The Analysis of Clinical Features of 186 Cases of Tuberous Sclerosis Complex-Associated Renal Angiomyolipoma / 罕见病研究

ObjectiveTuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disease involving multiple organ system. Renal angiomyolipoma (RAML) is a leading cause of death for adult TSC patients. Our study aims at investigating the clinical manifestations of TSC-RAML to enable clinicians to have a better understanding of the disease in Chinese patients.MethodsWe reviewed retrospectively the data collected from patients with TSC-RAML in Peking Union Medical College Hospital from January 2014 to January 2023. We also collected information about the age, gender, imageological examination, RAML stage, and comorbidities.ResultsA total of 186 TSC-RAML patients were registered, 65 of whom were males and 121 were females(male-to-female ratio 1∶1.86). The median age of all patients was 31 years old. Totally, 117 cases (62.9%)of RAML were rated stage 6. Twenty-two cases (11.8%) had a history of tumor rupture and bleeding. Research shows statistical differences between high and low grade on RAML rupture bleeding(P=0.0475). Angiofibromas/fibrous cephalic plaque (155/186, 83.3%), subependymal nodules(103/146, 70.5%), lymphangioleiomyomatosis (102/157, 65.0%), hypomelanotic macules (114/186, 61.3%), and shagreen patch (83/186, 44.6%)were the most common clinical manifestations. All patients with lymphangioleiomyomatosis(LAM) were female(P < 0.0001).ConclusionsFemale patients predominated TSC-RAML patients. Most RAML were in stage 6. About 11.8% cases had a history of tumor rupture and hemorrhage. The higher grade meant the higher proportion of tumor rupture and hemorrhage. Dermatological and nervous lesions were the most common comorbidities. All patients with LAM in this study were female.

Is kinesiophobia associated with disturbances in dynamic balance in individuals with chronic non-specific low back pain? / A cinesiofobia está associada a distúrbios de equilíbrio dinâmico em indivíduos com dor lombar crônica não-específica?

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic non-specific low back pain is a disabling condition that has a high worldwide prevalence. The aim of the study was to investigate the association between deficits in dynamic balance, age and body mass index (BMI), and kinesiophobia, as well as to establish a comparison between men and women. METHODS: A cross-sectional study with 145 individuals between 18 and 50 years of age with non-specific chronic low back pain. Sociodemographic data were collected, and dynamic balance was assessed using the Y-Balance Test. The Tampa Scale was used to assess kinesiophobia. A linear regression was applied to investigate the association between kinesiophobia and a set of predictor variables (balance, gender, BMI). Men and women were compared using the Student's t-test (kinesiophobia and dynamic balance). RESULTS: The overall mean kinesiophobia score was 41.3. The Y-Balance Test mean for the right and left lower limb, respectively, was 59.4 and 59.5. An association was found between kinesiophobia and two predictors: balance and BMI (R2:6.8%). No significant differences were found between gender for kinesiophobia (42.1 for women and 40.3 for men). However, women had worse dynamic balance compared to men (mean reach of 56.1 versus 63.5, respectively; p<0.05). CONCLUSION: Kinesiophobia was found to be associated with disturbances in dynamic balance and BMI of individuals with non-specific chronic low back pain. However, the model explained a small variation in kinesiophobia. Women showed worse dynamic balance compared to with men.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar crônica não-específica é uma condição incapacitante que possui alta prevalência mundial. O objetivo deste estudo foi analisar a associação entre déficits do equilíbrio dinâmico, idade e índice de massa corporal (IMC) e a cinesiofobia, além de realizar uma comparação entre homens e mulheres. MÉTODOS: Este estudo transversal incluiu 145 indivíduos com idade entre 18 e 50 anos com dor lombar crônica não-específica. Foram coletados dados sociodemográficos. O equilíbrio dinâmico foi avaliado por meio do Y-Balance Test. A escala Tampa foi usada para avaliar a cinesiofobia. Aplicou-se uma regressão linear para investigar a associação entre cinesiofobia e um conjunto de variáveis preditoras (equilíbrio, sexo, IMC). Homens e mulheres foram comparados por meio do teste T de Student (cinesiofobia e equilíbrio dinâmico). RESULTADOS: O escore médio geral de cinesiofobia foi de 41,3. A média do Y-Balance Test para o membro inferior direito e esquerdo, respectivamente, foi de 59,4 e 59,5. Verificou-se uma associação entre cinesiofobia e dois preditores, a saber, equilíbrio e IMC (R2:6,8%). Não foram encontradas diferenças significantes entre sexo para cinesiofobia (42,1 para mulheres e 40,3 para homens). Entretanto, as mulheres apresentaram pior equilíbrio em comparação aos homens (média de 56,1 de alcance versus 63,5, respectivamente; p<0,05). CONCLUSÃO: Verificou-se que a cinesiofobia apresentou associação com distúrbios no equilíbrio dinâmico e IMC de indivíduos com dor lombar crônica não-específica. Entretanto, o modelo explicou uma pequena variação na cinesiofobia. As mulheres apresentaram um pior equilíbrio dinâmico em comparação aos homens.

