A comparison of the spatial dependence of body mass index among adults and children in a Swiss general population.

BACKGROUND: Body mass index (BMI) may cluster in space among adults and be spatially dependent. Whether BMI clusters among children and how age-specific BMI clusters are related remains unknown. We aimed to identify and compare the spatial dependence of BMI in adults and children in a Swiss general population, taking into account the area's income level. METHODS: Geo-referenced data from the Bus Santé study (adults, n=6663) and Geneva School Health Service (children, n=3601) were used. We implemented global (Moran's I) and local (local indicators of spatial association (LISA)) indices of spatial autocorrelation to investigate the spatial dependence of BMI in adults (35-74 years) and children (6-7 years). Weight and height were measured using standardized procedures. Five spatial autocorrelation classes (LISA clusters) were defined including the high-high BMI class (high BMI participant's BMI value correlated with high BMI-neighbors' mean BMI values). The spatial distributions of clusters were compared between adults and children with and without adjustment for area's income level. RESULTS: In both adults and children, BMI was clearly not distributed at random across the State of Geneva. Both adults' and children's BMIs were associated with the mean BMI of their neighborhood. We found that the clusters of higher BMI in adults and children are located in close, yet different, areas of the state. Significant clusters of high versus low BMIs were clearly identified in both adults and children. Area's income level was associated with children's BMI clusters. CONCLUSIONS: BMI clusters show a specific spatial dependence in adults and children from the general population. Using a fine-scale spatial analytic approach, we identified life course-specific clusters that could guide tailored interventions.

Intra-oral laser welding: an in vitro evaluation of thermal increase.

The neodymium:yttrium-aluminium-garnet (Nd:YAG) laser is currently used in dental laboratories to weld metals on dental prostheses. Recently, the use of Nd:YAG has been suggested so that dentists themselves can repair broken fixed, removable and orthodontic prostheses by welding metals directly in the mouth. This work aimed to evaluate, through a four k-type thermocouple system on calf jaws, the thermal increase in the biological structures close to the metal parts during laser welding. We put two hemispherical metal plates onto mandibular molars and then laser welded them at three points with a four k-thermocouple system to determine the thermal rise in the pulp chamber, sulcus, root and bone. This procedure was carried out on 12 samples, and the results were processed. The highest values of thermal increase were found in the pulp chamber, 1.5 degrees C; sulcus, 0.7 degrees C; root, 0.3 degrees C; and bone, 0.3 degrees C. This study showed that thermal increases in pulp chamber, sulcus, root and bone were biologically compatible and that intra-oral laser welding, at the parameters used in this work, seems to be harmless to the biological structures close to the welding and thermally affected zones.

[Preprosthetic surgery of the edentulous maxilla: vestibular deepening with the aid of the CO2 laser]. / Chirurgie pré-prothétique de l'édenté maxillaire complet: approfondissement vestibulaire à l'aide du laser CO2.

Vestibular deepening for maxillary edentulous patients is mainly indicated once instability cannot be reached due to important bone resorption. Vestibular deepening with CO2 super-pulsed laser enhance, in a bloodless environment, sustentation as well retention of those full dentures in good operative conditions as compared with conventional techniques.

Temperature rise during photo-activated disinfection of root canals.

The aim of this study was to determine whether it is safe to use photo-activated disinfection (PAD) during root canal treatment without heating the periodontal tissues. Root canals of 30 freshly extracted single-rooted teeth were prepared using ProFiles up to size ISO 40 and then filled with photo-sensitiser: tolonium blue (1.2 mg/l). The 635 nm diode laser was used with the manufacturer's endo-tip. Samples were irradiated for 150 s (output power 100 mW, approximate energy density 106.16 J/cm(2)). Temperatures were recorded at working length on the external root surface. After 150 s of PAD irradiation, the average temperature rise was 0.16 +/- 0.08 degrees C. All values were lower than the 7 degrees C safety level for periodontal injury. It was concluded that, regarding the temperature increase, the use of PAD in root canals could be considered harmless for periodontal tissues.

[The bill of rights for children in sport: a tool to promote the health and protect the child in sport]. / La charte des droits de l'enfant dans le sport: un outil pour promouvoir la santé et protéger l'enfant dans le sport.

