Database: EMBASE <: international biomedical and pharmaceutical literature, 1988 - May 2000. [Trial access until 3/2001. Feedback welcome to medical.library@umich.edu] Search Strategy (You Saved Citations 1-118 From Set 82): ----------------------------------------------------------------------------- 1 Reproducibility of results/ 8828 2 exp risk/ 142555 3 Models, statistical/ 3445 4 Prevalence/ 28128 5 Discriminant analysis/ 1694 6 Forecasting/ 840 7 exp Cohort studies/ 6595 8 Evaluation studies/ 746 9 Risk-taking/ 9719 10 exp Health behavior/ 12119 11 reproducib:.mp. 30773 12 risk:.mp. 292899 13 forecast:.mp. 2095 14 or/1-13 359129 15 False negative reactions/ or False positive reactions/ 4291 16 (sensitivity or specificity).ti,ab. 171235 17 (predictive adj value$1).mp. 15190 18 (predictive adj validit:).mp. 597 19 (likelihood adj ratio:).mp. 1149 20 (false adj (negative$1 or positive$1)).ti,ab. 13376 21 double blind method/ or single blind method/ 32928 22 random$.ti,ab. 140380 23 random allocation/ 2503 24 (single blind$3 or double blind$3 or triple blind$3).ti,ab. 38568 25 exp "sensitivity and specificity"/ 173587 26 (controlled adj trial:).mp. 104667 27 (practice adj guideline:).mp. 19351 28 (consensus adj development adj conference:).mp. 169 29 or/15-28 564723 30 exp Tooth demineralization/ 7492 31 demineralization.mp. 879 32 caries.mp. 1798 33 caires.mp. 0 34 craies.mp. 0 35 careis.mp. 1 36 carise.mp. 0 37 (teeth adj3 cavit:).mp. 32 38 (tooth adj3 cavit:).mp. 97 39 (dental adj3 cavit:).mp. 85 40 (dentin adj3 cavit:).mp. 19 41 (enamel adj3 cavit:).mp. 10 42 (teeth adj3 decay:).mp. 58 43 (tooth adj3 decay:).mp. 58 44 (dental adj3 decay:).mp. 47 45 (dentin adj3 decay:).mp. 0 46 (enamel adj3 decay:).mp. 1 47 (active adj decay).mp. 5 48 (rampant adj3 decay:).mp. 4 49 (recurrent adj3 decay:).mp. 5 50 (white adj spot:).mp. 231 51 carious.mp. 109 52 cariology.ti,ab. 2 53 (non-cavitated adj3 lesion:).mp. 0 54 (noncavitated adj3 lesion:).mp. 1 55 Tooth remineralization/ 788 56 (dental adj3 fissure:).mp. 14 57 (tooth adj3 fissure:).mp. 8 58 (teeth adj3 fissure:).mp. 1 59 caries-free.mp. 29 60 cariesfree.mp. 0 61 Cariogenic agents/ 3 62 precavit:.mp. 2 63 (filled adj3 teeth).mp. 45 64 (filled adj3 tooth).mp. 9 65 (oral adj fissure:).mp. 17 66 (tooth adj3 remineraliz:).mp. 1 67 (teeth adj3 remineraliz:).mp. 5 68 dft.mp. 542 69 dfs.mp. 980 70 dmf:.mp. 1235 71 cariogeni:.mp. 164 72 or/30-71 12313 73 72 and 14 and 29 413 74 limit 73 to (human and english language) 356 75 limit 74 to (child < unspecified age > or preschool child < 114 1 to 6 years > or school child < 7 to 12 years > or adolescent < 13 to 17 years >) 76 exp Tooth, deciduous/ 142 77 Dentition, primary/ 411 78 Dentition, mixed/ 411 79 ((primary or deciduous or mixed) adj5 (tooth or teeth or 650 dent: or odont:)).mp. 80 or/76-79 1002 81 74 and 80 13 82 75 or 81 118 83 from 82 keep 1-118 118 *************************** <1> UI - 2000165600 AU - Medeiros AS AU - Gomide MR AU - Costa B AU - De Carvalho Carrara CF AU - Das Neves LT IN - Dr. M.R. Gomide, Setor de Odontopediatria, Hosp. Reabilotacao Anomal. Craniof., USP, Rua Silvio Marchionc, 3-20, 17043-900, Bauru, SP; Brazil. TI - Prevalence of intranasal ectopic teeth in children with complete unilateral and bilateral cleft lip and palate. SO - Cleft Palate-Craniofacial Journal Vol 37(3) (pp 271-273), 2000. AB - Objective: The objective of this study was to determine the prevalence of ectopic eruption of intranasal teeth. Design: This was a retrospective study, where records of children with repaired cleft lip and palate were analyzed. Setting: The study was conducted at a large craniofacial center, the Hospital for Rehabilitation of Craniofacial Anomalies, USP, Bauru, Sao Paulo, Brazil. Subjects: The sample consisted of 815 records from patients with bilateral cleft lip and palate (BCLP) and 1495 records from patients with unilateral Cleft lip and palate (UCLP). The age of the subjects was 5 to 10 years old and the groups included both males and females. Results: The results showed that 0.61% of the children With BCLP and 0.40% of those with UCLP had an intranasal tooth. The prevalence of an intranasal tooth for the whole group was 0.48%, and it appeared to be more common in females. [References: 23] <2> UI - 2000160042 AU - Merrick J AU - Shapira J IN - Prof. J. Merrick, Division for the Mentally Retarded, Ministry of Labour/Social Affairs, The Hebrew Univ.-Hadassah Faculty, Box 1260, IL-91012 Jerusalem; Israel. E-Mail: jmerrick@aquanet.co.il. TI - Dental concerns in Down syndrome. SO - International Journal of Adolescent Medicine & Health Vol 12(1) (pp 75-79), 2000. AB - Persons with Down syndrome (DS) have several cranial and oral cavity abnormalities resulting in dental disease. Two dental studies from Israel with a preadolescent (aged 8-13 years) and adult population (aged 20-48 years) of Down syndrome are reviewed. The studies used control groups of healthy and non-Down syndrome children and adults with mental retardation. All in all 84% of the children and 33% of the adults with DS were caries free. Periodontal treatment needs of the DS and non-Down adults were higher that the healthy group of persons and the DS adult group showed periodontal treatment needs three times greater than the DS children. It is recommended to start dental visits for persons with DS between the age of 18-24 months and to continue at least twice every year. [References: 3] <3> UI - 2000147972 AU - Carlander D AU - Kollberg H AU - Wejaker P-E AU - Larsson A IN - A. Larsson, Department of Medical Sciences, University Hospital, S-751 85 Uppsala; Sweden. E-Mail: anders.larsson@klinkem.uas.lul.se. TI - Peroral immunotheraphy with yolk antibodies for the prevention and treatment of enteric infections. SO - Immunologic Research Vol 21(1) (pp 1-6), 2000. AB - Oral administration of specific antibodies is an attractive approach to establish protective immunity against gastrointestinal pathogens in humans and animals. The increasing number of antibiotic-resistant bacteria emphasize the need to find alternatives to antibiotics. Immunotherapy can also be used against pathogens that are difficult to treat with traditional antibiotics. Laying hens are very good producers of specific antibodies. After immunization, the specific antibodies are transported to the egg yolk from which the antibodies then can be purified. A laying hen produces more than 20 g of yolk antibodies (IgY) per year. These antibodies also have biochemical properties that make them attractive for peroral immunotherapy: They neither activate mammalian complement nor interact with mammalian Fc receptors that could mediate inflammatory response in the gastrointestinal tract. Eggs are also normal dietary components and thus there is practically no risk of toxic side effects of IgY. Yolk antibodies have been shown in several studies to prevent bacterial and viral infections. [References: 25] <4> UI - 2000139034 AU - Ball ED AU - Wilson J AU - Phelps V AU - Neudorf S IN - Dr. E.D. Ball, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0960; United States. TI - Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow: Results of phase II studies with long-term follow-up. SO - Bone Marrow Transplantation Vol 25(8) (pp 823-829), 2000. AB - One hundred and thirty-eight patients with AML underwent ABMT with monoclonal antibody plus complement-purged marrow between August 1984 and March 1997. One hundred and ten patients were in CR (CR1: 23; CR2/3: 87) and 28 were in first relapse (R1) at ABMT. Preparative regimens included busulfan (16 mg/kg) and CY (120 mg/kg) (n = 93), CY (120 mg/kg over 2 days) with TBI (1200 cGy) (n = 35), and busulfan (16 mg/kg) plus etoposide (60 mg/kg) (n = 10). CR1 patients treated with CY/TBI (n = 7) had 3- and 5-year disease-free survival (DFS) rates of 71% and 57%. CR1 patients treated with BU/CY (n = 12), had 3- and 5-year DFS rates of 45%. Three and 5-year DFS for CR2/3 patients treated with CY/TBI (n = 26) was 23%. Three- and 5-year DFS for patients in CR2/3 treated with BU/CY (n = 55) was 31 and 28%. Three- and 5-year DFS for patients in R1 treated with BU/CY (n = 26) was 37%. In multivariate analysis, increased age was associated with greater risk of death and relapse. For CR2/3 patients, the length of CR1 was a significant predictor of DFS. ABMT performed in CR or R1 results in excellent 5-year DFS and OS. The contribution of purging may require a randomized trial comparing purged vs unpurged stem cell infusions. [References: 31] <5> UI - 2000132925 AU - Newacheck PW AU - Hughes DC AU - Hung Y-Y AU - Wong S AU - Stoddard JJ IN - Dr. P.W. Newacheck, Institute for Health Policy Studies, Department of Pediatrics, University of California, San Francisco, CA 94143; United States. TI - The unmet health needs of America's children. SO - Pediatrics Vol 105(4 II) (pp 989-997), 2000. AB - Objective. Unmet need for health care is a critical indicator of access problems. Among children, unmet need for care has special significance inasmuch as the failure to obtain treatment can affect health status and functioning in the near- and long-term. The purpose of this study was to present current prevalence estimates and descriptive characteristics of children with unmet health needs using nationally representative household survey data. Methods. We analyzed 4 years of National Health Interview Survey data spanning 1993 through 1996. Our analysis included 97 206 children <18 years old. Measures of unmet need for medical care, dental care, prescription medications, and vision care were obtained from an adult household member (usually the mother) responding for the child. Bivariate and multivariate analyses were used to assess the degree to which unmet need was related to the demographic and socioeconomic characteristics of the child and family. Results. Overall, 7.3% (4.7 million) of US children experienced at least 1 unmet health care need. Dental care was the most prevalent unmet need. After adjustment for confounding factors, near-poor and poor children were both about 3 times more likely to have an unmet need as nonpoor children (adjusted odds ratio [95% confidence interval] = 2.89 [2.52, 3.32], 3.0 [2.53, 3.56], respectively). Uninsured children were also about 3 times more likely to have an unmet need as privately insured children (adjusted odds ratio [95% confidence interval] = 2.92 [2.58, 3.32]). Conclusions. Despite the nation's great wealth, unmet health needs remain prevalent among US children. A combined public policy that addresses financial and nonfinancial barriers to care is required to reduce the prevalence of unmet need for health care. [References: 18] <6> UI - 2000106596 AU - Miyoshi S AU - Tanaka S AU - Kunimatsu H AU - Murakami Y AU - Fukami M AU - Fujisawa S IN - Prof. S. Fujisawa, Department of Oral Diagnosis, Meikai Univ. School of Dentistry, 1-1 Keyakidai, Sakado City, Saitama 350-0283; Japan. TI - An epidemiological study of supernumerary primary teeth in Japanese children: A review of racial differences in the prevalence. SO - Oral Diseases Vol 6(2) (pp 99-102), 2000. AB - OBJECTIVE: To clarify the prevalence of supernumerary primary teeth in Japanese children, we evaluated this prevalence in a sample of 8122 children aged 3-6 years. Furthermore, we undertook a statistical comparison of the findings of the present study with those of previous investigations on the prevalence of supernumerary primary teeth in Japanese, Chinese and Caucasian children. SUBJECTS: The subjects used in the study consisted of 8122 children aged 3-6 years (4102 boys and 4020 girls). The children were examined in kindergartens. METHODS: The prevalence of supernumerary primary teeth was recorded by visual inspection. Statistical analysis was carried out using the X2 test. RESULTS: Four cases of supernumerary primary teeth were found among the children examined, and thus the prevalence was 0.05%. All of the supernumerary primary teeth were located in the maxillary lateral incisor area. CONCLUSIONS: The prevalence in a sample of 8122 Japanese children was 0.05% and that in a combined sample of 65 068 Japanese children was 0.06%. [References: 16] <7> UI - 2000094636 AU - Lamell CW AU - Griffen AL AU - McClellan DL AU - Leys EJ IN - A.L. Griffen, Department of Pediatric Dentistry, Ohio State University, 305 W. 12th Ave., Columbus, OH 43210; United States. E-Mail: griffen.1@osu.edu. TI - Acquisition and colonization stability of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in children. SO - Journal of Clinical Microbiology Vol 38(3) (pp 1196-1199), 2000. AB - The presence of Porphyromonas gingivalis has been shown to be a risk factor for periodontitis in adults, and Actinobacillus actinomycetemcomitans has been implicated as a pathogen in early-onset periodontitis. Both species have been shown to establish stable colonization in adults. In cross- sectional studies, both A. actinomycetemcomitans and P. gingivalis have been detected in over one-third of apparently healthy children. Information on the stability of colonization with these organisms in children could help to elucidate the natural history of the development of periodontitis. For this purpose, samples previously collected from a cohort of 222 children between the ages of 0 and 18 years and previously examined for the presence of P. gingivalis with a PCR-based assay were examined for the presence of A. actinomycetemcomitans. It was detected in 48% of subjects and, like P. gingivalis, was found at similar frequencies among children of all ages (P = 0.53), suggesting very early initial acquisition. One hundred one of the original subjects were recalled after 1 to 3 years to determine the continuing presence of both A. actinomycetemcomitans and P. gingivalis. The prevalence of both species remained unchanged at resampling. However, in most children both species appeared to colonize only transiently, with random concordance between the results of the first and second sampling. Stability of colonization was unrelated to age for A. actinomycetemcomitans, but P. gingivalis was more stable in the late teenage years. [References: 34] <8> UI - 2000072313 AU - Glikson M AU - Luria D AU - Friedman PA AU - Trusty JM AU - Benderly M AU - Hammill SC AU - Stanton MS IN - Dr. M. Glikson, Heart Institute, Sheba Medical Center, Tel Hashomer 52621; Israel. E-Mail: mglikson@post.tau.ac.il. TI - Are routine arrhythmia inductions necessary in patients with pectoral implantable cardioverter defibrillators?. SO - Journal of Cardiovascular Electrophysiology Vol 11(2) (pp 127-135), 2000. AB - Introduction: The value of ventricular arrhythmia inductions as part of routine implantable cardioverter defibrillator (ICD) follow-up in new- generation pectoral ICDs is unknown. Methods and Results: We performed a retrospective analysis of a prospectively collected database analyzing data from 153 patients with pectoral ICDs who had routine arrhythmia inductions at predismissal, and 3 months and 1 year after implantation. Routine predismissal ventricular fibrillation (VF) induction yielded important findings in 8.8 % of patients, all in patients with implantation defibrillation threshold (DFT) >=. 