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For safe procedures, the surgeon performing thyroid gland surgeries must know precisely the anatomical relationships of the inferior laryngeal nerve with other cervical structures, in particular the inferior laryngeal artery and its branches. Classic descriptions of these relationships are based almost exclusively on the observation of Caucasian populations. However, this study shows that there are important differences between Caucasian and Sub-Saharian ethnic group, differences that any surgeon having the opportunity to operate in Africa should know to limit the risk of iatrogenic nerve damage and its morbid consequences.Lors de chirurgies de la glande thyroïde, il est nécessaire que le chirurgien connaisse précisément les relations anatomiques du nerf laryngé inférieur avec d’autres structures cervicales, en particulier l’artère thyroïdienne inférieure et ses branches. Les descriptions classiques de ces relations sont basées quasi exclusivement sur l’observation de populations caucasiennes. Or, cette étude montre qu’existent d’importantes différences entre les ethnies caucasiennes d’une part et celles d’Afrique subsaharienne d’autre part, différences que tout chirurgien ayant l’occasion d’opérer en Afrique devrait connaître pour limiter le risque de lésion iatrogène du nerf et ses conséquences morbides.

What place should be given to puberty? In France, it is an intimate act that belongs only to the young girl. In Sri Lanka, it is a family and collective act that is ritualized and celebrated. Young girls born into Tamil families living in France have to make these very different logics cohabit. Analyse of a young girl's great suffering at puberty and its methods of reconstruction, which take into account the ways of doing and thinking about puberty here and there.

In a cross-cultural consultation, a young girl of Tamil origin born in France seeks the love of her parents by oscillating between two cultures. Through group development and translation, the daughter and the mother are brought to understand each other's suffering and discover that they share the same deep love, even though it is expressed differently.

Through various research lead in the past, it has been made evident that Quebec is home to higher rates of acute myocardial infarction (AMI) and higher prevalence of cardiovascular risk factors than other Canadian provinces. This proposed study will perform a retrospective analysis on Caucasian populations in order to analyze the cardiovascular risk factors in partially francophone populations in comparison to French and Non-French Canadians. Furthermore, we will closely analyze both genders of aforementioned populations.This population-based retrospective cohort study was achieved using the University of Ottawa Heart Institute CCTA registry. Included are Caucasian patients of all ages who came to UOHI for a CCTA between 2006 and 2018 and provided written informed consent. SPSS was used to compare the different populations (French Canadian, partially French Canadian and non-French Canadian) and sex.The PFC population more closely resembles FC, having higher incidence of cardiovascular risk factors such as smoking, dyslipidemia and type 2 diabetes.Our results suggest that PFC, like FC, may benefit from more intensive education and lifestyle modification techniques.

Human Platelet Antigens (HPA) are of considerable interest in obstetric transfusion medicine and anthropological genetics. This study aims to provide clinicians with a detailed database of HPA antigenic variants, which allows them to estimate the probability of allo-immunisation of each antigen. In addition, it aims to make an interethnic comparison of the Tunisian population with other populations.The target population consists of 324 healthy and unrelated Tunisian blood donors recruited from the National Blood Transfusion Center in Tunis. DNA extraction was performed by the Salting Out method and molecular genotyping was performed by the PCR-SSP technique. The statistical analysis was performed using two approaches: manual calculation and computerized calculation. Phylogenetic trees were constructed through the use of Standard Genetic Distances that were calculated from allelic frequencies.With the exception of the HPA-4 system, statistical analysis showed that all HPA systems are polymorphic especially the two systems HPA-3 and HPA-15. The inter-ethnic analysis showed that Tunisians are closer to North Africans and Caucasians than Sub-Saharan and Asian populations, which shows genetic mixing between Tunisians, Arabs, Europeans and Africans.The results of this study could be exploited to prepare a ready-to-use genotyping plate dedicated to HPA antigens, with the aim of ensuring better management, especially for polytransfused patients.

