Published by Oxford University Press on behalf of the International Epidemiological Association. Background: To investigate the association between resting heart rate and the risk of developing impaired fasting glucose (IFG), diabetes and conversion from IFG to diabetes. Methods: The prospective analysis included 73 357 participants of the Kailuan cohort (57 719 men and 15 638 women). Resting heart rate was measured via electrocardiogram in 2006. Incident diabetes was defined as either the fasting blood glucose (FBG) ≥ 7.0 mmol/l or new active use of diabetes medications during the 4-year follow-up period. IFG was defined as a FBG between 5.6 and 6.9 mmol/l. A meta-analysis including seven published prospective studies focused on heart rate and diabetes risk, and our current study was then conducted using random-effects models. Results: During 4 years of follow-up, 17 463 incident IFG cases and 4 649 incident diabetes cases were identified. The corresponding adjusted hazard ratios (HRs) for each 10 beats/min increase in heart rate were 1.23 [95% confidence interval (CI): 1.19, 1.27] for incident diabetes, 1.11 (95% CI: 1.09, 1.13) for incident IFG and 1.13 (95% CI: 1.08, 1.17) for IFG to diabetes conversion. The risks of incident IFG and diabetes were significantly higher among participants aged < 50 years than those aged ≥ 50 years (P-interaction < 0.02 for both). A meta-analysis confirmed the positive association between resting heart rate and diabetes risk (pooled HR for the highest vs lowest heart rate quintile=1.59, 95% CI:1.27, 2.00; n=8). Conclusion: Faster resting heart rate is associated with higher risk of developing IFG and diabetes, suggesting that heart rate could be used to identify individuals with a higher future risk of diabetes.

ZL-Duraplant-Implantate Ticer

Les sarcomes sont des tumeurs malignes rares, représentant 1% de tous les cancers mais regroupant un large spectre d’entités histopathologiques distinctes. Du fait de leur rareté et de leur difficulté diagnostique, l’épidémiologie des sarcomes reste mal connue. Nous avons décrit l’incidence et la répartition géographique des sarcomes en région Rhône-Alpes grâce à la constitution d’une cohorte prospective et exhaustive de tous les cas incidents en 2005 et 2006, après relecture centralisée systématique des diagnostics par un pathologiste référent. Nous rapportons : - un taux d’incidence brut de 6,2 cas/100 000/an, supérieur à celui publié dans la littérature et confirmé sur les deux années de recueil de données ; - une répartition géographique et une épidémiologie spécifiques selon les sous-types histologiques ; - des discordances de diagnostic portant sur 45% des cas dont 19% de discordances majeures. Nos résultats sont différents des données publiées portant sur des séries rétrospectives ou incomplètes. Ils contribuent à une meilleure connaissance de l’épidémiologie des sarcomes. Ils permettent de poser des hypothèses étiopathogéniques dans la répartition géographique observée notamment pour les tumeurs stromales gastro intestinales et les liposarcomes / Sarcoma is a rare malignant tumour accounting for 1% of all cancers but comprising a wide range of distinct histopathological types. Given the rarity of cases and the difficulty of diagnosis, the epidemiology of sarcomas is still unclear. We have examined the incidence and the geographical distribution of sarcomas based on the results of a prospective cohort study of all incident cases diagnosed in 2005 and 2006 in the Rhône-Alpes region and after centralized and systematic review of diagnosis by a referent pathologist. We report: - a crude incidence rate of 6.2 cases/100 000/year confirmed on these two years of data collection, higher than the one published in the literature ; - a geographical distribution and epidemiology characteristic of each different histological sub-type ; - diagnostic discordances in 45% of cases, of which 19% were major discordances. Our findings, which differ from data published in retrospective or incomplete series, contribute to a better knowledge of the epidemiology of sarcoma. They make it possible to formulate etiopathogenic hypotheses regarding the geographical distribution of the disease, especially for gastrointestinal stromal tumours and liposarcomas

