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The aim of the study was to determine whether two postpartum intramuscular treatments with 200 mg of beta-(ß-)carotene (Carofertin; Alvetra u. Werfft, Vienna, Austria) in a 14-day interval increases ß-carotene concentrations in blood, particularly around the time of the first artificial insemination (AI), and to test the effect of the treatment on fertility parameters, luteal size, and progesterone blood levels of dairy cows. A total of 297 Holstein dairy cows were enrolled in the study. Between 28 and 34 days postpartum (dpp) ß-carotene concentrations were measured in blood samples using an on-site test (iCheck carotene; BioAnalyt, Teltow, Germany). Cows with a ß-carotene concentration <3.5 mg/L, indicating a deficiency of ß-carotene, were allocated either to the ß-carotene treatment group BCT (n = 123) or to the control group CON (n = 121). Cows with concentrations ≥3.5 mg/L were assigned to an optimally supplied reference group (REF; n = 53). Cows in the BCT group received 200 mg of ß-carotene intramuscularly at 28-34 dpp and at 42-48 dpp. Further blood samples were collected at 35-41 dpp, 42-48 dpp, 49-55 dpp, and in the week after the first AI and their ß-carotene concentrations were analyzed. Between day 10 and 14 after the first AI, the blood progesterone concentration was measured and the size of the corpus luteum (CL) was determined by ultrasound. Blood ß-carotene concentrations increased in the BCT cows in the week after the treatment with a peak at 49-55 dpp and were significantly higher than in the CON group at each time point after the first treatment. Logistic regression models, however, revealed that the treatment with ß-carotene had no effect on first service conception rate, days to first service, time to pregnancy, or percentage of pregnant cows within 150 dpp. Furthermore, there was no effect on progesterone concentration or the size of the CL between the groups. In conclusion, two treatments with Carofertin postpartum increased ß-carotene blood concentrations but had no effect on the fertility parameters in this study.
Assuntos
beta Caroteno/administração & dosagem , Animais , Bovinos , Corpo Lúteo/efeitos dos fármacos , Esquema de Medicação , Feminino , Hemangioma , Modelos Logísticos , Progesterona/sangue , beta Caroteno/sangue , beta Caroteno/farmacologiaRESUMO
OBJECTIVES: In this investigation, biased questionnaire response anchors were designed to indirectly manipulate respondents' estimates of their peers' stereotypic beliefs or the estimates of scientific research findings about individuals with obesity. The current study tested the hypothesis that biased response anchors could influence personal beliefs about obesity. METHODS: Two-hundred adults participated in the study. A simple manipulation of questionnaire items (i.e., asking respondents to estimate peers' beliefs or scientific research findings) using biased response scale anchors was designed to subtly relay information about certain personality traits of individuals with obesity. RESULTS: The anchor manipulation significantly influenced participants' immediate and follow-up weight biased beliefs as well as participants' evaluation of an obese job applicant's potential for employment. CONCLUSION: Social judgments about obese individuals may be susceptible to subtle manipulation of response anchors and may be impacted by the source of comparison information (e.g., peers; scientific research).
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Atitude , Comunicação , Julgamento , Obesidade , Preconceito , Estereotipagem , Inquéritos e Questionários , Adolescente , Adulto , Viés , Peso Corporal , Cultura , Feminino , Humanos , Masculino , Sobrepeso , Influência dos Pares , Personalidade , Pesquisa , Adulto JovemRESUMO
Current measures of internalized weight bias assess factors such as responsibility for weight status, mistreatment because of weight, etc. A potential complementary approach for assessing internalized weight bias is to examine the correspondence between individuals' ratings of obese people, normal weight people, and themselves on personality traits. This investigation examined the relationships among different measures of internalized weight bias, as well as the association between those measures and psychosocial maladjustment. Prior to the beginning of a weight loss intervention, 62 overweight/obese adults completed measures of explicit and internalized weight bias as well as body image, binge eating, and depression. Discrepancies between participants' ratings of obese people in general and ratings of themselves on both positive and negative traits predicted unique variance in measures of maladjustment above a traditional assessment of internalized weight bias. This novel approach to measuring internalized weight bias provides information above and beyond traditional measures of internalized weight bias and begins to provide insights into social comparison processes involved in weight bias.
