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PubMed2002

Suicide and suicide attempts in Ankara in 1998: results of the WHO/EURO Multicentre Study of Suicidal Behaviour.

BACKGROUND: The rates and associated basic demographic features of attempted and completed suicides in a catchment area in Turkey were investigated as part of the WHO/Euro Multicentre Study of Suicidal Behaviour. METHOD: All hospitals in the catchment area were screened in order to identify attempted suicides. Statistics for completed suicides were obtained from the State Institute of Statistics (SIS). RESULTS: The rates of attempted and completed suicides per 100,000 inhabitants over 15 years of age were 31.9 for males and 85.6 for females, and 9.9 for males and 5.6 for females, respectively. The majority of attempted suicides were in the 15-24-year-old age group, as is the case in all other European countries. The majority of completed suicides were also in the 15-24-year-old age group, although in other European centers most completed suicides occur in the 40+ age group. The most frequent methods were overdose for attempted suicide and hanging for completed suicide. The rates of both attempted and completed suicides were lower than those of other participating centers in Europe. CONCLUSION: Male sex is a risk factor for completed suicide and female sex is a risk factor for attempted suicide, while an age of 15-24 years may be a risk factor for both groups.

Adolescent↗
PubMed2026

A stent-plus-irrigation protocol after adolescent hypospadias repair: a multicentre randomised controlled trial.

OBJECTIVES: To evaluate whether a stent-plus-irrigation protocol reduces complication rates following hypospadias repair in adolescents compared with catheter drainage alone. PATIENTS AND METHODS: In this multicentre randomised controlled trial, adolescents (Tanner Stage II-V) undergoing hypospadias repair were randomly assigned to either a stent-plus-irrigation group or a catheter-drainage group. The catheter-drainage group received standard urethral catheter drainage alone, whereas the stent-plus-irrigation group received an additional small-calibre urethral stent positioned within the reconstructed urethra and twice-daily saline irrigation. The primary outcome was the overall postoperative complication rate; secondary outcomes included urinary function and cosmetic outcomes. RESULTS: A total of 172 adolescents were assessed for eligibility, with 150 participants (75 in the stent-plus-irrigation group and 75 in the catheter-drainage group) included in the final analysis. Compared with the catheter-drainage group, the stent-plus-irrigation group demonstrated a significantly lower overall complication rate (risk ratio [RR] 0.33, 95% confidence interval [CI] 0.20-0.56; P&#x2009;<&#x2009;0.001), urethral fistula rate (RR 0.27, 95% CI 0.14-0.51; P&#x2009;<&#x2009;0.001), and surgical site infection (SSI) rate (RR 0.43, 95% CI 0.21-0.87; P&#x2009;=&#x2009;0.020). CONCLUSIONS: A postoperative stent-plus-irrigation protocol was associated with lower rates of postoperative complications, particularly urethral fistula and SSI, compared with catheter drainage alone after adolescent hypospadias repair. Because the intervention included both an additional urethral stent and saline irrigation, the independent contribution of irrigation cannot be determined in this two-arm trial.

Humans↗
PubMed2006

Enrolment and baseline characteristics in the WHO Multicentre Growth Reference Study.

