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1.
Although the literature reports that occlusal disorders can be associated with temporomandibular disorders (TMD), their direct scientific correlation is still mainly unproved. The aim of this study was to establish the incidence of symptoms and signs of TMD and tissue-specific diagnoses in a population of subjects with tooth loss in the supporting zones. The study was conducted on 196 partially edentulous subjects (Eichner's class II and III) at the average age of 51.2. Manual functional analysis was used as a diagnostic procedure. Chi-square test for independent samples was used for establishing the significance of the differences between the variables. In the total sample, 16.3% of the subjects had symptoms and signs of temporomandibular disorders (TMD), while in 46.9% of the subjects a tissue-specific diagnosis of TMD was found. The most frequent tissue-specific diagnoses were osteoarthrosis and total or partial anterolateral disc displacement. A statistically significant difference between Eichner's class II and III was found for the tissue-specific diagnoses of myofascitis of the lateral pterygoid muscle, partial anterolateral disc displacement and capsulitis. The results of this study suggest that the incidence and intensity of TMD are higher in subjects with greater tooth loss in the supporting zones, regardless of their sex. 相似文献
2.
Background
Anxiety is common, with significant morbidity, but little is known about presentations and recording of anxiety diagnoses and symptoms in primary care. This study aimed to determine trends in incidence and socio-demographic variation in General Practitioner (GP) recorded diagnoses of anxiety, mixed anxiety/depression, panic and anxiety symptoms.Methodology/Principal Findings
Annual incidence rates of anxiety diagnoses and symptoms were calculated from 361 UK general practices contributing to The Health Improvement Network (THIN) database between 1998 and 2008, adjusted for year of diagnosis, gender, age, and deprivation. Incidence of GP recorded anxiety diagnosis fell from 7.9 to 4.9/1000PYAR from 1998 to 2008, while incidence of anxiety symptoms rose from 3.9 to 5.8/1000PYAR. Incidence of mixed anxiety/depression fell from 4.0 to 2.2/1000PYAR, and incidence of panic disorder fell from 0.9/1000PYAR in 1998 to 0.5/1000PYAR in 2008. All these entries were approximately twice as common in women and more common in deprived areas. GP-recorded anxiety diagnoses, symptoms and mixed anxiety/depression were commonest aged 45–64 years, whilst panic disorder/attacks were more common in those 16–44 years. GPs predominately use broad non-specific codes to record anxiety problems in the UK.Conclusions/Significance
GP recording of anxiety diagnoses has fallen whilst recording of anxiety symptoms has increased over time. The incidence of GP recorded diagnoses of anxiety diagnoses was lower than in screened populations in primary care. The reasons for this apparent under-recording and whether it represents under-detection in those being seen, a reluctance to report anxiety to their GP, or a reluctance amongst GPs to label people with anxiety requires investigation. 相似文献3.
ObjectiveTo study the impact of the COVID-19 pandemic and consequent lockdown on the number of diagnoses of gynaecological malignancies in the Netherlands.MethodsWe performed a retrospective cohort study using data from the Netherlands Cancer Registry (NCR) on women of 18 years and older diagnosed with invasive endometrial, ovarian, cervical or vulvar cancer in the period 2017–2021. Analyses were stratified for age, socioeconomical status (SES) and region.ResultsThe incidence rate of gynaecological cancer was 67/100.000 (n = 4832) before (2017–2019) and 68/100.000 (n = 4833) during (2020) the COVID-19 pandemic. Comparing the number of diagnoses of the two periods for the four types of cancer separately showed no significant difference. During the first wave of COVID-19 (March-June 2020), a clear decrease in number of gynaecological cancer diagnoses was visible (20–34 %). Subsequently, large increases in number of diagnoses were visible (11–29 %). No significant differences in incidence were found between different age groups, SES and regions. In 2021 an increase of 5.9 % in number of diagnoses was seen.ConclusionIn the Netherlands, a clear drop in number of diagnoses was visible for all four types of gynaecological cancers during the first wave, with a subsequent increase in number of diagnoses in the second part of 2020 and in 2021. No differences between SES groups were found. This illustrates good organisation of and access to health care in the Netherlands. 相似文献
4.
