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Fifth Decade (fifth + decade)
Selected AbstractsA comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesionsDIAGNOSTIC CYTOPATHOLOGY, Issue 11 2007Shailja Garg M.B.B.S. Abstract The present study was undertaken to compare the efficacy of needle core biopsy (NCB) of the breast with fine-needle aspiration cytology (FNAC) in breast lesions (palpable and non-palpable) in the Indian set-up, along with the assessment of tumor grading with both the techniques. Fifty patients with suspicious breast lesions were subjected to simultaneous FNAC and ultrasound-guided NCB following an initial mammographic evaluation. Cases were categorized into benign, benign with atypia, suspicious and malignant groups. In cases of infiltrating duct carcinomas, grading was performed on cytological smears as well as on NCB specimens. Both the techniques were compared, and findings were correlated with radiological and excision findings. Out of 50 cases, 18 were found to be benign and 32 malignant on final pathological diagnosis. Maximum number of patients with benign diagnosis was in the fourth decade (42.11%) and malignant diagnosis in the fourth as well as fifth decade (35.48% each). Sensitivity and specificity of mammography for the diagnosis of malignancy was 84.37% and 83.33%, respectively. Sensitivity and specificity of FNAC for malignant diagnosis was 78.15% and 94.44%, respectively, and of NCB was 96.5% and 100%, respectively. But NCB had a slightly higher specimen inadequacy rate (8%). NCB improved diagnostic categorization over FNAC by 18%. Tumor grading in cases of IDC showed high concordance rate between NCB and subsequent excision biopsy (94.44%) but low concordance rate between NCB and FNAC (59.1%). NCB is superior to FNAC in the diagnosis of breast lesions in terms of sensitivity, specificity, correct histological categorization of the lesions as well as tumor grading. Diagn. Cytopathol. 2007;35:681,689. © 2007 Wiley-Liss, Inc. [source] A case of progressive pseudorheumatoid arthropathy of ,childhood' with the diagnosis delayed to the fifth decadeINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2006A. CEFLE Summary Progressive pseudorheumatoid arthropathy of childhood (PPAC) is a rare single gene disorder which is frequently misdiagnosed as juvenile rheumatoid arthritis. It is characterised with arthralgia, joint contractures, bony swelling of metacarpophalangeal and interphalangeal joints and platyspondyly. Clinical and laboratory signs of joint inflammation such as synovitis, a high erythrocyte sedimentation rate and an elevated C-reactive protein level are usually absent. Although the disease begins early in life (usually between 3 and 8 years of age), the diagnosis may be delayed. In the present case report, we describe a male patient diagnosed with PPAC at the age of 46 years, although he had been exhibiting the typical radiological and clinical features of the disease since the age of 7 years. [source] Structural Trends in the Aging Femoral Neck and Proximal Shaft: Analysis of the Third National Health and Nutrition Examination Survey Dual-Energy X-Ray Absorptiometry Data,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 12 2000Thomas J. Beck Abstract Hip scans of U.S. adults aged 20,99 years acquired in the Third National Health and Nutrition Examination Survey (NHANES III) using dual-energy X-ray absorptiometry (DXA) were analyzed with a structural analysis program. The program analyzes narrow (3 mm wide) regions at specific locations across the proximal femur to measure bone mineral density (BMD) as well as cross-sectional areas (CSAs), cross-sectional moments of inertia (CSMI), section moduli, subperiosteal widths, and estimated mean cortical thickness. Measurements are reported here on a non-Hispanic white subgroup of 2719 men and 2904 women for a cortical region across the proximal shaft 2 cm distal to the lesser trochanter and a mixed cortical/trabecular region across the narrowest point of the femoral neck. Apparent age trends in BMD and section modulus were studied for both regions by sex after correction for body weight. The BMD decline with age in the narrow neck was similar to that seen in the Hologic neck region; BMD in the shaft also declined, although at a slower rate. A different pattern was seen for section modulus; furthermore, this pattern depended on sex. Specifically, the section modulus at both the narrow neck and the shaft regions remains nearly constant until the fifth decade in females and then declined at a slower rate than BMD. In males, the narrow neck section modulus declined modestly until the fifth decade and then remained nearly constant whereas the shaft section modulus was static until the fifth decade and then increased steadily. The apparent mechanism for the discord between BMD and section modulus is a linear expansion