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PubMed1997

Jaw movement tremor as a predictor of chewing performance.

The purpose of this study was to investigate normal physiologic tremor in jaw movement as a factor that may influence chewing performance more directly than either muscle activity or jaw displacement. Chewing performance was defined in terms of the reduction in food particle size after 15 chewing strokes. Data on chewing particle size and electromyographic activity were available for 24 asymptomatic adults from an earlier study. Jaw movements during chewing were recorded using electrognathography, and velocity and acceleration in three planes were determined. Power spectrum for acceleration was calculated during opening and closing phases of the chewing cycle. The frequency of the peak amplitude in the power spectrum represented physiologic tremor of the jaw. Tremor frequencies during both opening and closing phases of the chewing cycle were strong predictors of chewing performance. A multivariate model composed of variables derived from acceleration, together with electromyographic and jaw movement variables, produced a multivariate model that was able to predict chewing performance with an adjusted R2 value of .78.

Adult↗
PubMed1999

Psychological disorders and their correlates in an Australian community sample of preadolescent children.

The nature and correlates of psychological disorders of preadolescent children from the longitudinal Australian Temperament Project (ATP) are reported. Almost half of the children identified via checklists completed by mothers, teachers, and the children themselves as being in the at-risk range for disorder received a DSM-III-R diagnosis. Nine per cent of comparison, or low-risk, children also received a diagnosis. Internalising disorders were the most common, and 44% of cases had multiple problems. Children rated as problematic by all three informants or by child plus teacher were the most likely to receive a diagnosis. The at-risk group had more difficult temperament, poorer family and peer relationships, lower levels of social skills, and were of lower SES than the comparison group. There were minimal differences on these variables between at-risk children who did, or did not, receive a DSM-III-R diagnosis. It is argued that especially for boys, checklists from multiple informants are effective tools for identifying clinically significant disorders.

Australia↗
PubMed1999

The impact of comorbidity and age on survival with laryngeal cancer.

Previous studies have evaluated the effects of comorbidity on survival in patients with cancer. We applied the Charlson comorbidity index (CCI) to a cohort of patients with laryngeal cancer to validate its use and to assess the prognostic impact of age. Our study population consisted of 152 patients with laryngeal cancer who were seen over a 10-year period. Patients were assigned CCI scores and were categorized into low- and high-grade comorbidity groups for comparison. Age adjustments were performed by adding 1 point to the Charlson score for each decade over the median age. Low- vs. high-grade comorbidity was a valid predictor of survival independent of TNM (tumor, nodes, and metastases) stage. Low-grade comorbidity was present in 126 patients; their median survival was 41 months. High-grade comorbidity was present in 26 patients; their median survival was 8 months (p = 0.0002). The addition of the age factor to the CCI did not improve our prognostic ability. There was no difference in CCI groups with respect to tobacco and alcohol use, gender, treatment modality, or mean time to recurrence. The incidence and severity of complications were also similar in the two groups. We conclude that the CCI is a strong predictor of survival in patients with laryngeal cancer. The confounding effects of comorbidity should be considered in the TNM staging of laryngeal cancer to improve our prognostic ability. Further investigations are necessary to assess the validity of this index in patients with other head and neck cancers.

Adult↗
PubMed1999

Pulmonary hypertension in systemic lupus erythematosus: clinical association and survival in 18 patients.

OBJECTIVE: To examine the clinical and serologic features in patients with systemic lupus erythematosus (SLE) with pulmonary hypertension (PHT). METHODS: Case records were reviewed for 419 Chinese patients with SLE from a single center in Hong Kong between January 1985 and June 1997. Patients with PHT were compared with SLE controls. The diagnosis of PHT was made when the pulmonary artery systolic pressure (PASP), measured by 2 dimensional echocardiogram and Doppler studies at rest, was >30 mm Hg, or at postmortem. Clinical features, serologic profile, and outcome of those with PHT were compared with those without PHT. Thirteen patients had repeat echocardiogram to determine subsequent PASP. RESULTS: Eighteen of 419 patients, all female, were identified as having PHT. The clinical and serologic features of patients with SLE with PHT were similar to those without PHT except for serositis and Raynaud's phenomenon, which occurred more frequently in patients with PHT (p = 0.01, p = 0.03, respectively). The age at diagnosis of PHT was 30.5+/-10.2 (mean +/- SD) years. The duration of followup from time of diagnosis of PHT was 23.6+/-20.1 months. PASP was 52+/-23.4 mm Hg. There were 4 deaths. Survival of PHT patients as a group was 40.2+/-5.18 (95% CI 30.1-50.4) months. Repeat echocardiogram in 13 patients revealed a mean reduction in PASP of 21.3% over a median interval of 43 (range 4-52) months. CONCLUSION: Raynaud's phenomenon is associated in patients with SLE with PHT. The prognosis of these patients is variable, with the majority of patients having mild to moderate disease showing little change over 2 years. Nearly a quarter died and a few improved markedly.