O presente trabalho teve como objetivo identificar e caracterizar as causas de morte de aves de rapina de vida livre da região do município de São Paulo e áreas vizinhas. O estudo incluiu 114 aves de rapina, sendo 40 da ordem Falconiformes e 74 da ordem Strigiformes, atendidas pela Divisão de Fauna do município de São Paulo, São Paulo, Brasil, durante o período de outubro de 2002 a maio de 2006. As causas de morte identificadas foram: eutanásia (41,2%); causas não-infecciosas (32,5%); causas infecciosas (19,3%); causas parasitárias (3,5%) e causas indeterminadas (3,5%). As lesões traumáticas osteoarticulares foram o motivo mais freqüente de eutanásia (51,1%), seguindo-se das lesões em tecidos moles (17,0%), lesões isquêmicas das extremidades das asas (17,0%), tricomoníase (10,6%) e causas variadas (4,3%). Os traumas se destacaram como uma importante causa de morte natural ou induzida (eutanásia). Dentre as causas de morte infecciosas, as infecções por protozoários (tricomoníase) (54,5%) foram as mais freqüentes, seguindo-se das infecções bacterianas (40,9%). O presente trabalho permitiu identificar os principais processos que causam a morte de aves de rapina, Falconiformes e Strigiformes na região de São Paulo, fornecendo importantes subsídios para o atendimento clínico e tratamento das condições mais comumente encontradas nessa população. / The goal of this work was to identify and characterize the causes of death of free-living birds of prey from São Paulo city and its surroundings. In the present work 114 raptors were studied, 40 of them belonging to the Falconiformes order and 74 to the Strigiformes order, all admitted at the São Paulo City Fauna Division, Brazil, during the period of October 2002 to May 2006. The causes of death were determined as: euthanasia (41,2%), non-infectious causes (32,5%), infectious causes (19,3%), parasitic diseases (3,5%) and indeterminate (3,5%). Bones and joints lesions were the most frequent cause that lead to euthanasia (51,1%), followed by soft tissue lesions (17%), wing tips ischemic lesions (17%), Trichomoniasis (10,6%) and various causes (4,3%). Trauma outstands as an important cause of natural or induced death, while in the field of infectious diseases trichomoniasis (54,5%) was the most frequent, followed by bacterial infections (40,9%). The present study allowed us to identify the principal processes that cause the death of raptorial birds at São Paulo City. These findings also provided important information for clinical attendance and medical treatment for the most common conditions in this population.