in subperiosteal diameter in both sexes and in both regions, which tends to mechanically offset net loss of medullary bone mass. These results suggest that aging loss of bone mass in the hip does not necessarily mean reduced mechanical strength. Femoral neck section moduli in the elderly are on the average within 14% of young values in females and within 6% in males. [source] Gender Differences in Various Types of Idiopathic Ventricular TachycardiaJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 7 2002MIKIKO NAKAGAWA M.D. Gender Differences in Idiopathic VT.Introduction: The aim of this study was to evaluate gender differences in the incidence and age distribution of various types of idiopathic ventricular tachycardia (VT). Methods and Results: We conducted a search of the medical literature on idiopathic VT. According to their site of origin, we divided the VTs into three types: right ventricular outflow tract (RVOT-VT), left ventricular outflow tract (LVOT-VT), and left ventricular (LV) septum (LV-VT). We reviewed 68 articles and a total of 748 patients. Among RVOT-VT patients, there were more females than males (311 vs 153, male/female ratio 0.49). In LV-VT, males prevailed over females (175 vs 52, male/female ratio 3.37), whereas LVOT-VT was distributed almost equally between males (n = 33) and females (n = 24). To determine the age distribution, we assessed 419 patients from 51 studies. In both males and females, the highest incidence of RVOT-VT occurred in the third to fifth decade of life (males, mean 43.5 ± 18.7; females, mean 40.9 ± 13.8 years). LV-VT occurred at a younger age in both males and females than did RVOT-VT (mean 33.0 ± 13.9 and 25.7 ± 12.0 years, respectively, P < 0.0001 vs RVOT-VT). LV-VT occurred at a younger age in females than males (P < 0.005). Conclusion: Gender-specific differences exist in the incidence and age distribution of the various types of idiopathic VT. Studies on gender-specific differences in arrhythmia will lead to a better understanding of its mechanism(s) and provide valuable information for the development of optimal treatment strategies. [source] Defining the Clinical Characteristics of Peyronie's Disease in Young MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 2 2007Serkan Deveci MD ABSTRACT Introduction., Peyronie's disease (PD) is usually seen in men in their fifth decade of life. Aim., In this study, we investigated the characteristics of the disease in young men. Main Outcome Measures., The demographics, clinical features, and associated comorbidities of the patients with PD were retrospectively reviewed. Methods., The findings were compared between men with the disease who were under 40 years of age with those over 40 years. Statistical analyses were conducted to define differentiating features between these two groups. Results., Of the 296 patients, 32 were under the age of 40 years and 264 over 40 years. The mean duration of the disease was 2 ± 4 and 6 ± 8 months in the respective age groups. Fifty-six percent of the patients under the age of 40 years and 75% of the patients over this age presented with curvature (P < 0.01). Thirty-seven percent under 40 years and 12% men over 40 years had more than one plaque at presentation (P < 0.01). Dupuytren's contracture was seen only in patients over 40 years of age. Pain at presentation was found in 75% under the age of 40 years and in 65% over 40 years (P = 0.03). Trauma history was found in 18% under 40 years and in 5% over this age (P < 0.01). Statistical significant differences were found between the groups under and over the age of 40 years for hypertension (P < 0.01) and dyslipidemia (P < 0.01). Diabetes was noted in 50% of the patients under the age of 40 years and in 18% of the patients over this age (P < 0.001). Multivariate analysis of conditions associated in men with PD under 40 years of age showed statistical significant differences for diabetes (P = 0.015), presentation within 6 months (P = 0.004), and having multiple plaques (P = 0.008). Conclusions., Young men with PD are more likely to present at an earlier stage of the disease, to have diabetes, and to have more than one plaque at the time of presentation. Deveci S, Hopps CV, O'Brien K, Parker M, Guhring P, and Mulhall JP. Defining the clinical characteristics of Peyronie's disease in young men. J Sex Med 2007;4:485,490. [source] Early cortical lens opacities: a short overviewACTA OPHTHALMOLOGICA, Issue 6 2009Gijs F.J.M. Vrensen Abstract. Cataract is still the dominant cause of blindness worldwide. Cortical cataract is the most prevalent of the age-related changes in the human lenses that require surgical intervention to restore vision. The absence of adequate cataract surgery in most developing countries is the main cause of the high prevalence of cataract blindness worldwide. Lens ageing is accompanied by dramatic increases in