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Colorectal Carcinoma in Children and Young Adults in Ilorin, Nigeria
OK Ibrahim, AE Afolayan, KA Adeniji, OM Buhari, KB Badmos
West African Journal of Medicine , 2011,
Abstract: Background: Colorectal carcinoma is thought to be rare among children and young adults among whom presentation is usually at a late stage with poor prognosis. Objective: To review the demography, clinical presentation, morphology, and pathological stage of cases of colorectal carcinomas diagnosed in the children and adults. Methods: This was a retrospective review of cases of histologically diagnosed colorectal carcinoma of patients aged 40 years and below, between 1979 and 2008, using the request cards and hematoxylin and eosin stained slides. Results: Seventy-six (31.5%) of all cases of colorectal carcinoma were seen in patients aged 40 years and below. The mean age at presentation was 31years and the youngest aged 16 years. The male : female ratio was 1.6 : 1. The dominant clinical presentations were bloody diarrhea and rectal bleeding. Fifty-one (67.1%) cases were localized to the rectum, nine (16.1%) cases in the sigmoid colon, and eight (10.5%) cases in the caecum. Adenocarcinoma was the most common histological variant. Mucin-producing tumours were seen in 25 (32.9%) cases. Almost all the patients presented at advanced pathological stage. Conclusion: Colorectal carcinoma is not rare among young Nigerians and it should be suspected when young patients present with chronic bloody diarrhoea. Digital rectal examination should be encouraged as part of clinical examination in this age group too since a large percentage of colorectal carcinomas is within the reach of the examining finger.
Retrospective Study of Suicide Among Children and Young Adults  [PDF]
Navin Mishra,Devendra Shrestha,Rakesh Babu Poudyal,Pravin Mishra
Journal of Nepal Paediatric Society , 2013, DOI: 10.3126/jnps.v33i2.7512
Abstract: Introduction: The prevalence of suicide has been increasing globally in all age groups. There is dearth of literature on suicide among younger patients from developing country. The objective of this study was to find out the prevalence and cause of suicide as well as to identify the vulnerable groups of children and young adults to suicide. Materials and Methods: This is a retrospective observational study. Data was collected from the Police Head Quarters in Kathmandu and included all completed suicide cases of less than twenty one years of age from January 2005 to December 2009. Results: There were a total of 2172 documented cases of completed suicide in the age group between 4 to 21 years. The majority were female and belonged to the adolescent age group. The incidence of suicide showed an increasing trend within the five years of the study. A monthly breakdown of the cases revealed that the incidence of suicide was lowest in January and February and peaked from April to October. Hanging was the most common mode of suicide followed by poisoning and drowning. The reason for suicide could be ascertained only among 25.5 % of cases. Domestic violence (35%), mental illness (24%), failure in academic achievement (15.8%) and end of a romantic relationship (8.7%) were found to be common causes of committing suicide. Of the 87 cases found who committed suicide because of academic failure 46.6% were at a grade ten level. Conclusions: Suicide in children and young adults in Nepal appears to be a concealed but serious problem requiring immediate attention and systematic efforts. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7512 ? J Nepal Paediatr Soc. 2013; 33(2):110-116
A forensic pathology approach to sudden death in children and young adults in Biscay and Seville (Spain)  [cached]
Benito Morentin,Beatriz Aguilera,Ma Paz Suárez-Mier,Pilar Molina
Medwave , 2012,
Abstract: Sudden death (SD) in children and young adults is a complex multifactorial problem that entails medical forensic and socio-familial implications. Forensic pathology plays an important role in these cases due to the fact that they tend to occur unexpectedly, and therefore a postmortem examination is needed to determine cause and mechanism of death. Most of these deaths are of cardiovascular origin and many of them have a hereditary component. The autopsy may be the only way to establish the correct diagnosis of the underlying condition enabling the family to receive proper medical counseling, to identify asymptomatic relatives at risk, and to prevent subsequent deaths. A proper approach requires the collaboration of various medical specialties (coroners, pathologists, pediatricians, cardiologists, microbiologists, geneticians), who must work in coordination in accordance to international protocols. In this article, the epidemiologic and clinical-pathological features of the main conditions that may lead to SD in children and young adults are reviewed and a case series from Seville and Biscay provinces is presented. Finally, the importance of forensic pathology in the management and prevention of these cases is underlined.