Study of eosinophil count in nasal smear and peripheral blood smear in children with allergic rhinitis

Background: Allergic respiratory disorders are the common cases seen in Pediatrics OPD. With an appropriate history and detailed examination, the diagnosis usually may not be problematic and routine investigations may not contribute much for the final diagnosis but may help in ruling other possibilities. The objectives of this study were done to know the eosinophil counts in nasal and blood smear and to assess the feasibility of nasal cytogram which is simple, economical and reliable investigation in patients of allergic respiratory disorders.Methods: A prospective clinical correlation study conducted in outpatient visiting Mysore Medical College and Research Institute, Cheluvamba hospital Department of Pediatrics and ENT Department KR hospital. 60 children of age group between 2 to 18 years were selected to estimate the eosinophil count in nasal and peripheral smear in allergic rhinitis. All allergic rhinitis cases based on clinical signs and symptoms were selected and investigated for nasal and blood eosinophilia. The nasal and blood eosinophilia were compared with each other and the clinical findings of allergic rhinitis were studied.Results: In this study peak age incidence is between 6-10 years and there is equal gender distribution. Seasonal variation and pollen allergens were the most common risk factors for allergic rhinitis. Running nose and the nasal obstruction were the most common symptoms in children with allergic rhinitis followed by sneezing and itching. One tenth of the children with allergic rhinitis had bronchial asthma. Nasal eosinophilia contributes to the diagnosis of allergic rhinitis as compared blood eosinophilia. Mild intermittent variety of allergic rhinitis was the most common form of allergic rhinitis.Conclusions: Among various risk factors for allergic rhinitis, seasonal variation and pollen allergens have significant association with the severity of allergic rhinitis. Among various symptomology, only itching had a significant relation to the severity of allergic rhinitis.

Gender Specific Differences in Prevalence and Risk Factors for Gastro-Esophageal Reflux Disease

BACKGROUND: Gender-related factors might play an important role in the development of reflux esophagitis (RE) and symptomatic gastro-esophageal reflux disease (GERD). We aimed to evaluate the prevalence and risk factors for RE and symptomatic GERD and determine whether gender specific differences exist. METHODS: This study was conducted on a health cohort consisting of 10,158 participants who underwent comprehensive health screening. Lifestyles and gastrointestinal symptoms were investigated using a self-reported structured questionnaire. Questionnaires about menstrual status were added for the women. RESULTS: The prevalence of RE in men was significantly higher than that in women (10.6% vs. 2.0%, P < 0.001); however, symptomatic GERD showed predominance in women (6.2% vs. 2.5%, P < 0.001). Although the prevalence of RE gradually increased with the duration of menopause stratified by decade (P = 0.007), that of symptomatic GERD rapidly increased across the menopausal transit in women. Apart from common risk factors of obesity and current smoking for RE, over 70 years of age in women and hiatal hernia and hypertriglyceridemia in men were significant risk factors. In symptomatic GERD, high somatization was a common risk factor. Excessive alcohol drinking was a significant risk factor in men, but not in women. CONCLUSION: This study showed a predominance of RE in men, but a predominance of symptomatic GERD in women. In women, dynamic increase in the prevalence of GERD is closely related to the menopause conditions and its duration. There are specific risk factors for RE and symptomatic GERD according to gender differences.