The Bill of rights for children in sport was developed in response to the need for prevention and protection of children practicing sport. It is the result of an interdisciplinary approach and is used with young sportsmen, sport clubs and in the education of the professionals involved with children's sport. It is an excellent tool to sensitize people to children's vulnerabilities and to establish the bases for prevention and protection. In complete accordance with the UN Convention on the Rights of the Child, this Bill gives an example of a concrete application in the field of Sports. Used on a regular basis in the field, it contributes to change the adult's vision of children's sport and the approach to coaching;

[Medical certificates for physical education in schools; the situation in Geneva]. / Certificats médicaux de dispense de gymnastique scolaire, la situation à Genève.

The sedentarisation of youth is a major public health issue. Much hope has been placed on school physical education (PE) as a source of regular physical activity and to promote an active life style. A trans-disciplinary group counted the number of medical certificates in secondary school (11339 students), modified the existing excuse form, and generated a debate about PE. In 2000-2001, 15% of students (1688) presented medical certificates: 48% were for >3 months to one year, among which 75% were girls. The proportion of medical certificates varied from school to school (2,3 to 15%). A new form allowing to establish partial incapacity brought a 40% reduction in total medical certificates in 2002-2003.

[Dihydropyrimidine deshydrogenase (DPD): rhythm and consequences]. / Dihydropyrimidine déshydrogénase (DPD): rythme et conséquences.

Dihydropyrimidine deshydrogenase (DPD) is the rate limiting enzyme of 5-fluorouracil (5-FU) catabolism and its activity is generally determined in peripheral blood mononuclear cells. Several studies have highlighted interactions between toxicities to 5-FU and a DPD activity deficiency. Circadian variations in 5-FU anabolism enzymes are suggested. Circadian variations in 5-FU catabolism enzymes, and especially for DPD in healthy subjects or patients, have shown in some cases circadian variations in DPD activity but with different peak times. Based on this knowledge, chronomodulated therapy for the association 5-FU-folinic acid with maximal delivery rate in the first half of the night was shown clearly to be 5 times less toxic than control flat therapy. Nevertheless, in the most active chronotherapy pattern, 30% of the patients have also toxicities. However the timing of the individual peak of DPD activity remains controversial.

Histological study of the human temporo-mandibular joint and its surrounding muscles.

This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

Double-blind, randomized, controlled study on the efficacy and safety of a novel diclofenac epolamine gel formulated with lecithin for the treatment of sprains, strains and contusions.

To evaluate the efficacy of the new diclofenac-N-(2-hydroxyethyl)-pyrrolidine gel formulated with lecithin (DHEP lecithin) compared with diclofenac-N-(2-hydroxyethyl)-pyrrolidine gel (DHEP gel) without lecithin in mild-to-moderate posttraumatic injuries (grade 1 ankle, knee and muscle injuries), a multicenter, double-blind, controlled study was carried out. A total of 100 patients were enrolled and randomly assigned to either DHEP lecithin (n = 52) or DHEP gel (n = 48) treatment. All patients concluded the treatment period except for five, who did not turn up to their respective investigational sites for the follow-up visits. According to an intention-to-treat approach, they were all included in the statistical analysis. As for the efficacy and safety analysis, the primary variable was "pain on movement" as measured by a Huskisson visual analog scale. During the first 3 days of treatment each group recorded a significant within-group decrease, but patients treated with DHEP lecithin showed a decrease in absolute value that was statistically greater than that obtained with DHEP gel (p = 0.025). At the end of the treatment period (day 10) the difference between groups was still statistically significant (p = 0.036). The statistical analysis of the secondary efficacy variables showed significant results in favor of DHEP lecithin treatment. These were superimposable on the results found for the primary variable. The global efficacy and tolerability judgments, reported either by patient or by physician, showed no statistical difference between treatment groups. Due to the presence of lecithin in the new gel formulation, DHEP lecithin showed a faster and significantly more marked therapeutic effect compared with that of DHEP gel.

Computed tomographic evaluation of radiation pneumonitis in a canine model.

