Symptomatic Dystonia: Clinical Profile of 46 Brazilian Patients

ABSTRACT:Dystonia is a syndrome characterized by sustained muscle contraction, provoking twisting and repeti-tive movements or abnormal postures. It may be classified according to etiology, as idiopathic or symptomatic. We studied 122 Brazilian patients with a dystonic syndrome. Of these, 46 (37.7%) had symptomatic dystonia. The most frequent cause was tardive dystonia (34.8%) followed by perinatal cerebral injury (30.4%). Other causes were stroke (13.0%), encephalitis (6.5%) and Wilson’s disease (4.3%). Cranial trauma, mitochondrial cytopathy and psychogenic, were the least frequent causes with one patient in each category. The etiology in two patients could not be established. Perinatal cerebral injury and postencephalitic dystonia were seen in the younger age group, while post-stroke and tardive dystonia were seen in the older age group.

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Comparison of anthropometric data quality in children aged 6-23 and 24-59 months: lessons from population-representative surveys from humanitarian settings

BMC Nutrition ◽

10.1186/s40795-020-00385-0 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Oleg Bilukha ◽

Alexia Couture ◽

Kelly McCain ◽

Eva Leidman

Keyword(s):

Data Quality ◽

Age Groups ◽

Older Age ◽

Demographic And Health Surveys ◽

Age Group ◽

Anthropometric Data ◽

Digit Preference ◽

Anthropometric Indicators ◽

Younger Age

Abstract Background Ensuring the quality of anthropometry data is paramount for getting accurate estimates of malnutrition prevalence among children aged 6–59 months in humanitarian and refugee settings. Previous reports based on data from Demographic and Health Surveys suggested systematic differences in anthropometric data quality between the younger and older groups of preschool children. Methods We analyzed 712 anthropometric population-representative field surveys from humanitarian and refugee settings conducted during 2011–2018. We examined and compared the quality of five anthropometric indicators in children aged 6–23 months and children aged 24–59 months: weight for height, weight for age, height for age, body mass index for age and mid-upper arm circumference (MUAC) for age. Using the z-score distribution of each indicator, we calculated the following parameters: standard deviation (SD), percentage of outliers, and measures of distribution normality. We also examined and compared the quality of height, weight, MUAC and age measurements using missing data and rounding criteria. Results Both SD and percentage of flags were significantly smaller on average in older than in younger age group for all five anthropometric indicators. Differences in SD between age groups did not change meaningfully depending on overall survey quality or on the quality of age ascertainment. Over 50% of surveys overall did not deviate significantly from normality. The percentage of non-normal surveys was higher in older than in the younger age groups. Digit preference score for weight, height and MUAC was slightly higher in younger age group, and for age slightly higher in the older age group. Children with reported exact date of birth (DOB) had much lower digit preference for age than those without exact DOB. SD, percentage flags and digit preference scores were positively correlated between the two age groups at the survey level, such as those surveys showing higher anthropometry data quality in younger age group also tended to show higher quality in older age group. Conclusions There should be an emphasis on increased rigor of training survey measurers in taking anthropometric measurements in the youngest children. Standardization test, a mandatory component of the pre-survey measurer training and evaluation, of 10 children should include at least 4–5 children below 2 years of age.

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Study of Lipid Profile and Coronary Angiographic Pattern in Young Bangladeshi Patients with Acute Coronary Syndrome

Cardiovascular Journal ◽

10.3329/cardio.v1i2.8237 ◽

1970 ◽

Vol 1 (2) ◽

pp. 183-188 ◽

Cited By ~ 1

Author(s):