AIM: To describe the WHO Multicentre Growth Reference Study (MGRS) sample with regard to screening, recruitment, compliance, sample retention and baseline characteristics. METHODS: A multi-country community-based study combining a longitudinal follow-up from birth to 24 mo with a cross-sectional survey of children aged 18 to 71 mo. Study subpopulations had to have socio-economic conditions favourable to growth, low mobility and > or = 20% of mothers practising breastfeeding. Individual inclusion criteria were no known environmental constraints on growth, adherence to MGRS feeding recommendations, no maternal smoking, single term birth and no significant morbidity. For the longitudinal sample, mothers and newborns were screened and enrolled at birth and visited 21 times at home until age 24 mo. RESULTS: About 83% of 13 741 subjects screened for the longitudinal component were ineligible and 5% refused to participate. Low socioeconomic status was the predominant reason for ineligibility in Brazil, Ghana, India and Oman, while parental refusal was the main reason for non-participation in Norway and USA. Overall, 88.5% of enrolled subjects completed the 24-mo follow-up, and 51% (888) complied with the MGRS feeding and no-smoking criteria. For the cross-sectional component, 69% of 21 510 subjects screened were excluded for similar reasons as for the longitudinal component. Although low birthweight was not an exclusion criterion, its prevalence was low (2.1% and 3.2% in the longitudinal and cross-sectional samples, respectively). Parental education was high, between 14 and 15 y of education on average. CONCLUSION: The MGRS criteria were effective in selecting healthy children with comparable affluent backgrounds across sites and similar characteristics between longitudinal and cross-sectional samples within sites.

Child↗
PubMed2006

Breastfeeding in the WHO Multicentre Growth Reference Study.

AIM: To document how children in the WHO Multicentre Growth Reference Study (MGRS) complied with feeding criteria and describe the breastfeeding practices of the compliant group. METHODS: The MGRS longitudinal component followed 1743 mother-infant pairs from birth to 24 mo in six countries (Brazil, Ghana, India, Norway, Oman and the USA). The study included three criteria for compliance with recommended feeding practices that were monitored at each follow-up visit through food frequency reports and 24-h dietary recalls. Trained lactation counsellors visited participating mothers frequently in the first months after delivery to help with breastfeeding initiation and prevent and resolve lactation problems. RESULTS: Of the 1743 enrolled newborns, 903 (51.8%) completed the follow-up and complied with the three feeding criteria. Three quarters (74.7%) of the infants were exclusively/predominantly breastfed for at least 4 mo, 99.5% were started on complementary foods by 6 mo of age, and 68.3% were partially breastfed until at least age 12 mo. Compliance varied across sites (lowest in Brazil and highest in Ghana) based on their initial baseline breastfeeding levels and sociocultural characteristics. Median breastfeeding frequency among compliant infants was 10, 9, 7 and 5 feeds per day at 3, 6, 9 and 12 mo, respectively. Compliant mothers were less likely to be employed, more likely to have had a vaginal delivery, and fewer of them were primiparous. Pacifier use was more prevalent in the non-compliant group. CONCLUSION: The MGRS lactation support teams were successful in enhancing breastfeeding practices and achieving high rates of compliance with the feeding criteria required for the construction of the new growth standards.

Breast Feeding↗
PubMed2006

Complementary feeding in the WHO Multicentre Growth Reference Study.

AIM: To describe complementary feeding practices in the Multicentre Growth Reference Study (MGRS) sample. METHODS: Food frequency questionnaires and 24-h dietary recalls were administered to describe child feeding throughout the first 2 y of life. This information was used to determine complementary feeding initiation, meal frequency and use of fortified foods. Descriptions of foods consumed and dietary diversity were derived from the 24-h recalls. Compliance with the feeding recommendations of the MGRS was determined on the basis of the food frequency reports. Descriptive statistics provide a profile of the complementary feeding patterns among the compliant children. RESULTS: Complementary feeding in the compliant group began at a mean age of 5.4 mo (range: 4.8 (Oman)-5.8 mo (Ghana)). Complementary food intake rose from 2 meals/d at 6 mo to 4-5 meals in the second year, in a reverse trend to breastfeeding frequency. Total intake from the two sources was 11 meals/d at 6-12 mo, dropping to 7 meals/d at 24 mo. Inter-site differences in total meal frequency were mainly due to variations in breastfeeding frequency. Grains were the most commonly selected food group compared with other food groups that varied more by site due to cultural factors, for example, infrequent consumption of flesh foods in India. The use of fortified foods and nutrient supplements was also influenced by site-variable practices. Dietary diversity varied minimally between compliance groups and sites. CONCLUSION: Complementary diets in the MGRS met global recommendations and were adequate to support physiological growth.

