Italian Deprivation Index and Dental Caries in 12-Year-Old Children: A Multilevel Bayesian Analysis

Evidence from the literature has shown that people with a lower socioeconomic status enjoy less good health than people with a higher socioeconomic status. The Italian deprivation index (DI) was used with the aim to evaluate the association between the DMFT index and risk factors for dental caries, including city population and DI. The study included 4,305 12-year-old children living in 38 cities classified by demographic size as small, midsize and large. Zero-inflated negative binomial multilevel regression models were used to assess risk factors for DMFT and to address excess of zero DMFT and overdispersion through a Bayesian approach. The difference in the average level of DMFT among children living in cities with different DI quintile was not statistically significant (p = 0.578). The DI and ln(population), included as city-level fixed effects in the two-level variance components model, were not statistically significant. Consuming sweet drinks on average increased the mean DMFT of a susceptible child, while having a highly educated mother reduced it. Un-observed heterogeneity among cities was detected for the probability to be non-susceptible to caries (city-level variance = 0.26 with 95% credibility interval 0.09–0.57), while no territorial effect was found for the mean DMFT of the susceptible children. Our results suggest that the DI and city population did not play a role in explaining between-city variability. Interventions against social deprivation can be influential on the perception of oral health in Italian 12-year-old children to the extent that they can also affect individual level factors

Prevalence of sexual and physical abuse in patients with obstructed defecation: impact on biofeedback treatment

Background: obstructed defecation is one of the most com mon subtypes of constipation, and it is frequently responsive to biofeedback treatment. Aims: since a history of sexual and physical abuse may be pre sent in patients with obstructed defecation, we assessed the inci dence of abuse history in patients with obstructed defecation re ferred to a general gastroenterology practice, and whether such a history may lead to a different outcome of biofeedback training in these patients. Patients and methods: one hundred and twenty-one pa tients (17 men, 104 women, age 53 ± 15 years) with obstructed defecation were studied by retrospective chart review. Their histo ry of sexual, physical and psychological abuse was obtained by a standard interview, and biofeedback training was carried out by means of a three-balloon technique. Results: a history of sexual/physical or psychological abuse was present in 12.4% patients. Biofeedback training yielded a successful improvement of obstructed defecation in 93% patients without abuse and in 100% of patients with abuse; this difference was not statistically different (p = 0.53). Conclusions: the prevalence of sexual/physical or psycholog ical abuse in a population of patients with obstructed defecation referred to a general gastroenterology practice is relatively low; such a history seems not to affect the outcome of biofeedback training in these patients

Morphometry of the Glomerular Tuft During Normal Postnatal Growth in Female Rats. Effects of Age, Location of Glomeruli and Methods of Obtaining and Processing the Renal Tissue

Total glomerular filtration rate depends upon the structural integrity, number and area of glomeruli. Counting  the number of glomeruli as well as measuring glomerular area or volume is nowadays widely employed  in human and experimental biology. Although functional and morphological differences between superficial and juxtamedullary glomeruli have  been described, this is not always taken into account in morphometric studies. The aim of this paper was to  study in female rats the area of juxtamedullary glomeruli and the area of superficial glomeruli as well as the  influence of the age of rats and the methods of obtaining and processing the renal tissue. The glomerular area was larger in kidneys collected in liquid nitrogen and smaller in those fixed in Bouin  (See Materials and Methods); 4% formaldehyde. These results were obtained in superficial and in juxtamedullary  glomeruli (F=29.60, p<0.0001).  Glomerular area increased with time in superficial as well as in juxtamedullary glomeruli (F=9.21,  p<0.0001). The area of the juxtamedullary glomeruli was significantly higher (F=329.29, p<0.0001) than that of superficial  glomeruli, independently of the different methods of obtaining and processing renal tissue, or the  age of the animals. The results indicate that glomerular area is greater in juxtamedullary glomeruli, increases with age, and  that different methods of obtaining and processing the renal tissue do have influence on glomerular size.

[OP.7B.08] INFLUENCE OF GENDER ON THE RELATIONSHIPS BETWEEN NEW INDICES OF ADIPOSITY AND LEFT VENTRICULAR MASS AND HYPERTROPHY IN HYPERTENSIVE PATIENTS