OBJECTIVE--To establish the incidence of maxillary sinusitis in general practice and the predictive value of symptoms and signs. DESIGN--Population based study. SETTING--9 general practices with 15,220 patients aged 15 years and older on the list. PATIENTS--400 patients with 441 episodes in whom practitioners intended to confirm or to exclude sinusitis. MAIN OUTCOME MEASURES--Results of ultrasonography and signs and symptoms associated with positive results. RESULTS--212 of the 441 episodes were confirmed by ultrasonography. 15.7 episodes occurred per 1000 adults per year. The five symptoms beginning with common cold (beta coefficient = 1.035), purulent rhinorrhoea (0.996), pain at bending (0.950), unilateral maxillary pain (0.640), and pain in teeth (0.606) were associated with positive results on ultrasonography. General practitioners'' clinical diagnoses were correct in 177 episodes, false positive in 88, false negative in 22, and uncertain in 154. With an algorithm using the five weighted symptoms 243 of the diagnoses would have been correct, but 110 would remain uncertain and 44 cases would have been missed. CONCLUSION--The five symptoms algorithm would improve diagnostic accuracy of general practitioners, but incorrect and uncertain diagnoses cannot be avoided. 相似文献
5.
C A Charlton A Crowther J G Davies J Dynes M W Haward P G Mann S Rye 《BMJ (Clinical research ed.)》1976,1(6002):124-126
The length of a course of antibiotic treatment for urinary tract infection varies with the habits of the prescriber. Many patients do not complete a course of treatment once their symptoms have subsided. In uncomplicated urinary tract infection among women seen in general practice a three-day course of amoxycillin was as effective as a 10-day course of the same drug in the same dose. Relief of symptoms was equal in both groups and bacteriuria was eliminated equally successfully in both regimens. There was no significant difference between the two groups in the incidence of side effects from the drugs. The financial saving which could accrue from adopting this therapeutic regimen would be significant. 相似文献
6.
Birgitta S?der Leif C. Andersson Jukka H. Meurman Per-?sten S?der 《Philosophical transactions of the Royal Society of London. Series B, Biological sciences》2015,370(1661)
We investigated statistical association between gingival inflammation and cancer in a group of patients followed up for 26 years with the hypothesis that gingival inflammation affects carcinogenesis. Altogether, 1676 30- to 40-year-old subjects from Stockholm were clinically examined in 1985. In 2011, we compared the baseline oral examination and follow-up data with cancer diagnoses sourced from the Swedish national hospital register databases. Of 1676 individuals, 89 (55 women, 34 men) had got cancer by the year 2011. Women were found to be at higher risk for cancer than men. Smoking (expressed in pack-years) had been more prevalent in the cancer group than in those with no cancer diagnosis. Gingival index, marker of gingival inflammation, was higher in the cancer group than in subjects with no cancer. There were no significant differences between the groups regarding age, education, dental plaque and calculus index scores, or in the number of missing teeth. In multiple logistic regression analysis with cancer as the dependent variable and several independent variables, pack-years of smoking appeared to be a principal independent predictor with odds ratio (OR) 1.32 while gingival inflammation showed OR 1.29. Hence, our present findings showed that together with smoking, gingival inflammation indeed associated with the incidence of cancer in this cohort. 相似文献
7.
《Endocrine practice》2023,29(8):618-622
ObjectiveCase reports of postvaccine early-onset Graves’ hyperthyroidism (PVGD) after the administration of COVID-19 vaccination have emerged. Our aim was to investigate whether the incidence of Graves’ hyperthyroidism (GD) has increased after the introduction of COVID-19 vaccination.MethodsWe compared the incidence of new-onset GD at a single academic center during 2 periods: December 2017 to October 2019 and December 2020 to October 2022, ie, before and after the implementation of COVID-19 vaccinations. We defined PVGD as laboratory-confirmed hyperthyroidism and GD within 4 weeks after the vaccination or clear onset of symptoms of thyrotoxicosis within 4 weeks of vaccination with evidence of hyperthyroidism and GD within 3 months.ResultsDuring the prevaccination period, 803 patients carried diagnoses of GD, and of these, 131 were new. During the postvaccination period, 901 patients carried diagnoses of GD, and of these, 138 were new. There was no statistically significant difference in the incidence of GD (P = .52), age at onset, gender, or race between the 2 groups. Twenty-four of 138 newly diagnosed patients in the post–COVID-19 group met the criteria for PVGD. The median free T4 was higher, but this was not statistically significant (3.9 vs 2.5 ng/dL, P = .05). There were no differences in age, gender, race, antibody titers, or type of vaccination between PVGD and controls.ConclusionThere was no increase in new-onset GD after COVID-19 vaccination. Median free T4 was higher in patients with PVGD, but this was not statistically significant. 相似文献
8.