AR Khan ◽

AAS Majumder

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Lipid Profile ◽

Older Age ◽

Age Group ◽

Coronary Angiogram ◽

Coronary Syndrome ◽

Group I ◽

Younger Age ◽

Group Ii

Background: Majority of the patients of coronary heart disease (CHD) in our country are above 40 years of age but a good number of patients belong to the age under 40, the most valuable and productive period of life during which they can devote themselves to uplift their family, society and country and can participate in nation building activities.3,4 The number of young individuals falling into the spectrum of CHD is increasing everywhere However, this age trend is peculiar in relation to the western age incidence.5 Our objective was to investigate the lipid profile and coronary angiographic pattern in young Bangladeshi patients with acute coronary syndrome and also to find out the relationship between dyslipidemia and coronary artery disease in this age group. Methods: This observational study was carried out in National Institute of Cardiovascular Diseases (NICVD) during the period of January 2000 to December 2000. A brief history was recorded on the date of admission and fasting lipid profile was done within 24 hours of admission. Other associated major risk factors were looked for and recorded accordingly. After stabilization oh the acute condition patient was prepared for coronary angiogram and informed consent was taken. Accordingly elective CAG was done. Among them total 64 patients of ACS, underwent coronary angiogram in the cath lab of NICVD, were selected randomly of which of which 32 patients were up to the age 40 years (Group- I) and 32 were above 40 years of age (Group-II). Patient of ACS of either sex having no age limitation were included without prior history of Percutaneous Coronary Intervention or Coronary Artery Bypass Graft surgery. The findings were reviewed and scrutinized carefully by two interventional cardiologists. In doubtful cases third expert reviewed the CD. If a consensus was not reached due to technical or visual error, the case wais discarded from the study. Details of CAG findings i.e. site and number of diseased vessels, location, morphology and pattern of lesion were studied and recorded accordingly. Results: The prevalence of dyslipidaemia and positive family history were more in group I than group II. Younger age group has less favorable lipid profile than older age group having raised total cholesterol in 31.3 percent cases, low HDL in 12.5 percent cases and raised LDL in 31.3 percent cases, while in older age group, it was 21.8, 25.0, 0 and 18.7 percent, respectively. CAG study of the patients showed that no vessel involvement was more common in group I than group II (21.9% vs 12.5%), but triple vessel disease was more common in group II (12.5% vs 21.8%). Single vessel and double vessel diseases were similar in both the groups. Involvement of LAD was slightly more in-group I than group II (68.8% vs 65.6%) and involvement of LCX and RCA were less in group I than group II (21.9% vs 34.3%, and 43.8% vs 78.1%, respectively). Diffuse LAD and RCA lesions were more in group II (36.4% vs 52.4% and 42.9% vs 48.0%, respectively), but diffuse LCX lesion was more in group I (42.9 vs 36.4%). Multiple irregular lesions are more common in older age group (53.1%) than younger age group (28.1%). Conclusion: The younger age group has less favorable lipid profile than older age group having raised total cholesterol, decreased HDL and raised LDL. CAG findings show that most of the lesions are present in LAD (having less impressive LVEF) as like as in older age group, but older age group has more multiple irregular lesions. Prevalence of >2 lesions in one coronary artery was more in group I (31 vs. 25%) but difference was not statistically significant. Keywords: Lipid profile, Coronary angiogram, Younger patients, Acute Coronary Syndrome. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8237 Cardiovasc. j. 2009; 1(2): 183-188

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Paratesticular Adipocytic Neoplasms Evaluated at a Single Institution

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.090 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S73-S74

Author(s):

Mohamed Mustafa ◽

David Priemer ◽

Muhammad Idrees ◽

Shaoxiong Chen

Keyword(s):

Spermatic Cord ◽

Older Age ◽

Age Group ◽

Single Institution ◽

Complex Anatomy ◽

Younger Age ◽

Mean Size ◽

Cord Lipoma ◽

The Mean ◽

Well Differentiated

Abstract Objectives Some of the scrotal masses are extratesticular neoplasias and develop from paratesticular tissues. Paratesticular region has a complex anatomy and contains epididymal and testicular appendages as spermatic cord, testicular tunicas, epididymis, and vestigial remnants. Therefore, neoplasms originating from this region comprise a heterogeneous group of tumors. Herein, we document paratesticular adipocytic neoplasms and the patient’s mean age and the mean size of tumor at presentation. Methods We retrospectively searched our database for paratesticular adipocytic neoplasms from the year 2001 to 2015. A total of 47 cases were identified and reports were reviewed. Results Of the total 47 cases, 28 (60%) spermatic cord lipomas, 9 (19%) well-differentiated liposarcomas, and 10 (21%) dedifferentiated liposarcomas were identified. The mean age for presentation for these diseases was of 41, 59, and 68 years, respectively. Conclusion The most common paratesticular adipocytic neoplasm in our institution is spermatic cord lipoma (60%), occurring in younger age group (mean age 40 years). However, up to 40% cases are malignant and include well-differentiated and dedifferentiated liposarcoma, occurring at a relatively older age population (59 and 68, respectively).

