Are the school prevention programmes - aimed at de-normalizing smoking among youths - beneficial in the long term? An example from the Smoke Free Class Competition in Italy.

Tobacco smoking by young people is of great concern because it usually leads to regular smoking, nicotine addiction and quitting difficulties. Young people "hooked" by tobacco maintain the profits of the tobacco industry by replacing smokers who quit or die. If new generations could be tobacco-free, as supported by tobacco endgame strategies, the tobacco epidemic could end within decades. Smoking prevention programmes for teens are offered by schools with the aim to prevent or delay smoking onset. Among these, the Smoke Free Class Competition (SFC) was widely implemented in Europe. Its effectiveness yielded conflicting results, but it was only evaluated at short/medium term (6 - 18 months). The aim of this study is to evaluate its effectiveness after a longer follow-up (3 to 5 years) in order to allow enough time for the maturing of the students and the internalization of the experience and its contents. Fifteen classes were randomly sampled from two Italian high schools of Bologna province that regularly offered the SFC to first year students; 382 students (174 participating in the SFC and 208 controls) were retrospectively followed-up and provided their "smoking histories". At the end of their last year of school (after 5 years from the SFC), the percentage of students who stated that they were regular smokers was lower among the SFC students than in controls: 13.5% vs 32.9% (p=0.03). From the students' "smoking histories", statistically significant protective ORs were observed for SFC students at the end of 1st and 5th year: 0.42 (95% CI 0.19-0.93) and 0.32 (95% CI 0.11-0.91) respectively. Absence of smokers in the family was also a strongly statistically significant factor associated with being a non-smoker student. These results suggest that SFC may have a positive impact on lowering the prevalence of smoking in the long term (5 years).

Phenomenological Transition of an Aluminum Surface in an Ionic Liquid and Its Beneficial Implementation in Batteries.

Aluminum (Al) electrochemical dissolution in organic nonaqueous media and room temperature ionic liquids (RTILs) is partially hampered by the presence of a native oxide. In this work, Al activation in EMIm(HF)2.3F RTIL is reported. It was confirmed that as a result of the interaction of Al with the RTIL, a new film is formed instead of the pristine oxide layer. Aluminum surface modifications result in a transformation from a passive state to the active behavior of the metal. This was confirmed via the employment of electrochemical methods and characterization by XPS, AFM, and TEM. It was shown that the pristine oxide surface film dissolves in EMIm(HF)2.3F, allowing an Al-O-F layer to be formed instead. This newly built up layer dramatically restricts Al corrosion while enabling high rates of Al anodic dissolution. These beneficial features allow the implementation of Al as an anode in advanced portable power sources, such as aluminum-air batteries.

Tuberculosis Beijing strain outbreak in an Israeli Arab rural community linked to an incarcerated immigrant.

A tuberculosis (TB) outbreak with six definite and four probable cases, caused by a Beijing strain isolate, occurred in an Arab rural community in north Israel. Using epidemiological investigation and strain genotyping, we identified the source case as an incarcerated immigrant. This outbreak illustrates how a systematic breakdown in TB prevention and control measures at multiple levels, within prisons and upon exiting prison, can result in rapid, cross-ethnic transmission of TB to a low-risk population. The close social bonds in this rural community and downsizing of the regional TB clinic staff may also have contributed to the magnitude of this outbreak.

[Neonatal nonbacterial thrombotic endocarditis]. / Les endocardites thrombotiques néonatales non bactériennes.

UNLABELLED: Nonbacterial thrombotic endocarditis is not widely known in neonates. CASE REPORTS: We report three new cases which illustrate some specific aspects of this pathology. Respiratory distress with severe pulmonary hypertension, systemic hypotension and disseminated intravascular coagulopathy in a full-term newborn were characteristic findings. CONCLUSION: An early echocardiography should lead to accurate diagnosis. Hypoxemia and genetic factors could be determining factors in its pathogenesis.

Constitutional mutations of the hSNF5/INI1 gene predispose to a variety of cancers.