OBJECTIVE: The unfavourable effects of the association of obesity with hypertension on cardiac structure and function have been extensively studied. However, controversy still exists about the influence of gender on the relationship between obesity and left ventricular mass (LVM) and hypertrophy (LVH). Even if body mass index (BMI) and waist circumference (WC) are widely used as anthropometric predictors for cardiovascular diseases (CVD), their validity has been questioned. Recently, Body Shape Index (ABSI) and Body Roundness Index (BRI) were proposed as alternative measures of adiposity that may better reflect health status (1-2).Our study was aimed to assess the ability of ABSI and BRI in identifying LVH and to determine whether they are superior to BMI and WC. Moreover, the influence of gender on the relationships between all these indices of adiposity and LVM was also evaluated. DESIGN AND METHOD: We enrolled 724 subjects with EH (mean age 45 ± 12 years, 63 % men) without cardiovascular complications.In all subjects the anthropometric indices (weight, height and waist circumference) and the routine biochemical parameters were determined. BMI, ABSI and BRI were calculated. Furthermore, all patients underwent a 24-h blood pressure monitoring and an echocardiogram. LVM was indexed for body surface area (LVMI) and for height2.7 (LVMH2.7). RESULTS: The univariate correlations of LVMI and LVMH2.7 with the measures of adiposity evaluated are shown in the table 1.ROC curves analysis revealed that in overall population (table 2) and in men BRI has a greater ability to identify LVH defined as LVMH2.7 > 51 g/m2.7.(Figure is included in full-text article.) CONCLUSIONS: : Our results seems to suggest that in men, but not in women, the BRI has a greater sensitivity to detect LVH than ABSI and the traditional measures of adiposity

O papel profissional no laboratório de pesquisa industrial

O trabalho apresenta a formulate de um modelo de Análise do Papel Profissional, que tem sido exercitado em área de Pesquisa Aplicada de um CPqD industrial. Partindo de uma necessária diferenciação dos conceitos de cargo, função e papel, e desenvolvida uma matriz de informação que permite a caracterização objetiva do papel e do seu significado em relação ao meio. O conceito é então aprofundado através de uma visão transclássica que poderia se chamar de Dialetica do Papel. Por fim, e apresentado um estudo de caso, em que a análise do papel profissional, conforme enunciada, foi aplicada com resultados, ainda que parciais, encorajadores

Improvement in Lung Cancer Outcomes With Targeted Therapies: An Update for Family Physicians.

In the past decade the advent of target therapy has led to a silent revolution in the treatment of lung cancer. Thanks to the specificity of their target, new tailored drugs are able to achieve a larger benefit and lower toxicity and provide better quality of life than cytotoxic drugs in a limited number of patients, selected by molecular profile. Nowadays, the epidermal growth factor receptor tyrosine kinase inhibitors erlotinib and gefitinib, and the anaplastic lymphoma kinase inhibitor crizotinib, are targeted agents approved for treatment of non-small-cell lung cancer. Family physicians play an important role in the treatment, detection, and management of common toxicities and in providing emotional support. Therefore this review integrates molecular profile assessment with evidence of the efficacy and toxicity of tyrosine kinase inhibitors to provide an updated overview of the treatment of non-small-cell lung cancer, which radically changed after the advent of targeted therapies. It also aims to promote a more intensive and interactive collaboration between specialists and family physicians in the management of all phases of cancer care

Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Background: The addition of PD-L1 inhibitors to platinum-based chemotherapy (CT) has newly received United States Food and Drug Administration (FDA) approval in extensive stage-small cell lung cancer (ES-SCLC). PD-1 agents similarly improved survival rates, even if not yet supported by international regulatory agencies. The current work aims to assess different efficacy and safety profiles among chemoimmunotherapy plus immuno-oncology (CT+IO) approaches according to different immune checkpoint inhibitor (ICI) subtypes. Material & Methods: We included in our meta-analysis six first-line randomised controlled trials (RCTs) comparing the association of single-agent ICI with CT versus CT alone in ES-SCLC. Pooled hazard ratios (HRs) and risk ratios (RRs) for progression-free survival (PFS), overall survival (OS), objective response rates (ORR), 12-month duration of response rate (DORR), disease control rate (DCR), treatment-related adverse events (TRAEs) and discontinuation rates (DRs) were obtained. Moreover, we performed indirect comparisons according to ICI subtypes, also among subgroups and landmark survival analyses. Results: Although no ORR benefit was observed, our results showed how CT+IO significantly improved DORR, resulting in improved PFS and OS with no differences in TRAEs; however, CT+IO led to a significant increase in DR. Interestingly, an Eastern Cooperative Oncology Group performance status (ECOG PS) of 1, the use of cisplatin, and the absence of brain metastases seem to be associated with a survival gain using CT+IO in ES-SCLC. Indirect comparisons suggested a slight advantage in favour of programmed cell death-1 (PD-1) and programmed death ligand 1 (PD-L1) over anti-CTLA-4 agents in terms of efficacy with no additional safety concerns. No further differences were observed between PD-1 and PD-L1 inhibitors among subgroups and landmark survival analyses with benefit trends towards anti-PD-1 in terms of DORR and DR. Conclusion: While confirming a survival advantage of CT+IO in selected patients, these results suggested the association of PD-1 inhibitors with CT as a viable option for novel therapeutic approaches in the frontline management of ES-SCLC. Further trials evaluating anti-CTLA-4 agents should be carefully studied in biomarker-selected patients