scholarly journals Different disease characteristics in young patients with colorectal cancer: a large retrospective study in a city in Romania

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110166
Author(s):  
Adelina Gheju ◽  
Aura Jurescu ◽  
Sorina Tăban ◽  
Diana Al-Jobory ◽  
Fulger Lazăr ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Young Patients ◽  
Younger Adults ◽  
Disease Characteristics ◽  
Age Related ◽  
Residence Location ◽  
Group 2 ◽  
Microscopic Findings ◽  
Large Retrospective Study ◽  
Group 1

Objective In 2018, colorectal cancer (CRC) was the second most frequent malignancy in Romania after lung cancer. Although CRC is typically encountered in patients >50 years old, CRC's global incidence among younger adults has been increasing. We aimed to compare the disease characteristics of patients with CRC aged ≤50 years with those >50 years old. Methods We retrospectively evaluated data from patients with CRC who underwent standard surgery at “Pius Brinzeu” Emergency County Hospital, Timisoara, Romania. Patients were divided into two groups: Group 1 (patients ≤50 years old) and Group 2 (patients >50 years old). Six parameters were analyzed (sex, residence location, age, tumor localization, microscopic findings, pathological staging). Results Data on age-related CRC were available for 1380 patients treated from January 2012 to December 2018. Group 1 included 120 patients while group 2 included 1260 patients. Significantly more Group 1 patients presented with advanced CRC compared with Group 2 patients (94.2% vs. 87.4%). Furthermore, CRC in younger adults was more likely to be diagnosed at an advanced stage. Conclusions Monitoring the CRC incidence in younger adults is essential to assess whether screening practices require changes and to raise awareness among clinicians of the increasing CRC incidence among younger patients.

scholarly journals Clinical and phenotypic variants of hereditary and sporadic colorectal cancer in young patients

2021 ◽  
Vol 60 (2) ◽  
pp. 9-21
Author(s):  
G. A. Afonin ◽  
N. A. Baltayev ◽  
D. R. Kaidarova ◽  
А. К. Ababakriyev ◽  
P. B. Kalmenova
Keyword(s):  
Colorectal Cancer ◽  
Young People ◽  
Young Patients ◽  
Response To Therapy ◽  
Sporadic Colorectal Cancer ◽  
Upward Trend ◽  
Primary Tumors ◽  
The Republic ◽  
Group 2 ◽  
Group 1

Relevance: In the Republic of Kazakhstan, colorectal cancer (CRC) ranks third in the structure of oncological pathology. In 2008-2019, the CRC incidence in the Republic was growing each year. There is an upward trend in CRC incidence among young people. Cohort studies show that, in young patients, CRC is characterized by distal localization of the tumor process, advanced stages of the disease, an aggressive course, and low tumor differentiation. The known association of phenotypic signs with clinical characteristics of the disease, such as the response to therapy and survival rates, urges addressing this problem. The phenotypic and molecular genetic aspects of CRC in young people have not been systematically studied in Kazakhstan. The purpose of the study was to compare the phenotypic features of hereditary and sporadic colorectal cancer in young patients and patients over 65 years. Results: The study involved 185 patients aged 17 to 50 years (Group 1) and 112 patients aged 65 to 85 (Group 2). In Group 1, a locally advanced process (stage III) was 14.8% more often than in Group 2; stage IV was 1.23 times more common in men; and multiple primary tumors were 3.1% more often, with a prevailing metachronous course. In Groups 1 & 2, most tumors were localized in the rectum; 84.8% and 78.6% of tumors, respectively, occurred in the left half of the colon. The frequency of right-sided tumors increased with age modified by gender (in Group 2). Hereditary burdened anamnesis was detected in 14.6% patients before 50 (6.57% more than in Group 2); family history of CRC – in 4.8% patients. The latter is consistent with published data. The studied syndromic variants met the diagnostic criteria for familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, and familial type X colorectal cancer. Conclusion: The increase in CRC incidence at the age of 50-70 years is explained by the effectiveness of screening. However, the upward trend for the age below 50 needs a detailed study of etiological (dietary, environmental, behavioral, hereditary) factors. Effective early diagnostics requires considering the phenotypic characteristics and hereditary history associated with a high risk of CRC onset.

