Diabetes prevalence and diagnosis in US states: analysis of health surveys

Background  

Current US surveillance data provide estimates of diabetes using laboratory tests at the national level as well as self-reported data at the state level. Self-reported diabetes prevalence may be biased because respondents may not be aware of their risk status. Our objective was to estimate the prevalence of diagnosed and undiagnosed diabetes by state.     

精确设计巧填“天”坑—谈坑面女孩王某的治疗

王某,一个普普通通的农村女孩,只因“上帝”在她脸上留下了一个“天”坑,注定了她的一生将是不平常的一生;也注定了在她的身上将会发生感天动地的故事。她出生后即被遗弃,差点被冻死、饿死。不幸中的万幸,她被一对好心的夫妇收养,含辛茹苦将她养大成人。一个普通的一天,一次偶然的经历,从此改变了王某的生活,     

Global Body Posture Evaluation in Patients with Temporomandibular Joint Disorder

AIM:

To identify the relationship between anterior disc displacement and global posture (plantar arches, lower limbs, shoulder and pelvic girdle, vertebral spine, head and mandibles). Common signs and symptoms of anterior disc displacement were also identified.

INTRODUCTION:

Global posture deviations cause body adaptation and realignment, which may interfere with the organization and function of the temporomandibular joint.

METHODS

: Global posture evaluation was performed in a group of 10 female patients (20 to 30 years of age) with temporomandibular joint disc displacement and in a control group of 16 healthy female volunteers matched for age, weight and height. Anterior disc displacement signs, symptoms and the presence of parafunctional habits were also identified through interview.

RESULTS:

Patients with disc displacement showed a higher incidence of pain in the temporomandibular joint area, but there were no differences in parafunctional habits between the groups. In the disc displacement group, postural deviations were found in the pelvis (posterior rotation), lumbar spine (hyperlordosis), thoracic spine (rectification), head (deviation to the right) and mandibles (deviation to the left with open mouth). There were no differences in the longitudinal plantar arches between the groups.

CONCLUSION:

Our results suggest a close relationship between body posture and temporomandibular disorder, though it is not possible to determine whether postural deviations are the cause or the result of the disorder. Hence, postural evaluation could be an important component in the overall approach to providing accurate prevention and treatment in the management of patients with temporomandibular disorder.     

The effect of fibronectin and a bone xenograft on regenerative treatment: a feasibility study

The purpose of this study was to evaluate the ability of fibronectin to augment the regenerative effects of a bovine-derived xenograft in human periodontal defects. Using a parallel arm, randomized double-blind design, 24 patients with an intrabony defect or a Class II furcation defect were randomly assigned to either the experimental group (xenograft plus fibronectin) or the control group (xenograft without fibronectin). Probing attachment level, pocket depth, and gingival recession were measured at baseline and at 12 months after surgery. Both treatment modalities resulted in attachment gain and pocket depth reduction compared with baseline values. Changes in clinical attachment were not significantly different between the groups (gain of 1.5 mm +/- 1.1 mm in the experimental group and 1.3 mm +/- 1.4 mm in the control). Pocket depth reduction was greater in the control (2.3 mm +/- 1.2 mm) than in the experimental group (2.1 mm +/- 1.9 mm). Gingival recession also was greater in the control (0.9 mm +/- 0.6 mm) than in the experimental group (0.6 +/- 1.5 mm). Subtraction radiography revealed no significant differences between the groups when measuring changes in the distance between the cementoenamel junction and the crest of the bone or in the estimated gain in mineralized tissue mass. It was concluded that a significant difference between the regenerative treatment modalities could not be demonstrated within the limitations of the study. Fibronectin appears to have a stabilizing or proliferative effect on the gingival soft tissue by promoting less postoperative gingival recession.     

Frequency of thrombophilia-related genetic variations in patients with idiopathic pulmonary embolism in an urban emergency department

