Influence of Sociodemographic, Behavioral and Other Health-Related Factors on Healthy Ageing Based on Three Operative Definitions.

OBJECTIVES: Healthy ageing (HA) is a key concept and highly desirable phenomenon in every ageing and already old societies. The aim of our study was to evaluate the influence of socio-economic conditions as well as life-style and other health-related factors on the WHO definition of HA. DESIGN, SETTING, PARTICIPANTS: The study used cross-sectional data of the PolSenior Project - nationwide research evaluating different aspects of ageing in Poland - which included 4'653 respondents aged 65 years and over. MEASUREMENTS: Data were collected by trained interviewers in respondents' homes. Three definitions of HA including or not the participants' chronic conditions were analyzed. RESULTS: The prevalence of HA appeared as high as 17.6% if none or 1 chronic disease was present and 42.8% if no information about chronic diseases was taken into account. The association between known health predictors (age, marital status, education, income) and HA was observed. Moreover, HA appeared in relation with indicators of physical functioning and lifestyle. There was a strong concordance between HA and the fair self-rated health (OR = 1.87; 1.99, and 2.74 for the 1st, 2nd and 3rd definitions, respectively) and opposite relation with self-reported need for help (OR = 0.15; 0.15; and 0.13, respectively). CONCLUSIONS: The HA definition based on no functional activity limitations, no cognitive impairment, no depressive symptoms, no more than one disease and being socially active seems to be a useful approach of HA.

The significance of motivation in periodontal treatment: the influence of adult patients' motivation on the clinical periodontal status.

UNLABELLED: Motivation plays an important role in the treatment process of chronic diseases, as treatment requires behavioural change and lifelong adherence to medical recommendations. Periodontitis is a good example of such health condition as to maintain good periodontal health patients have to adhere to a strict oral hygiene regimen. OBJECTIVE: To examine whether the motivation of patients suffering from chronic periodontitis influences their clinical periodontal condition. BASIC RESEARCH DESIGN: Cross sectional study. CLINICAL SETTING: Department of Periodontology and Oral Medicine, Dental University Clinic, Jagiellonian University, Krakow, Poland. PARTICIPANTS: 199 adult periodontal patients, aged 20-78 years. INTERVENTIONS: Questionnaire concerning patients' medical and dental history, modified Zychlinscy motivation assessment questionnaire, clinical periodontal examination. MAIN OUTCOME MEASURES: The extent of motivation. Periodontal status evaluated with the use of periodontal indices (API, BOP, CPITN). RESULTS: The mean motivation score was 57.4. The mean API and BOP values were 55.7% and 46.4%, respectively. For most of the patients the recorded CPITN value was 3. Correlations were observed between motivation and both API and BOP, and between API and BOP. CONCLUSION: Periodontal patients with greater motivation having better oral health (lower API and BOP) suggests an influence on the quality of their self-management of the disease (i.e. adherence to their oral hygiene regimen).

The significance of motivation in periodontal treatment: validity and reliability of the motivation assessment scale among patients undergoing periodontal treatment.

OBJECTIVE: The individual evaluation of patients' motivation should be introduced to the protocol of periodontal treatment, as it could impact positively on effective treatment planning and treatment outcomes. However, a standardised tool measuring the extent of periodontal patients' motivation has not yet been proposed in the literature. Thus, the objective of the present study was to determine the validity and reliability of the Zychlinscy motivation scale adjusted to the needs of periodontology. BASIC RESEARCH DESIGN: Cross sectional study. CLINICAL SETTING: Department of Periodontology and Oral Medicine, Dental University Clinic, Jagiellonian University, Krakow, Poland. PARTICIPANTS: 199 adult periodontal patients, aged 20-78. INTERVENTIONS: 14-item questionnaire. The items were adopted from the original Zychlinscy motivation assessment scale. MAIN OUTCOME MEASURES: Validity and reliability of the proposed motivation assessment instrument. RESULTS: The assessed Cronbach's alpha of 0.79 indicates the scale is a reliable tool. Principal component analysis revealed a model with three factors, which explained half of the total variance. Those factors represented: the patient's attitude towards treatment and oral hygiene practice; previous experiences during treatment; and the influence of external conditions on the patient's attitude towards treatment. CONCLUSION: The proposed scale proved to be a reliable and accurate tool for the evaluation of periodontal patients' motivation.

A Turkish family with Ellis-van Creveld syndrome in six siblings; linkage analysis on 4p16 region (D4S3360-D4S2366).

