MATERIALS AND METHODS: In this cross-sectional study, 206 Malaysian adolescents (age: 11-18 years) were screened in orthodontic clinics to identify those with normative need, oral impacts due to malocclusion, and having high and medium-to-high behavioural propensities. The Index of Orthodontic Treatment Need classified normative need. The Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and the Condition-Specific Child-Oral Impacts on Daily Performances (CS-OIDP) index measured oral impacts. Subjects' behavioural propensities for successful treatment outcome were based on the Basic Periodontal Examination and International Caries Detection and Assessment System. Data were analysed using the McNemar test.
RESULTS: The response rate was 99.0%. Estimates of normative need (89.7%) were significantly reduced under the sociodental model by 65.7% (p
MATERIALS AND METHODS: Twenty surviving patients with expandable endoprosthesis from 2006 till 2015 were scored using Musculoskeletal Tumour Society (MSTS) outcomes instrument and reviewed retrospectively for range of motion of respected joints, limb length discrepancy, number of surgeries performed, complications and oncological outcomes. Patients with less than 2 years of follow-up were excluded from this study.
RESULTS: Forty-five percentage patients reached skeletal maturity with initial growing endoprosthesis and 25% of patients were revised to adult modular prosthesis. One hundred fifty-seven surgeries were performed over the 9-year period. The average MSTS score was 90.83%. The mortality rate was 10% within 5 years due to advanced disease. Infection and implant failure rate was 15% each. The event-free survival was 50% and overall survival rate was 90%.
CONCLUSION: There is no single best option for reconstruction in skeletally immature. This study demonstrates a favourable functional and survival outcome of paediatric patients with expandable endoprosthesis. The excellent MSTS functional scores reflect that patients were satisfied and adjusted well to activities of daily living following surgery despite the complications.
Patients and methods: This cross-sectional study included 167 SLE patients (21 males, 146 females; mean age 38.2±9.8 years; range, 20 to 60 years) recruited from the outpatient Rheumatology and Nephrology clinics. Face-to-face interviews were conducted to record patients' socio- demographics (age, sex, ethnicity, marital status, and occupation) and SLE disease characteristics (system involvement, age onset, and presence of organ damage). Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K). Short form 36 (SF-36) was used to determine health-related quality of life (HRQoL) while Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the four domains of absenteeism, presenteeism, overall work productivity, and non-work related ADL impairment. Univariate analyses and multivariable regression analysis examined the association of demographic variables, SLE disease characteristics, and activity with reduced HRQoL and WPAI scores.
Results: The majority of the patients were Malays (59.3%), followed by Chinese (34.7%) and Indian (3.6%) patients. More than two-thirds of the patients reported some degree of impairment in their work productivity and ADL due to the disease. The absenteeism rate was 10.4% in the past one week and their indirect costs were 2,875.17 Malaysian ringgits (US $701.22) in the past seven days. Significant predictors of higher work productivity and ADL impairment scores were higher disease activity, more frequent SLE flares, lupus nephritis, and hematological involvement of SLE. Patients with higher work productivity and ADL impairment scores were also strongly associated with poor QoL. No ethnic disparities of work productivity and ADL impairment were found.
Conclusion: Systemic lupus erythematosus significantly affected the overall productivity in work and non-work related activity in our Malaysian multi-ethnic cohort and both impairments were significantly associated with poor QoL.
METHODS: Sixty patients were randomised to receive IV dexmedetomidine 0.5 μg.kg-1 (Group DEX, n = 30) or IV saline (Group P, n = 30). General anaesthesia was maintained with Sevoflurane: oxygen: air, titrated to BIS 40-60. Pain intensity, sedation, rescue analgesics, nausea/vomiting and resumption of daily activities were recorded at 1 h, and postoperative day (POD) 1-5.
RESULTS: Group DEX patients had significant reduction in sevoflurane minimum alveolar concentration (MAC), mean (SD) DEX vs. Placebo 0.6 (0.2) vs. 0.9 (0.1), p = 0.037; reduced postoperative resting pain at 1 h (VAS 0-10) (mean (SD) 1.00 (1.84) vs. 2.63 (2.78), p = 0.004), POD 1 (mean (SD) 1.50 (1.48) vs. 2.87 (2.72), p = 0.002), POD 2 (0.53 (0.97) vs. 1.73 (1.96), p = 0.001) and POD 3 (0.30 (0.75) vs. 0.89 (1.49), p = 0.001). DEX patients also had less pain on movement POD 1 (3.00 (2.12) vs. 4.30 (3.10), p = 0.043) and POD 2 (2.10 (1.98) vs. 3.10 (2.46), p = 0.040), with higher resumption of daily activities by 48 h compared to placebo, 87% vs. 63%, p = 0.04.
CONCLUSIONS: We conclude that a single dose of dexmedetomidine was a useful adjuvant in reducing MAC and postoperative pain (at 1 h and POD 1-3), facilitating faster return to daily activities by 48 h.
TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617001120369 , 31st July 2017, retrospectively registered.
METHODS: We used the 11-item Duke Social Support Index to assess perceived social support through a face-to-face interview. Higher scores indicate better social support. Linear regression analysis was carried out to determine the factors that influence perceived social support by adapting the conceptual model of social support determinants and its impact on health.
RESULTS: A total of 3959 respondents aged ≥60 years completed the Duke Social Support Index. The estimated mean Duke Social Support Index score was 27.65 (95% CI 27.36-27.95). Adjusted for confounders, the factors found to be significantly associated with social support among older adults were monthly income below RM1000 (-0.8502, 95% CI -1.3523, -0.3481), being single (-0.5360, 95% CI -0.8430, -0.2290), no depression/normal (2.2801, 95% CI 1.6666-2.8937), absence of activities of daily living (0.9854, 95% CI 0.5599-1.4109) and dependency in instrumental activities of daily living (-0.3655, 95% CI -0.9811, -0.3259).
CONCLUSION: This study found that low income, being single, no depression, absence of activities of daily living and dependency in instrumental activities of daily living were important factors related to perceived social support among Malaysian older adults. Geriatr Gerontol Int 2020; 20: 63-67.
STUDY DESIGN AND OUTCOME VARIABLES: This study used data from four waves of the Chinese Longitudinal Health and Longevity Survey (CLHLS) conducted in 2002, 2005, 2008 and 2011. The sample comprised 2137 older adults who were interviewed in 2002 and re-interviewed in the following waves. Cross-tabulations were run to show the rise in chronic disease and disability with age. Ordinal logistic regression was run to examine the debilitating effects of these diseases in terms of the ability of the oldest old to perform activities of daily living.
RESULTS: The prevalence of chronic diseases rose sharply with age. The prevalence rate of six major diseases increased between 38% (respiratory diseases) and 533% (neurological disorder) among respondents who were re-interviewed nine years later. Cardiovascular diseases were the most common. Neurological disorder and cancer were less common, but had the most debilitating effects on patients. Overall, 10.0%, 3.1% and 3.1% of the respondents were disabled by cardiovascular, musculoskeletal and sensorial diseases, respectively. Ordinal logistic regression showed that neurological disorder had the strongest debilitating effects, followed by musculoskeletal and cardiovascular diseases among 2137 older persons who had survived and were followed up from the base year (2002) through 2011.
CONCLUSION: The rapid rise in chronic diseases has resulted in an increased burden of disability among the oldest old in China. There is a need to improve health care systems for the prevention and management of chronic diseases.