Child Development↗
PubMed2006

Reliability of anthropometric measurements in the WHO Multicentre Growth Reference Study.

AIM: To describe how reliability assessment data in the WHO Multicentre Growth Reference Study (MGRS) were collected and analysed, and to present the results thereof. METHODS: There were two sources of anthropometric data (length, head and arm circumferences, triceps and subscapular skinfolds, and height) for these analyses. Data for constructing the WHO Child Growth Standards, collected in duplicate by observer pairs, were used to calculate inter-observer technical error of measurement (TEM) and the coefficient of reliability. The second source was the anthropometry standardization sessions conducted throughout the data collection period with the aim of identifying and correcting measurement problems. An anthropometry expert visited each site annually to participate in standardization sessions and provide remedial training as required. Inter- and intra-observer TEM, and average bias relative to the expert, were calculated for the standardization data. RESULTS: TEM estimates for teams compared well with the anthropometry expert. Overall, average bias was within acceptable limits of deviation from the expert, with head circumference having both lowest bias and lowest TEM. Teams tended to underestimate length, height and arm circumference, and to overestimate skinfold measurements. This was likely due to difficulties associated with keeping children fully stretched out and still for length/height measurements and in manipulating soft tissues for the other measurements. Intra- and inter-observer TEMs were comparable, and newborns, infants and older children were measured with equal reliability. The coefficient of reliability was above 95% for all measurements except skinfolds whose R coefficient was 75-93%. CONCLUSION: Reliability of the MGRS teams compared well with the study's anthropometry expert and published reliability statistics.

Anthropometry↗
PubMed2006

Reliability of motor development data in the WHO Multicentre Growth Reference Study.

AIM: To describe the methods used to standardize the assessment of motor milestones in the WHO Multicentre Growth Reference Study (MGRS) and to present estimates of the reliability of the assessments. METHODS: As part of the MGRS, longitudinal data were collected on the acquisition of six motor milestones by children aged 4 to 24 mo in Ghana, India, Norway, Oman and the USA. To ensure standardized data collection, the sites conducted regular standardization sessions during which fieldworkers took turns to examine and score about 10 children for the six milestones. Assessments of the children were videotaped, and later the other fieldworkers in the same site watched the videotaped sessions and independently rated performances. The assessments were also viewed and rated by the study coordinator. The coordinator's ratings were considered the reference (true) scores. In addition, one cross-site standardization exercise took place using videotapes of 288 motor assessments. The degree of concordance between fieldworkers and the coordinator was analysed using the Kappa coefficient and the percentage of agreement. RESULTS: Overall, high percentages of agreement (81-100%) between fieldworkers and the coordinator and "substantial" (0.61-0.80) to "almost perfect" (> 0.80) Kappa coefficients were obtained for all fieldworkers, milestones and sites. Homogeneity tests confirm that the Kappas are homogeneous across sites, across milestones, and across fieldworkers. Concordance was slightly higher in the cross-site session than in the site standardization sessions. There were no systematic differences in assessing children by direct examination or through videotapes. CONCLUSION: These results show that the criteria used to define performance of the milestones were similar and applied with equally high levels of reliability among fieldworkers within a site, among milestones within a site, and among sites across milestones.

Child Development↗
PubMed2006

Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study.