S C Darby G M Kendall T P Fell J A O'Hagan C R Muirhead J R Ennis A M Ball J A Dennis R Doll 《BMJ (Clinical research ed.)》1988,296(6618):332-338
Altogether 22 347 men who participated in the United Kingdom''s atmospheric nuclear weapon tests and experimental programmes in Australia and the Pacific Ocean between 1952 and 1967 were identified from the archives of the Ministry of Defence and followed up. Their mortality and incidence of cancer were compared with those in 22 326 matched controls selected from the same archives. The risk of mortality in the participants relative to that in the controls was 1·01 for all causes and 0·96 for all neoplasms. Thirty eight causes of death were examined separately. Significant differences in mortality were found for leukaemia, multiple myeloma, and other injury and poisoning, with higher rates in the participants, and for cancers of the prostate and kidney and chronic bronchitis, with higher rates in the controls. The mortality from leukaemia and multiple myeloma in the participants was slightly greater than would have been expected from national values (standardised mortality ratios of 113 and 111, respectively), but in the controls it was substantially lower (standardised mortality ratios of 32 and 0, respectively). Examination of the rates of leukaemia and multiple myeloma in groups of participants showed very little difference between groups characterised by recorded doses of external radiation or type of test participation and failed to indicate any specific hazard. Evidence obtained from participants who reported themselves voluntarily (or were reported by relatives or friends) suggested that 17% of participants may have been omitted from the main study group but that any resulting bias was small.Most of the differences observed between the participants and controls were interpreted as due to chance, but some may be due to differences in smoking habits. Participation in the test programme did not seem, in itself, to have caused any detectable effect on the participants'' expectation of life, apart from possibly causing small risks of developing leukaemia and multiple myeloma. 相似文献
9.
BackgroundIncidental and non-incidental papillary microcarcinomas (PMC) are associated with different outcomes and treatment options may vary. The least favourable outcome is typically seen when carcinoma is suspected prior to surgery. Only a few studies have addressed the prognosis based on the way of detection for PMC, and they have been limited to retrospective single-center studies. We hypothesize that the “way of detection” may predict prognosis.The aim was to calculate the incidence and outcome of PMC based on the way of detection and to identify patients that may be suitable for active surveillance.MethodThis national cohort study consists of 803 patients diagnosed with PMC in Denmark from 1996 to 2015. Patients were identified from the DATHYRCA database and allocated into groups according to the way of detection leading to surgery: Incidental at surgery (n = 527), non-incidental with symptoms suspected from the index tumor (n = 134) and non-incidental with symptoms suspected from a metastasis (n = 142).ResultsAge-standardized incidence rates increased from 0.35 per 100,000 per year in 1996 to 1.19 per 100,000 per year in 2015. A significant rise in incidence was found for both the incidental group and non-incidental group with symptoms suspected from a metastasis. Recurrence free survival was significantly worse for patients with suspicion of metastasis prior to surgery than patient groups without. No difference in mortality was found between groups.ConclusionPMC patients without suspicion of metastasis have the same low risk of recurrence as incidental cases and may be candidates for active surveillance. 相似文献
10.