Assuntos
Imagem Corporal , Mecanismos de Defesa , Sobrepeso/psicologia , Estigma Social , Estereotipagem , Adolescente , Adulto , Idoso , Peso Corporal , Bulimia/psicologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Preconceito , Autoimagem , Inquéritos e Questionários , Redução de PesoRESUMO
PURPOSE: Intensity Modulated Neutron Radiotherapy (IMNRT) has been commissioned for clinical use. The number of allowable segments in IMNRT plans is limited by MLC speed. Quality and deliverability of static IMNRT treatment plans using the TG-119 test suite were evaluated to establish guidelines for the number of segments per plan. METHODS: Treatment plans were created and optimized to specified constraints for all cases in the TG-119 test suite using the Varian Eclipse TPS. A 4MV photon beam with similar penetration characteristics as the fast neutron beam was used as a surrogate for this optimization. Final dose calculations were performed using an in-house TPS commissioned for neutron dose calculations. Following optimization, MLC segments were created for three ranges of total plan complexity - very limited (15-23 segments), limited (24- 31 segments), and unlimited. Calculated DVHs were then compared for compliance with TG-119 dose constraints. The estimated time of delivery for plans in each range was calculated based on known delivery parameters. RESULTS: The prostate case passes all constraints for each complexity level. All other plans fail to meet at least one constraint for one or more of the complexity levels. For all cases combined, the very limited, limited, and unlimited complexity levels meet 16, 17, and 19 of 23 total dose constraints, respectively. The mean estimated delivery time for the very limited, limited, and unlimited plans is 34 minutes (range: 27-39), 40 minutes (range: 34-45), and 68 minutes (range: 53-81) respectively, neglecting any delay due to therapists entering the treatment room. CONCLUSION: IMNRT plan quality is limited by current MLC capabilities. IMNRT plans should be limited to 25 segments to ensure a reasonable treatment time of 45 minutes. Even with this small number of segments, we were able to meet most dose constraints set forth in TG-119.
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The education of medical physicists has historically been quite varied and medical physicists have entered the field through several pathways including specialized educational programs, postdoctoral fellowships, and on-the-job training. It is argued that the contributions of viewpoints from different branches of physics has contributed to the development of novel solutions and advances in radiation oncology. However, there also has been an effort recently to make graduate education of medical physicists more consistent and uniform, particularly for the preparation of clinically oriented therapy physicists. The trend towards a more systematic approach has been guided in part by the requirements for graduate program accreditation developed by CAMPEP and by the requirements for medical physicist certification by the ABR. At the same time, there has been criticism of this approach as being too confining and guiding graduates toward a career as technicians rather than independent thinkers. Educational programs have had to balance the requirements of accreditation and certification against the goal of preparing students for careers as independent researchers. Three speakers will describe the approaches taken by their graduate educational programs to meet the requirements of CAMPEP and adequately prepare graduates for certification by the ABR, while maintaining a commitment to providing a comprehensive education in medical physics. LEARNING OBJECTIVES: 1. Understand the requirements for graduate program accreditation 2. Understand the education and experience requirements for certification 3. Learn the approaches taken by several graduate programs to meet the requirements for accreditation and certification while providing a comprehensive education in medical physics.
RESUMO
L-glutamate (Glu) is the predominant excitatory neurotransmitter in the mammalian central nervous system. It plays major roles in normal neurophysiology and many brain disorders by binding to membrane-bound Glu receptors. To overcome the spatial and temporal limitations encountered in previous in vivo extracellular Glu studies, we employed enzyme-coated microelectrode arrays to measure both basal and potassium-evoked release of Glu in the anesthetized rat brain. We also addressed the question of signal identity, which is the predominant criticism of these recording technologies. In vivo self-referencing recordings demonstrated that our Glu signals were both enzyme- and voltage-dependent, supporting the identity of L-glutamate. In addition, basal Glu was actively regulated, tetrodotoxin (TTX)-dependent, and measured in the low micromolar range (approximately 2 microm) using multiple self-referencing subtraction approaches for identification of Glu. Moreover, potassium-evoked Glu release exhibited fast kinetics that were concentration-dependent and reproducible. These data support the hypothesis that Glu release is highly regulated, requiring detection technologies that must be very close to the synapse and measure on a second-by-second basis to best characterize the dynamics of the Glu system.