Current screening recommendations for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy are based on central 10°C static perimetry and a high-resolution SD-OCT with a special attention to the inferior part of the macula where the toxicity usually starts by ellipsoid zone disruption. However, Melles and Marmor, have recently shown a great variability in the topography of the initial toxicity observed among various ethnicities, which is important to keep in mind so as not to miss early toxicity in certain subgroups of patients.Review of the literature.Ethnic differences have been shown regarding the topography of the initial retinal toxicity of CQ and HCQ, particularly between Caucasian and Asian subjects. In Caucasians, the first signs of toxicity are more often localized in the inferior para-foveal area associated with a decrease in retinal sensitivity in the upper 10°C visual field. However, in Asian subjects, the first signs of toxicity appear more pericentral (still inferior) with an extramacular pattern that could be missed by the usual 10°C visual field screening.The pathophysiology of these ethnic differences is unknown and may be due to distinct genetic predisposition to CQ and HCQ toxicity. Screening strategies should be adjusted to the ethnicity and performed in Asian subjects with larger visual fields (30°C), along with SD-OCT, looking for ellipsoid disruption≥8°C from the fovea. The recognition of this pericentral topography and an adjusted screening protocol should avoid late diagnosis in Asians treated with CQ and HCQ.

Although cytotoxic chemotherapy is the main therapeutic option to treat gastric cancer in the metastatic setting, molecular targeted agents have recently been introduced in an effort to improve survival outcomes which in average do not exceed 1 year. Trastuzumab and ramucirumab, antibodies directed against HER2 and VEGFR2, respectively, may provide clinical benefit for some patients. Results of clinical studies show that Asian patients have increased survival compared to Caucasian patients. Differences between populations, and in particular the presence of polymorphisms capable of influencing the availability of fluorouracil, have been suggested as possible explanations. Other factors including histology, surgical procedures, administration of neoadjuvant chemotherapy in Western countries and screening programs in Asia have also been suggested. However, none of these elements can fully explain this phenomenon. The aim of this article is to present the main protocols used in clinical practice, the perspectives of metastatic gastric cancer treatment and the particularities observed in Asian and Caucasian patients.

Patterns of multimorbidity, the co-occurrence of two or more chronic diseases, may not be constant across populations. Our study objectives were to compare prevalence estimates of multimorbidity in the Aboriginal population in Canada and a matched non-Aboriginal Caucasian population and identify the chronic diseases that cluster in these groups.We used data from the 2005 Canadian Community Health Survey (CCHS) to identify adult (≥ 18 years) respondents who self-identified as Aboriginal or non-Aboriginal Caucasian origin and reported having 2 or more of the 15 most prevalent chronic conditions measured in the CCHS. Aboriginal respondents who met these criteria were matched on sex and age to non-Aboriginal Caucasian respondents. Analyses were stratified by age (18-54 years and ≥ 55 years). Prevalence was estimated using survey weights. Latent class analysis (LCA) was used to identify disease clusters.A total of 1642 Aboriginal respondents were matched to the same number of non-Aboriginal Caucasian respondents. Overall, 38.9% (95% CI: 36.5%-41.3%) of Aboriginal respondents had two or more chronic conditions compared to 30.7% (95% CI: 28.9%-32.6%) of non-Aboriginal respondents. Comparisons of LCA results revealed that three or four clusters provided the best fit to the data. There were similarities in the diseases that tended to co-occur amongst older groups in both populations, but differences existed between the populations amongst the younger groups.We found a small group of younger Aboriginal respondents who had complex co-occurring chronic diseases; these individuals may especially benefit from disease management programs.Grappes de multimorbidité chez les Autochtones et chez les non-Autochtones d'origine blanche au Canada.Les profils de multimorbidité, c'est-à-dire la présence concomitante de deux maladies chroniques ou plus, ne sont pas nécessairement constants d'une population à l'autre. Les objectifs de notre étude étaient de comparer les estimations relatives à la prévalence de la multimorbidité entre une population canadienne autochtone et une population appariée non autochtone d'origine blanche et de définir les grappes de maladies chroniques caractérisant ces deux groupes.Nous avons utilisé les données de l'Enquête sur la santé dans les collectivités canadiennes (ESCC) pour cibler les répondants adultes (18 ans et plus) ayant déclaré être d'origine autochtone ou d'origine non autochtone blanche et être atteints d'au moins 2 des 15 maladies chroniques les plus fréquentes visées par l'ESCC. Les Autochtones répondant à ces critères ont été appariés en fonction du sexe et de l'âge à des non-Autochtones d'origine blanche. Les analyses ont été stratifiées par âge (18 à 54 ans, 55 ans et plus). Nous avons estimé la prévalence en utilisant la pondération employée dans l'enquête. Nous avons procédé à une analyse de structure latente (ASL) pour définir les grappes de maladies.Nous avons apparié 1 642 répondants autochtones au même nombre de répondants non autochtones d'origine blanche. Sur l'ensemble, 38,9 % (IC à 95 %: 36,5 % à 41,3 %) des Autochtones étaient atteints de deux maladies chroniques ou plus, contre 30,7 % (IC à 95 %: 28,9 % à 32,6 %) des non-Autochtones. La comparaison des résultats de l'ASL a révélé que le meilleur ajustement aux données était obtenu avec trois grappes ou avec quatre grappes. Alors que les maladies concomitantes qui se manifestaient chez les personnes les plus âgées des deux populations avaient tendance à être similaires, les groupes plus jeunes de ces deux populations présentaient des différences.Un petit groupe de répondants autochtones dans le groupe des plus jeunes présentait un profil complexe de maladies chroniques concomitantes. Ces personnes tireraient sans doute grand profit de programmes de gestion des maladies.