AIM: To assess differences in length/height among populations in the WHO Multicentre Growth Reference Study (MGRS) and to evaluate the appropriateness of pooling data for the purpose of constructing a single international growth standard. METHODS: The MGRS collected growth data and related information from 8440 affluent children from widely differing ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman and the USA). Eligibility criteria included breastfeeding, no maternal smoking and environments supportive of unconstrained growth. The study combined longitudinal (birth to 24 mo) and cross-sectional (18-71 mo) components. For the longitudinal component, mother-infant pairs were enrolled at delivery and visited 21 times over the next 2 y. Rigorous methods of data collection and standardized procedures were applied across study sites. We evaluate the total variability of length attributable to sites and individuals, differences in length/height among sites, and the impact of excluding single sites on the percentiles of the remaining pooled sample. RESULTS: Proportions of total variability attributable to sites and individuals within sites were 3% and 70%, respectively. Differences in length and height ranged from -0.33 to +0.49 and -0.41 to +0.46 standard deviation units (SDs), respectively, most values being below 0.2 SDs. Differences in length on exclusion of single sites ranged from -0.10 to +0.07, -0.07 to +0.13, and -0.25 to +0.09 SDs, for the 50th, 3rd and 97th percentiles, respectively. Corresponding values for height ranged from -0.09 to +0.08, -0.12 to +0.13, and -0.15 to +0.07 SDs. CONCLUSION: The striking similarity in linear growth among children in the six sites justifies pooling the data and constructing a single international standard from birth to 5 y of age.

Body Height↗
PubMed2006

Assessment of sex differences and heterogeneity in motor milestone attainment among populations in the WHO Multicentre Growth Reference Study.

AIM: To assess the heterogeneity of gross motor milestone achievement ages between the sexes and among study sites participating in the WHO Multicentre Growth Reference Study (MGRS). METHODS: Six gross motor milestones (sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone) were assessed longitudinally in five of the six MGRS sites, namely Ghana, India, Norway, Oman and the USA. Testing was started at 4 mo of age and performed monthly until 12 mo, and bimonthly thereafter until all milestones were achieved or the child reached 24 mo of age. Four approaches were used to assess heterogeneity of the ages of milestone achievement on the basis of sex or study site. RESULTS: No significant, consistent differences in milestone achievement ages were detected between boys and girls, nor were any site sex interactions noted. However, some differences among sites were observed. The contribution of inter-site heterogeneity to the total variance was < 5% for those milestones with the least heterogeneous ages of achievement (hands-and-knees crawling, standing alone, and walking alone) and nearly 15% for those with the most heterogeneous ages of achievement (sitting without support, standing with assistance, and walking with assistance). CONCLUSION: Inter-site differences, most likely due to culture-specific care behaviours, reflect normal development among healthy populations across the wide range of cultures and environments included in the MGRS. These analyses support the appropriateness of pooling data from all sites and for both sexes for the purpose of developing an international standard for gross motor development.

Child Development↗
PubMed2003

Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass, and myoglobin for assessing patients with suspected acute coronary syndromes in routine clinical practice.

OBJECTIVE: To assess the diagnostic efficiency of the third generation cardiac troponin T assay in routine clinical practice. DESIGN: Prospective observational study of unselected consecutive admissions. SETTING: Multicentre study in 43 teaching and non-teaching hospitals in 13 countries. SUBJECTS: 1105 hospital admissions, median age 67 years (range 15-96 years, 63.7% male) with suspected acute coronary syndromes (72.3% of cases) or other non-specific symptoms where cardiac disease required exclusion (27.7%). INTERVENTIONS: Over the study period, myoglobin, creatine kinase MB isoenzyme (CK-MB), and cardiac troponin T where measured in parallel with conventional diagnostic tests. Final diagnostic classification involved standard ECG changes and CK-MB mass exceeding 5.0 microg/l. MAIN OUTCOME MEASURES: Diagnostic efficiency was assessed by receiver operator characteristic curve analysis including and excluding patients with unstable angina. RESULTS: Measurement of cardiac troponin T was diagnostically equivalent to CK-MB and both were better than myoglobin, with areas under the curve at 12 hours of 0.94, 0.99, and 0.80, respectively. Diagnostic criteria using CK-MB were inadequate and showed bias when patients with unstable angina were included. Elevations of cardiac troponin T did not occur when cardiac disease could be categorically excluded but were found in clinical conditions other than suspected acute coronary syndromes. CONCLUSIONS: CK-MB is unsuitable as a diagnostic gold standard even at the proposed lower threshold. A lower cut off for cardiac troponin T of 0.05 microg/l should be used for diagnosis of acute myocardial infarction. Diagnosis of acute myocardial infarction cannot be made solely on the basis of a cardiac troponin T result.

