A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry in the branch of Maxillofacial and Oral Surgery. Johannesburg, 2015 / Aim: The aim of this prospective study was to compare epidemiologic characteristics of maxillofacial fractures between Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Polokwane–Mankweng Hospital Complex (PMHC). Objective: To compare the patterns; aetiologies and incidences of maxillofacial fractures in patients of all ages between the two units. Materials and Methods: We present a prospective study of 194 patients with 226 maxillofacial fractures reported and treated between CMJH and PMHC from December 2013 to August 2014. These patients were clinically and radiographically assessed by registrars and a consultant in both units. Variables recorded included Patient’s age; file number; sex; socioeconomic status; population group; aetiology; time of injury; identity ( whether known or unknown ) of assailant; the site of the fracture and associated injuries. Results: Of the 194 total patients from both units, 159(82.0%) patients were males and 35(18.0%) patients were females, giving overall male to female ratio of 4.54:1. The minimum age was (2) two years and the maximum age was 61 years. In both males and females, the majority (75%) of patients were in the age group of 20-39 years with a peak frequency in the 3rd decade. The overall mean age was 30.6 (10.02). Assaults were by far the leading cause of maxillofacial fractures from our study accounting for 60.3% fractures of the total study population, followed by road traffic accidents accounting for 17.5%. Road traffic accidents accounted for 22.7% maxillofacial fractures in PMHC, a rate higher than CMJAH (14.8%) and overall rate (17.5%). Sport injuries accounted for more (6.1%) maxillofacial fractures in PMHC than CMJH (0.8%). In total, 127(65.8%) patients sustained maxillofacial fractures during the night and 66(34.2%) patients during the day. The mandible was the most frequently fractured facial bone (73.0%), followed by the zygoma. The angle of the mandible was the most common fractured site (35.0%). Conclusion: Interpersonal violence is by far the leading cause of maxillofacial fractures in South Africa. Prevailing factors like socioeconomic status of patient; industrialisation and geographic location have somewhat influenced the characteristics of maxillofacial fractures in the two units.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 129-135).

So Hung-kwan. / "August 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 251-23). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Orientador: José Ricardo de Albergaria Barbosa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T02:17:56Z (GMT). No. of bitstreams: 1 Vemba-Cidade_CasteloPedro_D.pdf: 1650381 bytes, checksum: 57909f2c0597a104881cfafff2f54a1a (MD5) Previous issue date: 2013 / Resumo: Estudos atuais demonstram um aumento da população idosa mundial. No Brasil os idosos representam cerca de 9% da população, sendo aproximadamente 21 milhões de pessoas com mais de 60 anos. Este trabalho analisou características epidemiológicas de pacientes idosos vítimas de trauma de face atendido pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba (FOP) - Unicamp, na cidade de Piracicaba e região, no período de abril de 1999 a dezembro de 2012. A análise foi direcionada a dados relativos de variáveis populacionais como idade, gênero, cor, etiologia do trauma, lesões corporais na face ou não, incluindo fraturas de face ou não e fraturas associadas, tratamento instituído, tempo decorrido entre o trauma e o tratamento, além do período de proservação e complicações. Foram analisados dados dos pacientes, através de preenchimento de um formulário clínico especificamente elaborado para a anotação de dados relativos ao estudo de traumatismos faciais. Foram excluídos do trabalho pacientes com preenchimento incompleto das informações. Um total de 237 pacientes idosos foram avaliados, 127 (53,6%) pacientes do gênero masculino e 110 (46,4%) do gênero feminino, a queda foi a causa mais frequente com 146 casos (61,6%) do total, com maior incidência no terço médio de face com 114 fraturas (48,1%), sendo que os ossos próprios do nariz 47 casos (19,8%) e o osso zigomático 42 casos (17,7%), da mesma forma que em relação ao tratamento, dos 237 pacientes avaliados 101 casos (42,6%) foram tratados conservadoramente, 28 casos (11,8%) foram submetidos à cirurgia e em 18 casos (7,6%) não foi realizado nenhum tratamento. O presente estudo mostrou que a queda foi à causa com maior predominância, resultando em fraturas do terço médio com indicação cirúrgica cada vez menor neste grupo de população, exceto em casos onde a função esteja comprometida, tendo-se em conta as alterações fisiológicas, psicológicas decorrentes do envelhecimento. / Abstract: