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PubMed2001

Phenotypic and genotypic diversity of Streptococcus sanguis in infants.

Streptococcus sanguis comprises a heterogeneous group of oral streptococci indigenous to the oral cavity of humans. A total of 289 isolates from an infant population (n=37) were tentatively identified as S. sanguis on the basis of the distinctive colony morphology as shown on MM10-sucrose non-selective medium. These isolates were divided into four biovars of S. sanguis as determined by an extended panel of biochemical attributes. Chromosomal DNA was extracted from each isolate, and an AP-PCR fingerprint profile was obtained to allow study of the diversity within and among the infants. In this study, all four biovars of S. sanguis were detected in the infants. A wide genotypic diversity of S. sanguis was observed among these isolates; on average, each infant harbored 2.7 unique amplitypes as shown by the AP-PCR fingerprints. To explore the phylogenic relationship among these S. sanguis isolates, 20 strains representing the four biovars were selected at random for sequencing of their 16S rDNA and 16S-23S rDNA intergenic spacer chromosomal loci. Two major sequence patterns were identified within the 16S rDNA sequences. A phylogenic analysis showed that members from each of the four biovars of S. sanguis bore close relationship with the type-strain ATCC 10556 sequence, and that all of the isolates representing the four biovars could be clustered into two main phylotypes. The biovars were distributed throughout the phylotypes, indicating no correlation between the genetic and phenotypic groupings.

Bacterial Typing Techniques↗

PubMed2000

Early adult outcomes of adolescent binge drinking: person- and variable-centered analyses of binge drinking trajectories.

BACKGROUND: Many studies of the consequences of binge drinking take a variable-centered approach that may mask developmentally different trajectories. Recent studies have reported qualitatively different binge drinking trajectories in young adulthood. However, analyses of developmental trajectories of binge drinking have not been examined for an important period of drinking development: adolescence. The purpose of this study was to examine young adult outcomes of adolescent binge drinking using an approach that combines person-centered and variable-centered methods. METHODS: Data were from the Seattle Social Development Project, an ethnically diverse, gender balanced sample (n = 808) followed prospectively from age 10 to age 21. Semiparametric group-based modeling was used to determine groups of binge drinking trajectories in adolescence. Logistic regression was used to examine how well the trajectory groups predicted young adult outcomes after demographics, childhood measures, and adolescent drug use were considered. RESULTS: Four distinct trajectories of binge drinking during adolescence were identified: Early Highs, Increasers, Late Onsetters, and Nonbingers. These trajectories significantly predicted positive and negative outcomes in adulthood after controlling for demographic characteristics, early proxy measures of the outcome, and adolescent drug use. CONCLUSIONS: This integrated person- and variable-centered approach provides more information about the effects of specific patterns of binge drinking than studies that employ variable-centered methods alone.

Adolescent↗

PubMed2026

Patterns and implications of co-use between vaping and hallucinogens: a systematic review and meta-analysis.

BACKGROUND: The co-occurrence use of e-cigarettes and hallucinogens has become increasingly common, particularly among youth and young adults. However, evidence regarding the association between these behaviors remains limited and fragmented. This systematic review and meta-analysis aimed to synthesize current evidence, examining the correlation between hallucinogen use and the likelihood of being an e-cigarette user. METHODS: A comprehensive search was conducted in PubMed, Scopus, Web of Science, EMBASE, and Cochrane CENTRAL up to June 2025. Eligible studies measured both hallucinogen and e-cigarette use and reported quantitative associations between these behaviors. Data extraction and risk-of-bias assessments were performed independently by three reviewers using the Newcastle-Ottawa Scale. Pooled effect sizes were calculated using a random-effects model (REML). Certainty of evidence was evaluated with the GRADE approach. RESULTS: Eleven studies met the inclusion criteria (n = 247,904), and seven were included in the meta-analysis (n = 217,478). The pooled analysis demonstrated that hallucinogen users had 4.47 times higher odds of being e-cigarette users (OR: 4.47, 95% CI 2.72 to 7.34; p < 0.001; I2 = 95.7%, n = 7). The certainty of evidence was rated as low. CONCLUSIONS: Hallucinogen use is directionally and strongly associated with e-cigarette use across diverse populations. Although the direction of association was consistent across studies, the magnitude of effect was heterogeneous. These behaviors likely share psychosocial and environmental determinants, although alternative explanations, including shared genetic liability, recall bias, and residual confounding, cannot be excluded. Further longitudinal studies are needed to clarify the underlying mechanisms of this association and establish temporality. The findings also support integrating hallucinogen-use screening into e-cigarette prevention and harm-reduction programs targeting youth and young adults.