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Prevalence of sleep disorders in children 3-7 years of age in perm

Perm Medical Journal ◽

10.17816/pmj38315-21 ◽

2021 ◽

Vol 38 (3) ◽

pp. 15-21

Author(s):

G. V. Anisimov ◽

T. P. Kalashnikova ◽

E. V. Bezdomnikova

Keyword(s):

Sleep Disorders ◽

Preschool Age ◽

Older Age ◽

Age Group ◽

Leg Muscles ◽

Younger Age ◽

Obstructive Sleep ◽

Falling Asleep ◽

One Year ◽

Questionnaire Method

Objective. The article analyzes the clinical features of sleep in preschoolers aged 3-7 years in the city of Perm on the basis of a continuous questionnaire method. Materials and methods. The presence of complaints related to sleep at the time of the survey was substantiated in 45 % of children of the younger age group (from 3 to 5 years) and 41 % of children in the older age group (from 5 to 7 years). Results. Sexual dimorphism manifested itself in a significant dominance of intrasomnic disturbances with frequent awakenings and increased motor activity during sleep in older boys. Nocturnal pains and / or cramps in the leg muscles prevailed in girls of the older age group. In the structure of parasomnias in Perm preschool children, there predominated nightmares (16.5 %), night fears (13.3 %), bruxism (14.8 %), sleepwalking (12.8 %), enuresis (8.2 %). Every fifth child of preschool age had sleep with an open mouth, snoring or puffing, hyperhidrosis during sleep and chronic adenotonsillar pathology, which does not exclude the presence of obstructive sleep apnea / hypopnea syndrome in this category of children. Conclusions. Sleep disorders were noted in a quarter of children under one year of age, manifested by difficult falling asleep, restless sleep and sleep inversion, which can be a marker of both disorders of maturation of chronobiological mechanisms and a high percentage of childhood behavioral insomnia.

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Prevalence of high-risk human papillomavirus in uterine cervical lesions among older Japanese women.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.5084 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 5084-5084

Author(s):

Kazuhiro Takehara ◽

Hiroko Nakamura ◽

Osamu Samura ◽

Tomoya Mizunoe ◽

Akihisa Saito ◽

...

Keyword(s):

High Risk ◽

Age Groups ◽

Hpv Infection ◽

Japanese Women ◽

Older Age ◽

Age Group ◽

Hpv 16 ◽

Younger Age ◽

Hpv Genotypes ◽

High Risk Hpv

5084 Background: To estimate the prevalence and genotypes of high-risk human papillomavirus (HPV) among older Japanese women, using liquid-based cytology (LBC). Methods: ThinPrep LBC specimens were collected from 11,039 Japanese women (age range, 14-98 years). After classifying cytodiagnosis, specimens were analyzed for HPV DNA using the multiplex polymerase chain reaction method. Cervical smear specimens from 1,302 women showed positive results. To examine the prevalence of HPV in women defined as negative for intraepithelial lesion or malignancy (NILM), 2,563 samples were randomly selected from the remaining 9,737 women. Comparisons were made between women ≥50 years of age (older age group) and women <50 years of age (younger age group). Written informed consent was obtained from all patients. In this study, the high-risk HPV genotypes encountered were 16, 18, 31, 33, 35, 45, 52, and 58. Results: In the older age group with abnormal smear findings, HPV genotypes were detected in 49.7% (148/298), including high-risk HPV genotypes in 40.9% (122/298). In the younger age group with abnormal smear findings, HPV genotypes were detected in 71.7% (720/1004), including high-risk HPV genotypes in 58.1% (583/1,004). In NILM, HPV-positive rates were 4.5% (39/873) in the older age group and 11.8% (199/1,690) in the younger age group. In high-grade squamous intraepithelial lesion (HSIL) or more severe cytological findings, HPV genotypes of each group (older age group/younger age group) were detected in 61.7%/83.1%, and high-risk HPV genotypes were detected in 56.4%/74.7% of women. In positive cervical smears, HPV 16 was the most frequently detected (28.5%) in the younger age group, while HPV 52 (31.3%) and 58 (27.2%) were detected more frequently than HPV 16 (18.4%) in the older age group. Conclusions: In Japan, although HPV infection as a cause of abnormal cervical cytology is more frequent among younger age groups than in older age groups, high-risk HPV infection was more highly associated with older individuals (older age group/younger age group: abnormal smear findings, 82.4%/81.0%; HSIL or more severe cytological findings, 91.3%/89.9%). In older age groups, HPV 52 and 58 were more frequent than HPV 16.