Assuntos
Encéfalo/metabolismo , Ácido Glutâmico/metabolismo , Potássio/metabolismo , Sinapses/metabolismo , Transmissão Sináptica/fisiologia , Anestésicos/farmacologia , Animais , Artefatos , Encéfalo/efeitos dos fármacos , Relação Dose-Resposta a Droga , Eletroquímica/instrumentação , Eletroquímica/métodos , Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Líquido Extracelular/efeitos dos fármacos , Líquido Extracelular/metabolismo , Masculino , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Microeletrodos/normas , Neuroquímica/instrumentação , Neuroquímica/métodos , Potássio/farmacologia , Ratos , Ratos Endogâmicos F344 , Tempo de Reação/efeitos dos fármacos , Tempo de Reação/fisiologia , Bloqueadores dos Canais de Sódio/farmacologia , Canais de Sódio/efeitos dos fármacos , Canais de Sódio/metabolismo , Sinapses/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacosRESUMO
Californium-252 is a neutron-emitting radioisotope used as a brachytherapy source for radioresistant tumors. Presented here are microdosimetric spectra measured as a function of simulated site diameter and distance from applicator tube 252Cf sources. These spectra were measured using miniature tissue-equivalent proportional counters (TEPCs). An investigation of the clinical potential of boron neutron capture (BNC) enhancement of 252Cf brachytherapy is also provided. The absorbed dose from the BNC reaction was measured using a boron-loaded miniature TEPC. Measured neutron, photon and BNC absorbed dose components are provided as a function of distance from the source. In general, the absorbed dose results show good agreement with results from other measurement techniques. A concomitant boost to 252Cf brachytherapy may be provided through the use of the BNC reaction. The potential magnitude of this BNC enhancement increases with increasing distance from the source and is capable of providing a therapeutic gain greater than 30% at a distance of 5 cm from the source, assuming currently achievable boron concentrations.
Assuntos
Terapia por Captura de Nêutron de Boro/métodos , Braquiterapia/métodos , Califórnio/uso terapêutico , Radiometria/métodos , Análise Espectral/métodos , Terapia Combinada , Estudos de Viabilidade , Dosagem RadioterapêuticaRESUMO
Intensity modulated neutron radiotherapy (IMNRT) is currently being investigated as a mechanism to improve dose conformality in neutron radiotherapy, thereby minimizing normal tissue toxicity. This study investigates the applicability of two different dose calculation algorithms for IMNRT, a commercial system which utilizes a finite size pencil beam (FSPB) model, and an in-house planning system which uses a differential scatter air ratio (DSAR) method. Calculated dose distributions were compared with measured profiles for validation purposes. The beam-profiles matched to within +/-3% in the central region of the field. The 80-20% penumbra width as measured using an ionization chamber varied as 0.6 cm and 1.0 cm for 3 x 3 and 10 x 10 cm2 profile at a depth of 2.5 cm. The FSPB model fitted the data to a penumbra width of 0.1 cm for both 3 x 3 and 10 x 10 cm2 profiles. These results indicate that the commercial system needs further investigation. However, the in-house planning system has been validated for small irregular fields for IMNRT to an accuracy of +/-5%. Absolute dose measurements agreed with the calculated doses to within +/-3%.