Adolescent↗
PubMed2001

Histamine challenges discriminate between symptomatic and asymptomatic children. MAS-Study Group. Multicentre Allergy Study.

The aims of this study were to investigate a threshold value for bronchial responsiveness in children aged 7 yrs, which discriminates between symptomatic and asymptomatic children, and to identify determinants of this responsiveness. Titrated bronchial histamine challenges using the reservoir method were performed in 645 children aged 7 yrs, from the birth cohort Multicentre Allergy Study (MAS). When defining a reference population of healthy children within the MAS cohort, the 95th percentile of the provocative concentration causing a 20% fall in forced expired volume in one second PC20 among these asymptomatic study subjects amounted to 0.60 mg x mL(-1). This resulted in a specificity of 93.0% and a sensitivity of 45.9%, for discriminating between "current wheezers" and "non-current wheezers". Determinants of airway responsiveness at this age were pulmonary function, sensitization to indoor allergens, total immunoglobulin E and current wheeze. The results indicate that a very low cut-off provocative concentration causing a 20% fall in forced expired volume in one second (<1.0 mg x mL(-1)) defines airway hyperresponsiveness in children aged 7 yrs using the reservoir method. Provocation protocols for histamine challenges in this age group should therefore start with concentrations markedly below 1.0 mg x mL(-1).

Allergens↗
PubMed2004

Oral transmucosal fentanyl citrate in the management of breakthrough pain in cancer: an open, multicentre, dose-titration and long-term use study.

Sixty-six patients with cancer-related pain entered an open multicentre study to examine the safety and efficacy of oral transmucosal fentanyl citrate (OTFC) in the treatment of breakthrough pain. Patients were eligible for the study if they were stabilized on a long-acting opioid but were experiencing up to four episodes of breakthrough pain a day and achieving at least partial relief from breakthrough pain using conventional medication (normal release oral morphine in the majority of patients). The efficacy of the conventional medication was documented in a run-in phase and patients then changed to OTFC. All patients were treated initially with a 200 mcg unit of OTFC and the dose was increased if necessary to a level that produced relief of breakthrough pain without troublesome adverse effects. Fifty-eight patients completed the run-in phase using their usual medication and entered the dose titration phase with OTFC and 57 patients received at least one dose of OTFC. Forty-two patients (72%) found a successful dose of OTFC. The primary outcome measures were the Summed Pain Intensity Differences (SPID) and Total Pain Relief (TOTPAR) scores at 60 min. There was a significant difference in both measures in favour of OTFC compared with conventional medication in these patients. Twenty-eight of the 42 patients (67%) preferred OTFC to their usual medication. The most common adverse effects attributed to OTFC were nausea, stomatitis, vomiting and dizziness but there were no unpredicted or severe problems. Thirty-seven patients continued into the long-term study and 12 of these completed six months treatment. Most drop-outs in this phase were associated with progression of the underlying disease. No patient stopped using OTFC because of dissatisfaction with the drug. OTFC appears to be a safe and effective treatment for breakthrough pain in cancer patients and may have advantages over currently available opioid formulations.

Administration, Buccal↗
PubMed2003

Associations among disease conditions, bone mineral density, and prevalent vertebral deformities in men and women 50 years of age and older: cross-sectional results from the Canadian Multicentre Osteoporosis Study.