15 J or with concomitant pacemaker systems. At 3 months and 1 year, routine VF induction yielded important findings in 5.9% and 3.8% of tested patients, respectively, all in patients who had high DFT on prior testing. Ventricular tachycardia (VT) induction at predismissal, and 3 months and 1 year after implantation resulted in programming change in 37.4%, 28.1%, and 13.8% of tested patients, almost all in patients with inducible VT on baseline electrophysiologic study and clinical episodes since implantation. Conclusion: Although helpful in identifying potentially important ICD malfunctions, routine arrhythmia inductions during the first year after ICD implantation may not be necessary in all cases. VF inductions have a low yield in patients with previously low DFTs who lack concomitant pacemakers. VT inductions have a low yield in patients without baseline inducible VT and in the absence of clinical events. Definite recommendations regarding patient selection must await larger prospective studies as well as consensus in the medical community about what comprises an acceptable risk justifying avoidance of the costs and inconveniences of routine arrhythmia inductions. [References: 23] <9> UI - 2000047432 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Dr. P.S. Frame, Tri-County Family Medicine, 23 Park Avenue, Cohocton, NY 14826; United States. TI - Preventive dentistry: Practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. SO - American Journal of Preventive Medicine Vol 18(2) (pp 159-162), 2000. AB - Introduction: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. Results: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Conclusions: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low- risk populations. (C) 2000 American Journal of Preventive Medicine. [References: 16] <10> UI - 2000040562 AU - Gales MA AU - Nguyen T-M IN - Dr. M.A. Gales, Department of Pharmacy, INTEGRIS, Baptist Medical Center, 3300 Northwest Expressway, Oklahoma City, OK 73112; United States. TI - Sorbitol compared with xylitol in prevention of dental caries. SO - Annals of Pharmacotherapy Vol 34(1) (pp 98-100), 2000. AB - OBJECTIVE: To summarize published data on the comparative efficacy of sorbitol and xylitol for prevention of dental caries. DATA SOURCES: Published double-blind comparative trials, using sorbitol and xylitol products, identified by MEDLINE (January 1966-December 1998) and International Pharmaceutical Abstracts (January 1970-December 1998) searches. DATA SYNTHESIS: Clinical trials generally used sorbitol and xylitol gums, which patients chewed three to five times daily for 20-40 months. Xylitol was superior to sorbitol in two longer, secondary dentition trials (30-63% reductions), but not in two primary dentition trials. CONCLUSIONS: The data suggest that xylitol-containing gums may provide superior efficacy in reducing caries rates in high-risk populations. [References: 16] <11> UI - 1999423455 AU - Rodrigues CS AU - Watt RG AU - Sheiham A IN - A. Sheiham, Dept. of Epidemiology Public Health, Royal Free Univ. Coll. Med. School, University College London, London WC1E 6BT; United Kingdom. TI - Effects of dietary guidelines on sugar intake and dental caries in 3-year-olds attending nurseries in Brazil. SO - Health Promotion International Vol 14(4) (pp 329-335), 1999. AB - The health outcomes of food and health policies are seldom evaluated. The objective of this study was to assess the effect of adoption of dietary guidelines on sugars by nurseries on levels of sugar consumption and 1-year dental caries increments in low-socio-economic 3-year-old children. Twenty-nine nurseries out of the 50 largest nurseries in Recife, Brazil were randomly selected. Five hundred and ten children (78% of those approached were examined); 245 children attending 12 nurseries adopting guidelines on restriction of sugar intake, and 265 at 17 nurseries without guidelines were assessed. The children's sugar intakes at nursery and at home were assessed by measuring 6 days weighed food intakes at the nursery, and a food inventory completed by the children's mothers. Dental caries were examined using standard WHO criteria. There were statistically significant differences in frequency and weight of sugar intake between children attending nurseries adopting and those not using dietary guidelines (p < 0.001). Children at nurseries adopting guidelines consumed less than half of the amount of sugar consumed in a day by children at non-adopting nurseries; 22.9 versus 53.5 g. Children attending nurseries with guidelines on reduction of sugar intake were 4.87 times more likely to develop caries in 1 year than those attending nurseries with guidelines Children who had a daily sugar intake of more than 32.6 g had nearly three times the risk of developing a high caries increment than those consuming less than 32.6 g. Dietary guidelines for sugar for nurseries are effective in providing menus with lower levels of sugar. Children consuming such menus are much less likely to develop dental caries. [References: 16] <12> UI - 1999402929 AU - Patton LL AU - Van der Horst C IN - L.L. Patton, Department of Dental Ecology, 388 Dental Office Building, University of North Carolina, Chapel Hill, NC 27599-7450; United States. TI - Oral infections and other manifestations of HIV disease. SO - Infectious Disease Clinics of North America Vol 13(4) (pp 879-900), 1999. AB - Oral lesions are important in the clinical spectrum of HIV/AIDS, arousing suspicion of acute seroconversion illness (aphthous ulceration and candidiasis), suggesting HIV infection in the undiagnosed individual (candidiasis, hairy leukoplakia, Kaposi's sarcoma, necrotizing ulcerative gingivitis), indicating clinical disease progression and predicting development of AIDS (candidiasis, hairy leukoplakia), and marking immune suppression in HIV-infected individuals (candidiasis, hairy leukoplakia, necrotizing periodontal disease, Kaposi's sarcoma, long-standing herpes infection, major aphthous ulcers). In addition, oral lesions are included in staging systems for HIV disease progressions and as entry criteria or endpoints in clinical trials of antiretroviral drugs. Recognition and management of these oral conditions is important for the health and quality of life of the individual with HIV/AIDS. In keeping with this, the U.S. Department of Health Services Clinical Practice Guideline for Evaluation and Management of Early HIV Infection includes recommendations that an oral examination, emphasizing oral mucosal surfaces, be conducted by the primary care provider at each visit, a dental examination by a dentist should be done at least two times a year, and patients should be informed of the importance of oral care and educated about common HIV-related oral lesions and associated symptoms. [References: 138] <13> UI - 1999398682 AU - Lin Y-TJ AU - Tsai C-L IN - Dr. Y.-T.J. Lin, Department of Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Ta Pei Rd, Niao Sung Hsiang, Kaohsiung Hsien; Taiwan. TI - Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. SO - Cleft Palate-Craniofacial Journal Vol 36(6) (pp 522-526), 1999. AB - Objective: The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. Design: Randomized and prospective study. Setting: Institutional setting. Patients and Methods: One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non- bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. Results: Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle- fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle- feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle- fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). Conclusions: Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents. [References: 21] <14> UI - 1999330989 AU - Granena A AU - Castellsague X AU - Badell I AU - Ferra C AU - Ortega JJ AU - Brunet S AU - Punti C AU - Sureda A AU - Picon M AU - Vallas A AU - Rutllant ML AU - Garcia J IN - Prof. A. Granena, Hematology Department, Institut Catala d'Oncologia, Hospital Duran i Reynals, Autovia de Castelldefels Km:2.7, 08907 Barcelona; Spain. TI - Autologous bone marrow transplantation for high risk acute lymphoblastic leukemia: Clinical relevance of ex vivo bone marrow purging with monoclonal antibodies and complement. SO - Bone Marrow Transplantation Vol 24(6) (pp 621-627), 1999. AB - Herein we describe our experience with 75 consecutive autologous BM transplants for patients with high-risk ALL, with special attention to the clinical impact of BM purging. Fifty-two patients received purged BM using monoclonal antibody (MoAb) cocktails and complement, and 23 patients received untreated BM. The distribution of prognostic factors was similar in both groups. Hemopoietic reconstitution was adequate and did not differ in the two groups. Transplant-related mortality was 9.6% and 13% in 'purged' and 'unpurged' groups. Median follow up was 11 months (2-71) and overall actuarial probability of disease-free survival (DFS) at 5 years was 40% (53% relapse probability). We found a beneficial effect of purging in patients over 15 years of age and in patients needing more than 1 month to reach CR1. Patients in CR1 receiving purged marrow had a longer DFS and a lower relapse probability (52% vs 12%, P = 0.02 and 35% vs 86%, P = 0.005, respectively) which were related to the efficacy of the purging procedure (more or less than one log of depletion). In further CR, no advantage of purging has been found. Our data strongly suggest the clinical relevance of BM purging in autologous BMT in high-risk ALL patients and support the need for prospective randomized studies. [References: 53] <15> UI - 1999218727 AU - Moss ME AU - Lanphear BP AU - Auinger P IN - Dr. M.E. Moss, Dept. of Community/Preventive Med., Univ. of Rochester Medical Center, Box 644, 601 Elmwood Ave, Rochester, NY 14642; United States. E-Mail: moss@prevmed.rochester.edu. TI - Association of dental caries and blood lead levels. SO - JAMA Vol 281(24) (pp 2294-2298), 1999. AB - Context: Experiments show that dental caries rates are higher among lead-exposed animals, but this association has not been established in humans. Objective: To examine the relationship between blood lead levels and dental caries. Design: Cross-sectional survey conducted from 1988 to 1994 that included a dental examination and venipuncture blood lead assay. Setting and Participants: A total of 24901 persons aged 2 years and older who participated in the Third National Health and Nutrition Examination Survey, which assessed the health and nutritional status of children and adults in the United States. Main Outcome Measures: For children aged 2 to 11 years, the sum of decayed and filled deciduous or primary surfaces; for persons aged 6 years and older, the sum of decayed and filled permanent surfaces; for those 12 years and older, the sum of decayed, missing, and filled surfaces. Results: The log of blood lead level was significantly associated with the number of affected surfaces for both deciduous and permanent teeth in all age groups, even after adjusting for sociodemographic characteristics, diet, and dental care. Among children aged 5 to 17 years, a 0.24-mumol/L (5-mug/dL) change in blood lead level was associated with an elevated risk of dental caries (odds ratio, 1.8; 95% confidence interval, 1.32.5). Differences in blood lead level explained some of the differences in caries prevalence in different income levels and regions of the United States. We estimated the population attributable risk of lead exposure to be 13.5% and 9.6% of dental caries occurring in 5- to 17-year-olds exposed to the high and moderate levels, respectively. Conclusions: Environmental lead exposure is associated with an increased prevalence of dental caries in the US population. Findings may help explain the distribution of caries by income and region of the United States. [References: 25] <16> UI - 1999207801 AU - Faggiano F AU - Di Stanislao F AU - Lemma P AU - Renga G IN - F. Faggiano, Department of Public Health, University of Turin, Via Santena 5bis, 10126 Turin; Italy. E-Mail: faggiano@molinette.unito.it. TI - Role of social class in caries occurrence in 12 year olds in Turin, Italy. SO - EUR J PUBLIC HEALTH, Vol 9(2) (pp 