A hidden periodontitis epidemic during the 20th century?

OBJECTIVES: Increasing evidence suggests a strong causal link between smoking and periodontitis. The goal of this study was to impute how the secular changes in smoking prevalence during the 20th century impacted the advanced periodontitis incidence in the US. METHODS: Epidemiological analyses based on US prevalence data of advanced periodontitis and smoking, and predictions of future smoking prevalence. RESULTS: Assuming other risk factors for periodontitis remained constant, we estimated that the incidence of advanced periodontitis decreased by 31% between 1955 and 2000. The changes in smoking habits, and consequently the changes in periodontitis incidence, depended strongly on education and gender. Between 1966 and 1998, we estimated a 43% decreased periodontitis incidence among college-educated individuals versus only an 8% decrease among individuals with less than a high school education. Between 1955 and 1999, we estimated a 41% decrease among males versus a 14% decrease among females. By the year 2020, the incidence of advanced periodontitis may decrease 43% from its level in 1955. CONCLUSIONS: A periodontitis epidemic fueled by smoking remained hidden for most of the 20th century. Because this epidemic was hidden, it distorted our understanding of the treatment and etiology of periodontitis. The socioeconomic polarization of this epidemic will dictate alterations in patterns of periodontal care.     

Fibre – Need to increase intake according to new recommendations

In its report on Carbohydrates and Health, the Scientific Advisory Committee on Nutrition (SACN) has recommended increases in the dietary reference values for fibre to 30 g/day for adults and 15–30 g/day for children, depending on their age. Intakes are currently much lower than this, at an average of 18 g/day in adults, less in children, and there are socio‐economic differences, with lower intakes in the lowest income quintile compared to the highest. Dietary modelling shows that achieving these recommendations is possible but will require substantial changes to dietary patterns for many, with meals based around fibre‐rich starchy foods (such as wholegrain and high‐fibre options of bread, breakfast cereals, pasta and rice, and jacket potatoes), supplemented by inclusion of high‐fibre snacks such as unsalted nuts and considerable amounts of vegetables and fruit, daily. This article discusses the challenges associated with communicating these new recommendations, in the context of current labelling legislation.     

国际全科医生制度发展历程:影响因素分析及政策启示

全科医生制度建设的国际经验可以为中国全科医生制度的建立和发展提供借鉴。本文首先梳理了国民健康服务体制、社会医疗保险体制、商业医疗保险体制等部分典型国家的全科医生制度发展历程,重点分析了全科医生制度建设的影响因素。结果发现,建立和发展全科医生制度的主要影响因素有:经济社会因素、卫生保健体制对卫生体系的控制力、医师对卫生体系的控制力、全科医学服务的激励机制、全科医学的发展程度等。最后,结合近年我国全科医生制度建设的实际提出几点政策启示,一要以满足我国公众健康需求为目标,构建中国特色全科医生制度;二要普及全科医学服务核心价值,为建立全科医生制度提供公众民意基础;三要建立健全促进全科医生制度发展的激励机制,提高全科医生地位;四要积极推动全科与专科医学的专业分工,促进全科医学发展。     

Sex differences in lower extremity coordinative variability during running

BackgroundDifferences in coordinative variability have been previously reported between healthy and injured runners. Many running-related injuries have a sex bias, particularly patellofemoral pain (PFP), as female runners are approximately twice as likely to develop PFP compared to males. However, very little is currently known regarding sex differences in coordinative variability during running.Research QuestionAre there sex differences in continuous relative phase (CRP) variability for pelvis-thigh and thigh-shank couplings during the stance phase of running?MethodsPelvis, thigh, and shank segment kinematics were collected on 15 female and 15 male subjects during overground running at a self-selected easy pace (2.39–3.56 m/s) using a 10-camera 3D motion capture system. Continuous relative phase (CRP) variability was calculated between the pelvis-thigh and thigh-shank, and averaged during four distinct stance sub-phases. A mixed effects linear model compared CRP variability between sexes at each stance sub-phase.ResultsCompared to males, females displayed significantly lower pelvis-thigh CRP variability in the transverse plane during the loading response phase, and significantly lower thigh-shank CRP variability in the sagittal plane during the loading response and pre-swing phases.SignificanceLower coordinative variability in females during the loading response for two couplings may provide additional insight into the sex bias for developing certain running-related injuries. However, any injury implications from these results are speculative and should be interpreted with caution.     

Plasma Transthyretin as a Biomarker of Lean Body Mass and Catabolic States

Plasma transthyretin (TTR) is a plasma protein secreted by the liver that circulates bound to retinol-binding protein 4 (RBP4) and its retinol ligand. TTR is the sole plasma protein that reveals from birth to old age evolutionary patterns that are closely superimposable to those of lean body mass (LBM) and thus works as the best surrogate analyte of LBM. Any alteration in energy-to-protein balance impairs the accretion of LBM reserves and causes early depression of TTR production. In acute inflammatory states, cytokines induce urinary leakage of nitrogenous catabolites, deplete LBM stores, and cause an abrupt decrease in TTR and RBP4 concentrations. As a result, thyroxine and retinol ligands are released in free form, creating a second frontline that strengthens that primarily initiated by cytokines. Malnutrition and inflammation thus keep in check TTR and RBP4 secretion by using distinct and unrelated physiologic pathways, but they operate in concert to downregulate LBM stores. The biomarker complex integrates these opposite mechanisms at any time and thereby constitutes an ideally suited tool to determine residual LBM resources still available for metabolic responses, hence predicting outcomes of the most interwoven disease conditions.     

Bilateral quadruple renal arteries

Variation in the number of renal arteries (RAs) constitutes the most common and clinically important renal vascular variation. In this study, the authors describe a rare case of a 58‐year‐old male with eight RAs (bilateral quadruple) as revealed by routine multidetector computed tomography angiography. All the eight RAs originated from the abdominal aorta and penetrated the renal parenchyma at the level of renal sinus. The main RAs had the intraluminal diameter larger than the diameter of the additional renal arteries (AdRAs) at the origin. All the AdRAs had a greater length than the main RAs. These aspects are particularly important in planning microsurgical procedures. Clin. Anat. 25:973–976, 2012. © 2012 Wiley Periodicals, Inc.