Reflux und Essstörungen - "Ein Fall für Zwei"

The term erosion describes tooth wear caused by acids. Erosions can be a consequence of medical problems like gastroesophageal reflux disease or eating disorders which lead to a regular contact of gastric acid with teeth. These, so called intrinsic erosions occur in such typical locations within the dental arches that even in the absence of other symptoms gastric acid can be assumed to be the cause. Dental professionals may thus be the first to discover and diagnose the underlying medical problem. A good cooperation between the physician and the dentist is consequently necessary for a causal treatment of the patient. Parallel to the therapy of the underlying disease practical dental prophylactic measures like chewing gum und fluoride rinses are recommended

Essstörungen (II): Zahnmedizinische Aspekte

Patients suffering from eating disorders exhibit oral symptoms indicative to the otherwise concealed illness. The most striking features are the intrinsic erosions due to the regular surreptitious vomiting. They occur in very typical locations within the dental arches and have been termed "perimolysis". Dental professionals are often the first to discover and diagnose eating disorders by detecting perimolysis and consequently face the difficult task to motivate the patients--who often deny their illness--to seek psychiatric help and dental care. Such motivation must be done while respecting the patients' integrity and sense of self-worth. The primary goal of dental care is to preserve the remaining teeth and to prevent further erosive loss of dental hard tissue. The key elements of a dental preventive programme based on pathophysiologic grounds are to enhance local defence mechanisms, to offer chemical and mechanical protection and to diminish abrasive and erosive challenges. Dental restorative therapy must be part of a combined medical and dental treatment plan and should not be started before the eating disorder has been treated and the patients are considered to have stable prognosis. In view of the young age of the patients, the large extension of the erosive lesions and in order to avoid endodontological treatment of mostly sound pulps, non-invasive restorative concepts using adhesive technology should be preferably used. Prophylactic measures and restorative treatment are covered by health insurance (KGV; KLV 18c, 7) if the patients undergo psychiatric or similar adequate treatment

Further caries decline in Swiss recruits from 1996 to 2006

Swiss army recruits (N = 606) from the army base at Thun were dentally examined with a standardized method in the year 2006. The results were compared with those of previous surveys (1985 and 1996). The mean DM6FT-value in the year 2006 was 3.11, whereas in 1996 it had been clearly higher (4.95). This corresponds to a caries decline of 37%. The observed caries decline can only partly be explained. Recruits, who were smokers, showed an increased caries experience. Recruits of the German-speaking part of Switzerland who had profited from oral health lessons by oral health instructors in Kindergarten and primary schools did not differ in caries experience from recruits of the French-speaking part of Switzerland

Weiterer Kariesrückgang bei Schweizer Rekruten von 1996 bis 2006

Rekruten der Rekrutenschule Thun (N = 606) wurden im Jahr 2006 mit einer standardisierten Methode zahnmedizinisch untersucht. Die Resultate wurden mit denjenigen aus früheren Erhebungen (1985 und 1996) verglichen. Der DM6FT-Wert betrug im Jahr 2006 im Durchschnitt 3,11; im Jahr 1996 lag er noch deutlich höher (4,95). Dies entspricht einem Kariesrückgang von 37%. Der beobachtete Kariesrückgang konnte nur zum Teil erklärt werden. Rekruten, die rauchten, zeigten einen erhöhten Kariesbefall. Rekruten aus der Deutschschweiz, die in Kindergarten und Primarschule von Schulzahnpflege- Instruktorinnen betreut worden waren, unterschieden sich im Kariesbefall nicht von den Rekruten aus der Romandie

Kariesprävalenz von Schülern in 16 Zürcher Landgemeinden in den Jahren 1992 bis 2000