109-113), 1999. AB - Background: The objective of the study was to evaluate the social distribution of dental caries and its determinants in the province of Turin, an area of 2,300,000 inhabitants in the north of Italy. Methods: A cross- sectional study was carried out among a representative school-based sample of 11-12 year olds. A total of 734 (84.0% of the starting sample) students were involved. Two questionnaires were submitted (to students and parents) and the children received a dental examination. Dietary and hygiene indicators were calculated and the DMFT index (the number of decayed, missing and filled teeth) was measured using methods recommended by the World Health Organisation (WHO). The education level of the head of family was used as a proxy of social class indicator. Univariate and multivariate analyses were applied to obtain results. Results: Students from disadvantaged families showed: i) a higher tendency to belong to the higher risk group for oral hygiene (RR primary school/university = 2.78); ii) a lower use of dental prevention (RR=0.40 for use of fluoride tablets and RR=0.43 for local applications of fluoride) and iii) a higher consumption of sucrose-sweetened foods (RR=1.17%, ns) when compared with children of graduate parents. The DMFT index was more than double among children whose parents only had a primary school education, compared with those of graduate parents (3.2 versus 1.5). In addition, the percentage of caries-free children increased from 16.4 to 59.1% from the lowest to the highest social group. Conclusions: Large social differences are found in caries experience and in determinants of dental decay. Nevertheless, determinants of caries occurrence seem to explain only a small fraction of inequalities. [References: 37] <17> UI - 1999195722 AU - Czyzewski EAD AU - Goldman S AU - Mundt AJ AU - Nachman J AU - Rubin C AU - Hallahan DE IN - Dr. D.E. Hallahan, Department of Radiation Oncology, Vanderbilt Clinic, 1301 22nd Avenue South, Nashville, TN 37232-5671; United States. E-Mail: dennis.hallahan@mcmail.vanderbilt.edu. TI - Radiation therapy for consolidation of metastatic or recurrent sarcomas in children treated with intensive chemotherapy and stem cell rescue. A feasibility study. SO - International Journal of Radiation Oncology, Biology, Physics Vol 44(3) (pp 569-577), 1999. AB - Purpose: To assess the role of consolidative radiation therapy (CRT) in conjunction with myeloablative therapy with or without total body irradiation (TBI) in children and young adults with metastatic or recurrent sarcoma. Methods and Materials: Twenty-one pediatric sarcoma patients with metastatic (10) or recurrent (11) disease were entered on a prospective feasibility study of intensive myeloablative therapy with or without TBI. Median patient age was 17.8 years (range, 9.4-24.7 years). Primary histologies included Ewing's (12), PNET (3), and other soft tissue sarcomas (6). Twenty patients received induction chemotherapy. Myeloablative therapy consisted of TBI in 11 patients with either high dose melphalan/etoposide (9) or high dose cytoxan/thiotepa (2). TBI consisted of 12 Gy in 2 Gy fractions delivered twice daily over 3 days. Ten patients received high dose chemotherapy alone, either with thiotepa/carboplatinum/etoposide (8) or cytoxan/carboplatinum (2). Myeloablative therapy was followed by autologous stem cell rescue (ASCR) 24 to 48 hours after completing chemotherapy. Fourteen patients (67%) received CRT either prior to (5) or following (9) myeloablative therapy. Median CRT dose was 37.2 Gy (range, 20-60). Fifty-one disease sites were present prior to myeloablative therapy. Twelve (24%) were bulky (> 8 cm) and 18 (35%) underwent surgical debulking. The median follow-up of surviving patients was 15 months (range, 8-20) with 25% of patients having been followed for more than 20 months. Results: The 3-year actuarial disease-free (DFS) and overall survival (OS) rates for the entire group were 36% and 27%, respectively. Following myeloablative treatment, responses were: 11 complete, 6 partial, 1 stable, and 3 progressive disease. Sixteen patients (71%) have relapsed. The most common site of relapse was the lung (13). Of the 51 disease sites present prior to myeloablative therapy, 36 sites (71%) were amenable to CRT. Nonamenable sites were: multiple lung metastases (13) and bone marrow (2). Twenty-six amenable sites (51%) received CRT either prior to (14) or following (12) ASCR. Amenable sites treated with CRT had a better 3- year actuarial local control (80 vs 37%) (p = 0.0065) than amenable sites not treated with CRT. Factors associated with improved disease-free survival (DFS) in univariate analysis were induction chemotherapy response (p = 0.002) and extent of surgical resection (p = 0.045). There was a trend toward improved DFS on univariate analysis with the use of TBI as part of myeloablative therapy (p = 0.07). The one factor associated with improved OS on univariate analysis was induction chemotherapy response (p = 0.007). Multivariate analysis revealed that induction chemotherapy response is the only factor that remains significant for DFS (p = 0.032) as well as for OS (p = 0.017). Patients with complete response to induction therapy had 40% probability of survival versus all other patients who had 10% survival (p = 0.05). Conclusion: Consolidative radiotherapy is feasible in primary metastatic or recurrent pediatric sarcoma patients treated with myeloablative therapy with or without TBI. CRT to sites amenable to irradiation provided an improved 3-year actuarial local control than that seen in sites amenable to CRT that did not undergo radiotherapy. There was a trend for improved DFS with the use of TBI. Improved DFS and OS can be predicted by response to induction therapy. This intensive regimen may improve the cure rate of advanced pediatric sarcomas in select patients. [References: 25] <18> UI - 1999151318 AU - Idigbe EO AU - Enwonwu CO AU - Falkler WA AU - Ibrahim MM AU - Onwujekwe D AU - Afolabi BM AU - Savage KO AU - Meeks VI IN - E.O. Idigbe, Nigerian Inst. of Medical Research, 6 Edmond Crescent, Yaba Lagos; Nigeria. TI - Living conditions of children at risk for noma: Nigerian experience. SO - Oral Diseases Vol 5(2) (pp 156-162), 1999. AB - The study reported in this paper was carried out in the Northwestern and Southwestern regions of Nigeria, between October 1996 and April 1998. The study examined the possible contributory role of living conditions in the development of acute necrotizing gingivitis (ANG) or noma from oral lesions. Questionnaire data obtained from 42 fresh noma cases seen in the Northwest and four fresh cases seen in the Southwest were examined. In addition 46 cases of advanced ANG from the Southwest were included. The main focus was to compare some of the environmental living conditions of cases with advanced ANG and those with noma in these regions. All the noma and ANG cases were seen in children aged 212 years. The level of good oral hygiene practices and general environmental living conditions were significantly higher in the Southwest than in the Northwest. Data also showed that living in close proximity with livestock was significantly higher in the Northwest than in the Southwest (P < 0.05). The environmental living conditions of children in the Northwest were further compounded by poor sanitary faecal disposal practices as well as minimal access to potable water. The overall data indicated that living in substandard accommodations, exposure to debilitating childhood diseases, living in close proximity to livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk for noma than the children in the Southwest. These could have been responsible for the higher prevalence of noma in the Northwest than in the Southwest. [References: 28] <19> UI - 1999130553 AU - Morrison HI AU - Ellison LF AU - Taylor GW IN - Dr. H.I. Morrison, Cancer Bureau, Laboratory Centre for Dis. Control, Tunney's Pasture, Ottawa, Ont. K1A 0L2; Canada. TI - Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. SO - Journal of Cardiovascular Risk Vol 6(1) (pp 7-11), 1999. AB - Background: Recent reports have implicated periodontal disease as a risk factor for coronary heart disease (CHD). Methods: A retrospective cohort study was conducted using participants in the 1970-1972 Nutrition Canada Survey (NCS). The mortality experience of male and female NCS participants aged 35-84 years without self-reported CHD (n=10 368) or cerebrovascular disease (CVD) (n=11 251) was determined through 1993. The relation between dental health and the risk of fatal CHD and CVD was assessed using Poisson regression modeling. Results: In total, 466 CHD and 210 CVD deaths were observed; missing confounder data reduced these numbers to 416 CHD and 182 CVD deaths. Adjusted for age, sex, diabetes status, serum total cholesterol, smoking, hypertensive status, and province, we found a statistically significant association between periodontal disease and risk of fatal CHD. Rate ratios (RR) of 2.15 [95% confidence interval (CI) 1.25-3.72) and 1.90 (95% CI 1.17-3.10) were observed for severe gingivitis and edentulous status, respectively. Nonstatistically significantly increased RRs of 1.81 and 1.63 were observed for severe gingivitis and edentulous status for CVD. Conclusions: These data indicate that poor dental health is associated with an increased risk of fatal CHD. [References: 19] <20> UI - 1999137879 AU - Dorn PA AU - Piskorski P AU - Gorga MP AU - Neely ST AU - Keefe DH IN - P.A. Dorn, Boys Town National Research Hospital, 555 North 30th Street, Omaha, NE 68131; United States. TI - Predicting audiometric status from distortion product otoacoustic emissions using multivariate analyses. SO - Ear & Hearing Vol 20(2) (pp 149-163), 1999. AB - Objectives: 1) To determine whether multivariate statistical approaches improve the classification of normal and impaired ears based on distortion product otoacoustic emission (DPOAE) measurements, in comparison with the results obtained with more traditional single-variable applications of clinical decision theory. 2) To determine how well the multivariate predictors, derived from analysis on a training group, generalized to a validation group. 3) To provide a way to apply the multivariate approaches clinically. Design: Areas under the relative operating characteristic (ROC) curve and cumulative distributions derived from DPOAE, DPOAE/Noise, discriminant function (DF) scores and logit function (LF) scores were used to compare univariate and multivariate predictors of audiometric status. DPOAE and Noise amplitudes for 8 f2 frequencies were input to a discriminant analysis and to a logistic regression. These analyses generated a DF and LF, respectively, composed of a linear combination of selected variables. The DF and LF scores were the input variables to the decision theory analyses. For comparison purposes, DPOAE test performance was also evaluated using only one variable (DPOAE or DPOAE/Noise when f2 = audiometric frequency). Analyses were based on data from over 1200 ears of 806 subjects, ranging in age from 1.3 to 96 yr, with thresholds ranging from -5 to >120 dB HL. For statistical purposes, normal hearing was defined as thresholds of 20 dB HL or better. For the multivariate analyses, the database was randomly divided into two groups of equal size. One group served as the 'training' set, which was used to generate the DFs and LFs. The other group served as a 'validation' set to determine the robustness of the DF and LF solutions. Results: For all test frequencies, multivariate analyses yielded greater areas under the ROC curve than univariate analyses, and greater specificities at fixed sensitivities. Within the multivariate techniques, discriminant analysis and logistic regression yielded similar results and both yielded robust solutions that generalized well to the validation groups. The improvement in test performance with multivariate analyses was greatest for conditions in which the single predictor variable resulted in the poorest performance. Conclusions: A more accurate determination of auditory status at a specific frequency can be obtained by combining multiple predictor variables. Although the DF and LF multivariate approaches resulted in the greatest separation between normal and impaired distributions, overlap still exists, which suggests that there would be value in continued efforts to improve DPOAE test performance. [References: 33] <21> UI - 1999113422 AU - Tsurusawa M AU - Katano N AU - Yamamoto Y AU - Hirota T AU - Koizumi S AU - Watanabe A AU - Takeda T AU - Hatae Y AU - Yatabe M AU - Mimaya J AU - Gushiken T AU - Nishi K AU - Anami K AU - Kikuta A AU - Kanegane H AU - Asami K AU - Nishikawa K AU - Sekine I AU - Kawano Y AU - Iwai A AU - Furuyama T AU - Ijichi O AU - Miyake M AU - Mugishima H AU - Ota S AU - Fujimoto T IN - Dr. M. Tsurusawa, Department of Pediatrics, Aichi Medical University, Nagakute, Aichi 480-1195; Japan. E-Mail: tsuru@aichi-med-u.ac.jp. TI - Improvement in CNS protective treatment in non-high-risk childhood acute lymphoblastic leukemia: Report from the Japanese Children's Cancer and Leukemia Study Group. SO - Medical & Pediatric Oncology Vol 32(4) (pp 259-266), 1999. AB - Background. Prevention of central nervous system (CNS) leukemia by early introduction of therapy to this sanctuary site is an essential component of modern treatment strategy for acute lymphoblastic leukemia (ALL). However, the optimal form of preventive CNS therapy remains debatable. Procedure. To address this issue, we evaluated the efficacy of CNS preventive therapy for 572 children with ALL who achieved complete remission in the Children's Cancer and Leukemia Study Group (CCLSG) ALL874 (1987-1990) and ALL911 (1991- 1993) studies. They received risk-directed therapy based on age and leukocyte count. In the ALL 874 study, the non-high-risk (low-risk [LR] + intermediate risk [IR]) patients were randomly assigned to the conventional cranial irradiation (CRT) regimen (L874A and 1874A) and the high-dose methotrexate (HDMTX) regimen without CRT (L874B and 1874B). The former patients received 18-Gy CRT plus 3 doses of intrathecal (IT) MTX and the latter patients received 3 courses of HDMTX at 2 g/m2 plus 13 doses of ITMTX (L874B) or 4 courses of HDMTX at 4.5 g/m2 plus 1 dose of ITMTX (1874B). Results. The 7- year probabilities (+/- SE) of CNS relapse-free survival were 97.3% +/- 2.6% (L874A, n = 41) vs. 90.3% +/- 5.3% (L874B, n = 39) (P = 0.25) in the LR patients, and 100% (1874A, n = 55) vs. 78.5% +/- 6.5% (1874B, n = 54) (P = 0.002) in the IR patients. The corresponding disease-free survival (DFS) rates were 79.4% +/- 6.5% vs. 74.4% +/- 7.3% (P = 0.62) in the LR group and 63.3% +/- 6.8% vs. 58.3% +/- 7.2% (P = 0.66) in the IR group. Thus, the HDMTX regimen could not provide better protection of CNS relapse as compared with the CRT regimen, although their overall efficacy was not significantly different. In the ALL 911 study, intensive systemic chemotherapy with extended i,t, injections of MTX plus cytarabine achieved a high CNS relapse- free survival (98% +/- 1.9% at 7 years) and a favorable DFS (85.5% +/- 5% at 7 years) in the IR patients. The patients in the high-risk (HR) group in both ALL874 and ALL911 studies received the 18-Gy or 24-Gy CRT with intensive systemic chemotherapy. Their 7-year probabilities of CNS relapse-free survival ranged from 88% to 95%, among which the T-ALL patients had a risk of CNS leukemia, which was 3-4 times higher compared with B-precursor ALL patients. Conclusions. These results indicate that long-term intrathecal CNS prophylaxis as well as appropriate systemic therapy for the non-high-risk patients can provide protection against CNS relapse equivalent to that provided by cranial irradiation. [References: 26] <22> UI - 1999090278 AU - Kwasman R IN - R. Kwasman, Kwasman Dental Team, 1299 Portland Avenue, Rochester, NY 14621; United States. TI - Dental treatment and asthma. SO - Pediatric Asthma Allergy & Immunology Vol 12(4) (pp 271-272), 1998. <23> UI - 1999052131 AU - Lulic-Dukic O AU - Radionov D AU - Bukovic D AU - Verzak Z AU - Bagic I IN - O. Lulic-Dukic, Stomatoloski Fakultet Sveucilista, Gunduliceva 5, 10000 Zagreb; Croatia. TI - Trauma of decidual teeth and the most common consequences. SO - Paediatria Croatica Vol 42(3-4) (pp 153-157), 1998. AB - Dental trauma during the decidual dentition period can cause the impairment of their permanent replacements. Therefore, it is necessary to establish a diagnosis on time, to apply adequate therapy and to follow-up the patient over a period of time. Trauma of the teeth has an important place in current pedodontics, partly because of the constant increase in its prevalence. In spite of the considerable regeneratory potential of young individuals, teeth affected by trauma are more prone to exhibit various changes on their permanent replacements. Therefore, a multidisciplinary team approach is usually required in the management of this problem. Parents need to be informed about the most vulnerable period for dental trauma, and the most frequently involved circumstances of its occurrence. It would be of a great importance to develop a program of education for pre-school and school children, as well as for their teachers, which would lead to greater care during play, sport and other activities in childhood. There is no doubt that such a program would result in a considerable decrease in the incidence of dental trauma. [References: 14] <24> UI - 1999014042 AU - Kumar JV AU - Swango PA AU - Lininger LL AU - Leske GS AU - Green EL AU - Haley VB IN - J.V. Kumar, Bureau of Dental Health, New York State Department of Health, Empire State Plaza, Albany, NY 12237-0619; United States. TI - Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York. SO - American Journal of Public Health Vol 88(12) (pp 1866-1870), 1998. AB - Objectives. This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. Methods. Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. Results. Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. Conclusions. The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline. [References: 51] <25> UI - 1998374816 AU - Evans PAS AU - Short MA AU - Owen RG AU - Jack AS AU - Forsyth PD AU - Shiach CR AU - Kinsey S AU - Morgan GJ IN - Dr. G.J. Morgan, Centre for Haematological Oncology, General Infirmary, Great George Street, Leeds LS1 3EX; United Kingdom. E-Mail: garethm@pathology.leeds.ac.uk. TI - Residual disease detection using fluorescent polymerase chain reaction at 20 weeks of therapy predicts clinical outcome in childhood acute lymphoblastic leukemia. SO - Journal of Clinical Oncology Vol 16(11) (pp 3616-3627), 1998. AB - Purpose: Ninety-five percent of children with acute lymphoblastic leukemia (ALL) will achieve a remission, but approximately 25% will relapse. Identifying these patients is difficult, as patients with adverse prognostic features at presentation are rare and the majority are standard risk. Analysis of minimal residual disease (MRD) may be able to determine those at risk of relapse, but the best method by which this can be accomplished has yet to be defined. The object of this study was to determine the predictive value of residual disease detection in a group of standard-risk patients with precursor-B ALL at a fixed point in therapy (week 20) using a simple fluorescent consensus immunoglobulin H (IgH) heavy chain polymerase chain reaction (PCR). Patients and Methods: Forty-two patients who presented with precursor-B ALL with standard-risk clinical features and treated according to either the Medical Research Council (MRC) UKALL X orXI protocols were assessed using a combination of both fluorescent consensus framework I and framework III Ig heavy-chain PCR. The results of the PCR were analyzed on an AB1373 genesequencer with genescan software (Applied Biosystems, Foster City, CA). Clonal rearrangements detected at presentation were looked for at week 20. Results: Of 42 patients, 35 had a clonal population detectable at presentation; of these, seven had more than two clonal rearrangements; this latter group showed a similar dlsease-free survival (DFS) to the group as a whole. Thirty of 35 patients were analyzed before their second course of intensification therapy at week 20. At this point, nine of 30 had a detectable clonal rearrangement, eight (89%) of whom have since relapsed with a median DFS of 27.5 months. Of the rest of the group (n = 21), in whom no clonal rearrangement was detectable, only six (21%) have relapsed. Conclusion: Fluorescent IgH PCR at week 20 provides a sensitive and specific means to predict ultimate relapse (57% and 89%, respectively) and is a simple yet promising technique for the identification of patients at risk of poor outcome. [References: 35] <26> UI - 1998355572 AU - Pein F AU - Michon J AU - Valteau-Couanet D AU - Quintana E AU - Frappaz D AU - Vannier JP AU - Philip T AU - Bergeron C AU - Baranzelli MC AU - Thyss A AU - Stephan JL AU - Boutard P AU - Gentet JC AU - Zucker JM AU - Tournade MF AU - Hartmann O IN - Dr. F. Pein, Pediatrics Department, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94800 Villejuif Cedex; France. E-Mail: pein@igr.fi. TI - High-dose melphalan, etoposide, and carboplatin followed by autologous stem-cell rescue in pediatric high-risk recurrent Wilms' tumor: A French Society of Pediatric Oncology Study. SO - Journal of Clinical Oncology Vol 16(10) (pp 3295-3301), 1998. AB - Purpose: The three-drug combination of melphalan (M), etoposide (E), and carboplatin (c) followed by autologous stem-cell (ASC) rescue has been evaluated prospectively by the French Society of Pediatric Oncology (SFOP) in pediatric high-risk recurrent (HRR) Wilms' tumor (WT) patients with chemotherapy-responsive disease. Patients and Methods: From October 1988 to October 1994, 29 patients with HRR WT were treated in nine SFOP centers. Two additional patients with stage IV anaplastic WT were consolidated in first complete response (CR) with the same regimen and have been studied separately. The regimen consisted of M 180 mg/m2 for 1 day, E 200 mg/m2/d for 5 days, and C at a daily targeted area under the concentration, time curve (AUC) of 4 mg . min/mL for 5 days. ASCs were reinfused 48 hours after M. Results: Twelve of 28 assessable patients with HRR WT are still in continuous CR at a median of 48.5 months (range, 36 to 96) after consolidation. Disease-free survival (DFS) and overall survival (os) estimated by the Kaplan-Meier method at 3 years were 50% +/- 17% and 60% +/- 18%, respectively. Sixteen patients relapsed at a median of 8.5 months (range, 3 to 53) after consolidation. Toxicity data are available in 31 grafted patients. Grade III and IV toxicities included hematologic side effects (n = 31), hemorrhage (n = 8), mucositis (n = 24), diarrhea (n = 12), renal disorders (n = 8), and pneumonitis (n = 3). Conclusion: The adverse prognostic factors (APF) used to select patients for this dose-intensive chemotherapy define children with very-poor-risk recurrent WT. Despite high treatment-related toxicity, about half of these patients remain disease-free at 3 years. Patient outcome is statistically better when high-dose chemotherapy (HDCT) is performed as early as the second CR or partial response (PR). Novel therapeutic approaches with innovative preparative regimens are warranted for the remaining high-risk patients. [References: 37] <27> UI - 1998333517 AU - Brodeur J-M AU - Payette M AU - Bedos C IN - J.-M. Brodeur, dept. medecine sociale preventive, Universite de Montreal, Succ. Centre-ville, CP 6128, Montreal, Que. H3C 3J7; Canada. E-Mail: brodeuje@ere.umontreal.ca. TI - Association of socio-economic variables with the prevalence of dental caries in second and sixth grade Quebec school children from 1989-1990. SO - Canadian Journal of Public Health. Revue Canadienne de Sante Publique Vol 89(4) (pp 274-279), 1998. AB - Objectives: 1) To determine caries risk factors in second and sixth grade Quebec children; 2) To test multivariate models which identify children as belonging to a high prevalence group. Methods: For the 1989-90 Sante Dentaire Quebec survey, 2291 second grade and 2111 sixth grade school children responded to a questionnaire on their personal habits of hygiene and diet and underwent a clinical examination, while their parents answered a questionnaire regarding their family's socioeconomic status. Results: Statistics demonstrate a stronger link between socioeconomic variables and caries prevalence than demographic and sanitary factors. Children emerging from a high socioeconomic milieu have better dental health than children with low socioeconomic standing. The most effective model, however, registers a sensitivity of 65% and a specificity of 66%, revealing the inadequacy of statistical models to accurately identify children in the caries high prevalence group. [References: 45] <28> UI - 1998319839 AU - Keating S AU - De Witte T AU - Suciu S AU - Willemze R AU - Hayat M AU - Labar B AU - Resegotti L AU - Ferrini PR AU - Caronia F AU - Dardenne M AU - Solbu G AU - Petti MC AU - Vegna ML AU - Mandelli F AU - Zittoun RA IN - Dr. S. Keating, Avenue E. Mounier 83, 1200 Brussels; Belgium. TI - The influence of HLA-matched sibling donor availability on treatment outcome for patients with AML: An analysis of the AML 8A study of the EORTC Leukaemia Cooperative Group and GIMEMA. SO - British Journal of Haematology Vol 102(5) (pp 1344-1353), 1998. AB - To determine whether patients with a HLA-identical sibling donor have a better outcome than patients without a donor, an analysis on the basis of intention-to-treat principles was performed within the framework of the EORTC-GIMEMA randomized phase III AML 8A trial. Patients in complete remission (CR) received one intensive consolidation course. Patients with a histocompatible sibling donor were then allocated allogeneic bone marrow transplantation (alloBMT), the patients without a donor were randomized between autologous BMT (ABMT) and a second intensive consolidation (IC2). 