G. Lindsay McCrea Christine Miaskowski Nancy A. Stotts Liz Macera Steven M. Paul Madhulika G. Varma 《Gender Medicine》2009,6(1):259-271
Objectives: This study assessed gender differences in the frequency of various characteristics of constipation, constipation-specific symptoms, and bowel and dietary habits, as well as the effects of independent but associated risk factors.Methods: A cross-sectional study of patients aged ≥18 years with a primary diagnosis of constipation (ie, constipation, slow-transit constipation, outlet dysfunction constipation) was conducted at a tertiary referral center; patients were excluded if they had a primary diagnosis of fecal incontinence. Patients completed both a clinical questionnaire to obtain information on demographic characteristics and medical history and an unvalidated self-report questionnaire relating to the characteristics and symptoms of constipation as well as various bowel and dietary habits. Likert scales were used to assess 4 characteristics of constipation (frequency of constipation, duration of constipation symptoms of ≥1 month, bowel movement frequency, stool consistency) and the frequency of occurrence of 6 constipation symptoms (abdominal pain, abdominal bloating, incomplete evacuation, unsuccessful attempts at evacuation, pain with evacuation, straining with evacuation). The bowel habits that were evaluated included time spent at each evacuation; frequency of needing to change position to evacuate; use of anal digitation to evacuate; and the use of laxatives, enemas, stool softeners, foods, drinks, or other aids. The dietary habits that were evaluated included use of dietary fiber, use of fiber supplements, and water intake.Results: Of the 518 patients, the majority were female (79.0%), white (76.3%), and employed (62.0%), with a mean (SD) age of 52.4 (16.5) years (range, 18.6–91.5 years). After controlling for a number of related conditions, women were more likely than men to have infrequent bowel movements (adjusted odds ratio [AOR] = 2.97; 95% CI, 1.67–5.28), abnormal stool consistency (ie, hard or pelletlike stools) (AOR = 3.08; 95% CI, 1.80–5.28), and a longer duration of constipation symptoms (AOR = 2.00; 95% CI, 1.05–3.82). In addition, women were more likely to report an increased frequency of occurrence of abdominal pain (AOR = 2.22; 95% CI, 1.22–4.05), bloating (AOR = 2.65; 95% CI, 1.50–4.70), unsuccessful attempts at evacuation (AOR = 1.74; 95% CI, 1.01–3.00), and the use of anal digitation to evacuate stool (AOR = 3.37; 95% CI, 1.15–9.90).Conclusions: The women in this specialty-based clinic study experienced a number of constipation symptoms and abnormal bowel habits more frequently than did men. These findings warrant replication in both population- and specialty clinic-based samples. In addition, the physiologic mechanisms that underlie these gender differences warrant investigation. 相似文献
11.
IntroductionIt has been suggested that fluoride in drinking water may increase the risk of osteosarcoma in children and adolescents, although the evidence is inconclusive. We investigated the association between community water fluoridation (CWF) and osteosarcoma in childhood and adolescence in the continental U.S.MethodsWe used the cumulative osteosarcoma incidence rate data from the CDC Wonder database for 1999–2006, categorized by age group, sex and states. States were categorized as low (≤30%) or high (≥85%) according to the percentage of the population receiving CWF between 1992 and 2006. Confidence intervals for the incidence rates were calculated using the Gamma distribution and the incidence rates were compared between groups using Poisson regression models.ResultsWe found no sex-specific statistical differences in the national incidence rates in the younger groups (5–9, 10–14), although 15–19 males were at higher risk to osteosarcoma than females in the same age group (p < 0.001). Sex and age group specific incidence rates were similar in both CWF state categories. The higher incidence rates among 15–19 year old males vs females was not associated with the state fluoridation status. We also compared sex and age specific osteosarcoma incidence rates cumulated from 1973 to 2007 from the SEER 9 Cancer Registries for single age groups from 5 to 19. There were no statistical differences between sexes for 5–14 year old children although incidence rates for single age groups for 15–19 year old males were significantly higher than for females.ConclusionOur ecological analysis suggests that the water fluoridation status in the continental U.S. has no influence on osteosarcoma incidence rates during childhood and adolescence. 相似文献
12.
We conducted a case-control study to test the hypothesis that women smokers who use oral contraceptives have an increased risk of developing venous thrombosis. Patients and controls were drawn from two sets of hospital patients already included in the Boston Collaborative Drug Surveillance Programme. Sixty patients with uncomplicated thromboembolism were matched with 180 controls with other diagnoses; all were premenopausal women taking oral contraceptives. Patients with conditions that might predispose to thromboembolism or be related to smoking were excluded. We found no association between smoking habits and thromboembolism. Similarly, we found no association between thromboembolism, smoking, and duration of oral contraceptive use. Thus we conclude that differences in fibrinolytic activity between smokers and non-smokers are not major factors in the aetiology of uncomplicated thromboembolism in women using oral contraceptives. 相似文献
13.
