Oral health in preschool children with cerebral palsy: a case–control community‐based study

International Journal of Paediatric Dentistry 2010; 20: 330–335 Objectives. To assess and compare the oral health status of preschool children with and without cerebral palsy (CP). Methods. Preschool children with CP (72) were recruited from 23 Special Child Care Centers in Hong Kong. An age (±3 months) and gender matched sample of preschool children from mainstream preschools were recruited as the control group. Dental caries status, gingival health status, tooth wear, developmental defect of enamel, malocclusion, dental trauma and oral mucosal health were assessed and compared between the two groups. Results. Significant differences in gingival health status were found between children with and without CP (mean plaque index scores, P = 0.001 and mean gingival index scores, P < 0.05). Tooth wear involving dentine was more prevalent among CP children (P < 0.001), as were evidence of anterior open‐bite (P < 0.001) and oral mucosal lesions (P < 0.05). Children with and without CP had similar caries experiences (P > 0.05), prevalence of enamel defects (P > 0.05) and dental trauma (P > 0.05). Conclusions. Differences of oral health status exist among preschool children with and without CP. Preschool children fare worse in terms of gingival health, tooth wear, oral mucosal health and malocclusion.     

Development of early postnatal peripheral nerve abnormalities in Trembler-J and PMP22 transgenic mice

Mutations in the gene for peripheral myelin protein 22 ( PMP22 ) are associated with peripheral neuropathy in mice and humans. Although PMP22 is strongly expressed in peripheral nerves and is localised largely to the myelin sheath, a dual role has been suggested as 2 differentially expressed promoters have been found. In this study we compared the initial stages of postnatal development in transgenic mouse models which have, in addition to the murine pmp22 gene, 7 (C22) and 4 (C61) copies of the human PMP22 gene and in homozygous and heterozygous Trembler-J ( Tr ^J ) mice, which have a point mutation in the pmp22 gene. The number of axons that were singly ensheathed by Schwann cells was the same in all groups indicating that PMP22 does not function in the initial ensheathment and separation of axons. At both P4 and P12 all mutants had an increased proportion of fibres that were incompletely surrounded by Schwann cell cytoplasm indicating that this step is disrupted in PMP22 mutants. C22 and homozygous Tr ^J animals could be distinguished by differences in the Schwann cell morphology at the initiation of myelination. In homozygous Tr ^J animals the Schwann cell cytoplasm had failed to make a full turn around the axon whereas in the C22 strain most fibres had formed a mesaxon. It is concluded that PMP22 functions in the initiation of myelination and probably involves the ensheathment of the axon by the Schwann cell, and the extension of this cell along the axon. Abnormalities may result from a failure of differentiation but more probably from defective interactions between the axon and the Schwann cell.     

Headache activity in children and adolescents

We examined headache activity in 900 Australian youth aged 10-18, using a self-report questionnaire. Headache prevalence, duration, severity, symptomatology and precipitants were examined, as well as the self-statements and coping responses of children. Headaches were experienced by most children, and girls reported more frequent headaches than boys. Common headache symptoms included those traditionally associated with muscle-contraction headache and migraine. Some children reported that they found headaches to be a terrible experience and 'wished they would die' during a headache. Of the various coping responses that were endorsed, the use of medication was the most frequent. Methodological problems include the reliability and validity of self-report data, and the limitations of cross-sectional investigations.     

The impact of a rubella prevention policy on the outcome of rubella in pregnancy

Summary. Surveillance of rubella vaccination in schoolgirls has continued intensively in Edinburgh since 1970. Screening for rubella antibody of all women attending antenatal clinics has been available since 1974. The analysis of cases of rubella occurring in pregnancy during an outbreak in 1979 confirmed the efficacy of schoolgirl vaccination in the city but indicated poor implementation of postnatal vaccination. Eighteen (67%) of 27 proven cases occurred in women who were screened in previous pregnancies and not immunized. Of the total of 13 liveborn infants the only two with congenital rubella defects were born to mothers in this group. Rubella immunization of schoolgirls and women of childbearing age must receive continued intensive effort if the problems of rubella in pregnancy are to be eradicated.     