Recent studies demonstrated an increase in the elderly population. In Brazil the elderly represent about 9% of the population, approximately 21 million people over 60 years. This study examined the epidemiological characteristics of elderly victims of facial trauma attended by Area Surgery Maxillo-Facial, Piracicaba Dental School (FOP) - Unicamp, in Piracicaba city and region, from April 1999 to December 2012. The analysis was directed at population data for variables such as age, gender, race, trauma etiology, injury to the face or not, including facial fractures or not and associated fractures, treatment given, time elapsed between injury and treatment, beyond the period of follow up and complications. We analyzed data of patients by completing a form specifically designed for clinical annotation data for the study of facial trauma. Were excluded from the study patients with incomplete filling of the information. A total of 237 elderly patients were evaluated, 127 (53.6%) patients were male and 110 (46.4%) females, the fall was the most frequent cause in 146 cases (61.6%) of total with the highest incidence in the middle third of the face with 114 fractures (48.1%), sit the bones of the nose 47 cases (19.8%) and zygoma 42 cases (17.7%), and the total patients evaluated with respect to treatment of 237 patients evaluated, 101 cases (42.6%) were treated conservatively, 28 cases (11.8%) underwent surgery and 18 cases (7.6%) underwent treatment. This study showed that the fall was the most predominant cause, resulting in fractures of the middle third and decrease less surgical indications for this group, except in cases where the function is compromised, and sings in the physiological, psychological resulting from aging. / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Background: Mental ill-health among adolescents is one of the most increasing public health problems in Sweden. Particularly girls suffer from mental and psychosomatic symptoms. The National Board of Health and Welfare recommend the DISA method as a preventive measure. Problem: Investigations has been done of the DISA method, but further investigations needs to be done. Aim: The aim of the study was partly to investigate how participants in DISA groups in two counties understand the method and its eventual effect and partly how their mood change, to contribute with knowledge to the development of the DISA method. Methods: A questionnaire and the self-report CES-D scale were collected from a population of 154 participants. A statistical analysis with Paired-Samples T Test carried out to examine if the difference between the sum of points of the group from the first and the last completing of the self-report CES-D scale was statistical guaranteed. Results: The participants were most satisfied with the group size and the rules. They were less satisfied with the mood diary and the homework. They wanted to talk less about negative thoughts and wanted it to be voluntary to participate in a DISA group. The participants got better insight and understanding of mental health and mental ill health. It is statistical significant that the average sum of points of the participants got lower the last time they completed the self-report CES-D scale compared to the first time. Conclusion: There are many indicators who points out that DISA is a well functioning depression preventive method.

O diagnóstico da asma baseia-se na anamnese e no exame clínico, mas provas de função pulmonar e avaliação da alergia contribuem para o diagnóstico. A espirometria é o exame complementar mais utilizado em pacientes asmáticos, por ser útil para o diagnóstico, por ser o exame mais disponível no sistema de saúde, para classificação da gravidade e para o monitoramento terapêutico. A medida da reatividade brônquica é um exame mais demorado, tem maior risco, maior custo e é menos disponível. No entanto, é superior por representar melhor a fisiopatologia da asma. Este projeto tem o objetivo de determinar o valor da espirometria na investigação de asma em estudos epidemiológicos (tendo como referência a medida de reatividade brônquica). Foram analisados os dados de 1922 indivíduos que constituíram uma coorte de nascidos em hospitais de Ribeirão Preto em 1978 e 1979. Estes indivíduos preencheram questionários, incluindo o questionário da European Community Respiratory Health Survey; foram submetidos à espirometria e ao teste de broncoprovocação com metacolina, que mede a reatividade brônquica. Para análise dos dados, a asma foi definida pela associação de teste de broncoprovocação positivo com pelo menos um dos sintomas: sibilância, aperto no peito, dispneia, dispneia noturna. A prevalência de volume expiratório forçado no primeiro segundo menor que oitenta por cento (VEF1 < 80%) do previsto (espirometria alterada ou VEF1 