831 patients <46 years old and alive >8 weeks from diagnosis were included. HLA typing was performed in 672 patients. AlloBMT was performed during CR1 in 180 (61%) out of 295 patients with a donor. Another 38 patients were allografted: five in resistant disease, 14 during relapse and 19 in CR2. ABMT was performed in 130 (34%) out of 377 patients without a donor in CR1, in six (2%) patients during relapse and in 38 (10%) patients during CR2. The disease-free survival (DFS) from CR for patients with a donor was significantly longer than for patients without a donor (46% v 33% at 6 years; P = 0.01, RR 0.78, 95% confidence interval 0.63-0.96). The overall survival from diagnosis for patients with a donor was longer, but not statistically significant, than for patients without a donor (48% v 40% at 6 years; logrank P = 0.24). When patients were stratified according to prognostic risk groups, the same trend in favour of patients with a donor was seen for survival duration and the DFS remained significantly longer for this group of patients. [References: 26] <29> UI - 1998305246 AU - Choubisa SL IN - S.L. Choubisa, P.G. Department of Zoology, S.B.P. Government College, M.L. Sukhadia University, Dungarpur - 314 001; India. TI - Fluorosis in some tribal villages of Udaipur district (Rajasthan). SO - Journal of Environmental Biology Vol 19(4) (pp 341-352), 1998. AB - Chronic fluoride intoxication (fluorosis) was observed in villagers and their domestic animals (cattle, buffaloes, sheep and goats) from ten villages of the Udaipur district of Rajasthan where drinking waters contained 0.3 to 7.0 mg/L fluoride. The prevalence of dental fluorosis and skeletal fluorosis in villagers was relatively higher than that observed in the animals. At 5.8 mg/L mean fluoride concentration, 88.7% of children (<18 years) and 100% of adults were found to be affected with dental fluorosis. The highest prevalence (42.2%) of skeletal fluorosis was observed at 5.8 mg F/L (mean). Males showed relatively a higher prevalence of skeletal fluorosis. In general, the prevalence and severeness of skeletal fluorosis increased with increasing of fluoride concentration and with age. None of fluorotic subjects revealed evidence of genu-valgum syndrome and goitre (hyperthyroidism). Among mature animals, buffaloes were found to have a higher prevalence and greater severity of dental and skeletal fluorosis when compared with cattle. The prevalence of dental fluorosis was higher in calves of both type of animals than in adults. Sheep and goats examined at the same time were found to be free of fluorosis. Radiological findings and deformities in fluorotic subjects as well as fluorosis in relation to fluoride concentrations, age and sex have also discussed. [References: 29] <30> UI - 1998263551 AU - Santini G AU - Salvagno L AU - Leoni P AU - Chisesi T AU - De Souza C AU - Sertoli MR AU - Rubagotti A AU - Congiu AM AU - Centurioni R AU - Olivieri A AU - Tedeschi L AU - Vespignani M AU - Nati S AU - Soracco M AU - Porcellini A AU - Contu A AU - Guarnaccia C AU - Pescosta N AU - Majolino I AU - Spriano M AU - Vimercati R AU - Rossi E AU - Zambaldi G AU - Mangoni L AU - Endrizzi L AU - Sileni VC AU - Miggiano MC AU - Marino G AU - Damasio E AU - Rizzoli V IN - Dr. G. Santini, Division of Haematology I, S. Martino Hospital, Largo Rosanna Benzi XV, 10, 16132 Genova; Italy. E-Mail: ginosantini@smartino.ge.it. TI - VACOP-B versus VACOP-B plus autologous bone marrow transplantation for advanced diffuse non-Hodgkin's lymphoma: Results of a prospective randomized trial by the non-Hodgkin's lymphoma cooperative study group. SO - Journal of Clinical Oncology Vol 16(8) (pp 2796-2802), 1998. AB - Purpose: The aim of this multicenter randomized study was to compare conventional therapy with conventional plus high-dose therapy (HDT) and autologous bone marrow transplantation (ABMT) as front-line treatment for poor-prognosis non-Hodgkin's lymphoma (NHL). Patients and Methods: Between October 1991 and June 1995, 124 patients, aged 15 to 60 years, with diffuse intermediate- to high-grade NHL (Working Formulation criteria), stages II bulky (<= 10 cm), III, or IV were enrolled. Sixty-one patients were randomized to receive etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (VACOP-B) for 12 weeks and cisplatin, cytarabine, and dexamethasone (DHAP) as a salvage regimen (arm A), and 63 to receive VACOP-B for 12 weeks plus HDT and ABMT (Arm B). Results: There was no significant difference in terms of complete remissions (CRS) in the two groups: 75% in arm A, and 73% in arm B. The median follow-up observation time was 42 months. The 6-year survival probability was 65% in both arms. There was no difference in disease-free survival (DFS) or progression-free survival (PFS) between the two groups. DFS was 60% and 80% (P = .1) and PFS was 48% and 60% (P = .4) for arms A and B, respectively. Procedure feasibility was the major problem. In arm B, 29% of enrolled patients did not undergo HDT and ABMT. A statistical improvement in terms of DFS (P = .008) and a favorable trend in terms of PFS (P = .08) for intermediate-/high- plus high-risk group patients assigned to HDT and ABMT was observed. Conclusion: In this study, conventional chemotherapy followed by HDT and ABMT as front-line therapy seems no more successful than conventional treatment in terms of overall results. However, our results suggest that controlled studies of HDT plus ABMT should be proposed for higher risk patients. [References: 28] <31> UI - 1998240018 AU - Burt BA IN - B.A. Burt, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI; United States. TI - Prevention policies in the light of the changed distribution of dental caries. SO - Acta Odontologica Scandinavica Vol 56(3) (pp 179-186), 1998. AB - Changes in the distribution of caries in economically developed nations over the last 15-20 years include 1) an overall decline in prevalence and severity in child populations; 2) an increasingly skewed distribution, with most disease now found in a small number of children; and 3) concentration of caries in pit and fissure lesions. Exposure to fluoride is usually seen as the principle reason for the caries decline, with little change in intraoral levels of cariogenic organisms or the annual consumption of sugars. Prevention activities are still most often conducted under policies that were established at a time when caries was a more widespread public health problem, so these policies should be critically examined in the light of modern conditions. While prevention should remain the prime activity of public health agencies, despite the reduced severity of caries, the relative economic efficiency of various procedures should be constantly evaluated. Despite the attractions of targeting, cost-effective prevention should be aimed first at the whole population, with more expensive activities targeted to all children in a chosen geographic area rather than to individually selected children. In the Scandinavian countries the prime population strategies are the regular use of fluoride toothpaste and public education that emphasizes oral hygiene. In selected areas where caries levels are still relatively high (that is, targeted geographic areas), fluoride rinse and tablet programs, provided for a whole classroom at a time, can enhance intraoral fluoride levels where necessary. Fluoride varnish and sealants, though effective, are expensive and need careful selection of locality and teeth to be efficient. Individual children with a persistent caries problem, now relatively small in number, can receive individualized preventive treatments in the clinics of the school dental service. [References: 53] <32> UI - 1998209170 AU - Angelillo IF AU - Anfosso R AU - Nobile CGA AU - Pavia M IN - I.F. Angelillo, Medical School, University of Reggio Calabria, Via Tommaso Campanella, 88100 - Catanzaro; Italy. TI - Prevalence of dental caries in schoolchildren in Italy. SO - European Journal of Epidemiology Vol 14(4) (pp 351-357), 1998. AB - The caries experience and its potential risk indicators such as socioeconomic status, sweets consumption, toothbrushing habits, dental visit attendance pattern and salivary mutans streptococci (in 12 year old only), were assessed in schoolchildren raised and living in low fluoridated areas (Catanzaro, Italy). Caries-free prevalence in the 6-year-old was 52.9% in their primary dentition; the dmft and dmfs were 2.1 and 5.1, and both DMFT and DMFS were 0.1. Almost 91% of the dmft was attributable to active decay. The proportion of children with a dmft+DMFT <= 1 and the dmft and dmfs were significantly higher in those with low socio-economic status. In the 12- year-old, 52.7% had a history of caries and the DMFT and DMFS were 1.5 and 2.6; the filled component was the dominant proportion. The more likely they visited a dentist for routine checkup, the higher socio-economic status (it was not associated with DMFT), the less frequently they had sweets, and the low level of Streptococcus mutans, the more likely they were caries-free and the less likely they were to have a high DMFT, DMFS, and DT. In the 15-year- old, 68.8% had a history of caries and the DMFT and DMFS were 2.8 and 4.8, with a higher prevalence of the F component. The children who visited a dentist for routine checkup had a significantly lower caries experience, DMFT, DMFS, and DT than the irregular attenders, and those with low socio- economic background were more likely to have a high DMFS. [References: 32] <33> UI - 1998191769 AU - Ogunbodede EO AU - Adamolekun B AU - Akintomide AO IN - Dr. E.O. Ogunbodede, Department of Preventive Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife; Nigeria. TI - Oral health and dental treatment needs in Nigerian patients with epilepsy. SO - Epilepsia Vol 39(6) (pp 590-594), 1998. AB - Purpose: We determined the prevalence of oral disorders and the dental treatment needs of outpatients with epilepsy. Methods: A questionnaire was administered to 56 consecutive patients (35 males, 21 females) presenting to an outpatient clinic. All patients underwent dental examinations. The clinical and diagnostic features of each patient's epilepsy were also obtained. Results: The mean age (+/-SD) of the patients was 25.1 +/- 12.1 years (range, 12-56 years). Of 9 patients receiving phenytoin (PHT) monotherapy, 3 (33.3%) had gingival hypertrophy; 15 of 18 (83.3%) patients receiving PHT in combination with phenobarbital (PB) manifested the disorder. Traumatized anterior teeth were found in 26 (46.4%) patients with the males significantly more affected than females (p = 0.02). When the dental treatment needs were considered, 24 (42.9%) patients required dental prophylaxis with oral hygiene instruction, and an equal number required various types of restorative treatments. Only 13 patients (23.2%) had previously visited a dental clinic; the 43 (76.8%) who had never sought dental treatment claimed they did not see any need for it. Conclusions: Our study showed an increased predilection to anterior dental injuries in patients with epilepsy: as compared with the prevalence earlier reported for those without epilepsy in Nigeria (p = 0.00). There is a clear need for effective interaction between medical and dental practitioners in the management of epilepsy. [References: 23] <34> UI - 1998197566 AU - Heaton KM AU - Sussman JJ AU - Gershenwald JE AU - Lee JE AU - Reintgen DS AU - Mansfield PF AU - Ross MI IN - Dr. M.I. Ross, Texas Univ. M.D. Anderson Can. Ctr., Box 106, Dept. of Surgical Oncology, 1515 Holcombe Blvd., Houston, TX 77030; United States. TI - Surgical margins and prognostic factors in patients with thick (>4 mm) primary melanoma. SO - Annals of Surgical Oncology Vol 5(4) (pp 322-328), 1998. AB - Background: Randomized trials have demonstrated the efficacy of 1- and 2-cm excision margins for thin and intermediate-thickness melanomas, respectively. The optimal margin of excision for thick melanomas is still unknown, however. We evaluated whether the margins used for intermediate- thickness melanomas can be applied safely to thicker lesions. Methods: The charts of 278 patients with thick primary melanomas treated between 1985 and 1996 were retrospectively reviewed. Patients with distant metastases at presentation or with follow-up less than 6 months were excluded. Median follow-up was 27 months. Known melanoma prognostic factors and excision margins were evaluated for their impact on local recurrence (LR), disease- free survival (DFS), and overall survival (OS). Results: Median tumor thickness was 6.0 mm, and 57% were ulcerated. At presentation, 201 patients (72%) were node negative and 77 (28%) were node positive (palpable or occult). The 5-year OS and DFS rates were 55% and 30%, respectively. The LR rate for all patients was 12%. Although nodal status, thickness, and ulceration were significantly associated with OS by multivariate analysis, neither LR nor excisional margin (<2 cm vs. >2 cm) significantly affected DFS or OS in these patients. Conclusions: Because margins of excision greater than 2 cm do not improve LR, DFS, or OS compared to a margin of 2 cm or less, a 2-cm margin of excision is adequate for patients with thick melanoma. Because nodal status is a significant prognostic factor in these patients, staging by sentinel node biopsy should be considered in patients with thick melanomas and clinically negative nodal basins to allow proper entry and stratification in adjuvant therapy trials. [References: 28] <35> UI - 1998165004 AU - Chen W AU - Chen P AU - Chen S-C AU - Shih W-T AU - Hu H-C IN - Dr. W. Chen, Department of Pediatrics, China Medical College Hospital, 2 Yuh-Der Road, Taichung; Taiwan. E-Mail: chenwalt@ms9.hinet.net. TI - Lack of association between obesity and dental caries in three-year-old children. SO - Chung-Hua Min Kuo Hsiao Erh Ko i Hsueh Hui Tsa Chih Vol 39(2) (pp 109-111), 1998. AB - To investigate whether the obese children are prone to develop dental caries, the cross-sectional data from a Three-year-old Children's Health Survey were evaluated. The body weight, height, body mass index (BMI), and decayed and filled teeth (dft) score were analyzed in 5,133 children. The prevalence of dental caries was not different significantly among different BMI groups. There were no significant differences in the dft score of carious children among different BMI groups. Little or no relationship was found between BMI and dft score. We conclude that there is no relationship between carious deciduous teeth and weight status in three-year-old children. [References: 17] <36> UI - 1998113080 AU - Arowojolu MO AU - Nwokorie CU IN - Dr. M.O. Arowojolu, P.O. Box 714 Secretariat, Ibadan; Nigeria. TI - Juvenile periodontitis in Ibadan, Nigeria. SO - East African Medical Journal Vol 74(6) (pp 372-375), 1997. AB - Juvenile periodontitis is a form of periodontitis characterised by a pattern of rapid vertical loss of alveolar bone around the permanent first molars and incisors. In this hospital based retrospective study of juvenile periodontitis in Ibadan, 34 