Les manifestations orales de la maladie de Crohn sont bien établies chez les adultes. Toutefois, aucune étude ne s’est concentrée sur les manifestations orales pathologiques chez la population infantile. En ce qui concerne la santé dentaire, très peu d’études ont évalué la prévalence de carie chez les patients atteints de la maladie de Crohn. Les objectifs de cette étude sont de décrire les manifestations orales des enfants et des adolescents atteints de la maladie de Crohn et tout lien possible avec le stade de la maladie (active ou rémission) ainsi que de déterminer s’il existe un lien entre la prévalence de carie et le score de potentiel cariogène de la diète des patients. Hypothèses • Les manifestations buccodentaires décrites chez les adultes sont présentes chez les enfants et adolescents du groupe de Ste-Justine. • Il existe différentes manifestations propres à la population infantile. • L’indice carieux des enfants atteints de la maladie de Crohn est supérieur à celui des enfants en bonne santé. • L’indice de potentiel cariogène est élevé chez les patients atteints de la maladie de Crohn • Le stade de la maladie influence la prévalence des manifestations. Méthodologie Un certificat d’éthique à la recherche fut obtenu de l’hôpital Ste-Justine. Sur 40 patients recrutés, 21 sujets (9 filles, 12 garçons) âgés de 5,1 à 17,3 ans ont participé à l’étude de type transversale. Un questionnaire médical, un examen buccal complet, l’analyse des journaux alimentaires ainsi qu’une revue des dossiers médicaux a permis d’établir la prévalence des lésions pathologiques, la prévalence de carie (indice CAO) et le score de potentiel cariogène (SPC) selon la méthode du Dre Monique Julien. Résultats Les analyses statistiques démontrent: • Aucune différence significative entre le CAO des patients atteints de la maladie et celui du groupe contrôle. • Aucune manifestation orale autre que celles présentées dans la littérature. • 57% des patients ont rapporté avoir eu des ulcères buccaux au cours de la maladie. • Les patients en phase active ne sont pas différents de ceux en rémission en ce qui concerne les manifestations orales, le CAO et le SPC. • Les enfants qui prennent du méthotrexate ont un CAO plus élevé. • Les patients qui ont plus de caries n’ont pas nécessairement une diète plus cariogène. Conclusion Selon les résultats de notre étude, nous n’avons pas observé de manifestations orales propre à la population infantile. De plus, les enfants atteints de la maladie ne semblent pas être un groupe à risque de carie dentaire. Davantage d’études sont nécessaires sur les manifestations orales de la maladie de Crohn chez la population pédiatrique. / Oral manifestations of Crohn’s disease are well documented in adults. However, no studies have investigated the oral manifestations of this condition in children and adolescents. Regarding oral health, only a few studies have evaluated the prevalence of dental caries in these patients. The objectives of this study are to describe the oral manifestations of Crohn’s disease in children and establish a link between the state of the disease (active and in remission) with the prevalence of dental caries and the cariogenicity of the diet of these children. Hypotheses • The oral manifestations described in adults are present in children and adolescents of the Ste-Justine group. • There are different oral manifestations in children. • Children with Crohn’s disease have more dental caries than children in good health. • The cariogenicity index of the diet is high in patients with Crohn’s disease • The state of the disease has an effect on the prevalence of the oral manifestations. Methodology An ethic’s certification was obtained from Ste-Justine Hospital. Of 40 recruited patients, 21 patients (9 girls, 12 boys) ranging in age from 5.1 to 17.3 years of age participated in our transversal study. A medical history, a complete oral exam, a diet analysis and a review of the medical chart gave us the opportunity to record the presence of oral manifestations, the prevalence of dental caries (DMFT) and the cariogenicity score (SPC). The DMFT of Crohn’s disease patients was compared with the DMFT of Quebec children establish in the Dr. Brodeur epidemiological study conducted in 1996. The patients were also divided into two groups according to the state of the disease (active or remission) to evaluate if it affected the prevalence of oral lesions, the DMFT and the SPC. Results The statistics show : • No significant difference between the DMFT of Crohn’s disease patients and the control group. • No oral manifestations other than those published in the adult literature. • 57% of patients reported to have ulcers at some time during the disease • The patient in the active phase is not different then those in remission ones regarding oral manifestations, DMFT and SPC. • Children taking methotrexate have a higher DMFT • Patients with a higher DMFT do not necesserarily have a higher SPC Conclusion The results of our study do not demonstrate any new oral manifestations in Crohn’s disease in children that have not already been described in adults. In addition, children with Crohn’s disease do not seem to be at high risk for dental caries. Further studies are necessary on the oral manifestations of Crohn’s disease in the pediatric population.

