Morphological spectrum and epidemiological profile of ovarian tumours in black West African women at Lagos state university teaching hospital, Ikeja, Nigeria

Background: This study was done to evaluate the histological types, frequency and age distribution of ovarian tumours in Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State. This study also aims to classify ovarian tumours in this centre according to the World Health Organisation (WHO).Methods: A retrospective, descriptive hospital study of all ovarian specimens that were sent to the department of pathology and forensic medicine, LASUTH between 1st January, 2011 and 31st December, 2019 was done. Relevant data composed of the age distributions and histopathological types were extracted from the departmental information system and filed documents. The data was analysed using the IBM-SPSS version 25.0.Results: There were 198 cases of ovarian tumours. The mean age at diagnosis of ovarian tumours was 34.6±15.3 years. Unilateral ovarian tumour was observed in 91.9%% of cases while bilateral disease was seen in 8.1%. Primary ovarian tumours constitute 97.0% of all diagnosed tumours of the ovary. Germ cell tumour was the most frequently diagnosed ovarian tumour; and teratoma was the most common, representing 91.2% of germ cell tumours and 47.0% of all ovarian tumours. Primary ovarian cancer peaked at the 6th decade of life and metastatic ovarian cancer was infrequently seen. Serous carcinoma is the most commonly diagnosed ovarian cancer.Conclusions: Ovarian tumour presents most frequently at the 4th decade of life, and germ cell tumour is the most common.

Histopathology of bladder carcinomas: an eight year retrospective study at Lagos state university teaching hospital, Ikeja, Nigeria

Background: This study was undertaken to evaluate the histological types, frequency, age and sex distribution of bladder carcinoma in Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos state. This study aims to classify bladder carcinoma in this centre according to the World Health Organisation/ International Society of Urological Pathology.Methods: An eight-year retrospective study of all bladder carcinomas specimens that were sent to the department of Pathology and Forensic Medicine, LASUTH between 1st January, 2011 and 31st December, 2018 was done. Relevant data consisting of the age and sex distributions as well as histopathological types were extracted from the departmental information system and filed documents. The data was analysed using the IBM-SPSS version 25.0.Results: There were 87 cases of bladder tumours, out of which 55 (63.2%) were bladder carcinomas. The mean age at diagnosis of bladder carcinomas was 56.9±13.9 years. Sex distribution has male to female ratio of 1: 1. Urothelial carcinoma predominates as the most common histological type.Conclusions: Bladder carcinoma presents most frequently at the 5th decade of life, with a slight male preponderance.

Age at Diagnosis of Hearing Impairment in Deaf Children Attending Special Schools in South India

Background: Congenital hearing loss is estimated to be 1–6/1000 live births. In India, it is reported to be 5.6/1000 live births. The Joint Committee on Infant Screening 2007 recommends that all newborns be screened for hearing loss by 1 month of age, have diagnostic follow-up by 3 months, and receive appropriate intervention by 6 months of age. Objective: This descriptive study was conducted to determine the age at diagnosis of hearing impairment in deaf children and determine the factors affecting it in South India.Materials and Methods: A cross-sectional questionnaire-based study was conductedon children with hearing impairment (bilateral profound hearing loss) attending 10special schools in Southern India.The cluster sampling technique was used to collect the data. Result: Our study involved 273 children in the age group of 3–22years.We found that the mean age at diagnosis of hearing impairment was 23.03(±3.696 SD) months while the mean age at suspicion of hearing impairment in these children was 13.70(±2.13 SD)months.The various factors responsible for the delay in diagnosis were financial constraints, influenced by friends and family, fear, and anxiety. The treatment-seeking behavior among the parents, lack of awareness of clear guidelines among the medical fraternity,and absence of awarenessof this problem among the general public also contributed to the delay

The update of AJCC/TNM staging system may change the post-operative assessment of differentiated thyroid cancer / 中华内分泌代谢杂志

