like TB, asbestosis, heart ailments, etc. It is the need of the hour to increase awareness about the adverse effects of tobacco addiction. Objectives: To study awareness regarding harmful effects of tobacco consumption among an urban population of Raipur. Methodology: Data was collected as part of an ongoing cross-sectional study in June 2023 in the Urban Field Practice area of AIIMS Raipur (Ward 24 and 25). Demographic details including age [40-74 years], gender, education, family type, addiction history, etc. were collected. A semi-structured questionnaire adapted from the WHO STEPS survey and GATS survey was used to collect information on tobacco awareness. Results: Data entry was done in Excel and analyzed in SPSS version 21. Among the 200 participants, 54.5% (109) were female and the rest male. The majority of participants belonged to Hindu religion (96.5%), nuclear family type (50%), and OBC caste (54%). About 10.5% of participants were current smokers, most of them male. Smokeless tobacco consumption like gudakhu, gutkha, and pan was more prevalent than smoking, especially in women (29%). Smokeless tobacco consumption was almost equal in both genders. Awareness improved with an increase in educational status and with younger age categories, which were found to be significant. Only 73% of males and 39.4% of females were aware of the harmful health effects of tobacco consumption. Conclusion: Illiteracy and easy accessibility of tobacco products at cheap prices, especially for smokeless tobacco and lack of awareness has led to extensive consumption of these products and hence, efforts must be made in these directions by various measures, such as policies, bans, taxes and health education.

Accuracy of the London Atlas to estimate the age of legal majority in a sample of the Amazon Regio.

Estimating the age of majority is a challenging task in forensic odontology, especially because the third molars are usually the only developing teeth between the ages of 16 and 21 years. The London Atlas emerged as an alternative to estimate age using dental development, eruption and deciduous root resorption as parameters. The method has performed well in young age categories, while its performance for age estimation via third molars has been disputed. The present study tested the performance of the London Atlas to estimate the age of legal majority in a sample of individuals from the Amazon Region. The sample consisted of 1.256 panoramic radiographs of women (n = 694) and men (n = 562) between 16 and 22.9 years. The method was applied to the maxillary (#28) and mandibular (#38) left third molars. For comparative purposes, the sample was divided into seven age groups: 16├ 16.99; 17├ 17.99; 18├ 18.99; 19├ 19.99; 20├ 20.99; 21├ 21.99; and 22├ 22.99 years. Chronological and estimated ages were compared descriptively by means of mean absolute errors (MAE) and root mean squared errors (RMSE), as well as through Receiver Operating Characteristic (ROC) curves and their area under the curve (AUC). The MAE of the age estimates using tooth #28 was 1.76 years for females and 1.52 years for males. When the tooth #38 was used, the MAE for the females and males were 1.68 and 1.51 years, respectively. The MAE and RMSE increased in ascending order between age categories. Tooth #28 led to 74% of correct classifications around the age of legal majority, while tooth #38 reached 77%. The area under the curve was 0.75 for tooth #28 and 0.73 for tooth #38. The London Atlas should be used carefully to estimate the age of legal majority and not as a single method when the age threshold is 18 years. Key words:Age determination by teeth, forensic dentistry, forensic science, third molar.

Epidemiology of tuberculosis in Saudi Arabia following the implementation of end tuberculosis strategy: Analysis of the surveillance data 2015-2019.

To analyze the evolution of tuberculosis (TB) epidemiology in Saudi Arabia in the 5 years following the implementation of the end-TB Strategy. A retrospective analysis of surveillance data, reported by the national tuberculosis control program from 2015-2019, was carried out. The annual incidence and the percentage of yearly changes were calculated and compared to the World Health Organization (WHO) milestones, which anticipate a 4-5% annual decline. Additionally, various other epidemiological indicators of TB were examined. The national TB incidence declined from 10.55% per 100,000 in 2015 to 8.76% per 100,000 in 2019, aligning with the WHO's 2019 milestone estimated between 8.59-8.96% per 100,000. While Makkah Region (40.3%) and Riyadh (24.6%) accounted for the majority of cases, Jazan region consistently exhibited the highest incidence throughout the study period. Demographic features shifted towards a younger age category, male, and native dominance. There was a consistent decrease in resistance and intermediate sensitivity to all first-line anti-TB drugs, associated with a substantial decrease in both polydrug resistance (from 4.7-1.9%; p<0.001) and multidrug resistance (from 4.4-2.4%; p=0.008). The figures of TB incidence TB in Saudi Arabia between 2015-2019 has met the WHO end-TB milestones, predicting successful progress toward the 2035 goal.