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Older Age Is An Independent Risk Factor in AML

Blood ◽

10.1182/blood.v112.11.555.555 ◽

2008 ◽

Vol 112 (11) ◽

pp. 555-555

Author(s):

Thomas Buchner ◽

Wolfgang E. Berdel ◽

Claudia Haferlach ◽

Susanne Schnittger ◽

Torsten Haferlach ◽

...

Keyword(s):

Risk Factors ◽

Older Patients ◽

Normal Karyotype ◽

Older Age ◽

Age Group ◽

Risk Profiles ◽

Mutation Status ◽

Younger Patients ◽

Age Related ◽

Younger Age

Abstract Among the entire patients with AML the majority is 60 years of age or older. In present German multicenter AML Cooperative Group (AMLCG) trial the proportion of these older patients amounts to 54% of all 2734 patients enrolled and receiving intensive chemotherapy. While older age AML is increasingly recognized as a main challenge the therapeutic outcome unlike that in younger patients has remained constantly poor. Thus, the patients of ≥ 60y show an overall survival (OS) of 13% and a relapse rate (RR) of 82% at 5y versus 40% and 52% in younger patients. Age related differences in treatment and in risk profiles are commonly used to explain the differences in outcome. In the AMLCG 99 trial including 2734 patients 16 to 85 (median 61) years of age we investigated factors determining the disease biology and outcome. For induction treatment patients received standard dose TAD and high-dose AraC 3 (age < 60y) and 1 (≥ 60y) g/m² × 6/mitoxantrone (HAM) or randomly HAM-HAM, for consolidation TAD, and for maintenance monthly reduced TAD randomized (in patients < 60y) against autologous SCT. When compared with patients younger than 60y older patients had more frequent secondary AML (29% vs 17%, p< 0.0001), unfavorable cytogenetics (29% vs 23%, p= 0.0004), less frequent favorable cytogenetics (4% vs 12%, p< 0.0001), and NPM1mut/FLT3-ITDneg status (26% vs 34%, p< 0.009) in those with normal karyotype, and overall even lower median WBC (7.360 vs 12.600/μl, p< 0.0001) and LDH (340 vs 413 U/l, p< 0.0001). A multivariate analysis identified independent risk factors determining therapeutic endpoints such as CR rate, OS, RR, and RFS. With similar results across all endpoints, risk factors for OS were age ≥ 60y (HR 1.96, 95% CI 1.75–2.17), AML secondary to MDS or cytotoxic treatment (1.28, 1.14–1.45), unfavorable karyotype (2.17, 1.92– 2.44), WBC > 20×10³/μl (1.15, 1.02– 1.30), LDH > 700U/L (1.32, 1.15– 1.52), favorable karyotype (0.49, 0.38– 0.63) and female gender (0.90, 0.81– 0.99). In the 891 patients with normal karyotype and complete mutation status risk factors for OS were age ≥ 60y (2.00, 1.64– 2.44), and NPM1mut/FLT3-ITDneg (0.39, 0.30– 0.49). Risk factors for RR overall were age ≥ 60y (2.04, 1.75– 2.38), unfavorable karyotype (2.08, 1.47– 2.13), LDH (1.41, 1.16– 1.72) and favorable karyotype (0.40, 0.29– 0.56). In patients with normal karyotype and complete mutation status risk factors for RR were age ≥ 60y (2.00, 1.56– 2.63), and NPM1mut/FLT3-ITDneg (0.32, 0.23– 0.43). Testing the role of older age in favorable subgroups, the 198 patients with CBF leukemia show an OS at 5 years of 27.5 (95% CI 12.0– 43.0) % in the older versus 69.4 (60.7– 78.2) % in the younger age group, and a RR of 56.6 (35.7– 77.3) % versus 25.0 (15.6– 34.4) %. Comparatively, the 264 patients with a normal karyotype and NPM1mut/FLT3-ITDneg show an OS of 37.1 (26.6– 47.5) % in the older versus 71.9 (63.4– 80.4) % in the younger age group, and a RR of 61.0 (47.8– 74.2) % versus 23.0 (14.0– 32.0) %. There was no influence by randomized treatment variables on any therapeutic endpoint. Conclusion: Considering the prognostic spectrum of all major historic or genetic subgroups older age maintains its dominant role not explained by age related differences in risk profiles. Even within CBF leukemias and sole NPM1 mutation as the best prognostic categories older age predicts for markedly shorter OS and higher RR. Thus, understanding older age AML requires further genetic and epigenetic work.

