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Genomic imprinting occurs before fertilization, impacts every cell of the developing child, and may be sensitive to environmental perturbations. The noncoding RNA, nc886 (also called VTRNA2-1) is the only known example of the ~100 human genes imprinted by DNA methylation, that shows polymorphic imprinting in the population. The nc886 gene is part of an ~1.6-kb differentially methylated region (DMR) that is methylated in the oocyte and silenced on the maternal allele in about 75% of humans worldwide. Here, we show that the presence or absence of imprinting at the nc886 DMR in an individual is consistent across different tissues, confirming that the imprint is established before cellular differentiation and is maintained into adulthood. We investigated the relationships between the frequency of imprinting in newborns and maternal age, alcohol consumption and cigarette smoking before conception in more than 1,100 mother/child pairs from South Africa. The probability of imprinting in newborns was increased in older mothers and decreased in mothers who drank alcohol before conception. On the other hand, cigarette smoking had no apparent relationship with the frequency of imprinting. These data show an epigenetic change during oocyte maturation which is potentially subject to environmental influence. Much focus has been placed on avoiding alcohol consumption during pregnancy, but our data suggest that drinking before conception may affect the epigenome of the newborn. [ABSTRACT FROM AUTHOR]

South African doctors (n = 211) experienced in antiretroviral therapy use were asked via an online questionnaire about the WHO 2013 adult antiretroviral integrated guidelines, as well as clinical and personal issues, in three hypothetical scenarios: directing the Minister of Health, advising a family member requiring therapy amidst unstable antiretroviral supplies, and where doctors themselves were HIV-positive. Doctors (54%) favoured the 500 cells/μl WHO initiation threshold if advising the Minister; a third recommended retaining the 350 cells/μl threshold used at the time of the survey. However, they favoured a higher initiation threshold for their family member. Doctors were 4.9 fold more likely to initiate modern treatment, irrespective of their CD4 cell count, for themselves than for public-sector patients (95%CI odds ratio = 3.33–7.33; P<0.001, although lower if limited to stavudine-containing regimens. Doctors were equally concerned about stavudine-induced lactic acidosis and lipoatrophy. The majority (84%) would use WHO-recommended first-line therapy, with concerns split between tenofovir-induced nephrotoxicity (55%), and efavirenz central nervous system effects (29%). A majority (61%), if HIV-positive, would pay for a pre-initiation resistance test, use influenza-prophylaxis (85%), but not INH-prophylaxis (61%), and treat their cholesterol and blood pressure concerns conventionally (63% and 60%). Over 60% wanted viral loads and creatinine measured six monthly. A third felt CD4 monitoring only necessary if clinically indicated or if virological failure occurred. They would use barrier prevention (83%), but not recommend pre-exposure prophylaxis, if their sexual partner was HIV-negative (68%). A minority would be completely open about their HIV status, but the majority would disclose to their sexual partners, close family and friends. Respondents were overwhelmingly in favour of continued antiretrovirals after breastfeeding. In conclusion, doctors largely supported adult WHO guidelines as public policy, although would initiate treatment at higher CD4 counts for their family and themselves. Resistance to INH-prophylaxis is unexpected and warrants investigation. [ABSTRACT FROM AUTHOR]

This article focuses the death of Briton tourists in a road crash in South Africa. On January 1, 2004 the Guardian newspaper reported that eight British tourists were killed in South Africa when their minibus crashed while swerving to avoid a pedestrian who was reportedly trying to commit suicide,it emerged today. The five men and three women were on their way to the Royal Natal National Park when the New Year's Eve tragedy happened. The following day the Guardian's headline to this story is Suicide Man Blamed for Road Deaths of British Tourists. On this occasion the story is filed by Owen Bowcott and Andrew Meldrum in Pretoria. It said that a pedestrian reportedly intent on committing suicide was being blamed for the deaths of eight British holidaymakers in South Africa, after their minibus swerved to avoid him, overturned and ploughed into a ditch. On the following day, the tone and content of the reporting had changed, with the headline, SA Crash Driver Not Licensed. Based on a Press Association report the driver in a minibus crash that killed eight British tourists in South Africa on New Year's Eve did not have the correct type of licence, officials have revealed. It is easy to think that tragedies such as these,and other events in the tourism industry,are reported in an entirely factual and objective way. In reality, the stories shown here demonstrate that they are a mixture of fact and opinion. The stories include information that is directly relevant to reporting events,and other information that may or may not be relevant. It therefore is easy for different readers to form different views as to what happened, and why it happened.