Humans↗

PubMedDate not supplied

The evolutionary basis of some clinical disorders of the human foot: a comparative survey of the living primates.

The living primates are a highly diverse group of essentially arboreal animals whose feet are variously adapted for grasping, climbing, and leaping in trees. One of the most remarkable aspects of the anatomical variation in the feet of the extant primates is that this diversity can be arranged in a graduated sequence ranging from the primitive transtarsal-opposition type of grasping foot found in the lemurs, through the specialized transmetarsal-adduction type that characterizes the higher primates, to the unique nongrasping foot of humans. The comparative study of this graded series makes it possible, without recourse to the fossil record, to appreciate the adaptive and functional stages through which the human foot passed in its evolution. It is hypothesized that the initial stage of human erect posture was characterized by a foot which was adapted to both hallucial grasping and short distance bipedal walking. In many respects, the structure of the foot of this primitive human was probably similar to that of the living highland gorilla. When compared with the feet of our closest living relatives, the African apes, the human foot is characterized by two major evolutionary specializations: the longitudinal and transverse arches, and the parallel first and second metatarsals. These two morphological adaptations, together with several associated specializations, are the structural basis of the bipedal human foot. Reconstructing the evolutionary and adaptive history of these specializations creates a better understanding of some of the more common clinical podiatric disorders. The modern human foot is structurally so well adapted to prolonged bipedal walking and standing that even slight deviations from its evolutionarily established pattern will produce debilitating clinical manifestations. In most cases, successful treatment of such disorders involves restoration of the foot's basic adaptive configuration.

Adaptation, Biological↗

PubMed1994

Patterns of class inequality in health through the lifespan: class gradients at 15, 35 and 55 years in the west of Scotland.

Data confirming the existence of social inequalities in health have continued to accumulate since the Black Report reported class inequalities across a broad range of causes of mortality, with an increasing emphasis on indicators of morbidity and current health status. Although evidence of continuing inequalities mounts, elucidation of underlying mechanisms generating and maintaining such inequalities has been more elusive, and much of the debate has oscillated from the very broad to the very specific. In this paper, the class patterning of a range of non-fatal indicators of health are modelled in an attempt to outline first the adequacy of models of linear relationships for this range of measures, and secondly, the extent to which these are generalizable across a series of age/sex subgroups and across different domains of health. Data are presented here for representative community samples of men and women in adolescence, early- and late-midlife. While orderly relationships between social class and health were seen for the majority of the measures considered; the detailed patterns show considerable diversity. Thus for some aspects of health, notably height (itself often heralded as a broad indicator of health and early life experience), common class gradients were observed for both sexes at each of the stages of the life course examined. For others (notably mental health and presence of chronic illness), gradients were evident in later life but not in adolescence. Others still showed sex but not age differences in class patterning (typically measures of body shape), or no clear patterns (notably blood pressure and consultations with general practitioners). The current analysis draws attention to the consistency of gradients in early- and late-midlife, which are apparent despite the marked increase in the burden of poorer health which manifests between these life stages for almost all indicators of health (an exception being mental health). The challenges which this presents for understanding the mechanisms and processes which have been candidate explanations for social inequalities in health are discussed.

Adolescent↗

PubMed1999

Life history of Eulemur fulvus rufus from 1988-1998 in southeastern Madagascar.