Standardized dental examinations of schoolchildren were regularly carried out since 1964 in 16 rural communities of the Canton of Zurich. In 1964, there were no 14-year-old schoolchildren free from caries; in the Nineties about half of the 14-year-olds had a caries-free permanent dentition (DMFT = 0). From the year 1992 to 2000, the caries prevalence (DMFT) of 14-year-olds decreased once again, by 31%. The pit and fissure caries prevalence (DFS) of 12- and 14-year-olds decreased by 28% and 37%, respectively. In 2000, the mean DMFT-value of the 12- and 14-year-old schoolchildren was 0.90 and 1.27 respectively. In 1964, only few 7-year-old schoolchildren were caries-free; in the Nineties about half of the 7-year-olds had a primary dentition without caries. From the year 1992 to 2000, caries prevalence (dmft) in 7-, 8- and 9-year-olds increased by 64%, 22% and 31%. In 2000, the mean dmft-value of all 7-year-old schoolchildren was 2.45. The Swiss schoolchildren had 1.79 dmft; the schoolchildren from former Yugoslavia and from Albania had 6.89 dmft and those of other nations had 3.37 dmft. Possible reasons for the continuous caries decrease in the permanent dentition and the increase in the primary dentition are discussed. Additional measures in order to improve the situation in the primary dentition are proposed

Predicting dementia from primary care records: a systematic review and meta-analysis

Introduction Possible dementia is usually identified in primary care by general practitioners (GPs) who refer to specialists for diagnosis. Only two-thirds of dementia cases are currently recorded in primary care, so increasing the proportion of cases diagnosed is a strategic priority for the UK and internationally. Clinical entities in the primary care record may indicate risk of developing dementia, and could be combined in a predictive model to help find patients who are missing a diagnosis. We conducted a meta-analysis to identify clinical entities with potential for use in such a predictive model for dementia in primary care. Methods and Findings We conducted a systematic search in PubMed, Web of Science and primary care database bibliographies. We included cohort or case-control studies which used routinely collected primary care data, to measure the association between any clinical entity and dementia. Meta-analyses were performed to pool odds ratios. A sensitivity analysis assessed the impact of non-independence of cases between studies. From a sift of 3836 papers, 20 studies, all European, were eligible for inclusion, comprising >1 million patients. 75 clinical entities were assessed as risk factors for all cause dementia, Alzheimer’s (AD) and Vascular dementia (VaD). Data included were unexpectedly heterogeneous, and assumptions were made about definitions of clinical entities and timing as these were not all well described. Meta-analysis showed that neuropsychiatric symptoms including depression, anxiety, and seizures, cognitive symptoms, and history of stroke, were positively associated with dementia. Cardiovascular risk factors such as hypertension, heart disease, dyslipidaemia and diabetes were positively associated with VaD and negatively with AD. Sensitivity analyses showed similar results. Conclusions These findings are of potential value in guiding feature selection for a risk prediction tool for dementia in primary care. Limitations include findings being UK-focussed. Further predictive entities ascertainable from primary care data, such as changes in consulting patterns, were absent from the literature and should be explored in future studies

Effects of dental probing on occlusal surfaces - A scanning electron microscopy evaluation

The aim of this clinical-morphological study was to investigate the effects of dental probing on occlusal surfaces by scanning electron microscopy (SEM). Twenty sound occlusal surfaces of third molars and 20 teeth with initial carious lesions of 17- to 26-year-old patients (n = 18) were involved. Ten molars of each group were probed with a sharp dental probe (No. 23) before extraction; the other molars served as negative controls. After extraction of the teeth, the crowns were separated and prepared for the SEM study. Probing-related surface defects, enlargements and break-offs of occlusal pits and fissures were observed on all occlusal surfaces with initial carious lesions and on 2 sound surfaces, respectively. No traumatic defects whatsoever were visible on unprobed occlusal surfaces. This investigation confirms findings of light-microscopic studies that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection. Critical views of tactile caries detection methods with a sharp dental probe as a diagnostic tool seem to be inevitable in undergraduate and postgraduate dental education programmes. Copyright (c) 2007 S. Karger AG, Basel

A combined view on precipitation and temperature climatology and trends in the southern Andes of Peru

