Two Young Sisters with Spinocerebellar Ataxia Type 2 Showing Different Clinical Progression of Disease

Spinocerebellar ataxia type 2 is a neurodegenerative disease caused by a CAG repeat expansion in the ataxin-2 gene. Gain-of-toxic effects caused by expanded polyglutamine tracts are important for the disease pathogenesis and there is an inverse relationship between the number of CAG repeats and the age of onset and clinical severity. Previously, we reported an extended Turkish family with spinocerebellar ataxia type 2 with several affected members in three generations. Two sisters in this generation showed an earlier age of onset (5 and 7years, respectively) than their father (30years). In this paper, we present a further interesting finding regarding the disease onset and manifestation in the two sisters. Interestingly, the age of onset was delayed and the clinical severity of the disease was milder in the child who had more CAG repeats (84 vs. 70). This finding suggests that there are other factors contributing to the age of onset and clinical severity in spinocerebellar ataxia type 2 other than the increased CAG repeat.     

Two years survival rate of class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars

The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries removal gel and (2) in the survival rate of class II composite resin restorations between two treatment groups after 2 years. Three hundred twenty-seven children with 568 class II cavitated lesions were included in a parallel mouth study design. Four operators placed resin composite (Filtek Z 250) restorations bonded with a self-etch adhesive (Adper prompt L pop). Two independent examiners evaluated the restorations after 0.5, 1, and 2 years using the modified Ryge criteria. The Kaplan–Meier survival method was applied to estimate survival percentages. A high proportion of restorations were lost during the study period. Therefore, the first hypothesis could not be tested. No statistically significant difference was observed between the cumulative survival percentages of restorations produced by the two treatment approaches over the 2-year period (ART, 54.1 ± 3.4%; ART with Carisolv™, 46.0 ± 3.4%). This hypothesis was accepted. ART with chemomechanical gel might not provide an added benefit increasing the survival percentages of ART class II composite resin restorations in primary teeth.     

Relationships between epidemiological features and tumor characteristics of breast cancer

Objectives. Breast cancer is a histological, morphological and molecular heterogenous disease. Like clinical outcomes and prognoses of different subtypes, etiologies might also be different. Therefore, epidemiologic risk factors like sociologic, demographic, antropometric, reproductive, and menstrual factors can be considered as an entity reflected in tumor features. This study was planned to explore the relation between well known risk factors of breast cancer and histological and molecular features of the tumor. Materials and Methods. Epidemiologic data for 250 breast cancer patients followed-up by our clinic and 250 healthy individuals without any diagnosis of malignancy were obtained. The data displaying a relation to breast cancer are age, height, weight, body mass index (BMI), place of birth and province, educational level, menstrual status, age of menarche and menopause, number of births, age at first childbirth, family history of breast cancer, history of smoking and hormone treatment, mammographic screening, and presence of benign lesions. The tumor characteristics of patients in the breast cancer group were recorded. Results. Advanced age, nulliparity, low educational level, irregular mammographic screening, early menarche and late menopause, and high BMI in postmenopausal period were found to be related to increased breast cancer risk. Striking results in terms of the relation between epidemiological factors and tumor features were the early diagnosis of breast cancer in patients with regular mammographic screening. Tumor size was decreased with increased age and increased with increased BMI. Advanced age, prolonged lactation, increased number of births, and high education level were found to decrease axillary involvement. Conclusions. Multiparity still continues to be the strongest protective factor against breast cancer in our society. The decrease in menarche age may be an early sign of the increased breast cancer incidence. Women should be informed about the relation between postmenopausal obesity and breast cancer and encouraged to attend physical activity and exercise programmes. Regular physical examination and mammographic screening are protective against breast cancer.     

新疆维吾尔族女性人乳头瘤病毒感染与宫颈癌相关性的流行病学调查

目的　了解新疆维吾尔族女性人乳头瘤病毒（ＨＰＶ）感染及宫颈癌的发病状况,为新疆宫颈癌预防和筛查提供数据。方法　于２００６年采用整群抽样方法选择新疆于田县有性生活、１６～５９岁维吾尔族女性,按年龄分层入组,依次行宫颈液基细胞学检查和ＨＰＶ检测。意义不明的不典型鳞状细胞（ＡＳＣＵＳ）以上或ＨＰＶ阳性者行阴道镜检查及必要的宫颈活检。结果　新疆维吾尔族妇女高危型、低危型和总体ＨＰＶ感染率分别为７.２５％、１.５９％和８.２７％。ＣＩＮⅡ级以上病变和宫颈癌现患率分别为１.９３％和０.２３％。高危型ＨＰＶ在细胞学ＡＳＣＵＳ、鳞状上皮内低度病变（ＬＳＩＬ）和鳞状上皮内高度病变（ＨＳＩＬ）中的比例分别为１３.４６％、６４.７１％和９０.００％;高危型ＨＰＶ在ＣＩＮⅠ、ＣＩＮⅡ、ＣＩＮⅢ和ＩＣＣ的比例分别为６６.６７％、８３.３３％、１００.００％和１００.００％。ＨＰＶ感染率随宫颈病变级别增加有增高趋势,但在ＣＩＮⅡ级以上病变中无统计学差异。结论　新疆维吾尔族女性ＨＰＶ感染率低于我国汉族女性,但宫颈癌现患率高于我国城市汉族女性,低于一些农村汉族女性。新疆维吾尔族女性ＨＰＶ感染率在不同级别宫颈上皮内瘤变中的分布趋势与中国其他地区相似,但同时具有自身民族特征。     

Risk perception of occupational hazards among dental health care workers in a dental hospital in Turkey

AIMS: To determine the factors associated with the level of occupational risk perceived by dental health care workers (DHCW), and to define the perceived sources of hazards. DESIGN: Cross-sectional. SETTING: Izmir Dental Hospital in Turkey. PARTICIPANTS: All employees (n = 308) in the hospital. METHODS: Data were collected by a questionnaire in 2007. Respondents rated their degree of individual risk that could be associated with the procedures they perform on a 10-point scale and listed the hazards they faced. Those with a score > or = 9 were classified as a high-risk perception group. We assessed the relation between variables using chi-square test and logistic regression analysis. RESULTS: Response rate was 90.3%. 57.2% of DHCW had a high-risk perception. Having children, job category and management's commitment to safety were related to the risk perception. DHCW who used preventive measures regularly and experienced an occupational accident in the previous year were 2.29 and 2.77 times more likely to have a high-risk perception. The perceived sources of hazards differed by job category. CONCLUSIONS: Risk perception is an initial step in developing procedures to minimise occupational risks and occupation specific risk management approaches should be performed.     

Government financing for health and specific national budget lines: the case of vaccines and immunization

A long standing question related to immunization financing and sustainability has been whether the existence of a specific line item for vaccines purchasing within the national health budget can contribute significantly to increasing national government financing of vaccines and routine immunizations. Based on immunization financing indicators from 185 countries collected through the joint WHO and UNICEF monitoring system, this paper attempts to answer this policy question. The study will present findings related to the status of countries that have such specific budget lines for purchasing vaccines and the levels of national budgetary allocation to the financing of vaccines and immunizations, particularly in low-income countries. The analysis shows evidence that the existence ofa specific line in the national budget is associated with increased governmental budget allocations for vaccines and routine immunization financing.