Policies to halve smoking deaths

Britain still has amongst the highest mortality rates in the world for all the major smoking diseases. A third of all adults smoke cigarettes regularly and smoking causes one third of UK deaths in middle age. This paper discusses factors related to changes in smoking levels and concludes that without the intervention of government policies, smoking prevalence and the amount smoked per smoker is likely lo rise, particularly for young people. Measures to reduce smoking are surveyed and estimates made of the maximum likely effects from health education, advertising control, general practitioner smoking cessation advice and public and work place policies. A pricing policy is suggested which, with the other policies could reduce cigarette consumption by a half so that only one in five adults smoke by the year 2000. Predictions are made of the effect of this policy package on lives and life years saved. Within twenty five years there would be 50 000 fewer deaths from smoking and half a million life years saved annually. This would rise to two thirds of a million within forty years. Deaths from lung cancer would fall by 38%. The quality of these life years saved would tend to the average for their age.     

Does Atrial Fibrillation Beget Ventricular Fibrillation in Patients with Acute Myocardial Infarction?

Background: Atrial fibrillation (AF) is associated with increased mortality and a higher complication rate postmyocardial infarction (MI), but the exact mechanisms are unknown. We investigated whether AF predisposes to ventricular arrhythmia in postmyocardial infarct patients, thereby accounting for increased mortality. Methods: Five hundred consecutive patients admitted to our coronary care unit with acute MI were monitored for in‐hospital arrhythmias. Detailed information was also compiled on past history, co‐morbidities, electrolyte disturbances, drug therapies, and ejection fraction. Mortality data were collected for an average of 5.5 years. Results: The results have shown that the incidence of ventricular fibrillation (VF) is much greater in patients presenting with AF (P = 0.03) and multivariate analysis has shown that AF is independently associated with the development of VF. This association occurs principally in patients who are admitted with AF (P = 0.01) rather than those who develop it during their admission, although these patients are also at mildly increased risk. The increased incidence of VF does account for increased mortality in the AF patients but does not explain all of their excess risk. There was no association between AF and ventricular tachycardia (VT); P = 0.50. Conclusions: In conclusion, AF on admission to the hospital with acute MI is associated with an increased risk of VF and subsequent mortality.     

Age‐related changes in energy efficiency of gait,activity, and participation in children with cerebral palsy

Aim The aim of this study was to use a prospective longitudinal study to describe age‐related trends in energy efficiency during gait, activity, and participation in ambulatory children with cerebral palsy (CP). Method Gross Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory (PEDI), and Lifestyle Assessment Questionnaire‐Cerebral Palsy (LAQ‐CP) scores, and energy efficiency (oxygen cost) during gait were assessed in representative sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4–16y) with CP. Ninety‐four children had unilateral spastic CP, 84 bilateral spastic CP, and six had other forms of CP. Fifty‐seven were classified as Gross Motor Function Classification System (GMFCS) level I, 91 as level II, 22 as level III, and 14 as level IV). Assessments were carried out on two occasions (visit 1 and visit 2) separated by an interval of 2 years and 7 months. A total of 157 participants returned for reassessment. Results Significant improvements in mean raw scores for GMFM, PEDI, and LAQ‐CP were recorded; however, mean raw oxygen cost deteriorated over time. Age‐related trends revealed gait to be most inefficient at the age of 12 years, but GMFM scores continued to improve until the age of 13 years, and two PEDI subscales to age 14 years, before deteriorating (p<0.05). Baseline score was consistently the single greatest predictor of visit 2 score. Substantial agreement in GMFCS ratings over time was achieved (κ_lw=0.74–0.76). Interpretation These findings have implications in terms of optimal provision and delivery of services for young people with CP to maximize physical capabilities and maintain functional skills into adulthood.     

Dental caries and dental care level (restorative index) in children with diabetes mellitus type 1

International Journal of Paediatric Dentistry 2011; 21: 13–22 Introduction. The aim of the study was to investigate caries experience and dental care index in diabetic children and to determine if correlation exists between caries experience and metabolic control, insulin treatment, and the duration of diabetes. Materials and methods. The study group consisted of 52 children and adolescents, 3–16 years of age with type 1 diabetes attending the outpatient diabetic clinic at Ghent University Hospital, Belgium. Fifty healthy subjects recruited from the paediatric dental clinic served as the control group. Caries lesions were assessed using DMF‐index both at cavity and non‐cavity levels. Participants and/or their guardians provided information about oral hygiene habits and dietary habits. Diabetes‐related data (type, duration, insulin regimen) were collected from medical records and completed with the lab data on HbAlc. Conclusion. It became clear that, although children with type 1 diabetes mellitus could be expected to run a potential high caries risk taking into account the diabetes‐associated biological and behavioural alterations, no significant differences were observed regarding caries experience and dental care between diabetic children and healthy controls. The level of untreated dental decay among the diabetic children is, however, considerably high, which was reflected by a significant lower dental attendance.     

Assignment of the human cardiac/slow skeletal muscle troponin C gene (TNNC1) between D3S3118 and GCT4B10 on the short arm of chromosome 3 by somatic cell hybrid analysis

We have determined the chromosomal location of the human cardiac/slow skeleletal muscle troponin C gene (TNNC1) to the short arm of chromosome 3 using somatic cell hybrids. PCR-based analysis of a 'monochromosomal' hybrid panel identified the presence of the TNNC1 gene on human chromosome 3 and subsequent analysis of the Genebridge4 radiation hybrid panel located the gene between D3S3118 (7·3cR) and GCT4B10 (4·2cR) with a lod score of >3·0.     

The prevalence of taurodontism in Down's syndrome

ABSTRACT. Taurodontism, a condition in which the pulp chambers of teeth are elongated, was observed in extracted lower molars of 12 out of 33 (36.4%) individuals with Down's syndrome (DS). It is suggested that this high prevalence is associated with a delayed ingrowth and fusion of the epithelial flaps of the developing root sheath and that taurodontism represents one of several characteristic morphological dental features in DS that result from decreased mitotic activity of cells in developing tooth germs.