Objective To investigate the post-operative mortality risk staging changes of differentiated thyroid cancer resulted from the changes of the AJCC/TNM cancer staging system and to explore its clinical significance. Methods This study included 2 553 patients accepting surgical therapies in Department of Thyroid Surgery from January 2013 to February 2017. Overall,2 553 patients were staged according to the 7th and 8th editions of the AJCC/TNM cancer staging system respectively. Results Compared with the previous staging outcomes,548 patients(21.46%)were downstaged according to the 8th edition of the staging system. Of these 548 patients,438 (17.16%)migrated from an advanced stage(Ⅲ/Ⅳ)to stage Ⅰ/Ⅱ. The difference of the staging outcomes was significant(P<0.01). Because of the change of age cut off,364 patients(14.26%)were downstaged to stage I. Of these 364 patients, 318(12. 46%) migrated from an advanced stage(Ⅲ/Ⅳ) to stage I. Conclusion For the changes of the AJCC/TNM cancer staging system,particularly for the change of age cut off,many patients with DTC would be referred to lower stages, and therefore they would receive less aggressive post-operative management strategies.

Underestimation of Smoking Rates in an East Asian Population with Crohn's Disease

BACKGROUND/AIMS: The reported rates of current smoking at the time of Crohn’s disease (CD) diagnosis tend to be low in East Asian studies. However, we hypothesized that East Asian patients may be reluctant to disclose their smoking history, likely because of the influence of the Confucian culture. METHODS: We prospectively re-evaluated the smoking status at diagnosis in 1,437 Korean CD patients whose smoking status had been reported in our previous study. RESULTS: After re-evaluation, the current smokers at diagnosis increased from 388 patients (27.0%) to 445 patients (31.0%), indicating that 12.8% (57 of 445 patients) of the current smokers at diagnosis did not disclose their smoking status at their initial evaluation. The proportion of current smokers at diagnosis who had initially concealed their smoking status was significantly higher among the female patients (29.7%, 11/37) compared with the male patients (11.3%, 46/408) (p18 years old at diagnosis (8.6%, 35/406) (p<0.001). CONCLUSIONS: Subgroups of Korean CD patients, particularly young patients and female patients, are reluctant to disclose their smoking history. Therefore, the suggestion that smoking is not a risk factor for the development of CD in East Asians should be made with caution.

Association between age at diagnosis and degree of liver injury in hepatitis C

Introduction: A population-based survey conducted in Brazilian capital cities found that only 16% of the population had ever been tested for hepatitis C. These data suggest that much of the Brazilian population with HCV infection remains undiagnosed. The distribution of age ranges at diagnosis and its association with the degree of hepatitis C are still unknown in Brazilian patients. Material and methods: Patients with HCV infection, diagnosed by HCV RNA (Amplicor-HCV, Roche), were included in the study. Patients with HBV or HIV coinfection, autoimmune diseases, or alcohol intake > 20 g/day were excluded. HCV genotyping was performed by sequence analysis, and viral load by quantitative RT-PCR (Amplicor, Roche). The METAVIR classification was used to assess structural liver injury. The Chi-square (χ2) test and student's t-test were used for between-group comparisons. Spearman's rank correlation coefficient were used for analysing the correlation between parameters. Results: A total of 525 charts were reviewed. Of the patients included, 49.5% were male, only 10% of the patients were aged less than 30 years; peak prevalence of HCV infection occurred in the 51-to-60 years age range. Genotype 1 accounted for 65.4% of the cases. Information on HCV subtype was obtained in 227 patients; 105 had subtype 1a and 122 had 1b. According to the degree of structural liver injury, 8.3% had F0, 23.4% F1, 19.8% F2, 11.9% F3, and 36.5% F4. Age at diagnosis of hepatitis correlated significantly with fibrosis (rs = 0.307, p < 0.001). The degree of fibrosis increased with advancing age. Only age at diagnosis and fasting blood glucose were independently associated with disease stage. Those patients with subtype 1a had higher prevalence of F2–F4 than those with subtype 1b. Conclusion: In Brazil, diagnosis of hepatitis C is more commonly established in older patients (age 45–60 years) with more advanced disease. Reassessment of strategies ...