Este estudo prospectivo foi delineado com o objetivo de avaliar os achados citológicos, colposcópicos e histológicos da infecção pelo papilomavírus humano em adolescentes e estabelecer a correlação entre o resultado da colpocitologia oncológica e os fatores de risco para a infecção pelo papilomavírus humano. O grupo foi constituído por 82 adolescentes entre 13 e 19 anos, acompanhadas no Ambulatório de Adolescentes e encaminhadas ao Setor de Patologia do Trato Genital Inferior e Colposcopia da Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. As pacientes foram submetidas a anamnese, coleta da colpocitologia oncológica, colposcopia e biópsia de colo uterino na presença de aspectos colposcópicos anormais. A média etária das pacientes foi de 17,7 anos, com desvio-padrão de 1,4 anos. A colpocitologia oncológica foi normal em 57% e alterada em 43%. Os achados citológicos anormais diagnosticados foram: lesão intra-epitelial escamosa de baixo grau em 38%, lesão intra-epitelial escamosa de alto grau em 4% e células escamosas atípicas de significado indeterminado em 1%. A colposcopia foi satisfatória em todos os casos. Os achados colposcópicos normais foram o epitélio pavimentoso original em 4%, epitélio cilíndrico em 18% e a zona de transformação normal em 28%. A zona de transformação anormal estava presente em 50% dos casos, sendo representada pelas alterações epiteliais em 52%, seguida das vasculares em 41% e mistas em 7%. O exame histológico do material de biópsia de colo uterino diagnosticou cervicite crônica em 33%, cervicite crônica associada à infecção pelo papilomavírus humano em 2,4%, neoplasia intra-epitelial cervical grau 1 em 11%, neoplasia intra-epitelial cervical grau 2 em 2,4% e neoplasia intra-epitelial cervical grau 3 em 1,2%. Quanto aos fatores de risco e sua associação com o resultado da colpocitologia oncológica, a análise univariada dos parâmetros idade, menarca, início da atividade sexual, intervalo entre menarca e primeira relação sexual, número de parceiros, tabagismo e método contraceptivo não apresentou diferença estatisticamente significante. A análise conjunta das variáveis independentes através do método de regressão logística identificou os parâmetros idade, menarca e método contraceptivo como fatores relevantes. O aumento em um ano na idade da adolescente diminui a probabilidade (30%) de alteração no resultado citológico. O atraso em um ano na menarca reduz a probabilidade (35%) de colpocitologia oncológica alterada. A utilização de método anticoncepcional hormonal (anticoncepcional oral ou injetável) aumenta a probabilidade de alteração citológica / This prospective study was designed to evaluate the cytologic, colposcopic and histologic findings related to human papillomavirus infections in adolescents and to correlate cytologic reports with risk factors. The study sample consisted of 82 adolescents from 13 to 19 years of age, who were examined in a hospital-based adolescent clinic and referred to Inferior Genital Tract Disease and Colposcopy Unit in the Gynecologic Department - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Every adolescent answered a questionnaire administered by the physician and afterwards underwent cytologic and colposcopic examination followed by cervical biopsy when colposcopic abnormalities were found. Participant mean age was 17.7 years old and the standard-deviation was 1.4 years. Normal patterns of cytologic findings were present in 57% of the cases. Abnormalities were found in 43%. Abnormal cytologic findings were placed as follows: low-grade squamous intraepithelial lesion in 38%, high-grade squamous intraepithelial lesion in 4% and atypical squamous cells of undetermined significance in 1%. All colposcopic examination were satisfactory. Normal colposcopic appearance was represented by original squamous epithelium in 4%, columnar epithelium in 18% and transformation zone in 28%. Abnormal colposcopic findings corresponded to 50% of the cases, distributed in epithelial abnormalities in 52%, followed by vascular pattern in 41% and both (epithelial and vascular pattern) in 7%. Histological exam of cervical biopsy specimen revelead chronic cervicitis in 33%, chronic cervicites associated with human papillomavirus infection in 2.4%, cervical intra-epithelial neoplasia grade 1 in 11%, cervical intraepithelial neoplasia grade 2 in 2.4% and cervical intraepithelial neoplasia grade 3 in 1.2%. Univariate analysis was used to correlate the concerning risk factors such as age, menarche, sexual activity onset, interval between menarche and first sexual intercourse, number of sexual partners, smoking and contraceptive method, and cytologic results and no statistically significant correlation was found. Logistic regression modelling was used to determine variables associated with abnormal cytology and pointed up age, menarche and hormonal contraceptive method as relevant factors. Aging one year decreases the probability (30%) of abnormal cytology, as well as, delay in one year in menarche results in reduction (35%) of abnormal cervical cytology. Hormonal contraceptive methods (oral contraceptives and injection) increase the probability of cytologic abnormalities