Adolescent↗
PubMed1999

Epidemiologic, bacteriologic, and long-term follow-up data of children with acute hematogenous osteomyelitis and septic arthritis: a ten-year review.

A total of 69 children with acute hematogenous osteomyelitis and 48 with septic arthritis admitted in the period 1978 through 1987 were included in a retrospective review. Epidemiologic and bacteriologic data were analyzed and compared with those of an earlier study (1965 through 1975), confined to the same geographic area. Long-term outcome was evaluated by a questionnaire and clinical and radiographic follow-up. A significant increase in the admission rate for both disorders was observed. The long-term outcome was favorable: major sequelae were found in three patients (3%), minor sequelae in two patients (2%). The benign long-term outcome may well be related to rapid hospital admission and appropriate long-lasting antibiotic treatment.

Adolescent↗
PubMed1999

[Carotid atherosclerosis in patients with suspected coronaropathy: the relationship to traditional risk factors in the 2 vascular areas].

UNLABELLED: In order to evaluate the prevalence of carotid atherosclerosis (CA) in patients with coronary artery disease (CAD) and to identify the differential role of traditional risk factors, we analyzed data concerning 290 patients aged 61.9 +/- 10.8 years who underwent color duplex ultrasound of extracranial arteries before coronary angiography. Significant CA (stenosis > or = 50% in at least one extracranial artery) was disclosed in 44 patients (15%); significant CAD (stenosis > or = 70% at least in a major epicardial vessel) was documented in 238 patients (82%). Age and smoking were significantly associated with both CAD (respectively, p = 0.034 and p = 0.050) and CA (respectively, p = 0.000 and p = 0.000), but a stronger correlation was documented with CA (r = 0.325 vs r = 0.125 for age; r = 0.218 vs r = 0.114 for smoking). Diabetes (p = 0.031) and male gender (p = 0.016) were significantly associated with CAD, and hypertension (p = 0.029) with CA. CONCLUSIONS: Traditional risk factors play different roles in the pathogenesis of atherosclerotic disease of carotid and coronary circulation. Color duplex evaluation of the carotid arteries can be useful in high-risk patients, particularly if candidates for coronary surgery.

Age Distribution↗
PubMedDate not supplied

Characterization by phenotype of families with atopic dermatitis.

The aetiology of atopic dermatitis is unknown, but is probably multifactorial, with interactions between several genetic and environmental factors. Twin studies indicate a strong genetic factor, but the susceptibility genes are unknown. This paper, describing the phenotypes of family material, forms part of a large genetic study seeking to identify susceptibility genes for atopic dermatitis by linkage analysis. We selected families with at least 2 siblings affected with atopic dermatitis (1,097 affected siblings who together form 650 affected sib pairs and 49 affected half-sib pairs). We established a phenotype database of information about the affected siblings and their relatives, in total 5,830 individuals. All siblings were diagnosed with atopic dermatitis and participated in a standardized interview covering aspects of atopy and atopic dermatitis. Of the affected siblings, 72% suffered or had suffered from asthma and/or allergic rhinoconjunctivitis and 74% had raised total and/or allergen-specific IgE serum levels. Seventeen percent of the siblings had been hospitalized for atopic dermatitis. Sixty-nine percent had 1 or both parents with atopic dermatitis. Among siblings with 1 parent with atopic dermatitis, 37% had a father with atopic dermatitis and 63% had a mother with atopic dermatitis, indicating maternal preponderance. Analysis of the occurrence of atopic dermatitis in relation to the birth order in the sibship shows an increased risk of atopic dermatitis in persons born early in a sibship. Although the families were selected for genetic sib-pair linkage analysis, we believe that this material is representative of atopic dermatitis families managed at hospitals in Stockholm.

Adolescent↗
PubMed1995

[Spontaneous intracerebral hemorrhage: case histories].

Spontaneous intracerebral hemorrhage is a significant cause of morbidity and mortality. The disease primarily affects men between the age of 45 to 75 years. Arterial hypertension is the most frequent etiologic factor. Here is presented a case-record of 148 intracerebral hemorrhages observed during a five years period. Several clinical and radiological features have been correlated and analyzed from a statistical point of view. The most important prognostic factor is the state of consciousness. Either deep coma and a normal state of consciousness do not represent surgical indications.

Adult↗
PubMed1995

Modulation of occlusal plane during puberty.

