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A diagnostic test is a simple test, sometimes based on a clinical measurement, which is used when the gold-standard test providing a definitive diagnosis of a given condition is too expensive, invasive or time-consuming to perform. The diagnostic test can be used to diagnose a dental condition in an individual patient or as a screening device in a population of apparently healthy individuals.

This study determined the presence of human papillomavirus (HPV) DNA in oral mucosa cells from 121 patients with different types of oral mucosal lesions (13 squamous cell carcinomas, 59 potentially malignant lesions, 49 benign erosive ulcerative lesions) and from 90 control subjects. HPV DNA was detected by nested polymerase chain reaction, and genotype was determined by DNA sequencing. HPV prevalence was 61.5% in carcinomas, 27.1% in potentially malignant lesions, 26.5% in erosive ulcerative lesions, and 5.5% in control subjects. The risk of malignant or potentially malignant lesions was associated with HPV and was statistically significant. HPV-18 was found in 86.5% of HPV-positive lesions but was not associated with a particular type of lesion and was found in 80% of the HPV-positive control subjects. HPV infection was related to older age but not to sex, smoking, or alcohol use; the presence of lesions in the oral cavity increased the risk of HPV infection.

Background . HIV testing, with appropriate counseling, can help prevent the spread of HIV infection. This study is the first national survey in Italy that examines factors associated with serotesting among Italian heterosexuals and is part of a European Concerted Action. Methods . In 1998, a cross-sectional telephone survey was conducted on a random sample ( n = 2,603) of the Italian population ages 18–49 years. Associations between HIV testing and risky sexual behaviors (multiple sexual partners in the past 5 years, intercourse with prostitutes, not always using condoms with a new sexual partner) and sociodemographic variables are examined separately for men and women using multiple logistic regression. Results . The prevalence of having ever been tested for HIV, whether voluntarily or not, among heterosexual men and women is 27.0 and 32.8%, respectively. Voluntary testing is reported by 8.4% of heterosexual men and 6.1% of heterosexual women. Multivariate analysis shows that having multiple sexual partners significantly increases the odds of testing (Men: OR = 2.10; 95% CI: 1.3–3.4. Women: OR = 3.03; 95% CI: 1.7–5.4). Multiple logistic regression, controlling for risky behavior, shows also that persons ages 30–39 years have significantly higher probability of being tested than younger subjects (Men: OR = 3.30; 95% CI: 1.4–7.9. Women: OR = 2.61; 95% CI:1.1–6.4). Better educated women tend to have a higher probability of testing, but this increase is not significant at the 5% level. Conclusions . The prevalence of voluntary serotesting in Italy is lower than in other countries. Risky sexual behavior is associated with higher odds of testing; however, a high proportion of at-risk heterosexuals never sought testing. Particular attention should be dedicated to younger persons and to less educated women.

Helicobacter pylori (H. pylori ) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in the last decades, abetted by modern clinical practices, may have other health consequences.

Background It is estimated that 10-15% of all couples have experienced an infertility problem. The objective of this study was to evaluate the effect of occupation on the time interval between when a couple starts unprotected intercourse and a clinically recognizable pregnancy time to pregnancy (TTP). Methods Data from 622 women who successfully delivered in the week preceding the interview were analysed using the Cox proportional hazards regression. Thirty independent variables were included in the full model. Results Eleven per cent of women had to wait more than one year before conceiving (mean TTP = 6.7 months). The regression analysis showed that the most important determinants of TTP are the age of the woman (rate ratio = 0.44 for age 35+) and her parity (rate ratio = 1.39). TTP also increased significantly with maternal smoking (rate ratio = 0.77), and decreased with coital frequency (rate ratio = 1.24 for > or = 6 per month) and consumption of coffee (rate ratio = 1.29). None of the female occupational exposures has been found to have an independent statistically significant effect, while male occupation in industry and exposure to welding fumes were associated with an increase of TTP (rate ratio = 0.73 and 0.78, respectively). Conclusions Female occupational exposures seem to have only a small effect on TTP compared with biological and lifestyle factors. The present data also suggest that work-related factors may have a bigger influence on male fecundity.

Biological systems use a relatively small number of molecular building blocks to generate a vast array of structurally and functionally diverse molecular architectures. The keys to the diversity found in nature are the oligomeric nature of the covalent framework and the range of different non-covalent structural motifs which are possible within this family of molecules [1,2].

Susceptibility to type I diabetes has been shown to be highly correlated with the presence of an amino acid other than Asp at position 57 of the DQ β-chain (non-Asp57) and also with the presence of an Arg at position 52 of the DQ α-chain (Arg52). In this study we analyzed the DQA1 and DQB1 gene polymorphisms in 65 patients from central Italy and 93 randomly selected control subjects. Polymerase chain reaction amplification of DNA encoding the first polymorphic domain of the DQB1 and DQA1 chains was performed, and DQB1 gene polymorphism was evaluated by dot blot analysis using 11 sequence-specific oligonucleotide probes. For DQA1 typing, a new simple procedure based on allele-specific amplification and analysis of heteroduplex DNA molecules formed by the annealing of mismatched allelic strands was used. This technique allows the discrimination of Arg52 and non-Arg52 DQA1 alleles. We then calculated by logistic regression the contribution of these genetic markers to the development of diabetes. Frequencies and odds ratios relative to the amino acid in position 57 of the DQ β-chain and the amino acid in position 52 of the DQ α-chain showed that the highest odds ratio (odds ratio = 161; 95% confidence interval 19–1386) was that of the homozygous combination of the two susceptibility markers (non-Asp57 and Arg52). Based on the incidence estimates of type I diabetes in the continental Italian population, the annual incidence rate of the disease was estimated for the different genotypes grouped according to the number of potentially formed susceptible heterodimers as 212.53, 12.60, 3.24, and 1.33/100,000 individuals per yr for the 4, 2 , 1 , and 0 susceptible heterodimers groups, respectively.

