Caries in primary dentition related to age, sex social status, and county of residence in Finland

Abstract The study material consisted of 1417 children 6–8 years old representing 86% of a stratified random sample from the Finnish population. Data on caries and social class were obtained by questionnaire from the municipal dental clinics in 1978. Clinical findings for primary teeth were recorded by local dentists. Incisors were excluded from the study. 80% of the children had caries lesions, and 63 % were in need of restorative care. Mean dmft value was 4.4, mean dt, ft, and mt values were 2.3, 2.6 and 0.3, respectively. Occurrence of untreated caries lesions did not vary according to age. Compared to the girls, boys had lost twice as many teeth due to caries. No other differences were observed between sexes. Both past caries experience and need of restorative care increased continuously from the highest social class to the lowest. Observed regional differences were explained mainly by variation in social stratification, except in an area with abundant natural fluoride. More active dental care is needed for children with primary teeth, especially in lower social classes.     

Diabetes, coeliac disease, multiple sclerosis and chronic arthritis in first-degree relatives of patients with juvenile idiopathic arthritis

Aim: To evaluate the occurrence of autoimmune diseases in first‐degree relatives of children with juvenile idiopathic arthritis (JIA) and to compare the figures with published population data. Materials and methods: Families of the 362 children with recently diagnosed JIA admitted to Rheumatism Foundation Hospital, Finland, from 1996 to 2001 were contacted by questionnaires regarding autoimmune diseases in family members. Data were collected on type 1 diabetes, coeliac disease, multiple sclerosis and chronic arthritis, consisting mainly of JIA, rheumatoid arthritis, spondyloarthropathy or psoriatic arthritis. Results: In all, 21.4% of the 355 families with a patient with JIA had members with type 1 diabetes, coeliac disease, multiple sclerosis or chronic arthritis. Thirty‐three mothers and 23 fathers had type 1 diabetes, coeliac disease, multiple sclerosis or chronic arthritis in 15.2% (95% CI 11.6–19.4) of the families, and 23 mothers and 15 fathers had chronic arthritis in 10.7% (95% CI 7.7–14.5) of the families. When compared with available research data, the prevalences of rheumatoid arthritis, spondyloarthropathy, psoriatic arthritis, paediatric type 1 diabetes and JIA (in siblings) were increased in JIA families. Coeliac disease was as prevalent as in the population. Conclusion: Autoimmune diseases cluster in families with a child with JIA.     

Validation of a 3D CT method for measurement of linear wear of acetabular cups

Background

We evaluated the accuracy and repeatability of a 3D method for polyethylene acetabular cup wear measurements using computed tomography (CT). We propose that the method be used for clinical in vivo assessment of wear in acetabular cups.

Material and methods

Ultra-high molecular weight polyethylene cups with a titanium mesh molded on the outside were subjected to wear using a hip simulator. Before and after wear, they were (1) imaged with a CT scanner using a phantom model device, (2) measured using a coordinate measurement machine (CMM), and (3) weighed. CMM was used as the reference method for measurement of femoral head penetration into the cup and for comparison with CT, and gravimetric measurements were used as a reference for both CT and CMM. Femoral head penetration and wear vector angle were studied. The head diameters were also measured with both CMM and CT. The repeatability of the method proposed was evaluated with two repeated measurements using different positions of the phantom in the CT scanner.

Results

The accuracy of the 3D CT method for evaluation of linear wear was 0.51 mm and the repeatability was 0.39 mm. Repeatability for wear vector angle was 17°.

Interpretation

This study of metal-meshed hip-simulated acetabular cups shows that CT has the capacity for reliable measurement of linear wear of acetabular cups at a clinically relevant level of accuracy.Debris due to polyethylene wear may trigger aseptic loosening in total hip arthroplasty (THA) (Santavirta et al. 1995, Mohanty 1996). With the methods currently available, it is difficult to determine small amounts of wear in vivo without using invasive methods such as radiostereometric analysis (RSA) (Schewelov et al. 2004). Conventional radiography is the most common routine clinical method, but it yields only 2D results with low accuracy—of about 4 mm (Clarke et al. 1976). Several 3D reconstruction methods exist, such as AP radiographs, but these methods are still too complicated to be reliable in a routine clinical setting and the accuracy tends to be lower in a clinical situation than under laboratory conditions (Clarke et al. 1976).Current multislice CT scanners, which offer accurate spatial volume resolution in both 2D and 3D without substantial distortion, are non-invasive and fast. Metal artifacts from the implant are suitably suppressed by software algorithms from the CT manufacturers. We have previously shown that CT can also be used for evaluation of acetabular cup position and migration (Olivecrona et al. 2002, 2003c, 2004). A retrieval study showed that CT can also be used for evaluation of 3D penetration of the femoral head into metal-backed acetabular cups with an accuracy of 1 mm (Olivecrona et al. 2005). Based on that study, we developed a new approach for wear assessment using CT and it was shown to achieve an accuracy of 0.6 mm and a repeatability of 0.4 mm (Olivecrona et al. 2005). This new approach relies on placing several landmarks in the 3D CT volume on the surfaces of the head and cup. Spheres are then fitted to these data points, and from these spheres the femoral head penetration can be calculated.As part of this study, the method described was developed futher—mainly with improved software that allowed many more landmark points to be placed on the 3D surfaces, and the possibility of comparing the same implant at 2 time points (e.g. pre-wear and post-wear). A model study was performed with a hip simulator in order to estimate the accuracy and reproducibility of the method proposed. Both gravimetric results and measurement results from a coordinate measurement machine (CMM) were used as reference methods. We used a different cup design with a metal mesh molded into the polyethylene outer surface, in order to avoid back-side wear.Due to an unanticipated upgrade of the CT software, we also simulated the clinical situation where a CT scan is done postoperatively and then at a follow-up several years later, by using a different CT scan protocol before and after wear.     

