Correlation between gingival crevicular fluid dipeptidyl peptidase II and IV activity and periodontal attachment loss. A 2–year longitudinal study in chronic periodontitis patients

OBJECTIVE: The aim of this study is to determine whether gingival crevicular fluid (GCF) dipeptidyl peptidase (DPP) II or IV levels, total activity (TA) and concentration (EC), predict progressive attachment loss (AL). SUBJECTS AND METHODS: Seventy five patients with moderate periodontitis were recruited. GCF was first collected from 16 molar and premolar mesiobuccal sites and then probing attachment level (PAL) and probing pocket depth (PPD) were measured with an electronic probe. Finally, gingival index, gingival bleeding and plaque indices were scored. Patients were given basic periodontal treatment prior to baseline after which the above procedures were repeated. Patients were seen 3 monthly for 2 years and the procedures were repeated. Carefully localised radiographs were taken of the test teeth annually. RESULTS: One hundred and twenty AL sites, 88 rapid AL (RAL) and 32 gradual AL (GrAL), in 48 patients were detected. DPP It and IV levels (TA and EC) at RAL sites were significantly higher (P ≤ 0.0001) than paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels over the study period of both proteases (TA and EC) at GrAL sites were significantly higher (P≤ 0.0001) than paired control sites. The GCF levels of DPP IV were always slightly higher than those of DPP II. Critical values (CV) of 5 μU per 30 s (TA) and 25 μU μPI^-1 (EC) for both proteases showed high sensitivity and specificity values for TA and EC and these were the same at both ALT and PT. The positive predictive values were slightly higher for DPP II. Mean site DPP II and IV levels (TA and EC) in intra-patient comparisons were significantly higher (P ≤ 0.0001) at RAL and GrAL sites than non-attachment loss (NAL) sites in AL patients and mean patient levels were significantly higher (P ≤ 0.0001) in AL patients than NAL patients in inter-patient comparisons. CONCLUSIONS: These results indicate that both GCF DPP II and IV may be predictors of periodontal attachment loss.     

Laboratory diagnosis of syphilis: A survey to examine the range of tests used in Canada

Laboratory diagnosis of syphilis has undergone major changes in the past decade with the introduction of immunoassays and recombinant Treponema pallidum antigens as screening tools for syphilis infection. To address this change in laboratory practice, a national syphilis laboratory working group was established with members from the Public Health Agency of Canada, provincial public health laboratories across the country as well as sexually transmitted infection researchers, clinicians and epidemiologists. This working group aims to examine how the use of newer immunoassays will affect syphilis diagnosis, surveillance and disease management. To provide a baseline for this work, an e-mail survey was conducted in the fall of 2009 to determine current laboratory practices for syphilis diagnosis in Canada. The most commonly used tests were rapid plasma reagin, enzyme immunoassay, T pallidum passive particle agglutination, venereal disease research laboratory, fluorescent treponemal antibody absorption, line immunoassay and polymerase chain reaction with 92%, 36%, 32%, 20%, 12%, 12% and 12% of the responding laboratories reporting using these tests, respectively. The ultimate goal of this working group will be to update laboratory guidelines for the diagnosis of syphilis, and to identify syphilis surveillance and research priorities in Canada.     

Embodying the mind: movement as a container for destructive aggression

Violent, nonmentalizing individuals who act out aggression do not usually respond to verbal therapeutic approaches alone. We suggest the movement in physically oriented therapies, such as yoga and martial arts, combined with psychodynamic psychotherapy are critical in reaching these individuals. We also suggest embodiment as a direct link to the kinesthetic core of easily disturbed attachment experiences. This process embodying the mind requires a safe, containing context found in the therapist. Clinical vignettes show how this might be done in both individual and social contexts. These vignettes also show a way to think about such a combination of techniques and theories.     

Accuracy and feasibility of point-of-care and continuous blood glucose analysis in critically ill ICU patients

Introduction  

To obtain strict glucose regulation, an accurate and feasible bedside glucometry method is essential. We evaluated three different types of point-of-care glucometry in seriously ill intensive care unit (ICU) patients. The study was performed as a single-centre, prospective, observational study in a 12-bed medical ICU of a university hospital.     

辽西地区汉族成人的体型特征

目的:应用Heath-Carter法分析辽西地区汉族成人的体型特征,为体质人类学补充必要的资料。方法:于2002-09随机选择辽西地区20～82岁的汉族成人1002名(男490名,女512名)为测量对象。从20岁起,每5岁为一组,55岁以上为1个年龄组;每个年龄组按性别又分男、女两个小组,每小组测量人数不低于30名。由专人负责按Heath-Carter体型法进行指标测量和计算。10项测量指标分别是身高、体质量、上臂紧张围、小腿围、肱骨和股骨内外上髁间径、肱三头肌皮褶厚度、肩胛下皮褶厚度、髂前上棘皮褶厚度、腓肠肌皮褶厚度,测试数据按年龄、性别在微机中建立数据库。依次计算出各年龄组的内因子、中因子、外因子、体型图上的X,Y坐标值、身高体质量比、体型位置均数、两体型点间距离、体脂率和各类体型分布频数等。结果:1002名的各项指标均被测量,全部进入结果分析。①城市男女在内因子值(代表脂肪发育程度)方面占有明显的优势,中因子值(代表骨骼肌肉发育程度)方面和外因子值(代表身材相对瘦削程度)方面,城乡两组呈交替领先局面。提示汉族成人城市男女与农村男女相比,脂肪较发达,骨骼肌肉发育中等,身体线性度较差。②男性体型分布主要集中在偏中胚层的内胚层体型(53.5%),均衡内胚层体型(13.9%),偏外胚层的内胚层体型(9.1%),女性体型分布主要集中在偏中胚层的内胚层体型(62.8%),偏外胚层的内胚层体型(16.3%),均衡内胚层体型(13.7%)。体型频数分布提示汉族成年男女体型分布均较集中,以女性最为突出。③男女间体型相比,只有20～24岁和40～44岁年龄组男女间差异有显著性意义(P<0.05),其余各组差异无显著性意义。提示20～24岁为青春期的发育后期,男性得到充分的发育,而女性由于发育较早,发育已经停滞或缓慢。40～44岁女性更容易有脂肪沉积,而影响到其他有关体型的参数,出现男女差异。④辽西汉族城市成年人与农村成年人体型比较,内因子值城市成年男女均明显高于农村成年男女,中因子值和外因子值城乡较为接近,差异无显著性意义。结论:辽西地区城市成年男女骨骼、肌肉中等发达,体脂较多,身体线性度较差;农村成年男女,骨骼、肌肉较发达,体脂少于城市成人,身体线性度尚佳。