Lidocaine-prilocaine (EMLA) cream as analgesia for hysterosalpingography: a prospective, randomized, controlled, double blinded study.

Background: The aim of our study is to evaluate the efficacy of applying lidocaine 25 mg-prilocaine-25 mg/G cream (EMLA 5%) on the uterine cervix for pain relief when performing hysterosalpingography (HSG).

Methods: Eighty-two patients undergoing HSG as part of infertility evaluation were randomized into groups receiving EMLA (42) or placebo cream (40) in a double-blinded prospective study from which four women were later excluded. The cream was applied to the uterine cervix by means of a cervical cup 30 min before the HSG.

Infection-age structured epidemic models with behavior change or treatment.

We formulate infection-age structured susceptible-infective-removed (SIR) models with behavior change or treatment of infections. Individuals change their behavior or have treatment after they are infected. Using infection age as a continuous variable, and dividing infectives into discrete groups with different infection stages, respectively, we formulate a partial differential equation model and an ordinary differential equation model with behavior change or treatment.

Challenges in interpreting study results: the conflict between appearance and reality.

Background: Many studies investigating the relationship between periodontal disease and systemic diseases have been reported; the majority of these have been epidemiologic (or observational) studies. The purpose of this article is to help readers understand the strengths and limitations of epidemiology for the purpose of being better able to interpret these studies.

Findings: Epidemiologic studies include retrospective case-control studies and prospective cohort studies.

Pseudohypoparathyroidism: a rare cause of bilateral slipped capital femoral epiphysis.

Pseudohypoparathyroidism (PHP) type 1b is a rare childhood disorder characterized by renal resistance to parathyroid hormone (PTH) resulting in biochemical hypoparathyroidism but with skeletal sensitivity to PTH. We describe a patient with PHP type 1b who we believe is one of the youngest reported patients with bilateral slipped capital femoral epiphyses (SCFE).

Management of salivary fistulas after microvascular head and neck reconstruction.

Unlabelled: Salivary fistulas after head and neck microvascular reconstruction are difficult problems whose treatment remains controversial. Although aggressive, early operative intervention has been suggested by some groups, we have found that many patients respond to conservative management with bedside debridement and aggressive local wound care. The purpose of this study was, therefore, to review our experience with the management of postoperative salivary fistulas.

Estimation of the reproductive number of the Spanish flu epidemic in Geneva, Switzerland.

The 1918 influenza pandemic known as the "Spanish Flu" has been the worst in recent history with estimated worldwide mortality ranging from 20 to 100 million deaths. Using epidemic modeling and hospital notification data during the 1918 influenza pandemic in the Canton of Geneva, Switzerland, we estimated the reproductive numbers of the first and second waves of influenza infection to be R(1)=1.49 (95% CI: 1.

The military oral health care system as a model for eliminating disparities in oral health.

Background: Healthy People (HP) 2010 is a national health promotion and disease prevention initiative of the U.S. Department of Health and Human Services.

Aesthetic skin branding: a novel form of body art with adverse clinical sequela.

Branding is a form of body art wherein third-degree burns are inflicted on the skin to produce permanent scars. This method of scarification is a common practice among many indigenous cultures and has become exceedingly common in western societies. As with other forms of body art, branding is not a manifestation of a psychiatric disorder but, rather, a method of self-expression.

Towards a National Pediatric Musculoskeletal Trauma Outcomes Registry: the Pediatric Orthopaedic Trauma Outcomes Research Group (POTORG) experience.

This study is a pilot effort towards the broader implementation of a national pediatric musculoskeletal trauma outcomes registry. The primary goal of this project is to explore the feasibility of a web-based data acquisition and management platform and to identify catalysts and obstacles to multi-center collaboration. A prospective cohort of children presenting to the Pediatric Emergency Departments with ankle, femur, supracondylar humerus, tibial spine, or open fractures at five clinical centers between October 2001 and March 2003 comprised the study population.

Predicting scorpion sting incidence in an endemic region using climatological variables.

Scorpionism is a public health problem in several regions of the world. The highest mortality, with over 1000 deaths per year, has been reported in Mexico. We analysed the significance of climatological variables to predict the incidence of scorpion stings in humans in the state of Colima (Mexico) for the years 2000-2001.

Dental insurance and clinical dental outcomes in NHANES III.

Objectives: The National Health and Nutrition Examination Survey (NHANES III) 1988-1994 is one of the few nationally representative data sets with information on both private dental insurance and a clinical dental exam. The objective of this analysis was to examine the possible associations between private dental insurance and clinical exam outcomes, demographic variables, and dental visits.

Methods: Using NHANES III data, analysis was limited to persons aged 20 years or older who had a dental exam and reported on their private dental insurance status.

Human-mediated foot-and-mouth disease epidemic dispersal: disease and vector clusters.

Disease clusters were retrospectively explored at national level using a geo-referenced dataset from the 2001 Uruguayan Foot-and-Mouth Disease (FMD) epidemic. Disease location and time (first 11 epidemic weeks) were analysed across 250 counties (of which 160 were infected), without and with control for human mobility related factors (human population and road densities). The null hypothesis of random disease distribution over space and/or time was assessed with: (i) purely temporal; (ii) purely spatial; and (iii) space/time tests.

Identification of case clusters and counties with high infective connectivity in the 2001 epidemic of foot-and-mouth disease in Uruguay.

Objective: To evaluate the influence of individual spatial units (ie, counties) on the epidemic spread of foot-and-mouth disease (FMD) virus.

Sample Population: 163 counties in Uruguay where there was an outbreak of FMD between April 23 and July 11, 2001.