Epidemiological survey of tibial plateau fractures in the Third Hospital of Hebei Medical University from 2009 to 2018 / 中华创伤骨科杂志

Objective To analyze the epidemiological characteristics of all the patients with tibial plateau fracture admitted to the Third Hospital of Hebei Medical University in the past 10 years.Methods The picture achieving and communication system was used to collect the general information and disease-related information from the hospitalized patients with tibial plateau fracture who met the inclusion and exclusion criteria from January 1,2009 to December 31,2018.The patients from January 1,2009 to December 31,2013 were assigned into group A while those from January 1,2014 to December 31,2018 into group B.The 2 groups were compared to find out the epidemiological characteristics and trends of tibial plateau fractures in the past 10 years in gender,age,occupation,injury cause and Schatzker classification.Results A total of 1,936 patients with tibial plateau fracture were included in the study,including 1,352 males and 584 femaleswith a male to female ratio of 2.32∶ 1.The peak age ranged from 50 to 59 years,with 40 to 49 years for males and 50 to 59 for females.There were 793 cases in group A (a male to female ratio of 1.89∶1) and 1,143 ones in group B (2.69∶1),showing a significant difference between the 2 groups in the male to female ratio (P ＜ 0.05).The peak age ranged from 40 to 49 years (25.09％,199/793) in group A and from 50 to 59 years (23.27％,266/1,143)in group B.There were significant differences between the 2 groups in the constituent ratios of age groups from ≥50 years (P ＜ 0.05).Physical workers accounted for the highest proportion in group A (57.12％,453/793) and group B (52.58％,601/1,143).There were significant differences between the 2 groups in the constituent ratios of occupations (P ＜ 0.05).In all the 1,837 patients with a definite injury cause,the fall and indoor activity accounted for the highest proportion(41.92％,770/1,837),the traffic accident(33.25％,248/769) in group A did and the fall and indoor activity(48.88％,522/1,068) in group B did too.There were significant differences between the 2 groups in the injury causes (P ＜ 0.05).Of all the 1,658 patients with X-ray films available,by the Schatzker classification,types Ⅱ and Ⅵ were the most common.Type Ⅵ accounted for the highest proportion in group A (33.25％,248/769) while type Ⅱ did in group B (48.88％,522/1,068).There were significant differences between the 2 groups in the proportions of Schatzker types (P ＜ 0.05).Conclusions The tibial plateau fractures admitted to the Third Hospital of Hebei Medical University in the past 10 years were more common in males than in females,and predominant in physical workers.Fall and indoor activity was the most common injury cause.Schatzker types Ⅱ and Ⅵ prevailed.The fractures showed an aging trend by comparing the former 5 years and the latter 5 years.

Epidemiological survey of glenoid fractures in the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To analyze the epidemiological features and trends of glenoid fractures from 2003 through 2012 in the Third Affiliated Hospital to Hebei Medical University.Methods The clinical data were collected of the patients with glenoid fracture who had been treated between January 2003 and December 2012 in our hospital.The patients' gender,age and fracture type of Ideberg classification were documented.The data from January 2003 to December 2007 were assigned into group A and those from January 2008 to December 2012 into group B.The 2 groups were compared to find out the general epidemiological characteristics and trends in the recent 10 years.Results A total of 225 patients with glenoid fracture were collected,including 176 males and 49 females.The total male/female ratio was 3.59∶ 1.The glenoid fractures predominated in an age range of 31 to 40 years (23.56％).According to Ideberg classification,there were 35 cases (15.56％) of type Ⅰ,58 ones (25.78％) of type Ⅱ,64 ones (28.44％) of type Ⅲ,21 ones (9.33％) of type Ⅳ,30 ones(13.33％) of type Ⅴ and 17 ones(7.56％) of type Ⅵ.The male/female ratio was 5.29∶1 in group A of 107 patients and 2.69∶1 in group B of 118 patients.The mean age of group A was 40.2 ± 16.0 years and that of group B 47.5 ± 14.8 years.The differences in male/female ratio,mean age and distribution of age were statistically significant between the 2 groups (P ＜ O.05).The fractures predominated in an age range of 31 to 40 years (28.97％) in group A and in the age group of 51 to 60 years (27.12％) in group B.The most frequent fracture type was type Ⅲ in both groups,accounting for 29.91％ and 27.12％ respectively.There was no significant difference between the 2 groups in distribution of Ideberg classification (P ＞ 0.05).Conclusions The peak age of glenoid fractures was from 31 to 40 years.There was an increasing trend in the mean age.There were more male patients than female ones.The high-frequency type was Ideberg type Ⅲ.