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The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00305 ◽

2017 ◽

Vol 37 (1) ◽

pp. 70-77 ◽

Cited By ~ 7

Author(s):

Asmaa Al-Chidadi ◽

Dorothea Nitsch ◽

Andrew Davenport

Keyword(s):

Peritoneal Dialysis ◽

Serum Sodium ◽

Cox Regression ◽

Strong Association ◽

Age Groups ◽

Older Age ◽

Age Group ◽

Younger Age ◽

Increased Risk ◽

The Uk

Background Studies in hemodialysis patients suggest that hyponatremia is associated with increased mortality. However, results from peritoneal dialysis (PD) patients are discordant. We wished to establish whether there was an association between serum sodium and mortality risk in PD patients. Methods We analyzed 3,108 PD patients enrolled at day 90 of renal replacement therapy (RRT) into the UK Renal Registry (UKRR) data base with available serum sodium measurements (in 3 groups: ≤ 137, 138 - 140, ≥ 141 mmol/L) who were then followed up until death or the censoring date (31 December 2012). Analysis used Cox-regression with adjustment for age, sex, year of starting RRT, primary renal disease, serum albumin, smoking, and comorbidities. Results Unadjusted mortality rates were 118.6/1,000 person-years (py), 83.4/1,000 py, and 83.5/1,000 py for the lowest, middle, and highest serum sodium tertiles, respectively. After adjustment for covariates, patients in the lowest serum sodium group had almost 50% increased risk of dying compared with those with the highest serum sodium (hazard ratio [HR] 1.49, confidence interval [CI]:1.28 - 1.74), with a graded association between serum sodium and mortality. The association of serum sodium with mortality varied by age (p interaction < 0.001), and whilst this association attenuated after adjustment for confounding variables in the older age groups (55 - 64, and > 65 years), it remained in the younger age group of 18 - 54 years (HR 2.24 [1.36 – 3.70] in the lowest compared with the highest sodium tertile). Conclusions Lower serum sodium concentrations at the start of RRT in PD patients are associated with increased risk of mortality. Whilst this association may well be due to confounding in the older age groups, the persistent strong association between hyponatremia and mortality in the younger age group after adjustment for the available confounders suggests that prospective studies are required to assess whether active intervention to maintain serum sodium changes outcomes.

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Stepwise School Opening Online and Off-line and an Impact on the Epidemiology of COVID-19 in the Pediatric Population

10.1101/2020.08.03.20165589 ◽

2020 ◽

Cited By ~ 4

Author(s):

Yoonsun Yoon ◽

Kyung-Ran Kim ◽

Hwanhee Park ◽

So young Kim ◽

Yae-Jean Kim

Keyword(s):

Pediatric Patients ◽

Pediatric Population ◽

Family Members ◽

Press Release ◽

School Closure ◽

Older Age ◽

Age Group ◽

School Students ◽

Younger Age ◽

The Press

Background Data on SARS-CoV-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiologic data on pediatric COVID-19 cases after school opening is warranted. Methods We analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and re-opening policies were achieved from the press release from Korean Ministry of Education. Findings The school openings were delayed three times in March 2020. Online classes started from April 9, and off-line classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases remained around 7.0% to 7.1%. As of July 11, 45 children from 40 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 11,000 students and staff were tested; only one additional student was found to be infected in the same classroom. Among those 45, 32 (71.1%) patients had available information for the source of infection. Twenty-five (25/45, 55.6%) were infected by the family members. The proportions of pediatric patients without information on infection sources were higher in older age group (middle and high school students) than in younger age group (kindergarten and elementary school students) (47.6% vs 12.5%, p=0.010). In the younger age group, 79.1% of children were infected by family members, while only 28.6% of adolescents in the older age group were infected by family members (p<0.001). Interpretation Korea had a successful transition from school closure to re-opening with online and off-line classes. Although partial, off-line school opening did not cause significant school-related outbreak among pediatric population although young children and adolescents may have different epidemiologic features.

