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The sexuality of the elderly is rarely mentioned in general medicine although it holds an important place in many old people's life, and sexual well-being is a part of the global well-being according to the World Health Organization. To explore the representations of their own sexuality and aging body by the elderly. Qualitative study using semi-structured interviews in 15 healthy elderly people over 65 years of age, living at home. In-depth interviews were transcribed and submitted to qualitative content using a phenomenological and a psychodynamic analysis. The phenomenological approach allows to explore the meaning and significance of the sexuality of older people (their representations and individual experience). The psychodynamic approach allows an analysis of defense mechanisms in verbal and nonverbal behavior. Some elderly maintain a view of their sexuality in accordance with the societal standards existing before the sexual liberalization following the events of May 68 in France. For these people, sexuality is tabooed and only linked to procreation, no longer part of the aging body, and perceived as degraded, then difficult to be approached by general practitioners in relation with defense mechanisms. Other elderly people have managed to free themselves from those previous societal standards. The notion of pleasure is still present in these people and their aging body is perceived as an altered body, difficult to be accepted on account of the pressure for conformity due to actual societal standards. These standards reserve sexuality to young people and convey a picture of a sexuality that would be improper for the elderly. Understanding the representations of their sexuality by the elderly allows GPs a better approach for helping older patients to improve their sexual well-being.

We report the case of a 31-year-old immunocompetent woman residing in Senegal, with localized microscopy-proved pulmonary tuberculosis, complicated by macrophage activation syndrome and associated with viral hepatitis B, identified due to hepatic cytolysis and a bicytopenia.

According to global data for 2002, one quarter of new cases of primary bronchopulmonary cancer were non-smokers. We undertook this study with the aim of describing the epidemiological characteristics of non-smokers with primary bronchopulmonary cancer in the Dakar region of Senegal.A multicenter descriptive study that included all non-smokers who presented with primary bronchopulmonary cancer between January 1st 2014 and December 31st 2015. The data were captured on an Excel file and then transferred to Epi InfoThe rate of diagnosis for primary bronchopulmonary cancers was 72.1 %. The prevalence of non-smokers was 33.3 %. The sex ratio was 1.27. The average age was 54.6 years. More than a third of the sample were housewives. Carpenters and craftsmen exposed to metals predominated. Exposure to cooking oils was reported in one case. Three patients presented sequelae of pulmonary tuberculosis. Adenocarcinoma was the most common histological type and predominated in young subjects.The proportion of primary bronchopulmonary cancers diagnosed among non-smokers is increasing in Dakar. An analytical study of suspected risk factors would be helpful for prevention.

The long diagnostic delay is responsible for the extension of radiological lesions and spread of TB in the community. These radiological lesions can leave significant scars responsible for respiratory disability.The aim of the study is to characterize radiologic features according to tuberculosis diagnostic delay.We conducted a prospective cross-sectional study, about 66 patients with positive sputum.The average diagnostic delay was 16 (±15) weeks; whether 22 (±14.1) weeks in the female gender versus 14.6 (±14.3) weeks in the male gender (P=0.10). The first care use was respectively health centers (62.1%), drugstores (51.9%), and traditional medicine (28.7%). Only 27.2% of patients used the marabouts care. Bilateral radiographic abnormalities in bivariate analysis were associated with consultation at the health center (66.7% versus 33.3%; P0.031), as is the extension of the lesions (70.2% versus 29.8% RP=1.66 [1.05 to 2.91]; P0.03). Lake of knowledge of the symptoms of TB was associated with the use of marabouts care (12.5% versus 87.5; PR=0.35 [0.11 to 1.08], P0.04).These results should prompt consideration in an emergency, appropriate control interventions, advocacy, patient information and medical personnel on the reality of tuberculosis to prevent its spread often causing respiratory disability with radological effects.

To access publisher's full text version of this article click on the hyperlink at the bottom of the page We analyzed 3,872 common genetic variants across the ESR1 locus (encoding estrogen receptor α) in 118,816 subjects from three international consortia. We found evidence for at least five independent causal variants, each associated with different phenotype sets, including estrogen receptor (ER(+) or ER(-)) and human ERBB2 (HER2(+) or HER2(-)) tumor subtypes, mammographic density and tumor grade. The best candidate causal variants for ER(-) tumors lie in four separate enhancer elements, and their risk alleles reduce expression of ESR1, RMND1 and CCDC170, whereas the risk alleles of the strongest candidates for the remaining independent causal variant disrupt a silencer element and putatively increase ESR1 and RMND1 expression. National Institute for Health Research (NIHR) info:eu-repo/grantAgreement/EC/FP7/223175 Cancer Research UK C1287/A10118 C1287/A10710 C12292/A11174 C1281/A12014 C5047/A8384 C5047/A15007 C5047/A10692 C8197/A16565 US National Institutes of Health (NIH) CA128978 CA192393 CA116167 CA176785 US National Institutes of Health (NIH Specialized Program of Research Excellence (SPORE) in Breast Cancer) CA116201 Post-Cancer GWAS initiative 1U19 CA148537 1U19 CA148065 1U19 CA148112 Post-Cancer GWAS initiative (GAME-ON initiative) US Department of Defense W81XWH-10-1-0341 Canadian Institutes of Health Research (CIHR) Komen Foundation for the Cure Breast Cancer Research Foundation Ovarian Cancer Research Fund