Analysis of chromosomal karyotypes, age and height on diagnosis of 232 patients with Turner syndrome / 中华实用儿科临床杂志

Objective To study the distribution characteristics of chromosomal karyotypes,age and height on diagnosis of patients with Turner syndrome(TS).Methods Karyotypes analysis was performed in 1015 girls with short stature who visited the hospital in recent 27 years.And statistical analysis of the chromosomal karyotypes,age and height on the diagnosis of patients with TS were performed by using the SPSS 11.0 software.Results 1.Two hundred and thirty-two (22.9％) patients were diagnosed with TS.2.A total of 26 kinds of abnormal karyotypes were detected in 232 patients with TS and the 45,X (32.4％,75/232 cases) and 46,Xi (Xq) (16.4％,38/232 cases) were the more common karyotypes.In addition,there were 111 cases(47.8％) with 21 kinds of mosaicisms which were related to the number and/or structural anomalies of one X chromosome.3.The median(range) age on the diagnosis was (10.90 ±4.55) years old.TS was mainly discovered during adolescence.The diagnosis rates at different ages were as follows:＜2 years 15 cases(6.4％),2-＜7 years 35 cases(15.1％),7-＜ 12 years 93 cases(40.1％) and 12-＜ 18 years 89 cases(38.4％).4.The median height Z score was-3.60 ± 1.20.There was a significant negative linear correlation between age and Z score of height on the diagnosis of TS (r =-0.613,P ＜ 0.000).5.Eighty-six point five percent (64/74 cases)TS patients with age over 13 years presented pubertal delay at diagnosis,which occurred only in 27.2 ％(22/81 cases) of the control group,and there existed a significant difference(OR =16.297,P =0.000).Conclusions 1.Chromosomal karyotypes in TS are in diverse ness.2.In TS patients,as the age increases,delay of height and pubertal development could be more obvious to observe and more characteristic manifestation of pubertal development would appear.3.The diagnosis of TS was later in children in our cotmtry than that in the developed countries.The analysis of chromosomal karyotypes should be detected earlier in the girls with unexplained short stature,height below-2 Z score of the mean age or the height below the specific lower limit of the peers,so as to benefit the diagnose of TS earlier.

Associação entre idade ao diagnóstico de diabetes do tipo 2 e o uso de insulina / Relationship between age at diagnosis of type 2 diabetes and insulin requirement

Objetivos: Verificar a relação entre a idade ao diagnóstico de DM tipo 2 e a necessidade de uso insulina. Determinar os possíveis papéis do sexo, peso, pressão arterial, lipídios sangüíneos, relação cintura-quadril e circunferência abdominal no uso precoce de insulina em pacientes com DM tipo 2. Métodos: Medimos as variáveis do estudo nos pacientes que compareceram à Clínica de Diabetes do Ambulatório Central da Universidade de Caxias do Sul e naqueles que se apresentaram em duas Ações Comunitárias (forças-tarefas realizadas pela Universidade, cujo objetivo é de oferecer serviços de diferentes profissionais à comunidade) entre setembro de 2002 e agosto de 2003. Resultados: A amostra foi composta de 61,1% de mulheres e 38,9% de homens. Do total, 17,7 % usavam insulina. O tempo decorrido do diagnóstico de diabetes foi maior entre os usuários do que nos não-usuários de insulina (9,6 ± 9,2 vs 6,0 ± 6,1 anos; p=0,043). A média de idade ao diagnóstico foi similar entre usuários e não-usuários de insulina (52 ± 16,1 ± 11,4 vs 50 ±11,4 anos; p = 0,8) Conclusão: Não houve diferença estatisticamente significativa entre a idade ao diagnóstico de DM tipo 2 e o uso de insulina (AU)