To determine a possible correlation between plasma levels of vitamin D and pregnancy rates obtained by in vitro fertilization (IVF).One hundred and ninety-eight womens participated in an IVF cycle from January to May 2012 in a prospective study. During the follicular phase locking, serum fluid was collected for vitamin D, calcium, FSH and estradiol analysis. The serum bhCG was checked 16 days after oocyte collect. Clinical pregnancy was confirmed by transvaginal sonography with at least one gestational sac in the uterine cavity.The mean levels of vitamin D was 31.7 nmol/L. A total of 169 patients (85.3%) had a vitamin D insufficiency (50 nmol/L). Only 29 patients (14.7%) had a sufficient vitamin D status (vitamin D 50 nmol/L). Pregnancy rate was 29.8% (59/198). There was no significant correlation between the levels of vitamin D and mean age (P = 0.92), BMI (P = 0.16) and etiology of infertility (P = 0.78). In contrast, the levels of vitamin D mean were significantly lower in patients from North Africa (P0.0001) and Black African (P = 0.0003) compared to Caucasian patients.No correlation was found between serum vitamin D level and the pregnancy rate in IVF cycle.

Irinotecan is a cytotoxic agent administered by IV infusion in the treatment of advanced colorectal cancer. Its anticancer activity results from its bioactivation into SN-38 metabolite, which is cleared through glucuronidation by the hepatic enzyme uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1). In the general population, there is wide inter-subject variability in UGT1A1 enzyme activity related to UGT1A1 gene polymorphisms. The French joint workgroup coming from the National Pharmacogenetic Network (RNPGx) and the Group of Clinical Oncologic Pharmacology (GPCO) herein presents an updated review dealing with efficacy and toxicity clinical studies related to UGT1A1 genetic variants. From a critical analysis of this review it clearly emerges that, for doses higher than 180 mg/m(2), hematologic and digestive irinotecan-induced toxicities could be prevented in daily clinical practice by generalizing the use of a simple pharmacogenetic test before starting treatment. The clinical relevance of this test is also discussed in terms of treatment efficacy improvement, with the possibility of increasing the irinotecan dose in patients not bearing the deleterious allele. This test involves using a blood sample to analyze the promoter region of the UGT1A1 gene (UGT1A1*28 allele). Best execution practices, laboratory costs, as well as results interpretation are described with the aim of facilitating the implementation of this analysis in clinical routine. The existence of a French laboratories network performing this test in clinical routine makes it possible to generalize UGT1A1 deficiency screening, so as to guarantee equal access to safe treatment and optimized irinorecan-based therapy for the many patients receiving irinotecan-based therapy in advanced colorectal cancer.