In this study, we compare the life-history patterns of male and female Eulemur fulvus rufus based on longitudinal data collected on individuals from two study groups from 1988-1998 in southeastern Madagascar. Mean group size was 9.5 individuals, and groups either contained more adult males than females or equal numbers of both sexes. Females reproduced for the first time between 2 and 4 years of age and reproduced each year, although the mean interbirth interval between surviving offspring was 2.1 years. An average of two adult females reproduced annually in each social group, and age and body weight may positively influence reproductive success. Females also appear to be philopatric but not female-bonded. Young natal males immigrated between 3 and 4.5 years of age and may join a new group within 612 months based on the age of emigrants. Once in a social group, they remained until old age, although a male's spatial position in the social group varied with age. Young nonnatal males were members of the social core and had the first opportunity to mate with all estrous females. Older males were peripheral to the social group and mated with females later in their cycle. We hypothesize that group size, the number of females in the group, and individual variation in reproductive success is influenced by several ecological conditions at this site: extreme variability in food availability during reproductive periods, the lack of large food patches, low plant species diversity, and small numbers of important aseasonal food sources such as Ficus species.

Animals↗

PubMed2000

Molecular and biological characterization of a zonula occludens-1 homologue in Hydra vulgaris, named HZO-1.

Zonula occludens-1 (ZO-1) is one of the earliest identified molecular components of tight junctions. Sequence analysis has placed ZO-1 into the broader membrane-associated guanylate kinase (MAGUK) protein family that contains such diverse members as post-synaptic density 95 (PSD-95), Drosophila discs large tumor suppressor gene product (dlg-A), p55, and TamA. Studies in both vertebrates and invertebrates have established that the MAGUK family is involved in a wide variety of cellular functions. These functions involve the regulation of such cellular processes as: (1) tight junction formation, (2) cell proliferation, (3) cell differentiation, and (4) neuronal synapse transmission. Extending these studies, we report the presence of a ZO-1 homologue in Hydra vulgaris, a member of the Cnidaria, the second oldest phylum of the animal kingdom. Hydra ZO-1 (HZO-1) is encoded by a single messenger RNA (mRNA) of approximately 6.0 kb that contains an open reading frame of 5,085 bp. The 191 kDa predicted protein consists of a characteristic MAGUK domain structure, including three PSD-95/SAP90, discs-large, ZO-1 (PDZ) domains, a src homology (SH3) domain, and a guanylate kinase (GUK) domain. Western blot analysis using an antibody generated from a synthetic peptide designed from the HZO-1 sequence confirmed the presence of a Hydra protein of the appropriate mass. While whole mount in situ hybridization determined that HZO-1 mRNA was expressed along the entire longitudinal axis of Hydra, cross-sectional analysis established that HZO-1 mRNA expression was restricted to the ectoderm or outer cell layer of the organism's epithelial bilayer. Consistent with this mRNA expression pattern, immunofluorescence studies localized HZO-1 protein to the apical plasma membrane of ectodermal cells. It is unclear what role HZ0-1 has in the cellular physiology of Hydra; however, immunolocalization studies indicate a conserved plasma membrane-associated function(s), as reported for its counterparts in other invertebrate and vertebrate species. These studies establish that the MAGUK family of proteins with a membrane-associated function arose early during metazoan evolution, even before the divergence of protostomes and deuterostomes.

Amino Acid Sequence↗

PubMed1991

Musculoskeletal design in relation to body size.

Irrespective of body size and phylogenetic diversity, the skeletal systems of terrestrial mammals are built of tissue components having similar mechanical properties and material organization. Because of scale effects on skeletal form, therefore, larger mammals increase the effective mechanical advantage of their limbs to decrease mass-specific forces associated with the support of gravitational loads imposed during locomotion to maintain a similar safety factor. Larger animals accomplish this by adopting a more upright posture while running, which aligns their limb joints more closely with the resultant ground reaction force, thereby decreasing the mass-specific force that their muscles must generate to support externally applied joint moments. As a result, peak (compressive) bone stresses determined from in vivo bone strain recordings and force platform and kinematic analyses of the limb generally range from -40 to -80 MPa (mean: -55 +/- 23 MPa), corresponding to a safety factor to compressive bone failure of about three to four. The decrease in mass-specific muscle force indicates that the maximum stresses developed in limb muscles of different sized species are also similar at equivalent levels of performance. Stresses developed in the midshafts of most long bones are primarily the result of bending, often engendered by axial forces transmitted about the bone's longitudinal curvature. The consistency of bending-induced skeletal strain over a range of physical activity and the associated expense of increased strain magnitude that this form of loading incurs suggest that functional strain patterns developed through bending may be a desirable architectural objective of most long bones. Alteration of a bone's normal functional strain distribution, therefore, is likely a key factor underlying adaptive remodeling in response to changes in mechanical loading.

