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PubMed2004

Long-term effects (up to 18 months) of a smoking cessation program among women smokers in public health clinics.

BACKGROUND: We conducted longitudinal analysis of long-term outcomes of a motivational smoking cessation program. The program consisted of clinic-based minimal interventions delivered to women smokers in public health clinics by clinic personnel, a reminder letter, and an optional brief telephone counseling. METHODS: Subjects seen in six intervention (N=541) and six control clinics (N=527) were interviewed by telephone 2, 6, 12, and 18 months later. At each measurement point, unadjusted percent abstinence and mean action, motivation, and readiness scores by study group were compared with standard bivariate comparisons tests. Hierarchical linear modeling that adjusted for clustering of subjects within clinics and clustering of results over 18 months (four waves) within individuals was used to compare outcomes by study group. RESULTS: Number of actions toward quitting, motivation, and stage of readiness to quit remained better in the intervention than in the control group up to 18 months. The program effect on abstinence was still significant at 12 months, but not at 18 months. CONCLUSIONS: Exposure to one-time, brief interventions in public health clinics appears sufficient to enhance abstinence up to 12 months, and action toward quitting and motivation and readiness to quit up to 18 months.

Adolescent↗
PubMed2000

Growth of the anterior dental arch in black American children: a longitudinal study from 3 to 18 years of age.

Dental arch size and form change systematically because of tooth emergence and because teeth migrate into shorter and broader arch forms in the deciduous dentition and again in the permanent dentition. The present longitudinal analysis describes changes in arch form in a cohort of 52 black American children (Nashville, Tenn) between the ages of 3 and 18 years. The anterior (incisor-canine) arch dimensions were analyzed. Incisor-to-canine depth remained static in both arches between 3 and 5 years but shortened significantly between 12 and 18 years. Intercanine width broadened significantly in both arches, first during the deciduous dentition, then again as the primary teeth were supplanted by the permanent incisors and canines. But there was no change in intercanine width once the permanent canines were in functional occlusion (approximately 11-18 years). These changes alter anterior arch form (the ratio depth/width). This index decreased significantly during the deciduous phase as the arches broadened; the index increased from 6 to 10 years as teeth were replaced, then again decreased during the duration of the study (approximately 10-18 years). Dimensions of these black American children all exceed comparable values for white American children, although the anterior shapes are indistinguishable. The present data focus attention on the dynamics of arch form in which considerable, protracted change occurs by physiologic migration, not just during the short phase of tooth replacement.

Adolescent↗
PubMedDate not supplied

The growth of boys in the Stuttgart Carlschule, 1771-93.

Height measurements taken in a mixed longitudinal manner on 1084 German-born boys aged 7 to 21+ at the Carlschule Academy in Stuttgart during the period 1771-93 have been examined. The boys can be divided into upper (aristocrat), middle and lower (artisan, servant) classes, nearly all housed and fed in this boarding school. Preece-Baines curves have been fitted to a subsample of 155 boys whose measurements cover at least the period 12-16 years at a density of two or three per year. In addition, the whole data, totalling 11,040 observations, have been examined as if purely cross-sectional; and the height-at-entry measurement for each of 670 students has been examined. The results of the longitudinal subsample and the cross-sectional analyses agree reasonably well. Social class differences existed both in tempo of growth as signified by age at peak height velocity, and in adult height. The longitudinal analysis gives adult differences of about 2 cm between upper and middle classes and a further 2 cm between middle and lower, even amongst these boys all resident in the same, very privileged, school. Tempo differences between upper and middle class were minor, amounting to only 0.3 year, but lower-class boys had their maximum growth increment about a year later than the others. Amongst middle classes a secular trend of about 2 cm averaged over all ages was found between those born before 1770 and those born later. This mainly represents a trend in tempo rather than in adult height. The heights of these boys are compared with those of contemporary Austrian upper and lower classes, English upper and lower classes, American Army cadets, and American slaves. The increase in German middle-class heights during the 18th century indicates that this group was improving its nutritional status and well-being, at a time when the heights of the remainder of the population were constant or declining. This is evidence in favour of the view that at the beginning of economic development the distribution of income tends to become more skewed.