scholarly journals Clinical and phenotypic variants of hereditary and sporadic colorectal cancer in young patients

2021 ◽  
Vol 60 (2) ◽  
pp. 9-21
Author(s):  
G. A. Afonin ◽  
N. A. Baltayev ◽  
D. R. Kaidarova ◽  
P. B. Kalmenova
Keyword(s):  
Colorectal Cancer ◽  
Young Patients ◽  
Response To Therapy ◽  
Published Data ◽  
Sporadic Colorectal Cancer ◽  
Upward Trend ◽  
Primary Tumors ◽  
The Republic ◽  
Group 2 ◽  
Group 1

Relevance: In the Republic of Kazakhstan, colorectal cancer (CRC) ranks third in the structure of oncological pathology. In 2008-2019, the CRC incidence in the Republic was growing each year. There is an upward trend in CRC incidence among young people. Cohort studies show that, in young patients, CRC is characterized by distal localization of the tumor process, “late” stages of the disease, an aggressive course, and low tumor differentiation. The known association of phenotypic signs with clinical characteristics of the disease, such as the response to therapy and survival rates, urges addressing this problem. The phenotypic and molecular genetic aspects of CRC in young people have not been systematically studied in Kazakhstan. The purpose of the study was to compare the phenotypic features of hereditary and sporadic colorectal cancer in young patients and patients over 65 years. Results: The study involved 185 patients aged 17 to 50 years (Group 1) and 112 patients aged 65 to 85 (Group 2). In Group 1, a locally advanced process (stage III) was 14.8% more often than in Group 2; stage IV was 1.23 times more common in men; and multiple primary tumors were 3.1% more often, with a prevailing metachronous course. In Groups 1 & 2, most tumors were localized in the rectum; 84.8% and 78.6% of tumors, respectively, occurred in the left half of the colon. The frequency of right-sided tumors increased with age modified by gender (in Group 2). Hereditary burdened anamnesis was detected in 14.6% patients before 50 (6.57% more than in Group 2); family history of CRC – in 4.8% patients. The latter is consistent with published data. The studied syndromic variants met the diagnostic criteria for familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, and familial type X colorectal cancer. Conclusion: The increase in CRC incidence at the age of 50-70 years is explained by the effectiveness of screening. However, the upward trend for the age below 50 needs a detailed study of etiological (dietary, environmental, behavioral, hereditary) factors. Effective early diagnostics requires considering the phenotypic characteristics and hereditary history associated with a high risk of CRC onset

Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals Comparing Five Year Out-Come in Two Cohorts of Patients with Early Rheumatoid Arthritis – A BARFOT Study

2015 ◽  
Vol 9 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Maria L.E Andersson ◽  
Kristina Forslind ◽  
Ingiäld Hafström
Keyword(s):  
Prospective Observational Study ◽  
Disease Activity Score ◽  
Disease Duration ◽  
Disease Onset ◽  
Health Assessment ◽  
Disease Characteristics ◽  
Group 2 ◽  
Assessment Questionnaire ◽  
Group 1

The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively. Methods : All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6. Results : At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point. Conclusion : Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.

scholarly journals Occlusion and Disocclusion Time Analysis in Young Patients Affected by Bruxism

Folia Medica ◽  
2021 ◽  
Vol 63 (3) ◽  
pp. 400-404
Author(s):  
Tanya Bozhkova
Keyword(s):  
Young Adults ◽  
Oral Cavity ◽  
Young Patients ◽  
Control Group ◽  
System Software ◽  
Time Analysis ◽  
Diagnostic Device ◽  
Jaw Muscles ◽  
Group 2 ◽  
Group 1