Thesis (M.S.P.H.)--University of Michigan, 1938.

Thesis--Copenhagen. / Summary in Danish. Includes bibliographical references (p. 202-221) and index.

Thesis (M.S.P.H.)--University of Michigan, 1938.

Inaug.--Diss.--Münster, 1937. / Includes bibliographical references (p. 89-101).

There are many studies done to determine factors what can cause susceptibility to Sjögren's syndrome. Despite intensive research of the immune system, the model of the Sjögren's syndrome pathogenesis is not completely clear. Lymphopenia is a common symptom found in the pSS patients. Numerous studies are performed in order to determine the causes of lymphopenia, but there is a lack of detailed studies to reveal which cell population counts increase or decrease. Scarce studies are done to associate the changes in the immune cell population and the expression of humoral factors in the peripheral blood of pSS patients. The aim of dissertation work was to investigate the changes of the components of the systemic immune response in the peripheral blood of patients with primary Sjögren's syndrome (pSS) with different manifestations of the disease. In this study, a comprehensive analysis of B, NK and T cell populations and humoral factors in the peripheral blood of pSS patients was performed. For the first time the expression of CD57 and CD27 markers on CD8+ T cell population was analyzed. For the first time Th17/Th1-like cells in the peripheral blood of pSS patients were identified and imbalance in the distribution of T helper cell population was revealed. It can be explained by the significant increase of Th17/Th1-like lymphocyte population. The levels of IL-27 and IL-35 in sera of pSS patients were measured (not in the model system) for the first time as well. Primary Sjögren’s... [to full text] / Pastaruoju metu ypatingai intensyviai tiriami veiksniai, kurie gali paskatinti išsivystyti sindromą. Nepaisant intensyvių imuninės sistemos tyrimų, Sjögreno sindromo (SS) patogenezės modelis nėra pilnai aiškus. Pirminiu Sjögreno sindromu (pSS) sergančiųjų kraujyje būdinga limfopenija. Siekiant nustatyti to priežastis atlikta nemažai tyrimų, tačiau trūksta detalesnių tyrimų, atskleidžiančių kokių ląstelių populiacijų padaugėja/sumažėja, bei kokių ląstelių subpopuliacijų sąskaita, tai vyksta. Trūksta tyrimų, kurie susietų imuninės sistemos ląstelių populiacijų pokyčius ir humoralinių veiksnių raišką. Šio darbo tikslas buvo įvertinti pirminiu Sjögreno sindromu sergančių pacientų su skirtinga ligos raiška sisteminio imuninio atsako komponentų pokyčius periferiniame kraujyje. Darbe buvo atlikta kompleksinė, detali B, NK, T limfocitų populiacijų, jų subpopuliacijų ir humoralinių veiksnių analizė sergančių pSS pacientų periferiniame kraujyje. Pirmą kartą pSS pacientų periferiniame kraujyje tirtos CD8+ limfocitų populiacijos pagal jų ekspresuojamus CD57 ir CD27 žymenis. Pirmą kartą pSS pacientuose, o ne modelinėse sistemose, ištirta IL-27 ir IL-35 raiška kraujo serume. Pirmą kartą identifikuoti Th17/Th1-like limfocitai pSS pacientų periferiniame kraujyje. Nustatyta, kad pacientų sergančių pSS periferiniame kraujyje Th limfocitų populiacijų pusiausvyra yra sutrikusi, ir to priežastimi reikšmingas Th17/Th1-like limfocitų populiacijos pagausėjimas. Sergantiesiems pirminiu Sjögreno... [toliau žr. visą tekstą]