cases in the age range 17-34 years were seen over a period of five years. The mean age was 23.2 years. Diagnosis was made on accepted clinical and radiological parameters. The findings showed a low prevalence of 1.56 %, (64.7 % of localised juvenile periodontitis, 35.3 % of generalised juvenile periodontitis). There was a 2:1 female to male relationship and the oral hygiene status of the subjects was fairly good in most instances. Remarkable symmetrical pattern and relationship was observed. The age of onset or age at presentation was 17 years contrary to reports from other studies which revealed circumpubertal age of onset. [References: 18] <37> UI - 1998082359 AU - Chisick MC AU - Poindexter FR AU - York AK IN - M.C. Chisick, U.S. Army Center, Hlth. Promotion and Preventive Med., Aberdeen Proving Ground, MD; United States. TI - The need for and prevalence of dental sealants in active duty U.S. military personnel. SO - Military Medicine Vol 163(3) (pp 155-158), 1998. AB - This paper explores the need for and the prevalence of dental sealants in active duty U.S. military personnel. The data come from the 1994 Tri- Service Comprehensive Oral Health Survey. Data were collected on 13,050 Army, Air Force, Marine Corps, and Navy active duty personnel at 26 sites. Women and minorities were oversampled. Both bivariate and logistic regression analyses were done on the need for at least one dental sealant and the prevalence of at least one dental sealant in service members. Weighted data (1,669,662) were used for the bivariate analyses; unweighted data were used for the regressions. Results show that 3.6% of service members need dental sealants and that 6.8% have dental sealants. The need for dental sealants varies across age, rank, and branch of service. The prevalence of dental sealants varies across age, race, rank, and branch of service. The cost- effectiveness of dental sealants in this population should be established. [References: 20] <38> UI - 1998052953 AU - Bohmer CJM AU - Klinkenberg-Knol EC AU - Niezen-De Boer MC AU - Meuwissen PRM AU - Meuwissen SGM IN - Prof. S.G.M. Meuwissen, Academic Hosp. 'Vrije Universiteit', Department of Gastroenterology, Boelelaan 1117, 1081 HV Amsterdam; Netherlands. TI - Dental erosions and gastro-oesophageal reflux disease in institutionalized intellectually disabled individuals. SO - Oral Diseases Vol 3(4) (pp 272-275), 1997. AB - OBJECTIVE: Both exogenous acids, from the diet, and endogenous acids, from stomach juice, can dissolve the enamel mineral, resulting in dental erosions. Gastric acid may reach the mouth by gastro-oesophageal reflux disease (GERD), recurrent vomiting, rumination and regurgitation. These conditions are frequently found in the intellectually disabled population. Therefore, we investigated the presence of dental erosions in combination with GERD among intellectually disabled inhabitants, with an IQ<50, taken from three Dutch institutes. MATERIALS AND METHODS: At random 63 individuals underwent an oesophageal pH test and dental screening and possible predisposing and attributable factors were determined. An abnormal pH level was defined as a pH <4, >4.5% of the measured time. Subjects with dental erosions were compared to those without dental erosions. RESULTS: In 29 out of 63 (46.0%) cases evidence of dental erosions was found. In 19 of these 29 subjects with erosions (65.5%) GERD was diagnosed, compared to nine (26.5%) out of 34 subjects without erosions (P = 0.04). In the subjects with erosions mean duration of pH <4 was 15.6% (range: 0.5-90.5) compared to 6.3% (range 0- 40.4) in subjects without erosions (P = 0.02). An IQ <35 was found to be predisposing (P <0.001). CONCLUSION: In this population of 63 institutionalised intellectually disabled persons dental erosions were diagnosed in 46%. Sixty-five per cent of them had GERD. Individuals with longer duration of pH <4 than 6.3% of the measured time and with an IQ <35 were at higher risk to develop dental erosions. This study shows that dental erosions in the intellectually disabled population might be an oral manifestation of GERD. [References: 27] <39> UI - 1998036322 AU - Fanin R AU - Silvestri F AU - Geromin A AU - Infanti L AU - Sperotto A AU - Cerno M AU - Stocchi R AU - Savignano C AU - Rinaldi C AU - Damiani D AU - Baccarani M IN - Dr. R. Fanin, Division of Hematology, University Hospital, P le S Maria della Misericordia, 33100 Udine; Italy. TI - Autologous stem cell transplantation for aggressive non-Hodgkin's lymphomas in first complete or partial remission: A retrospective analysis of the outcome of 52 patients according to the age-adjusted International Prognostic Index. SO - Bone Marrow Transplantation Vol 21(3) (pp 263-271), 1998. AB - The aim of the study was to retrospectively evaluate the outcome of patients with aggressive non-Hodgkins lymphoma (NHL), undergoing autologous stem cell transplantation (ASCT) in first complete (CR) or partial (PR) remission, according to the age-adjusted International Prognostic Index (IPI). Fifty-two consecutive patients, aged less than 60 years, with intermediate- or high-grade NHL, and at least one of the following adverse risk factors: bulky disease, B symptoms or Ann Arbor stage III-IV, and at least a PR after CHT (and radiotherapy (RT) on residual mediastinal mass when required), underwent ASCT conditioned with BAVC. Sixty-five percent (33/52) of the patients achieved CR after CHT; 69% (36/52) after CHT + RT; 90% (47/52) after CHT + RT + ASCT. One death during conditioning and three major toxic events after ASCT were recorded. Overall survival (OS) is 98% at 37 months (16-88); disease-free survival (DFS) is 100% at 27 months (7-82). Comparing the observed results with those expected if patients were treated only with CHT, the sequential treatment including ASCT conferred an advantage in terms of CR rate of 14, 23 and 54%, respectively, in the low-intermediate (LI), high-intermediate (HI) and high (H)-risk groups, respectively. The 2-year OS advantage is 10, 21, 31 and 63%, respectively, and the 2-year DFS advantage is 12, 26, 38 and 39%, respectively. Even more striking is the 5-year projected advantage in the number of patients alive without disease, even when considering only the low (L) (P < 0.0001) and the LI (P < 0.0001) risk groups. For patients in the higher (HI + H) risk groups, ASCT should be included in the initial plan of treatment as consolidation of first CR or PR, but the differences seen in this study suggest a formal comparison in a randomized study also for patients in the LI risk group. [References: 49] <40> UI - 1998013547 AU - Lazarchik DA AU - Filler SJ IN - D.A. Lazarchik, University Hospital Dental Clinic, RWUH B-50, Birmingham, AL 35294-3280; United States. TI - Effects of gastroesophageal reflux on the oral cavity. SO - American Journal of Medicine Vol 103(5 A) (pp 107S-113S), 1997. AB - The effects of chronic exposure of the oral cavity to gastric acid can be many and varied. Soft tissue symptoms (nonspecific burning and sensitivity) have been mentioned in the literature, but pathognomonic soft tissue lesions have not been documented. Dental erosion can be considered to be the predominant oral manifestation of gastroesophageal reflux disease. Erosion begins with subtle changes in the surface enamel and can progress to severe loss of tooth substance. Because the causes of such tooth lesions may be multifactorial, combining the effects of erosion, attrition, and abrasion and because of the subtle changes present in the beginning stages of such lesions, diagnosis may be difficult. Although the basic mechanism of erosion in gastroesophageal reflux patients is the dissolution of enamel and dentin due to acid exposure, a multitude of other factors can modify the effects of gastric acid. Salivary parameters, in particular, may play an important role in affecting oral pH after reflux episodes. Once dental erosion is diagnosed, thorough evaluation is necessary to document the extent of damage and to detect a cause, which may have both intrinsic and extrinsic components. Treatment goals include eliminating the causes of acid exposure, preventing the effects of acid exposure when it is not controllable, treating symptoms of soft tissue irritation and dental erosion, and restoring the dentition to an esthetically and functionally acceptable level. [References: 29] <41> UI - 1998004268 AU - Becart A AU - Hedouin V AU - Martin-Bouyer L AU - Revuelta E AU - Gosset D IN - Prof. D. Gosset, Service med. legale penitentiaire, Hopital Roger Salengro, Boulevard Professeur Jules Leclercq, 59037 Lille Cedex, CHRU de Lille; France. TI - The oral health status of drug addicts. A prison survey in Lille, France. SO - Journal of Forensic Odonto-Stomatology Vol 15(2) (pp 27-29), 1997. AB - The purpose of this study was to describe the prevalence of decayed, missing and filled teeth among the inmates of the jail of Loos (France) and to assess the impact of drug addiction, especially heroin, on these parameters of oral health. A representative sample was selected and two groups were compared: heroin addicts and non-drug addicts. The same dentist examined 93 inmates, males and females, from age 16 to 35. The results found a significant difference of DMFT index between the groups, with a higher value of DMFT for the heroin users. This investigation also highlighted atypical caries lesions among the heroin addicts. [References: 9] <42> UI - 1997377522 AU - Giona F AU - Testi AM AU - Rondelli R AU - Amadori S AU - Arcese W AU - Meloni G AU - Moleti ML AU - Ceci A AU - Pillon M AU - Madon E AU - Comis M AU - Pession A AU - Mandelli F IN - Dr. F. Giona, Ematologia, Dipto. Biotecnol. Cellulari Ematol., Via Benevento 6.00161, Rome; Italy. TI - ALL R-87 protocol in the treatment of children with acute lymphoblastic leukaemia in early bone marrow relapse. SO - British Journal of Haematology Vol 99(3) (pp 671-677), 1997. AB - Seventy-three children with acute lymphoblastic leukaemia (ALL) in first bone marrow (BM) relapse, occurring within 30 months from complete remission (CR), were enrolled in an Italian cooperative study (ALL R-87 protocol). This treatment programme consisted of an induction phase with intermediate-dose cytarabine (IDARA-C) plus idarubicin (IDA) and prednisone (PDN), followed by a multidrug consolidation therapy and bone marrow transplant (BMT). 55/73 children achieved CR (75.3%); 15 (20.5%) failed to respond and three (4.2%) died during induction. The response rate was significantly higher for children with a first CR duration <=12 months (P=0.0005) and for those with a white blood cell (WBC) count at relapse <20 x 109/l (P=0.004). The estimated disease-free survival (DFS +/- SE) at 82 months was 0.18 +/- 0.05 for all responders, and 0.70+/-0.14 for allotransplanted patients versus 0.05 +/- 0.05 for those autografted (P=0.001). The estimated probabilities of survival +/- SE and event-free survival (EFS +/- SE) at 83 months were 0.16 +/- 0.07 and 0.13 +/- 0.04, respectively, for all enrolled children. Univariate analysis showed that age <10 years at initial diagnosis and B-lineage immunophenotype favourably influenced both DFS (P=0.001) and EFS probabilities (P=0.0014 and P=0.012, respectively), whereas a first CR duration <=12 months and a WBC count at relapse <20 x 109/l were associated only with a better EFS rate (P = 0.026 and P = 0.004, respectively). Our results show the efficacy of the IDA plus IDARA-C schedule used in the ALL R-87 protocol in high-risk relapsed ALL children. Allogeneic BMT proved effective for patients with an HLA sibling donor. In a multivariate analysis, age <= 10 years at initial diagnosis (P= 0.016) and WBC count at relapse <=20x109/l (P=0.048) were independently associated with a worse disease outcome. [References: 24] <43> UI - 97374509 AU - Casetta I AU - Granieri E AU - Desidera M AU - Monetti VC AU - Tola MR AU - Paolino E AU - Govoni G AU - Calura G IN - Dr. I. Casetta, Sezione di Clinica Neurologica, Dipto.Discipline Med.