General dentists' perceptions and clinical management of hypomineralised second primary molars (HSPM) in Ireland.

PURPOSE: This questionnaire aimed to explore how general dentists in the Republic of Ireland perceive and manage hypomineralised second primary molars (HSPM). METHODS: Following ethical approval, a validated structured questionnaire containing 19 questions was sent to Irish dentists using Survey Monkey. Questions on awareness, dentist's experience, barriers to care and clinical scenarios with different treatment options were included. Binary outcomes and independent variables were compared using logistic regression analysis (α = 5%). RESULTS: Responses from 279 general dentists were analysed. The majority of dentists were aware of HSPM (72%) and most dentists felt confident in diagnosing HSPM (71%). Dentists who had practiced for ≥ 15 years were significantly more likely to document HSPM frequently compared to those with less experience (OR 0.29; p = 0.012). No significant association was found between confidence in HSPM diagnosis and other variables, such as age group, years of practice and workplace. Dentists not working in private practice reported to be less comfortable in the management of HSPM (OR 0.49; p = 0.030). The most cited barrier to management of HSPM was child's behaviour. A broad variation was observed in the clinical scenarios, in particular when treatment planning more severe HSPM. CONCLUSIONS: In general, Irish dentists are aware of HSPM and are confident in diagnosis and management. Variation existed in treatment options reflecting the disparity that exists in clinical management.

Patterns of dreissenid mussel invasions in western US lakes within an integrated gravity model framework.

Freshwater invasive species, such as the quagga mussel (Dreissena rostriformis bugensis), are causing over $1 billion USD annually in damages to water infrastructure, recreation, and the environment. Once established, quagga and other dreissenid mussels are extremely difficult to eradicate. Preventing the spread of these invasives is critical and of high management concern. Invasive dreissenid establishment is predicated upon both successful dispersal from a source and suitable habitat in the uninfested waterbody to which they are transported. Recreational boaters have become predominant dispersal vectors making it possible to forecast the risk of invasion of waterbodies for more targeted management and prevention. We developed an integrated mussel dispersal model that couples a constrained gravity model and habitat suitability model to forecast future invasions. The model simulates boater movement between lakes, the likelihood of boats transporting mussels, and the likelihood that those mussels survive in the environmental conditions of the new lake. Model output was most sensitive to changes in boater threshold, then buffer zones, while not as sensitive to changes in habitat suitability. From an initial infested source pool of 11 among 402 Western inland US lakes, we forecast additional lakes infested in several possible simulation scenarios. Constraining movement reduced connectivity between waterbodies with amplifying effects at different distance levels. This model can be used to determine waterbodies most at risk for dreissenid mussel invasion and to highlight the importance of multifactor integrated models in environmental management.

Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal.

We report two cases of primary progressive multiple sclerosis (PPMS) included in the INFORMS cohort, experiencing a relapse related to a single MRI gadolinium-enhancing lesion 3 months after fingolimod withdrawal. These two patients share similarities with relapsing-remitting multiple sclerosis cases described in the same situation, suggesting that the initiating process of the active demyelinating plaques is also present in PPMS, even without relapses, but may be triggered as fingolimod is withdrawn. Although the results of the INFORMS study suggest that fingolimod may not slow down the progression, some PPMS patients might still benefit from a disease-modifying treatment.

[Cerebrotendinous xanthomatosis: a multicentric retrospective study of 15 adults, clinical and paraclinical typical and atypical aspects]. / Étude rétrospective multicentrique de 15 cas adultes de xanthomatose cérébrotendineuse : aspects cliniques et paracliniques typiques et atypiques.

INTRODUCTION: Cerebrotendinous xanthomatosis, a metabolic leukodystrophy with an autosomal recessive inheritance, is secondary to deficiency of sterol 27-hydroxylase, an enzyme involved in cholesterol catabolism. Classical symptoms include clinical or infraclinical xanthomas affecting the skin and tendons, early cataracts, neurological signs and diarrhea. Brain imaging reveals involvement of the dentate nuclei and periventricular white matter hyperintensities. The diagnosis is based on an increased cholestanol level in serum, confirmed by the presence of a mutation in the CYP27A1 gene. Treatment is based on chenodeoxycholic acid. METHOD: We report a retrospective multicentric study of 15 cases of cerebrotendinous xanthomatosis diagnosed in French adults. Clinical, molecular and MRI findings were recorded in all patients. RESULTS: The average age at diagnosis was 39years (range 27-65). Disease onset occurred in childhood in 73% of patients and in adulthood in 27%. All patients with a pediatric onset were diagnosed during adulthood (age range 28-65years). Clinical symptoms variably associated cerebellar syndrome, pyramidal syndrome, cognitive decline, epilepsy, neuropathy (sought in 10 of our patients, present in forms in 8), psychiatric disorders, cataract and xanthomas. One patient had an atypical presentation: monoparesis associated with xanthomas. Brain MRI was abnormal in all: findings consisted in T2-weighted hyperintensity of the dentate nuclei (47%), periventricular leuoencephalopathy (73%) which preferentially involved the posterior cerebral part (60%), leucoencephalopathy with a vascular pattern (7%), hyperintensity of the cortico-spinal tracts (53%), globi pallidi, corpus callosum and cerebral atrophy (33%). Serum cholestanol was elevated in 93% of patients. The most frequent mutation was 1183C>T (n=5/15). Under treatment with chenodeoxycholic acid, eight patients improved initially, followed by stabilization in five of them, and worsening in the others. Four patients died. CONCLUSION: Patients with the xanthoma-neurological disorder association should be tested for cerebrotendinous xanthomatosis. The disease often begins in childhood with a diagnostic delay but also in adulthood. Involvement of the dentate nuclei is specific but not sensitive and the supratentorial leucoencephalopathy is not specific but with an antero-posterior gradient. A vascular distribution and involvement of the corpus callosum are possible. Serum cholestanol assay is very reliable: an elevated level provides the diagnosis, which must nevertheless be confirmed by molecular biology.

