Parental age and birth defects: a sibling study

European Journal of Epidemiology - Higher parental age at childbearing has generated much attention as a potential risk factor for birth disorders; however, previous research findings are mixed....     

OSU-6162, a Sigma1R Ligand in Low Doses,Can Further Increase the Effects of Cocaine Self-Administration on Accumbal D2R Heteroreceptor Complexes

Neurotoxicity Research - Cocaine was previously shown to act at the Sigma1R which is a target for counteracting cocaine actions. It therefore becomes of interest to test if the monoamine stabilizer...     

Repetitive syncopal episodes in a child with documented ventricular tachycardia,early repolarization pattern in leads I an aVL,Brugada syndrome,and fever

We present a small child with febrile peaks and syncopal episodes secundary to ventricular tachycardia, in whom it was eventually possible to demostrate the Brugada Syndrome with a special presentation in the ECG; early repolarization pattern in lead I and a aVL and Brugada pattern during fever in V1‐V2. This is, to our knowledge, tha first case with this special ECG presentation in a small child.     

The effects of fixed and removable implant-stabilised prostheses on posterior mandibular residual ridge resorption

Abstract: This study investigated the change over time in the area of the posterior mandibular residual ridge in patients wearing either i) mandibular overdentures stabilised by two implants (Brånemark System; Nobel Biocare, Göteborg, Sweden) connected by a bar, or ii) mandibular fixed cantilever prostheses stabilised on five or six implants. Proportional measurements were made in order to compare the area of the residual ridge with an area of bone uninfluenced by resorption. Measurements were made by digitising tracings of panoramic radiographs that were taken shortly after implant insertion and up to seven years later. With the use of overdentures, the posterior bone area index reduced by a mean of 1.1% per annum, while a mean bone area index increase of 1.6% per annum was demonstrated in association with fixed prostheses. A multiple linear regression model was fitted to predict the change in posterior area from type of prosthesis, gender, age, years of edentulism and initial height of the mandible. The model was only significant for initial height of mandible (P = 0.04) and type of prosthesis (P = 0.0001). In conclusion, patients rehabilitated with implant‐stabilised mandibular overdentures demonstrated low rates of posterior mandibular residual ridge resorption, while patients rehabilitated with implant‐stabilised mandibular fixed cantilever prostheses demonstrated bone apposition in the same area.     

Caries experience and caries predictors--a study of Tanzanian children consuming drinking water with different fluoride concentrations

The aim of this investigation was to assess the role of predictors of caries experience among children in urban and rural areas of northern Tanzania. Children of the different communities had varying dietary habits and consumed water with varying fluoride (F) concentration. Subjects (n=256) aged 9-14 years were examined in high-F areas (3.6 mg F/l, Arusha and Arusha Meru, n=101) and low-F areas (<0.4 mg F/l, Moshi and Kibosho, n=155). Dental caries was assessed under field conditions using the decayed, missing, filled teeth (DMFT) index and the WHO criteria. The prevalence of caries was 14%. The mean DMFT score was 0.22 (n=256), the range between areas 0.07-0.66. Carious lesions were mainly observed in mandibular first molars. Logistic regression analyses indicated that subjects in the high-F and urban Arusha municipality were at a significantly higher risk of dental caries than children in the low-F areas (odds ratio [OR] 2.6). Controlling for ethnicity, children in urban areas were at higher risk for caries (OR 5.4) than children living in low-F rural Kibosho.     

Risk periods in the development of dental fluorosis

In order to study the age-related susceptibility to dental fluorosis, 40 children who had been lifelong consumers of moderate- to high-fluoride water (0.55–8.48 mg F/l) were examined, as well as a group of older siblings (n = 40) who were born 6 months to 6 years before the fluoride-containing drinking water was introduced to the household. Background information was obtained through a structured questionnaire. Dental fluorosis was scored according to the TF index. Among the 80 children examined, the permanent incisors were erupted in 66, while 67 had permanent first molars present. As compared to their older siblings, the prevalence of dental fluorosis was significantly higher in the children who had consumed moderate- to high-fluoride water throughout their lives. In a multiple regression analysis, the variable “age when introduced to moderate- to high-fluoride water” came out as the only significant risk factor associated with dental fluorosis. This variable was divided into three categories according to the first exposure to moderate- to high-fluoride drinking water (1) 0–12 months of age, (2) 13–24 months of age and (3) after 24 months of age. Category 3 was used as the reference group. Fluoride exposure starting during the 1st year of life showed the highest odds ratio as compared to exposure only after 2 years of age. The findings indicate that early mineralising teeth (central incisors and first molars) are highly susceptible to dental fluorosis if exposed to fluoride from the first and – to a lesser extent – also from the 2nd year of life. Received: 20 July 1998 / Accepted: 22 October 1998     