The biological significance of the occlusal plane is of tremendous importance in the study of the etiology, diagnosis and treatment of malocclusion. The purpose of this investigation was to correlate the changes on the occlusal plane of patients in treatment with functional appliances and the subjects with no need of treatment during the prepubertal and pubertal period. Data on the space between the upper and lower occlusal lines-Interocclusal Distance (IOD) was obtained periodically. Some remarks about which changes are naturally provoked or not are very useful in the treatment of malocclusions and the evaluation of the occlusal plane in cases that do not need treatment.

Adolescent↗
PubMed1995

Periodontal findings in cases of incisor cross-bite.

The effect of cross-bite on periodontal health in the anterior teeth was investigated in 40 teenage subjects. The results have shown a relationship between the cross-bite in the anterior teeth and periodontal health as assessed by Plaque Index, Gingival index and pocket depth measurements. The periodontal status of the teeth in cross-bite revealed a more unfavorable condition compared to the well-aligned teeth. This was observed in both males and females. However, pocket depth on the lingual site for both sexes does not reach a significant difference between the cross-bite and the control teeth.

Child↗
PubMed1995

[The epidemiology of proximal femur fracture at the Hospital da Horta (Azores)].

The aim of this study was to know the incidence of osteoporotic hip fracture in a defined area of the Azores. The catchment area included the islands of Faial, Pico, Flores and Corvo, with 11,617 subjects aged 50 or more: 5,373 males and 6,244 females. The time period of the survey was 1991 to 1993. Data was obtained from the records of the Orthopedic Department of Hospital Horta. Thirty seven fractures were diagnosed during the time survey: 12 in 1991, 13 in 1992 and 12 in 1993. The age-adjusted mean incidence rates of hip fracture for the population over 49 years old was 10.3/10,000: 5.6/10,000 in men and 14.4/10,000 in women. Most fractures occurred in women over the age of 65 years. The ratio of male to female cases was 1:3. The mean age of all patients was 77 +/- 8 years of age: 72 +/- 8 in males and 79 +/- 6 in females (p = 0.05). About 70 percent of these patients were treated surgically. The acute mortality rate was 8 percent and the mean age of the deceased patients, 82 +/- 6, was significantly higher than the mean age of the survivors, 73 +/- 6 (p = 0.01).

Age Distribution↗
PubMed1994

Statistical power to detect occupationally related respiratory cancer risk in a cohort of female employees in the US man-made vitreous fiber industry.

The current update of the US man-made vitreous fiber production worker cohort includes women for the first time. Preliminary comparisons of 3,820 female and 27,767 male workers from 11 participating fibrous glass plants show different hiring patterns during World War II. The gender-specific person-year distributions are similar with respect to duration of employment and time since first employment. The current follow-up of 118,559 person-years for women provides an estimated 80% power to detect a threefold relative risk of respiratory cancer for women who worked more than 14 years in these plants, based on a Poisson regression analysis of the cohort rates. When women comprise a small fraction of the cohort, the statistical power may be inadequate to detect risks of the magnitude typically of interest in studies of men.

Aged↗
PubMed1994

Limitations of the correlation coefficient in the validation of diet assessment methods. CODIAB-INSERM-ZENECA Pharma Study Group.

Dietary assessment methods usually are validated one against the other, using the correlation coefficient between the methods to assess agreement. The correlation coefficient, however, is only an indicator of relative agreement and depends on the range of intakes. As this dependence can lead to misinterpretation, we propose that the standard deviation of the difference between methods should be used as an indicator of absolute agreement and the standard deviation of their average as an indicator of the range of intakes. We illustrate this method in a validation study of a diet history against a 3-day diet record in 58 non-insulin-dependent diabetes mellitus patients. A re-analysis of studies from the literature validating food frequency questionnaires against diet records showed that the absolute agreement between methods is very consistent and that the differences in the correlation coefficients are mostly due to the selection of subjects.

Adult↗
PubMed1996

The demographics of slipped capital femoral epiphysis. An international multicenter study.

One thousand six hundred thirty children with 1993 slipped capital femoral epiphyses were reviewed; 41.2% were girls and 58.8% were boys. There were 47.5% white, 24.8% black, 16.9% Amerindian, 7.4% Indonesian-Malay, 2.1% Native Australian/Pacific Islands, and 1.3% Indo-Mediterranean children. The diseased hip was unilateral in 77.7% and bilateral in 22.3% of the children, and chronic in 85.5% and acute in 14.5% of the children. Of the unilateral slips, 40.3% involved the right hip and 59.7% the left hip. The child's weight was greater than or equal to the ninetieth percentile in 63.2% of the children. The average age for the girls and boys was 12 and 13.5 years. The age at diagnosis decreased with increasing obesity. The youngest children were the Native Australian/Pacific Island children (11.8 years) and the oldest were the white and Indo-Mediterranean children (13 years). The Indonesian-Malay and Indo-Mediterranean children were the lightest in weight, and the black children the heaviest. The Indo-Mediterranean children had the highest proportion of boys (90.5%), and the Native Australian/Pacific Island children the lowest (50%). The highest percentage of bilaterality was in the Native Australian/Pacific Island children (38.2%), and the lowest in the Amerindian children (16.5%). The relative racial frequency of slipped capital femoral epiphysis compared with the white population was 4.5 for the Polynesian, 2.2 for the black, 1.05 for the Amerindian, 0.5 for the Indonesian-Malay, and 0.1 for the Indo-Mediterranean children. In children with unilateral involvement, the age at presentation was younger for those children in whom bilateral disease later developed (12 versus 12.9 years old). In 82% of the children with sequential bilateral slips, the second slip was diagnosed within 18 months of the first slip.