Pastaruoju metu ypatingai intensyviai tiriami veiksniai, kurie gali paskatinti išsivystyti sindromą. Nepaisant intensyvių imuninės sistemos tyrimų, Sjögreno sindromo (SS) patogenezės modelis nėra pilnai aiškus. Pirminiu Sjögreno sindromu (pSS) sergančiųjų kraujyje būdinga limfopenija. Siekiant nustatyti to priežastis atlikta nemažai tyrimų, tačiau trūksta detalesnių tyrimų, atskleidžiančių kokių ląstelių populiacijų padaugėja/sumažėja, bei kokių ląstelių subpopuliacijų sąskaita, tai vyksta. Trūksta tyrimų, kurie susietų imuninės sistemos ląstelių populiacijų pokyčius ir humoralinių veiksnių raišką. Šio darbo tikslas buvo įvertinti pirminiu Sjögreno sindromu sergančių pacientų su skirtinga ligos raiška sisteminio imuninio atsako komponentų pokyčius periferiniame kraujyje. Darbe buvo atlikta kompleksinė, detali B, NK, T limfocitų populiacijų, jų subpopuliacijų ir humoralinių veiksnių analizė sergančių pSS pacientų periferiniame kraujyje. Pirmą kartą pSS pacientų periferiniame kraujyje tirtos CD8+ limfocitų populiacijos pagal jų ekspresuojamus CD57 ir CD27 žymenis. Pirmą kartą pSS pacientuose, o ne modelinėse sistemose, ištirta IL-27 ir IL-35 raiška kraujo serume. Pirmą kartą identifikuoti Th17/Th1-like limfocitai pSS pacientų periferiniame kraujyje. Nustatyta, kad pacientų sergančių pSS periferiniame kraujyje Th limfocitų populiacijų pusiausvyra yra sutrikusi, ir to priežastimi reikšmingas Th17/Th1-like limfocitų populiacijos pagausėjimas. Sergantiesiems pirminiu Sjögreno... [toliau žr. visą tekstą] / There are many studies done to determine factors what can cause susceptibility to Sjögren's syndrome. Despite intensive research of the immune system, the model of the Sjögren's syndrome pathogenesis is not completely clear. Lymphopenia is a common symptom found in the pSS patients. Numerous studies are performed in order to determine the causes of lymphopenia, but there is a lack of detailed studies to reveal which cell population counts increase or decrease. Scarce studies are done to associate the changes in the immune cell population and the expression of humoral factors in the peripheral blood of pSS patients. The aim of dissertation work was to investigate the changes of the components of the systemic immune response in the peripheral blood of patients with primary Sjögren's syndrome (pSS) with different manifestations of the disease. In this study, a comprehensive analysis of B, NK and T cell populations and humoral factors in the peripheral blood of pSS patients was performed. For the first time the expression of CD57 and CD27 markers on CD8+ T cell population was analyzed. For the first time Th17/Th1-like cells in the peripheral blood of pSS patients were identified and imbalance in the distribution of T helper cell population was revealed. It can be explained by the significant increase of Th17/Th1-like lymphocyte population. The levels of IL-27 and IL-35 in sera of pSS patients were measured (not in the model system) for the first time as well. Primary Sjögren’s... [to full text]

Visceral leishmaniasis is a severe systemic illness and early case management is important for the avoidance complications and control of the disease. Improving health workers’ knowledge on leishmaniasis is essential in improving the control programme. A quantitative, retrospective study of patient records and descriptive, explorative study of health care professionals’ knowledge on leishmaniasis were conducted. Data was collected from patient records (n=299) using a structured audit tool and from health care professionals (n=55) by means of a structured questionnaire. The study findings highlight that the commonest clinical manifestations of visceral leishmaniasis are fever and splenomegaly. Severe malnutrition and HIV co-infection contribute to mortality. The findings indicate the need for training to improve health care professionals’ awareness of visceral leishmaniasis. Leishmaniasis disease surveillance and support by the regional and district heath offices should be improved / Health Studies / M.A. Public Health (MPH)

In Lycia, Xanthos and its main sanctuary, the Letoon, have throughout centuries kept some very particular features which have survived intense cultural upheavals and influences both Persian and Greeks. The infrastructures and shape of the Letoon indicates that there is more to the sanctuary’s rituals and architecture than normalised Greek divinities and temples. Lycia, following the Persian invasion in the 540s, remained a remote region of the empire and benefited from an autonomous status. Nevertheless the outside contacts and cultural exchanges multiplied and intensified, especially with the Persian ruling class, but also with the Greeks who took an increasing part into the trade and artistic influence of Lycia. The most important city of the region, Xanthos was the focus of the Persian presence in Lycia but also at the spearhead of Hellenic influence in western Lycia. This underlying Greek presence became ever more pregnant under the rule of the last dynasts of Xanthos at the turn of the fourth century and under the rule of the Carian satraps under the power of whom Lycia was put in the 360s. The Hellenistic period only confirm the prior trend. To begin with, we are trying to define how the Persians had an impact on the Lycian culture and conclude that it was a great influential force but stayed somewhat limited to the higher classes of the Xanthian society. The parallel with the Greek influence is contrasting. The arrival of Greek trends was more insidious but also more widespread to the lower classes of society and lasted longer. We will conclude that none of those influences were imposed but rather chosen by the Xanthian society. We will continue by trying to understand how those cultural manifestations affected local religious beliefs. By exposing the successive evolutions of the Letoon and of the divinities residing here, we will see that the syncretic divinities of the Letoon kept a lot of their ancestral attributes and places of worship are keeping track with their sacred past. In this process we are trying to show that religion holds a peculiar place in a nation or a city’s culture. In this attempt we are concluding that religion is the most stable aspect of a local culture and is the recipient for the safeguard of a nation’s identity.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.