Biallelic, truncating mutations of the hSNF5/INI1 gene have recently been documented in malignant rhabdoid tumor (MRT), one of the most aggressive human cancers. This finding suggests that hSNF5/INI1 is a new tumor-suppressor gene for which germline mutations might predispose to cancer. We now report the presence of loss-of-function mutations of this gene in the constitutional DNA from affected members but not from healthy relatives in cancer-prone families. Furthermore, a constitutional mutation is documented in a patient with two successive primary cancers. In agreement with the two-hit model, the wild-type hSNF5/INI1 allele is deleted in the tumor DNA from mutation carriers. In all tested cases, DNA from parents demonstrated normal hSNF5/INI1 sequences, therefore indicating the de novo occurrence of the mutation, which was shown to involve the maternal allele in one case and the paternal allele in two other cases. These data indicate that constitutional mutation of the hSNF5/INI1 gene defines a new hereditary syndrome predisposing to renal or extrarenal MRT and to a variety of tumors of the CNS, including choroid plexus carcinoma, medulloblastoma, and central primitive neuroectodermal tumor. This condition, which we propose to term "rhabdoid predisposition syndrome," may account for previous observations of familial and multifocal cases of the aforementioned tumor types. It could also provide the molecular basis for cases of Li-Fraumeni syndrome without p53 germline mutations.

[Prenatal diagnosis of chylothorax]. / Le chylothorax de découverte anténatale.

Chylothorax is defined as the presence of lymph in the pleural space. Congenital chylothorax is one of the most frequent causes of fetal pleural effusion. It may be primary or secondary. Careful assessment of the etiology and of possible associated anomalies is required. Main complications are pulmonary hypoplasia, hydrops fetalis and the risk of premature delivery. Management is still a mater of controversy, the diagnosis of fetal pulmonary hypoplasia being difficult in utero. Factors such as gestational age, evolution of pleural effusion on two weeks, signs of seriousness (hydrops fetalis), and pulmonary expansion after pleural puncture may help the physician to choose between abstention, pleural tapping or long-term in utero drainage. Post natal treatment consists of pleural drainage and assisted ventilation in cases of respiratory distress, correction of metabolic and immune disorders and exclusive parenteral nutrition. Once chylothorax is resolved, formula feeding without long-chain triglycerides is allowed. If pleural effusion persists despite a well conducted treatment, albumin infusion and diuretics may be used before considering surgical treatment.

[Comparative evaluation of clinical and ultrasonographic screening of hip dislocation in Breton and Languedoc populations]. / Evaluation comparée du dépistage clinique et échographique de la luxation de la hanche dans une population bretonne et languedocinne.

BACKGROUND: Congenital dislocation of the hip varies greatly in incidence among different regions. This work is aimed at comparing results of clinical investigation and ultrasonography of the hip in Languedoc-Roussillon and Brittany. POPULATION AND METHODS: Two thousand eight hundred and twelve and 2,809 neonates admitted to Nîmes and Vannes hospitals respectively, were enrolled in a prospective study. Clinical examinations were made according to the protocol established by the "Groupe d' études en orthopédie pédiatrique". Ultrasound investigations were performed in every risk case. RESULTS: No dislocation occurred in the 4946 neonates without risk factors. In the 675 neonates with risk factors, 213 ultrasonographic examinations were abnormal, more frequently in the Brittany group (P < 0.001); nine dislocations were observed. A familial history of hip dysplasia (P < 0.001) and the addition of two risk factors (P < 0.001) were more frequent in Brittany. One hundred and six cases required treatment, more frequently in Brittany (P < 0.001). CONCLUSIONS: Some clinical risk factors and delayed ossification or hip dysplasia at ultrasound examination are significantly more frequent in Brittany. Clinical examination with selective ultrasonography is a reliable method, allowing early diagnosis and treatment of delayed dislocations.

Coexistent hereditary coproporphyria and congenital erythropoietic porphyria (Günther disease).

We present data on one patient with an inheritance pattern for two porphyrias. From her mother she inherited the trait of hereditary coproporphyria; from both parents she inherited the trait of congenital erythropoietic porphyria (Günther disease). Enzyme studies confirmed this new type of dual porphyria.

[Role of echography in the screening of congenital hip luxation at a maternity department]. / Place de l'échographie dans le dépistage de la luxation congénitale de hanche à la maternité.