Regional variation in diagnostic intensity of dementia among older U.S. adults: a cross‐sectional study

AbstractBackgroundAlzheimer’s disease and related dementias (ADRD) are known to be underdiagnosed; but little is understood about how the likelihood of obtaining a diagnosis varies across place or demographic subgroups. Using observed diagnosed cases from national billing data, we report variation by region, age, and race/ethnicity in newly diagnosed dementia cases taking into account underlying population risk.MethodAmong a 20% random sample of fee‐for‐service Medicare beneficiaries, we identified those who received a new ADRD diagnosis in 2019 using billing data. The rate of new ADRD diagnosis was estimated overall and by Hospital Referral Region (HRR) and stratified by age category (65‐74, 75‐84, ≥85) and by race/ethnicity. A measure of ADRD diagnosis intensity across HRRs was calculated as the observed‐to‐expected ratio (O:E ratio) of new cases; expected new ADRD cases for each HRR were estimated using Poisson regression adjusted for regional measures of education, population health (diabetes, obesity, and smoking), and diagnostic intensity for chronic illness. Among older Americans, the probability of receiving an ADRD diagnosis was estimated according to regional ADRD diagnosis intensity.Result3.0% (143,029 of 4,842,034) of older adults received a new ADRD diagnosis in 2019 and ranged from 1.7‐5.4% across HRRs (Figure 1). The unadjusted mean ADRD diagnosis rate was 2.9 per 100 and differed by age (age ≥ 85 = 8.8/100, 75‐84 = 3.4/100, and 65‐74 = 1.0/100, p&lt;.001) and race (White = 2.9/100, Black 3.4/100, and Hispanic 2.8/100, p&lt;.001). Variability across HRRs was largest among the youngest age category, Black, and Latino groups. In adjusted analyses, all the regional characteristics explained 33% of the variation in new ADRD diagnosis (pseudo‐R2 = 0.33). Adjusted for regional characteristics, the ADRD diagnosis intensity (i.e., O:E ratio) varied from 0.7 to 1.4 across HRRs overall (Figure 2) and was most variable among the youngest age category (65‐74), Black, and Latino groups. These groups also had the greatest difference in the likelihood of diagnosis if residing in low versus high ADRD diagnosis intensity (Figure 3).ConclusionThe likelihood of receiving an ADRD diagnosis varies across the U.S., particularly among those 65‐74 years of age, and Black, and Latino groups.

Measuring and assessing motor skills of selected Croatian U12, U14 and U16 tennis players

Purpose: The aim of this research is to analyse and to determine the differences between tennis players in younger age categories (U12, U and U16) in certain motor skills.Methods: A total of 60 tennis players ranked in the rankings of the Croatian Tennis Federation were measured by using 10 tests for assessing explosive strength in jump, speed, agility, and trunk strength. The tennis players were divided into three groups of 20 respondents, depending on the age category in which they compete. Statistically significant differences (p &amp;lt; 0.05) between all age categories were found in indicators of frontal and lateral agility, running speed in the 20-m shuttle run test, and explosive strength in jump and repetitive trunk strength.Results: The results of the conducted tests indicate a linear development trend for the mentioned skills in relation with the increase of chronological age of the tennis players. Statistically significantly better results were shown between test subjects under 14 years compared to test subjects under 12 years in tests for the assessment of agility (SST,A9-3-6-3-9), in the 20 m sprint test, in tests of explosive strength of lower extremities (CMJ, CMJmax,SJ) and in the test of repetitive trunk strength (TF). Subjects under 16 years achieved significantly better results compared to subjects under 14 years in tests for assessing agility (SST, A9-3-6-3-9), speed (SRT5m, SRT10m, SRT20m) and explosiveness (CMJ, CMJmax, SJ). Players under 16 years recorded significantly better results in all tests for assessing agility (SST,A9-3-6-3-9), speed (SRT5m, SRT10m, SRT20m), explosiveness of the lower extremities (CMJ, CMJmax, SJ) and in the test for assessing repetitive trunk strength (TF). Statistically significant differences were not detected in tests of running speed in the 5-m and 10-m shuttle run tests among U12 and U14 tennis players, nor between U14 and U16 tennis players in the 60-s trunk flexion test. The highest heterogeneity of results in a single age category was determined in the test for assessing isometric trunk strength, and thus tennis players of different age categories do not differ significantly in this skill.Conclusion: The results of this research point to the development of specific motor skills in accordance with the increase of game demands and chronological age, however, also refer to the problem of muscle imbalance between front and back trunk musculature. Physical conditioning of young tennis players should be multilaterally directed in order to enable injury prevention and adjustment of tennis players to competitive demands.