Adolescent↗
PubMed1998

Patient noncompliance with hormone replacement therapy: a nationwide estimate using a large prescription claims database.

OBJECTIVE: The purpose of this investigation was to use a large prescription claims database to characterize noncompliance with hormone replacement therapy (HRT). DESIGN: A retrospective longitudinal analysis was conducted among 28,718 women aged 40-59 years who were new HRT users. In the present study, HRT was defined as an oral estrogen (with or without progestin in separate prescribing) or as an oral estrogen combination with 21 or more recommended therapy days for every 28 calendar days. Compliance was determined by constructing a ratio of the total days of HRT received during the follow-up period divided by the total number of days in the follow-up period (365 days). An individual with a medication availability ratio less than 0.75 was considered to be noncompliant. RESULTS: After 1 year, 54.4% of the study subjects were noncompliant with HRT. Noncompliance was associated with younger age, living in the southern region of the United States, and not having an obstetrician/gynecologist as the initial prescriber. CONCLUSIONS: Noncompliance with HRT in the general population is higher than that reported in randomized clinical trials, suggesting that women are not benefiting optimally from therapy and that they are at risk for unnecessary morbidity and mortality from osteoporosis and cardiovascular disease. Increased efforts to improve long-term HRT compliance are urgently needed.

Adult↗
PubMed2005

Inequity in recording of risk in a local population-based screening programme for cardiovascular disease.

BACKGROUND: Screening for cardiovascular disease is an important primary preventive measure, yet research has documented that not all population groups receive the same quality of preventive healthcare. DESIGN: Longitudinal analysis of cardiovascular disease risk factor recording. METHODS: Data were made available from a local population-based screening programme for cardiovascular disease (1989-1999), whereby residents aged 35-60 years were invited for screening every 5 years (n=84,646). Data were recorded for major risk factors including blood pressure, cholesterol, body mass index, smoking status, and alcohol consumption. Completeness of risk factor recording was compared between groups in the screened population defined by gender, ethnicity (Caucasian/South Asian) and employment status (employed/unemployed). RESULTS: Recording of risk in the screened population was significantly less complete for women and South Asian participants over the duration of the screening programme, compared with men and Caucasian participants respectively. Conversely, recording of risk was significantly more complete for the unemployed compared with the employed participants. CONCLUSIONS: These findings present evidence of a less systematic screening procedure for women and South Asians, whilst it seems that men, Caucasian participants and the unemployed were appropriately screened. Inequalities at the primary preventive level will likely influence outcome, because equitable identification of risk is important for the provision of successful treatment measures, and to reduce inequalities in morbidity and mortality due to cardiovascular disease.

Adult↗
PubMed1996

Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis. A Department of Veterans Affairs Cooperative Study.

OBJECTIVE: To determine whether sulfasalazine (SSZ) at a dosage of 2,000 mg/day is effective for the treatment of active ankylosing spondylitis (AS) that is not controlled with nonsteroidal antiinflammatory drug therapy. METHODS: Two hundred sixty-four patients with AS were recruited from 15 clinics, randomized (double-blind) to SSZ or placebo treatment, and followed up for 36 weeks. Treatment response was based on morning stiffness, back pain, and physician and patient global assessments. RESULTS: While longitudinal analysis revealed a trend favoring SSZ in the middle of treatment, no difference was seen at the end of treatment. Response rates were 38.2% for SSZ and 36.1% for placebo (P = 0.73). The Westergren erythrocyte sedimentation rate declined more with SSZ treatment than with placebo (P < 0.0001). AS patients with associated peripheral arthritis showed improvement that favored SSZ (P = 0.02). Adverse reactions were fewer than expected and were mainly due to nonspecific gastrointestinal complaints. CONCLUSION: SSZ at a dosage of 2,000 mg/day does not seem to be more effective than placebo in the treatment of AS patients with chronic, longstanding disease. SSZ is well tolerated and may be more effective than placebo in the treatment of AS patients with peripheral joint involvement. This effect is more pronounced in treatment of the peripheral arthritis in this subgroup of AS patients.