In Need of Creative Mobile Service Ideas? Forget Adults and Ask Young Children  [PDF]
Ilona Kuzmickaja,Xiaofeng Wang,Daniel Graziotin,Gabriella Dodero,Pekka Abrahamsson
Computer Science , 2015,
Abstract: It is well acknowledged that innovation is a key success factor in mobile service domain. Having creative ideas is the first critical step in the innovation process. Many studies suggest that customers are a valuable source of creative ideas. However, the literature also shows that adults may be constrained by existing technology frames, which are known to hinder creativity. Instead young children (aged 7-12) are considered digital natives yet are free from existing technology frames. This led us to study them as a potential source for creative mobile service ideas. A set of 41,000 mobile ideas obtained from a research project in 2006 granted us a unique opportunity to study the mobile service ideas from young children. We randomly selected two samples of ideas (N=400 each), one contained the ideas from young children, the other from adults (aged 17-50). These ideas were evaluated by several evaluators using an existing creativity framework. The results show that the mobile service ideas from the young children are significantly more original, transformational, implementable, and relevant than those from the adults. Therefore, this study shows that young children are better sources of novel and quality ideas than adults in the mobile services domain. This study bears significant contributions to the creativity and innovation research. It also indicates a new and valuable source for the companies that seek for creative ideas for innovative products and services.
The Co-Morbidity Burden of Children and Young Adults with Autism Spectrum Disorders  [PDF]
Isaac S. Kohane, Andrew McMurry, Griffin Weber, Douglas MacFadden, Leonard Rappaport, Louis Kunkel, Jonathan Bickel, Nich Wattanasin, Sarah Spence, Shawn Murphy, Susanne Churchill
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033224
Abstract: Objectives Use electronic health records Autism Spectrum Disorder (ASD) to assess the comorbidity burden of ASD in children and young adults. Study Design A retrospective prevalence study was performed using a distributed query system across three general hospitals and one pediatric hospital. Over 14,000 individuals under age 35 with ASD were characterized by their co-morbidities and conversely, the prevalence of ASD within these comorbidities was measured. The comorbidity prevalence of the younger (Age<18 years) and older (Age 18–34 years) individuals with ASD was compared. Results 19.44% of ASD patients had epilepsy as compared to 2.19% in the overall hospital population (95% confidence interval for difference in percentages 13.58–14.69%), 2.43% of ASD with schizophrenia vs. 0.24% in the hospital population (95% CI 1.89–2.39%), inflammatory bowel disease (IBD) 0.83% vs. 0.54% (95% CI 0.13–0.43%), bowel disorders (without IBD) 11.74% vs. 4.5% (95% CI 5.72–6.68%), CNS/cranial anomalies 12.45% vs. 1.19% (95% CI 9.41–10.38%), diabetes mellitus type I (DM1) 0.79% vs. 0.34% (95% CI 0.3–0.6%), muscular dystrophy 0.47% vs 0.05% (95% CI 0.26–0.49%), sleep disorders 1.12% vs. 0.14% (95% CI 0.79–1.14%). Autoimmune disorders (excluding DM1 and IBD) were not significantly different at 0.67% vs. 0.68% (95% CI ?0.14-0.13%). Three of the studied comorbidities increased significantly when comparing ages 0–17 vs 18–34 with p<0.001: Schizophrenia (1.43% vs. 8.76%), diabetes mellitus type I (0.67% vs. 2.08%), IBD (0.68% vs. 1.99%) whereas sleeping disorders, bowel disorders (without IBD) and epilepsy did not change significantly. Conclusions The comorbidities of ASD encompass disease states that are significantly overrepresented in ASD with respect to even the patient populations of tertiary health centers. This burden of comorbidities goes well beyond those routinely managed in developmental medicine centers and requires broad multidisciplinary management that payors and providers will have to plan for.
Quantification of left ventricular myocardial collagen system in children, young adults, and the elderly
Mendes,Andrea Bogoslavsky Levy; Ferro,Marcelo; Rodrigues,Bruno; Souza,Monica Rodrigues de; Araujo,Rubens Correa; Souza,Romeu Rodrigues de;
Medicina (Buenos Aires) , 2012,
Abstract: studies on the collagen system of the human myocardium are still limited compared to those on small laboratory animals. the aim of this work was to observe the collagen tissue of the myocardium of the human heart as a function of age. the types of collagen, as well as the density of collagen tissue and the diameter of collagen fibrils, were examined. fragments of the left ventricular wall from 15 hearts, 5 from children, 5 from young adults, and 5 from elderly individuals, were analyzed by using the picrosirius-polarization method and by transmission electron microscopy (tem). the results showed the presence of collagen type iii and collagen type i, both in the endomysium and perimysium of the 3 groups studied. measurements of collagen content in myocardial tissue displayed that both endomysial and perimysial collagen increase in number and thickness in the adult and elderly. these histochemical results coincided with the observations obtained with the electron microscope in showing an increase in the number of collagen fibrils with a large diameter in the adult and elderly hearts. the present results on cardiac collagen may be important for assessing the pathogenesis of several cardiopathies in the hearts of children, young adults, and the elderly.