Introduction: Bruxism&nbsp;is an involuntary&nbsp;parafunctional&nbsp;habit performed unconsciously during sleep by the jaw muscles in which the tooth rows are pressed against each other and move horizontally. The symptoms in the oral cavity are slightly elusive which makes it difficult to diagnose.Aim: The aim of this study was to analyze the occlusion and disocclusion times in young adults affected by bruxism compared with healthy subjects.Materials and methods: Thirty-four patients (15 men and 19 women) aged between 20-25 years were included in the study. They were allocated into two groups: group 1 &ndash; controls (n=13), and group 2 &ndash; patients who reported clenching or grinding their teeth (n=21). The study was conducted using a T-Scan Novus occlusion diagnostic device. The results obtained for the occlusion and disocclusion times were analyzed using the latest version of the T-Scan system software (ver. 9.1). The values for occlusion and disocclusion times of all subjects were recorded in the T-Scan.Results: The occlusion times in the control group were found to be longer than those in the bruxism group. The disocclusion times of the subjects in group 1 were found to be shorter than those in group 2.Conclusions: The T-Scan system makes it possible to quantify the occlusion and disocclusion times, which helps to diagnose an initial form of bruxism in individuals at a young age.

scholarly journals The effect of hormonal disbalance on the aging rate change in the patients with arterial hypertension and comorbid endocrinopathies

2019 ◽  
Vol 23 (2) ◽  
pp. 277-282
Author(s):  
V. D. Nemtsova ◽  
I. A. Ilchenko ◽  
V. V. Zlatkina
Keyword(s):  
Arterial Hypertension ◽  
Premature Aging ◽  
Endocrine Disorders ◽  
Anthropometric Parameters ◽  
Aging Rate ◽  
Age Related ◽  
Number Of Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Due to the growing number of patients with age-related diseases, the aim of the study was to investigate in the changes of aging rate (AR) in patients with comorbid course of arterial hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SH) and to study the features of these changes depending on hormonal imbalance. 118 patients (63 women and 55 men, average age — 53.6±4.3 years) were divided into 3 groups: group 1 (n=37) with isolated H; group 2 (n=42) — with H and T2DM; group 3 (n=39) — with H, T2DM and SH. The investigation program included: measurement of anthropometric parameters (blood pressure, height, body weight (BW), body mass index (BMI)), carbohydrate and thyroid metabolism using standard methods, biological age (BA) by V.P. Voitenko et al. Statistical processing was performed using the Statistica for Windows 8.0 software package. When evaluating AR, physiological aging was found in 8 patients (21.6%) of group 1, in 4 (9.5%) patients of group 2 and 3 (7.7%) of patients in group 3. In the overwhelming majority of the examined patients, premature aging (PA) was noted, however, the acceleration of PA between patients of groups 2 and 3 was not differ significantly (p>0.05). The increase in AR in group 2 patients was accompanied by an increase in BA by 7.2 years, in 3 group patients — by 7.3 years compared with their chronological age. A correlation analysis revealed a positive relationship between BMI and coefficient of aging rate (CAR) (r=0.679; p<0.05); BMI and BA (r=0.562; p<0.05) and CAR and the TSH level (r=0.050; p=0.388) in the 3rd group. Thus, the presence of hypertension and comorbid endocrinopathies — T2DM and SH significantly increases the AR and when assessing the effect of endocrine disorders, the presence of T2DM is more important than SH.

scholarly journals Screening for MELAS mutations in young patients with stroke of undetermined origin

2007 ◽  
Vol 65 (2b) ◽  
pp. 371-376 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Fabio Iuji Yamamoto ◽  
Sueli Mieko Oba-Shinjo ◽  
Julio Guy C. Pinto ◽  
Maurício Hoshino ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Healthy Subjects ◽  
Young Patients ◽  
Clinical Findings ◽  
Melas Syndrome ◽  
Mitochondrial Mutations ◽  
A3243g Mutation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PURPOSE: It has been suggested that mitochondrial disease may be responsible for a substantial proportion of strokes of indetermined origin. We have preliminarily screened for MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) mutations in young patients with cryptogenic strokes. METHOD: The mitochondrial mutations A3243G and T3271C were investigated in 38 subjects aged less than 46 years. Group 1: 15 patients with cryptogenic strokes; Group 2: 3 patients with diagnosis of MELAS syndrome, including stroke-like episodes; Group 3: 20 healthy subjects. RESULTS: The A3243G mutation was absent in all subjects in Groups 1 and 3 but was present in all subjects in Group 2. CONCLUSION: Our results do not support screening for these mutations to diagnose oligosymptomatic forms of MELAS in cryptogenic strokes in the absence of other features of the syndrome. We suggest that clinical findings should guide mitochondrial genetic testing.