We try, from our clinical practice in a geriatric medicine department, to identify the processes involved in family crisis, especially in the relationship carer/cared. Psychodynamic and systemic determinants are highlighted to understand how family caregivers may suffer burn out, and suggest preventive measures.

G-quadruplex (G4) structures in intron 3 of the p53 pre-mRNA modulate intron 2 splicing, altering the balance between the fully spliced p53 transcript (FSp53, encoding full-length p53) and an incompletely spliced transcript retaining intron 2 (p53I2 encoding the N-terminally truncated Δ40p53 isoform). The nucleotides forming G4s overlap the polymorphism rs17878362 (A1 wild-type allele, A2 16-base pair insertion) which is in linkage disequilibrium with rs1642785 in intron 2 (c.74+38 G>C). Biophysical and biochemical analyses show rs17878362 A2 alleles form similar G4 structures as A1 alleles although their position is shifted with respect to the intron 2 splice acceptor site. In addition basal FSp53 and p53I2 levels showed allele specific differences in both p53-null cells transfected with reporter constructs or lymphoblastoid cell lines. The highest FSp53 and p53I2 levels were associated with combined rs1642785-GG/rs17878362-A1A1 alleles, whereas the presence of rs1642785-C with either rs17878362 allele was associated with lower p53 pre-mRNA, total TP53, FSp53 and p53I2 levels, due to the lower stability of transcripts containing rs1642785-C. Treatment of lymphoblastoid cell with the G4 binding ligands 360A or PhenDC3 or with ionizing radiation increased FSp53 levels only in cells with rs17878362 A1 alleles, suggesting that under this G4 configuration full splicing is favoured. These results demonstrate the complex effects of intronic TP53 polymorphisms on G4 formation and identify a new role for rs1642785 on mRNA splicing and stability, and thus on the differential expression of isoform-specific transcripts of the TP53 gene.

In 1994, European Directive 94/35/CE authorised the use as food additives of five intense sweeteners for which Acceptable Daily Intakes (ADI) were established. The same directive stipulated that member states should organise a monitoring system to determine the consumption of these substances. Diabetic children are normally considered to constitute a group with a high consumption of sweeteners (European Commission, 1998. Report on Methodology for the Monitoring of Food Additives Intake across the European Union. Report of the Scientific Cooperation, Task 4.2 SCOOP/INT/REPORT/2. European Commission Directorate General III, Brussels.). A stepwise approach to the food additive intake in the general population had shown that three of the five authorised intense sweeteners (aspartame, saccharin and acesulfame K) are used at particularly high levels in sugar-free foods and are also very commonly utilised as table-top sweeteners. This paper presents the results of a food intake survey conducted in a group of French, insulin-dependent children in 1997, aimed at estimating the Theoretical Maximum Daily Intake (TMDI) for these three sweeteners and comparing this with the relevant ADI values. A 5-day diary questionnaire was used to estimate the intake of sugar-free, artificially sweetened foods and table-top sweeteners. When assessing the intake of each additive, all sugar-free products were assumed to be sweetened using a single sweetener at its maximum authorised level. This study was performed in five age groups, and based on the mean and 97.5th percentile of the distribution of consumption, demonstrated that it was unlikely that total exposure could rise above the ADI.

The aim of the present study was to describe some histopathologic features of tissues collected from root resorption areas of maxillary canines after transalveolar transplantation surgery. In 8 of 101 transplanted canines, complications including cervical root resorption occurred between 6 and 11 years after treatment. The resorptive processes were located at the supra-alveolar portions of the distal and/or mesial aspects of the teeth and were scheduled for treatment involving surgical exploration. The resorption cavities, which extended from the cementoenamel junction to a position immediately below the bone crest, were filled with a granulation tissue. In four of the diagnosed complication cases, this granulation tissue was carefully excised concomitant with the adjacent gingival tissue after flap elevation and placed in a buffered fixative. After proper soft-tissue healing, the cavities were filled with a glass-ionomer material. The collected biopsy specimens were, after fixation and, in one case, decalcification in ethylenediaminetetraacetic acid, dehydrated and embedded in Epon. Sections 3 microns thick were produced, stained in periodic acid-Schiff and toluidine blue, and used for histometric and morphometric analyses. The histologic analysis showed that the dissected tissue harbored well-encapsulated areas of inflammatory infiltrates. The lesions comprised a relatively low volume of collagen and a large number of inflammatory cells, predominantly lymphocytes.

