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Selected AbstractsOccurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II)CONTACT DERMATITIS, Issue 6 2008Christian J. Apfelbacher Background:, Only a few epidemiological studies on hand eczema (HE) in the metalworking industry have been conducted, and no study has attempted a long-term follow-up. Objectives:, In the Prospective Audi Cohort (PACO) II follow-up study, we aimed to estimate burden and prognosis of HE in a car industry setting (follow-up > 10 years). Patients/Methods:, Eligible participants were individuals who had been examined in the original PACO study (1990,1998) and had been followed through until the end of their apprenticeship (n = 1909). Participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm. Results:, The follow-up rate was 78.3% (1494/1909). Mean follow-up time was 13.3 [standard deviation 1.3] years. The period prevalence of HE in the follow-up period was 21.0% [95% confidence interval (CI) 19.0,23.1%], yielding a cumulative incidence of 29.3% (95% CI 26.9,31.6%) in the entire study period. HE persisted after the end of apprenticeship in 40.0% (95% CI 33.3,46.7%) of subjects who had had HE during apprenticeship (n = 205). 18.0% (95% CI 15.9,20.1%) developed HE in the follow-up period (n = 1289). Conclusions:, Around 30% of subjects were affected by HE at least once during the study period. HE persisted in 40% of the participants affected during apprenticeship. [source] Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 yearsDENTAL TRAUMATOLOGY, Issue 6 2008Elena C. Ferrazzini Pozzi Material and methods:, Patients presenting with lateral luxation of permanent teeth during 2001,2002 were enrolled in this clinical study. Laterally luxated teeth were repositioned and splinted with a TTS/composite resin splint for 4 weeks. Immediate (prophylactic) root-canal treatment was performed in severely luxated teeth with radiographically closed apices. All patients received tetracycline for 10 days. Re-examinations were performed after 1, 2, 3, 6, 12 and 48 months. Results:, All 47 laterally luxated permanent teeth that could be followed over the entire study period survived. In 10 teeth (21.3%), a prophylactic root-canal treatment was performed within 2 weeks following injury. The remaining 37 teeth showed the following characteristics at the 4-year re-examination: 19 teeth (51.4%) had pulp survival (no clinical or radiographic signs or symptoms), nine teeth (24.3%) presented with pulp canal calcification, and pulp necrosis was seen in another nine teeth (24.3%), within the first year after trauma. None of the teeth with a radiographically open apex at the time of lateral luxation showed complications. External root resorption was only seen in one tooth. Conclusions:, Laterally luxated permanent teeth with incomplete root formation have a good prognosis, with all teeth surviving in this study. The most frequent complication was pulp necrosis that was only seen in teeth with closed apices. [source] Seedling dynamics of shrubs in a fully closed temperate forest: greater than expectedECOGRAPHY, Issue 5 2004N. A. Laskurain Shrub seedling emergences were studied in a beech-birch forest in the Basque Country (Spain). During four years (1998,2001) all emerging shrubs were tagged and regularly monitored in 198 1 m2 plots. Seedling emergence was intense during the entire study period and primarily occurred in early spring. Emerging seedlings mainly belonged to Hedera helix, Rubus gr. glandulosus and several heath species (including genera Erica, Calluna and Daboecia). In contrast, some dominant species components of the shrub layer (Vaccinium myrtillus and Lonicera periclymenum) showed no emergences. While small seeded species (heath species and Rubus) showed clear microsite preferences, avoiding litter for emergence, that was not the case of large seeded Hedera helix. Strict microsite requirements appear clearly associated with having seed bank, suggesting that this trait may allow these species to select favourable microenvironment prior to germination. Average life varied largely among the different taxa. It was very low for Rubus (7.4 months) and heath (4.9), and high for Hedera seedlings (23.1). Final survival was extremely low in the case of small-seeded species. Survival of Hedera seedlings was high, although their growth was very low, suggesting the existence of a conspicuous seedling bank. Our results clearly show that several shrubs species have dramatic seedling dynamics in full closed forest stands. Small seeded species preferentially emerge on bare surfaces in early spring from the soil seed banks. On the other hand, Hedera seedlings are able to emerge on litter and maintain a conspicuous seedling bank based on an efficient dispersal capability. [source] Soil