stiffness, light scattering and coloration of the lens nucleus. These changes start to become manifest as early as the fourth or fifth decade of life and lead to nuclear cataract in old age. In the same period the equatorial deep lens cortex starts to show small opaque shades, which eventually grow out to segmental and annular opacities. These opaque shades are filled with small vesicles and contain abnormal amounts of cross-linked proteins, cholesterol and phospholipids. They are bordered by membranes that are rich in square arrays, have ,degenerate' gap junctions and have few intramembranous particles. It has been shown that the opaque shades represent cohorts of locally affected fibres segregated from unaffected neighbouring fibres by ,non-leaky' membranes. This segregation is an effective mechanism delaying the outgrowth of these opacities to cuneiform cataracts entering the pupillary space and thus leading to blinding cortical cataracts. Although cataract formation is mostly considered to be a multi-factorial disease, oxidative stress might be one of the leading causes for both nuclear and cortical cataract. In cortical cataracts shear stress between cortex and nucleus during accommodation may also play a significant role. [source] Angioleiomyoma: a clinical, pathological and radiological reviewINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2004P. Ramesh Summary Angioleiomyoma is a benign tumour arising from the vascular smooth muscle (tunica media) and presents commonly between third and fifth decades of life. Although there are sporadic reports about this tumour in the literature, none describes all the information in detail. This review is an attempt to collate all the facts in one concise article. Angioleiomyoma presents as a painful mass in approximately 60% of the cases. One of the distinct clinical feature noted is the increase in size of the swelling with physical activity of the involved part, especially in the hand. It should be considered in the differential diagnosis of painful nodular lesions of the extremity. Pre-operative diagnosis is difficult, but with a high index of suspicion and awareness, it is possible. The use of ultrasound and magnetic resonance imaging should be considered. It causes minimal morbidity and excision is usually curative. Histological examination using smooth muscle Actin stain portraits the smooth muscle bundles clearly. [source] Desmoid Tumor: A Case of Mistaken IdentityTHE BREAST JOURNAL, Issue 1 2005Alicia Privette BS Abstract: Desmoid tumors are rare tumors accounting for only 0.03% of all neoplasms. Mainly occurring in the fourth and fifth decades of life, these tumors originate in musculoaponeurotic tissues of the limbs, neck, trunk, abdominal wall, and mesentery. We present a rare case of a chest wall desmoid tumor that was mistaken for breast cancer on both physical examination and mammography, which highlights the unique risk these tumors present for confusion with other malignant processes. Although past literature contains numerous reports of other misdiagnoses, this case is unique in reporting the potential for misdiagnosis between chest wall desmoid tumors and breast cancer. In cases where suspicious breast findings do not correlate to usual diagnostic measures, such as fine-needle aspiration or core needle biopsy, the possibility of another pathology such as a chest wall desmoid tumor mimicking breast cancer should be considered in the differential diagnosis. [source] Sexual factors and prostate cancerBJU INTERNATIONAL, Issue 3 2003G.G. Giles OBJECTIVE To assess whether prostate cancer might be related to hormone levels and, by inference, to differences in sexual activity. PATIENTS, SUBJECTS AND METHODS In a case-control study of men with prostate cancer aged < 70 years at diagnosis and age-matched control subjects, information was collected on two aspects of sexual activity; the number of sexual partners and the frequency of total ejaculations during the third to fifth decades of life. RESULTS There was no association of prostate cancer with the number of sexual partners or with the maximum number of ejaculations in 24 h. There was a negative trend (P < 0.01) for the association between risk and number of ejaculations in the third decade, independent of those in the fourth or fifth. Men who averaged five or more ejaculations weekly in their 20s had an odds ratio (95% confidence interval) of 0.66 (0.49,0.87) compared with those who ejaculated less often. CONCLUSIONS The null association with the number of sexual partners argues against infection as a cause of prostate cancer in this population. Ejaculatory frequency, especially in early adult life, is negatively associated with the risk of prostate cancer, and thus the molecular biological consequences of suppressed or diminished ejaculation are worthy of further research. [source] | ||||||||||