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.

EBV infection is common in gingival epithelial cells of the periodontium and worsens during chronic periodontitis

An amplifying role for oral epithelial cells (ECs) in Epstein-Barr Virus (EBV) infection has been postulated to explain oral viral shedding. However, while lytic or latent EBV infections of oro/nasopharyngeal ECs are commonly detected under pathological conditions, detection of EBV-infected ECs in healthy conditions is very rare. In this study, a simple non-surgical tissue sampling procedure was used to investigate EBV infection in the periodontal epithelium that surrounds and attaches teeth to the gingiva. Surprisingly, we observed that the gingival ECs of the periodontium (pECs) are commonly infected with EBV and may serve as an important oral reservoir of latently EBV-infected cells. We also found that the basal level of epithelial EBV-infection is significantly increased in chronic periodontitis, a common inflammatory disease that undermines the integrity of tooth-supporting tissues. Moreover, the level of EBV infection was found to correlate with disease severity. In inflamed tissues, EBV-infected pECs appear to be prone to apoptosis and to produce larger amounts of CCL20, a pivotal inflammatory chemokine that controls tissue infiltration by immune cells. Our discovery that the periodontal epithelium is a major site of latent EBV infection sheds a new light on EBV persistence in healthy carriers and on the role of this ubiquitous virus in periodontitis. Moreover, the identification of this easily accessible site of latent infection may encourage new approaches to investigate and monitor other EBV-associated disorders.

Intraoral metal laser welding: a case report

The possibility of laser welding of dental prostheses offers great advantages: first, the operator has the possibility of welding on the master model, which decreases the number of passages and thus the possibility of errors and damage, and secondly, the patient attends only a few sessions, and, due to the possibility of fixing the damaged prostheses, there is no need to resort to the technician's laboratory. In a previous study we described the experimental phases of intraoral welding, from the in vitro model on animal jaws with evaluations of the temperature variations during welding through thermal chamber and type K thermocouples. In this study we describe the intraoral welding in vivo on human subjects by using, as in the previous study, a fibre-delivered neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. The in vivo phase allowed a restored prosthesis to be positioned and intraorally welded in the upper central sector with optimal results both in patient's comfort and in aesthetic effects. This first in vivo test confirmed that the use of a laser technique for the intraoral welding of metal prostheses is possible, with no particular problems and risks for the biological structures close to the welding zone.

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]

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.

[The bill of rights for children in sport: a tool to promote the health and protect the child in 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]

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.

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.

[Dihydropyrimidine deshydrogenase (DPD): rhythm and consequences]

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.

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.

Functional fixation of autotransplanted tooth germs by using bioresorbable membranes

OBJECTIVE

The purpose of this study was to evaluate the contribution of a bioresorbable membrane placement to the healing of immature teeth after autotransplantation of tooth buds.

STUDY DESIGN

Six cases were selected: 2 transplantations of wisdom teeth, 2 for premolar agenesis, 1 for ectopia, and 1 premolar in an incisor position. The crown of each tooth germ and the marginal alveolar bone were covered with a resorbable membrane.

RESULTS

The radicular edification was nearly complete, neither ankylosis nor inflammatory resorption was observable, the pulp vitality was preserved, and the periodontal integration was identical to that of other teeth. The membrane ensured contention and stabilization of the transplant, allowed functional stimulation, permitted protection of the coagulum and periodontal cells, and kept the epithelium at a distance.

CONCLUSIONS

The transplantations of immature teeth were improved by the use of a resorbable membrane, which caused an optimal functional fixation of the transplanted tooth.

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.

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.

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.

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.

Growth of trigemino-cerebellar areas in infant rat studied by micrometric and cytophotometric methods

The cerebellar lobules receiving trigeminal afferents, crus 2 and paramedian, and the lingula which receives only vestibular and spinal afferents were studied. Time and the modality of development were compared with earlier experiments carried out on other trigeminal cortico-cerebellar areas. A close connection between quantitative and qualitative aspects of afferents and one type of growth was demonstrated. There was correlation between various morphological features of the cerebellar area and the stages of genesis of masticatory function. Maturity of the certain lobules of the cerebellar cortex corresponded to the onset of weaning. Thus, the development of cerebellar structure seems to run parallel to progressive synergic musculo-mandibular activities associated with certain primary and secondary neuronal tracts.

Radioprotection of normal tissues against gamma rays and cyclotron neutrons with WR-2721: LD50 studies and 35S-WR-2721 biodistribution

The ability of WR-2721 to protect mice against two modes of death following whole-body radiation with 137Cs gamma rays or d(22)+Be neutrons was examined. For single fractions, 400 mg/kg WR-2721 was administered prior to irradiation. In two-fraction exposures, the dose was 275 mg/kg given prior to each fraction. Dose modification factors (DMFs) were calculated as ratios of LD50 values. For single fractions of gamma rays, the DMF was 1.74 for the LD50/7 end point and for LD50/30, the DMF for single fractions was 2.25. For two fractions 3 hr apart, it was 1.88. For single fractions of cyclotron neutrons, the DMF was 1.32 for LD50/7. Measured with the LD50/30 end point, the DMF for single neutron doses was 1.41 and for two fractions, 1.19. Substantial radioprotection of bone marrow and intestinal epithelium against cyclotron neutrons was seen in these investigations. Biodistribution studies were done following ip injection of 35S-labeled WR-2721 into C3H mice bearing RIF-1 tumors. Blood levels peaked at 10 min after injection and declined thereafter. Most normal tissues achieved maximum levels of 35S at 30 to 60 min postinjection and high concentrations were retained in most tissues for up to 2 hr. Assuming that all 35S is in parent compound or dephosphorylated radioprotective metabolites, the concentration of protector (milligram per gram tissue) in various organs at 30 min postinjection ranked as follows: kidney greater than submandibular gland much greater than liver = lung greater than gut greater than heart much greater than blood greater than skin greater than tumor greater than brain. High levels of 35S were achieved and retention times were long in certain normal tissues which respond at early or late times postradiation and may be dose limiting in radiotherapy: kidney, liver, salivary gland, and lung. These combined observations suggest that there is potential for protecting dose-limiting, late-responding normal tissue in the radiotherapy of human cancer with both neutrons and conventional radiotherapy.