Animals↗

PubMed1995

Frontal and temporal lobe brain volumes in schizophrenia. Relationship to symptoms and clinical subtype.

BACKGROUND: Quantitative magnetic resonance imaging (MRI) studies demonstrate reduced brain volumes in schizophrenics, but specific structural abnormalities have not been clearly delineated. The structural abnormalities of this disorder are likely to be heterogeneous, consistent with its diverse clinical presentation. To investigate the relationship between structural abnormality and clinical symptoms, we examined regional brain and cerebral spinal fluid (CSF) volumes in a large sample of schizophrenic patients and controls, with patients aggregated into clinical subtypes. METHODS: Right and left hemisphere frontal and temporal lobe brain and CSF volumes were quantified from 5-mm axial spin-echo MRIs for 71 schizophrenic patients and 77 age- and sex-matched controls. The following four standardized rating scales were used to assess symptom severity: Negative Symptoms, Disorganization, Schneiderian Delusions and Hallucinations, and Suspicion-Hostility. Patients were also subtyped as either deficit or nondeficit on the basis of enduring negative symptoms. RESULTS: Schizophrenic patients overall exhibited abnormal brain asymmetry, with selective decrease in brain volume in the left temporal and right frontal regions. Left temporal lobe parenchymal volume reduction and CSF volume increase were correlated with the severity of negative symptoms. Consistent with this, the subtype analysis revealed abnormal temporal lobe asymmetry for the deficit subgroup only. Right frontal lobe volume reduction correlated with the duration of illness, independent of symptom severity or schizophrenic subtype. CONCLUSIONS: Abnormal lateral asymmetry suggests selective structural deficits in schizophrenia, rather than diffusely undifferentiated CNS abnormalities. The pattern of regional abnormalities is related to clinical symptoms, with negative symptoms being associated with left temporal lobe rather than frontal lobe abnormality. This is consistent with suggestions of a temporolimbic prefrontal network abnormality in schizophrenia. Further longitudinal studies are warranted, using higher-resolution MRI technology and gray matter-white matter segmentation to confirm and extend these findings.

Adolescent↗

PubMed2026

From glycosylation to inflammation: insights from NMR-Derived GlycA and GlycB.

Post-translational modifications (PTMs) play a crucial role in increasing proteomic diversity. N-linked glycosylation acts as a key regulatory layer that influences protein stability, trafficking, circulation, and immune responses. Unlike conventional inflammatory biomarkers that measure individual proteins, nuclear magnetic resonance (NMR) spectroscopy identifies the combined signals GlycA and GlycB from glycoproteins, offering an overall view of systemic glycoprotein changes. These signals represent the N-glycosylation patterns of several abundant acute-phase proteins (APPs), giving detailed molecular insights. This review offers a detailed assessment of GlycA and GlycB as mechanistically grounded indicators of liver glycoprotein remodeling and systemic inflammation. GlycA mainly indicates the levels and structural complexity of N-acetylglucosamine (GlcNAc) and N-acetylgalactosamine (GalNAc) residues linked to acute-phase glycoproteins and glycan branching. In contrast, GlycB reflects changes in terminal sialylation, which influences glycoprotein half-life, immune recognition via lectins, and inflammatory signaling. Collectively, these biomarkers combine measurements of hepatic APP production with variations in glycan structure, offering mechanistically anchored reporters of hepatic glycoprotein remodeling. We explore the enzymatic pathways responsible for N-glycan branching, fucosylation, and sialylation, as well as the roles of major APP scaffolds in the GlycA and GlycB resonances. We also highlight the emerging clinical significance of these signals across infectious, autoimmune, cardiovascular, metabolic, neurodegenerative, and cancer-related diseases. Rather than serving simply as markers of inflammation, GlycA and GlycB provide mechanistically interpretable readouts of cytokine-driven hepatic glycoprotein remodeling and systemic immune activation, supporting their application in disease risk stratification, longitudinal monitoring, therapeutic response assessment, and precision medicine.

GlycA↗

PubMed2006

Culture of human skeletal muscle myoblasts: timing appearance and localization of dystrophin-glycoprotein complex and vinculin-talin-integrin complex.