Procedure: A geographically referenced database was created, and the distance between counties (13,203 county pairs), road density of counties (163 counties), and time when cases were reported in those counties (11 weeks of the epidemic) were considered to assess global spatial and spatial-temporal autocorrelation, determine the contribution of links connecting pairs of counties with infected animals, and allow us to hypothesize the influence for spread during the epidemic for counties with greater than the mean infective link contributions.

Transmission dynamics of the great influenza pandemic of 1918 in Geneva, Switzerland: Assessing the effects of hypothetical interventions.

Recurrent outbreaks of the avian H5N1 influenza virus in Asia represent a constant global pandemic threat. We characterize and evaluate hypothetical public health measures during the 1918 influenza pandemic in the Canton of Geneva, Switzerland. The transmission rate, the recovery rate, the diagnostic rate, the relative infectiousness of asymptomatic cases, and the proportion of clinical cases are estimated through least-squares fitting of the model to epidemic curve data of the cumulative number of hospital notifications.

Differential susceptibility and infectivity epidemic models.

We formulate differential susceptibility and differential infectivity models for disease transmission in this paper. The susceptibles are divided into n groups based on their susceptibilities, and the infectives are divided into m groups according to their infectivities. Both the standard incidence and the bilinear incidence are considered for different diseases.

Electrophysiologic differentiation of homozygous and heterozygous Abyssinian-crossbred cats with late-onset hereditary retinal degeneration.

Objective: To develop a method to electrophysiologically differentiate heterozygous-carrier Abyssinian-crossbred cats from homozygous-affected Abyssinian-crossbred cats before clinical onset of inherited rod-cone retinal degeneration.

Animals: 14 back-crossed Abyssinian-crossbred cats of unknown genotype (homozygous or heterozygous) for inherited rod-cone retinal degeneration, 24 age-matched mixed-breed control cats, 6 age-matched heterozygous Abyssinian-crossbred cats, and 6 homozygous Abyssinian cats.

Procedure: Electroretinography (ERG) of heterozygous and homozygous cats revealed differences, especially for scotopic recordings.

Assessment of health status in patients with cerebral palsy: what is the role of quality-of-life measures?

Measuring quality of life (QOL) in a population with a functional range as large as that of the pediatric cerebral palsy population is challenging. This study assessed the utility of two common QOL instruments in this population: the Child Health Questionnaire (CHQ) and the Pediatric Outcomes Data Collection Instrument (PODCI). The goal was to determine the efficacy of these questionnaires in detecting subtle differences in the QOL among children with cerebral palsy and to demonstrate the need for dynamic assessment when evaluating QOL within this group.

The role of spatial mixing in the spread of foot-and-mouth disease.

A model of epidemic dispersal (based on the assumption that susceptible cattle were homogeneously mixed over space, or non-spatial model) was compared to a partially spatially explicit and discrete model (the spatial model), which was composed of differential equations and used geo-coded data (Euclidean distances between county centroids). While the spatial model accounted for intra- and inter-county epidemic spread, the non-spatial model did not assess regional differences. A geo-coded dataset that resembled conditions favouring homogeneous mixing assumptions (based on the 2001 Uruguayan foot-and-mouth disease epidemic), was used for testing.

The effect of limb length discrepancy on health-related quality of life: is the '2 cm rule' appropriate?

The primary goal of surgical equalization of lower extremity limb length discrepancy is to enhance the quality of life of patients by improving their function, gait, appearance, and pain secondary to compensation for the limb length discrepancy. While many surgeons use a cutoff point of 2 cm as an indication for intervention, little attention has been given to the effect of limb length discrepancy on quality of life. Therefore, the purpose of this study was to determine the relationship between limb length discrepancy and health-related quality of life and to assess whether the commonly accepted 2 cm cutoff serves to predict patients with and without quality of life perturbations.

Dental visits among smoking and nonsmoking US adults in 2000.

Objective: To examine dental visits among smoking and nonsmoking adults in a nationally representative sample.

Methods: Logistic regression analysis was performed, using a sample of 15,250 US adults from the Medical Expenditure Panel Survey Household Component 2000.

Results: Current smokers were less likely to report dental visits (32.

Pediatric orthopaedic injuries: the effect of treatment on school attendance.

This study aims to determine whether children experience difficulty attending school after an acute orthopaedic injury and, if so, what the barriers are to attendance. Seventy-eight school-aged patients receiving treatment of acute orthopaedic injuries or conditions at the authors' institution were enrolled in this prospective study. Follow-up interviews were conducted with children who could not return to school.

Modelling the transmission dynamics of acute haemorrhagic conjunctivitis: application to the 2003 outbreak in Mexico.

We model an outbreak of acute haemorrhagic conjunctivitis (AHC) using a simple epidemic model that includes susceptible, infectious, reported, and recovered classes. The model's framework considers the impact of underreporting and behaviour changes on the transmission rate and is applied to a recent epidemic of AHC in Mexico, using a fit to the cumulative number of cases to estimate model parameters, which agree with those derived from clinical studies. The model predicts a 'mean time from symptomatic onset to diagnosis' of 1.

Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002.

Problem/condition: Dental caries is a common chronic disease that causes pain and disability across all age groups. If left untreated, dental caries can lead to pain and infection, tooth loss, and edentulism (total tooth loss). Dental sealants are effective in preventing dental caries in the occlusal (chewing) and other pitted and fissured surfaces of the teeth.

Medial prefrontal cortex cells show dynamic modulation with the hippocampal theta rhythm dependent on behavior.

Both the hippocampus and the medial prefrontal cortex are essential for successful performance in learning- and memory-related tasks. Within the hippocampus the theta rhythm plays an integral role in the timing of action potentials of hippocampal neurons responding to elements of any given task. Medial prefrontal cortex (mPFC) neurons display firing rate changes to specific facets of behavioral tasks (Jung et al.