Adult↗
PubMed1995

Compliance after 17 years of breast cancer screening.

OBJECTIVE: To investigate changes in attendance over the course of a population based breast screening programme. DESIGN: Longitudinal; analysis of registered data over nine screening rounds. SETTING: Subjects belong to the screening population of the Nijmegen experimental breast screening programme (1975-1990). SUBJECTS: A cohort of 6898 women who were enrolled in 1975 at the age of 50-69 years and who were invited to nine subsequent screening rounds, irrespective of their attendance at previous rounds. RESULTS: Attendance of women aged 50-53 years at entry was high at the initial screening (88%), decreased in the course of the programme, but remained well over 60% until round 8; 39% completed nine rounds and 24% completed seven to eight rounds. Attendance of women who were older at entry was somewhat lower at the initial screening (87%-82%) and declined more strongly. Regular compliance was also lower. Specific compliance patterns are found that can be relevant for further research. CONCLUSIONS: A substantial proportion of eligible women can be committed to mammography every two years, possibly even after reaching the age of 70, if the age at entry is around 50 and the screening programme is well established in the community. Starting a screening programme in older women seems ineffective.

Age Factors↗
PubMed2004

Impact of a statewide Medicaid managed care system on healthcare utilization and outcomes for people living with HIV.

BACKGROUND: Medicaid managed care (MMC) systems provide insurance for many persons living with HIV and AIDS (PLWH). This study sought to assess the impact of a statewide MMC system (TennCare) on healthcare utilization and outcomes for PLWH. METHODS: A retrospective longitudinal analysis of trends in population characteristics was performed. The study population included all Tennessee PLWH identified by State Health Department, enrolled for 1 year or longer in Medicaid (1992-1993) or TennCare (1994-1997). Main outcome measures included health care utilization, incidence of opportunistic infections, and mortality. RESULTS: From 1992 to 1997, the following decreased: average number of hospitalizations for HIV (0.72 to 0.37) and AIDS (1.27 to 0.52); emergency visits for HIV (1.70 to 1.12) and AIDS (1.65 to 1.02); outpatient visits for HIV (5.94 to 5.00) and AIDS (8.37 to 7.35), percentage of persons diagnosed with Pneumocystis carinii pneumonia for AIDS (10% to 6%) and percentage of persons diagnosed with community-acquired pneumonia for HIV (14% to 9%) and AIDS (27% to 12%), annual incidence of AIDS in the HIV population (33% to 10%), and annual mortality for HIV (3% to 1%) and AIDS (16% to 3%). The average number of antiretroviral medication prescriptions filled increased for HIV (1.27 to 2.45) and AIDS (1.31 to 3.34). CONCLUSIONS: This study documents improvements in utilization patterns, morbidity, and mortality in a statewide MMC system. These findings suggest that MMC patients are benefiting from recent advances in therapy.

Adult↗
PubMed1999

Normal telomere lengths in naive and memory CD4+ T cells in HIV type 1 infection: a mathematical interpretation.

