The dental health of 12-year-old children whose diets include canned fruit from local factories: an added risk for caries?

OBJECTIVE: To determine the dental health of 12-year-old children from households that are supplied with sweetened canned fruit from local factories. METHODS: The DMFS and DMFT indices were determined for 12-year-old pupils from 6 schools, 3 of which are situated in communities with fruit canning factories. Subjects were questioned about the workplace of household members and supplies of sweetened canned fruit from factories. To compare indices we used a two-way analysis of variance, for multiple comparisons the Bonferroni Test and for proportions the Chi-Squared Test. Fluoride content of the drinking water was measured for each school. RESULTS: The fluoride content for all schools was less than 0.1 ppm. In only 2 schools were the majority of pupils from households that were supplied regularly with canned fruit from factories. An analysis of the DMFT data of the children in all the schools showed that there were significantly fewer children with a DMFT = 0 and significantly more with a DMFT = 4+ in the 2 schools. The mean DMFS and DMFT of children in households supplied with canned fruit were significantly higher than those children without the supply. CONCLUSION: The supply of sweetened canned fruit to households may be an added risk to dental health for the children in that household.

Can cervical cancer be prevented by a see, screen, and treat program? A pilot study.

OBJECTIVE: Our purpose was to determine the feasibility of providing a cervical screening facility to the underprivileged communities through an educational program and a mobile clinic in which cytologic smears could be taken, screened immediately, and, when appropriate, the patients treated on site with minimal delay. STUDY DESIGN: A prospective study was conducted in two parts on 5045 patients living in squatter areas around Cape Town, South Africa. The patients were educated about cervical cancer and its prevention and were offered a free Papanicolaou smear taken in a fully equipped mobile clinic. These were immediately stained and processed. Patients diagnosed cytologically as having high-grade squamous intraepithelial lesions were assessed colposcopically and, when indicated, immediately treated by large loop excision of the transformation zone under local anesthesia. RESULTS: In phase 1, colposcopy was done in the nearest colposcopy clinic, 20 km from the screening site. The defaulter rate was 66%. In phase 2, colposcopy and treatment were offered on site. A total of 97% of patients referred for colposcopy attended the clinic, and all patients requiring treatment have been adequately treated. CONCLUSION: With a rapid turnaround time for the reporting of cytologic results and given a colposcopy and treatment facility available located at the screening site at the time women receive their results, the majority of women will undergo colposcopy and treatment.

Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses.

We examined the safety and utility of the combined assessment of aspiration cytology and mammography in 705 women who had clinically suspicious or malignant palpable breast masses. Histological assessment confirmed 176 benign and 529 malignant lesions. There were no incorrect (false positive) diagnoses made in the 176 benign masses when combined assessment was used (specificity 1.0; predictive value 0.86); in isolation, however, there was a false positive cytological diagnosis ('papillary carcinoma') and 3 false positive mammographic diagnoses. Benign disease (false negative) was incorrectly diagnosed by combined assessment in 4 of the 529 malignant masses (sensitivity 0.99; predictive value 0.98): cytological diagnoses were of fat necrosis (2) and benign cells on cytospin (1) and aspiration biopsy (1); mammographic diagnoses were of benign disease (2) and normality (2). Indeterminate ('atypical', 'suspicious') diagnoses were problematic and frequent (overall 223 (31.6%), malignant masses 137 (25.9%), benign masses 86 (48.9%); cytology 117 (16.6%), mammography 141 (20%). Thus, with the combined assessment of mammography and cytology in clinically suspicious breast masses, a decisive diagnosis was made in about two-thirds of cases allowing the safe commencement of therapy; the balance of patients required core or excision biopsy.

The influence of diet and dimethylhydrazine on the large intestine of vervet monkeys: scanning and transmission electron microscope studies.

The study was designed to identify diet and carcinogen-dependent ultrastructural changes in the epithelium of macroscopically normal colonic mucosa in primates. Seventy adult female vervet monkeys were divided into seven equal treatment groups. Four received a Western high-fat low fibre diet (WD), two a prudent low-fat higher fibre diet (PD) and one a control low-fat high fibre diet (CD). Three groups (2 WD, 1 PD) received dimethylhydrazine intramuscularly at 14 day intervals. After 18 months, monkeys of two groups on the WD were transferred to the PD (WD----PD) and 30 months later all were killed. Mucosae of caecum, colon transversum and rectum were examined by scanning and transmission electron microscopy and showed close similarity to that of humans. Rectal mucosae showed increased surface goblet cell secretory activity, mucin production and microvillar changes related to WD and WD----PD. The enhancing effect of a carcinogen on ultrastructural changes such as cellular pleomorphism, cytoplasmic interbridging, nuclear and nucleolar irregularities and appearance of argentaffin cells in the free surface epithelium were noted predominantly in high-fat treated animals. Such changes observed in the upper part of crypt, orifice and free surface epithelium can be characteristic for precancerous change and could be utilised practically in the detection of precursor lesions of the colon.

Focal epithelial hyperplasia: a survey of two isolated communities in the Cape Province of South Africa.

The aims of this study were to determine the distribution of focal epithelial hyperplasia (FEH) among Cape Coloured communities, and whether a family connection could be traced. Two isolated communities near Cape Town were selected and it was attempted to examine as many population members as possible. After it was established that one community had a comparatively high prevalence of FEH, a second visit was undertaken to determine whether a familial distribution existed. Six hundred and fifty-six people and 130 households were examined in the above community and 486 people in the second. The median ages of the two communities were 18.6 and 18.4 yr respectively. Both age and sex distributions of the two populations did not differ significantly. A significant difference in the prevalence of FEH was found between the two communities. Ninety-seven cases (14.8%) were diagnosed in the first and 21 cases (4.3%) in the second community (P less than 0.05). FEH occurred in all age groups and both sexes. Lesions occurred mostly on the mucosae of the lower and upper lips and in the gingiva. No definite familial distribution could be established.