This cross-sectional cohort study of 5566 women and 2187 men 50 years of age and older in the population-based Canadian Multicentre Osteoporosis Study was conducted to determine whether reported past diseases are associated with bone mineral density or prevalent vertebral deformities. We examined 12 self-reported disease conditions including diabetes mellitus (types 1 or 2), nephrolithiasis, hypertension, heart attack, rheumatoid arthritis, thyroid disease, breast cancer, inflammatory bowel disease, neuromuscular disease, Paget's disease, and chronic obstructive pulmonary disease. Multivariate linear and logistic regression analyses were performed to determine whether there were associations among these disease conditions and bone mineral density of the lumbar spine, femoral neck, and trochanter, as well as prevalent vertebral deformities. Bone mineral density measurements were higher in women and men with type 2 diabetes compared with those without after appropriate adjustments. The differences were most notable at the lumbar spine (+0.053 g/cm2), femoral neck (+0.028 g/cm2), and trochanter (+0.025 g/cm2) in women, and at the femoral neck (+0.025 g/cm2) in men. Hypertension was also associated with higher bone mineral density measurements for both women and men. The differences were most pronounced at the lumbar spine (+0.022 g/cm2) and femoral neck (+0.007 g/cm2) in women and at the lumbar spine (+0.028 g/cm2) in men. Although results were statistically inconclusive, men reporting versus not reporting past nephrolithiasis appeared to have clinically relevant lower bone mineral density values. Bone mineral density differences were -0.022, -0.015, and -0.016 g/cm2 at the lumbar spine, femoral neck, and trochanter, respectively. Disease conditions were not strongly associated with vertebral deformities. In summary, these cross-sectional population-based data show that type 2 diabetes and hypertension are associated with higher bone mineral density in women and men, and nephrolithiasis may be associated with lower bone mineral density in men. The importance of these associations for osteoporosis case finding and management require further and prospective studies.

Aged↗
PubMed2005

Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study.

OBJECTIVE: To determine the association of different feeding patterns for infants (exclusive breastfeeding, predominant breastfeeding, partial breastfeeding and no breastfeeding) with mortality and hospital admissions during the first half of infancy. METHODS: This paper is based on a secondary analysis of data from a multicentre randomized controlled trial on immunization-linked vitamin A supplementation. Altogether, 9424 infants and their mothers (2919 in Ghana, 4000 in India and 2505 in Peru) were enrolled when infants were 18-42 days old in two urban slums in New Delhi, India, a periurban shanty town in Lima, Peru, and 37 villages in the Kintampo district of Ghana. Mother-infant pairs were visited at home every 4 weeks from the time the infant received the first dose of oral polio vaccine and diphtheria-pertussis-tetanus at the age of 6 weeks in Ghana and India and at the age of 10 weeks in Peru. At each visit, mothers were queried about what they had offered their infant to eat or drink during the past week. Information was also collected on hospital admissions and deaths occurring between the ages of 6 weeks and 6 months. The main outcome measures were all-cause mortality, diarrhoea-specific mortality, mortality caused by acute lower respiratory infections, and hospital admissions. FINDINGS: There was no significant difference in the risk of death between children who were exclusively breastfed and those who were predominantly breastfed (adjusted hazard ratio (HR) = 1.46; 95% confidence interval (CI) = 0.75-2.86). Non-breastfed infants had a higher risk of dying when compared with those who had been predominantly breastfed (HR = 10.5; 95% CI = 5.0-22.0; P < 0.001) as did partially breastfed infants (HR = 2.46; 95% CI = 1.44-4.18; P = 0.001). CONCLUSION: There are two major implications of these findings. First, the extremely high risks of infant mortality associated with not being breastfed need to be taken into account when informing HIV-infected mothers about options for feeding their infants. Second, our finding that the risks of death are similar for infants who are predominantly breastfed and those who are exclusively breastfed suggests that in settings where rates of predominant breastfeeding are already high, promotion efforts should focus on sustaining these high rates rather than on attempting to achieve a shift from predominant breastfeeding to exclusive breastfeeding.

Bottle Feeding↗
PubMed1981

Multicentric reticulohistiocytosis. Electron microscopic and ultracytochemical studies.

