Prosthetic treatment in the adult French population: Prevalence and relation with demographic,socioeconomic and medical characteristics

BackgroundThe aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dentures in a representative sample of adults living in France.MethodsThe data were obtained from the 2002–2003 Decennial Health Survey, a cross-sectional study of a representative sample of the population living in France, which included 29,679 adults. Information was collected by interview. The variables collected were fixed denture, removable denture, age, gender, number of children, area of residence, nationality, educational attainment, family social status, employment status, annual household income per capita, supplementary insurance, chronic disease, eyesight problems/glasses, hearing problems/hearing aids. Multinomial logistic regression models were used to study the relationship between prosthetic treatment and demographic, socioeconomic and medical characteristics unadjusted, adjusted for age and adjusted for all the characteristics.ResultsThe prevalence of prosthetic treatment was 34.6% (95% confidence interval (CI): [34.1; 35.2]) for fixed prosthetic dentures and 13.8% (95% CI: [13.4; 14.2]) for removable prosthetic dentures. We showed a gradient between educational attainment and removable dentures; the odds ratio adjusted for all the variables (aOR) associated with no or primary education compared to post-secondary education was 2.56; 95% CI: [2.09; 3.13]. When annual household income per capita was low, subjects were less likely to report fixed dentures (aOR = 0.68; 95% CI: [0.62; 0.75]) than those with high annual household income per capita. Individuals without insurance less often reported fixed dentures than those with private insurance. Those reporting chronic disease were less likely to report fixed dentures (aOR = 0.87; 95% CI: [0.79; 0.95]) but more likely to report removable dentures (aOR = 1.29; 95% CI: [1.17; 1.43]) than those without chronic disease.ConclusionThis study reveals social, economic and medical inequalities in fixed and removable prosthetic treatment among adults in France.     

Treatment of stage I testicular germ-cell tumors

More than a half of patients with testicular cancer are diagnosed with clinical stage I disease. In this setting, definitive cure is the rule. However, there is no consensus on the optimal treatment choice. A literature review (1990–2005) was performed in order to identify the pros and the cons associated with each therapy, as well as their long-term outcomes. Several treatment alternatives yield similar efficacy results. Thus, therapy-related morbidity, economic costs, quality-of-life issues, and patient preferences should be considered. Refinement in the knowledge of predictive factors for relapse and amounting experience with both surveillance and adjuvant chemotherapy have led to consideration of risk-adapted treatment policies as an alternative to more traditional approaches (i. e., prophylactic irradiation for seminomas and retroperitoneal lymph node dissection for non-seminomas). In conclusion, with cure rates approaching 100%, close surveillance for low-risk patients and adjuvant chemotherapy for those at high risk of relapse seems the preferred option for clinical stage I testicular cancer, in both seminoma and non-seminoma cases.     

Early risk factors for posterior crossbite and anterior open bite in the primary dentition

Objective:To investigate risk factors specific to posterior crossbite and anterior open bite at the age of 3 years.Materials and Methods:The study included 422 children of the French EDEN mother-child cohort. The main outcomes were the presence of posterior crossbite and anterior open bite assessed by dentists at 3 years. Social characteristics (collected during pregnancy), neonatal characteristics (collected at birth), duration of breast-feeding (collected prospectively), sucking habits at 3 years, and open lips (as a proxy for mouth breathing) were studied and two logistic regressions conducted.Results: Preterm birth appears to be a risk factor specific for posterior crossbite (OR: 3.13; 95% CI: 1.13–8.68), whereas small for gestational age seems to be associated with a lower risk of posterior crossbite (OR: 0.32; 95% CI: 0.12–0.87). Ongoing pacifier or thumb sucking at 3 years is a risk factor for both posterior crossbite and anterior open bite.Conclusions: Children born preterm seem to be more at risk for posterior crossbite than those born at term. Different mechanisms may be involved in posterior crossbite and anterior open bite.     