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Nêutrons/uso terapêutico , Planejamento da Radioterapia Assistida por Computador , Radioterapia Assistida por Computador/métodos , Radioterapia Conformacional/instrumentação , Radioterapia Conformacional/métodos , Algoritmos , Calibragem , Humanos , Íons , Modelos Estatísticos , Modelos Teóricos , Método de Monte Carlo , Fótons , Radiometria , Radioterapia/métodos , Dosagem Radioterapêutica , SoftwareRESUMO
The use of steam in sterilization processes is limited by the implementation of heat-sensitive components inside the machines to be sterilized. Alternative low-temperature sterilization methods need to be found and their suitability evaluated. Vaporized Hydrogen Peroxide (VHP) technology was adapted for a production machine consisting of highly sensitive pressure sensors and thermo-labile air tube systems. This new kind of "cold" surface sterilization, known from the Barrier Isolator Technology, is based on the controlled release of hydrogen peroxide vapour into sealed enclosures. A mobile VHP generator was used to generate the hydrogen peroxide vapour. The unit was combined with the air conduction system of the production machine. Terminal vacuum pumps were installed to distribute the gas within the production machine and for its elimination. In order to control the sterilization process, different physical process monitors were incorporated. The validation of the process was based on biological indicators (Geobacillus stearothermophilus). The Limited Spearman Karber Method (LSKM) was used to statistically evaluate the sterilization process. The results show that it is possible to sterilize surfaces in a complex tube system with the use of gaseous hydrogen peroxide. A total microbial reduction of 6 log units was reached.
Assuntos
Desinfetantes/química , Peróxido de Hidrogênio/química , Esterilização , Umidade , Indicadores e Reagentes , Modelos Teóricos , TemperaturaRESUMO
Multisite microelectrode arrays designed for electrochemical measures of neurochemicals in CNS tissues are presented. The arrays have platinum recording sites insulated with polyimide on a ceramic substrate. Most designs include 4 recording sites, however arrays with 5 to 8 recording sites have been fabricated. Enzyme coatings have been developed to measure glutamate, choline, lactate, and glucose. Electroactive compounds such as dopamine, norepinephrine, and O/sub 2/ can also be measured. The multiple recording sites can be exploited for interferent or noise removal and measures of multiple compounds using a single microelectrode array.
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Sistema Nervoso Central/metabolismo , Ácido Glutâmico/metabolismo , Aminoácido Oxirredutases , Animais , Técnicas Biossensoriais , Sistema Nervoso Central/efeitos dos fármacos , Cerâmica , Eletroquímica , Antagonistas de Aminoácidos Excitatórios/farmacologia , Cinética , Microeletrodos , Ratos , Tetrodotoxina/farmacologiaRESUMO
Antiphospholipid antibodies are commonly found in patients with systemic lupus erythematosus or the antiphospholipid syndrome, and a subset of such antibodies is associated with prothrombotic events such as stroke and with adverse pregnancy outcomes and fetal loss. We examined sera from 411 patients who were clinically characterized as to their periodontal disease status for serum levels of beta2-glycoprotein I-dependent anti-cardiolipin autoantibodies (anti-CL). The prevalence of patients with chronic periodontitis (CP) and generalized aggressive periodontitis (GAgP) positive for anti-CL (16.2% and 19.3%, respectively) was greater than that in healthy controls (NP) and localized aggressive periodontitis (LAgP) patients (6.8% and 3.2%). Patients with these autoantibodies demonstrated increased pocket depth and attachment loss compared with patients lacking the antibodies. Analysis of the data indicates that patients with generalized periodontitis have elevated levels of autoantibodies reactive with phospholipids. These antibodies could be involved in elevated risk for stroke, atherosclerosis, or pre-term birth in periodontitis patients.
