A population-based study on epilepsy in mentally retarded children

PURPOSE: This study presents data on cumulative risk of seizures, cause, comorbidity, and remission of epilepsy among mentally retarded (MR) children followed until the age of 22 years. METHODS: A total of 151 MR children were identified at the age of 8 or 9 years by screening four birth cohorts of 12,882 children born from 1969 to 1972 in the Finnish province of Kuopio. Information about epilepsy was gathered longitudinally when children were 9 to 10, 17, and 22 years old. The guidelines for epidemiological studies on epilepsy proposed by the International League Against Epilepsy were followed. RESULTS: By the age of 10 years, 29 of the 151 MR children (19%) had epilepsy. The cumulative risk for epilepsy at 22 years was 21%. The probability of developing epilepsy was increased fivefold in severely MR children compared with mildly MR children, i.e., in 27 of the 77 severely MR children (35%) versus 5 of the 74 mildly MR children (7%). Postnatal causes of mental retardation or association with cerebral palsy increased the risk for epilepsy, especially in the mildly MR children. When these risk factors were not present, the mildly MR children exhibited only a 3% risk for epilepsy, whereas the respective risk was about 10-fold in severe mental retardation. The cumulative probability of epilepsy being in remission for 5 years by the age of 22 was 32%. CONCLUSIONS: The cumulative risk of epilepsy varies according to the severity and the cause of the retardation as well as the presence of additional disabilities. The cumulative probability of epilepsy remission tended to increase with age.     

Monitoring microvascular free flaps with tissue oxygen measurement and pet

Snoring occurs as a major symptom in patients with sleep disordered breathing (SDB). The aetiology of snoring remains still unclear despite various attempts to localize snoring. The correlation between different snoring sounds and the severity of SDB has not yet been investigated in a larger population. The aim of this study was to record and analyse snoring sounds and to correlate the obtained data with clinical and polysomnographical parameters. Sixty male patients with suspected SDB and reported snoring underwent a clinical examination and night time polysomnography. The parallel digitally recorded snoring sounds were analysed by fast fourier transformation (FFT). Peak intensity was determined from the power spectrum. The periodicity of snoring was classified into rhythmic and non-rhythmic snoring according to the presence of air flow interruptions due to obstructive apneas. Patients with primary snoring revealed peak intensities between 100 and 300 Hz. Patients with an obstructive sleep apnea syndrome (OSAS) revealed peak intensities above 1,000 Hz. Polysomnographical data (AHI, mean and minimum SpO₂) as well as body mass index (BMI) correlated with peak intensity of the power spectrum. None of the parameters of the clinical examination correlated with peak intensity. Frequency analysis of snoring sounds provides a useful diagnostic tool to distinguish between different patterns of snoring and respective SDB. The topodiagnosis of snoring is not possible by means of frequency analysis or clinical examination alone. Acoustical analysis of snoring sounds seems a promising additional diagnostic tool to verify different types of SDB in snoring patients.     

Risk-based early prevention in comparison with routine prevention of dental caries: a 7-year follow-up of a controlled clinical trial; clinical and economic aspects

Background  

The results in an earlier study with 2–5-year-old children indicated that, in comparison with conventional prevention, a risk-based prevention programme was effective in reducing dental caries in a low-caries community. The aim of the present study was to examine the clinical and economic findings seven years after the cessation of the targeted programme, from the perspective of public health care.     

The aqueous humour antioxidative capacity in different types and color of the age-related cataract

BACKGROUND/AIM: Oxidative stress results from increased oxidative processes, decreased antioxidative protection, or both processes simultaneously. Photooxidative stress, as a form of oxidative stress, induced by the energy of solar radiation, today is considered as crucial in the age-related cataractogenesis. Other known and unknown, endogenous and egsogenous factors that contribute to the oxidative stress intensity, can influnce the cataract type and brunescence. Thus the oxidative stress intensity and its form might determine the cataract type and brunescence, and also make the efforts in cataract prevention more complex. Hence, the objective of the present paper was to investigate the current amount of antioxidative capacity in aqueous humour during the cataract genesis of different types and pigmentation of cataract. METHODS: Transversal review of 80 samples of humour aqueous obtained during extracapsular cataract extraction. Aqueouses were analyzed by tiobarbituric acid (TBA) method for the total antioxidant activity estimation, expressed as %iMDA, and by using 0.1 ml of aqueous. RESULTS: The mixed type of cataract showed the statistically significantly lower values of the intensities of antioxidative protection in aqueous humour compared to cortical and nuclear cataracts (p < 0.001, respectively). Between pure nuclear and cortical cataracts we found the small differences of the investigated parameter, but they pointed to the decreased level of antioxidative protection, i.e. the increased intensity of the aqueous humour oxidative stress in the cortical cataract type. A significant correlation betweer the cortical cataract maturation and the %iMDA (p < 0.05) was found. CONCLUSIONS: The role of the oxidative stress, here expressed as the antioxidative capacity of aqueous humour, could not be the same for all the cataract types. The lower level of antioxidative protection of aqueous in brunescent and mixed cataracts may point to the higher intensity of oxidative stress in those cataract types. The correlation betweer the cortical cataract maturity and %iMDA points to the significant decrease of the aqueous antioxidative protection in the cataract progression.     