-Chir.Comm.Com., Universita di Ferrara, Corso della Giovecca 22203, I-44100 Ferrara; Italy. TI - Phenytoin-induced gingival overgrowth: A community-based cross-sectional study in Ferrara, Italy. SO - Neuroepidemiology Vol 16(6) (pp 296-303), 1997. AB - A community-based cross-sectional study was carried out in Ferrara, Northern Italy, to verify the frequency of gingival overgrowth in chronic phenytoin (PHT) users and the risk factors associated with its development. All subjects taking phenytoin were identified using the computerized list of drug prescriptions available in the study area. Most of the subjects were interviewed and underwent an oral examination to evaluate their periodontal condition. The prevalence of gingival enlargement in chronic PHT users was about 40%. In our study, sex, age, age at onset of therapy, treatment duration, and oral hygiene were not significantly associated with the risk of developing gingival overgrowth. A direct relationship with daily dose was found to be an independent risk factor. Younger age and poorer oral hygiene seemed to predispose to the severest level of gingival involvement. These results support data from experimental studies by suggesting that drug induced gingival overgrowth is a dose-dependent side effect whose severity could be affected by local factors. [References: 30] <44> UI - 97349205 AU - De Witte T AU - Van Biezen A AU - Hermans J AU - Labopin M AU - Runde V AU - Or R AU - Meloni G AU - Mauri SB AU - Carella A AU - Apperley J AU - Gratwohl A AU - Laporte J-P IN - Dr. T. De Witte, Department of Hematology, University Hospital St Radboud, Geert Grooteplein 8, 6525 GA Nijmegen; Netherlands. TI - Autologous bone marrow transplantation for patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia following MDS. SO - Blood Vol 90(10) (pp 3853-3857), 1997. AB - Intensive chemotherapy followed by autologous bone marrow transplantation (ABMT) may provide an alternative therapy for young patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia following MDS (sAML) lacking a suitable donor. We report the results for 79 patients with MDS/sAML transplanted with autologous marrow in first complete remission (CR). Within the total group of 79, a cohort of 55 patients for whom the duration of first CR was known were compared with a matched control group of 110 patients with de novo AML. The 2-year survival, disease-free survival (DFS), and relapse rates for the 79 patients transplanted in first CR were 39%, 34%, and 64%, respectively. The relapse risk was greater than 55% for all stages and all disease categories. Patients younger than 40 years had a significantly (P = .04) better DFS (39%) than patients older than 40 years (25%). The DFS at 2 years was 28% for the cohort of 55 patients transplanted for MDS/sAML and 51% for those transplanted for de novo AML (P = .025). Relapse rates were 69% for patients with MDS/sAML and 40% for those with de novo AML (P = .007). ABMT for MDS or secondary leukemia results in a lower DFS when compared with similarly treated patients with de novo AML due to a higher relapse rate. The DFS of 28% for these patients suggests that autotransplantation may be a valuable therapy for this disease. The low treatment-related mortality rate of less than 10% supports the view that sufficient numbers of hematopoietic stem cells are present in patients with MDS to allow adequate repopulation after autologous stem-cell transplantation. [References: 26] <45> UI - 97341154 AU - Garcia-Closas R AU - Garcia-Closas M AU - Serra-Majem L IN - R. Garcia-Closas, Unidad de Investigacion, Hospital Universitario de Canarias, Tenerife, Canary Islands; Spain. E-Mail: rclosas@huc.rcanaria.es. TI - A cross-sectional study of dental caries, intake of confectionery and foods rich in starch and sugars, and salivary counts of Streptococcus mutans in children in Spain. SO - American Journal of Clinical Nutrition Vol 66(5) (pp 1257-1263), 1997. AB - In this cross-sectional study of 236 schoolchildren living in Manresa, Spain, we evaluated the association between prevalence of dental caries and frequency of consumption of various food groups, including sweetened baked goods and similar foods (rich in starch and sugars) and confectionery (rich in sugars but not starch), using a food-frequency questionnaire. Because Streptococcus mutans is associated with the cariogenicity of carbohydrates, we also evaluated the modification of these associations by salivary counts of this microorganism. Odds ratios (ORs) were used to measure the association between caries and tertiles of consumption. Sex, age, use of fluorides, tooth-brushing frequency, frequency of dental visits, socioeconomic status, and intake of other potentially cariogenic food groups were considered as potential confounders. We did not find a significant association between any of the food groups evaluated and caries prevalence. Failure to detect an association could have been due to the low prevalence of caries in our population (decayed, missing, or filled permanent teeth = 1.3 at age 10.6 y) or to underestimation of the association due to diet misclassification. In this population, the association between consumption of sweetened baked goods and caries appeared to be modified by the numbers or S. mutans [OR = 6.1 (95% CI: 1.6, 23.0) for low compared with high intake in children with moderate- to-high S. mutans counts and OR = 0.3 (95% CI: 0.1, 1.6) for low compared with high intake in children with low S. mutans counts]. These results suggest that a high intake of sweetened baked goods may be a determinant of caries prevalence in children with moderate-to-high salivary counts of S. mutans. [References: 57] <46> UI - 97318454 AU - Weisdorf DJ AU - Billett AL AU - Hannan P AU - Ritz J AU - Sallan SE AU - Steinbuch M AU - Ramsay NKC IN - Dr. D.J. Weisdorf, Box 480, University of Minnesota Hospital, 420 Delaware St SE, Minneapolis, MN 55455; United States of America. TI - Autologous versus unrelated donor allogeneic marrow transplantation for acute lymphoblastic leukemia. SO - Blood Vol 90(8) (pp 2962-2968), 1997. AB - Bone marrow transplantation (BMT) can cure patients with high-risk or recurrent acute lymphoblastic leukemia (ALL). Those lacking a related donor can receive either autologous or histocompatible unrelated donor (URD) marrow. Autotransplantation may result in higher risk of relapse, whereas URD allografts, although associated with serious posttransplant toxicities, may reduce relapse risk. Six years (1987 to 1993) of consecutive autologous BMT (University of Minnesota, Dana Farber Cancer Institute; n = 214) were compared with URD transplants (National Marrow Donor Program; n = 337). Most transplants (70% autologous, 48% URD) were in early remission (first or second complete remission [CR1 or CR2]); 376 patients (75% autologous, 64% URD) were less than 18 years old. Autologous BMT led to significantly lower transplant-related mortality (TRM; relative risk [RR] 0.35; P = .001). URD transplantation offered greater protection against relapse (autologous RR 3.1; P = .001). Patients greater than 18 years old, women, and BMT recipients beyond CR2 had higher TRM, whereas adults, BMT recipients in CR2+, or BMT recipients during 1991 through 1993 had significantly more relapse. After 25 months median follow-up, 100 URD and 56 autologous recipients survive leukemia free. URD BMT in CR2 resulted in superior disease-free survival (DFS), especially for adult patients. Multivariate analysis showed superior DFS for children, men, and BMT during CR1 or 2. Autologous and URD BMT can extend survival for a minority of patients unlikely to he cured by chemotherapy, and the results with either technique are comparable. Greater toxicity and TRM after URD BMT are counterbalanced by better protection against relapse. Prospective studies addressing additional clinical variables are needed to guide clinical decision making about transplant choices for patients with ALL. [References: 38] <47> UI - 97309778 AU - Saunders SR AU - De Vito C AU - Katzenberg MA IN - S.R. Saunders, Department of Anthropology, McMaster University, 1280 Main St. W., Hamilton, Ont. L8S 4L9; Canada. E-Mail: saunders@mcmaster.ca. TI - Dental caries in nineteenth century upper Canada. SO - American Journal of Physical Anthropology Vol 104(1) (pp 71-87), 1997. AB - This study examines the presence of dental caries in a large sample of adult skeletons from the 19th century cemetery of St. Thomas' Anglican Church in Belleville, Ontario. The cemetery was used from 1821 to 1874. Caries prevalence and frequencies of diseased and missing teeth were calculated both by observing summary statistics of individual rates and by the total sample of teeth. Postmortem tooth loss is low in this sample and antemortem tooth loss is highest in first mandibular molars, all other molars and then premolars. Age at death, but not sex, was found to be significantly related to the overall Caries Rate while both age and sex were significantly associated with the Diseased-Missing Index. The increase in diseased and missing teeth in older individuals is expected while the sex difference is not explained by simple dietary factors. When compared to reports on British and American samples, caries and antemortem tooth loss in the St. Thomas' sample is most similar to a pre-1850 British group and higher than American samples. Although there is undoubtedly a complex of factors contributing to caries prevalence in this sample, more data are required from large historic samples, particularly from the American northeast and late 19th century Britain, to have a clearer understanding of the influence of diet, cultural, and environmental factors affecting caries rates in historic populations. [References: 65] <48> UI - 97249609 AU - Asou N AU - Adachi K AU - Tamura J-I AU - Kanamaru A AU - Kageyama S-I AU - Hiraoka A AU - Omoto E AU - Sakamaki H AU - Tsubaki K AU - Saito K AU - Ohno R IN - N. Asou, Second Department Internal Medicine, Kumamoto University School Medicine, 1-1-1 Honjo, Kumamoto 860; Japan. TI - All-trans retinoic acid therapy for newly diagnosed acute promyelocytic leukemia: Comparison with intensive chemotherapy. SO - Cancer Chemotherapy & Pharmacology, Supplement Vol 40 (pp S30-S35), 1997. AB - We analyzed the results of treating patients with newly diagnosed acute promyelocytic leukemia (APL) with all-trans retinoic acid (ATRA) in the JALSG AML-92 study and compared them with those of the AML-87 and AML-89 studies, which consisted of standard chemotherapy. In the AML-92 study, patients were scheduled to receive 45 mg/ m2 oral ATRA daily until achievement of a complete remission (CR). If patients had initial leukocyte counts of >3.0 x 109/l, they received 40 mg/m2 daunorubicin (DNR) for 3 days and 200 mg/m2 behenoyl cytarabine (BHAC) for 5 days in addition to ATRA. During remission induction therapy, if the patients showed peripheral blood myeloblast and promyelocyte counts of >1.0 x 109/l, they received additional DNR and BHAC on the same schedule. After achievement of a CR, patients received three courses of consolidation and six courses of maintenance/intensification chemotherapy. Of 196 evaluable patients, 173 (88%) achieved a CR: 59 of 62 (95%) treated with ATRA alone, 41 of 49 (84%) treated with ATRA plus later chemotherapy, 63 of 73 (86%) treated with ATRA plus initial chemotherapy, and 10 of 12 (83%) treated with ATRA plus both initial and later chemotherapy. The CR rate in AML-92 was significantly higher than that in AML-89, but not than that achieved in AML-87. In addition, the early mortality and relapse rates in AML-92 were significantly lower than those in AML-89, but were not than those in AML-87, At a median follow-up of 36 months the predicted 4-year event-free survival (EFS) rate for 196 evaluable patients and the 4-year disease-free survival (DFS) rate for the CR cases were 54% and 62%, respectively. There was a significant difference in DFS between AML-92 and AML-87 (P = 0.0418) but not between AML-92 and AML-89 (P = 0.0687). In contrast, significant differences in EFS between AML-92 and both AML-87 (P = 0.0129) and AML-89 (P = 0.005) were observed. These results suggest that non-cross-resistant therapy combined with ATRA and intensive chemotherapy for APL contributes synergistically to the significant improvement in EFS. [References: 24] <49> UI - 97234781 AU - Tang JMW AU - Altman DS AU - Robertson DC AU - O'Sullivan DM AU - Douglass JM AU - Tinanoff N IN - D.M. O'Sullivan, Univ. of Connecticut Health Center, Department of Pediatric Dentistry, MC1610, 263 Farmington Ave., Farmington, CT 06030-1610; United States of America. E-Mail: osullivan@sun.uchc.edu. TI - Dental caries prevalence and treatment levels in Arizona preschool children. SO - Public Health Reports Vol 112(4) (pp 319-329), 1997. AB - Objectives. To assess the prevalence of dental caries in a large group of preschool children, to determine the extent to which the children received dental treatment, to examine the association between demographic and socioeconomic factors and the prevalence of caries, and to compare these findings with those from previous studies of preschool populations in the United States. Methods. Dental caries exams were performed on 5171 children ages 5 months through 4 years, and a parent or other caregiver was asked to complete a questionnaire giving information about the child and her or his household. The children were recruited from Head Start programs; Women, Infants, and Children (WIC) nutrition programs; health fairs; and day care centers in a representative sample of Arizona communities with populations of more than 1000 people. Results. Of the 994 one-year-old children examined, 6.4% had caries, with a mean dmft (decayed, missing [extracted due to caries], and filled teeth) score of 0.18. Nearly 20% of the 2-year-olds had caries, with a mean dmft of 0.70. Thirty-five percent of the 3-year-olds had caries, with a mean draft of 1.35, and 49% of the 4-year-olds had caries, with a mean draft of 2.36. Children whose caregivers fell into the lowest education category had a mean draft score three times higher than those with caregivers in the highest education category. Children with caregivers in the lowest income category had a mean dmft score four times higher than those with caregivers in the highest category. Children younger than age 3 had little evidence of dental treatment, and most of the children with caries in each age group had no filled or extracted teeth. Conclusions. The data show that dental caries is highly prevalent in this preschool population, with little of the disease being treated. Timing of diagnostic examinations and prevention strategies for preschool children need to be reconsidered, especially for children identified as having a high risk of caries. [References: 40] <50> UI - 97234127 AU - Sakashita R AU - Inoue M AU - Inoue N AU - Pan Q AU - Zhu H IN - R. Sakashita, Department of Preventive Dentistry, Kagoshima University Dental School, 8-35-1 Sakuragaoka, Kagoshima 890; Japan. E-Mail: reiko@dentlb.hal.kagoshima-u.ac.jp. TI - Dental disease in the Chinese Yin-Shang period with respect to relationships between citizens and slaves. SO - American Journal of Physical Anthropology Vol 103(3) (pp 401-408), 1997. AB - Seventy-one skulls from the Yin-Shang period tombs of Anyang, China, were examined for the incidence of observable dental diseases, including