Adolescent↗
PubMedDate not supplied

Factors correlated with caraniomandibular disorders in young and older adults.

This study was conducted to examine prevalence of craniomandibular disorders in young adults compared with that in older subjects. In addition, the relationship between various oral conditions and this dysfunction was studied. No difference was found in the incidence of craniomandibular disorders between the groups. Classification according to the Helkimo index showed significant difference in complaints of craniomandibular disorders symptoms between the groups. Most of the older patients did not complain of mild disorders. The results suggest that conditions such as the number of teeth, presence or absence of dentures, and the type of denture worn are not important factors in the pathogenesis of craniomandibular disorders.

Adult↗
PubMedDate not supplied

Improving procedures for recording suicide statistics.

OBJECTIVE: To explore the changing relationship between rates of suicide and undetermined death in Britain and Ireland. DESIGN: Longitudinal analysis of the official statistics relating to unnatural deaths in England and Wales and the Republic of Ireland between 1976 and 1992. MAIN OUTCOME MEASURES: Male and female rates of suicide and undetermined deaths for Ireland and England and Wales, age adjusted to the standard world population. Ratio of undetermined deaths to suicide. RESULTS: The official Irish male suicide rate is now much higher than that of England and Wales while the female rates are broadly similar. The rate of undetermined deaths has risen amongst English males and remained stable for females but has significantly fallen off among both Irish males and females. The proportion of deaths classified as 'undetermined' is now very much less in Ireland than in England and Wales. DISCUSSION: National plans for suicide prevention in either country cannot be properly audited unless improved procedures are put in place to increase the validity and reliability of the official suicide figures. Each country could beneficially learn from the other in this regard.

Adolescent↗
PubMed1997

Waist-hip ratio and blood pressure correlation in an urban Indian population.

Truncal obesity judged by increased waist-hip ratio (WHR) is an important risk factor for atherosclerosis. One of the mechanisms postulated by which truncal obesity increases coronary risk is high blood pressure (BP). Studies of correlation of WHR with systolic and diastolic BP have shown conflicting results. A study on 443 persons (250 males, 193 females) for WHR measurement during a comprehensive cardiovascular survey in an urban population of Rajasthan was undertaken. The mean WHR in males was 0.90 +/- 0.07 and in females 0.87 +/- 0.08. The median value was 0.91 in males and 0.88 in females. Correlational analysis of WHR with anthropometric and clinical parameters showed that in males there was a positive relationship of WHR with weight (r = 0.11), body mass index (r = 0.13) and systolic (r = 0.11) and diastolic BP (r = 0.11) but not with age and height. In females no significant relationship was seen with these variables. When classified according to the US Fifth Joint National Committee (JNC-V) recommendations for diagnosis of truncal obesity (WHR males > 0.95, females > 0.85) it was seen in 42 (17%) males and 131 (68%) females. Sub-analysis of these two groups showed that mean values of systolic and diastolic BP were not significantly different in truncally obese subjects. However, stratified analysis after classifying WHR in four groups (WHR < 0.85, 0.85-0.89, 0.90-0.95 and > 0.95) showed that in males there was a significantly rising trend of weight, body mass index, systolic and diastolic BP with increasing WHR. WHR of > or = 0.85 was associated with higher systolic and diastolic BP.

Adult↗
PubMed1997

Prevalence of malocclusion traits in an Australian adult population.

The prevalence of certain malocclusion traits in an Australia adult population was examined in a sample of 113 female and 103 male adult subjects aged between 18 and 64 years (average age = 38.1 years). If cross-sectional studies of younger population groups are to be used for research into the long-term physiological effects of malocclusion, it is essential to know if certain and specific malocclusion traits are stable over time. In this cross-sectional study, the prevalence of many malocclusion traits did not change; however, with advancing age, the incidence of posterior crowding, posterior rotations, posterior crossbite and anterior irregularity increased significantly.

Adolescent↗