Interpersonal aspects of personality disorders in opioid-dependent patients: the convergence of the ICL-R and the SIDP-IV

This study aims to establish the convergence of the empirically based Diagnostic Statistical Manual (DSM)- and theory-based interpersonal behavioral approaches to personality, in opioid-dependent patients (n = 110), with the use of the Structured Interview for DSM-IV Personality [Pfohl et al.: Structured Interview for DSM-IV PD. Iowa City, UICM, 1995] and the Interpersonal Checklist-Revised (ICL-R) [DeJong and VandenBrink: ICL-R. St. Oedenrode/NL, Novadic, 1998]. As hypothesized, based on prior research, we found the two approaches to be complementary rather than interchangeable. However, some overlap was found between the SIDP-IV dimensions and the ICL-R, mainly with rebellious/distrustful, reserved/silent and masochistic/self-effacing styles. Results indicate that drug dependence in itself is not a predictor of interpersonal style, while personality pathology is. Patients with a personality disorder (PD) perceive themselves as hostile and submissive, while patients without a PD view themselves as friendly and controlling. The SIDP-IV seems informative in classifying PDs, in addition guidelines for behavioral change, in addicted patients, were provided based on the ICL-R.     

Complete auriculo-ventricular block. A study of supplemental pacemakers]

The following conclusions have been drawn from a study of 20 cases of total atrio-ventricular block, which were supra-His in 7 cases, intra-His in 4 cases, infra-His in 9 cases, and were with (11 cases) or without (8 cases) recent Stockes-Adams (1 case was excluded): resumption of the basal rhythm after the post-stimulatory pause is slower in cases of infra-His A-V block; automatic discharge from the focus is easily upset by rapid stimulation, whatever the site of the focus (ventricular or junctional); subsidiary foci of stimulation would behave from the electro-physiological standpoint like a sinus focus with reduced autonomy, and deprived of its peripheral zone of physiologically slow conduction; unfortunately electro-physiological investigation of this group does not allow us to separate with confidence those patients who have had Stockes-Adams attacks from those who have not.     

Multicentre phase II study and pharmacokinetic analysis of irinotecan in chemotherapy-na?ve patients with glioblastoma.

BACKGROUND: To assess the antitumour activity and safety profile of irinotecan and its pharmacokinetic interactions with anticonvulsants in patients with glioblastoma multiforme. PATIENTS AND METHODS: This multicentre phase II and pharmacokinetic study investigated the effects of irinotecan 350 mg/m(2) given as a 90-min infusion every 3 weeks either prior to (group A) or after relapse following radiotherapy (group B) in chemotherapy-na?ve patients with glioblastoma. Preferred concomitant medication for seizure prevention was valproic acid. Pharmacokinetic analysis of irinotecan and its main metabolites (SN-38, SN-38-G, APC and NPC) was performed during cycle 1. An independent panel of experts reviewed the activity data. RESULTS: Fifty-two patients (25 patients in group A and 27 patients in group B) received a total of 191 cycles of irinotecan. Forty-six patients (22 patients in group A and 24 patients in group B) were evaluable and externally reviewed for activity. According to external review, one partial response (group B), seven minor responses (three in group A and four in group B), 12 disease stabilisations (seven in group A and five in group B) were observed. This resulted in an overall response rate of only 2.2% (95% confidence interval 0.2% to 6.5%). The median time to tumour progression was 9 weeks in group A and 14.4 weeks in group B. Six-month progression-free survival rates were 26% in group A and 43% in group B. Grade 3-4 toxicities (percentage of patients in groups A and B) consisted of neutropenia (12.5% and 25.9%), diarrhoea (8.3% and 7.4%), asthenia (12.5% and 7.4%) and vomiting (0% and 7.4%). The clearance of irinotecan was 12.4 and 14.4 l/h/m(2) in two patients who received no anticonvulsant. In patients receiving valproic acid, the clearance of irinotecan was 17.2 +/- 4.4 l/h/m(2). CONCLUSIONS: Irinotecan given at the dose of 350 mg/m(2) every 3 weeks has limited clinical activity as a single agent in patients with newly diagnosed and recurrent glioblastoma after radiotherapy. The toxicity profile and plasma disposition of irinotecan and SN-38 were not strongly influenced by anticonvulsant valproic acid therapy. Although the response rate of irinotecan as a single agent was limited, it remains an attractive drug for combination studies in patients with glioblastoma.