O presente trabalho teve como objetivo identificar e caracterizar as causas de morte de aves de rapina de vida livre da região do município de São Paulo e áreas vizinhas. O estudo incluiu 114 aves de rapina, sendo 40 da ordem Falconiformes e 74 da ordem Strigiformes, atendidas pela Divisão de Fauna do município de São Paulo, São Paulo, Brasil, durante o período de outubro de 2002 a maio de 2006. As causas de morte identificadas foram: eutanásia (41,2%); causas não-infecciosas (32,5%); causas infecciosas (19,3%); causas parasitárias (3,5%) e causas indeterminadas (3,5%). As lesões traumáticas osteoarticulares foram o motivo mais freqüente de eutanásia (51,1%), seguindo-se das lesões em tecidos moles (17,0%), lesões isquêmicas das extremidades das asas (17,0%), tricomoníase (10,6%) e causas variadas (4,3%). Os traumas se destacaram como uma importante causa de morte natural ou induzida (eutanásia). Dentre as causas de morte infecciosas, as infecções por protozoários (tricomoníase) (54,5%) foram as mais freqüentes, seguindo-se das infecções bacterianas (40,9%). O presente trabalho permitiu identificar os principais processos que causam a morte de aves de rapina, Falconiformes e Strigiformes na região de São Paulo, fornecendo importantes subsídios para o atendimento clínico e tratamento das condições mais comumente encontradas nessa população. / The goal of this work was to identify and characterize the causes of death of free-living birds of prey from São Paulo city and its surroundings. In the present work 114 raptors were studied, 40 of them belonging to the Falconiformes order and 74 to the Strigiformes order, all admitted at the São Paulo City Fauna Division, Brazil, during the period of October 2002 to May 2006. The causes of death were determined as: euthanasia (41,2%), non-infectious causes (32,5%), infectious causes (19,3%), parasitic diseases (3,5%) and indeterminate (3,5%). Bones and joints lesions were the most frequent cause that lead to euthanasia (51,1%), followed by soft tissue lesions (17%), wing tips ischemic lesions (17%), Trichomoniasis (10,6%) and various causes (4,3%). Trauma outstands as an important cause of natural or induced death, while in the field of infectious diseases trichomoniasis (54,5%) was the most frequent, followed by bacterial infections (40,9%). The present study allowed us to identify the principal processes that cause the death of raptorial birds at São Paulo City. These findings also provided important information for clinical attendance and medical treatment for the most common conditions in this population.

Foram estudados prospectivamente os linfonodos, em 19 pacientes com adenocarcinoma de reto distal através de tomografia pélvica e linfocintilografia pélvica e realizado o estudo comparativo dos métodos, tendo como base à anatomia patológica e o estadiamento clinico-cirúrgico. Foram comparados os exames obtendo-se que os métodos não são concordantes. E a linfocintilografia é método mais sensível para linfonodos do que a tomografia / They were studied prospectivamente the lymph nodes, in 19 patient with adenocarcinoma of distal rectum through pelvic tomography and pelvic lymphoscintigraphy and accomplished the comparative study of the methods, having as based to the pathological anatomy and the staging practise-surgical. It compared the exams to each other obtaining itself that the methods are not concordant. And the lymphoscintigraphy is more sensitive method for lymph nodes than for

The aim of this thesis was to examine the validity of the main concepts of metacognitive theory in a Turkish sample and set the stage for metacognitive research in Turkey from the clinical psychology perspective. In addition to this, research attention was focused on two important topics remained to be empirically validated in the metacognition literature: (1) the unique contributions of &ldquo / cognitive content&rdquo / versus &ldquo / metacognition&rdquo / to the prediction of anxiety and depression symptoms, and (2) the vulnerability function of metacognitions in the development of anxiety and depression symptoms. To achieve these generic aims of the study, a two-step research plan each of which has its own specific objectives was followed. Data for cross-sectional and prospective parts of the study were collected from Turkish and British non-clinical samples. In the cross-sectional part, mainly the independent contribution of metacognitions to pathological worry, obsessive-compulsive symptomatology, and anxiety and depressive symptoms above and beyond the contribution of cognitive content was evaluated. By doing so, also the relationship patterns between metacognitions and psychological symptomatology were revealed in the Turkish sample. Consistent with the recent burgeoning of research, the association between increased levels of metacognitions and increased levels of anxiety and depression was shown in the Turkish sample, as well. Moreover, metacognitive factors were found to be associated with the symptoms of anxiety and depression independently of the relevant cognitive content. In most analyses, metacognitions emerged as slightly stronger predictors of a given symptom dimension compared to the relevant cognitive content. In the prospective part, the causal role of metacognitions following stress in the development of anxiety and depression symptoms was examined. In the Turkish sample, higher levels of negative beliefs about worry predicted augmentation in anxiety and depression symptoms from Time 1 to Time 2. Besides, higher levels of lack of cognitive confidence interacted with higher levels of daily hassles to predict intensification of the anxiety scores. However, the British data did not support the causal role of metacognitions in the development of anxiety and depression symptoms. The statistical comparisons between Turkish and British samples indicated that the Turkish sample has a tendency to score significantly higher than the British sample on the metacognitive variables. Moreover, for all but one metacognitive factor, the interactions with cultural group (Turkish vs. British) were not significant in predicting psychopathology, indicating generalization of metacognitive theory to both the Turkish and British samples. Findings of this study were well in line with the metacognitive theory and discussed in the light of the relevant literature.

