Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study

Extent: 7p.Background Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. Methods/Design This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. Discussion This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.Amit Arora, Jane A Scott, Sameer Bhole, Loc Do, Eli Schwarz and Anthony S Blinkhor

Factors inhibiting the implementation of the atraumatic restorative treatment approach in public oral health services in Gauteng province, South Africa.

Contains fulltext : 51790.pdf (publisher's version ) (Open Access

Abstract P6-08-02: Do personal, familial or counseling factors influence the choice for prophylactic mastectomy and/or bilateral salpingo-oöphorectomy of female BRCA mutation carriers?

Abstract Background: A germline mutation in the BRCA1 or BRCA2 gene predisposes for breast- and ovarian cancer. Female carriers of a BRCA-mutation ≥ 25 years of age, need to choose between surveillance and prophylactic surgery for their breasts and ovaries. Until now it remains unclear which factors contribute to these choices. Aim: The aim of our study was to investigate whether psychosocial or care provider-related factors influence the choice for prophylactic surgery in BRCA mutation carriers. Design: The cohort consisted of 635 women (mean age 46 (18–90) years), all living in the South East of The Netherlands and counseled between 1994 and April 2012. 323 women were carrier of a BRCA1 and 312 of a BRCA2 mutation. 239 had breast cancer, 38 ovarian cancer, 28 had breast and ovarian cancer and 330 women had no cancer history. Univariable and multivariable logistic regression analyses were performed with either breast surveillance vs. mastectomy or ovarian surveillance vs. bilateral salpingo-oöphorectomy (BSO) as outcome. The following factors were investigated: – Personal: age at time of BRCA test and cancer history,– Familial: presence of first degree relative with breast and/or ovarian cancer, age of the relative and the BRCA carrier at time of cancer diagnosis in this relative, whether the BRCA carrier had children and if so age of the children(&amp;lt; 18 or ≥ 18),– Counseling: professional responsible of counseling (clinical geneticist vs genetic counselor), Psychsocial support (if needed) (genetic counselor vs psychologist) and whether the follow up was in specialized multidisciplinary teams or a peripheral hospital. Results: Prophylactic mastectomy was chosen by 132 of the women, breast surveillance by 352 women. BSO was chosen by 268 women, most of them above 40 years of age; ovarian surveillance by 161 women. Ovarian surveillance was the choice of women younger than 40, women with a breast cancer history and older women. Univariable analyses revealed that women more often chose for mastectomy when they had a younger age (OR 0.94 CI 0.919–0.964), breast cancer (OR 4.827 CI 2.843–8.198), children (OR: 1.889 CI 1.085–3.289), especially children under the age of 18 (OR 1.778 CI 1.103–2.866), a first degree relative with cancer (OR 0.41 CI 0.231–0.728) or consulted a psychologist (OR 5.299 CI 1.425–19.703). The choice for mastectomy was not influenced by the counselor or the place where the follow-up was given. Multivariable analysis showed that if all factors were considered together, 3 factors remained significant for choosing mastectomy: age, personal cancer history and first degree relative with cancer factors. No factors were found that influence the choice for preventive measures for ovarian cancer. This was expected because since 2002 all women BRCA carriers where advised to chose BSO above 40 years of age. Conclusion: Personal and familial factors play important roles in the choice for prevention of breast- and ovarian cancer in female BRCA mutation carriers. In our study counseling factors, such as type of counselor or place of follow-up did not influence the choice for prophylactic mastectomy. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-08-02.</jats:p

A mutation update for the FLNC gene in myopathies and cardiomyopathies

Filamin C (FLNC) variants are associated with cardiac and muscular phenotypes. Originally, FLNC variants were described in myofibrillar myopathy (MFM) patients. Later, high-throughput screening in cardiomyopathy cohorts determined a prominent role for FLNC in isolated hypertrophic and dilated cardiomyopathies (HCM and DCM). FLNC variants are now among the more prevalent causes of genetic DCM. FLNC-associated DCM is associated with a malignant clinical course and a high risk of sudden cardiac death. The clinical spectrum of FLNC suggests different pathomechanisms related to variant types and their location in the gene. The appropriate functioning of FLNC is crucial for structural integrity and cell signaling of the sarcomere. The secondary protein structure of FLNC is critical to ensure this function. Truncating variants with subsequent haploinsufficiency are associated with DCM and cardiac arrhythmias. Interference with the dimerization and folding of the protein leads to aggregate formation detrimental for muscle function, as found in HCM and MFM. Variants associated with HCM are predominantly missense variants, which cluster in the ROD2 domain. This domain is important for binding to the sarcomere and to ensure appropriate cell signaling. We here review FLNC genotype-phenotype correlations based on available evidence.status: publishe