Factors contributing to differences in the prevalences of respiratory symptoms and diseases among ethnic groups were studied in primary schoolchildren living in 20 inner city areas of England in 1983. The raised prevalences of respiratory symptoms in these groups were compared with results from a national representative sample of children studied in 1982. Data on age, sex, respiratory illness, and social and environmental variables were obtained by questionnaire for 4815 children living in inner cities. The children were classified as white, Afro-Caribbean, Urdu, Gujarati, Punjabi, other Asian, or “other.” Significant differences in the prevalence of respiratory conditions were found among the ethnic groups after allowance was made for the effects of interfering variables. Except for asthma all conditions were most prevalent in Afro-Caribbeans and whites. In these two ethnic groups respiratory illness was significantly associated with belonging to a one parent family and the combined use of gas cookers and paraffin heaters at home.Respiratory illness was found to vary in prevalence among ethnic groups but may be perceived differently by different groups. Further studies, measuring lung function, are necessary. 相似文献
14.
The incidence of anoestrus, suboestrus, delayed ovulation, cystic ovaries, repeat breeder cows, endometritis and other forms of infertility was studied in 283 herds over a period of eight years (2,304 cases). The total incidence of infertility (0.111 cases per cow per year) varied significantly from year to year. The peak of the seasonal variation occurred in December-April and did not correspond with the seasonal variation in calving. Both the size of herd and the type of housing affected the incidence of infertility, but the differences were great in respect of the various diagnoses. The incidence of ketosis by herd correlated significantly with the incidence of infertility by herd. 相似文献
15.
This international multicentre, open-label, parallel-group trial was undertaken to compare the therapeutic efficacy and tolerability of topical levocabastine and oral cetirizine in patients with perennial allergic rhinoconjunctivitis, with particular reference to the comparative onset of action of the two drugs. A total of 207 patients were randomized to receive either levocabastine nasal spray (0.5 mg/ml, two sprays in each nostril twice daily) plus levocabastine eye drops as required (0.5 mg/ml, one drop in each eye twice daily p.r.n.) or cetirizine orally (10 mg once daily) with a treatment duration of 2 weeks. Onset of action was found to be significantly more rapid with levocabastine than with cetirizine for both nasal and ocular symptoms (p < 0.001). Within 15 min of study drug administration, 36% of levocabastine-treated patients reported relief from nasal symptoms and 32% relief from ocular symptoms compared with 10% and 17% of patients on cetirizine, respectively. At 1 h, the percentages of patients reporting relief were 76% and 38% for nasal symptoms, and 81% and 48% for ocular symptoms in the levocabastine and cetirizine treatment groups, respectively. At 8 h there were no differences between the two treatments. Overall therapeutic efficacy was found to be comparable in the two treatment groups over the 2-week study period with no significant intergroup differences in symptom severity or global therapeutic efficacy. Both drugs were well tolerated with no significant differences in the incidence or type of adverse reactions between the two groups. In conclusion, levocabastine eye drops and nasal spray are as effective and well tolerated as oral cetirizine for the treatment of perennial allergic rhinoconjunctivitis with the advantage of a significantly faster onset of action for both nasal and ocular symptoms. 相似文献
16.
目的 探讨根除幽门螺杆菌(H. pylori)对老年功能性消化不良(functional dyspepsia,FD)的治疗效果。 方法 选取2016年3月至2018年4月我院诊治的92例老年FD合并H. pylori阳性患者进行研究,采用随机分组表分为常规组(常规促进胃动力治疗,46例)和干预组(常规治疗联合H. pylori根除治疗,46例),比较两组患者治疗前后症状评分、疗效及药物不良反应发生率。 结果 治疗前,常规组和干预组患者上腹不适、饱胀感、灼烧感评分比较差异无统计学意义(均P>0.05)。治疗14 d,两组患者上腹不适、饱胀感、灼烧感评分均下降,且干预组患者下降程度更大(均P2=5.134 2,P=0.023 5)。两组患者治疗14 d期间,口干、恶心呕吐、头晕、皮疹、乏力发生率比较差异无统计学意义(均P>0.05)。 结论 对老年FD合并H. pylori阳性患者实施H. pylori根除性治疗能协助改善患者消化不良症状,提高患者疗效,同时不增加药物不良反应发生率。 相似文献
17.