Laparoscopic repair of a Bochdalek hernia with incarcerated bowel during pregnancy: report of a case

A Bochdalek hernia is a rare type of diaphragmatic defect, generally presenting in early childhood with acute signs of cardiorespiratory distress. We herein report a case of acute abdomen in a pregnant patient with pain increasing when lying on her right side. Laparoscopic evaluation revealed a right-sided Bochdalek hernia with incarcerated bowel. A successful reduction was possible, and laparoscopic repair appears to be a safe and feasible technique for the repair of these hernias.     

Urine biomarkers for monitoring juvenile lupus nephritis: a prospective longitudinal study

Background

In juvenile-onset systemic lupus erythematosus (JSLE), renal involvement (lupus nephritis) is frequently seen and can result in long-term morbidity. This prospective longitudinal study aimed to identify the utility of standard and/or novel biomarkers for monitoring and predicting lupus nephritis in a real world setting.

Methods

Using an unselected JSLE cohort, urine samples were collected during routine clinical review. Protein concentrations of urinary monocyte chemo-attractant protein 1 (uMCP1) and neutrophil gelatinase-associated lipocalin (uNGAL) were analysed along with standard disease activity markers, and were compared with current and subsequent disease activity.

Results

JSLE patients (n?=?64; median age 14.1 years) were seen at 3 (interquartile range: 2–5) clinical reviews over 364 (182–532) days. Multivariate analysis demonstrated uMCP1 and serum C3 as independent variables (p?<?0.001) for active renal disease at the time of the current review. uMCP1 was an excellent predictor of improved renal disease over time (AUC: 0.81; p?=?0.013). uNGAL was a good predictor of worsened renal disease activity (AUC 0.76; p?=?0.04) over time.

Conclusion

Biomarkers (uMCP1, serum C3) can indicate current renal involvement in JSLE, whilst uMCP1 and uNGAL are able to predict subsequent renal disease activity changes. Moving towards biomarker-led monitoring may improve the renal outcome for our patients.     

Experimental Disc Herniation in the Rat Causes Downregulation of Serotonin Receptor 2c in a TNF-dependent Manner

Background

During recent decades, the knowledge of the pathophysiology of disc herniation and sciatica has drastically improved. What previously was considered a strict biomechanical process is now considered a more complex interaction between leaked nucleus pulposus and the tissue in the spinal canal. An inflammatory reaction, with tumor necrosis factor (TNF) playing an essential role, has been demonstrated. However, the exact mechanisms of the pathophysiology of disc herniation remain unknown.

Questions/purposes

In this study we use an animal model to investigate (1) if and/or how experimental disc herniation affects gene expression in the early phase (24 hours postsurgery) in the dorsal root ganglion; and (2) if TNF inhibition can reduce any observed changes.

Methods

A rat model of disc herniation was used. Twenty rats were evenly divided into four groups: naïve, sham, disc herniation, and disc herniation with TNF inhibition. The dorsal root ganglion of the affected nerve root was harvested 24 hours after surgery and analyzed with a TaqMan Low Density Array^® quantitative polymerase chain reaction assay. Gene expression levels in sham were compared with disc herniation to assess question 1 and disc herniation to disc herniation with TNF inhibition to assess question 2.

Results

Experimental disc herniation caused a decrease in the expression of the serotonin receptor 2c gene (p = 0.022). TNF inhibition was found to reduce the observed decrease in expression of serotonin receptor 2c (p = 0.037).

Conclusions

Our results suggest that a decrease in the expression of the serotonin receptor 2c gene may contribute to the pathophysiology of disc herniation. Further research on its involvement is warranted.

Clinical Relevance

This pilot study gives a brief insight into cellular changes that may contribute to the pathophysiology of disc herniation. This knowledge may contribute to the development of more and better treatment options for patients with disc herniation and sciatica.