Assuntos
Anticorpos Anticardiolipina/sangue , Periodontite/sangue , Periodontite/imunologia , Adulto , Análise de Variância , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Índice PeriodontalRESUMO
IgG2 is elevated in localized but not in generalized aggressive periodontitis (AgP). Exposure to pathogenic bacteria is essential for disease. Immune responses are dominated by IgG2 reactive with bacterial surface carbohydrates. We used variance component analyses to assess IgG2 heritability and determine whether genes that influence IgG2 are the same genes that influence disease susceptibility. We studied 17 Caucasian and 43 African American families with two or more localized or generalized AgP-affected members (274 subjects with IgG2 measurements). Only 16% of the variance in IgG2 was attributable to age, race, and smoking. Even with the addition of localized AgP, the model still explained only 19% of IgG2 variance. By contrast, heritability of IgG2 levels was estimated to be 38% and highly significant (P = 0.0006), demonstrating a substantial genetic basis. Bi-trait variance component analyses of IgG2 and quantitative measures of AgP indicate that different genes appear to control IgG2 levels and disease susceptibility.
Assuntos
Imunoglobulina G/genética , Periodontite/genética , Adolescente , Adulto , Fatores Etários , Idoso , População Negra/genética , Feminino , Predisposição Genética para Doença , Variação Genética/genética , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/genética , Perda da Inserção Periodontal/imunologia , Periodontite/imunologia , Fatores de Risco , Fumar/genética , Fumar/imunologia , População Branca/genéticaRESUMO
Classical microdosimetry concerns the measurement and analysis of the spectrum of radiation energy deposition events in simulated microscopic tissue-equivalent sites. Over the past three decades, classical microdosimetry has been extensively applied for the direct measurement of dosimetric quantities, such as the ambient dose equivalent, and for the spectroscopic properties of tissue-equivalent proportional counters that have led to methods of mixed-field analysis and particle identification. This paper reviews some of the special applications of classical microdosimetry such as the determination of kerma coefficients, differential dosimetry and aviation dosimetry. Also reviewed are some of the technological innovations related to the application of microdosimetry in operational health physics and in particular the development of multi-element proportional counters and detectors based on gas microstrip technology.
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Proteção Radiológica/métodos , Radiometria/métodos , Relação Dose-Resposta à Radiação , Física Médica/instrumentação , Física Médica/métodos , Monitoramento de Radiação/instrumentação , Monitoramento de Radiação/métodos , Proteção Radiológica/instrumentação , Radiometria/instrumentaçãoRESUMO
Boron neutron capture therapy (BNCT) is a bimodal radiation therapy used primarily for highly malignant gliomas. Tissue-equivalent proportional counter (TEPC) microdosimetry has proven an ideal dosimetry technique for BNCT, facilitating accurate separation of the photon and neutron absorbed dose components, assessment of radiation quality and measurement of the BNC dose. A miniature dual-TEPC system has been constructed to facilitate microdosimetry measurements with excellent spatial resolution in high-flux clinical neutron capture therapy beams. A 10B-loaded TEPC allows direct measurement of the secondary charged particle spectrum resulting from the BNC reaction. A matching TEPC fabricated from brain-tissue-equivalent plastic allows evaluation of secondary charged particle spectra from photon and neutron interactions in normal brain tissue. Microdosimetric measurements performed in clinical BNCT beams using these novel miniature TEPCs are presented, and the advantages of this technique for such applications are discussed.
Assuntos
Terapia por Captura de Nêutron de Boro/métodos , Neoplasias/radioterapia , Humanos , Sensibilidade e EspecificidadeRESUMO
A dual miniature tissue-equivalent proportional counter (TEPC) system has been developed to facilitate microdosimetry for Boron Neutron Capture Therapy (BNCT). This system has been designed specifically to allow the analysis of the single event charged particle spectrum in phantom in high intensity BNCT beams and to provide this microdosimetric information with excellent spatial resolution. Paired A-150 and 10B-loaded A-150 TEPCs with 12.3 mm3 collecting volumes have been constructed. These TEPCs allow more accurate neutron dosimetry than current techniques, offer a direct measure of the boron neutron capture dose, and provide a framework for predicting the biological effectiveness of the absorbed dose. Design aspects and characterization of these detectors are reviewed, along with an exposition of the advantages of microdosimetry using these detectors over conventional dosimetry methods. In addition, the utility of this technique for boron neutron capture enhancement of fast neutron therapy (BNCEFNT) is discussed.