To study CD4+ T cell productivity during HIV-1 infection, CD4+ T cell telomere lengths were measured. Cross-sectional and longitudinal analysis of HIV-1-infected individuals with CD4+ T cells counts >300 cells/mm3 showed normal average telomeric restriction fragment (TRF) length and normal shortening rates of CD45RA+ naive and CD45RO+ memory CD4+ T cells. These TRF data were interpreted in terms of CD4+ T cell production by means of a mathematical model. This model resolves previous criticisms arguing that the normal TRF length of CD4+ T cells in HIV-1 clinical latency is due to the killing of dividing CD4+ T cells by the virus. Only an increased priming rate of naive CD4+ T cells to become memory cells may elongate the average TRF length of memory CD4+ T cells, and may therefore mask the shortening effect of increased turnover in the CD4+ memory T cell compartment. The data are more compatible with the notion that during HIV-1 clinical latency the turnover of CD4+ T cells is not markedly increased, however, and that HIV-related interference with renewal from progenitors plays a role in CD4+ T cell depletion. In such a "limited renewal" scenario disease progression is no longer a consequence of markedly increased CD4+ T cell production.

CD4-Positive T-Lymphocytes↗
PubMed1986

Growth changes in head posture related to craniofacial development.

Cross-sectional studies have demonstrated an association between craniocervical angulation and craniofacial morphology. It was the aim of the present study to determine if the growth coordination suggested by this association could be detected in a longitudinal analysis of growth changes in posture and craniofacial morphology. The sample comprised 43 children, 20 girls and 23 boys. Cephalometric radiographs obtained in the natural head position (mirror position) were taken on two occasions. Mean age at the first observation was 9.5 years; mean period of observation was 2.7 years with a range from 1 to 4 years. Forty-one reference points and four fiducial points were digitized on each film. Individual growth changes were determined by computerized structural superimposition of the digitized sets of points. Correlation coefficients were calculated between growth changes in 11 postural and 35 morphologic variables. Correlations of r = 0.41-0.55 (P less than 0.01) were found between the change in craniocervical angulation and the true growth rotation of the mandible as assessed by the method of structural superimposition. On the average, a reduction of the craniocervical angle was seen in connection with increased forward rotation of the mandible and an increased craniocervical angle was found in conjunction with a less-than-average forward rotation of the mandible. The true mandibular rotation was masked by remodeling of the lower mandibular border. The changes in the conventional measures of head posture--the craniovertical angles--during the observation period showed no associations with the growth changes in craniofacial morphology.

Cephalometry↗
PubMed2006

White matter and subcortical gray matter lesion volume changes and late-life depression outcome: a 4-year magnetic resonance imaging study.

BACKGROUND: Cross-sectional studies have shown that late-onset depression is associated with larger deep white matter lesions (WMLs) and subcortical gray matter lesions (GMLs). In a longitudinal analysis, we examined changes in deep WMLs and subcortical GMLs in older depressed and nondepressed subjects over a 4-year period. METHODS: Brain magnetic resonance imaging (MRI) scans were obtained on 164 depressed and 126 healthy subjects aged 60 years or older at baseline, and 2 and 4 years after recruitment. WMLs and GMLs were measured using a semiautomated technique. We used repeated-measures analysis of covariance to determine cross-sectional lesion volume differences, whether lesion volume changes differed between patients and controls, and the effect of lesion volume changes on outcome in late-life depression. RESULTS: Mean volumes of lesions for the depressive group were 6.51, 8.18 and 7.75 cm2 for WMLs and 0.23, 0.30 and 0.34 cm2 for GMLs at baseline, 2-year and 4-year follow-up, respectively. Mean volumes of lesions for the control group were 4.83, 6.22 and 6.45 cm2 for WMLs and 0.17, 0.25 and 0.23 cm2 for GMLs at baseline, 2-year and 4-year follow-up, respectively. Cross-sectional between-group mean lesion volumes were significantly different for each measure. However, the pattern of WML and GML volume changes over time was not significantly different between groups. Treatment outcome was associated with changes in total and white matter lesion volume over time. CONCLUSIONS: Lesion volume progression is associated with aging and the pathological condition of late-life depression. The mechanisms that produce these progressive lesion changes remain unclear. Treatments aimed at arresting lesion progression may play a role in the management of late-life depression.

Aged↗
PubMed2002

Using seasonal variations in asthma hospitalizations in children to predict hospitalization frequency.

