Family practitioner committee records — a neglected resource. 1. An information service for general practitioners based on claims for fees

Data held by a London family practitioner committee for the purpose of paying general practitioners' capitation and item of service fees were analysed every quarter for one year to provide an information service for general practices in the area. Each practice received a quarterly printout showing the age structure of its patient population, the numbers of new registrations and removals and data about items of service. These were expressed as rates which could be compared with those of the area as a whole, and with the highest and lowest rates found in individual practices. A survey at the end of the year showed that the service was welcomed and found useful by the practices. A fully computerized family practitioner committee could provide a similar service without great difficulty, and could make it more informative by linking items of service to specific age groups; data about prescribing and use of hospital and district services could also be incorporated when the relevant agencies are fully computerized too.     

Transient apical breakdown and its relation to color and sensibility changes after luxation injuries to teeth

Abstract In examining a population of 637 luxated permanent teeth, it was found that 27 teeth (4.2%) demonstrated apical breakdown in the form of either a pronounced radiolucency which appeared spontaneously some time after injury, or a persistent expansion of the periodontal ligament space (PDL) over an extended interval after injury, which at later follow-up controls had either returned to normal without further radiographic change or was accompanied by surface resorption and/or pulp canal obliteration without intervening treatment. Two of the 27 teeth demonstrated radiographic change alone, while the remaining 25 demonstrated color and/or electrometric sensibility-changes as well. Twenty-three teeth had fully-formed roots whose apices were either closed or half-closed at the time of injury. Five had roots which were fully formed, but with an open apex; the remaining tooth had three-quarter root formation. The injuries were moderate, the majority being extrusion or lateral luxation, affecting both pulpal and periodontal structures. Based on clinical findings, the following hypothesis is proposed: Transient apical breakdown appears to be a phenomenon linked to the repair processes in the traumatized pulp or pulp and periodontium of luxated mature teeth which returns to normal when repair is complete. Whether this is related to a transitory infection and/ or removal of necrotic traumatized tissue cannot be evaluated from the material available.     

Evaluating the importance of information sources for preventive health care in rural Australia

Abstract: Health promotion and prevention are critical elements of public health programs designed to improve health status and extend life chances. The pattern of mortality and morbidity in rural Australia suggests a particularly important role for health promotion and preventive measures in country areas. However, the importance of preventive health measures and how people access health-related information is not well understood. This study examines which sources of health-related information are most valued by rural residents and whether the importance attributed to different sources varies according to age, sex and geographic location. The results demonstrate the overwhelming importance of the general practitioner and pharmacist in provision of preventive health information for all rural people. There is a need to ensure that the work carried out by all those involved with health promotion is closely integrated with that of rural general practitioners.     

Plectin and human genetic disorders of the skin and muscle

Abstract Recent progress in understanding the molecular organization of the cutaneous basement membrane zone (BMZ) has revealed an intricate network of structural proteins necessary for stable association of the epidermis to the underlying dermis. Molecular genetics of the cutaneous BMZ has also revealed that defects in as many as nine distinct genes within the dermal-epidermal junction which result in different forms of epidermolysis bullosa (EB). a group of heritable mechano-bullous disorders. We have recently demonstrated that a variant of EB associated with late-onset development of muscular dystrophy (EB-MD. MIM no. 226670) results from mutations in the gene encoding plectin (PLEC1). a cytoskeleton associated attachment protein present in the hemidesmosomal inner plaque and the sarcolemma of the muscle. Consequently, mutations in this multi-functional gene/protein system can result in phenotypic manifestations of EB-MD both in the skin and the muscle. In this overview, we will summarize the domain organization of plectin and the structure of the corresponding gene (PLEC1). as well as the genetic basis of EB-MD in families studied thus far. Elucidation of the molecular basis of this subtype of EB adds to our understanding of the structural and functional complexity of the cutaneous BMZ.