Ong JC Gramling SE Vrana SR Nicholson RA Buenaver LF 《Applied psychophysiology and biofeedback》2006,31(4):295-313
Despite the advancement of the biopsychosocial model, the interrelationship between behavioral, emotional, and physiological factors in tension-type headache (TTH) remains unclear. Using a picture-viewing paradigm, the present study investigated differences between females with TTH and controls on physiological reactivity, affective valence and arousal, and oral motor habits. In addition, the concordance between EMG activity and self-reported oral habits (i.e., proprioceptive awareness) and EMG activity and self-reported affect (i.e., affective coherence) were measured using within-subject correlations per individual and then compared between groups. Data were analyzed for 27 TTH sufferers and 27 controls who completed a questionnaire packet followed by a psychophysiological assessment consisting of 3 phases (adaptation, scheduled-viewing, recovery) with EMG activity recorded continuously at 3 sites (frontalis, corrugator, zygomatic). During the scheduled-viewing phase, participants were presented with 24 pictures designed to elicit positive, neutral, and negative affect. Compared to controls, the headache group reported elevations in pain, oral habits, and stress across the 3 phases of the assessment, along with elevations in arousal while viewing the pictures. There were no significant differences between the groups in EMG activity while viewing the pictures. Analyses on concordance revealed partial evidence for poor proprioceptive awareness and affective coherence among the headache group, although the correlations were not significantly different than the control group. These findings suggest that arousal, stress perception, and oral habits may play a role in the pathophysiology of TTH and that within-subject designs should be tested further against group designs when measuring psychophysiological concordance. 相似文献
18.
A study of structural chromosome aberration frequencies in blood lymphocytes was performed in a group of 20 oil catalytic cracking unit workers and in 26 subjects belonging to the office staff of an oil refining plant, as well as in 35 matched controls. Subjects in the latter group were of the same sex (males) and similar age as the exposed group, and had similar smoking habits. Benzo[a]pyrene levels in workplace air samples were also determined. The cytogenetic analysis failed to show any differences between the exposed and control groups. A slight increase in benzo[a]pyrene level above the Cuban national standard of 1 ng/m3 was found during the air sample analysis in the oil catalytic cracking unit. 相似文献
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20.
BackgroundThe Hungarian National Cancer Registry (HNCR) was legally established as a population-based cancer registry in 1999, and its operation started in 2000 supporting the planning and development of the Hungarian oncology network as well as informing national cancer control policies. Ensuring comparable, accurate, and complete data on malignant and in situ neoplasms is critical in determining the applicability of the database. The aim of this study was to perform a comprehensive evaluation of the data quality at the HNCR.MethodsBased on qualitative and semiquantitative methods from current international guidelines, we assess the comparability, completeness, validity, and timeliness of the collected data over the diagnostic period 2000–2019, with a focus on the year 2018.ResultsCoding practices and the classification system used at the HNCR are based on the International Classification of Diseases (ICD-10), which differs from the internationally recommended ICD-O. The annual trends in incidence did not indicate major fluctuations, that may have resulted from data collection discrepancies, while comparisons of the mortality-to-incidence ratio (M:I) compared with 1 minus 5-year observed survival indicated some systematic differences requiring further exploration. The age-standardized (European standard) incidence rate per 100 000 measured by the HNCR in 2018 was very high: 647.9 for men and 501.6 for women, 11.6% and 14.6% higher than the International Agency for Research on Cancer (IARC) estimates respectively. Behind the overall differences between the two data sources, we identified that the vast majority were due to ill-defined ICD codes: malignant neoplasm of other and ill-defined sites (C76), and malignant neoplasm without specification of site (C80). Otherwise, there were no major discrepancies by localization. The proportion of morphologically verified cancer cases was 57.8% overall, that of death certificates was 2.3%, and that of unknown primary tumors was 1.4%.ConclusionFurther implementations and interventions are required to ensure that the operations, coding practices, and the classification system used at the national registry are in accordance with international standards, and to increase the completeness and validity of the collected cancer data. In particular, the low morphologically verified proportion questions the overall accuracy of the stated diagnoses within the database. Nevertheless, our examination implies that the data of the HNCR are reasonably comparable, and without doubt fulfill the requirements to support national oncology services and cancer planning. However, most importantly, a review of registry personnel and resource requirements to run the national population-based cancer registry should be an essential part of Hungary’s national cancer strategy. 相似文献