arthropods as indicators of water stress in Antarctic terrestrial habitats?GLOBAL CHANGE BIOLOGY, Issue 12 2003Peter Convey Abstract Abiotic features of Antarctic terrestrial habitats, particularly low temperatures and limited availability of liquid water, strongly influence the ecophysiology and life histories of resident biota. However, while temperature regimes of a range of land microhabitats are reasonably well characterized, much less is known of patterns of soil water stress, as current technology does not allow measurement at the required scale. An alternative approach is to use the water status of individual organisms as a proxy for habitat water status and to sample over several years from a population to identify seasonal or long-term patterns. This broad generalization for terrestrial invertebrates was tested on arthropods in the maritime Antarctic. We present analyses of a long-term data set of body water content generated by monthly sampling for 8,11 years of seven species of soil arthropods (four species of Acari, two Collembola and one Diptera) on maritime Antarctic Signy Island, South Orkney Islands. In all species, there was considerable within- and between-sample variability. Despite this, clear seasonal patterns were present in five species, particularly the two collembolans and a prostigmatid mite. Analyses of monthly water content trends across the entire study period identified several statistically significant trends of either increase or decrease in body water content, which we interpret in the context of regional climate change. The data further support the separation of the species into two groups as follows: firstly, the soft-bodied Collembola and Prostigmata, with limited cuticular sclerotization, which are sensitive to changes in soil moisture and are potentially rapid sensors of microhabitat water status, secondly, more heavily sclerotized forms such as Cryptostigmata (=Oribatida) and Mesostigmata mites, which are much less sensitive and responsive to short-term fluctuations in soil water availability. The significance of these findings is discussed and it is concluded that annual cycles of water content were driven by temperature, mediated via radiation and precipitation, and constituted reliable indicators of habitat moisture regimes. However, detailed ecophysiological studies are required on particular species before such information can be used to predict over long timescales. [source] Evapotranspiration rates and crop coefficients for a restored marsh in the Sacramento,San Joaquin Delta, California, USA,HYDROLOGICAL PROCESSES, Issue 6 2008Judy Z. Drexler Abstract The surface renewal method was used to estimate evapotranspiration (ET) for a restored marsh on Twitchell Island in the Sacramento,San Joaquin Delta, California, USA. ET estimates for the marsh, together with reference ET measurements from a nearby climate station, were used to determine crop coefficients over a 3-year period during the growing season. The mean ET rate for the study period was 6 mm day,1, which is high compared with other marshes with similar vegetation. High ET rates at the marsh may be due to the windy, semi-arid Mediterranean climate of the region, and the permanently flooded nature of the marsh, which results in very low surface resistance of the vegetation. Crop coefficient (Kc) values for the marsh ranged from 0·73 to 1·18. The mean Kc value over the entire study period was 0·95. The daily Kc values for any given month varied from year to year, and the standard deviation of daily Kc values varied between months. Although several climate variables were undoubtedly responsible for this variation, our analysis revealed that wind direction and the temperature of standing water in the wetland were of particular importance in determining ET rates and Kc values. Published in 2007 by John Wiley & Sons, Ltd. [source] Levocetirizine is an effective treatment in patients suffering from chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled, parallel, multicenter studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2006Alexander Kapp MD Background, Chronic idiopathic urticaria (CIU) is defined by the almost daily presence of urticaria for at least 6 weeks without an identifiable cause. Symptoms include short-lived wheals, itching, and erythema. CIU impedes significantly a patient's quality of life (QoL). Levocetirizine is an antihistamine from the latest generation approved for CIU. Aim, To investigate the efficacy of levocetirizine, 5 mg, and placebo for the symptoms and signs of CIU, as well as for the QoL and productivity. Methods, The primary criteria of evaluation were the pruritus severity scores over 1 week of treatment and over 4 weeks. The QoL was assessed via the Dermatology Life Quality Index (DLQI). Results, Baseline pruritus severity scores were comparable in the two treatment groups (2.06 ± 0.58). After 1 week, levocetirizine was superior to placebo and demonstrated a considerable efficacy (difference = 0.78, P < 0.001). This efficacy was maintained over the entire study period (4 weeks, P < 0.001). The number and size of wheals were considerably reduced compared with placebo over 1 week and over the total treatment period (P , 0.001). This was paralleled by an improvement in the QoL (DLQI: 7.3 units in the levocetirizine group and 2.4 units in the placebo group) and a higher productivity at work in the levocetirizine group (3.0 workdays lost per patient per month in the placebo group, 0.3 in the levocetirizine group). No unexpected adverse events occurred. Conclusions, Levocetirizine, 5 mg once daily, is an effective treatment for CIU, characterized not only by a rapid and sustained response, but also by an important improvement in QoL. [source] Estimating natal dispersal movement rates of female European ducks with multistate modellingJOURNAL OF ANIMAL ECOLOGY, Issue 6 2003Peter Blums Summary 1We used up to 34 years of capture,recapture data from about 22 100 new releases of day-old female ducklings and multistate modelling to test predictions about the influence of environmental, habitat and management factors on natal dispersal probability of three species of ducks within the Engure Marsh, Latvia. 2The mean natal dispersal distances were very similar (c. 0·6,0·7 km) for all three species and were on average 2·7 times greater than breeding dispersal distances recorded within the same study system. 3We were unable to confirm the kinship hypothesis and found no evidence that young first-nesting females nested closer to their relatives (either mother or sister) than to the natal nest. 4Young female northern shovelers, like adults, moved from small islands to the large island when water level was high and vice versa when water level was low before the construction of elevated small islands. Movement probabilities between the two strata were much higher for young shovelers than adults, suggesting that young birds had not yet developed strong fidelity to the natal site. Movements of young female tufted ducks, unlike those of shovelers, were not dependent on water level fluctuations and reflected substantial flexibility in choice of first nesting sites. 5Data for young birds supported our earlier conclusion that common pochard nesting habitats in black-headed gull colonies were saturated during the entire study period. Young females, like the two adult age groups, moved into and out of colonies with similar probability. Fidelity probability of female pochards to each stratum increased with age, being the lowest (0·62) for young (DK) females, intermediate (0·78) for yearlings (SY) and the highest (0·84) for adult (ASY) females. 6Young female tufted ducks, like adults, showed higher probabilities of moving from islands to emergent marshes when water levels were higher both before and after habitat management. The relationship between the spring water levels and movement was much weaker for young females than for adults. 7Young female diving ducks exhibited much stronger (compared to adults) asymmetric movement with respect to proximity to water, with higher movement probabilities to near-water locations than away from these locations. 8Local survival of day-old ducklings during the first year of life was time-specific and very low (means for different strata/states 0·01,0·08) because of high rates of emigration and prefledging mortality. [source] Frequent occurrence of multidrug-resistant CC17 Enterococcus faecium among clinical isolates in SwedenJOURNAL OF APPLIED MICROBIOLOGY, Issue 5 2010H. Billström Abstract Aims:, To screen for the globally spread cluster of Enterococcus faecium, clonal complex 17 (CC17) and characterize the genetic profile of Swedish clinical Ent. faecium isolates. Methods:, A total of 203 consecutive isolates collected from 2004 to 2007 from patients with bacteraemia in Sweden. All isolates were genotyped using multiple-locus variable-number tandem repeat analysis (MLVA) and 20 isolates representing different MLVA types (MT) were chosen for multilocus sequence typing (MLST). Minimal inhibitory concentrations against clinically relevant antibiotics were determined with agar dilution. Presence of the virulence genes esp and hyl was investigated using PCR. Results:, A total of 65% (n = 109) of all isolates belonged to MT-1, and the second most common MLVA type was MT-159 (13%, n = 21). MLST analysis confirmed the presence of CC17 during the entire study period. The number of isolates resistant to gentamicin and vancomycin, as well as the presence of hyl, increased significantly during the investigation