Follicle growth patterns and endocrinological abnormalities in infertile women with minor degrees of endometriosis

Summary. Eighteen patients whose only demonstrable cause of infertility was a minor degree of endometriosis and whose partners were normal, were investigated prospectively for one menstrual cycle using ultrasonography and endocrine profiles. Twelve cycles appeared to be normal. A luteinized unruptured follicle (LUF) occurred in two cycles and one patient had a follicular cyst. In a further two patients there was inadequate or abnormal folliculogenesis whilst in the last patient the follicle ruptured prematurely. This study describes the variety of endocrinological abnormalities found in women with mild endometriosis, and concludes that, in this series at least, there is a low frequency of LUF.     

Successful in vitro fertilization and pregnancy in a patient with autoimmune chronic active hepatitis and cirrhosis

Abstract Fertility is reduced in women with chronic active autoimmune hepatitis (AIH) and pregnancy is hazardous. This report describes a 33 year old woman with AIH and cirrhosis in whom a successful pregnancy was achieved following in vitro fertilization/embryo transfer. Disease exacerbation during pregnancy was controlled by azathioprine and an increased dose of prednisone, and a healthy child was delivered by Caesarean section at 36 weeks gestation. Since the perinatal care of preterm infants and the obstetric care available to women with complicated medical problems has improved markedly in recent years and since active disease can be controlled by adequate immunosuppressive therapy, we propose that it is justified to allow these patients access to in vitro fertilization programmes.     

The consistency of family and peer influences on the development of substance use in adolescence

Latent growth modeling (LGM) was used to analyse longitudinal data for adolescent substance use from five overlapping age cohorts (11, 12, 13, 14 and 15 years at first assessment) measured at four annual time points. An associative cohort-sequential model was tested for alcohol, cigarette and marijuana use with a sample of 345 adolescents (11–18 years old) from an urban area in the Pacific Northwestern region of the United Stales. Hypotheses concerning the shape of the growth curve, the extent of individual differences in the common trajectory over time, and the influence of family cohesion, peer encouragement and gender on initial substance use and shape of the growth curve were tested. Results indicated similarities between alcohol, cigarette and marijuana initial use and development, with peer encouragement and family cohesion predictive of initial levels of use, and changes in peer encouragement influencing the developmental trajectories of the three substances. Females were higher than males in initial status and developed less rapidly in their use of the substances than did males. Findings are discussed in terms of the similarities and differences in the developmental trajectories of the three substances and the importance of family and peer influences on these trends.     

The Involvement of General Practitioners in the Care of Patients with Human Immunodeficiency Virus Infection: Current practice and Future Implications

The objective was to determine the current use of their generalpractitioner (GP) by patients with human immunodeficiency virus(HIV) infection and whether such patients would be interestedin having ‘shared care’ between a specialist HIVclinic and their GP. A questionnaire was administered to 203HIV-positive men attending the HIV outpatient clinic of a centralLondon teaching hospital. The main outcome measures were patientcharacteristics, numbers of patients registered with a GP, numbersof patients with a GP aware of their diagnosis, contacts withthe GP in the last year and level of interest and shared care.Eighty-five per cent of patients were registered with a GP ofwhom 67% knew of the diagnosis. Those diagnosed for more than2 years were significantly more likely to have an informed GP.A total of 73% of those registered had visited their GP in theprevious year although only 27% had visited for an HIV-relatedproblem. Only 19% had a GP actively involved in their HIV care.In all 51% of the patients indicated an interest in having sharedcare between the clinic and their GP. A high proportion of HIVpatients are registered with and attend a GP although they rarelyconsult for HIV-related problems. A significant proportion ofpatients expressed interest in having shared care suggestingthat there is the potential for increased GP involvement inthe care of patients with HIV infection.