Objective: To compare patient attendance rates 1 year before and after the introduction of free primary dental health services in Soweto, South Africa. Methods: Monthly clinic records for clinic attendance, both casual and booked, and number of dental operators were recorded 1 year either side of April 1996. Results: Patient attendance fluctuated by day and season. There was a mean 46% increase in attendance after free primary dental health services were introduced, with more than a sixfold increase in casual attendees (pain, sepsis) than in booked patients (restorative treatment, dentures, orthodontics). Conclusions: There was a statistically significant increase in casual patient attendance in the year after free primary dental health care was introduced with an increased dental operator load. [ABSTRACT FROM AUTHOR]

Objective: This 17-year-long study examined trends of dental caries rates n the primary dentition of 6843 preschool children in a South African city. Methods: Calibrated dentists did repeated cross-sectional epidemiological surveys of dental caries in 2- to 5-year-old nursery school children using WHO diagnostic criteria between 1981 and 1997. Results: Both the percentage of children with dmft>0 and mean dmft increased between 1981 and 1989 and have slowly declined ever since in the absence of organised prevention to produce a secular trend of decreasing caries rates. The dt/dmft percentage ranged between 60% and 100% except in 1991 when it dropped to 40% and the ft/dmft percentage component rose proportionally, probably due to an economic effect. Conclusions: The percentage of children with dmft>0 and mean dmft decreased over the study period at all ages, the reason for which is unknown but is speculated to be due to a change in mutans streptococci strains. [ABSTRACT FROM AUTHOR]

The study examined energy intake in relation to dental caries and periodontal disease in 11-yr-old rural and urban black children in low fluoride areas of KwaZulu and Namibia (0.15 ppm F) and one higher fluoride area of Namibia (1.56 ppm F). Twenty-four hour dietary recalls were conducted by trained interviewers and daily energy intake estimated using the MRC dietary analysis programme. DMFS was recorded according to WHO criteria; periodontal disease was measured using CPITN and SAS was used for statistical analysis. The prevalence of dental caries and periodontal disease (using CPITN), were compared within three energy groupings: &LE;850 kcal/day; >850, <1400 kcal/day and >400 kcal/day. The rural low fluoride Namibian children had the lowest mean energy intake (616 kcal/day), which also was the grouping with highest healthy periodontal prevalence (65%). The urban groups had higher energy intakes than the rural communities. Statistically significant effects on caries prevalence were seen for country and fluoride grouping; for periodontal disease, significant effects were noted for country, fluoride group and environment. Energy intake had no statistically significant effect, so this is not a risk marker for the disease. [ABSTRACT FROM AUTHOR]

Mean sugar intake in South Africa has fallen in Black rural groups and remained more or less constant for their urban counterparts; for Indian groups it has risen, but fallen in White groups. The amounts of sugar in mean snack/sweet intakes have not shown the same degree of fall and have remained relatively constant in all but Indian groups where there has been a definite fall in consumption. Caries prevalences (percentages of children with caries) have risen in all but White groups. It can be concluded that quantitative changes in sugar consumption and caries prevalences do not parallel each other. [ABSTRACT FROM AUTHOR]

The article discusses contributions of the Dental Research Institute for fifty years. It states that this internationally recognized research unit has been active since 1954, when dental research actually began in South Africa. The first formal report, on the oral health of African adults around Johannesburg, was in the "British Dental Journal." In order to ease the path of budding researchers, a general research methods course was initiated to ensure capacity building in scientific investigative techniques. Since 1978, 1355 individuals of every imaginable biomedical discipline, from within and outside South Africa's borders, have attended the 50-hour research training course run by the institute. Until recently, this was the only such training course available to postgraduates in the clinical discipline.

The caries prevalence (dmft) and severity (css) in 3-. 4-. and 5-yr-old children in South Africa were examined. Four levels of S. mutans in the saliva of 228 of these children was estimated by the spatula method. In all three age groups a statistically higher dmft and css was found with a S. mutans level of > 10[Sup6] CFU ml in saliva than at lower concentrations. At age 5 ANOVA showed significant differences between dmft and css at all S. mutans levels. A high concentration of S. mutans in the saliva may be an indicator of the high risk child at an early age. [ABSTRACT FROM AUTHOR]

This editorial comments on clinical research with vulnerable populations in South Africa. The Network of Chairs of South African Human Health Research Ethics Committees believes that the pharmaceutical industry has accepted its responsibility for research injuries, but the U.S. National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) have not. A statement from the informed-consent document used by an NIH-sponsored clinical trial is mentioned. The authors suggest that research sponsors provide insurance against research injuries in developing countries.