reduzido) foi de 10,9%, a prevalência de hiperreatividade brônquica foi de 22,2% e a prevalência de asma foi de 10,4% na amostra de 1922 indivíduos. A espirometria teve sensibilidade de 38% para detectar asma no sexo masculino e de 16% no sexo feminino com especificidades de 94% e 90%, respectivamente. Na análise univariada, houve associação entre espirometria alterada e diagnóstico de asma apenas no sexo masculino com razão de prevalência (RP) de 5,31 com intervalo de confiança de 95% de 3,60-7,83. No sexo feminino, a RP foi de 1,34 (0,87-2,07). Na análise multivariada, a associação entre espirometria alterada e o diagnóstico de asma foi evidenciada em homens pela RP de 4,20 (2,71-6,71), mas não foi evidenciada em mulheres: 1,24 (0,79-1,93). O índice Kappa entre VEF1 reduzido e asma foi de 0,13 (0,08 - 0,19). Portanto, empregando-se o teste de broncoprovocação com sintomas para definir asma, a espirometria demonstra limitações, como baixa sensibilidade, fraca concordância e diferenças na capacidade de detectar asma entre homens e mulheres. / The diagnosis of asthma is based on history and clinical examination, but pulmonary function tests and allergy evaluation contribute to diagnosis. Spirometry is the most used complementary test in patients with asthma because it is useful and the most available in medical routine to classify the severity and therapeutic monitoring. Measurement of bronchial reactivity is more time consuming, has a higher risk, higher cost and lower availability. However, it is thought to be superior because it represents the pathophysiology of asthma. This project aims to determine the value of spirometry for asthma screening in epidemiological studies (as compared with bronchial reactivity measurement). Data from 1922 individuals who comprised a cohort of children born in hospitals in Ribeirão Preto in 1978 and 1979 were analyzed. These individuals completed questionnaires, including the questionnaire of the European Community Respiratory Health Survey; underwent spirometry and methacholine challenge test, which measures the bronchial reactivity. For data analysis, asthma was defined by the association of bronchial hyper reactivity with corresponding symptoms: wheezing, tightness in the chest, dyspnea and nocturnal dyspnea. The prevalence of reduced forced expiratory volume in one second (FEV1), i.e. less than 80% of predicted, was 10.9%; the prevalence of bronchial hyper reactivity was 22.2%; and, the prevalence of asthma was 10.4% in this sample of 1922 individuals. Spirometry had a sensitivity of 38% to detect asthma in males and 16% in females with specificities of 94% and 90%, respectively. According to univariate analysis, there was an association between spirometry and asthma diagnosis in males, with prevalence ratio (PR) of 5.31 and 95% confidence interval of 3.60 to 7.83, but there was not association in females, PR was 1.34 (0.87 to 2.07). These results were confirmed by multivariate analysis with PR of 4.20 (2.71 to 6.71) in men and 1.24 (0.79 to 1.93) in women. Kappa agreement between reduced FEV1 and asthma was 0.13 (0.08 - 0.19). Therefore, by using positive methacholine challenge test with symptoms to define asthma, spirometry shows limits, as low sensitivity, poor concordance and differences between genders.

O diagnóstico da asma baseia-se na anamnese e no exame clínico, mas provas de função pulmonar e avaliação da alergia contribuem para o diagnóstico. A espirometria é o exame complementar mais utilizado em pacientes asmáticos, por ser útil para o diagnóstico, por ser o exame mais disponível no sistema de saúde, para classificação da gravidade e para o monitoramento terapêutico. A medida da reatividade brônquica é um exame mais demorado, tem maior risco, maior custo e é menos disponível. No entanto, é superior por representar melhor a fisiopatologia da asma. Este projeto tem o objetivo de determinar o valor da espirometria na investigação de asma em estudos epidemiológicos (tendo como referência a medida de reatividade brônquica). Foram analisados os dados de 1922 indivíduos que constituíram uma coorte de nascidos em hospitais de Ribeirão Preto em 1978 e 1979. Estes indivíduos preencheram questionários, incluindo o questionário da European Community Respiratory Health Survey; foram submetidos à espirometria e ao teste de broncoprovocação com metacolina, que mede a reatividade brônquica. Para análise dos dados, a asma foi definida pela associação de teste de broncoprovocação positivo com pelo menos um dos sintomas: sibilância, aperto no peito, dispneia, dispneia noturna. A prevalência de volume expiratório forçado no primeiro segundo menor que oitenta por cento (VEF1 < 80%) do previsto (espirometria alterada ou VEF1 reduzido) foi de 10,9%, a prevalência de hiperreatividade brônquica foi de 22,2% e a prevalência de