Asthma hospitalization rates have increased in the United States since 1980. The exposure risk of many environmental factors, which contribute to respiratory disease, vary throughout the year. The objective of this study was to investigate the seasonal variation of pediatric asthma hospitalizations and predict hospitalization frequency. This was a longitudinal analysis of all pediatric asthma hospitalizations in the state of Maryland by age, gender, race, and residence using non-confidential discharge data sets from 1986 to 1999. Of the 631,422 pediatric hospitalizations in the state of Maryland during the years 1986-1999, 45,924 (7%) had a primary admission diagnosis of asthma. Frequency of hospitalization for asthma was lowest in the summer in all age groups, and highest in the fall. Seasonal variation in severe asthma episodes was least striking in children aged 15-18. This was in contrast to non-asthma admissions, which were highest in winter in preschool children, but relatively flat in school- and teenaged children. Using neural network modeling, weekly asthma hospitalizations could be predicted with an R2 between 0.71 and 0.8. Temporal trends in asthma hospitalizations were seen in each age group, gender, race, and location. The seasonal variability in asthma hospitalizations suggests that acute asthma is influenced by variables beyond socioeconomic factors and adherence to medical regimens. Strategies to combat exacerbations of asthma should take into consideration seasonal effects on a population. In addition, temporal trends examined over many years can be used to predict frequency of severe asthma episodes in a population.

Adolescent↗
PubMed1990

Significance of C1q-binding macromolecules within the head and neck cancer patient.

Elevated levels of macromolecules, within the peripheral blood of head and neck cancer patients, capable of binding the first component of complement (C1qBM) in vitro have prognostic implication. Namely, elevated levels of C1qBM have been associated with nonresponse to induction chemotherapy. In this investigation, a series of in vitro studies regarding the biological properties of C1qBM were combined with a longitudinal analysis of 112 previously untreated head and neck cancer patients. Our purpose was to shed light on the biological significance of this circulating macromolecule, a substance composed, in part, of IgG and IgM. A potential confounding influence of C1qBM with induction chemotherapy, which could contribute to observed prognostic findings, was negated by two in vitro observations: the macromolecule failed both to bind the chemotherapeutic agents cisplatin, bleomycin, and 5-fluorouracil and to impede the cytotoxic effect of these same drugs on a cultured human head and neck cancer cell line. The clinical relevance of C1qBM was reinforced by the observation that elevated levels predicted a high probability of death with disease (P = 0.005 by Cox's proportional hazards model). The prognostic implication was independent of the use of induction chemotherapy, i.e., patients with high C1qBM levels treated with multimodality therapy not composed of anticancer drugs did equally poorly. Thus, the prognostic significance of C1qBM in patients undergoing induction chemotherapy appears independent of drug effect and appears reflective of tumors that are more rapidly progressive and potentially less responsive to therapeutic intervention, including combinations of surgery, radiation, and/or chemotherapy.

Antigen-Antibody Complex↗
PubMedDate not supplied

Predictors of long-term immunological outcome in rebounding patients on protease inhibitor-based HAART after initial successful virologic suppression: implications for timing to switch.

