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.     

Human metabolism: pathways and clinical aspects

Metabolism describes the series of chemical reactions that are concerned with the provision of energy to biological systems. They may be divided into reactions involved in energy yield (catabolism: demand exceeds supply), and energy storage (anabolism: supply exceeds demand). Regulation of these pathways is critical for homeostasis, and derangements in metabolism are seen in a wide variety of pathological processes. Understanding metabolism is key to the treatment of many diseases, notably diabetes, as well as underpinning clinical nutritional support.     

可弯曲胸腔镜和硬质胸腔镜诊断不明原因胸腔积液的对比临床研究

目的对比可弯曲胸腔镜和硬质胸腔镜在不明原因胸腔积液诊断中的准确性和安全性。方法采用前瞻性随机对照研究,连续筛选四川大学华西医院2012年3月至2014年3月期间不明原因胸腔积液住院患者,患者年龄18~75岁。经知情同意后,患者随机进入可弯曲胸腔镜组或硬质胸腔镜组进行检查。结果可弯曲胸腔镜组入组49例患者,硬质胸腔镜组入组48例患者。两组共有44例患者通过胸腔镜检查确诊为恶性疾病,48例确诊为良性疾病。两组诊断不明原因胸腔积液总体准确性分别为93.9%和95.8%,可弯曲胸腔镜组诊断肿瘤的敏感性为96.0%,硬质胸腔镜组诊断肿瘤的敏感性为95.2%,两组诊断肿瘤的特异性均为100.0%,两组之间差异无统计学意义。两种胸腔镜技术并发症多数轻微,患者均耐受良好。结论对于不明原因胸腔积液,可弯曲胸腔镜诊断的准确性与硬质胸腔镜相当。尽管可弯曲胸腔镜取材组织小,但是通过多点多次取材,所获得的组织标本能满足病理科医生进行包括免疫组织化学检测在内的疾病诊断。     

Atypical Abnormal Pulmonary Vein Drainage with Atrial Septal Defect: Surgical Treatment

Sinus venosus atrial septal defect (SV‐ASD) usually coexists with partial anomalous pulmonary vein connection (PAPVC). It is a difficult diagnosis in transthoracic echocardiography (TTE) due to eccentric position of defects. We present a rare case of atypical anatomical variation in PAPVC, which was never described before. Two right pulmonary veins drained into superior vena cava, which overrode SV‐ASD and interatrial septum, a third pulmonary vein into the right atrium. Complete diagnosis could not be set after TTE, nor transesophageal echocardiography, whereas angio‐CT was finally conclusive. This diagnostic approach allowed the surgical planning.