Epidemiological comparison of adult tibial plateau fractures from 2010 to 2011 between West China and East China / 中华创伤骨科杂志

Objective To compare and analyze the epidemiological features of adult tibial plateau fractures from 2010 to 2011 between West China and East China.Methods The data of adult patients with tibial plateau fracture treated from January 2010 to December 2011 in 63 hospitals from West China and East China were collected through the PACS system and case reports checking system.The data of 28 hospitals from West China were classified as West group while the data of 35 hospitals from East China as East group.The analytic items included gender,age,age distribution and type of Schaztker classification.Results A total of 4,603 adult tibial plateau fractures were collected.The largest age proportion was from 41 to 50 years,with 41 to 50 years in males and 51 to 60 years in females.The highest age proportion in group A was from 51 to 60 years,and that in group B was from 41 to 50 years,showing significant differences between the 2 groups in age distribution (P ＜ 0.05).There were 3,346 cases in group A,including 2,438 males and 998 females with a male to female ratio of 2.35:1;there were 1,257 cases in group A,including 821 males and 436 females with a male to female ratio of 1.88:1.There were significant differences between the 2 groups in gender distribution (P ＜ 0.05).The high-risk fracture type was Schaztker type Ⅵ in both groups,with 898 cases in group A and 411 ones in group B;the lowest fracture type was Schaztker type Ⅴ in both groups,with 214 cases in group A and 149 ones in group B.There were significant differences between the 2 groups in fracture type ratios (P ＜ 0.05).Conclusions Adult tibial plateau fractures predominated in males in both East and West China.The average age of the patients from East China was higher than that from West China.The high-risk type was Schaztker type Ⅵ in both areas.

Epidemiological analysis of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the adult patients with carpal fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender and fracture type were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 1,181 carpal fractures were collected,accounting for 5.99％ (1,181/19,712) of the hand fractures and 1.10％ (1,181/107,648) of the total fractures in the same period.They involved 967 males and 214 females,with a male/female ratio of 4.52∶ 1.The high-risk age group was from 21 to 30 years (33.28％);the high-risk type was scaphoid fracture (72.99％).In group A of 453 cases,the male/female ratio was 6.68∶1,the median age 29 years and the high-risk type scaphoid fracture (83.89％).In group B of 728 cases,the male/female ratio was 3.70∶ 1,the median age 34 years and the high-risk type also scaphoid fracture (66.21％).Group B had a significantly lower male/female ratio,a significantly lower proportion of scaphoid fractures and a significantly older median age than group A (P ＜ 0.05).Conclusions In the 10 years at our institute,adult carpal fractures accounted for 5.99％ of the hand fractures and 1.10％ of the total fractures in the same period.They mostly occurred in males and during the age from 21 to 30 years.Of all the carpal bones,the scaphoid was the most often fractured.The latter 5 years witnessed significantly increased median age,proportion of females and proportion of scaphoid fractures compared with the former 5 years.

Gender Disparity and Influencing Factors for In-hospital Mortality in Patients With ST-segment Elevation Myocardial Infarction at Secondary Hospitals in China / 中国循环杂志

Objective: To understand the gender disparity and influencing factors for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) at secondary hospitals in China. Methods: A total of 5525 in-hospital STEMI patients from 99 secondary hospitals of 15 provinces or autonomous regions between 2011-09 to 2014-06 were recruited including 1649 female and 3876 male. The in-hospital mortalities were compared between 2 genders and the relevant inlfuencing factors were studied by multiple Logistic regression analysis. Results: There were about 29.8% female and 70.2% male STEMI patients were studied. The in-hospital mortalities in female and male were 13.2% and 5.9%,P<0.01; gender disparity was obviously existing regardless of age, history of MI, hypertension and diabetes mellitus. The mortality in female was higher than male even without diseases history and cardiovascular risk factors. Compared with male gender, female patients were usually having elder age and likely complicated with cardiovascular risk factors; they were with lower incidence to receive ECG, drug therapy and thrombolysis within 10 minutes of admission. With adjusted confounding factors, multiple regression analysis presented that female STEMI patients had the higher mortality than male (OR:1.7, 95% CI:1.4-2.0). Conclusion: The in-hospital mortality for STEMI patients was higher in female than male at secondary hospitals in China. Female patients were usually having elder age, complicated with more cardiovascular risk factors, while with less chances to receive ECG, drug therapy and thrombolysis within 10 minutes of admission.

Diferenças entre sexos nos determinantes da obesidade abdominal em adultos de 40 anos ou mais: estudo de base populacional / Gender differences in the determinants of abdominal obesity among adults aged 40 years or older: A population-based study