Reports on a study of dental caries and sucrose intake of South African preschool children. Prevalence of labial caries in black and white preschoolers; Association of the type of caries with prolonged bottle feeding; Source of the sucrose content of the feeding bottles.

Describes the dilemma faced by the South African ethics committee asked to approve the clinical trials of treatment for HIV infection after the end of the trial. Responsibility of a trial sponsor to a trial subject to responds to treatment; Concerns on the large number of people insufficiently educated to understand the implications of the clinical trials.

Abstract – Objective: To report on associations between caries and micronutrient intake among a ‘true cohort’ group of 5-year-old urban black South African children. Methods: The study sample was a true cohort that had nutrition as well as dental information for 1991 and 1995 (n = 259). Micronutrient intake and dental caries associations were examined with SAS using the linear logistic analysis and a critical level of statistical significance of P < 0.05. Results: Of the 21 micronutrients investigated, vitamin B12 , riboflavin, magnesium and biotin were individually significantly associated with caries incidence, but taken together only magnesium was significant. Conclusions: The association of micronutrient intake with caries was weak, isolated and not clinically relevant. Micronutrient intake was not an indicator of the presence or absence of caries among the children studied. [ABSTRACT FROM AUTHOR]

This commentary uses personal research ethics experience in South Africa to consider the position of Tsan who recommends a consortium to develop common metrics / performance indicators for determining quality of RECs / IRBs. Terms such as performance, quality and throughput need clarification in research metrics before effective metrics may be useful.

Background: The study was undertaken in an academic maxillofacial and oral surgical unit in a large quaternary hospital attached to the Medical School of the University of the Witwatersrand, Johannesburg, between 2002 and 2006., Objective: To investigate the number of days in seven patient management intervals from facial fracture occurrence to discharge from hospital, to gain insight into reasons for treatment delays., Results: Facial fractures were treated a mean of 20.4 days from occurrence. There was a mean of 10.3 days from fracture to hospital presentation, and an identical period from hospital presentation to treatment. Statistical analysis showed that delay times decreased from 2002 to 2006., Conclusion: More rapid referral to the maxillofacial and oral surgical unit is the most practical way to reduce delays further.

Objective: To determine caries rate trends in children in South Africa and Swaziland since the first published epidemiological study in 1910., Method: Cochrane Collaboration methods were used to do a systematic review of reported caries rates from 1919 to 2007 in 5-6y, 11-13y and 14-17y children., Results: There are variations in caries rates among racial groups and between rural and urban areas but secular trends show decreasing prevalence and dmft or DMFT over time., Conclusion: This systematic review shows decreasing caries rates in children in a developing region of Africa.

The diversity between Streptococcus mutans clinical isolates from 5-year-old children and their mothers in two South African ethnic groups was investigated. The gtfB gene encoding for glucosyltransferase (EC 2.4.1.5), an enzyme responsible for the synthesis of extracellular polysaccharides was characterized by PCR-RFLP with HaeIII restriction enzyme digestion. Forty-seven children were examined for dental caries and 128 S. mutans clinical isolates cultured from samples of their saliva and plaque and from the saliva of their mothers. Thirty-three children had active caries (70%) and the remainder (n = 14) were caries-free. Caries prevalence was significantly different (p = 0.02) between black African and coloured children, but no differences were found between gtfB amplitypes by caries or ethnic grouping. Thirty-four (27%) of the S. mutans clinical isolates investigated did not ferment melibiose. Melibiose-negative phenotypes (n = 10) isolated from four families showed gtfB RFLP patterns identical to each other. Mothers and children harboured between one and three amplitypes. GtfB amplitypes were identical in 17 families (17/47), of which nine only were identical to S. mutans reference strains. The percentage match between S. mutans amplitype from mothers and their children was low (13%) in the caries-free group compared to children with caries (44%). RFLP analysis of the gtfB gene showed the diversity of S. mutans genotypes within two South African populations that were acquired from mothers and other sources.