Dr. Virginia Bolton, Sir John Osborn, and Denise Servante present an account of the process whereby legislation was enacted in Britain. Each is a member of PROGRESS (the Campaign for Research into Human Reproduction), which was established in 1985 to present the case regulating research using human embryos to the British parliament and public.

Response We thank Mark Crowther and his colleagues for the comments that they have made on our paper.[1][1] While we welcome their opinions, it is worth noting that systematic reviews and meta-analyses are areas where opinions differ, controversy remains, and comments on published work are common

Part of the results of a study of subgingival plaque by darkground microscopy was used to investigate morphotype distribution at different levels within the periodontal pocket. Subgingival plaque was sampled at coronal, middle and apical levels from each of 28 approximal surfaces on 28 teeth extracted from 28 adults with untreated moderate to advanced periodontitis. Sample preparation and darkground microscopy were as described previously. The data recorded only the subgingival level at which the maximum count occurred for a given morphotype and subject. It was found that the maximum count of spirochaetes occurred most frequently at the apical level (p less than 0.05) and the maximum count of 'others' at the coronal level (p less than 0.05). Also, coccal counts showed a trend to increase the more apical the sample. Standardised darkground microscopy was able to show that the sampled subgingival level had a significant influence on plaque bacterial morphotype distribution, indicating the importance of accurate sampling of subgingival plaque at the most apical level.

The aim of the present study was to evaluate possible associations between subgingival plaque bacterial morphotypes, as assessed by darkground microscopy, and clinical indices of routine adult chronic periodontitis. Clinical indices were plaque index (PlI), gingival index (GI), sulcus bleeding index (SBI), papilla bleeding index (PBI), attachment loss (AL), pocket depth (PD) and probeable pocket depth (PPD). Apical border plaque was sampled in vivo and after extraction to test whether direct or indirect sampling affected any such associations. Similarly, pocket depth and attachment loss were also assessed directly and indirectly on the same teeth, in vivo or after extraction. The influence of the type of index used to record inflammation (GI, SBI, PBI) was also assessed, as were the effects of the numbers of sampled subjects and the method of analysis, which comprised the use of transformed and untransformed data and of parametric and non-parametric tests. Data were collected in relation to the approximal surfaces of 44 teeth extracted from 22 adults (2 teeth each) and from 1 pair of contralateral upper anterior or premolar teeth in each of 100 adults, all which untreated routine chronic periodontitis. Selected subjects had greater than or equal to 4 mm probeable pocket depth and/or attachment loss, and radiographic evidence of bone loss in relation to 1 approximal surface on each of 1 pair of contralateral anterior or premolar teeth, or to 2 teeth scheduled for extraction. Plaque preparation and darkground microscopy were as described previously. Insignificant associations (p greater than 0.05) were demonstrated between supragingival plaque (PlI) and periodontal inflammation (GI, SBI, PBI) or destruction (PPD and AL), as well as between inflammation and attachment level. In contrast, significant moderate associations (r = 0.5-0.77) were demonstrated between each of the 3 morphotype groups; spirochaetes, other motiles and cocci. Spirochaetes showed a significant moderate (r = 0.5) positive association with pocket depth with a 2.43% mean increase of spirochaetes for each 1 mm increase of PPD. Although highly significant associations (r = 0.9) were demonstrable between the 3 inflammation indices (GI, SBI, PBI) themselves, only PBI showed significant positive associations (r = 0.3) with spirochaetes and other motiles. Also, PlI showed significant associations with each of the 4 morphotypes (r = 0.3-0.5). The heterogeneity of spirochaetes and other motiles as well as the multiplicity of possible aetiological microbial agents in plaque may have resulted in underestimated associations between subjects as well as undetectable association within a given mouth using only 4 morphotype groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Sections of the torsioned side revealed a marked hyperplasia and hypertrophy of all the several coats of the uterus, i.e., endometrial, muscular and serous. There was a marked increase in the number and of the blood vessels. There was also an actual increase in the elastic tissue ratio of the blood vessels while the connective tissue ratio of the entire organ was grossly increased.

To conclude, I may summarize the trend of gynecology today, as follows: 1. (1) It is in the direction of a better understanding of the basic pathology. 2. (2) All of our therapy is based upon this underlying principle. 3. (3) The trained surgeon has a greater respect for the physiological processes known as nature's defensive barriers. 4. (4) Fewer operations are being done for the correction of obstetric errors. 5. (5) All operations are being preceded by intelligent preoperative preparation. 6. (6) Operation for cancer is done only in selected cases.

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