Dental Age Assessment: a comparison of 4- to 24-year-olds in the United Kingdom and an Australian population

Background.  The physiological age of a person is determined by the degree of maturation of the different tissue systems. Children of the same chronological age (CA) can demonstrate different degrees of maturation. Dental age (DA) is based on the maturation of teeth. Tooth formation is a continuous process, where the developmental stages of the tooth can be sequenced and defined depending on the degree of mineralization. These stages can be visualized on a dental panoramic tomograph (DPT).
Aim.  The aim of this study was to use a new method of Dental Age Assessment (DAA) to compare a United Kingdom (UK) and an Australian (AUS) population.
Design.  The DPTs used are from the archives of the Westmead Centre for Oral Health (Westmead, Australia) and the King's College London Dental Institute. From the preliminary sample of 89 DPTs from each population, 77 were suitable for use as matched pairs. The radiographic technique used was developed by Demirjian and describes eight stages of tooth development. This was used in combination with numerical data derived from a meta-analysis of a single UK subject.
Results.  A significant difference was shown between the CA and DA of the AUS patients. The AUS patients were also shown to have a significant 0.82 years delay in their DA compared to the UK patients. The findings indicate a difference in AUS compared to UK patients. These results indicate the need to develop a reference data set for the AUS population for DAA.
Conclusions.  This research is of significance in a number of clinical disciplines and can also be used to assist in age determination of subjects of unknown birth date to assist in forensic dentistry or social deliberations.     

Harlequin fetus successfully treated with etretinate

A harlequin fetus seen at birth was treated with etretinate and more general measures, including careful attention to fluid balance, calorie intake and temperature control. She improved, continued to develop, and had survived to 5 months at the time of this report.     

Subthreshold response to white-noise current input in a tapering cable model of a neuron

^* Author to whom all correspondence should be addressed The expectation (mean) and variance of the depolarization inthe absence of a threshold for action-potential generation isobtained in a neuron model represented by a tapering equivalentcable with a random (white noise) synaptic input current ata point along the dendrites. The results show that the introductionof a taper in the equivalent-cable representation of the neuronproduces larger values for both the expectation and variancewhich are neither insensitive nor symmetrical with respect tothe location of the input. It is also shown that taper extendsthe invariance of the variability in the steady-state somaticresponse to proximally located random inputs, implying thatonly small changes in the noisiness of the somatic responseoccur for a random input located in the dendrites.     

A two-year follow-up study of alcohol dependent men rehabilitated at a special unit in a developing country

Two hundred and thirty-four alcohol dependent men who had all failed to improve after previous hospital-based interventions were admitted to an intensive 6-week residential rehabilitation programme conducted at a special unit in Sri Lanka. Outcome was assessed at 2 years post-treatment, and 36% of dependent persons remained totally abstinent. During an extended period of follow-up (mean 39.2 months) a significant association was found between abstinence and having a life partner, stable family support, a higher income and regular employment. However, there was no significant association between abstinence and age, duration of alcohol dependence, level of education or type of employment. Although the majority of alcohol dependent persons did not benefit from the programme, our results compare favourably with those of similar studies done in developed countries.     

The effect of a target controlled infusion of propofol on predictability of recovery from anesthesia in children

Background: Emergence following termination of a general anesthetic depends on the effect site concentration (C_e) of the drug declining to an awakening value (C_e‐awake). C_e‐awake has been described in adults, but is unknown in children. Objectives: To determine C_e‐awake in children following a target‐controlled infusion (TCI) of propofol and to assess a C_e‐driven TCI system’s ability to predict times to emergence from anesthesia. Methods: Subjects undergoing elective surgery, aged 3 months to <10 years were recruited into three age‐stratified groups. A target C_e of 3–4 μg·ml^?1 was selected for induction and subsequently titrated to patient response and surgical stimulus. Preoperative acetaminophen, a remifentanil infusion and regional anesthesia were permitted for supplemental analgesia. State Entropy (SE) was monitored from induction to emergence. Emergence was defined as the time of first purposeful spontaneous movement (PSM). Time zero was defined as the end of propofol infusion. Based on a pilot study, a C_e‐awake of 1.9 μg·ml^?1 was chosen as the wake‐up threshold used by the software to predict emergence times. Results: Data was collected for 90 of 104 recruited patients. PSM occurred at a mean (sd ) C_e of 2.0 (0.5) μg·ml^?1 and an SE of 79 (11). There were no differences between age groups. A wide variation in emergence time was observed, with a mean (sd ) of 16.9 (7) min, and a trend to more rapid emergence in older subjects. Conclusion: A predicted C_e‐awake of 2.0 μg·ml^?1 in children aged 3 months to <10 years was identified with the selected model. For expert users of propofol in children, during shorter surgical procedures, TCI predicted emergence times do not offer significant clinical advantages.     

Scytalidium hyalinum infection of skin and nails

Five cases of skin and nail infection associated with Scytalidium hyalinum are described. The lesions were confined to the hands, feet and toenails. All the patients were from the West Indies and were of Negroid descent. Scytalidium hyalinum was the only fungus isolated on repeated culture from three patients, while the remaining two patients had mixed infections, one with Trichophyton mentagrophytes var. interdigitale and the other with Hendersonula toruloidea.     

Avian influenza: Update on pathogenesis and laboratory diagnosis

Abstract:   In the past 10 years, two respiratory viral infections—severe acute respiratory syndrome (SARS) and H5N1—have emerged that have led to a high mortality among infected individuals. Laboratory investigations have demonstrated that these two emerging infections have similar features; and understanding the pathophysiological mechanisms of the disease causation will lead to insight into standard and novel treatments for these infections. In this review we highlight the similarities and differences of SARS and H5N1, and emphasize the importance of appropriate sampling for laboratory diagnosis of the latter.