We present a Turkish family and their 6 children, consecutively affected by Ellis-van Creveld (EVC) Syndrome. Four of the affected children died in the postnatal period, and 2 of them had been admitted to the pediatric cardiology department for their cardiologic evaluation. Since they had the features of the EVC Syndrome, linkage analysis was performed with the polymorphic markers, D4S3360-D4S2366, selected from 4p 16 locus. There was complete segregation between the disease and marker allels and the two affected siblings were homozygote for the polymorphic markers, as expected in autosomal recessive inheritance. The diagnosis of EVC Syndrome was confirmed by this molecular analysis. Two cases with EVC were presented in this report. Case 1 had partial abnormal pulmonary venous return and pulmonary stenosis additional to ostium primum atrial septal defect and mitral cleft. Partial abnormal pulmonary venous return and pulmonary stenosis were previously not reported with EVC Syndrome. Postaxial polydactyly phenotype of the Case 2 differs from her brother's. There is bifid 5th metacarpal and unilateral (L) bifid middle and distal phalanges resembling syndactyly.

Childhood Guillain-Barré syndrome. MR imaging in diagnosis and follow-up.

PURPOSE: To evaluate the value of serially obtained spinal MR images in the diagnosis and clinical follow-up of childhood Guillain-Barré syndrome (GBS), and the time period for resolution of contrast enhancement during the course of illness. MATERIAL AND METHODS: Contrast-enhanced spinal MR images of 11 pediatric patients with GBS were reviewed prospectively. In the first group of 6 patients, follow-up MR was performed three times after the 1st, 3rd and 6th months after onset of the disease. In the second group (the other 5 patients) who had not accepted serial MR examinations, control MR was repeated once after 1 year. Patients were graded clinically into five categories according to their initial clinical signs and symptoms and three grades (mild, moderate and severe) according to level of contrast enhancement on T1-weighted images to correlate the severity of enhancement with clinical findings and recovery. RESULTS: Ten of the 11 patients revealed contrast enhancement in varying degrees in the spinal nerve roots surrounding the conus medullaris and extending the length of the cauda equina. One patient showed no contrast enhancement. Anterior nerve roots enhanced more intensely than the posterior roots in 3 patients. Follow-up MR images in all patients revealed diminishing or resolving contrast enhancement in the nerve roots as the clinical symptoms improved. CONCLUSION: We suggest contrast-enhanced spinal MR imaging as a supplementary diagnostic modality in diagnosing GBS, especially when the clinical and electrophysiological findings are equivocal. Follow-up images may play a role in predicting the clinical course of the disease.

Endovascular stent implantation in congenital heart defects.

We report the immediate and short-term results of endovascular stent implantations from our center. We performed stent implantations in four patients (3, 12, 18 and 20 years old) with different stenoses or obstructions: right ventricular outflow conduit obstruction, left Blalock-Taussig obstruction, post-operative recoarctation and cavopulmonary anastomosis obstruction. Stent were implanted successfully. The mean diameters of stenoses were expanded from 4.5 +/- 3.5 (2-7) mm to 9 +/- 1. 2 (8-10) mm, and the complaints of patients were improved significantly by stent implantation. There was no complication related to the procedures. All patients are living except one who died from cerebrovascular event unrelated to the stent implantation. The mean follow-up period of three living patients is 6.3 +/- 5.5 (1-2) months. As of the last control, all have remained at the caliber achieved at original placement. In light of our limited experience and previous reported studies, we conclude that intravascular stents are safe and can be used effectively in selected patients with congenital heart defects.

Serum zinc, copper, and magnesium levels in obese children.

Serum zinc, copper and magnesium levels were measured using atomic absorption spectrophotometry in 41 obese and 41 healthy (control) children (between 7 and 11 years of age) who were living in Malatya (Turkey). Serum zinc levels of obese children (mean value 102.40 +/- 2.78 micrograms/dL) were found to be significantly higher than those of the control group (mean value 80.49 +/- 2.98 micrograms/dL; P < 0.01). Serum copper concentrations were also found to be significantly higher in obese children (mean value 132.34 +/- 1.79 micrograms/dL) than the healthy controls (mean value 107.58 +/- 1.62 micrograms/dL; P < 0.01). On the other hand, serum magnesium levels were found to be significantly lower in obese children (mean value 1.78 +/- 0.03 mg/dL) than in the healthy children (mean value 2.14 +/- 0.04 mg/dL; P < 0.01).

Absent pulmonary valve syndrome with agenesis of the left pulmonary artery.

Absent pulmonary valve syndrome is represented by rudimentary nodules without identifiable leaflets, and it is commonly associated with a ventricular septal defect and tetralogy of Fallot. Unilateral absence of a pulmonary artery is also a rare congenital anomaly. The following is a case report of a one-day-old newborn with cyanosis. The physical examination revealed a to-and-fro murmur and no expansion of the left hemithorax. Echocardiography revealed tetralogy of Fallot, absent pulmonary valve, and enlarged main and right pulmonary arteries. The catheterization and angiography confirmed the diagnosis and absence of the left pulmonary artery.