BACKGROUND: The frequency of the thrombophilic genetic variants factor V Leiden (FVL) G1691A, prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T in acutely symptomatic ambulatory patients with idiopathic pulmonary embolism (PE) has not been measured. METHODS: This prospective case-control study included patients presenting to urban emergency departments (EDs) with chest pain or shortness of breath. Cases were classified as idiopathic PE (49 patients with PE, but without overt risk factors for thrombosis). Control groups included (a) patients with nonidiopathic PE (152 patients with PE and risk factors); (b) patients in whom PE was excluded (91 patients who had PE ruled out with a structured protocol, including follow-up); and (c) patients in whom PE was not suspected (193 patients without a workup for PE, who were free of PE on follow-up). Blood DNA extracts were analyzed by PCR and restriction fragment length polymorphism analysis for the FVL, prothrombin, and MTHFR sequence variations. RESULTS: Either the FVL or prothrombin variant was found in 10% (95% confidence interval, 3%-22%) of patients with idiopathic PE compared with 13% (8%-20%) of nonidiopathic PE, 2% (5%-14%) of PE excluded, and 9% (5%-14%) of PE not suspected patients. Patients with idiopathic PE tended to have a higher frequency of homozygous MTHFR sequence variants, but mean (SD) plasma homocysteine concentrations were not increased [15.6 (5.4) micromol/L vs 12.8 (4.6) micromol/L for homozygous, and wild-type, respectively; P = 0.40]. CONCLUSIONS: The frequency of either the FVL or prothrombin sequence variant was not increased in idiopathic PE patients compared with nonidiopathic PE patients or patients who had PE excluded. These data suggest that genotyping to detect idiopathic PE would have limited clinical utility in the urban ED setting.     

Characterization of knowledge production on the patient care system in Brazil

This is a bibliographical study that has as its aim characterizing the Brazilian scientific production on the "Patient Care System" and visualizing its trends. A retrospective bibliogra-phical study (1990-2002) was carried out taking into consideration the items: date, title of the journal, type of research and approach of the publication. Production average was 13.4 publications/ year and articles were distributed among 23 journals, with a majority of them dealing with hospitals (63.2%). Cardiology was the theme of 17.6% of the articles, and 78.6% of them were focused on the implementation, development and evaluation of SAE models. NANDA taxonomy was men-tioned in 40.2% of the production, and Wanda Horta in 40.5%. There are still some blanks in this area of knowledge, but the increasing availability of the scientific production on this subject may help professionals in the implementation of the patient care system.     

��-Arrestin 1 and 2 stabilize the angiotensin II type I receptor in distinct high-affinity conformations

BACKGROUND AND PURPOSE

The angiotensin II type 1 (AT₁) receptor belongs to family A of 7 transmembrane (7TM) receptors. The receptor has important roles in the cardiovascular system and is commonly used as a drug target in cardiovascular diseases. Interaction of 7TM receptors with G proteins or β-arrestins often induces higher binding affinity for agonists. Here, we examined interactions between AT_1A receptors and β-arrestins to look for differences between the AT_1A receptor interaction with β-arrestin1 and β-arrestin2.

EXPERIMENTAL APPROACH

Ligand-induced interaction between AT_1A receptors and β-arrestins was measured by Bioluminescence Resonance Energy Transfer 2. AT_1A-β-arrestin1 and AT_1A-β-arrestin2 fusion proteins were cloned and tested for differences using immunocytochemistry, inositol phosphate hydrolysis and competition radioligand binding.

KEY RESULTS

Bioluminescence Resonance Energy Transfer 2 analysis showed that β-arrestin1 and 2 were recruited to AT_1A receptors with similar ligand potencies and efficacies. The AT_1A-β-arrestin fusion proteins showed attenuated G protein signalling and increased agonist binding affinity, while antagonist affinity was unchanged. Importantly, larger agonist affinity shifts were observed for AT_1A-β-arrestin2 than for AT_1A-β-arrestin1.

CONCLUSION AND IMPLICATIONS

β-Arrestin1 and 2 are recruited to AT_1A receptors with similar ligand pharmacology and stabilize AT_1A receptors in distinct high-affinity conformations. However, β-arrestin2 induces a receptor conformation with a higher agonist-binding affinity than β-arrestin1. Thus, this study demonstrates that β-arrestins interact with AT_1A receptors in different ways and suggest that AT₁ receptor biased agonists with the ability to recruit either of the β-arrestins selectively, would be possible to design.     

International incidence of oropharyngeal cancer: a population-based study

The incidence of oropharyngeal cancer is not well documented as it is rarely described according to the anatomic definition but usually grouped with oral cavity subsites. The aim of this study was to calculate oropharyngeal cancer incidence and compare it to oral cavity cancer incidence. Age-standardized incidence rates (ASR) of oropharyngeal cancer were calculated for the period between 1998 and 2002, based on data from Cancer Incidence in 5 Continents, Volume IX (CI5-IX). These ASRs were compared with previously published oral cavity cancer data. Among males, the highest ASRs were observed in France, Slovakia, Slovenia and Brazil. The highest oral cavity/oropharyngeal cancer rate ratio was observed in Pakistan, among males (6.2) and females (13.5). The results provide an overview of oropharyngeal cancer incidence and constitute a basis for the development of primary and secondary prevention, according to geographical variations and topography.