The incidence and prevalence of hypertension is markedly elevated in Afro-American populations vs Caucasians. The development of end-stage renal disease is also more frequent in Afro-American subjects, independently of blood pressure control. As compared to Caucasians, Afro-American subjects have a higher risk of end-stage renal disease when they are infected with HIV or have lupus. For decades, these data remained mysterious. Within the last 3 years, results from studies in the field of genetics and infectious diseases have transformed our view on this problem. The aim of this paper is to explain how these results have changed our understanding of hypertension and its consequences in Afro-American subjects.

Arterial hypertension is a major public health problem not only internationally, but also in our country, and it is the major risk factor for cardiovascular diseases. In south Algeria, the black population is nearly half the population of the oases of the Algerian Sahara.The objectives of the study are to analyze the long-term fate of the black hypertensive subjects in Algerian oases in southern Algeria, in terms of morbidity and mortality, comparing the morphometric profile and cardiovascular complications with the white population of the same oases.One thousand four hundred and twenty-five subjects of both sexes were included (811 blacks and 614 white subjects), aged 40 and older, living in the Algerian Sahara and were reviewed after six years of decline. The control consisted of filling a questionnaire oriented on civil status, target organ damage, the number of hospitalizations and mortality. All calculations and statistical analyzes are processed by the SPSS 17.0 and Epi Info6 software.Mean age for the black population and the white population was 60.3±11.1 and 58.6±10.6years, respectively. The incidence of hypertension was 50 % among blacks. The main complications observed were: stroke in 3.8 %, heart failure in 3.1 %, myocardial infarction in 1.7 %, hospitalizations related to cardiovascular complications of the black population was around 4.4 %, mortality 5.4 %.These data on hypertension black subjects emphasize the importance of a policy of adequate local health issues raised, both in terms of the management of hypertension, as in investment in local medical research.

To further explore early Eurasian steppe migration, we determined the Y chromosome and mitochondrial haplotypes of 26 ancient human specimens from the Krasnoyarsk area, dated between the middle of the second millennium BC and the fourth century AD. Our autosomal Y chromosome and mitochondrial DNA analyses reveal that, whereas few specimens seem to be related matrilineally or patrilineally, nearly all the subjects belong to haplogroup R1a1--M17, which is thought to mark the eastward migration of early Indo-Europeans. Our results also confirm that, during the Bronze and Iron Ages, southern Siberia was a region of overwhelming European settlement.

International audience; Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference normal values are given within the age range. Despite the long known role of creatine for muscle physiology, muscle signs are not necessarily the major complaint expressed by PCDD patients. These disorders drastically affect brain function inducing, in patients, intellectual disability, autistic behavior and other neurological signs (delays in speech and language, epilepsy, ataxia, dystonia and choreoathetosis), being a common feature the drop in brain creatine content. For this reason, screening of PCDD patients has been repeatedly carried out in populations with neurological signs. This report is aimed at providing reference laboratory values and related age ranges found for a large scale population of patients with neurological signs (more than 6 thousand patients) previously serving as a background population for screening French patients with PCDD. These reference laboratory values and age ranges compare rather favorably with literature values for healthy populations. Some differences are also observed, and female participants are discriminated from male participants as regards to urine but not blood values including creatine on creatinine ratio and guanidinoacetate on creatinine ratio values. Such gender differences were previously observed in healthy populations; they might be explained by literature differential effects of testosterone and estrogen in adolescents and adults, and by estrogen effects in prepubertal age on SLC6A8 function. Finally, though they were acquired on a population with neurological signs, the present data might reasonably serve as reference laboratory values in any future medical study exploring abnormalities of creatine metabolism and transport.

