Familial occurrence of inflammatory bowel disease

Article Abstract:

To learn more concerning possible familial factors in Crohn's disease and ulcerative colitis (two conditions involving bowel inflammation), a study of first- and second-degree relatives of 637 patients (504 with colitis, 133 with Crohn's disease) was carried out. The patients, all residents of Copenhagen county in Denmark, had been diagnosed according to criteria that are listed in the report. They received a questionnaire in the mail that included items about family history and family members with inflammatory bowel disease. Patients who listed affected family members were contacted by telephone to learn more concerning these members' illnesses; the medical records of the family members were then examined. Sex- and age-adjusted risk levels for Crohn's disease and ulcerative colitis in first- and second-degree relatives (only sex-adjusted for second-degree relatives) were calculated and compared with risk levels among the general population. Results showed that 60 patients had relatives with inflammatory bowel disease; some had more than one affected relative. As compared with disease rates in the general population, first-degree relatives of patients with ulcerative colitis had 9.5 and 1.8 times the prevalence rates of ulcerative colitis and Crohn's disease, respectively. Among first-degree relatives of patients with Crohn's disease, prevalence rates for Crohn's disease and ulcerative colitis were elevated 10.3 times and 4.4 times greater. Prevalence rates for the same disease as the patients were also elevated among second-degree relatives. Overall, the study showed that first-degree relatives of people with ulcerative colitis or Crohn's disease have 10 times the risk of developing that disease as the general population. A review of the medical literature concerning familial occurrence of inflammatory bowel disease and possible sources of bias is presented. Although a shared environment is unlikely to lead to increased relative risks of the magnitude found, the relative contributions of genetic and environmental factors cannot be sorted out in such a study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Denmark, Demographic aspects, Genetic aspects, Ulcerative colitis, Inflammatory bowel diseases, Crohn's disease

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Abnormalities of striatal projection neurons and N-methyl-D-aspartate receptors in presymptomatic Huntington's disease

Article Abstract:

Huntington's disease is an inherited condition that causes a gradual deterioration in mental functioning, changes in personality, and neurological abnormalities. The average patient age at disease onset is between 30 and 40 years, and the symptoms become progressively worse with time. Researchers have begun to identify which neurons, or nerve cells, in the brain degenerate in Huntington's disease and which are spared from damage. Certain neurons, called striatal projection neurons because their fibers terminate beyond the region called the striatum, are the nerves affected. Within the category of striatal projection neurons, subtypes degenerate in a predictable sequence that explains the symptoms of the patient. Scientists are now investigating why these nerve cells die, and one possibility involves the activation of certain cell receptors, called N-methyl-D-aspartate receptors, in the striatum. Unfortunately, to reveal the mechanisms behind the disease process it is necessary to examine the brain tissue of patients with early Huntington's disease, but postmortem analysis can usually be done only on patients who have died with advanced Huntington's disease. A case is described of a young woman who had the gene for Huntington's disease; she committed suicide before she developed symptoms of the disease and had expressed a wish to donate her brain for research. There were several cases of Huntington's disease in her family, including a sibling of the victim's. Over approximately 10 years she had developed depression, anxiety and outbursts of anger, and at age 32 she killed herself by a gunshot to the chest. Research on her brain revealed that scientists had been correct in their theories about the pathogenesis of the disease; the brain tissue was found to have early abnormalities in the striatal projection neurons and the N-methyl-D-aspartate receptors of the striatum. The findings and their implications are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Development and progression, Neurons, Huntington's chorea, Huntington's disease

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Periodontal disease

Article Abstract:

Periodontal disease refers to diseases of the periodontium, which consists of the gingiva or gums, connective tissue, and bones that anchor the teeth into the jaws. Periodontal diseases may be classified into those involving only the gingiva and those involving the gingiva as well as other structures of the periodontium. Gingivitis, an inflammation of the gums, may progress to a more severe form called trench mouth or Vincent's infection, characterized by pain, tissue decay, and sudden onset, often during adolescence. Gingival diseases may result from illnesses or conditions such as herpesvirus infections, blood disorders, diabetes, disorders of the immune system, and pregnancy, as well as from drugs that alter the secretion of saliva or the development of the gums. Periodontal disease is more serious than gingival disease in that it is the major cause of adult tooth loss; it is classified according to the age group affected. Diagnosis of periodontal disease involves physical examination by a dentist and X-rays of the mouth region. Factors such as the use of fluorides, antiseptic rinses, and antibiotics have decreased the prevalence of periodontal disease, which tends to occur in recurrent acute episodes followed by remission. Studies have indicated that only certain types of bacteria cause periodontal disease, although tissue destruction results from both bacteria and a pathologic immune response of the patient's natural defense against infection. Current treatment and research in the management of periodontal disease are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Periodontal disease, Periodontal diseases

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