period. Conclusions:, The present study demonstrates that nosocomial infections caused by Ent. faecium CC17 are commonly occurring in Sweden. Significance and Impact of the Study:, This is the first report of CC17 Ent. faecium in Sweden. The increase of antibiotic resistance and virulence indicates that these strains are further adapting to the hospital environment. [source] Adjuvant treatment of atopic eczema: assessment of an emollient containing N-palmitoylethanolamine (ATOPA study)JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2008B Eberlein Abstract Background For long-term management of atopic eczema, the use of skin care creams is recommended, but effectiveness of this treatment is not well established. Objective The objective of this study was to yield data on the skin care properties of a cream with a unique lamellar matrix containing N -palmitoylethanolamine (PEA) and to assess quality-of-life variables in patients with mild to moderate atopic eczema. Setting In this multinational, multicentre, observational, non-controlled, prospective cohort study, patients between 2 and 70 years of age were enrolled. All patients were supplied with the study product sufficient for treatment over the entire study period. Outcome was followed in periods between 3 and 7 days and 4 and 6 weeks after study start. Data were gathered from doctor reports and patient self-assessments via patient questionnaires. Results Data from 2456 patients entered the database. The mean examination intervals were 6 days for the 3- to 7-day period and 38 days for the 4- to 6-week period. At study end, intensities of erythema, pruritus, excoriation, scaling, lichenification and dryness were significantly reduced with a combined score reduction of 58.6% in the entire population (57.7% in adults > 12 years and 60.5% in children , 12 years) according to doctors' reports. Patients reported a reduction of pruritus on visual analogue scales from 4.9 ± 2.6 to 2.7 ± 2.4 6 days after treatment start and a further reduction to 2.0 ± 2.3 at study end (P < 0.001 each). Likewise, sleep quality improved significantly during the study period. Earlier-used topical corticosteroids were omitted by 56% of all patients (53.4% in adults and 62.5% in children) at study end, and the average weekly application rate decreased by 62% from 7.9 ± 6.0 to 3.0 ± 5.1 (P < 0.001). The tolerance was assessed as very good or good in 92% of cases by both patients and doctors. Conclusion This study showed substantial relief of objective and subjective symptoms of atopic eczema after regular skin care with the study cream. The patient-related effectiveness (decline of pruritus and loss of sleep) indicated a gain in quality of life in these patients. The reduced use of topical corticosteroids is important in view of safety and pharmacoeconomic implications in the treatment of atopic eczema. [source] Bone healing performance of electrophoretically deposited apatite,wollastonite/chitosan coating on titanium implants in rabbit tibiaeJOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 7 2009Smriti Sharma Abstract Bone healing of tibial defect in rabbit model was used to evaluate a composite coating of apatite,wollastonite/chitosan on titanium implant. This coating has been developed to overcome the shortcomings, such as implant loosening and lack of adherence, of uncoated titanium implant. An electrophoretic deposition technique was used to coat apatite,wollastonite/chitosan on titanium implants. The present study was designed to evaluate the bone response of coated as compared to uncoated titanium implants in an animal model. After an implantation period of 14 (group A), 21 (group B), 35 (group C) and 42 days (group D), the bone,implant interfaces and defect site healing was evaluated using radiography, scintigraphy, histopathology, fluorescence labeling and haematology. Radiography of defect sites treated with coated implants suggested expedited healing. Scintigraphy of coated implant sites indicated faster bone metabolism than uncoated implant sites. Histopathological examination and fluorescence labeling of bone from coated implant sites revealed higher osteoblastic activity and faster mineralization. Faster bone healing in the case of coated implant sites is attributed to higher cell adhesion on electrostatically charged chitosan surfaces and apatite,wollastonite-assisted mineralization at bone,implant interfaces. Haematological studies showed no significant differences in haemoglobin, total erythrocyte and leukocyte counts, done using one way-ANOVA, during the entire study period. Our results show that AW/chitosan-coated implants have the advantages of faster bone healing, increased mechanical strength and good bone,implant bonding. Copyright © 2009 John Wiley & Sons, Ltd. [source] Immunohistochemical and electron microscopic study of extrinsic hepatic reinnervation following orthotopic liver transplantation in ratsLIVER INTERNATIONAL, Issue 5 2001Tsuyoshi Takahashi Abstract:Background/Aims: Because little has been known about the morphological and functional consequences of liver transplantation on hepatic autonomic nerves, we examined the time-course of extrinsic hepatic innervation at the level of the porta hepatis of liver allografts. Methods: Orthotopic liver transplantation was performed using male Lewis rats. Crosscut tissue specimens were obtained postoperatively for up to 6 months from the porta hepatis of transplanted livers, and processed for immunohistochemical staining for protein gene product 9.5 (PGP 9.5) and growth-associated protein 43 (GAP-43), and for transmission electron microscopy (TEM). Results: Extrinsic nerve fibers at the porta hepatis stained positively for PGP 9.5 throughout the entire study period. In contrast, the immunoreactivity of GAP-43 was negative at postoperative day (POD) 1 and 2. GAP-43-positive nerves were first observed to appear in the porta hepatis at POD 3. The immunoreactivity of GAP-43 remained positive thereafter until 3 months post-OLT, and became negative in all the specimens at 4 months post-OLT. Transmission electron microscopy demonstrated a small number of regenerating axons existing among many degenerating axons at POD 3. At 3 months post-OLT, most regenerating axons had been fully ensheathed by the cytoplasm of Schwann cells, although their density remained at a lower level compared with normal. Conclusion: The results of this study suggest that liver allografts become extrinsically reinnervated, with the regenerating axons reaching the hepatic hilus 3 days after transplantation. The process of extrinsic hepatic reinnervation is considered to almost terminate 4 months after transplantation in rats. [source] Comparison of histidine-tryptophan-ketoglutarate solution (HTK) and University of Wisconsin solution (UW) in adult liver transplantation,LIVER TRANSPLANTATION, Issue 2 2006Richard S. Mangus Histidine-tryptophan-ketoglutarate solution (HTK) and University of Wisconsin solution (UW) have been shown to have similar outcomes in cadaveric kidney, pancreas, and liver transplantation. Our institution changed from UW to HTK as the primary preservation solution for liver, kidney and pancreas transplantation. This study compares the perioperative and first year outcomes of liver transplantation using UW or HTK. Primary use of HTK began on May 1, 2003. We reviewed the records of all adult liver transplant recipients from July 1, 2002 to December 31, 2004. Recipients were compared based on organ preservation solution (UW n=204, HTK n=174). Outcomes included 1-, 6- and 12-month graft and patient survival and 1-, 7-, 14-, and 30-day liver function and serum creatinine. During the entire study period, the two groups were managed similarly in operative technique, immunosuppressive regimens, and donor liver criteria. Over 30 months, 378 adult patients underwent liver transplantation. There were no significant differences between UW and HTK in 1-, 6-, or 12-month graft or patient survival. The HTK group had a higher day 1 median AST, ALT, and total bilirubin, but the two groups were similar thereafter. An anticipated difference in infused volume between UW and HTK was demonstrated. In conclusion, to our knowledge, this is the first reported large case series from North America comparing HTK and UW in liver transplantation with 2- to 12-month follow-up. There were no significant differences between HTK and UW in this population when comparing 1 month graft function and first-year graft and patient survival. Liver Transpl 12:226,230, 2006. © 2006 AASLD. [source] Fluctuations in land values in a rural municipality in southern Québec, CanadaTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 4 2006ÉRIK PROVOST The agro-forested region of the Haut-St-Laurent, in southwestern Québec, in Canada, has served as a laboratory for several years to a multi-disciplinary research team seeking to understand the interplay of stakeholders and processes influencing the rural space of southern Québec. Following directly in the footsteps of previous research, this study was undertaken to analyze the hitherto neglected but important aspect of fluctuations in land values with respect to geomorphology and land use, during the 1958,1997 period. A geo-referenced database was built within an object-oriented geographic information system (GIS) that includes data from the sale of parcels of land within the study area, land registry maps, land use maps, and a geomorphological map. These data were analyzed and sorted through queries addressed to the database. Finally, a statistical analysis