Ultrasonically activated scalpel compared with electrocautery in tonsillectomy

The occurrence of postoperative bleeding, the quantity of operative bleeding and the duration of operation were retrospectively evaluated in 407 patients who underwent tonsillectomy within a 32-month period. They were operated on with either an ultrasonically activated scalpel (UAS), bipolar diathermy (BPD) or blunt dissection with monopolar diathermy (MPD) with the following results. (1) Primary bleeding was more common with MPD: MPD 7.1% vs. BPD 2.4% (p < 0.01) vs. UAS 1.0% (p < 0.001). Secondary bleeding was more common with UAS: UAS 19.6% vs. MPD 14.5% (p < 0.001) vs. BPD 14.5% (p < 0.01). There was no statistical significance in the differences between overall postoperative bleeding rates. (2) There was statistically significantly less operative bleeding with UAS:UAS 24.8 ml vs. MPD 58.7 ml vs. BPD 43.8 ml. (3) On the other hand, the operation time was on average longer with UAS: UAS 32.3 min vs. MPD 18.4 min vs. BPD 22.1 min. Our results suggest that UAS offers no significant advantage over MPD or BPD in tonsillectomy other than minimal operative bleeding possibly due to longer duration of operation.     

Contribution of parental and school personnel smoking to health risk behaviours among Finnish adolescents

Background  

This study compared parental smoking with school personnel smoking in relation to adolescents' smoking behaviours, alcohol use, and illicit drug use.     

JNK inhibitor SP600125 reduces COX-2 expression by attenuating mRNA in activated murine J774 macrophages

Inducible prostaglandin synthase (cyclooxygenase-2, COX-2) is highly expressed in inflammation. The signaling mechanisms involved in the up-regulation of COX-2 are not known in detail. In the present study we investigated the role of c-Jun NH2-terminal kinase (JNK), a member of the mitogen-activated protein kinase (MAPK) family in COX-2 expression and prostaglandin (PG) E2 production in murine J774 macrophages activated by bacterial lipopolysaccharide (LPS). LPS caused a transient activation of JNK which was followed by increased COX-2 expression. Anthra(1,9-cd)pyrazol-6(2H)-one (SP600125), an inhibitor of JNK, inhibited phosphorylation of c-Jun with an IC50 of 5-10 microM. At the same concentrations SP600125 suppressed also LPS-induced COX-2 protein levels and PGE2 production. SP600125 did not alter LPS-induced COX-2 mRNA levels when measured 3 h after addition of LPS, whereas mRNA levels were significantly reduced in SP600125-treated cells when measured 24 h after addition of LPS. LPS-induced COX-2 mRNA levels reduced faster in cells treated with SP600125 than in control cells. Cycloheximide (that is known to activate JNK) enhanced COX-2 expression and its effect was inhibited by SP600125. The present results suggest that JNK pathway is involved in the up-regulation of COX-2 expression possibly by a mechanism related to the stability of COX-2 mRNA.     

Organizational justice at school and its associations with pupils' psychosocial school environment, health, and wellbeing

It has been shown that the psychosocial environment perceived by school staff is associated with children’s academic performance and wellbeing. In this study we examined the associations between organizational justice (procedural and relational justice) as reported by school staff and pupils’ perceptions of their school environment, health problems, academic performance, and absenteeism. We combined data from two surveys: for the staff (the Finnish Public Sector Study, n = 1946) and pupils (the Finnish school health promotion survey, n = 11,781 boys and 12,842 girls) of 136 secondary schools, collected during 2004–2005. Multilevel cumulative logistic regression analyses showed that after adjustment for potential individual and school-level confounding factors, low procedural justice was associated with pupils’ dissatisfaction with school-going. Low relational justice was associated with a 1.30 times higher risk of poor academic performance, 1.15 times higher risk of psychosomatic symptoms and 1.13 times higher risk of depressive symptoms among pupils. Both organizational justice components were associated with truancy. We concluded that staff perceptions of organizational justice at school are associated with pupils’ reports of their psychosocial school environment, health, performance, and absenteeism due to truancy. Improving managerial and decision making procedures among school personnel may be an important factor for protecting pupils’ academic performance and wellbeing.     

High concordance of daidzein-metabolizing phenotypes in individuals measured 1 to 3 years apart

Particular intestinal bacteria are capable of metabolizing the soya isoflavone daidzein to equol and/or O-desmethylangolensin (O-DMA), and the presence of these metabolites in urine after soya consumption are markers of particular intestinal bacteria profiles. Prevalences of equol producers and O-DMA producers are approximately 30-50 % and 80-90 %, respectively, and limited observations have suggested that these daidzein-metabolizing phenotypes are stable within individuals over time. Characterizing stability of these phenotypes is important to understand their potential as markers of long-term exposure to particular intestinal bacteria and their associations with disease risk. We evaluated concordance within an individual for the equol-producer and O-DMA-producer phenotypes measured at two time points (T1, T2), 1-3 years apart. Phenotypes were ascertained by analysing equol and O-DMA using GC-MS in a spot urine sample collected after 3 d soya (source of daidzein) supplementation. In ninety-two individuals without recent (within 3 months before phenotyping) or current antibiotics use, 41 % were equol producers at T1 and 45 % were equol producers at T2, and 90 % were O-DMA producers at T1 and 95 % were O-DMA producers at T2. The percentage agreement for the equol-producer phenotype was 82 and for the O-DMA-producer phenotype was 89. These results indicate that these phenotypes are stable in most individuals over time, suggesting that they provide a useful biomarker for evaluating disease risk associated with harbouring particular intestinal bacteria responsible for, or associated with, the metabolism of the soya isoflavone daidzein.