dental caries, alveolar bone resorption (an index of periodontal disease), ante-mortem tooth loss and tooth attrition. Because the remains were excavated from tombs with funerary items, the burials are believed to be of Anyang citizens. Our study indicates carious tooth frequency in the Yin- Shang period was rather low (2.9-4.0%). Periodontal disease frequency was 18.3-26.9%, and ante-mortem tooth loss frequency was 2.0-7.5%. To determine the relative prevalence of overall dental health in the Yin-Shang populations, observations from the 42 male crania were compared to those from 183 male crania of slaves from 'sacrificial pits' from the Yin-Shang period (Inoue et al. [1992] J. Anthropol. Soc. Nippon 100:1-29). Results from this comparison indicate no apparent difference between social classes in younger age groups. However, in the older ages the rates of the ante-mortem tooth loss, periodontal disease and tooth attrition were significantly higher in the citizen sample. The findings would suggest dietary development in the Yin-Shang period was not dissimilar enough between social classes to induce clear differences in dental diseases at least at younger ages. Conversely, it appears there must have been significant differences between social class diets in the earlier phase of the Yin-Shang period to produce the differences in dental disease present in the older samples. [References: 34] <51> UI - 97213661 AU - Lo GL AU - Bagramian RA IN - G.L. Lo, Department of Preventive Dentistry, University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074; Singapore. TI - Declining prevalence of dental caries in school children in Singapore. SO - Oral Diseases Vol 3(2) (pp 121-125), 1997. AB - OBJECTIVE: Dental health surveys of school children in Singapore from past decades were reviewed to document reductions in prevalence of dental caries. MATERIALS AND METHODS: Surveys were carried out in schools by the Dental Division, Ministry of Health in 1970, 1979, 1984, 1989 and 1994. A sample size of approximately 5000 school children representing 1.2% of the school population aged 6 to 18 years old was examined in each survey. RESULTS: Survey data showed an increase in the proportion of children free of caries in the permanent dentition from 30% in 1970 to 58.7% in 1994. The DMFT index for 6 to 18 year old children has dropped from 2.98 in 1970, 2.61 in 1979, 1.97 in 1984, 1.61 in 1989 to 1.05 in 1994. CONCLUSION: Fluoridation of public water supplies together with the adoption of preventive dental health programmes by the State and professional bodies is credited as the major factor in caries reduction. [References: 15] <52> UI - 97203754 AU - Haugejorden O AU - Nord A AU - Klock KS IN - O. Haugejorden, Department of Community Dentistry, Aarstadveien 17, N-5009 Bergen; Norway. TI - Direct evidence concerning the 'major role' of fluoride dentifrices in the caries decline: A 6-year analytical cohort study. SO - Acta Odontologica Scandinavica Vol 55(3) (pp 173-180), 1997. AB - The role of fluoride (F) dentifrices in caries decline was investigated by assessing the effect of variation in their use on caries scores among teenagers. The material comprised 211 subjects aged about 11 years at base line and 18 years at the last examination. Pairs of posterior bitewing radiographs were assessed by one examiner. Information concerning dental health behavior was collected by questionnaire and about treatment received from dental records. A reversal of the traditional. DFS gender difference occurred during teenage years. Multivariate regression analyses showed an inverse relationship between variation in F dentifrice use and current decay (D1S) at age 18 years (P < 0.04) and which caries incidence per year (D1FS) during the whole observation period (P < 0.02). Total explained variance in 6-year DeltaD1FS scores was 29.8%, of which variation in toothbrushing behavior contributed 1.8 percentage points. While confirming the multifactorial nature of dental caries, these results also provided quantitative evidence for the role of variation in F dentifrice use in caries incidence and decline. [References: 37] <53> UI - 97196060 AU - Wilson S AU - Smith GA AU - Preisch J AU - Casamassimo PS IN - Dr. S. Wilson, Department of Pediatric Dentistry, Children's Hospital, 700 Children's Drive, Columbus, OH 43205; United States of America. TI - Nontraumatic dental emergencies in a pediatric emergency department. SO - Clinical Pediatrics Vol 36(6) (pp 333-337), 1997. AB - The objectives of this study were to describe nontraumatic dental emergencies among children treated in a pediatric emergency department. The children studied received emergency treatment for a nontraumatic dental problem from December 1992 through November 1993. Among the 1,459 children treated for dental emergencies, 949 had a nontraumatic emergency (65%) and were enrolled in this study. Patients ranged in age from 1 month to 19 years, with a mean age of 6.9 years. Fifty-two percent of patients were male. The teeth were involved in 99% of cases. An abscess was present in 33% of patients; and among these patients, 26% also had a fistula. Pericoronitis was seen in 4% of patients, primary vital stomatitis in 1%, and an eruption hematoma in 0.5%. Caries is the etiology of the problem prompting the emergency department visit in 73% of patients, and baby bottle caries accounted for 18% of all cases of caries. Other etiologies included the late effects of trauma (8%), iatrogenic (7%), idiopathic (3%), and periodontal processes (2%). Tooth extraction was performed in 45% of patients. Findings of this large consecutive series provide a better understanding of this type of visit to the pediatric emergency department. [References: 34] <54> UI - 97171959 AU - Tenenbaum H AU - Elkaim R AU - Cuisinier F AU - Dahan M AU - Zamanian P AU - Lang JM IN - H. Tenenbaum, Department of Periodontology, Dental Faculty, 1 Place de I'Hopital, 67000 Strasbourg; France. TI - Prevalence of six periodontal pathogens detected by DNA probe method in HIV vs non-HIV periodontitis. SO - Oral Diseases Vol 3(SUPPL. 1) (pp S153-S155), 1997. AB - OBJECTIVE: The aim of the study was to examine the prevalence of selected periodontal pathogens associated with HIV and non-HIV related periodontal lesions. METHODS: Subgingival plaque samples were obtained from both HIV-seropositive and HIV-seronegative patients affected with periodontal disease. DNA probes were used to detect Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus, Eikenella corrodens and Campylobacter rectus. RESULTS: A. actinomycetemcomitans, P. intermedia and B. forsythus (P < 0.05) were more prevalent in HIV-seronegative patients with rapidly progressive periodontitis. Only C. rectus was slightly more prevalent in HIV-seropositive subjects with periodontal diseases, but this was not significant. [References: 13] <55> UI - 97099765 AU - Geara FB AU - Glisson BS AU - Sanguineti G AU - Tucker SL AU - Garden AS AU - Ang KK AU - Lippman SM AU - Clayman GL AU - Goepfert H AU - Peters LJ AU - Hong WK IN - Dr. F.B. Geara, Department of Radiation Oncology, M. D. Anderson Cancer Center, Box 97, Houston, TX 77030; United States of America. TI - Induction chemotherapy followed by radiotherapy versus radiotherapy alone in patients with advanced nasopharyngeal carcinoma: Results of a matched cohort study. SO - Cancer Vol 79(7) (pp 1279-1286), 1997. AB - BACKGROUND. Prospective randomized and retrospective studies on adjunctive chemotherapy in patients with advanced locoregional nasopharyngeal carcinoma have yielded conflicting results and the role of chemotherapy in this disease had not been clearly defined. The authors report the results of a single institution, matched cohort study comparing a group of 61 patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy followed by radiation therapy with a matched group treated with radiotherapy alone. METHODS. Between 1985 and 1992, 61 patients with advanced locoregional nasopharyngeal carcinoma received induction chemotherapy [cisplatin, 100 mg/m2 on Day 1 and 5-fluorouracil [5-FU], 1000 mg/m2, on Days 1-5) for 3 cycles followed by definitive radiation therapy (CT/RT group). This group was matched with a group of 61 patients from a population of 378 patients who received radiation therapy alone (RT group). Matching characteristics were T classification, N classification, histology, and level of cervical lymph node metastases. These characteristics were found to be significant determinants of distant metastasis (DM) and/or survival in a multivariate analysis that was performed in the entire radiotherapy group. Radiation therapy consisted of 66-72 gray in 6.5 to 7 weeks in both groups. Fifty-nine patients (97%) in both groups had Stage IV disease. Fifteen patients (25%) in both groups had lower cervical lymph node metastases. The tumor histologic types also had similar distribution in both groups. Median follow-up time among surviving patients of the CT/RT group was 4.9 years (range, 1.3-9.8 years). RESULTS. The 5-year cumulative incidence of DM was 19 +/- 5% for the CT/RT group and 34 +/- 6% for the RT alone group (P = 0.019; log rank test). This reduction in distant failure was more prominent in patients with intermediate (N2-N3 disease; upper or midcervical lymph nodes), or high risk (N2-N3 disease; lower cervical lymph nodes) of DM. This reduction in DM translated into improvement in disease free survival (DFS) and overall survival (OS). The 5- year actuarial DFS rates were 64 +/- 6% for the CT/RT group compared with 42 +/- 7% for the RT group (P = 0.015). The 5-year actuarial OS rates were 69 +/- 6% (CT/RT group) and 48 +/- 7% (RT group), respectively (P = 0.012). The incidence of locoregional failure was slightly lower in the CT/RT group, but this difference did not reach statistical significance. There was no significant difference in the incidence and severity of acute mucositis between the two groups during radiotherapy. The 5-year cumulative incidence of Grade 3 or higher late complications was also similar in both groups (5 +/- 3% in the CT/RT group and 8 +/- 3% in the RT group; P = 0.721). CONCLUSIONS. This matched cohort study provides additional evidence that induction cisplatin-5-FU chemotherapy prior to definitive radiation improves freedom from distant metastasis, DFS, and OS for patients with locoregional Stage IV nasopharyngeal carcinoma without increasing treatment-related morbidity. [References: 26] <56> UI - 97053690 AU - Jacquy C AU - Ferrant A AU - Leners N AU - Cogneau M AU - Jamar F AU - Michaux JL TI - Additional myeloablation with 52Fe before bone marrow transplantation. SO - Bone Marrow Transplantation Vol 19(3) (pp 191-196), 1997. AB - For many hematological malignancies, high-dose chemoradiotherapy followed by bone marrow transplantation offers the best and sometimes the only chance for cure. However, the main causes of failure of this therapy are relapse and toxicity. In order to selectively deliver higher doses of radiotherapy to the bone marrow and to spare normal organs, we explored 52Fe therapy before a conventional BMT conditioning regimen. Twenty-four patients at high risk for relapse after BMT were included in a phase II study. The median follow-up was 42 months. The median 52Fe dose was 59 mCi. This resulted in a median radiation-absorbed dose (RAD) to the BM of 626 rad. The median RAD to the liver was 338 rad. No untoward effects were noted after the injections of 52Fe. The patients recovered hematopoiesis without toxicity in excess of that expected with conventional conditioning alone. The 3-year DFS probability was 49% (95% CI: 20-78%), Eight patients have relapsed,three of them in extramedullary sites. 52Fe should provide a way to boost the radiation dose to marrow-based diseases before bone marrow transplantation without excessive toxicity. [References: 18] <57> UI - 97045008 AU - De Nully Brown P AU - Hoffmann T AU - Hansen OP AU - Boesen AM AU - Gronbaek K AU - Hippe E AU - Jensen MK AU - Thorling K AU - Storm HH AU - Pedersen-Bjergaard J TI - Long-term survival and development of secondary malignancies in patients with acute myeloid leukemia treated with aclarubicin or daunorubicin plus cytosine arabinoside followed by intensive consolidation chemotherapy in a Danish national phase III trial. SO - Leukemia Vol 11(1) (pp 37-41), 1997. AB - In 1991 we reported the results from a prospective randomised phase 3 trial comparing 7 days continuous infusion of cytosine arabinoside (ara-C) combined with either daunorubicin (DNR) or aclarubicin (ACR) as direct i.v. injection for 3 days as induction chemotherapy (CT) for patients with de novo acute myeloid leukemia (AML) followed by early intensive consolidation CT with two alternating cycles of high-dose ara-C and two cycles of amsacrine plus etoposide, and finally 3 days of daunomycin plus 7 days of ara-C as administered for induction of remission. A total of 174 patients with de novo AML in the age group 17-65 years were included. The patients have now been followed till death or for at least 7 years, and an evaluation of the long-term survival and the risk of developing secondary neoplasms has been made. The overall survival rate 5-years after diagnosis was 23%, and after 10 years 19%. No difference was found between the two treatment regimens in overall survival or disease-free survival (DFS). For the subgroup of 99 patients who achieved complete remission after one or two induction courses, 5- and 10-year survival rates were 35% and 31% respectively, with the highest survival rates in the age group 17-39 years (57% at 5 years) as compared with 27% in patients aged 40-60 years (P = 0.007). Seven secondary neoplasms were diagnosed simu