was performed to analyze the relationship between sale price, geomorphology and indirectly land use, for the entire study period and for each of its decades. The results show that land value has increased at different times during the past, according to its geomorphological type and land use. These relationships are explained by the important transformation phases that have affected southern Québec during the second half of the twentieth century. La région agroforestière du Haut-St-Laurent, dans le sud-ouest du Québec, au Canada, sert de laboratoire depuis plusieurs années à une équipe de recherche multidisciplinaire afin de comprendre le jeu des acteurs et des processus affectant l'espace rural du Sud du Québec. S'inscrivant dans la lignée de ces travaux, cette étude a été entreprise afin d'analyser un aspect important mais négligé jusqu'à maintenant, celui de la fluctuation de la valeur des terres en relation avec la géomorphologie et l'utilisation du sol, durant la période 1958,1997. Une base de données géo-référencées a été créée dans un système d'information géographique (SIG) orienté-objet composée des données provenant des ventes associées aux parcelles composant la région d'étude, des cartes cadastrales, de cartes d'utilisation du sol et d'une carte géomorphologique. Ces données ont été analysées et triées par le biais de requêtes formulées à la base de données. Une analyse statistique multivariée a été réalisée pour analyser la relation entre le prix de vente, la géomorphologie et indirectement l'utilisation du sol pour l'ensemble de la période d'étude et pour chaque décennie. Les résultats montrent que les terres ont connu une hausse de leur valeur à différents moments dans le temps, selon leur type géomorphologique. Cette relation peut être expliquée par les phases importantes de transformation qui ont affecté le Sud du Québec durant la deuxième moitié du XXième siècle. [source] Racial Disparity Trends for Graft Failure in the US Pediatric Kidney Transplant Population, 1980,2004AMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2009B. M. Chavers Graft survival among adult African American kidney transplant patients remains low compared to whites, but little information is available for children and adolescents. We examined trends in graft failure among US incident primary kidney transplant patients aged <19 years (n = 13 692), 1980,2004. Trends in 1-year and 2- to 5-year graft failure (for patients whose grafts survived the first year) were analyzed in 5-year intervals. One-year graft failure declined 70% for white and 77% for African American patients over the 25-year period, and 1-year graft failure rates improved at a slightly higher rate for African American compared to white patients (p = 0.02). In contrast, the graft failure rates for years 2,5 declined 53% for white and only 41% for African American patients over the 25 years (p = 0.29). In fully adjusted Cox proportional hazards analysis, the rate of graft failure among African Americans was approximately 2-fold higher than for white patients over the entire study period. Graft survival has improved slightly more for African American than white pediatric patients over the past 25 years. However, graft survival for African American pediatric patients remains poor compared with white patients. [source] Competing Risks and Time-Dependent CovariatesBIOMETRICAL JOURNAL, Issue 1 2010Giuliana Cortese Abstract Time-dependent covariates are frequently encountered in regression analysis for event history data and competing risks. They are often essential predictors, which cannot be substituted by time-fixed covariates. This study briefly recalls the different types of time-dependent covariates, as classified by Kalbfleisch and Prentice [The Statistical Analysis of Failure Time Data, Wiley, New York, 2002] with the intent of clarifying their role and emphasizing the limitations in standard survival models and in the competing risks setting. If random (internal) time-dependent covariates are to be included in the modeling process, then it is still possible to estimate cause-specific hazards but prediction of the cumulative incidences and survival probabilities based on these is no longer feasible. This article aims at providing some possible strategies for dealing with these prediction problems. In a multi-state framework, a first approach uses internal covariates to define additional (intermediate) transient states in the competing risks model. Another approach is to apply the landmark analysis as described by van Houwelingen [Scandinavian Journal of Statistics 2007, 34, 70,85] in order to study cumulative incidences at different subintervals of the entire study period. The final strategy is to extend the competing risks model by considering all the possible combinations