The objective of this study was to document the utility of computed tomography (CT) and a three-dimensional (3-D) radiotherapy treatment planning system for assessing the development of acute radiation pneumonitis in a canine model. Fourteen dogs were randomly assigned to a nonirradiated control group or one of three radiation dose groups receiving a single fraction of either 12, 15, or 18 Gy delivered to two-thirds of the right hemithorax. CT and survey radiographs were performed in all dogs prior to and at defined intervals for up to 13 weeks following irradiation. All images were subjectively evaluated for development of radiation pneumonitis and CT images were quantitatively analyzed. Radiation pneumonitis was detected earlier with CT images than with radiographs. Quantitatively, functional lung volume and radiation pneumonitis lesion volume on CT images changed over time in all irradiated dogs. However, there was no statistically significant difference between the three radiation dose groups, but a marked difference between irradiated dogs and nonirradiated controls. These data suggest that CT is superior to survey radiography for the evaluation and quantification of acute radiation pneumonitis in this canine model. Quantification of acute radiation pneumonitis suggests future promise for evaluating the efficacy of modifiers to lessen the effects of irradiating normal lung tissue in this canine model.

A revolving food pellet test for measuring sensorimotor performance in rats.

A revolving food pellet (RFP) test is presented, measuring the ability of rats to eat food pellets suspended from a horizontal bar in their home cage. This easy to make and economical device evaluates the efficiency of bilateral front paw coordination while standing. During the beginning of a ten day testing period, rats exposed to the RFP chamber had a lower intake of food and decreased body weight than rats housed in a standard home cage. With continued practice, the experimental group increased their food intake and body weight. During this time, the rats learned to control the revolving pellets by stabilizing them with their front paws and chewing on them. This apparatus is suitable for assessing a form of sensorimotor learning, involving the efficiency of front paw reaching, grasping, and holding movements, together with appropriate postural adjustments and biting movements. This test was sensitive to brain lesioning, as rats with bilateral lesions of the cerebellar fastigial nucleus were impaired.

Effects of midline and lateral cerebellar lesions on motor coordination and spatial orientation.

Rats were lesioned in the midline cerebellum, comprising the vermis and fastigial nucleus, or the lateral cerebellum, comprising the cerebellar hemispheres and dentate nucleus, and evaluated in a series of motor and non-motor learning tests. Rats with midline lesions had difficulty in maintaining their equilibrium on a bridge and were slower before turning upward and traversed less squares on an inclined grid. They were not impaired for muscle strength when suspended from a horizontal wire. Rats with lateral lesions had milder deficits on the bridge and were not affected in the other two tests. In the Morris water maze test, rats with lateral lesions were deficient in spatial orientation, whereas rats with midline lesions were deficient in visuomotor coordination. Lateral lesions had no effects on visual discrimination learning. These results illustrate the differential influence of midline as opposed to lateral cerebellar regions on both motor and non-motor behaviors. Fastigial nucleus lesions decreased the time spent in equilibrium and latencies before falling on the bridge and the distance travelled along the inclined grid but had no effect on muscle strength when suspended from the horizontal string. Quadrant entries and escape latencies were higher in rats with fastigial lesions during the hidden platform condition of the Morris water maze but not during the visible platform condition. It is concluded that fastigial-lesioned rats are impaired in equilibrium and spatial orientation but with repeated trials learn to improve their performances.

Selling biotechnology in the dental medicine marketplace: the OmniGene Diagnostics DNA probe tests for periodontal pathogens.

OmniGene Diagnostics, Inc. has applied the principles of genetic engineering to develop species-specific DNA probe tests for eight periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetem-comitans, Fusobacterium nucleatum, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, and Treponema denticola). The test requires minimal effort on the part of the clinician: subgingival plaque samples are collected from the patient and sent through the mail for analysis by OmniGene Diagnostics' fully licensed clinical reference laboratory. Results are transmitted to the practitioner by phone, fax, or mail. The use of diagnostic tests for periodontal pathogens is a relatively new concept in dentistry and acceptance of the OmniGene Diagnostics tests by the dental marketplace has been slower than anticipated. OmniGene Diagnostics' challenge for the future is to persuade the dental community that monitoring periodontal pathogen levels, as well as other clinical indicators of disease, is essential to providing optimal care to the periodontitis patient.

Dorsal striatal lesions in rats. 1: Effects on exploration and motor coordination.