The dystrophin-glycoprotein complex together with the vinculin-talin-integrin complex plays an important role in muscle function; in fact the mutations of their elements lead to diverse forms of muscular dystrophies. The relationship between the elements of dystrophin-glycoprotein complex and vinculin-talin-integrin and the time course of their formation are still not known in detail. In order to better understand this relationship we studied their expression during development in normal human skeletal muscle culture. Using a standardized muscle cell culture procedure, this study was performed to analyze the timing, appearance and the localization of some proteins of the dystrophin-glycoprotein complex and vinculin-talin-integrin complex during cellular proliferation (myoblast) and differentiation (4, 7, 15 and 21 days). The indirect immunofluorescence technique was used and cells were examined using a Meta Zeiss LSM510 confocal laser scanning inverted microscope. We examined the progressive appearance of the following proteins: alpha, beta, gamma, delta-sarcoglycans, beta-dystroglycan, dystrophin, talin, vinculin and integrin isoform alpha7/beta1. Immunofluorescence of these proteins, in satellite cells entering myogenic differentiation, revealed different patterns of localization depending on the time of culture. We showed that nondifferentiated cultures of human myoblasts expressed a perinuclear distribution of all proteins tested. During myoblast differentiation into myotubes (4 days) immunofluorescence gradually increased and was located in the whole cytoplasm. Subsequently, at day 7, a strong and homogeneous cytoplasmic labelling of all proteins was seen. At 15 days the distribution of the proteins was on the membrane. At this time some myotubes displayed a significant degree of precostameric banding pattern. As fusion proceeded at 21 days, the cytodistribution progressively changed and appeared along fibrillar longitudinal structures, and myotubes showed a clear periodic distribution (costameres). In conclusion, in normal human muscle cultures DGC and vinculin-talin-integrin proteins are first localized in the perinuclear region, then they diffuse in the cytoplasm and finally form at the plasma membrane into typical rib-like structures that are sarcolemma-associated.

Adult↗

PubMed1994

The relative performance of diverse measures of alcohol abuse and dependence in a community sample.

There is broad diversity among the ways in which alcohol abuse and/or dependence are defined and operationalized by researchers. In a community survey of 1,257 adult males and females, eight different measures of alcohol abuse or dependence were used. For analysis, each measure was dichotomized at its usual cutoff point. A factor analysis of distance scores between pairs of measures gave only one interpretable factor representing drinking patterns and social problems. Sensitivity and specificity were calculated for each measure with respect to abuse or dependence, as measured by the DIS-III-R. High maximum levels of drinking and social problems were moderately sensitive and specific to DIS-III-R. These relationships varied, though, for subgroups of age and gender. DSM-III-R alcohol abuse and dependence are widely respected variables but relatively expensive to measure. Alternative approaches for various survey purposes are discussed. Measures to be regarded as alternatives to the DIS-III-R are found to perform better in that role in samples limited by age and gender.

Adolescent↗

PubMed1996

Anatomy and physiology of the primate interstitial nucleus of Cajal I. efferent projections.

1. The efferent projections of the interstitial nucleus of Cajal (NIC) were studied in the squirrel monkey after iontophoretic injections of biocytin and Phaseolus Vulgaris leucoagglutinin into the NIC. To ensure the proper placement of the tracer, the same pipettes were used to extracellularly record the discharge pattern of NIC neurons. 2. Three projection systems of the NIC were distinguished: commissural (through the posterior commissure), descending, and ascending. 3. The posterior commissure system gave rise to dense terminal fields in the contralateral NIC, the oculomotor nucleus, and the trochlear nucleus. 4. The descending system of NIC projections deployed dense terminal fields in the ipsilateral gigantocellular reticular formation and the paramedian reticular formation of the pons, as well as in the ventromedial and commissural nuclei of the first two spinal cervical segments. It also gave rise to moderate or weak terminal fields in the vestibular complex, the nucleus prepositus hypoglossi, the inferior olive, and the magnocellular reticular formation, as well as cell groups scattered along the paramedian tracts in the pons and the pontine and medullary raphe. 5. The ascending system of NIC projections gave rise to dense terminal fields in the ipsilateral mesencephalic reticular formation and the zona incerta as well as moderate or weak terminal fields in the ipsilateral centromedian and parafascicular thalamic nuclei. It also provided dense bilateral labeling of the rostral interstitial nucleus of the medial longitudinal fasciculus and the fields of Forel, and moderate or weak bilateral labeling of the mediodorsal, central medial, and central lateral nuclei of the thalamus. 6. Models of saccade generation that rely on feedback from the velocity-to-position integrators and include the superior colliculus in their local feedback loop are contradicted because no fibers originating from the NIC traveled to the superior colliculus to deploy terminal fields. 7. Consistent with its morphological and functional diversity, these data indicate that the primate NIC sends signals to a multitude of targets implicated in the control of eye and head movements.