Voters’ Attitudes towards the Gender Quota System in Elections in Poland and the Possibility of Its Modification

The article concerns the support for the gender quota system in the elections in Poland. The research was conducted on a double sample of adults for a representative national research, by means of quota sampling method (n = 2119). The respondents who believed that there is insufficient representation of women in parliament outnumbered those with the opposite opinion. We have observed a reluctance among the respondents to introduce solutions aimed at strengthening women’s representation. The difference in views were determined by political preferences, gender, age, domicile, and education. Women and leftist supporters more frequently believed that there are too few women in parliament and supported quotas, as opposed to men and persons with right-wing views. The differences were observed in the youngest age category, where women more often opted for quotas than men.

Material Need Insecurities among People on Hemodialysis: Burden, Sociodemographic Risk Factors, and Associations with Substance Use.

Despite their relevance to health outcomes, reports of food insecurity and housing instability rates among adults on hemodialysis are limited. Their relation to sociodemographic and behavioral factors are unknown for this population. We enrolled a convenience sample of people receiving hemodialysis at Baltimore and Washington D.C. metropolitan area facilities. Participants completed measures of socioeconomic position, food insecurity, housing instability, and substance use disorder. We cross-referenced participant and facility zip codes with measures of area poverty and residential segregation. We examined associations between individual- and area-level sociodemographic characteristics, food insecurity, and housing instability using multivariable logistic regression models. Of the 305 participants who completed study surveys, 57% were men, 70% were Black, and the mean age was 60 years. Thirty-six percent of the sample reported food insecurity, 18% reported housing instability, and 31% reported moderate or high-risk substance use. People on hemodialysis who were younger, with lower educational attainment, with lower incomes or experiencing financial strain were more likely to have material need insecurities (p<0.05 for all). Among participants living in segregated jurisdictions, men had increased odds of food insecurity compared to women (OR 3.7, 95% CI 1.61 - 8.53); younger participants (age <55 years) had increased odds of food insecurity compared to older participants (OR 3.3, 95% CI 1.49 - 7.32). Associations between gender or younger age category and food insecurity were not statistically significant in less segregated counties (p interaction for residential segregation x gender: p = 0.006; residential segregation x younger age category: p = 0.12). Food insecurity, housing instability, and substance use were common among this sample of adults on hemodialysis. Younger adults on hemodialysis, particularly those living in residentially segregated jurisdictions, were at increased risk for food insecurity. Future research should examine whether material need insecurities perpetuate disparities in dialysis outcomes.

Long-term mortality among adults diagnosed with cancer during three decades in Finland

IntroductionThis study aimed to determine all-cause and cause-specific mortality and, their time trends among adults with cancer, particularly among those who survived at least 5 years after cancer diagnosis, in comparison with mortality in the general population of the same age and sex.MethodsThe data on people with cancer were obtained from Finnish Cancer Registry and their underlying causes of death was obtained from Statistics Finland. All-cause and cause-specific standardized mortality ratios (SMR) and their 95% confidence intervals (CIs) were calculated for 327,585 people with cancer diagnosed between 1971 and 2000 and followed up until December 2012, stratified by decade and age of cancer diagnosis, sex, and type of cancer.ResultsIn the working age (25–64 years), 50% of men and 74% of women diagnosed during 1991–2000 were alive 5 years of diagnosis; the corresponding proportions during 1971–1980 were 29 and 54%. Among the elderly people (65–74 years), corresponding proportions were 40 and 49%, and 19 and 32% in men and women, respectively. During the follow-up of 5–12 years, the all-cause SMR among working age people with cancer diagnosed 1971–2000 was 2.5 (95% CI 2.4–2.5) in men and 3.6 (95% CI 3.5–3.6) in women. A 20% excess mortality due to cardiovascular diseases was observed among working-age people in both sexes. Highest all-cause SMRs were observed among working age people with lung cancer in 1991–2000 (men 5.1, 95% CI 4.5–5.8: women 8.1, 95% CI 6.5–11). People diagnosed with cancer at an adult age in Finland have higher SMR in the follow-up category of 5–11.9 years but the absolute excess mortality for all calendar periods 1971–2000 combined in the older age category (3,448 per 100,000) is higher than in the younger category (2,247 per 100,000).DiscussionAlthough the primary cause of death among cancer patients is cancer itself, increased SMRs of other conditions such as infections could indicate possible effect of cancer treatments as well as presence of shared risk factors among these diseases.

Rubbing Massage Provides Good Evidence in Reducing Pain in the First Stage of Labor

Pain is a common complaint felt by mothers during labor. Massage can be used as an intervention to reduce labor pain. The study contributes to determining the effect of rubbing massage on pain in the first phase of active labor in Pekalongan City. This quantitative research uses a quasi-experiment approach with a pretest and posttest without a control group design. The population was the first phase of active maternity mothers in Pekalongan, Central Java, Indonesia, in September-November 2017. Samples of 21 mothers were taken using purposive sampling. Statistical tests use the Wilcoxon test. Most respondents of the young age category (&gt; 26 years) are 12 mothers (57%). Respondents had the most junior high school education of 9 mothers (43%). The median of the pretest pain was six, and the posttest pain was 5. The bivariate results obtained a p-value of 0,000. The results showed that rubbing massage effectively reduces pain in first-phase active mothers.