Aim: To verify the relationship between age at diagnosis of Type 2 Diabetes and the need of insulin requirement. To determine the possible role of gender, blood pressure, blood lipids, waist to hip ratio, and abdominal circumference on the early onset of insulin use in patients with type 2 diabetes. Methods: We measured the study variables in patients who did attend to the Diabetic Clinic at the Central Ambulatory of the University of Caxias do Sul and in those presented in two Cumunitarian Actions (task-forces carried out by the University which the aim is to offer the services of different professionals to the community) between September 2002 and August 2003. Results: The sample was composed by 61,1% of women and 38,9% of men. From the total sample, 17,7 % of the patients where on insulin use. The time elapsed from the diagnosis of diabetes was greater in the users than in non-users of insulin (9,6 ± 9,2 vs 6,0 ± 6,1 years; p =0,043). The mean age at diagnosis was similar between users and non users of insulin (52 ± 16,1 ± 11,4 vs 50 ± 11,4 years; p = 0,8). Conclusion: There was not statistically significant difference between the age of diagnosis of type 2 diabetes and the use of insulin (AU)

Biological Characteristics of Thyroid Carcinomas

Thyroid carcinomas show a broad spectrum of neoplastic phenotypes with distinct molecular events. In a thyroid multistep tumorigenesis model for differentiated thyroid carcinomas of follicular cell origin(DTCs), normal thyrocytes are transformed to differentiated thyroid cancer and progress to poorly differentiated thyroid carcinomas(PDTCs) and ultimately anaplastic thyroid carcinomas(ATCs), through the progressive accumulation of alterations in genes related with cell proliferation and differentiation. PDTCs and ATCs lose expression of thyroid-specific genes such as thyroglobulin, TSH-R, sodium/iodide symporter(NIS) genes and thyroid specific transcription factors. These tumors unfortunately may grow rapidly, invade adjacent structures and spread to other parts of the body. Biological characteristics of thyroid carcinomas are also quite different according to histological types. Most of DTCs show favorable biological behavior and keep their differentiated functions such as iodine uptake and TSH responsiveness. Unlike the other human carcinomas, presence of regional lymph node metastasis does not alter outcome significantly but age at diagnosis profoundly affect biological behavior of DTCs. Many cases of ATCs appear to be associated with preexisting DTC and p53 mutation plays an important role in this terminal dedifferentiation. ATC is highly aggressive and lethal. Medullary thyroid carcinomas(MTCs) originate from calcitonin secreting C cell by point mutation of ret protooncogene. Some specific ret mutations(genotypes) predict the phenotypic expression of hereditary MTC, guiding the timing of thyroidectomy. Understanding of biological characteristics and behavior of thyroid carcinomas help us to make a logical decision for optimal timing and extent of surgical treatment and postoperative adjuvant therapy.

Clinical Analysis of Seventeen Korean Families of Hereditary Congenital Cataract

To elucidate genetic traits, clinical findings and treatment outcomes in Korean families with hereditary congenital cataract, 24 patients(17 families)were retrospectively analysed. Genetic trait was analysed by family pedigree. Chief complaints, ages at diagnosis, bilaterality, types of lens opacity, associated systemic or ocular anomalies were examined. The final best-corrected visual acuity was compared among groups according to the presence of surgery or the age at diagnosis. Among 17 families, 15 belonged to an autosomal dominant trait and two an autosomal recessive trait. Bilateral cataracts were shown in all patients. Twelve(50.0%)out of 24 patients who had cataracts were diagnosed before 3 months of age. Five(29.4%)out of 17 patients who received surgery were done before 3 months of age. Final best-corrected visual acuity was not different between surgery group before 3 months of age and that of after 3 months of age. Associated ocular anomalies were microphthalmia(4 patients), nystagmus(4 patients), and esotropia(3 patients), but no systemic anomalies were found. These results show that most Korean families with hereditary congenital cataract have an autosomal dominant genetic trait and the age at diagnosis or surgery is too late to treat them properly.