Comparison of two tests to recognize or exclude 5α-reductase deficiency in prepubertal children

1987 ◽  
Vol 114 (1) ◽  
pp. 113-117 ◽  
Author(s):  
S. Greene ◽  
M. Zachmann ◽  
B. Manella ◽  
V. Hesse ◽  
W. Hoepffner ◽  
...  
Keyword(s):  
Testosterone Propionate ◽  
Physiological Age ◽  
Plasma Testosterone ◽  
Prepubertal Children ◽  
Reductase Deficiency ◽  
Age Related ◽  
Significant Difference ◽  
Group 2 ◽  
5Α Reductase Deficiency ◽  
Group 1

Abstract. Plasma testosterone (T, nmol/l) and dihydrotestosterone (DTH, nmol/l) were measured in 54 children and young adults with male pseudohermaphroditism (46XY, no defect of steroid biosynthesis) 4 h after im injection of testosterone propionate (25 mg/m2, group 1, N = 18), or before and 2, 4 and 6 days after hCG (5000 IU/m2 im, group 2, N = 36). The response to hCG was also studied in 5 control children (unilateral cryptorchidism, group 3) and that to testosterone propionate in a gonadectomized child with confirmed 5α-reductase deficiency. Mean T (133.1 ± 14.0, sem) and DHT (17.1 ± 2.6) in group 1 were higher than in group 2 (17.3 ± 2.1 and 2.9 ± 0.4), but there was not significant difference in the T/DHT ratios (group 1: 10.7 ± 2.0; group 2: 7.2 ± 0.6). Following testosterone-propionate, there was a negative correlation of T with age (r = −0.723). After hCG, T and DHT were lower in the prepubertal children than in those under 2 or over 10 years, and the T/DHT-ratio rose with age. Two children from group 1 had a T/DHT-ratio above 18, but urinary aetiocholanolone/androsterone (Ae/A) ratios were normal. In the child with 5α-reductase deficiency, the T/DHT ratio was 60, and the urinary Ae/A ratio high. We concluded that the two tests are suitable for confirming or excluding 5α-reductase deficiency in prepubertal children, in whom basal DHT is too low for evaluation, but that physiological age-related changes in 5α-reductase activity have to be taken into consideration.

Effect of Antagonism at Central Nervous System M3 Muscarinic Receptors on Laryngeal Chemoresponse

1997 ◽  
Vol 106 (11) ◽  
pp. 920-926 ◽  
Author(s):  
Brent E. Richardson ◽  
Kerri J. Pernell ◽  
George S. Goding
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Messenger Rna ◽  
Sudden Infant ◽  
Respiratory Drive ◽  
Age Related ◽  
M3 Receptors ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The laryngeal chemoresponse (LCR), comprising laryngeal adductor spasm, central apnea, and subsequent cardiovascular instability, is thought to be a factor in sudden infant death syndrome. A muscarinic subtype receptor, M3, appears to be involved in central respiratory drive and control. Both the duration of the LCR apnea and levels of M3 receptor messenger RNA in the brain stem change according to postnatal age. This study examined the effect of central nervous system antagonism at M3 receptors on the LCR with respect to animal age and dose of antagonist. Ten piglets in each of three age groups (group 1, 5 to 8 days; group 2, 18 to 21 days; and group 3, 40 to 43 days) received a series of four increasing doses of an M3 antagonist ( p-fluoro-hexahydro-siladiphenidol) by intracerebral ventricle injection. The LCR was evoked at baseline and after each dose of antagonist. An effect on susceptible animals (groups 1 and 2) was evident by the second antagonist dose, and persisted for the remainder of the experiment (2 hours). At completion of the experiment, mean apnea duration had decreased in group 1 (61%, p < .05), and group 2 (57%, p < .05), but was unchanged in group 3 (<10%, p not significant). Length of mean baseline apneas correlated directly with degree of apnea shortening. The reduction is not attributable to changes in arterial Po2 or Pco2 or baseline respiratory rate. These results support an age-related influence on the LCR by M3 receptors in younger animals that decreases with maturation.

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