A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURO bservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry

Aims: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ESC member countries. Methods and results: We conducted a registry of consecutive in- and outpatients with AF presenting to cardiologists in nine participating ESC countries. All patients with an ECG-documented diagnosis of AF confirmed in the year prior to enrolment were eligible. We enroled a total of 3119 patients from February 2012 to March 2013, with full data on clinical subtype available for 3049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease, and heart failure. Lone AF was present in only 3.9% (122 patients). Asymptomatic AF was common, particularly among those with permanent AF. Amiodarone was the most common antiarrhythmic agent used (~20%), while beta-blockers and digoxin were the most used rate control drugs. Oral anticoagulants (OACs) were used in 80% overall, most often vitamin K antagonists (71.6%), with novel OACs being used in 8.4%. Other antithrombotics (mostly antiplatelet therapy, especially aspirin) were still used in one-third of the patients, and no antithrombotic treatment in only 4.8%. Oral anticoagulants were used in 56.4% of CHA 2DS2-VASc = 0, with 26.3% having no antithrombotic therapy. A high HAS-BLED score was not used to exclude OAC use, but there was a trend towards more aspirin use in the presence of a high HAS-BLED score. Conclusion: The EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry has provided systematic collection of contemporary data regarding the management and treatment of AF by cardiologists in ESC member countries. Oral anticoagulant use has increased, but novel OAC use was still low. Compliance with the treatment guidelines for patients with the lowest and higher stroke risk scores remains suboptimal. © The Author 2013

Prevention of caries in children and adolescents and oral health promotion - the role of health care professionals

Wprowadzenie i cel pracy. Próchnica zębów jest częstym schorzeniem jamy ustnej, które pociąga za sobą poważne skutki i znaczne koszty, zwłaszcza jeśli dotyczy dzieci i młodzieży. Po pojawieniu się choroby w zębach stałych wymagana jest pilna diagnostyka i intensywne leczenie, co może być utrudnione w czasach poważnego ograniczenia dostępu do bezpłatnej opieki stomatologicznej oraz obniżania się standardu życia i ubożenia niektórych środowisk. Poza tym próchnicę obserwuje się u dzieci w coraz młodszym wieku, już w zębach mlecznych i u dzieci w wieku przedszkolnym. Niniejsza praca ma na celu: • przedstawienie najnowszych wiadomości dotyczących patogenezy, wykrywania i profilaktyki próchnicy, • opisanie koncepcji domów dentystycznych i szkół promujących zdrowie, • przedstawienie roli pracowników służby zdrowia na każdym etapie profilaktyki i edukacji dotyczącej próchnicy, • zaprezentowanie zaleceń profilaktycznych skierowanych do rodziców oraz młodzieży. Skrócony opis stanu wiedzy. Na podstawie dostępnego piśmiennictwa opisano aktualne wiadomości dotyczące patogenezy próchnicy, jej wykrywania oraz zapobiegania. Opisano koncepcję domu dentystycznego i szkół promujących zdrowie, ponadto przedstawiono zalecenia dla rodziców i młodzieży, w przekazywaniu których dużą rolę może odegrać personel służby zdrowia. Podsumowanie. Właściwa profilaktyka próchnicy, wdrożona możliwie wcześnie (najlepiej jeszcze przed urodzeniem dziecka), ma niesłychanie korzystny wpływ na dalsze życie dzieci, stan jamy ustnej oraz ogólny stan zdrowia. Trwała zmiana światopoglądu i stylu życia oraz likwidacja barier w dostępie do opieki stomatologicznej, mogą przyczynić się do obniżenia częstości występowania tej choroby, z korzyścią dla chorych i całego społeczeństwa.Introduction and objectives. Dental caries (tooth decay) is a common disease of the oral cavity, usually followed by serious outcomes and generating considerable costs, especially when it concerns children and adolescents. If permanent teeth are affected, prompt diagnosis and intensive treatment are indispensable, which may be difficult because of considerable limitations in access to public dental care, and is additionally burdened by a continuous decrease of life standards and impoverishment of families and communities. Moreover, dental caries is detected in children at an increasingly younger age, as early as in preschool period and deciduous teeth. The objectives of the presented study are as follows: • presentation of the latest data concerning pathogenesis, detection and prevention of dental caries; • concepts of dental home and health-promoting schools; • description of health care professionals’ role at each stage of prophylaxis and education; • anti-caries preventive recommendations for parents and adolescents. Brief presentation of current knowledge. According to available literature, some current data concerning pathogenesis, diagnosis and prevention of dental caries are presented. In addition, concepts of dental home and health-promoting schools are mentioned, together with recommendations for parents and adolescents, normally provided by health care staff. Summary. Correct and adequate prevention of dental caries, if implemented early (preferably even before the child’s birth), exerts highly beneficial effects upon the lives of children, their oral health and general health status. Long-lasting changes in attitude and life-style, as well as decreasing barriers in access to dental care, are supposed to decrease the prevalence of this common disease, with obvious benefits for patients and the whole of society