The Heterogeneity of Asthma Phenotypes in Children and Young Adults  [PDF]
Bill Hesselmar,Anna-Carin Enelund,Bo Eriksson,Leonid Padyukov,Lars ?. Hanson,Nils ?berg
Journal of Allergy , 2012, DOI: 10.1155/2012/163089
Abstract: Objective. Genetic heterogeneity and risk factor distribution was analyzed in two previously proposed asthma phenotypes. Method. A sample of 412 subjects was investigated at 7-8, 12-13, and 21-22 years of age with questionnaires, skin prick tests, and genetic analysis of IL-4 receptor (IL4R) single-nucleotide polymorphisms. The sample was subdivided in one group with no asthma, and two groups with asthma separated by age of onset of symptoms, namely, early onset asthma (EOA) and late onset asthma (LOA). Risk factors and IL4R markers were analyzed in respect to asthma phenotypes. Results. EOA and LOA groups were both associated with atopy and a maternal history of asthma. Female gender was more common in LOA, whereas childhood eczema, frequent colds in infancy, and a paternal history of asthma were more common in EOA. The AA genotype of rs2057768 and the GG genotype of rs1805010 were more common in LOA, whereas the GG genotype of rs2107356 was less common in EOA. Conclusion. Our data suggest that early and late onset asthma may be of different endotypes and genotypes. 1. Introduction Asthma is a common disease, but it has been questioned if it is one single disease, or a group of asthmatic diseases. Such different “phenotypes” of asthma may vary in response to treatment [1], in prognosis [2], in inflammatory patterns [3], and in susceptibility to environmental exposure [4]. Identifying possible subphenotypes has therefore rendered increasing interest in recent years [5, 6]. But a reliable subgroup classification of asthma (or any other disease) can seldom include only clinical parameters, very often additional biomarkers have to be included [7] in order to find genetic or endotypic differences. In the 1990s, the Tucson group presented data on lung function of infants from a population-based birth-cohort study and they also retrospectively classified preschool wheeze into three subgroups or phenotypes, namely, transient wheeze, early persistent wheeze, and late onset asthma [8]. Interestingly, not only transient wheeze had a characteristic phenotype pattern, there were also differences between the two asthma subgroups, with eczema being more common among children with early persistent wheeze than among children with asthma onset after the age of 3 years. If the noticed difference in the prevalence of eczema in children with early versus late onset of respiratory symptoms is of any phenotypic significance is, however, not known. Our own data reveal that 12-13-year-old children with asthma and eczema differ regarding the interleukin-4 receptor genotype from
Postoperative craniospinal radiotherapy of medulloblastoma in children and young adults  [PDF]
Golubi?i? Ivana V.,Bokun Jelena,Nikitovi? Marina R.,Mladenovi? Jasmina
Srpski Arhiv za Celokupno Lekarstvo , 2003, DOI: 10.2298/sarh0306226g
Abstract: PURPOSE The aim of this study was: 1. to evaluate treatment results of combined therapy (surgery, postoperative craniospinal radiotherapy with or without chemotherapy) and 2. to assess factors affecting prognosis (extend of tumor removal, involvement of the brain stem, extent of disease postoperative meningitis, shunt placement, age, sex and time interval from surgery to start of postoperative radiotherapy). PATIENTS AND METHODS During the period 1986-1996, 78 patients with medulloblastoma, aged 1-22 years (median 8.6 years), were treated with combined modality therapy and 72 of them were evaluable for the study end-points. Entry criteria were histologically proven diagnosis, age under 22 years, and no history of previous malignant disease. The main characteristics of the group are shown in Table 1. Twenty-nine patients (37.2%) have total, 8 (10.3%) near total and 41 (52.5%) partial removal. Seventy-two of 78 patients were treated with curative intent and received postoperative craniospinal irradiation. Radiotherapy started 13-285 days after surgery (median 36 days). Only 13 patients started radiotherapy after 60 days following surgery. Adjuvant chemotherapy was applied in 63 (80.7%) patients. The majority of them (46 73%) received chemotherapy with CCNU and Vincristine. The survival rates were calculated with the Kaplan-Meier method and the differences in survival were analyzed using the Wilcoxon test and log-rank test. RESULTS The follow-up period ranged from 1-12 years (median 3 years). Five-year overall survival (OS) was 51% and disease-free survival (DFS) 47% (Graph 1). During follow-up 32 relapses occurred. Patients having no brain stem infiltration had significantly better survival (p=0.0023) (Graph 2). Patients with positive myelographic findings had significantly poorer survival compared to dose with negative myelographic findings (p=0.0116). Significantly poorer survival was found in patients with meningitis developing in the postoperative period, with no patient living longer than two years (p=0.0134) (Graph 3). By analysis of OS and DFS in relation to presence of the malignant cells in liquor, statistically significant difference, i. e. positive CSF cytology was not obtained, which was of statistical importance for survival (p=0.8207). Neither shunt placement nor shunt type showed any impact on survival (p=0.5307 and 0.7119, respectively). Children younger than three years had significantly poorer survival compared to those older than 16 years (p=0.0473). Although there was a better survival rate in females than in males this was not statist