Regular discussions between the Departments of Oral Surgery and Orthodontics at Göteborg University have resulted in a modified operative technique for impacted maxillary canines, called transalveolar transplantation. After exposure of the operation field, large amounts of bone are removed, avoiding damage to the surface of the cementum and the periodontal membrane. Throughout the surgical procedure the tooth is kept in the alveolar process and then finally gently moved to its desired position. Orthodontic fixation is used to stabilize, not to immobilize, the tooth. So far 101 maxillary canines have been autotransplanted in 85 patients (11-76 years old) with an observation period of 1-17 years. Transalveolar transplantation is considered a good alternative for impacted maxillary canines, provided that the treatment planning is discussed by an orthodontist and an oral surgeon together and the treatment is performed with meticulous surgical techniques and adequately functioning orthodontic fixation and used in patients with proper oral hygiene.

This study highlights the incongruence of geriatric institutions to set up activities for elderly people without taking into account the circadian fluctuations of cognitive processes related to circadian rhythms. By example, rehabilitation for falls is based on the indication given by the therapist (instruction), its integration and assimilation by the patient (comprehension), and the resulting action (execution). However, the recorded information and the execution may present a shift of phase and even an opposition of phase. The Test of Folding a Rhombus (TFR) was conceived to assess the fluctuation and articulation of these processes. It was proposed to 60 elderly individuals divided into 2 groups (30 subjects with cognitive disorders - case group - and 30 subjects without cognitive disturbance - control group -), and was applied at different time schedules of the day (8:00, 11:00, 15:00 and 18:00 h) once a week during 4 weeks. Its purpose was to quantify the relationship between automatic and controlled processes. Statistical analysis indicates significant circadian differences during the evolution of the two processes between the case and control groups. Simple, fast and easy to use, the TFR can also help professionals to choose the best automatic or controlled processes activity according to the need of patients.

This follow-up study on transalveolar transplantation includes 56 maxillary impacted canines in 47 patients, with a post-operative control period of 2-10 years (mean 4.7 years). The prognosis of the transplanted teeth is still very good; only two canines have been lost, due to poor oral hygiene or fracture of the tooth. These positive follow-up results indicate that transalveolar transplantation will offer greater flexibility in the treatment of impacted maxillary canines in adults.

This paper summarizes by four recent examples the procedure of the characterization of groups at risk for ingestion of food chemicals and its limitations. The examples concern two food additives (sulfites and aspartame), one nutrient (calcium), and one food contaminant (patuline). On the one hand, results show that the empirical description of a group at risk is nowadays the best way to provide to risk managers information useful for consumer protection. On the other hand, these examples show that in any case if risk 0 does not exist, it is impossible to completely avoid any group at risk. The responsibility of risk managers is to decide what is the minimum size of the population to protect as a function of the risk and of the cost of the protection.

In 431 patients treated for malignant tumors 21 osteoradionecroses (ORN) were diagnosed in 19 patients. The relation of ORN to radiotherapeutic factors and surgical as well as extraction schemes were studied. There was a clear relation to high dose, high CRE and superfractionation. Six ORN developed in connection with tooth extraction. The importance of atraumatic extraction is stressed.

Transalveolar transplantation of 31 maxillary canines in 26 patients was performed. Fixed orthodontic appliances were used for fixation for 6 to 8 weeks. All the transplanted teeth were firmly affixed in the new positions 3 to 6 months postoperatively. Complete bone regeneration and an attached gingiva with a stippled surface buccally and a normal pocket depth were observed 1 to 2 years postoperatively. These positive treatment results indicate that transalveolar transplantation is a useful alternative in the treatment of impacted maxillary canines in selected patients.

The light microscopical and ultrastructural morphology in vitro of one case each of human plexiform, follicular and acanthomatous ameloblastoma are described. Ultrastructural analysis of cultured tumour cells revealed that the main cell type growing in vitro displayed morphological features typical of columnar cells or preameloblast-like cells of ameloblastomas. Irrespective of histological type all cases showed indistinguishable in vitro light microscopical and ultrastructural morphology. These findings strongly suggest that the columnar cell type accounts for the main proliferative capacity of ameloblastomas in vitro and most likely also in vivo.

The development of lower third molar anlage was investigated longitudinally and related to chronological age and to skeletal maturation stage as judged by the mineralization of epiphyses in the hand. Strong correlations were found between lower third molar development and both skeletal maturation and chronological age. These results indicate that lower third molar development on the whole seems to be correlated with skeletal maturation. One or two lower third molars were found to be missing in 11% of the subjects.