Few studies have reported racial differences of electrocardiogram.To compare clinical and electrocardiographic parameters of black African and white European young adults.Students from Cameroon (black group) and France (white group) were recruited (ratio 2/1). Resting ECG was recorded in supine position using a numerical electrocardiograph. Participants underwent demographic, clinical and ECG measurements.We included 162 black and 81 white students (68% female), mean age 24±3 years. Longest QRS duration, sinus bradycardia, right bundle branch block and slurred pattern of repolarization were more common in whites (P0.05) while longest PR interval (P0.05), QRS microvoltage and positive T wave in lead V1 were more common in blacks (P0.001).Most of ECG patterns are similar in these black and white individuals; particularly repolarization features. Positive T wave in V1 lead and isolated R wave microvoltage in aVL lead are predominant in blacks whereas slurring variant of early repolarization is more frequent in whites.

International audience; Antibodies to neutral endopeptidase, a podocyte protein, are responsible for rare alloimmune neonatal membranous nephropathy that develops in children from neutral endopeptidase-deficient mothers. Neutral endopeptidase was the first podocyte antigen described in human membranous nephropathy. PLA2R1, the type-M receptor of soluble phospholipase A2, is a major target antigen in so-called idiopathic membranous nephropathy in adults. Antibodies to PLA2R1 are detected in 60 to 80% of patients before immunosuppressive treatment, and are only occasionally found in secondary membranous nephropathy. To date, they have not been detected in other pathological conditions and in healthy individuals. PLA2R1 and HLA-DQA1 gene variants defined by single nucleotide polymorphisms are strongly associated with idiopathic membranous nephropathy in patients of white ancestry, and can thus be considered as predisposing genes. In addition to their diagnostic value, anti-PLA2R1 antibodies can be used to monitor treatment. Immunization against cationic bovine serum albumin is a cause of early childhood membranous nephropathy. This finding points to a possible role of food and environmental antigens in membranous nephropathy. The newly identified antigen-antibody systems should be considered as molecular signatures challenging the uniform histological definition and having a major impact on patient care in a near future.

Hypokaliemic thyrotoxic periodic paralysis (TPP) is an uncommon complication of hyperthyroidism. Mostly described among Asian patients, it is rare in other ethnic groups, in particular in Caucasian people.We present the case of a Caucasian male admitted to our unit after several paretic episodes. Tachycardia, goiter and mild proptosis led to the diagnosis of Graves' disease.Rare in the Caucasian population, TPP involves dysfunction of the NA-K-ATPase pump. Beta-blockers should be associated with medical or surgical treatment of hyperthyroidism.

Because different groups in human society view beauty in stereotypical terms of their own ethnicity, orthodontists should study the concept of facial beauty with scientific rigor. Is it time for us to re-examine the assumption that the original cephalometric esthetic norms based on samples of North Americans can be applied to other populations? Many cephalometric analyses of Afro-American and Asian subjects who had not received orthodontic treatment but whose occlusions were normal have shown that their esthetic criteria were far different from those of the Caucasian North American sample. The Afro-Americans and Asians share a principal ethnic facial characteristic of bi-maxillary alveolo-dental protrusion with a reduced naso-labial angle. Afro-Americans frequently have maxillae in an anterior position with mandibles in similar or retruded positions. Asians appear to have similar cutaneous profiles but group skeletal profiles differ: Japanese often have more retruded maxillae; Chinese often have protruded maxillae and retruded mandibles. Koreans tend to have characteristics resembling those of Japanese groups. So it would seem necessary for the specialty of orthodontics to establish specific data of facial characteristics that reflect the ethnic origin of potential patients in order for specialists to make accurate and appropriate esthetic diagnoses.