Prevention of alcohol misuse among children, youths and young adults
Korczak, Dieter,Steinhauser, Gerlinde,Dietl, Markus
GMS Health Technology Assessment , 2011,
Abstract: Background: Despite many activities to prevent risky alcohol consumption among adolescents and young adults there is an increase of alcohol intoxications in the group of ten to twenty year old juveniles. Objectives: This report gives an overview about the recent literature as well as the German federal prevention system regarding activities concerning behavioral and policy prevention of risky alcohol consumption among children, adolescents and young adults. Furthermore, effective components of prevention activities are identified and the efficiency and efficacy of ongoing prevention programs is evaluated. Methods: A systematic literature review is done in 34 databases using Bool’sche combinations of the key words alcohol, prevention, treatment, children, adolescents and young adults. Results: 401 studies were found and 59 studies were selected for the health technology assessment (HTA). Most of the studies are done in USA, nine in Germany. A family strengthening program, personalized computer based intervention at schools, colleges and universities, brief motivational interventions and policy elements like increase of prices and taxes proved effective. Discussion: Among the 59 studies there are three meta-analyses, 15 reviews, 17 randomized controlled trials (RCT) and 18 cohort studies. Despite the overall high quality of the study design, many of them have methodological weaknesses (missing randomization, missing or too short follow-ups, not clearly defined measurement parameters). The transferability of US-results to the German context is problematic. Only a few prevention activities reach a sustainable reduction of frequency and/or amount of alcohol consumption. Conclusion: The HTA-report shows the need to develop specific and target group focused prevention activities for the German situation. Essential for that is the definition of target goals (reduction of consumption, change of behaviour) as well as the definition and empirical validation of risky alcohol consumption. The efficacy of prevention activities should be proven before they are launched. At present activities for the reduction or prevention of risky alcohol consumption are not sufficiently evaluated in Germany concerning their sustainable efficacy.
Leukemia mortality trends among children, adolescents, and young adults in Latin America
Curado,Maria Paula; Pontes,Thais; Guerra-Yi,Marta E.; Cancela,Marianna de Camargo;
Revista Panamericana de Salud Pública , 2011, DOI: 10.1590/S1020-49892011000200004
Abstract: objective: to describe and compare trends in leukemia mortality among children (0-14 years of age) and adolescents and young adults (aya, 15-24 years of age) in 12 countries in latin america during 1980-2004. methods: data from the world health organization mortality database was analyzed using a joinpoint regression model to identify significant mortality rate changes over time and to estimate annual percent change. results: leukemia is ranked first among cancer-related causes of death among children and aya in latin america. in children, the global percentage changes indicate increased rates for both sexes in colombia, ecuador, and mexico, with substantially higher rates for mexico. in aya, significant increases were observed for both sexes in mexico; ecuador saw some increase for both sexes; and colombia and uruguay had increases in females only. downward trends were observed in argentina for both sexes, and in costa rica for males only. there were no major changes in the other countries analyzed. conclusions: leukemia mortality rates among aya are declining, but show less significant decreases than rates among children. the study results point to a global need for further advances, specifically for aya, similar to those made by childhood leukemia therapeutic protocols. also, specialized oncological centers exist in most countries of latin america, but they are often inaccessible. special attention should be given to mexico due to the significant increase in mortality rates.
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