Zum Thema der Weisheitszahnentfernung existieren zahlreiche Publikationen überwiegend aus dem universitären Umfeld, von denen ein Großteil retrospektiv erhoben wurde. Prospektive Studien hingegen, die sich mit den Komplikationen der ambulanten Weisheitszahnentfernung einschließlich des postoperativen Heilungsverlaufs in der niedergelassenen mund-, kiefer- und gesichtschirurgischen Praxis befassen sind äußerst selten. In dieser prospektiven Studie wurden 330 Patienten im Zeitraum von November 2002 bis Juni 2005 in einer Gemeinschaftspraxis für Mund-, Kiefer und Gesichtschirurgie in Leipzig operiert und nachuntersucht, bei denen zusammen 1005 obere und untere Weisheitszähne entfernt wurden. Der Schwerpunkt der Arbeit lag auf der Identifikation von Merkmalen und operativen Maßnahmen, die das Risiko typischer intra- und postoperativer Komplikationen, die Dauer eines Eingriffes sowie das postoperative follow up unter besonderer Berücksichtigung des Patientenalters beeinflussen. Weisheitszahnentfernungen in einem Alter unter 18 Jahren korrelierten mit stärkerer postoperativer Schwellung, Kieferklemme und Schmerzempfindung sowie erhöhtem Risiko einer Wundheilungsstörung. Insbesondere aus der Germektomie resultierten lange OP-Zeiten. Sowohl chirurgische Komplexität als auch begleitende Komplikationen stiegen ab einem Alter von 25 Jahren an. Daher empfehlen wir unter Abwägung von chirurgischem Schwierigkeitsgrad, aber auch der bereits dargelegten Begleitfaktoren ein Alter zwischen 18 und 24 Jahren als günstigsten Zeitpunkt für die Entfernung dritter Molaren.

Objectives: Inadequate maternal vitamin D (25(OH)D) levels during pregnancy may affect primary tooth calcification predisposing enamel hypoplasia (EH), a risk factor for Early Childhood Caries (ECC). The purpose of the study was to determine the relationship between 25(OH)D status of expectant mothers and the incidence of EH and ECC among their infants. Methods: This prospective study recruited expectant mothers during their second trimester of pregnancy. A prenatal questionnaire was completed and serum sample drawn for a 25(OH)D assay. Infant dental exams, scheduled at approximately 12 months of age, determined EH and ECC, at which time the mother completed a second questionnaire. The dental examiner was blinded to each mother's prenatal vitamin D status. Results: 207 women, 90% of whom self-declared Aboriginal heritage, were enrolled at a mean age of 19.0 ± 4.7 years. The mean serum 25(OH)D was 48.1 ± 24.4 nmol/L. 35% had levels ≤ 35 nmol/L, a formerly-defined threshold of deficiency. Only 10% of women had concentrations ≥ 80 nmol/L, denoting adequacy. 135 infants were examined at 16.1 ± 7.4 months of age. EH was identified in 22% of infants, 23% had ECC and (36% ECC when white spot lesions were included). Mothers of children with EH had lower mean serum 25(OH)D concentrations during pregnancy than mothers of children without EH (43.2 ± 21.1 vs. 51.4 ± 27.4 nmol/L, p=.072). Mothers of children with ECC had lower 25(OH)D levels than mothers whose children were caries-free (41.4 ± 20.4 vs. 52.4 ± 27.4 nmol/L, p=.045). The rate of untreated decay was inversely related with maternal vitamin D concentrations (p<.001). Infants with EH were significantly more likely to have ECC (p<.001). Logistic regression identified low maternal calcium levels (p=.034), not having heard of vitamin D (p=.036), and not using margarine daily (p=.024) as being significantly associated with EH in the primary dentition of infants. Backwards logistic regression revealed that EH (p<.001), infant age (p=.002), and lower 25(OH)D levels during pregnancy (p=.019) were significantly associated with ECC. Conclusions: This study shows for the first time that maternal vitamin-D levels may influence primary dentition and the development of ECC in their babies.