Sex-specific association between obesity and self-reported falls and injuries among community-dwelling Canadians aged 65 years and older.

This study investigated the relationship between body mass index (BMI) and falls among community-dwelling elderly. Results indicate that obesity is associated with increased falls and there appears to be a sex-specific difference with obese men at higher risk of falling. Obesity is identified as a risk factor for falls in men. INTRODUCTION: The prevalence of falls, fall-related injuries, and obesity has increased over the last decade. The objectives of this study were to investigate sex-specific association and dose-response relationship between BMI and falls (and related injuries) among community-dwelling elderly. METHODS: Our study sample consisted of 15,860 adults aged 65 years or older (6399 men and 9461 women) from the 2008-2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA). Falls, fall-related injuries, and BMI measures were self-reported. For both sex, dose-response curves presenting the relationship between BMI, falls, and fall-related injuries were first examined. Thereafter, multivariate logistic regression analyses were also performed to investigate these relationships after adjustment for potentially confounding variables. RESULTS: Of women, 21.7 % reported a fall and 16.9 % of men. The dose-response relationship between BMI and prevalence of falls showed that underweight and obese individuals reported falling more than normal and overweight individuals; this being more apparent in men than women. Finally, the dose relationship between BMI and prevalence of fall-related injuries showed that only obese men seem more likely to have sustained a fall-related injury. Results from the multivariate analysis showed that obesity in men was significantly associated with higher odds of falling odds ratio (OR) 1.33 (1.04-1.70) and was not significantly associated with higher odds of fall-related injuries OR 1.10 (0.66-1.84) over a 12-month period compared to normal weight men. For women, obesity was not significantly associated with higher fall prevalence OR 0.99 (0.79-1.25) and fall-related injuries OR 0.71 (0.51-1.00). CONCLUSION: Obesity is associated with self-reported falls, and there appears to be a sex-specific difference in elderly persons.

Validity Assessment of an Automated Brain Morphometry Tool for Patients with De Novo Memory Symptoms.

BACKGROUND AND PURPOSE: Automated volumetric analysis of structural MR imaging allows quantitative assessment of brain atrophy in neurodegenerative disorders. We compared the brain segmentation performance of the AI-Rad Companion brain MR imaging software against an in-house FreeSurfer 7.1.1/Individual Longitudinal Participant pipeline. MATERIALS AND METHODS: T1-weighted images of 45 participants with de novo memory symptoms were selected from the OASIS-4 database and analyzed through the AI-Rad Companion brain MR imaging tool and the FreeSurfer 7.1.1/Individual Longitudinal Participant pipeline. Correlation, agreement, and consistency between the 2 tools were compared among the absolute, normalized, and standardized volumes. Final reports generated by each tool were used to compare the rates of detection of abnormality and the compatibility of radiologic impressions made using each tool, compared with the clinical diagnoses. RESULTS: We observed strong correlation, moderate consistency, and poor agreement between absolute volumes of the main cortical lobes and subcortical structures measured by the AI-Rad Companion brain MR imaging tool compared with FreeSurfer. The strength of the correlations increased after normalizing the measurements to the total intracranial volume. Standardized measurements differed significantly between the 2 tools, likely owing to differences in the normative data sets used to calibrate each tool. When considering the FreeSurfer 7.1.1/Individual Longitudinal Participant pipeline as a reference standard, the AI-Rad Companion brain MR imaging tool had a specificity of 90.6%-100% and a sensitivity of 64.3%-100% in detecting volumetric abnormalities. There was no difference between the rate of compatibility of radiologic and clinical impressions when using the 2 tools. CONCLUSIONS: The AI-Rad Companion brain MR imaging tool reliably detects atrophy in cortical and subcortical regions implicated in the differential diagnosis of dementia.

Quebecers with celiac disease: analysis of dietary problems.

The only known treatment for celiac disease is lifelong avoidance of dietary gluten. For many sufferers from celiac disease, this may be difficult to achieve. The purpose of this study was to analyse dietary habits and related problems of adults afflicted with celiac disease. A questionnaire was mailed to 617 current and former members of the Quebec Celiac Foundation to document health, dietary habits, sources of celiac disease treatment information, daily concerns, and level of difficulty in complying with a gluten-free diet. The final sample size was 234 (75% female). Results indicated that over 35% of participants experienced intestinal discomfort at least twice a week. In addition, 66% felt that their consumption of grain products was insufficient. Only 44% said they had received from dietitians a large quantity of information about celiac disease treatment, and only 57% had a high level of confidence in the information received from dietitians. Thirty-six percent reported difficulty in complying with the gluten-free diet. According to a probit analysis, larger region of residence (p<0.02) and concern about preparing meals (p<0.005) were directly related to difficulty in complying, while older age (p<0.05), satisfaction with gluten-free products (p<0.01), and a high level of confidence in treatment information from gastroenterologists and dietitians (p<0.005) were inversely associated with compliance difficulty. Awareness of these results should encourage dietitians to improve their skills in treating celiac disease.

