The prevalence of approximal caries in patients after fixed orthodontic treatment and in untreated subjects: A retrospective, cross-sectional study on bitewing radiographs

Objective: The aim of this retrospective, cross-sectional study was to investigate the prevalence of approximal carious lesions in patients after fixed multibracket therapy and in subjects without orthodontics on bitewing radiographs. Material and methods: Bitewing radiographs of 104orthodontically treated patients with fixed multibracket appliances were compared to those of 111untreated subjects. The individuals in both groups were between 15 and 16.25years of age when radiographs were taken. The test group with orthodontics was recruited from the archive of the Department of Orthodontics at the University of Zürich. The untreated control group was selected randomly from 16communities in the Canton of Zürich. The approximal surfaces of the permanent premolars and molars of all subjects were assessed by two calibrated investigators. Results: The average number of enamel lesions in the test group after fixed orthodontic treatment was lower than in the control group (0.57 vs. 1.85, p < 0.001). The same was found for dentin lesions (0.06 vs. 0.49, p < 0.001). The distribution of lesions was similar in both groups. Conclusion: Fewer approximal carious lesions were detected in the test group after fixed multibracket appliances than in the age-matched control group without orthodontic treatmen

Carbon and nitrogen stable isotope fractionation during abiotic hydrolysis of pesticides

Compound-specific Stable Isotope Analysis (CSIA) has been recently established as a tool to study pesticide degradation in the environment. Among degradative processes, hydrolysis is environmentally relevant as it can be chemically or enzymatically mediated. Here, CSIA was used to examine stable carbon and nitrogen isotope fractionation during abiotic hydrolysis of legacy or currently used pesticides (chloroacetanilide herbicides: Acetochlor, Alachlor, S-Metolachlor and Butachlor, acylalanine fungicide: Metalaxyl, and triazine herbicide: Atrazine). Degradation products analysis and Csingle bondN dual-CSIA allowed to infer hydrolytic degradation pathways from carbon and nitrogen isotopic fractionation. Carbon isotopic fractionation for alkaline hydrolysis revealed similar apparent kinetic isotope effects (AKIEC = 1.03–1.07) for the 6 pesticides, which were consistent with SN2 type nucleophilic substitutions. Neither enantio-selectivity (EF ≈ 0.5) nor enantio-specific isotope fractionation occurred during hydrolysis of R (AKIEC = 1.04 ± 0.01) and S (AKIEC = 1.04 ± 0.02) enantiomers of a racemic mixture of Metalaxyl. Dual element isotope plots enabled to tease apart Csingle bondCl bond breaking of alkane (Λ ≈ εN/εC ≈ 0, Acetochlor, Butachlor) and aromatic π-system (Λ ≈ 0.2, Atrazine) from Csingle bondO bond breaking by dealkylation (Λ ≈ 0.9, Metalaxyl). Reference values for abiotic versus biotic SN2 reactions derived from carbon and nitrogen CSIA may be used to untangle pesticide degradation pathways and evaluate in situ degradation during natural and engineered remediation

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

Kleinkinderkaries - Fakten und Vorbeugung

In 2003, 771 randomly selected two-year-old children from the town of Zurich were examined. Teeth with carious cavities were observed in 12.6% of the children. Caries including initial (not yet cavitated) lesions was seen in 25.3% of children. Caries prevalence was strongly associated with immigrant background. Caries was found in 7.5% of Swiss children and in 38.5% of children from ex-Jugoslavia. 5% of children of mothers born in Switzerland, and 17.4% of children of mothers not born in Switzerland showed caries. The average number of teeth with carious lesions in children with caries was 4.3 irrespective of immigrant or Swiss background. This finding suggests that all kids with caries had similar risk behaviours. Multivariate logistic regressions elucidated the behavioural components associated with caries. The presence of plaque and the use of a night-time bottle proved to be the strongest predictor variables for caries. Frequent drinking of sugared non-milk drinks, age and no pacifier use were further risk indicators in children of foreign-born mothers. A significant improvement of oral health of small children can be achieved by a concerted action of child welfare consultants, paediatricians and carers of day-nurseries. The primary goal is to convince parents to actively participate in preserving dental health of their offsprings. The following recommendations should be adhered to: 1. Parents should brush the teeth of the children daily, using a fluoridated children-toothpaste starting the very day of the appearance of the first milk tooth. 2. At the age of 12 months, the bottle should be replaced by a cup and the continuous use of a nursing bottle while falling asleep and during the night should absolutely be avoided. 3. Children should primarily be offered water and milk as a beverage. A first dental inspection is due at the age of two years

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

The impact of pharmacist-led medication reconciliation and interprofessional ward rounds on drug-related problems at hospital discharge

BACKGROUND During transitions of care, including hospital discharge, patients are at risk of drug-related problems (DRPs). AIM To investigate the impact of pharmacist-led services, specifically medication reconciliation at admission and/or interprofessional ward rounds on the number of DRPs at discharge. METHOD In this retrospective, single-center cohort study, we analyzed routinely collected data of patients discharged from internal medicine wards of a regional Swiss hospital that filled their discharge prescriptions in the hospital's community pharmacy between June 2016 and May 2019. Patients receiving one of the two or both pharmacist-led services (Study groups: Best Care = both services; MedRec = medication reconciliation at admission; Ward Round = interprofessional ward round), were compared to patients receiving standard care (Standard Care group). Standard care included medication history taken by a physician and regular ward rounds (physicians and nurses). At discharge, pharmacists reviewed discharge prescriptions filled at the hospital's community pharmacy and documented all DRPs. Multivariable Poisson regression analyzed the independent effects of medication reconciliation and interprofessional ward rounds as single or combined service on the frequency of DRPs. RESULTS Overall, 4545 patients with 6072 hospital stays were included in the analysis (Best Care n = 72 hospital stays, MedRec n = 232, Ward Round n = 1262, and Standard Care n = 4506). In 1352 stays (22.3%) one or more DRPs were detected at hospital discharge. The combination of the two pharmacist-led services was associated with statistically significantly less DRPs compared to standard care (relative risk: 0.33; 95% confidence interval: 0.16, 0.65). Pharmacist-led medication reconciliation alone showed a trend towards fewer DRPs (relative risk: 0.75; 95% confidence interval: 0.54, 1.03). CONCLUSION Our results support the implementation of pharmacist-led medication reconciliation at admission in combination with interprofessional ward rounds to reduce the number of DRPs at hospital discharge

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