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Terapia por Captura de Nêutron de Boro , Nêutrons Rápidos/uso terapêutico , Radiometria/instrumentação , Fenômenos Biofísicos , Biofísica , Boro , Desenho de Equipamento , Humanos , Miniaturização , Imagens de Fantasmas , Radiometria/estatística & dados numéricos , Planejamento da Radioterapia Assistida por Computador/instrumentação , Planejamento da Radioterapia Assistida por Computador/estatística & dados numéricosRESUMO
Antibodies reactive with phosphorylcholine (PC) are ubiquitous in human sera, but the antigens stimulating their production and their function are not clear. Previous studies have shown that a significant proportion of dental plaque bacteria contain PC as determined by reactivity with PC-specific mouse myeloma proteins and monoclonal antibodies. Additionally, serum antibody concentrations of immunoglobulin (IgG) G anti-PC are higher in sera of individuals who have experienced periodontal attachment loss than those who are periodontally healthy. These data implicate the oral microflora as a source of antigen-stimulating anti-PC responses. Recent data also indicate that antibodies with specificity for PC are elevated in ApoE-deficient mice, a model for studies of athersclerosis, and that such antibodies bound oxidized low-density lipoproteins (LDL) (oxLDL) in atherosclerotic plaques. These data prompted the hypothesis that human anti-PC could bind to both oral bacteria and human oxLDL, and that these antigens are cross-reactive. We therefore examined the ability of human anti-PC to bind to PC-bearing strains of oral bacteria using enzyme-linked immunosorbent inhibition assays and by assessment of direct binding of affinity-purified human anti-PC to PC-bearing Actinobacillus actinomycetemcomitans. Our results indicated that PC-bearing strains of Streptococcus oralis, Streptococcus sanguis, Haemophilus aphrophilus, Actinomyces naeslundii, Fusobacterium nucleatum, and A. actinomycetemcomitans, as well as a strain of Streptococcus pneumoniae, absorbed up to 80% of anti-PC IgG antibody from human sera. Furthermore, purified anti-PC bound to a PC-bearing strain of A. actinomycetemcomitans but only poorly to a PC-negative strain. OxLDL also absorbed anti-PC from human sera, and oxLDL but not LDL reacted with up to 80% of the anti-PC in human sera. Furthermore, purified anti-PC bound directly to oxLDL but not to LDL. The data indicate that PC-containing antigens on a variety of common oral bacteria are cross-reactive with neoantigens expressed in oxLDL. We propose that PC-bearing dental plaque microorganisms may induce an antibody response to PC that could influence the inflammatory response associated with atherosclerosis.
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Placa Dentária/microbiologia , Lipoproteínas LDL/imunologia , Fosforilcolina/imunologia , Actinomyces/imunologia , Aggregatibacter actinomycetemcomitans/imunologia , Anticorpos Antibacterianos/imunologia , Bactérias/imunologia , Reações Cruzadas , Fusobacterium nucleatum/imunologia , Haemophilus/imunologia , Humanos , Streptococcus oralis/imunologia , Streptococcus sanguis/imunologiaRESUMO
A self-referencing technique utilizing two microelectrodes on a ceramic-based multisite array is employed for confirmation and elimination of interferences detected by enzyme-based microelectrodes. The measurement of L-glutamate using glutamate oxidase was the test system; however, other oxidase enzymes such as glucose oxidase can be employed. One recording site was coated with Nafion with L-glutamate oxidase and bovine serum albumin (BSA) cross-linked with glutaraldehyde while the other had Nafion with BSA cross-linked with glutaraldehyde. Differences in the chemistry of the two recording sites allowed for identification and elimination of interfering signals to be removed from the analyte response. The electrode showed low detection limits (LOD = 0.98 +/- 0.09 microM, signal-to-noise ratio of 3), fast response times (T90 approximately 1 s), and excellent linearity (R2 = 0.999 +/- 0.000) over the concentration range of 0-200 microM for calibrations of L-glutamate in vitro. The selectivity and dimensions of the multisite electrode allow in vivo glutamate measurements. This electrode has been applied to in vivo measurements of the clearance of locally applied glutamate and release of glutamate in the prefrontal cortex of anesthetized rats. In addition, a aimilar approach has been applied to the development of a microelectrode for measures of glucose.