between internal covariate levels and cause-specific events as final states. In all of those proposals, it is possible to estimate the changes/differences of the cumulative risks associated with simple internal covariates. An illustrative example based on bone marrow transplant data is presented in order to compare the different methods. [source] Prescribing pattern of anti-epileptic drugs in an Italian setting of elderly outpatients: a population-based study during 2004,07BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2010Alessandro Oteri WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , In the last years there has been a growing trend in anti-epileptic drug (AED) use, particularly in elderly patients, but few data concerning indication of use are available in general practice. , Various AEDs, including newer agents, have been approved for indications other than epilepsy and are increasingly also used for unlicensed indications. , No data about the impact of re-imbursement restrictions on the choice of anti-epileptic drugs in general practice are available. WHAT THIS STUDY ADDS , In general practice, a rapid increase of AED prescriptions in the elderly was observed, principally due to the use of newer AEDs for indications other than epilepsy. , Re-imbursement restrictions influenced newer AED use, particularly pregabalin and gabapentin prescriptions. , Phenobarbital, accounting for more than 50% of total AED volume, was the most prescribed medication during the entire study period. This finding should be considered in light of the potential risks associated with phenobarbital use in the geriatric population. AIMS The aims of the study were to assess the trend of older and newer anti-epileptic drugs (AEDs) in the elderly population and to analyze the effects of a health-policy intervention with regard to AED use in general practice in a setting in Southern Italy. METHODS Data were extracted from the ,Caserta-1' Local-Health-Unit Arianna database in the years 2004,07. Patients aged over 65 years, receiving at least one AED prescription and registered in the lists of 88 general practitioners, were selected. The use of older and newer AEDs was calculated as 1 year prevalence and incidence of use and defined daily dose (DDD) per 1000 inhabitants day,1. Sub-analyses by gender, age and indication of use were performed. RESULTS Most of AED users were treated because of neuropathic pain (64.8%). However, the main indication of use for older AEDs (57.8%) was epilepsy, whereas newer AEDs (79.5%) were used for neuropathic pain. Prevalence and incidence of newer AED use increased until 2006, followed by a reduction in 2007. Newer AEDs, particularly gabapentin and pregabalin, were used in the treatment of more patients than older AEDs. However phenobarbital, accounting for more than 50% of total AED volume, was the most prescribed medication during the entire study period. CONCLUSIONS An increasing use of AEDs has been observed during 2004,07, mostly due to the prescription of newer compounds for neuropathic pain. The fall in the use of newer AEDs during 2007 coincides with revised re-imbursement criteria for gabapentin and pregabalin. The large use of phenobarbital in the elderly should be considered in the light of a risk of adverse drug reactions. [source] Both Th1- and Th2-derived cytokines in serum are elevated in Graves' ophthalmopathyCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2000I. M. M. J. Wakelkamp Increased serum cytokine levels have been reported in patients with autoimmune thyroid disease, but less is known about their levels in patients with Graves' ophthalmopathy (GO). It is not known whether GO is a cell-mediated or humoral autoimmune disease. We investigated whether serum cytokines are elevated in GO patients and whether the cytokines were Th1- or Th2-derived. In addition, elevated cytokines might reflect the activity of GO, and thus we investigated whether cytokine levels could predict the clinical response to orbital radiotherapy. We studied 62 consecutive patients with moderately severe untreated GO and 62 healthy controls, matched for sex, age and smoking habits. Serum concentrations of IL-1RA, sIL-2R, IL-6, sIL-6R, tumour necrosis factor-alpha (TNF- ,) RI and II and sCD30 were measured using highly sensitive ELISAs, in the patients before and 3 and 6 months after radiotherapy. All patients were euthyroid, with anti-thyroid drugs, before and during the entire study period. All baseline cytokine and cytokine receptor levels were significantly elevated in GO patients compared with healthy controls, except for IL-1RA. The levels did not correlate with parameters of the thyroid disease, nor with the duration, activity or severity of GO. However, backward logistic regression analysis showed that