Afferent Pathways↗

PubMed2026

Distinct cochlear cell types associated with genetic susceptibility to sensory and metabolic hearing loss in older adults.

Hearing loss is a heterogeneous condition that can be classified into different subtypes with diverse genetic and cellular components. To investigate the cochlear cell types underlying the genetic basis of sensory and metabolic components of age-related hearing loss (ARHL), we integrated human genome-wide association study data with mouse cochlear single-cell RNA sequencing data using the single-cell disease relevance score tool. These analyses revealed that genes associated with the sensory component of ARHL were most highly expressed in hair cells, while genes associated with the metabolic component of ARHL were most highly expressed in spiral ganglion neurons. We also investigated whether ARHL-associated gene expression patterns differed across subpopulations of the same cell type. Sensory hearing loss-associated genes showed differential expression across supporting cell subpopulations in younger mice, whereas metabolic hearing loss-associated genes exhibited differences across intermediate cell subpopulations of the stria vascularis in older mice. These findings provide evidence for the role of distinct genetic and cellular risk profiles for different ARHL subtypes, suggesting that prevention and therapeutic strategies may require targeting specific cell populations at different life stages.

ARHL↗

PubMed1990

The Mikamo lecture. Role of higher nervous activity in sudden cardiac death.

The brain receives and catalogues myriads of information from within and without the organism. These inputs promote neural integration of bodily function through a multiplicity of cybernetic feedback loops. Higher nervous activity shapes the contours of perceived well-being and determines the course and progress of disease. Behavioral and neural factors play an important role in cardiovascular function and are especially relevant to the problem of sudden cardiac death (SCD). Clinical data attesting to the role of biobehavioral factors in SCD derive from a diversity of sources. It has long been known that bereavement increases the prevalence of cardiac fatality. Business failure rates are strongly related to increased mortality among persons aged 55 and over. Recession in economic activity, with increasing unemployment, is associated with augmented death rates from ischemic heart disease. In extensive surveys conducted among London civil servants, Rose and Marmot found not only the level but the type of employment to be a factor determining coronary heart disease mortality. Blue collar workers had a 3.6 times greater chance of dying from heart disease than an age-matched population in the higher ranks of civil service. A man's employment status was a stronger predictor of risk for dying from coronary heart disease than any of the usual risk factors, such as smoking, blood pressure, height-weight ratio, leisure time activities, glucose tolerance, or plasma cholesterol. Operation of behavioral factors is also suggested by the time of occurrence of sudden death. Among 3,983 men followed for more than 30 years, Rabkin and co-workers observed an excess proportion of fatalities on Mondays. No such pattern was noted for cancer mortality. Not only the day of the week but the time of day appears to be a factor. Muller and co-workers found a significant preponderance in the occurrence of myocardial infarction and sudden death from 6:00 AM to noon. They could not implicate operation of circadian rhythm, but suggested a role for augmented autonomic neural discharge associated with early morning activities following waking from sleep. The longitudinal epidemiologic studies of the Health Insurance Plan of New York (HIP) have indicated an important association between behavioral and psychologic factors and the prevalence of sudden cardiac death.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed2003

Biology of common beta receptor-signaling cytokines: IL-3, IL-5, and GM-CSF.

IL-3, IL-5, and GM-CSF are related hematopoietic cytoines that are important for allergic inflammation. The receptors for human IL-5, IL-3, and GM-CSF are members of the hematopoietin receptor superfamily and are comprised of a cytokine-specific alpha chain and the common beta chain that is shared among these cytokines for signaling. Each of these cytokines contributes to the differentiation and function of leukocyte subpopulations and have clinical importance in protective immunity and in the pathophysiology of a spectrum of immunologic diseases that are as diverse as allergy and asthma, pulmonary alveolar proteinosis, neurodegenerative diseases, and malignancies. Delineating the biology of these cytokines is enabling the development of new strategies for diagnosing and treating these diseases and modulating immune responses.