Hereditary renal hypouricemia is characterized by a decreased serum uric acid, a uric acid fractional excretion above normal and the absence of another cause of hyperuricosuric hypouricemia. This pathology, generally caused by a mutation of urate renal transporter URAT1, is relatively common in Asia, but occurs very infrequently in Caucasian populations. The disease's association with exercise-induced acute renal failure is well known. This article reports the case of a 47-year-old man of Italian origin who was diagnosed with hereditary renal hypouricemia after an episode of exercise-induced acute renal failure. Molecular analysis of SLC22A12 encoding URAT1 for renal hypouricemia using peripheral blood genomic DNA of the patient was performed. Single-strand conformation polymorphism screening, amplification, and direct sequencing of SLC22A12 revealed no mutation in this patient. This suggests that another gene can be involved in this disease.

Children's refraction can usually be measured using cyclopentolate 0.5%. Instilling three drops is time-consuming and inconvenient to both the clinical staff and the child. To remedy this situation, we investigated the refractive results of instilling two drops of cyclopentolate 0.5% at a 10-min interval compared with three drops at a 5-min interval in a group of a Caucasian nonstrabismic children. The kinetics of refraction in this population was also assessed.We conducted a randomized cross-over study on 36 children aged between 4 and 13 years from March 1st to August 1st, 2003 at the University of Tours School of Ophthalmology. In protocol I, two cyclopentolate eyedrops were instilled in both eyes at a 10-min interval. In protocol II, three eyedrops were instilled at a 5-min interval. The refractive results were evaluated in terms of sphere and cylinder strength and axis. We used an auto-kerato-refractometer every 15 min from the first instillation for both protocols until the 90th min.Before the first drop instillation, there was no significant influence on skiascopy results for both eyes (-0.30+/-0.20 D for the right eye; -0.37+/-0.24 D for the left eye). The strength and the axis of the cylinder were comparable and stable (-0.5+/-0.18 D for strength; 5 degrees +/-22 for the axis) for all protocols and subjects tested. Sphere variation reached +1+/-0.6 D between t0 and t30 min for both protocols and remained stable between t30 and t90 min (+0.01+/-0.2 D).Instilling two eyedrops of cyclopentolate 0.5% at a 10-min interval in Caucasian nonstrabismic children aged 4-13 years is as effective as instilling three eyedrops at a 5-min interval in terms of kinetics and depth of cycloplegia. In addition, skiascopy can be performed as early as 30 min after the first instillation and until the 90th minute with the same effectiveness. The stability of astigmatism should be underlined in this population. Since these refractive results cannot be extrapolated for strabismic and ametropic children, we recommend, especially for the latter, instilling three drops for the first exam and only two thereafter, depending on the results.

One of the orthodontist's goals is to improve dental occlusion while taking into account dental, maxillary and facial balance. It is his responsibility, prior to any orthodontic treatment to make a positive and etiopathogenic diagnosis that will drive his treatment planning. One of the basic parameters to be considered is the mesiodistal width of the teeth. Indeed, a tooth size discrepancy often causes therapeutic failures; its diagnosis has been possible since 1958 thanks to Bolton whose researches were carried out on the American population. The principal objective of this study was to verify if his analysis is applicable to the Senegalese population. Its secondary objective was to specify the odontometric data of Senegalese subjects. For this reason, 60 Senegalese aged between 13 and 33 have been selected and for each subject we have measured the overjet and overbite, the mesiodistal and vestibulo-lingual diameters of the 12 maxillary and mandibular teeth. The obtained results have allowed us to assume that the Bolton analysis can be applied to the Senegalese population as a whole. We have also found that the Senegalese subject's odontometric data did not have any significant difference with the known data.

