Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population

BACKGROUND: It has previously been shown that low back pain (LBP) often presents already in the teenage years and that previous LBP predicts future LBP. It is also well documented that there is a large degree of comorbidity associated with LBP, both in adolescents and adults. The objective of this study is to gain a deeper insight into the etiology of low back pain and to possibly develop a tool for early identification of high-risk groups. This is done by investigating whether different types of morbidity in adolescence are associated with LBP in adulthood. METHODS: Almost 10,000 Danish twins born between 1972 and 1982 were surveyed by means of postal questionnaires in 1994 and again in 2002. The questionnaires dealt with various aspects of general health, including the prevalence of LBP, classified according to number of days affected during the previous year (0, 1–7, 8–30, >30). The predictor variables used in this study were LBP, headache, asthma and atopic disease at baseline; the outcome variable was persistent LBP (>30 days during the past year) at follow-up. Associations between morbidity in 1994 and LBP in 2002 were investigated. RESULTS: LBP, headache and asthma in adolescence were positively associated with future LBP. There was no association between atopic disease and future LBP. Individuals with persistent LBP at baseline had an odds ratio of 3.5 (2.8–4.5) for future LBP, while the odds ratio for those with persistent LBP, persistent headache and asthma was 4.5 (2.5–8.1). There was a large degree of clustering of these disorders, but atopic disease was not part of this pattern. CONCLUSION: Young people from 12 to 22 years of age with persistent LBP during the previous year have an odds ratio of 3.5 persistent LBP eight years later. Both headache and asthma are also positively associated with future LBP and there is a large clustering of LBP, headache and asthma in adolescence

Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial

<p>Abstract</p> <p>Background</p> <p>Periodontitis is a common, chronic inflammatory disease caused by gram-negative bacteria leading to destruction of tissues supporting the teeth. Epidemiological studies have consistently shown increased frequency, extent and severity of periodontitis among diabetic adults. More recently, some controlled clinical trials have also suggested that periodontal treatment could improve glycaemic control in diabetic patients. However current evidence does not provide sufficient information on which to confidently base any clinical recommendations. The main objective of this clinical trial is to assess whether periodontal treatment could lead to a decrease in glycated haemoglobin levels in metabolically unbalanced diabetic patients suffering from chronic periodontitis.</p> <p>Methods</p> <p>The DIAPERIO trial is an open-label, 13-week follow-up, randomized, controlled trial. The total target sample size is planned at 150 participants, with a balanced (1:1) treatment allocation (immediate treatment vs delayed treatment). Periodontal treatment will include full mouth non-surgical scaling and root planing, systemic antibiotherapy, local antiseptics (chlorhexidine 0.12%) and oral health instructions. The primary outcome will be the difference in change of HbA1c between the two groups after the 13-weeks' follow-up. Secondary outcomes will be the difference in change of fructosamine levels and quality of life between the two groups.</p> <p>Discussion</p> <p>The DIAPERIO trial will provide insight into the question of whether periodontal treatment could lead to an improvement in glycaemic control in metabolically unbalanced diabetic patients suffering from periodontitis. The results of this trial will help to provide evidence-based recommendations for clinicians and a draft framework for designing national health policies.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN15334496</p

Periodontitis and diabetes: a two-way relationship

Periodontitis is a common chronic inflammatory disease characterised by destruction of the supporting structures of the teeth (the periodontal ligament and alveolar bone). It is highly prevalent (severe periodontitis affects 10–15% of adults) and has multiple negative impacts on quality of life. Epidemiological data confirm that diabetes is a major risk factor for periodontitis; susceptibility to periodontitis is increased by approximately threefold in people with diabetes. There is a clear relationship between degree of hyperglycaemia and severity of periodontitis. The mechanisms that underpin the links between these two conditions are not completely understood, but involve aspects of immune functioning, neutrophil activity, and cytokine biology. There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. Incidences of macroalbuminuria and end-stage renal disease are increased twofold and threefold, respectively, in diabetic individuals who also have severe periodontitis compared to diabetic individuals without severe periodontitis. Furthermore, the risk of cardiorenal mortality (ischaemic heart disease and diabetic nephropathy combined) is three times higher in diabetic people with severe periodontitis than in diabetic people without severe periodontitis. Treatment of periodontitis is associated with HbA1c reductions of approximately 0.4%. Oral and periodontal health should be promoted as integral components of diabetes management