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Assessment of Problematic Eating Behaviour and Dental Caries in Children

Balkan Journal of Dental Medicine ◽

10.2478/bjdm-2019-0016 ◽

2019 ◽

Vol 23 (2) ◽

pp. 88-92 ◽

Cited By ~ 1

Author(s):

Harsha Nembhwani ◽

Jasmin Winnier

Keyword(s):

Dental Caries ◽

Eating Behaviour ◽

The Body ◽

Older Age ◽

Age Group ◽

Younger Age ◽

Wide Range ◽

Group 6 ◽

Problematic Eating ◽

Group B

Summary Background/Aim: Eating behaviour in children has wide range from anorexia, to selective eating, fussy eater, neophobic/pouching of food & slow eating. Eating behaviour in childhood has been implicated in the development of dental caries and further affecting the body mass index of the child. The aim was to assess the Problematic Eating Behaviour (PEB) and its association with dental caries status of the child. Material and Methods: Parents of 150 children between 3-8 years of age were divided into 2 groups, Group A (3-5 years) and Group B (6-8 years). The parents completed the Children’s Eating Behaviour Questionnaire (CEBQ) & the child’s dental caries status was recorded. The collected data was subjected to statistical analysis using unpaired t test & Pearson’s correlation coefficient test. Results: The results showed that the dental caries status was significantly higher in younger age group (3-5 years) than older age group (6-8 years). Further evaluating the PEB using CEBQ, there was no significant relation found between PEB and dental caries in younger age group of children (3-5 years), but in the older age group (6-8 years) the Factor 4 Desire to Drink (p=0,274) and Factor 5 Satiety Responsiveness (p=0,291) were significantly associated to the dental caries. Conclusions: Eating behaviour can contribute to the development of caries and this has been successfully studied with the use of CEBQ in the present study.

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Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Minimally Invasive Surgery ◽

10.1155/2018/5828071 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Natalie De Cure ◽

Stephen J. Robson

Keyword(s):

Age Groups ◽

Laparoscopic Hysterectomy ◽

Abdominal Hysterectomy ◽

Population Based ◽

Incidence Rates ◽

Older Age ◽

Age Group ◽

Female Population ◽

Younger Women ◽

Younger Age

Objective. Hysterectomy rates have fallen over recent years and there remains debate whether salpingectomy should be performed to reduce the lifetime risk of ovarian cancer. We examined trends in adnexal removal and route of hysterectomy in Australia between 2001 and 2015. Methods. Data were obtained from the national procedural dataset for hysterectomy approach (vaginal, VH; abdominal, AH; and, laparoscopic, LH) and rates of adnexal removal, as well as endometrial ablation. The total female population in two age groups (“younger age group,” 35 to 54 years, and “older age group,” 55 to 74 years) was obtained from the Australian Bureau of Statistics. Results. The rate of hysterectomy fell in both younger (61.7 versus 45.2/10000/year, p<0.005) and older (38.8 versus 33.2/10000/year, p<0.005) age groups. In both age groups there were significant decreases in the incidence rates for VH (by 53% in the younger age group and 29% in the older age group) and AH (by 53% and 55%, respectively). The rates of LH increased by 153% in the younger age group and 307% in the older age group. Overall, the proportion of hysterectomies involving adnexal removal increased (31% versus 65% in the younger age group, p<0.005; 44% versus 58% in the older age group, p<0.005). The increase occurred almost entirely after 2011. Conclusion. Hysterectomy is becoming less common, and both vaginal and abdominal hysterectomy are being replaced by laparoscopic hysterectomy. Removal of the adnexae is now more common in younger women.

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