OBJECTIVE: To assess predictive factors of long-term immune restoration in patients who started protease inhibitor (PI)-based HAART and experienced virological rebound after initial complete success. METHOD: A retrospective longitudinal analysis of all HIV-infected patients who started their first PI-based HAART and reached viral load below 500 copies/mL was carried out in a large academic center in Italy. Patients were classified either as complete virologic responder (CR) or rebounders (REB) when confirmed plasma viremia was detected thereafter. Immunological outcome was the area under the curve (AUC) of the absolute CD4+ cell count change since the 8th month after treatment initiation (CD4+ T-cell AUC). Association between baseline characteristics, virological outcome, and CD4+ T-cell AUC was assessed by univariate and multivariate analysis. RESULTS: There were 374 patients who were included in the study. Mean follow-up was 30.2 months. There were 226/374 patients (60.4%) who remained CR while 148/374 (39.6%) presented at least one rebound (REB). Among REB patients, complete viral suppression was regained in 15/42 (35.7%) and 50/106 (47.1%) patients who underwent therapy changes or not, respectively. When multiple linear regression was carried out, previous nucleoside reverse transcriptase inhibitor (NRTI) experience and baseline CD4+ cell count below 350 cells/muL did not impair long-term immune restoration. The occurrence of rebound, its duration (> 18 months), and its magnitude (peak of viral load > 10,000 copies/mL) were independent negative prognostic factors. CONCLUSION: The occurrence of viral rebound is independently associated with significantly impaired long-term immunological restoration. The magnitude of viral rebound (< 10,000 copies/mL) and its duration (< 18 months) may be useful to identify those rebounding patients who may still profit from maintaining the current failing therapy if a more aggressive approach may be expected to be deleterious for tolerability reasons or lack of options.

Adolescent↗
PubMed2026

Sex-stratified mortality trends in preterm birth complications in Sierra Leone: progress, persistence, and equity implications.

BACKGROUND: Preterm birth complications remain a leading cause of neonatal mortality in Sierra Leone, despite recent health system gains. Evidence on long-term sex-specific disparities in mortality due to preterm birth complications is limited, constraining equitable neonatal care planning. OBJECTIVE: To examine two&#x2011;decade trends in sex&#x2011;stratified mortality from preterm birth complications using standardized equity indicators. METHODS: We conducted a retrospective longitudinal analysis of sex-disaggregated mortality estimates from the World Health Organization (WHO) Global Health Estimates (GHE), accessed through the WHO Health Equity Assessment Toolkit (HEAT), Built-in Database Edition (Version 6.0). Mortality rates per 100,000 population were extracted for 2001, 2006, 2011, 2016, and 2021. Inequality was assessed using absolute difference (D), relative ratio (R), population attributable risk (PAR), and population attributable fraction (PAF). RESULTS: Mortality declined substantially between 2001 and 2021 for both males (85.1-49.3 per 100,000) and females (71.2-39.9 per 100,000). Male mortality remained consistently higher across all years, with relative ratios indicating approximately 20-25% excess mortality among male neonates. Absolute inequalities narrowed modestly over time, whereas relative inequalities remained largely unchanged. PAR and PAF remained close to zero throughout the study period. Wider uncertainty intervals in earlier years reflected limited empirical data availability. CONCLUSION: Although preterm mortality declined over two decades, a persistent male disadvantage remained in Sierra Leone. These findings highlight the importance of integrating sex-disaggregated equity monitoring into neonatal policies and programmes. Future research should evaluate strategies to reduce the persistent excess mortality among male neonates while sustaining overall improvements in neonatal survival and progress toward Sustainable Development Goal 3.2.

Humans↗
PubMed2003

Phenotype and functional characteristics of HIV-specific cytotoxic CD8+ T cells in chronically infected patients: dual effects of highly active antiretroviral therapy.

BACKGROUND: Cytotoxic CD8+ T cells (CTLs) are critical for the control of viral infections. Although these cells can be recognized in most HIV-infected individuals, they fail to successfully control HIV replication. Distinct functional defects seem to limit their efficacy in HIV infection, although they have been not fully elucidated. PATIENTS AND METHODS: Blood lymphocytes collected from 61 HLA-A0201+, untreated, chronically HIV-infected individuals were examined for the presence of CTLs against epitopes from HIV Gag and Pol proteins, using tetrameric complexes. Several functional aspects of these cells were further analyzed (immunophenotype; ability to produce interferon-gamma (IFN-gamma) in response to the specific peptide; proliferative capacity; and cytolytic activity). Lymphoproliferative responses of these cells confronting different stimulus were also evaluated. A longitudinal analysis was carried out in a subgroup who underwent antiretroviral therapy and were followed for 6 months. RESULTS: CD8+ T cells staining with the tetramer complexes (Tet+) were detected in 44% of patients, with TetGag+ cells being more frequently detected and at higher levels than TetPol+ cells. Most Tet+ cells expressed a memory phenotype, showed an impaired ability to produce IFN-gamma when stimulated with the cognate peptide, and showed a very low expansion when cultured in the presence of the peptide. There was a negative correlation between the proportion of Tet+ cells producing IFN-gamma and plasma HIV-RNA. Although Tet+ cells diminished in most individuals after beginning antiretroviral therapy, some patients showed de novo appearance of Tet+ cells. CONCLUSIONS: Most Tet+ cells in chronic HIV-infected individuals express a memory phenotype and show an impaired production of IFN-gamma and a lower proliferative response to specific HIV antigens. Interestingly, some individuals under successful antiretroviral therapy may show de novo appearance of specific CTLs. The implications of these findings are relevant for a better understanding of virus-host interactions.