Diagnosing knee osteoarthritis in patients, differences between general practitioners and orthopedic surgeons: a retrospective cohort study

Backgroundknee complaints are one of the most common reasons to consult the general practitioners in the Netherlands and contribute to the increasing burden on general practitioners. A proportion of patients that are referred to orthopedic outpatient clinics are potentially referred unnecessarily. We believe osteoarthritis is not always considered by general practitioners as the cause of atraumatic knee complaints. This may impede early recognition and timely care of osteoarthritis complaints and lead to unnecessary referrals.Methodsthe aim of this study was to compare the frequency of (differential) diagnosis of osteoarthritis mentioned in referral letters of general practitioners with the frequency of osteoarthritis mentioned as orthopedic diagnosis at the outpatient clinic. Therefore we conducted a retrospective cohort study based on data collected from referral letters and the corresponding outpatient clinic reports of patients with atraumatic knee complaints of 45 years or older referred to a regional hospital in Nijmegen, The Netherlands in the period from 1-6-2019 until 1-01-2020.Resultsa total of 292 referral letters were included. In the younger aged patients (45–54 years) osteoarthritis was mentioned less frequent and meniscal lesions were mentioned more frequent in referral letters when compared to diagnoses made at the outpatient clinic. Differences in differential diagnosis of osteoarthritis as well as meniscal lesions between orthopedic surgeon and general practitioners were found (both p < 0.001, McNemar). Matching diagnoses were present in 58.2% when all referral letters were analyzed (n = 292) and 75.2% when only referrals containing a differential diagnosis were analyzed (n = 226). Matching diagnoses were present in 31.6% in the younger age categories (45–54 years). A linear trend showing fewer matching diagnoses in younger patient categories was observed (p < 0.001).ConclusionsOsteoarthritis was less frequently mentioned in general practitioner referral letters among the differential diagnosis then it was diagnosed at the outpatient clinic, especially in younger patients (45–54 years). Also matching diagnoses in younger patients were evidently lower than in older patients, partly explained by underdiagnosing of osteoarthritis in younger patients in this cohort. Better recognition of osteoarthritis in younger patients and changing the diagnostic approach of general practitioners might improve efficacy in knee care. Future research should focus on the effectiveness of musculoskeletal triage, the need for multidisciplinary educational programs for patients and promotion of conservative treatment modalities among general practitioners.

Causes, Types and Management of Fracture of Dentate Region of Mandible

Aim: The mandible fracture ranks as the second most often occurring facial fracture. The advent of high-speed automobiles has led to a significant increase in the frequency of accidents in recent times. Mandibular fractures are observed as a notable occurrence of maxillofacial trauma in the region of Multan. Purpose: To determine the Causes, types and management of fracture of dentate region of mandible fracture. Method: The present research is an observational and descriptive investigation including a sample of 52 patients diagnosed with mandible fractures. The study was done at the Nishter Institute of Dentistry in Multan, Pakistan, spanning from September 2021 to February 2023. Following the endorsement of the research by the Ethical Review Board of the hospital, patients were recruited using a non-probability sequential sampling method. This research included patients who had a history of trauma and were admitted to Nishter Institute of Dentistry in Multan, Pakistan, as well as those from the surrounding districts of Multan. The assessment of mandibular fractures included doing extra-oral and intra-oral clinical evaluations, as well as obtaining panoramic and posterior-anterior radiographs of the mandible to establish a diagnosis. The data collected was then subjected to statistical analysis. Result: Among the sample of 52 individuals diagnosed with mandibular fractures, the age group of 21-30 years had the greatest proportion, with a notable male preponderance. The leading causes of fractures were road traffic accidents and assault, with the parasymphysis being the most often affected anatomical region. The occurrence and aetiology of mandibular fracture are indicative of the prevailing trauma patterns in a given population and may serve as a valuable resource for informing the development of initiatives aimed at mitigating and managing such injuries. Conclusions: Patients in the older age (51 years and over) exhibited a higher prevalence of fracture sites in comparison to patients in the younger age. This observation might perhaps be ascribed to the presence of a larger tooth-to-bone ratio. As a result, a decrease in bone density was seen among participants in the younger age category, whereas those in the older age category exhibited an elevation in bone frailty Keywords: Dentate fracture, mandible, trauma