Objetivo:Verificar diferenças entre sexos na prevalência de excesso de peso abdominal e seus determinantes em adultos a partir de 40 anos de idade.Métodos:Estudo transversal de base populacional realizado no município de Cambé, Paraná, com 1.161 indivíduos de 40 anos de idade ou mais, residentes em todos os setores censitários urbanos. A obesidade abdominal foi definida como circunferência da cintura ≥88 cm para mulheres e ≥102 cm para homens. A análise de fatores associados foi realizada para cada sexo por meio da regressão de Poisson hierarquizada baseada em modelo teórico conceitual, com seleção de variáveis distais, intermediárias e proximais.Resultados:A prevalência de obesidade abdominal foi de 49,7% e aumentou com a idade para ambos os sexos. A prevalência em mulheres foi mais que o dobro da verificada em homens (RP=2,29; IC95%=1,98-2,65). Após ajuste, as variáveis que permaneceram associadas à obesidade abdominal em ambos os sexos foram: inatividade física no lazer, idade e hipertensão arterial. Classe econômica, tabagismo e diabetes associaram-se com a obesidade abdominal apenas entre as mulheres.Conclusão:As altas prevalências de obesidade abdominal, especialmente no sexo feminino, e a presença de alguns fatores associados distintamente em cada sexo evidenciam a necessidade de ações diferenciadas de enfrentamento.

Objective:To investigate gender differences in the prevalence of excess abdominal weight and its determinants in adults aged 40 years and over.Methods:Cross-sectional population-based study conducted in the city of Cambé, Paraná, Brazil, with 1,161 individuals 40 years or older living in all urban sectors. Abdominal obesity was defined as a waist circumference ≥88 cm in women and ≥102 cm in men. The analysis of associated factors was performed for each gender using the hierarchical Poisson regression based on a conceptual theoretical model, with the selection of distal, intermediate, and proximal variables.Results:The prevalence of abdominal obesity was 49.7%, which increased with age in both genders. Women had more than double the prevalence compared to men (PR=2.29; 95%CI=1.98-2.65). After adjustment, the following variables remained associated with abdominal obesity in both genders: physical inactivity, age, and hypertension. Socioeconomic status, smoking, and diabetes were associated with abdominal obesity only in women.Conclusion:The high prevalence of abdominal obesity, especially among women, and the presence of some factors found to be distinctly associated in each gender show the need for different measures to address this issue.

Audiometria de resposta evocada de acordo com sexo e idade: achados e aplicabilidade / Evoked response audiometry according to gender and age: findings and usefulness

A audiometria de respostas evocadas (ABR) é um registro não-invasivo de potenciais elétricos auditivos nos primeiros 12 milissegundos, da orelha média ao córtex auditivo. ABR é importante na avaliação otoneurológica. OBJETIVO: Esclarecer as utilidades do exame, faixas etárias e sexo com maior incidência e topodiagnóstico segundo as latências absolutas e os intervalos interpicos. CASUÍSTICA E MÉTODO: Neste estudo retrospectivo foram analisados 403 prontuários de ABR realizados em clínica particular na cidade de Jundiaí/SP, Brasil, suspeitos de alteração auditiva e/ou doença do SNC, com os pacientes divididos por sexo e faixa etária. RESULTADOS E CONCLUSÕES: ABR é um importante exame para determinar a integridade da via auditiva, limiares eletrofisiológicos e topodiagnóstico, embora o teste não indique a etiologia das alterações. Foi demonstrado que ocorreu maior incidência de achados retrococleares na faixa etária de 12-20 anos e sexo masculino, contudo crianças menores de um ano com fatores de risco não apresentaram um aumento na incidência de alterações condutivas, cocleares e retrococleares em relação à população geral estudada. As latências absolutas das ondas I, III e V foram maiores no sexo masculino e as alterações dos intervalos interpicos foram similares em ambos os sexos, sendo que o intervalo I-III foi o mais freqüentemente alterado.

Auditory evoked brainstem responses (ABR) is a non-invasive electrical potential registration which evaluates the auditory tract from the middle ear to the auditory cortex in the first 12 milliseconds (ms). The ABR is an important otoneurological evaluation. AIM: confirm the test's usefulness, major incidence and topography according to are range gender considering the absolute latencies of the waves and interpeak intervals. MATERIALS AND METHOD: we retrospectively analyzed 403 tests from a private clinic in the city of Jundiaí-São Paulo State-Brazil, from patients suspected of auditory damage or central nervous disorder, and the patients were broken down according to gender and age. RESULTS AND CONCLUSIONS: ABR is an important test to determinate the soundness of the auditory tract, the electrophysiological thresholds and topodiagnosis. We found no differences between type of loss and gender; there was a major incidence of retrocochlear findings among male patients between 12-20 years old; children under one year with risk factors did not present higher incidences of auditory findings when compared with all the population analyzed. The absolute latencies of waves I, III and V were higher in males, but the interpeak intervals were similar in both genders, showing that interval I-III was more frequently altered.