IL-6, sCD30 and TNF,RI were able to predict a beneficial response to orbital radiotherapy. We therefore conclude that both Th1- and Th2-derived cytokines are elevated in GO patients compared with its controls. IL-6, sCD30 and TNF,RI had some value for predicting therapeutic outcome to orbital irradiation, and may thus reflect active eye disease. [source] Evaluation on the movement of endosseous titanium implants under continuous orthodontic forces: an experimental study in the dogCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2008Yao-Dung Hsieh Abstract Objectives: The purpose of this study was to evaluate the movement of pure titanium implants under different continuous forces in the edentulous alveolar ridge. Material and methods: Four pairs of titanium implants were inserted into the right maxillary and mandibular post-extraction edentulous ridge of the experimental dog. Three different levels of continuous force (100, 200, and 500 g) were loaded onto three pairs of adjacent implant abutments using a memory Ni,Ti coil spring for up to 6 months and the remaining two implant abutments as the control group received no force. The positions of implant abutments were observed and the distances between the implants abutment at the top, middle and base levels were measured at the 0th, 2nd, 3rd, 6th and 8th month of the follow-up period. Results: There was no significant change in the distances between adjacent abutments loaded with 100 or 200 g continuous forces throughout the entire study period. However, significantly more movement of implant abutments was noted in the 500 g pair after the 3rd month of loading when compared with the 200 or the 100 g pair (both P<0.001). This change further increased at the 6th month (P<0.001, 0.01, respectively). Moreover, the difference in the measurements at the top, middle and base level indicated that the two adjacent implants moved in a tipping manner in the 500 g pair after 3 and 6 months of loading. Conclusion: The osseointegrated implants remained stable and rigid with a pulling force of 100 and 200 g after 6 months of loading. However, when the force reached 500 g, the implants moved in an inward-tipping pattern. The results suggested that endosseous titanium implants might not necessarily be rigid anchorages under all circumstances. [source] The association between fluoride in drinking water and dental caries in Danish children.COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2010Linking data from health registers, administrative registers, environmental registers Kirkeskov L, Kristiansen E, Bøggild H, von Platen-Hallermund F, Sckerl H, Carlsen A, Larsen MJ, Poulsen S. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers. Community Dent Oral Epidemiol 2010; 38: 206,212. © 2010 John Wiley & Sons A/S Abstract,,, Objectives:, To study the association between fluoride concentration in drinking water and dental caries in Danish children. Methods:, The study linked registry data on fluoride concentration in drinking water over a 10-year period with data on dental caries from the Danish National Board of Health database on child dental health for 5-year-old children born in 1989 and 1999, and for 15-year-old children born in 1979 and 1989. The number of children included in the cohorts varied between 41.000 and 48.000. Logistic regression was used to assess the correlations, adjusting for gender and taxable family income as a proxy variable for socioeconomic status. Results:, Fluoride concentration in drinking water varied considerably within the country from very low (<0.10 mg/l) to more than 1.5 mg/l. Only little variation was found over the 10-year study period. Dental caries in both 5-year-olds and 15-year-olds decreased over the study period. An inverse relation between the risk of dental caries and fluoride concentration in drinking water was found in both primary and permanent teeth. The risk was reduced by approximately 20% already at the lowest level of fluoride exposure (0.125,0.25 mg/l). At the highest level of fluoride exposure (>1 mg/l), a reduction of approximately 50% was found. Similar findings were found if analysis was limited to children residing in the same place during the entire study period. Conclusions:, The study confirmed previous findings of an inverse relation between fluoride concentration in the drinking water and dental caries in children. This correlation was found in spite of the extensive use of fluoridated toothpaste and caries-preventive programs implemented by the municipal dental services in Denmark. Linking Danish health registers with environmental and administrative registers offers an opportunity for obtaining sample sizes large enough to identify health effect, which otherwise could not be identified. [source] | ||||||||||||||||||||||||||||