Rats with small dorsal striatal lesions were compared to sham-operated controls in a series of test measuring their exploratory behavior in a T-maze, a hole-board, and an elevated plus-maze. Motor coordination was evaluated in the inclined grid and in the square bridge tests and grip strength in the wire suspension test. The rats with dorsal striatal lesions were not impaired in the motor coordination tests, the grip strength test, nor in spontaneous alternation. By contrast, an increase of emergence latencies in the elevated plus-maze and a reduction of motor activity in the hole-board confined space during the early part of testing were observed in rats with dorsal striatal lesions. These results are ascribed to a lesion-induced situation-specific increase in inhibition.

Dorsal striatal lesions in rats. 2: Effects on spatial and non-spatial learning.

Rats with small electrolytic lesions of the dorsal striatum were evaluated in acquisition of spatial learning, sensorimotor learning, and a straight runway food approach response and its extinction. No differences were detected between rats with dorsal striatal lesions and sham-operated controls during acquisition of hidden and visible trials in the Morris water maze. Neither was an intergroup difference observed during acquisition of the rotorod test of motor coordination. Lesioned rats were not impaired in running for a food reward, but their running latencies on day 2 of extinction were lower than those of controls, an indication of perseveration. These results indicate that perseverative responding may occur in dorsal striatal lesioned rats in the absence of spatial or sensorimotor defects.

Late radiation injury to muscle and peripheral nerves.

Late radiation injury to muscles and peripheral nerves is infrequently observed. However, the success of radiation oncology has led to longer patient survival, providing a greater opportunity for late effects to develop, increase in severity and, possibly, impact the quality of life of the patient. In addition, when radiation therapy is combined with surgery and/or chemotherapy, the risk of late complications is likely to increase. It is clear that the incidence of complications involving muscles and nerves increases with time following radiation. The influence of volume has yet to be determined; however, an increased volume is likely to increase the risk of injury to muscles and nerves. Experimental and clinical studies have indicated that the alpha/beta ratio for muscle is approximately 4 Gy and, possibly, 2 Gy for peripheral nerve, indicating the great influence of fractionation on response of these tissues. This is of concern for intraoperative radiation therapy, and for high dose rate brachytherapy. This review of clinical and experimental data discusses the response of muscle and nerves late after radiation therapy. A grading system has been proposed and endpoints suggested.

Differential cell analysis and phenotypic subtyping of lymphocytes in bronchoalveolar lavage fluid from clinically normal dogs.

In 33 healthy dogs, 66 bronchoalveolar lavage samples from the right and left caudal lung lobes were analyzed for volume of return, cellularity, differential cellularity, and immunophenotypic lymphocyte subpopulations. Lavage return was 64.8% (mean) following 3 sequential 25-ml lavages, for a total lavage volume of 75 ml. With this technique, 21.1 x 10(6) cells/sample (mean) were obtained. The cellular components of bronchoalveolar lavage samples, in decreasing order of frequency, were alveolar macrophages (79.4%), lymphocytes (13.5%), eosinophils (3.6%), mast cells (2.1%), epithelial cells (0.8%), and neutrophils (0.6%). Mean alveolar lymphocyte subpopulation frequencies, determined in 18 samples, for pan T, CD4, and CD8 cells were 52, 21.9, and 17.8%, respectively, with a CD4/CD8 ratio of 1.3. Variables analyzed did not vary between right and left caudal lung lobes, nor were they affected by body weight.

An unexpected role of the cerebellum: involvement in nutritional organization.

The influence of cerebellectomy in nutritional function was studied in the rat. Feeding behavior and analyses of lipids, proteins, nitrogen, and catecholamines in fecal and urinary excreta and in plasma were studied in 20 cerebellectomized, 20 sham operated, and 20 control animals. The results demonstrate that feeding behavior (quantitative rates of daily absorbed food, body weight, and the choice of the nutriment form) was lower in cerebellectomized animals compared to sham operated and control animals. Rates of steatorrhea and urinary levels of vanylmandelic acid, homovanillic acid, and metanephrine were higher in cerebellectomized animals while plasma levels of proteins, fatty acids, and glycerol were lower. Thus, the cerebellum is involved in nutritional regulation in the rodent.