[Serious clinical manifestations of vitamin deficiency after a "sleeve" gastrectomy: role of psychogenic anorexia]. / Anorexie psychogène et carences vitaminiques sévères dans les suites d'une gastrectomie longitudinale.

INTRODUCTION: Morbid obesity is an emerging condition in the general population. Bariatric surgery, which has demonstrated its effectiveness for weight loss, mortality and morbidity related to obesity, is required in some patients. However, it may be associated with various adverse effects, including vitamin deficiencies. CASE REPORT: We report a 33-year old man who presented central and peripheral neurological deficits and cardiac manifestations related to multiple vitamin deficiencies, following "sleeve" gastrectomy. The vitamin deficiencies were related to insufficient ingesta secondary to psychogenic anorexia. The patient improved with vitamins, antidepressant drugs and atypical neuroleptics. CONCLUSION: Post-operative complications of "sleeve" gastrectomy include vitamin deficiencies that can develop in the context of psychogenic anorexia and ingesta reduction, in the absence of any digestive malabsorption.

Case reports in anesthesiology: their trend through 17 years.

UNLABELLED: The study objective was to delineate the trend of case reports (the simplest of the descriptive forms of study) in the anesthesiological literature by analyzing the frequency of publication, and citation, and especially of the place of citation of a sample of published case reports. It is our opinion that case report in anesthesia is particularly suitable for this specialty rather than for others and is often the first signal of a complication, an adverse event, an anesthetic problem in rare disease and alerts other anesthesiologists to the possibility of unexpected events. METHODS: We analyzed the case reports published on an Anesthesiological journal placed in the middle in term of Impact Factor, from January 1980 to December 1997. Citations of each case report were obtained using computer searches of the Science Citation Index (SCI). For each of these case reports we collected in a custom-designed data base the following data: year of publication, number of authors, number of citations per year, place of citation, type of article quoting the case report, number of self-citations, year of first citation. MAIN RESULTS: We identified 637 case reports and 1946 citations. The number of case reports increased through the years up to a peak in 1994-95 and the same trend was observed for citations and self-citations, the number of authors per case report was < or = 4 in 90.4%; 74.2% of total case reports cited were first cited within two years of publication, while 34.7% were never cited. The type of article quoting the case reports has been, in the majority of cases, an original article. CONCLUSIONS: The analysed case reports and the number of citations can give us information about the importance of a clinical situation at a particular time.

Ion chemistry of anti-o,o dibenzene.

The ion chemistry of anti-o,o'-dibenzene (1) was examined in the gaseous and the condensed phase. From a series of comparative ion cyclotron resonance (ICR) mass spectrometry experiments which involved the interaction of Cu+ with 1, benzene, or mixtures of both, it was demonstrated that 1 can be brought into the gas phase as an intact molecule under the experimental conditions employed. The molecular ions, formally 1*+ and 1*- , were investigated with a four-sector mass spectrometer in metastable-ion decay, collisional activation, charge reversal, and neutralization-reionization experiments. Surprisingly, the expected retrocyclization to yield two benzene molecules was not dominant for the long-lived molecular ions; however, other fragmentations, such as methyl and hydrogen losses, prevailed. In contrast, matrix ionization of 1 in freon (77 K) by gamma-radiation or in argon (12 K) by X-irradiation leads to quantitative retrocyclization to the cationic dimer of benzene, 2*+. Theoretical modeling of the potential-energy surface for the retrocyclization shows that only a small, if any, activation barrier is to be expected for this process. In another series of experiments, metal complexes of 1 were investigated. 1/Cr+ was formed in the ion source and examined by metastable ion decay and collisional activation experiments, which revealed predominant losses of neutral benzene. Nevertheless, comparison with the bis-ligated [(C6H6)2Cr]+ complex provided evidence for the existence of an intact 1/Cr+ under these experimental conditions. No evidence for the existence of 1/Fe+ was obtained, which suggests that iron mediates the rapid retrocyclization of 1/Fe+ into the bis-ligated benzene complex [(C6H6)2Fe]+.

Effects of contextual interference on learning technical sports skills.

The effects of contextual interference on learning skills of volleyball (volley, bump, serve) are influenced by the scheduling of actual practice sessions: the activities can be proposed in a repetitive practice schedule (blocked practice) by continuously repeating the same task (low interference) or in random practice schedules by performing more tasks or variations of one same activity (high interference). High contextual interference, even though causing immediate limited performance, leads to superior performance on retention and transfer tests. Four experimental groups (13 students each) were placed in conditions of random, blocked, serial, and serial with high interference practice for 8 meetings (2 tests and 6 practice). Analysis yielded significant differences among the groups on a transfer test (long transfer) for the serve, so results in this instructional setting are partially in line with those generally found in laboratory experiments.