Fluoride removal and its impact on oral health in Sri Lanka's dry zone: Discussion and recommendation

Fifty percent of the dry zone areas in Sri Lanka have fluoride levels above 1 ppm. This paper discusses the ground conditions and recommends an appropriate range of fluoride in drinking water which can support preventive practices for improving the oral health of children 8-years old and younger. In efforts to address the Chronic Kidney Disease of Unknown etiology (CKDU), water treatment to reduce contaminant level in potable water has been implemented. Such treatment would also remove fluoride and has resulted in potable water with various fluoride levels, depending on concentrations in the raw water. While it is important to reduce fluoride levels, it is important to have appropriate residual levels for prevention of dental caries. It needs, however, to be noted fluoride in excess can cause dental fluorosis. In Sri Lanka's dry zone areas increasing prevalence of dental fluorosis with decreasing prevalence of dental caries has been noted. Consumption of tea and powdered milk could increase total intake of fluoride. Fluoridated toothpaste, when used properly, may, however, result in negligible intake of fluoride. Sri Lanka's hot tropical climate which results in substantial intake of fluids reinforces the need to consider reduction in water fluoride. Consideration of local studies and international standards indicate fluoride levels should be in the range of 0.225–0.500 ppm. In the range of 0.225–0.500 ppm, the prevalence of dental fluorosis and caries was only 14% and 8%, respectively, in an endemic district. When fluoride levels are above 0.500 ppm, the issue of dental fluorosis shall need to be addressed. When levels are below 0.225 ppm, oral health care services shall need to be directed at preventing dental caries.     

Prenatal ultrasound diagnosis of Toriello–Carey syndrome

Toriello–Carey syndrome is a rare malformative complex, described for the first time in 1988, characterized by agenesis of the corpus callosum, facial anomalies, cardiac defects and hypotonia. Relatively few neonatal cases have been reported. We describe here the first prenatal ultrasound diagnosis of the syndrome based on the detection of agenesis of the corpus callosum and spongious cardiomyopathy in a 22-week-old fetus of a couple with positive family history. The first sib of the couple was diagnosed with Toriello–Carey syndrome at 1 year of age, and had, in addition to the typical facial anomalies not detectable by ultrasound, agenesis of the corpus callosum and the same heart lesion (spongious cardiomyopathy). This report demonstrates that prenatal diagnosis of Toriello–Carey syndrome is feasible in the second trimester of pregnancy. Copyright © 2002 John Wiley & Sons, Ltd.     

Restrictive dermopathy and fetal behaviour

We report three siblings from consecutive pregnancies affected with restrictive dermopathy (RD). During the second pregnancy, fetal behavioural development and growth were studied extensively using ultrasound at 1–4 week intervals. Dramatic and sudden changes occurred in fetal body movements and growth but not until the end of the second trimester of pregnancy. Prominent at that time were prolonged periods of fetal quiescence and very low heart rate variability, together with abnormally executed body movements of short duration. Retarded femoral development and jerky abrupt fetal body movements (abnormal movement quality) were already present in the early second trimester of pregnancy. Facial anomalies emerged despite the presence of fetal mouth movements. The clinical features of RD were only partly explained by present knowledge of skin development and the fetal akinesia deformation sequence hypothesis. Quantitative assessment of fetal movements proved to be a poor early marker for antenatal diagnosis of this disorder. Copyright © 2001 John Wiley & Sons, Ltd.     

Changes in fetal heart rate pattern after intrauterine paracentesis in one twin with meconium peritonitis

We report a case of in utero paracentesis of ascites in a fetus with meconium peritonitis due to volvulus at 34 weeks which resulted in the correction of an abnormal fetal heart rate pattern and enabled vaginal delivery by preventing abdominal dystocia. The intrauterine intervention also helped to establish the diagnosis and potentially reduced the respiratory compromise after birth. Copyright © 2001 John Wiley & Sons, Ltd.     

南宁城市大气污染对人体健康的危害及治理对策

南宁市大气属煤烟型污染 ,大气的主要污染物为SO2 、NOx、TSP、降尘 ,虽然随着环境管理和污染治理工作的加强 ,污染物浓度逐年下降 ,但是工业区大气污染仍然较重。污染物流行病学调查显示 :工业区癌症和呼吸系统疾病死亡率均高于全市平均水平 2倍左右 ,城区又高于郊区 2倍 ,大气污染综合指数与呼吸内科门诊就诊人数呈正相关。用邓聚龙的灰色系统理论分析得知污染物对癌症和呼吸系统疾病死亡率有关联 ,关联度从大到小排序为 :TSP >降尘 >SO2 >NOx ,最后提出了大气污染治理的对策。     

Prenatal diagnosis for huntington's disease: A molecular and psychological study

Two linked probes were used to determine the Huntington's disease status of the fetus conceived by a woman affected with the condition. The fetus was found to be unaffected with a certainty of 97 per cent. The ethical issues associated with presymptomatic testing were avoided since the mother presented with initial symptoms of Huntington's disease, but other psychological and ethical issues arose. The concerns of an affected woman planning a pregnancy, and the dilemmas involved in decision-making regarding prenatal diagnosis and possible selective abortion were exposed and explored with the patient and her husband.     

中国臭氧短期暴露与人群死亡之间关系的Meta分析研究

为探讨中国臭氧短期暴露与死亡率之间的关系，更新适用于中国本地化的暴露-反应系数，本研究全面检索了1990年1月1日-2020年1月1日在Web of Science数据库、PubMed、中国期刊全文数据库（CNKI）、万方医学数据库和维普数据库上发表的文献，以"O₃/臭氧（ozone）"、"空气污染（air pollution）"、"死亡率（mortality）"、"时间序列（time-series）"，"病例交叉（case-crossover）"、"中国（China）"为关键词，对符合纳入标准的文献进行质量评价后提取相关数据，通过Meta分析方法合并估计值.结果显示，大气中臭氧浓度每增加10 μg·m^-3，人群总死亡率、心血管系统疾病和呼吸系统疾病死亡率分别增加0.40%（95% CI：0.28%~0.52%）、0.67%（95% CI：0.46%~0.88%）、0.23%（95% CI：-0.20%~0.66%）.亚组分析结果表明，除季节外，温度、年龄、性别均不存在显著的修饰作用.本文结论可为开展城市大气污染健康风险精细化评估提供依据.