Nitrate and nitrite exposure in Italian populations with different gastric cancer rates.

Exposure to nitrate and nitrite from dietary sources was estimated by questionnaire and measurement of salivary levels of the ions in residents of four regions of Italy with longstanding, contrasting, gastric cancer mortality rates. Whether using salivary levels or dietary questionnaire estimations no association was found between nitrate and nitrite exposure and gastric cancer mortality rates. For salivary nitrate and nitrite, the intra-provincial variation was greater than any inter-province difference. However, for dietary nitrate and nitrite intakes, there were significant differences between the regional groups (but not related to gastric cancer risk). Despite the limitations of the methods used, there was a weak positive association between salivary concentrations of nitrate and questionnaire assessment. Dietary factors are likely to play key roles at different stages of the gastric carcinogenic process. Nitrate may play a part but is unlikely to be a rate-limiting factor in all individuals or populations.

Validation of clinical measurement of kyphosis with a simple instrument, the arcometer.

STUDY DESIGN: Evaluation of concordance between different clinical surface measurements and radiographic measurements of kyphosis. OBJECTIVES: To validate a new instrument, the Arcometer, in the clinical assessment of kyphosis. SUMMARY OF BACKGROUND DATA: Although a few instruments are available that are designed to study the spine in the sagittal plane, they usually are not simple to use, and radiographic concordance data, when reported, are not optimal. METHODS: One hundred forty-five outpatients with different degrees of kyphosis were submitted to 1) spinal radiography and Arcometer evaluation (32 patients, 53 measurements); 2) Arcometer evaluation by two different observers (95 patients, 123 measurements); and 3) Arcometer evaluation by the same observer at two different times (16 patients, 56 measurements). RESULTS: The mean difference between the radiographic and Arcometer values was 2.9 degrees, whereas the interobserver difference was 1.1 degrees and intraobserver difference was 0.1 degree; the linear correlation between the first and the second measurement in the three groups was higher than 0.98. However, the standard deviation was rather wide- 8.8 degrees in sample one, 5.6 degrees in sample two, and 5.7 degrees in sample three. CONCLUSIONS: The Arcometer is a practical and reasonably reliable instrument. However, there is considerable disagreement with radiography and some interobserver and intraobserver variability. The arcometer may be useful in following patients with known kyphosis and in the general population screening to decrease x-ray exposure.

New tridimensional approach to the evaluation of the spine through surface measurement: the BACES system.

The aim was to test a new instrument, the BACES system, an articulated arm connected to a computer, to improve noninvasive examination of the spine and to reduce X-ray examinations. To this aim, four observers performed three series of eight measurements on a dummy and two healthy volunteers. Data on the projection of the spine, any curve detectable on the frontal and sagittal plane, and any rotation at each thoracolumbar level were collected and analysed. To detect the role of the observer, of the procedure and of the object in measurement variability, a two-factor analysis of variance was performed. The results showed measurement errors for kyphosis and scoliosis generally below 3 degrees, whereas the lordosis showed a major variability, especially in volunteers, because of the attitude role. Rotations showed a limited variability too, generally below 2 degrees. In the clinical setting, > 2 SD may reasonably be considered a clinical change because it has not a great chance of being a measurement error. Thus, the BACES system allowed us to identify with fairly good precision kyphosis, scoliosis and trunk rotations. Even though at the moment no surface measurement method can replace X-rays, the instrument can integrate and limit the use of radiographic evaluations.

Neonatal and post-neonatal onset of early congenital syphilis: a report from Mozambique.

Congenital syphilis (CS) has been and continues to be a principal public health problem in developing countries. Despite the wide experience acquired, physicians still have problems in diagnostic evaluation. We report 145 cases of CS at the Central Hospital, Maputo, emphasizing the differences in clinical features and in the results of serological and X-ray examinations between the neonatal and post-neonatal age groups. In the post-neonatal age group, the clinical expression of CS is mostly overt. It is commonly recognized that manifestations of CS in the neonatal age group are often poor or negative, yet a relevant percentage of CS that we report were fully symptomatic. In the neonatal age, the Venereal Disease Research Laboratory (VDRL) test in the mother and characteristic osteochondritic lesions on X-ray examination of the long bones help to make the diagnosis; in the post-neonatal age group, the VDRL test in the child is more often positive than in the mother and X-ray examination shows most periostitic lesions.

PIP: Even though congenital syphilis (CS) has been and remains a key public health problem in developing countries, physicians continue to have trouble diagnosing it. Experience with 145 cases of CS reported over the period May 1989-May 1990 at the Central Hospital in Maputo are discussed with particular emphasis and attention given to differences in clinical features and in the results of serological and X-ray examinations between neonatal and post-neonatal age groups. 51% of the newborns were diagnosed with CS on the basis of clinical features of systemic congenital infection; the diagnosis of remaining cases was based upon history or isolated and nonspecific signs such as fever, low birth weight for gestational age, or skin lesions. Condition characteristics were mostly overtly expressed among the post- neonates. While it may be commonly recognized that manifestations of CS among neonates tend to be poor or negative, analysis of the data found a relevant percentage of subjects to be fully symptomatic. The Venereal Disease Research Laboratory (VDRL) test in the mother and characteristic osteochondritic lesions on X-ray examination of the long bones help make the diagnosis at neonatal age. Among post-neonates, the VDRL test in the child is more often positive than in the mother and X-rays show most periostitic lesions.

[Dental caries in a group of Carnia children. Epidemiological study]. / Carie dentarie in un campione di bambini della Carnia. Studio epidemiologico.

The purpose of the research is to analyse the prevalence of dental caries of children living in Carnia divided into 2 groups, one of which was treated with fluoride tablets since the first months of life. In the considered area there is a reduction of dental caries even if the problem remains a major one. The prevention programme, based on collaboration with relatives from the first months of their babies, can be considered a valid operative support.