A double-blind randomized analgesic trial was carried out on 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients took their first dose of either 1000 mg paracetamol plus 60 mg codeine or 650 mg paracetamol plus 65 mg dextropropoxyphene when pain appeared after the decline of the local anaesthesia. If needed, another two doses were available during the observation period (less than or equal to 10 h). The analgesic efficacy of paracetamol/codeine was overall superior to paracetamol/dextropropoxyphene in all variables. Sufficient pain relief was obtained in most patients. The pain reduction after the first dose was 64% in the group receiving paracetamol/codeine compared with 53% in the group receiving paracetamol/dextropropoxyphene and the mean durations of effect of the first dose were 6.6 and 5.8 h, respectively. Side-effects appeared in all patient groups but were most frequent in women taking paracetamol/codeine.

The status of the periapical tissue has been investigated in skull materials dating from different periods of time. In these investigations, the bone connected with the root apices has been shown to be destroyed to so great an extent as to make the destruction of bone the most common inflammatory reaction in skeletal material (1). However, the frequencies reported have generally been relatively low in comparison with modern materials, which may be partly explained by the fact that direct inspections without radiography were carried out, in which only the destruction which had penetrated the compactum could be recorded. In the study of exhumed material, there are also special sources of error on account of the occurrence of post-mortem changes, as SWARDSTEDT (11) has pointed out. Attempts have been made to distinguish between different types of pathological changes, such as apical granulomas and cysts, by assessing the radiographic character of the bone destruction in the skull material (1) in the same way as in clinical investigations (10). However, it has proved to be possible to make a reliable differentiation only by a microscopical examination of the soft tissue of the destruction (9). An attempt has also been made to classify the periapical bone destructions in skull material according to size, in the same way as in clinical investigations (11).

Common features in two patients with chronic suppurative lesions of the maxillofacial region from vegetable foreign bodies were : foreign body origin of the accident ; chronic nature of the suppuration (7 and 23 months respectively) ; multiple operations by different surgical teams ; radiotransparency of the foreign bodies. Positive signs on CT scanning can confirm the diagnosis, but cannot exclude it when normal images are obtained. The number and localization of wood fragments may limit the value of the scan, and fistulography and xeroradiography may then provide confirmation of the diagnosis. Operative treatment may be difficult due to fragmentation of the wood into multiple pieces, a possible source of recurrence of infection.

In investigations of many early population groups, the frequency of carious teeth has been shown to be less than 10 % (3, 5). In various medieval materials in Scandinavia, the frequency of individuals with caries has been between 40 and 60 Ufo (4, 10, 13, 19). Thus, the incidence of caries during the Middle Ages has been shown to have been clearly less than that in modern man in the Scandinavian countries. However, the recording of caries in exhumed material has been stated to be subject to special sources of error. Thus, the occurence of post-mortem defects has been reported to yield an erroneous frequency of caries (5, 18). However, other investigators consider that it is quite possible to distinguish between artefacts and real caries (13, 14, 19). The question of whether teeth missing intra vitam can affect the values for the frequency of caries in a skull material has interested a large number of investigators. Thus, MELLQVIST & SANDBERG (13) have classified a tooth missing intra vitam as carious when other causes, such as "senile atrophy, pyorrhoea, trauma, infection after abrasion to the pulp, impaction or underdevelopment of teeth" could be excluded. BRINCH & MOLLERCHRISTENSEN (4) have also pointed out that consideration must be given to the frequency of teeth missing intra vitam in describing the incidence of caries. On the basis of his studies of an early British population, HARDWICK (8) has suggested that 25 Ufo of the missing teeth may be expected to have been lost on account of caries when the proportion of carious teeth is below 5 Ufo and 33 % lost for the same reason when the frequency of caries is 5-20 Ufo. SW ARDSTEDT (19) analysed the cause of the tooth

This is a study of 15 fractures of the mandible in children. We were able to make the following conclusions: --the usual causes of these fractures are road traffic accidents or accidents at play, --the fracture is usually single (7 cases) multiple (8 cases) and in 13 children out of 15 there was a fracture of the condyle. --the presence of the first dentition and dental germs posed special problems. The treatment is mainly orthopedic, and the fracture is maintained in place by metallic arches which may or may not be completed with a resin dropper. Condyle fractures are treated classically by functional mechanotherapy. The indications of osteosynthesis seem to be limited to cases of very unstable fractures or where these are comminutive. The treatment of sequelae requires techniques very similar to orthodontic apparatuses.

The root anatomy of the lower third molars and the distance from apex to the mandibular canal were examined in radiographs. Three different materials were examined; one medieval with erupted teeth, one modern with erupted teeth and one modern with impacted third molars. Uncomplicated root anatomy was recorded for 75% of the teeth in the medieval material and for 20% in the modern materials. A position of the root apex near the mandibular canal was more frequently observed in the modern material.