Animals↗

PubMed2003

The dynamics of toothache pain and dental services utilization: 24-month incidence.

OBJECTIVES: The aims of this study were twofold: (1) to describe patterns of change in reported toothache pain, and (2) to examine the impact of toothache pain on dental care utilization and vice versa. METHODS: Data from the Florida Dental Care Study (FDCS), a longitudinal study of oral health and dental service utilization conducted in north Florida, were used to measure self-reported toothache pain among dentate adults at baseline and four subsequent times during a 24-month period. Only persons 45 years of age or older with at least one remaining natural tooth at baseline were eligible. A total of 873 subjects participated, 764 of whom participated through 24 months. The analysis is focused on modeling transitions in the reported experience of toothache pain during intervals of six months. RESULTS: At the time of the baseline interview, 11.5 percent of subjects reported current toothache pain. During subsequent six-monthly interviews, from 13.4 percent to 21.6 percent of subjects reported having experienced toothache pain during the prior six-month interval. Among those with no toothache pain at baseline (n = 772), 31.2 percent experienced toothache pain at some time during the 24-month study period. The six-month incidence probability reflects the likelihood of developing toothache pain by estimating the conditional probability of reporting a toothache in a later interval given that this problem was not reported in the earlier one (for consecutive pairs of intervals). Overall, the six-month incidence probability for toothache pain in this study was. 11. Significantly higher 24-month incidence was observed for African-American subjects, those with less formal education, those in poorer financial circumstances, and problem-oriented dental attenders. CONCLUSIONS: In this diverse sample of adults, toothache pain occurs frequently and is quite variable overtime. Toothache occurs in conjunction with various forms of self-reported oral disease (e.g., abscess, cavities) or tissue damage (e.g., loose tooth, broken tooth, bleeding gums). Subjects who experience toothache are slightly more likely than others to utilize dental services in the time period proximate to the toothache pain.

Aged↗

PubMed2002

Gallbladder management in obesity surgery.

BACKGROUND: In the 1980s, some surgeons recommended routine cholecystectomy for patients undergoing bariatric surgery. This was based on the high prevalence of gallstones in the obese and concern that rapid weight loss would increase the risk of gallbladder disease. Others recommended waiting for a lower weight and a definite need. With increasing prevalence and severity of obesity and increased use of gastric reduction surgery for weight control, it seemed appropriate to review the current standard of care for cholecystectomy. A survey was also made of ursodeoxycholic acid usage for prevention of gallstone formation. METHODS: Data collected from active contributors for the 28th Report of the International Bariatric Surgery Registry (IBSR) were examined. Two questionnaires were also sent to members of the American Society for Bariatric Surgery (ASBS). The first (Q1) asked about the indications for cholecystectomy. The second (Q2) asked about ursodeoxycholic acid usage for prevention of gallstone formation during rapid weight loss following surgical treatment of obesity. RESULTS: There has been an increase in concurrent cholecystectomy during the last 15 years. Some of this is due to a shift from simple gastric restrictive operations to gastric bypass with gastric restriction. When the most extensive bypass of intestine is used, as in distal Roux-en-Y gastric bypass (RYGBP-X) or biliopancreatic diversion with a duodenal switch (BPD-DS), all patients were reported to have undergone cholecystectomy. Only 30% of surgeons performing standard Roux-en-Y gastric bypass (RYGBP) remove normal-appearing gallbladders. Ursodeoxycholic acid is used to prevent gallstone formation in one-third of patients when a normal-appearing gallbladder is left in place. CONCLUSIONS: Prophylactic cholecystectomy is left to the discretion of the surgeon when RYGBP is used. There has been an increase in cholecystectomy and malabsorptive operations during the last 15 years. When most of the small bowel is bypassed, all remaining gallbladders are removed. For patients with simple restriction operations, normal-appearing gallbladders are usually left in place. Urso-deoxycholic acid during rapid weight loss for prevention of gallstone formation is used in one-third of patients with remaining gallbladders.

Adult↗