Lesions from a patient affected with multicentric reticulohistiocytosis (MR) were studied by ultracytochemical techniques to determine the relationship of PAS-positive materials and/or acid phosphatase (AP) activity to electron-dense granules found in the large mononucleated or multinucleated giant cells that are characteristic of this entity. The lead phosphate reaction products that mark the sites of AP activity were found in the electron-dense granules. The granules were also PAS positive by the periodic acid-thiosemicarbazide-silver proteinate method. These findings suggest that the PAS-positive and diastase-resistant materials in the large mononucleated or multinucleated giant cells of MR are not phagocytized materials but are pre-existing lysosomes.

Adult↗
PubMed1997

Multicentric eighth cranial nerve schwannoma.

To our knowledge, only 3 histopathologically proved cases of multicentric eighth cranial nerve schwannoma have been described in the literature since 1981. We describe a patient with 2 isolated eighth cranial nerve schwannomas arising separately from the left cochlea and internal auditory canal. These 2 tumors were diagnosed using magnetic resonance imaging prior to resection, and the diagnosis was further confirmed by intraoperative findings and histopathologic analysis. The genetic molecular basis and clinical features of this rare tumor have been overlooked. The value of the transotic approach for total tumor removal is emphasized.

Adult↗
PubMed1985

Abdominal midline incision closure. A multicentric randomized prospective trial of 3,135 patients, comparing continuous vs interrupted polyglycolic acid sutures.

A randomized prospective multicentric study was organized to compare results between techniques using continuous sutures and interrupted sutures in closing abdominal midline incisions. The suture material employed was polyglycolic acid. This study included 3,135 patients who were randomized between the two methods of closure and who were stratified according to the type of wound: clean, clean-contaminated, and contaminated. The overall dehiscence rate was 1.6% in the continuous sutures group vs 2% in the interrupted sutures group. The dehiscence rate in the interrupted sutures group was significantly higher than in the continuous sutures group only in the stratum of contaminated wounds. The death rate was significantly higher in the interrupted sutures group. The number of needle sets was significantly less important when the continuous sutures technique was used. Continuous closure is preferable because it is more economic and expedient and also because it has the same incidence of wound dehiscence as interrupted sutures closure.

Adult↗
PubMed1998

European Multicentre Association Study of Schizophrenia: a study of the DRD2 Ser311Cys and DRD3 Ser9Gly polymorphisms.

As part of the European Multicentre Association Study of Schizophrenia (EMASS), we studied polymorphisms in the dopamine DRD2 and DRD3 receptor genes. The EMASS collaboration was established to create a large, statistically powerful sample of schizophrenic patients and controls from different European centres. Previous studies have suggested associations between schizophrenia and the Ser311Cys polymorphism in exon 7 of the dopamine DRD2 receptor gene [Arinami et al., (1994): Lancet 343:703-704] and a polymorphism Ser9gly in exon 1 of the dopamine DRD3 receptor gene [Crocq et al. (1992): J Med Genet 29:858-860]. We tested for these associations in samples of 373 and 413, and 311 and 306 patients and controls, respectively. We found no evidence for allelic association between schizophrenia and the Cys311 variant of the DRD2 receptor gene and no homozygotes for this variant were observed by any group. However, an excess of homozygotes for both alleles of the DRD3 polymorphism was observed in schizophrenic patients (chi2 = 8.54, P = 0.003, odds ratio = 1.64, 95% CI = 1.18-2.29). We also observed a significant excess of the 1-1 (Ser9Ser) genotype (chi2 = 8.13, P = 0.004, odds ratio = 1.7, 95% CI = 1.18-2.4). No evidence of heterogeneity between samples was detected and there was no evidence of an allelic association. These findings suggest that the rare Cys311 variant in exon 7 of the DRD2 receptor gene does not play a role in the pathogenesis of schizophrenia in European populations. Currently, our results do support the previous findings of an association between increased homozygosity of the Ser/Gly variant of the Dopamine D3 receptor gene and schizophrenia.

Alleles↗