Adult↗
PubMedDate not supplied

[Hospitalization and premature surgeries; language and psychism: a report of 2 cases].

BACKGROUND: mutual influences between body, psychism and language. AIM: The purpose of this work was to analyze the possible connections between hospital internations and surgeries, to which children were submitted at their earliest life years, as well as subsequent language and psychic adversities. METHOD: It is a qualitative/clinical research, of a descriptive/interpretative nature, carried out through the longitudinal analysis of two clinical case studies with small children of approximately three years of age, whose families had co-occurrent complaints: surgeries and premature hospital internations (as a consequence of organical diseases) and subsequent language disorders. Clinical material was analyzed under a theorical perspective, articulating psychoanalytical and speech therapy theories, based on clinical practice. RESULTS: In both cases, speech therapy symptoms decreased progressively as the organic disorders gained space during therapeutic dialogues (between speech therapist and patient), as well as in home-circle narratives. This promoted modifications/surpasses of the language symptoms presented by the patients. CONCLUSION: The organic birth of the studied children was not concomitant to their symbolic birth, thus creating a gap between them. This gap is derived from the lack of compatibility between the development of corporal scheme and subjective processes. The symbolic effects suffered by parents due to the birth of children who are radically divergent from what was expected was devastating, making it impossible for parents to conceive their babies symbolically. After the violent impact of disappointment, these children remained being interpreted by their parents. This created a disturbance in the functioning of language and in the psychism of these children. Thus, unconsciously, parents were only able to represent their children based on the place that was originally given to them: the place of disease.

Child Development↗
PubMed1991

[Sequence in calcification and eruption of second premolars and molars--a longitudinal study].

Investigation was done with the purpose of establishing frequency of eruption and calcification of P2 and M2 and to perform a longitudinal analysis of certain types, observing the changes during growth, character of these changes and their durability. Analysis was done on 354 orthopantomographic radiographs of orthodontic patients from Nis, aged 7 to 12 years. Eruption phase was determined on the bases of vertical relation to M1 Development phase was determined with the help of a table with 11 developmental phases. Depending on tooth in predominance, patients were divided into three groups: P2M2, (P2M2) and M2P2. All three types of eruption and calcification were recorded. (P2M2) eruption is dominant in maxilla, while M2 has some advantage in mandible. In calcification of both jaws, type P2M2 is predominant in both sexes. In later age, eruption shows changes of type-in 31% to 39% of cases, but this percentage is lower in calcification-from 22% to 25%. Relation of P2 and M2 in eruption is not permanent and changes with growth: in maxilla, P2 has synchronous position in relation to M2 until 8 years of age, to gain advantage in later years; in mandible, P2 has lower position until 10 years of age, to start quicker growth in eleventh year so that in 42% of cases it erupts before M2. In development phase, P2 has advantage in both jaws. P2M2 type shows least changes with age. Other two types change into type P2M2 in 40% of cases. Once set sequence of eruption and calcification cannot be a reliable indicator of later growth since considerable changes were observed in most patients.

Bicuspid↗