Ultrasound was established as a remarkable means of recognizing dysplasia of hips or dislocations in the neonatal period following the work of R. Graf and later in France of H. Gomes and J. Schirrer et al. All the same, different techniques have been suggested and the role of the examination has been debated. Those who advocate routine screening of all pregnancies are in opposition to those who employ it selectively in cases that are known to be abnormal or at risk. The authors report a study carried out in their maternity department using ultrasound of the hip as an examination complementary to clinical screening. Echography has been shown to be able to give more information than radiography of the pelvis which cannot usefully be employed for screening until the age of 4 months. In 1781 newborns examined consecutively the indication for ultrasound of the hip was suggested in 201 cases (11%) and showed an abnormality in 42 patients (21% of the examinations carried out). Exenteration in 2, dysplasia in 8, failure to ossify correctly in 25, and endoscopic laxity without a morphological abnormality in 7 cases. The clinical signs that were used to predict an abnormality on ultrasound were: feminine sex. Clinical appearance of instability and the association of 2 risk factors. 3 cases of dislocation were found. Two of them occurred early and one at the age of 5 months who was a girl delivered by the breech and in whom a delay in ossification was noted at birth.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pneumococcal pneumonia and septic shock in the newborn infant]. / Pneumopathie et choc septique à pneumocoque chez le nouveau-né.

Pneumococcal sepsis and pneumonia in the neonate are rarely reported. They appear either as an early-onset respiratory distress with a high mortality rate or as a delayed infection. The authors describe 3 term neonates with an early respiratory distress syndrome and recall the main points of this severe foeto-maternal infection. Neonatal pneumococcal sepsis is strikingly similar to early-onset group B streptococcal infection. The isolation of the germ in the mother's vaginal flora is hazardous. Such cases suggest that early respiratory support and intensive circulatory resuscitation lead only to a slight decrease in the mortality rate, and thus preventive antibiotherapy is a necessity.

Skin reactivity and specific IgE levels in the evaluation of allergic sensitivity to common allergens for epidemiological purposes.

An investigation was conducted to test the validity of the skin-prick test (SPT) with eleven common allergens (Lofarma series proposed by Italian National Research Council for epidemiological studies) as a method for predicting the presence of specific antibodies in serum. The relationship between SPT, evaluated by two different methods (MWD = mean weal diameter, AHWR = allergen histamine weal ratio), and specific IgE levels (RAST) has been investigated in 101 patients tested consecutively for suspected allergic disease. Sensitivity, specificity and overall efficiency were assessed for different criteria of SPT positivity (greater than or equal to 4 mm or greater than or equal to 5 mm using MWD; ++ or using AHWR). For pollens and moulds, a weal diameter greater than or equal to 5 mm gave better results than 4 mm, whereas for mites a MWD greater than or equal to 4 mm showed a better sensitivity and overall efficiency than 5 mm. Danders showed low sensitivity when either 5 or 4 mm criterion was considered. AHWR evaluation gave no better results, except for animal danders. Correlation coefficients between weal size and RAST class showed a good relationship for mites and pollens using both methods of SPT evaluation; a moderate relationship was observed with MWD criterion for moulds and with AHWR for danders. We conclude that a weal diameter greater than or equal to 5 mm can be assumed to to predict RAST positivity for pollens and moulds, and for mites, a weal greater than or equal to 4 mm can be a more accurate criterion.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hereditary renal adysplasia. Apropos of 2 families]. / Adysplasie rénale héréditaire. A propos de deux familles.

Two families with hereditary renal adysplasia are reported. Transmission is dominant autosomal. There were no genital abnormalities.

[Validity of a specific bronchial provocation test with proteolytic enzymes in occupational bronchial asthma caused by enzymatic detergents]. / Validità di un test di broncostimolazione specifica con enzimi proteolitici nell'asma bronchiale professionale da detergenti enzimatici.

Six asthmatic subjects exposed to enzymatic detergents derived from B. Licheniformis were examined by means of a specific Bronchial Provocative Test (sBPT) with solutions of the enzyme. All subjects, except for one, were positive to prick tests with solutions of the "crude" enzyme and with Alcalase, and showed high levels of specific IgE by RAST. The sBPT with solutions of the enzyme, administered by means of a Bird Mark 7 nebulyzer in IPPB with measurement of the delivered dose, showed a positive response in all 6 subjects. No positive result was obtained in 5 normal subjects and in 5 non exposed asthmatic patients, even at much higher doses of the delivered enzyme. The occupational-type sBPT showed only two positive results out of the 6 examined. A good relationship was observed between bronchial hyperresponsiveness and provocative dose of the enzyme. Therefore, the sBPT with solutions of the enzyme is proved to be highly sensitive and specific in confirming the diagnosis of occupational asthma due to proteolytic enzymes.