In the southern Peruvian Andes, communities are highly dependent on climatic conditions due to the mainly rain-fed agriculture and the importance of glaciers and snow melt as a freshwater resource. Longer-term trends and year-to-year variability of precipitation or temperature severely affect living conditions. This study evaluates seasonal precipitation and temperature climatologies and trends in the period 1965/66–2017/18 for the southern Peruvian Andes using quality-controlled and homogenized station data and new observational gridded data. In this region, precipitation exhibits a strong annual cycle with very dry winter months and most of the precipitation falling from spring to autumn. Spatially, a northeast–southwest gradient in austral spring is observed, related to an earlier start of the rainy season in the northeastern partof the study area. Seasonal variations of maximum temperature are weak withan annual maximum in austral spring, which is related to reduced cloud coverin austral spring compared to summer. On the contrary, minimum tempera-tures show larger seasonal variations, possibly enhanced through changes inlongwave incoming radiation following the precipitation cycle. Precipitationtrends since 1965 exhibit low spatial consistency except for austral summer,when in most of the study area increasing precipitation is observed, and in aus-tral spring, when stations in the central-western region of the study area regis-ter decreasing precipitation. All seasonal and annual trends in maximum temperature are larger than trends in minimum temperature. Maximum temperature exhibits strong trends in austral winter and spring, whereas minimum temperature trends are strongest in austral winter. We hypothesize, that these trends are related to precipitation changes, as decreasing (increasing) precipita-tion in spring (summer) may enhance maximum (minimum) temperature trends through changes in cloud cover. El Niño Southern Oscillation (ENSO), however, has modifying effects onto precipitation and temperature, and thereby leads to larger trends in maximum temperatures

SEHR-ECHO v1.0: A spatially explicit hydrologic response model for ecohydrologic applications

This paper presents the Spatially Explicit Hydrologic Response (SEHR) model developed at the Laboratory of Ecohydrology of the Ecole Polytechnique Fédérale de Lausanne for the simulation of hydrological processes at the catchment scale. The key concept of the model is the formulation of water transport by geomorphologic travel time distributions through gravity-driven transitions among geomorphic states: the mobilization of water (and possibly dissolved solutes) is simulated at the subcatchment scale and the resulting responses are convolved with the travel paths distribution within the river network to obtain the hydrologic response at the catchment outlet. The model thus breaks down the complexity of the hydrologic response into an explicit geomorphological combination of dominant spatial patterns of precipitation input and of hydrologic process controls. Nonstationarity and nonlinearity effects are tackled through soil moisture dynamics in the active soil layer. We present here the basic model set-up for precipitation-runoff simulation and a detailed discussion of its parameter estimation and of its performance for the Dischma River (Switzerland), a snow-dominated catchment with a small glacier cover

A reconfigurable real-time compressive-sampling camera for biological applications

Many applications in biology, such as long-term functional imaging of neural and cardiac systems, require continuous high-speed imaging. This is typically not possible, however, using commercially available systems. The frame rate and the recording time of high-speed cameras are limited by the digitization rate and the capacity of on-camera memory. Further restrictions are often imposed by the limited bandwidth of the data link to the host computer. Even if the system bandwidth is not a limiting factor, continuous high-speed acquisition results in very large volumes of data that are difficult to handle, particularly when real-time analysis is required. In response to this issue many cameras allow a predetermined, rectangular region of interest (ROI) to be sampled, however this approach lacks flexibility and is blind to the image region outside of the ROI. We have addressed this problem by building a camera system using a randomly-addressable CMOS sensor. The camera has a low bandwidth, but is able to capture continuous high-speed images of an arbitrarily defined ROI, using most of the available bandwidth, while simultaneously acquiring low-speed, full frame images using the remaining bandwidth. In addition, the camera is able to use the full-frame information to recalculate the positions of targets and update the high-speed ROIs without interrupting acquisition. In this way the camera is capable of imaging moving targets at high-speed while simultaneously imaging the whole frame at a lower speed. We have used this camera system to monitor the heartbeat and blood cell flow of a water flea (Daphnia) at frame rates in excess of 1500 fps