Methyl methacrylate and respiratory sensitization: A Critical review

Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants.The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer

Effect of spectral sampling on the temporal coherence analysis of a broadband source in a SFG interferometer

International audienceIn the frame of sum frequency generation of a broadband infrared source, we aim to enlarge the converted bandwidth by using a pump frequency comb while keeping a high conversion efficiency. The nonlinear effects are simultaneously induced in the same nonlinear medium. In this paper, we investigate the spectral filtering effect on the temporal coherence behavior with a Mach-Zehnder interferometer using two pump lines. We show that joined effects of quasi-phase matching and spectral sampling lead to an original coherence behavior

Etat des lieux et profil de l’imagerie par resonance magnetique dans l’exploration du cancer de la prostate au Togo

Objectif: Faire l’état des lieux de la prescription de l’Imagerie par Résonance Magnétique (IRM) et de décrire les aspects IRM des cancers de la prostate au TogoMatériel et Méthode: Etude rétrospective, descriptive des IRM prostatiques dans le service de radiologie de la clinique Autel d’ELIE sur une période de 5 ans.Résultats: Les demandes des IRM prostatiques représentaient 0,2% des demandes d’IRM et une fréquence de 03 IRM prostatiques par an. L’âge moyen des patients était de 63 ans. Le motif de demande d’IRM était dominé la suspicion d’une lésion suspecte à l’échographie (08 cas).Le diagnostic de lésion suspecte de malignité a été évoqué chez 10 patients et se présentaient sous l’aspect de nodules multiples dans 7 cas. Les nodules prédominaient dans la glande périphérique (7 cas). Dans tous les cas, les nodules étaient en iso signal T1, en hypo signal T2 chez 9 patients. Le rehaussement était modéré chez 8 patients, et intense avec Wash in et Wash out chez 2 patients.Le volume de la prostate était normal chez 7 patients, avec un volume moyen de 56,23ml.Le signe d’extension extra capsulaire était dominé par le contact capsulaire (8 cas).Des lésions de métastases ganglionnaires et hépatiques ont été retrouvées chez un patient.Le cancer localisé classé T1/T2 N0 M0 prédominait (6 cas).Conclusion: La prescription de l’IRM prostatique est quasi inexistante au Togo. Bien que cet examen soit de bas champs (0,3 Tesla) au Togo, reste efficaceMots clés: IRM bas champs, prescription, cancer de la prostate, efficacité, TogoEnglish Title: Profile of magnetic resonance imaging in the exploration of prostate cancer in TogoEnglish AbstractObjective: To take stock of the prescription of Magnetic Resonance Imaging (MRI) and to describe the MRI aspects of prostate cancer in TogoMaterial and method: A retrospective, descriptive study of prostate MRI in the radiology department of Autel d’Elie clinic over a 5-years.Results: Prostate MRI prescription accounted for 0.2% of MRI prescription and a frequency of 03 prostate MRIs per year. The mean age of patients was 63 years. The pattern of MRI application was dominated suspicion of a suspicious lesion on ultrasound (08 cases). The diagnosis of suspected malignancy was mentioned in 10 patients and presented as multiple nodules in 7 cases. Nodules predominated in the peripheral gland (7 cases). In all cases, the nodules were in iso T1 signal, hypo T2 signal in 9 patients. The contrast enhancement was moderate in 8 patients, and intense with Wash in and Wash out in 2 patients. Prostate volume was normal in 7 patients, with an average volume of 56.23ml. The sign of extra-capsular extension was dominated by capsular contact (8 cases). Adenopathies and hepatic metastasis lesions were found in one patient. The localized cancer ranked T1 / T2 N0 M0 predominated (6 cases).Conclusion: The prescription of prostatic MRI is almost non-existent in Togo. Although this examination is of low fields (0.3 Tesla) in Togo, remains effectiveKeywords: MRI low fields, prescription, prostate cancer, efficacy, Tog