Assuntos
Ácido Glutâmico/análise , Aminoácido Oxirredutases , Animais , Química Encefálica , Cerâmica , Enzimas Imobilizadas , Glucose/análise , Glucose Oxidase , Ácido Glutâmico/metabolismo , Indicadores e Reagentes , Microeletrodos , Córtex Pré-Frontal/química , Córtex Pré-Frontal/metabolismo , Ratos , Ratos Endogâmicos F344 , Soroalbumina BovinaRESUMO
The mean age at which the diagnosis of growth disorders such as Turner's syndrome, growth hormone (GH) deficiency or true GH-dependent gigantism is established is still rather late in many countries around the world. In addition, the question of secular trends in a given population and the rate at which childhood obesity is increasing in industrialized countries make it mandatory to establish a time-adapted system to develop percentiles for body height, weight and body mass index (BMI) and also to develop a screening system for growth disorders. In 1998 we established a network, now involving more than 160 paediatric practices in Germany and seven paediatric endocrinology departments. Paediatricians record heights, weights and growth velocities of all children in their care and systematically feed the data into the database at our centre usually by mailing formatted, structured data tickets. Data are then continuously analysed at the centre and the paediatricians in the network are informed immediately about their individual patients' growth situations via phone or E-mail (feedback system). Regular annual conferences including structured reports, scientific presentations and discussion groups are organized for all participants at our centre. By May 2001, the data of 83,721 children and adolescents had been analysed. The mean values for height were 1-1.5 cm higher than the mean values in the German Synthetic Growth Curve, which serves as an internal standard. However, and most importantly, in comparison with the internal standard and historical normative data from Germany and Switzerland, there is a continuous increase in the 97th percentile for weight and BMI, while the third percentile remains unchanged. In addition, many children with short stature and tall stature due to a variety of endocrine disorders and genetic diseases which had not been diagnosed previously are now being identified. In conclusion, the databank allows for a continuous adaptation of normative curves based on a large number of children in a given population, i.e. eastern Germany. Secondly, the system allows for detection of pathological growth curves and is already serving to diagnose growth disorders in a defined population in a systematic way.
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Desenvolvimento Infantil , Redes de Comunicação de Computadores , Diagnóstico por Computador , Transtornos do Crescimento/diagnóstico , Programas de Rastreamento , Adolescente , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Valores de ReferênciaRESUMO
BACKGROUND: A few previous studies have suggested that risk for adult periodontitis (AP) has a genetic (heritable) component. We estimated genetic and environmental variances and heritability for gingivitis and adult periodontitis using data from twins reared together. METHODS: One hundred seventeen (117) pairs of adult twins (64 monozygotic [MZ] and 53 dizygotic [DZ] pairs) were recruited. Probing depth (PD), attachment loss (AL), plaque, and gingivitis (GI) were assessed on all teeth by two examiners. Measurements were averaged over all sites, teeth, and examiners. Extent of disease in subjects was defined at four thresholds: the percentage of teeth with AL > or = 2, AL > or = 3, PD > or = 4, or PD > or = 5 mm. Genetic and environmental variances and heritability were estimated using path models with maximum likelihood estimation techniques. RESULTS: MZ twins were more similar than DZ twins for all clinical measures. Statistically significant genetic variance was found for both the severity and extent of disease. AP was estimated to have approximately 50% heritability, which was unaltered following adjustments for behavioral variables including smoking. In contrast, while MZ twins were also more similar than DZ twins for gingivitis scores, there was no evidence of heritability for gingivitis after behavioral covariates such as utilization of dental care and smoking were incorporated into the analyses. CONCLUSIONS: These results confirm previous studies and indicate that approximately half of the variance in disease in the population is attributed to genetic variance. The basis for the heritability of periodontitis appears to be biological and not behavioral in nature.