Pain and anxiety reduction using a manual stimulation distraction device when administering local analgesia oro-dental injections: a multi-center clinical investigation.

OBJECTIVE: This study was designed to assess the effects of a manual stimulating distraction device (Isoflex referred to as Manual Stimulation Distraction Device or MSDD) for reducing pain and anxiety experienced with standard dental local anesthetic injections. Additionally, the memory recall effects on injection pain and anxiety were also explored. METHODOLOGY: Patients from different dental clinics were identified by their practitioners as requiring dental procedures under local anesthesia, in the same area on both sides of the mouth. A local anesthetic solution was injected on either the left or right side at different times by random selection; one side using MSDD, while the opposite side used a solution without MSDD. Each patient acted as his or her own symmetrical split-mouth control. The same dentist administered both injections, using identical technique and equipment for each side. Forty-six patients used the MSDD first with the injection, while 54 used MSDD second when they received the injection. Using 10-point visual analogue nominal and ordinal scales, pain and stress were recorded by the patient each time after receiving the injection. The results were pooled and subjected to statistical analysis. Student's paired t-test was employed to test for significant differences in pain and anxiety (stress) when injections were administered with and without MSDD. RESULTS: Results showed significant reductions in perceived pain and stress from local analgesia injections (p < 0.001) when MSDD was used. There was no correlation of pain reduction with age, gender, upper or lower jaw, with or without MSDD. There was a trend for pain and stress to be scored higher for those subjects who had a lower period since the first injection (POFI) scores. This was attributed to recent memory of pain, as POFI scores over one week were significantly lower (p < 0.05). Stress reduction for POFI scores greater than one week proved to be non-significant (p = 0.099). CONCLUSION: In this study, MSDD was effective at reducing pain and stress experienced with local regional analgesic injections.

The evolution of dental esthetics.

Dental esthetics has been based for a long time, on time-honoured theories where the restored or replaced teeth had to match the face shape while providing due respect to the sex, the age and the personality of the patient. Most of these theories have since been disproved and the standards of dental esthetics have been revised following surveys of naturally perfect smiles and patients' preferences. Guidelines are presented in a sequence of 5 easily applicable steps with the objective of creating the right smile for the right patient.

Immunological and biological properties of recombinant Lol p 1.

BACKGROUND: Current forms of allergy diagnosis and therapies are based on the use of natural allergenic extracts. Despite strong evidence that higher therapeutic efficacy may be achieved with purified allergens, the purification of multiple allergic components from extracts is a fastidious and sometimes an impossible task. However, the use of recombinant allergens may be an alternative to overcome this problem. OBJECTIVE: In this study, we compared the immunological properties of recombinant (r) Lol p 1 with those of the natural protein. METHOD: We cloned directly the gene encoding Lol p 1 from genomic DNA of ryegrass pollen. This gene was subcloned into the expression vector pMAL-c and expressed as fusion protein. Subsequently, rLol p 1 was cleaved from maltose-binding protein using factor Xa. Using binding inhibition and proliferative assays, we assessed the immunological properties of the recombinant allergens. The capacity of rLol p 1 to trigger basophil histamine release and to elicit a skin reaction was also assessed and compared to those of its natural counterpart. RESULTS: We found that the Lol p 1 gene has no introns since we amplified this gene directly from genomic DNA. We demonstrated that the binding sites of anti-Lol p 1 monoclonal antibody, specific human IgG and IgE antibody are well conserved on rLol p 1 as no difference in the binding inhibition profile was observed when using either natural or recombinant protein. At the T-cell level, rLol p 1 elicited a T-cell response in mice comparable to that observed with the natural protein. In addition, we demonstrated that the biological characteristics of rLol p 1 were comparable to those of the natural counterpart, in that rLol p 1 elicited a skin wheal reaction and induced basophil histamine release in grass-allergic patients only. CONCLUSION: The data indicate that natural Lol p 1 and rLol p 1 shared identical immunological and biological properties.

[Comparative study of 3 irreversible hydrocolloids]. / Etude comparative de 3 hydrocolloïdes irréversibles.

This study was realized: to determine the best manipulation of 3 alginates; to compare their dimensional stability; to compare their reproduction of detail; to evaluate, through these 3 criteria, the best of the 3 alginates. It seems necessary to point out that: The 3 examined alginates show a poor dimensional stability on account of the deformations produced during the setting time and the removal of the impression. The immediate pouring of the model gives the best results, because storing the impression is accompanied by dimensional changes. The other methods of conservation seem considerably less accurate. The reproduction of detail is excellent with the 3 alginates. The accuracy is of 25 micrometer, but it is not possible to take advantage of this quality, because the compatibility and the accuracy of model stone are insufficiently adapted to the properties of the alginates. CA-37 is, among the 3 studied alginates, the one which gave the worst results with regard to the ease of manipulation and compatibility with Vel Mix Stone.