asma foi de 10,4% na amostra de 1922 indivíduos. A espirometria teve sensibilidade de 38% para detectar asma no sexo masculino e de 16% no sexo feminino com especificidades de 94% e 90%, respectivamente. Na análise univariada, houve associação entre espirometria alterada e diagnóstico de asma apenas no sexo masculino com razão de prevalência (RP) de 5,31 com intervalo de confiança de 95% de 3,60-7,83. No sexo feminino, a RP foi de 1,34 (0,87-2,07). Na análise multivariada, a associação entre espirometria alterada e o diagnóstico de asma foi evidenciada em homens pela RP de 4,20 (2,71-6,71), mas não foi evidenciada em mulheres: 1,24 (0,79-1,93). O índice Kappa entre VEF1 reduzido e asma foi de 0,13 (0,08 - 0,19). Portanto, empregando-se o teste de broncoprovocação com sintomas para definir asma, a espirometria demonstra limitações, como baixa sensibilidade, fraca concordância e diferenças na capacidade de detectar asma entre homens e mulheres. / The diagnosis of asthma is based on history and clinical examination, but pulmonary function tests and allergy evaluation contribute to diagnosis. Spirometry is the most used complementary test in patients with asthma because it is useful and the most available in medical routine to classify the severity and therapeutic monitoring. Measurement of bronchial reactivity is more time consuming, has a higher risk, higher cost and lower availability. However, it is thought to be superior because it represents the pathophysiology of asthma. This project aims to determine the value of spirometry for asthma screening in epidemiological studies (as compared with bronchial reactivity measurement). Data from 1922 individuals who comprised a cohort of children born in hospitals in Ribeirão Preto in 1978 and 1979 were analyzed. These individuals completed questionnaires, including the questionnaire of the European Community Respiratory Health Survey; underwent spirometry and methacholine challenge test, which measures the bronchial reactivity. For data analysis, asthma was defined by the association of bronchial hyper reactivity with corresponding symptoms: wheezing, tightness in the chest, dyspnea and nocturnal dyspnea. The prevalence of reduced forced expiratory volume in one second (FEV1), i.e. less than 80% of predicted, was 10.9%; the prevalence of bronchial hyper reactivity was 22.2%; and, the prevalence of asthma was 10.4% in this sample of 1922 individuals. Spirometry had a sensitivity of 38% to detect asthma in males and 16% in females with specificities of 94% and 90%, respectively. According to univariate analysis, there was an association between spirometry and asthma diagnosis in males, with prevalence ratio (PR) of 5.31 and 95% confidence interval of 3.60 to 7.83, but there was not association in females, PR was 1.34 (0.87 to 2.07). These results were confirmed by multivariate analysis with PR of 4.20 (2.71 to 6.71) in men and 1.24 (0.79 to 1.93) in women. Kappa agreement between reduced FEV1 and asthma was 0.13 (0.08 - 0.19). Therefore, by using positive methacholine challenge test with symptoms to define asthma, spirometry shows limits, as low sensitivity, poor concordance and differences between genders.

The purpose of this secondary data analysis was to assess for the relationships among sleep disturbances, depressive symptoms, inflammatory markers, and sexual trauma in female veterans. This may contribute to an understanding of the physical and mental health effects of sexual trauma in female veterans. Correlational analyses were conducted to evaluate the strength of these relationships. A reported history of sexual trauma was significantly correlated with longer sleep latencies, poorer sleep efficiency, shorter sleep durations, more daytime dysfunction, and poorer overall sleep quality in female veterans. A reported history of sexual trauma was also significantly correlated with depressive symptoms including anhedonia and a negative affect in female veterans. No significant correlations were noted between inflammatory markers and a reported history of sexual trauma in female veterans. Female veterans with a reported history of sexual trauma had more trouble falling and staying asleep, had more trouble functioning during daytime hours, and had total poorer sleep quality. These veterans also appeared depressed and they found normally pleasurable activities unenjoyable. Disturbed sleep and depressive symptoms may be risk factors in the development of chronic health diseases. By assessing and treating the sleep disturbances and depressive symptoms experienced by sexually traumatized female veterans, nurses may help to prevent the development of costly and deadly chronic diseases

名古屋大学博士学位論文 学位の種類 : 博士(医学)(課程) 学位授与年月日:平成23年3月25日 村松崇氏の博士論文として提出された

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (p. 164-170).