Rehabilitation agency of older adults in group-based intervention

Aims: This study investigated the individual rehabilitation agency of older adults in a one-year group-based gerontological rehabilitation context. Here, rehabilitation agency is understood as being manifested when older adults make choices and decisions regarding their everyday lives, including notions of themselves.

Methods: The data were obtained via non-participant observation of the final individual goal evaluation sessions of 38 older adults with their personal counselor. In these sessions, older adults discussed their rehabilitation outcomes, actions, choices and decisions during the rehabilitation year, along with their future in home settings. The data were analyzed using qualitative content analysis and an agency-centred approach.

Findings: The findings revealed that older adults made choices and decisions differently concerning their life in and beyond the rehabilitation context. Four forms of rehabilitation agency of older adults were identified: (i) renewable, (ii) widened, (iii) selective and (iv) fractured. These forms of agency were differently connected to older adults’ life courses and to their peer relations in the rehabilitation context.

Conclusions: An agency-centred approach could produce new theoretical ideas and practical implications for developing older adults’ rehabilitation to better meet their needs as well as the goals of group-based rehabilitation interventions.     

Recognition and identification of UV-absorbing leachables in EPREX pre-filled syringes: an unexpected occurrence at a formulation-component interface

During the period of 1998 to 2002, there was an increase in the incidence of antibody-positive pure red cell aplasia (PRCA) in patients receiving subcutaneous administration of EPREX (epoetinum alfa). As part of the investigation of this event, the aqueous formulation containing polysorbate 80, introduced in 1998, facilitated the leaching of small-molecule, aromatic compounds from the uncoated rubber syringe stoppers. The leachables were identified using Liquid Chromatography-Mass Spectroscopy, Electrospray Ionisation-MS/MS, Dithiothreitol reduction, and Hydrogen/Deuterium exchange. The major leachable was identified as a dialkylphenol disulfide, and the majority of the remaining peaks were identified as structural variants containing different numbers of sulfur atoms in the sulfide bridge. In this report, we describe the strategies and experimental designs that were used to overcome the analytical challenges and that led to successful structural identification of the leachables in EPREX pre-filled syringes with uncoated syringe stoppers.     

Response of respiratory flour allergics in an ingested flour challenge may involve plasmacytoid dendritic cells, CD25+ and CD152+ T cells

BACKGROUND: A number of occupational respiratory allergens are food related, and little is known about the responses these allergens elicit in sensitized persons that ingest them. METHODS: Nine respiratory flour-allergic volunteers were exposed in a double-blind placebo-controlled food challenge with flour. Responses were monitored by spirometry, acoustic rhinometry, determination of urinary methyl histamine and tryptase and flow cytometric evaluation of basophil, dendritic and T cell numbers and markers. RESULTS: Significant increases in serum tryptase (compared with placebo post-exposure levels) and methyl histamine and a coordinated decrease in blood basophils and nasal volume after ingestion of allergen compared with placebo suggest an allergic response to ingested allergen. There was no change in forced expiratory volume in 1 s. The number of blood plasmacytoid dendritic cells (DC), but not of myeloid DC, decreased after exposure (p = 0.001). DC HLA DR was reduced after both exposures (p < 0.001). Expression of CXCR4 on DC was reduced after allergen (p = 0.033) but not after placebo exposure. CD4+ T cell expression of CD25 was elevated after placebo (p = 0.021) but reduced after allergen provocation. The reduction in CD25 expression after allergen compared with placebo was significant (p = 0.024). CD152 was downregulated on these cells after allergen (p = 0.039) but less so after placebo exposure. CONCLUSION: Persons with respiratory allergy respond after ingestion of the relevant allergen. Response to this allergen challenge may selectively recruit plasmacytoid DC through CXCR4 and T cells expressing CD25 and CD152, which may be a regulatory phenotype.     

Coat colour and sex identification in horses from Iron Age Sweden

Domestication of animals and plants marked a turning point in human prehistory. To date archaeology, archaeozoology and genetics have shed light on when and where all of our major livestock species were domesticated. Phenotypic changes associated with domestication have occurred in all farm animals. Coat colour is one of the traits that have been subjected to the strongest human selection throughout history. Here we use genotyping of coat colour SNPs in horses to investigate whether there were any regional differences or preferences for specific colours associated with specific cultural traditions in Iron Age Sweden. We do this by identifying the sex and coat colour of horses sacrificed at Skedemosse, ?land (Sweden) during the Iron Age, as well as in horses from two sites in Uppland, Ultuna and Valsg?rde (dated to late Iron Age). We show that bay, black and chestnut colours were all common and two horses with tobiano spotting were found. We also show how the combination of sex identification with genotyping of just a few SNPs underlying the basic coat colours can be used to identify the minimum number of individuals at a site on a higher level than morphological methods alone. Although separated by 500 km and from significantly different archaeological contexts the horses at Skedemosse and Ultuna are quite homogenous when it comes to coat colour phenotypes, indicating that there were no clear geographical variation in coat colouration in Sweden during the late Iron Age and early Viking Age.