The aim of this study was to compare the prevalence of abnormal glucose tolerance in patients stemming from two French ethnic groups and admitted for acute coronary syndrome (ACS) to intensive coronary care unit.During a period of six months, 53 and 60 consecutive patients were enrolled at Fort-de-France (Martinique, French West Indies, Afrocaribbeans, group F) and at Bordeaux (France, Europeans, group B), respectively. Glucometabolic state was classified according to medical history and fasting glycemia measured from the fourth day after ACS.At baseline, 36% of the patients of group F and 20% of the patients of group B had previously known diabetes (p=0.06). Prevalence of hypertension was higher in Afrocaribbeans than in Europeans (60 versus 40%, p0.05). According to fasting glycemia, newly detected diabetes were found in six Afrocaribbeans and only one was found in Europeans; two patients in group F and three patients in group B displayed impaired fasting glycemia. As a whole, 51% of Afrocaribbeans and 27% of Europeans showed abnormal glucose tolerance (p0.05). Furthermore, Afrocaribbeans displayed lower levels of triglycerides and higher levels of HDL cholesterol than Europeans (p0.05).Our study suggested a higher prevalence of impaired glucose metabolism in French Afrocaribbeans than in European counterparts after ACS. Furthermore, French Afrocaribbeans displayed a more favorable lipoprotein profile. These characteristics look like that of the American and British Afrocaribbeans, maybe because of a common genetic origin.

Improvement of dentofacial appearance is often the main motives of patient seeking orthodontic treatment. However perception of aesthetic and orthodontic treatment need may be different among populations of different cultural background. The aim of the present study was to compare the perception of aesthetic and orthodontic treatment need between Caucasian (French) and African (Senegalese)In the present study the perception of the attractiveness of 98 colours photographs of dentitions were assessed by 34 Caucasian and 31 African lay judges by mean of a Power Point presentation. Each slide were displayed for evaluation during 20 secondsThe two populations share the same perception of orthodontic aesthetic with respect to some occlusal traits. However they diverge in their appreciation of 70% of the dentitions with midline diastemas. There were also significant differences in the perception of orthodontic treatment need with the Caucasian judges suggesting treatment more often than Africans.The results are discussed in term of accessibility in orthodontic treatment in association with socioeconomic status.

The authors report the case of 2-old-caucasian women in the pre- and interhospital setting, who presented chest pain with ST segment elevation. Coronary angiography did not show any significant coronary lesion, ventriculography revealed typical aspect of tako-tsubo. It resolved in a short time, with normalisation of the left ventricule function. The tako-tsubo syndrome, or transient left ventricular apical ballooning syndrome, first described by Japanese physicians, is more and more frequently observed in caucasian patients. This cardiomyopathy associates an apical transient dysfunction without any significant coronary lesion. This syndrome is usually observed in elderly women, occurs frequently after acute emotional or physical stress. The clinical presentation looks like an acute coronary syndrome, with chest pain, electrocardiographic changes and moderate cardiac enzymes release. Coronary angiography shows no significant coronary disease and ventriculography a systolic dysfunction with akinesia of middle and apical segments, leading apical ballooning, and basale hyperkinesia. These abnormalities are transient, with quick favorable outcome. The aetiopathegenia is still uncertain. The differential diagnosis with an acute coronary syndrome with thrombosis is not yet possible. Clinical or biological criteria allowing early diagnosis would lead to optimize the therapeutic management.

The aim of this study is to observe the possible impact of socioeconomic level on stages of macroscopic dental development. The sample consists of 456 children from European origin, aged 3.5 to 16 years (242 girls and 214 boys). We apply a radiographic method of non-adult dental age estimation based on Bayes' theorem. Both socioeconomic level and geographic origin of grandparents are given in a questionnaire devised by the first author. First, results obtained with the Bayesian dependent method (BD method) are compared to those obtained with a more commonly used method of dental age estimation based on Correspondence Analysis and linear Regression (CAR method). Second, two approaches are proposed in order to test potential relationships between socioeconomic level and stages of macroscopic dental development. Both are based on observed shifts between dental age and chronological age with regard to socioeconomic level. Results obtained with the BD method are better, in terms of quality, than those obtained with the CAR method. We observed no influence of socioeconomic level on stages of macroscopic dental development.