The role of the gynaecologist in the promotion and maintenance of oral health during pregnancy

Objectives: The aim of the study was to assess routine dental examination attendance of pregnant women and a possible impact of gynaecological referrals on the attendance rate. Material and methods: An electronic survey was conducted that was inclusive of women up to 5 years following delivery. The questions related to socio-demographic data, the course of pregnancy and childbirth, and visits to dental office during pregnancy. For statistical analysis, the authors utilized the chi-square test, Spearman’s rank correlation coefficient and odds ratios. A significance level of 0.05 has been assumed. Results: A total of 3455 questionnaires were analyzed encompassing women aged 13.1–45.4 years. The respondents were on average 1.78 ± 1.44 years after childbirth. The population comprises of women in 59.1% from large cities, in 74.8% with higher education and in 41% with good socio-economic status. A total of 62.3% of women from the study population have visited a dentist for a routine dental examination. Gynaecologists have given a simple referral to a dentist to 17.6% of all women. 45.9% of them were further requested to provide back the feedback of their dental consultation. Dental appoint­ments were upheld by 87.3% of referred women and by 56.9% of those without a referral (OR = 5.20 (4.05–6.67); p < 0.001). Among those who were referred, dental appointments were upheld in 91.7% of cases when further asked to provide oral health feedback and in 83.5% of cases in absence of such further request (OR = 2.19 (1.3–3.66); p = 0.003). Conclusions: It was determined that referrals from a gynaecologist, and associated oral health feedback requests increase the frequency of abiding to dental appointments during pregnancy. As such, it is necessary to increase the involvement of gynaecologists in the promotion and maintenance of perinatal oral health

Ciudad-territorio sustentable. Procesos, actores y estructuras

En los últimos años, los estudios urbanos especializados insisten en que los procesos de urbanización por los que atraviesan los distintos países desarrollados, parecen dejar atrás las explicaciones de la urbanización industrial, han surgido otras construcciones y perspectivas unas más acabadas que otras (Indovina, 1998, la “ciudad difusa”; Dematteis 1998, ciudad sin centros; Nel-lo, 1998 ciudad sin confines, Soja, 2008, la exópolis). En suma se dice que se avanza hacia la urbanización generalizada, ello acaba con la larga trayectoria del funcionamiento y naturaleza de la ciudad moderna, el cambio urbano estructural actual, es nuevamente, consecuencia de la descentralización, difusión, redistribución del desarrollo, del crecimiento y las innovaciones ahora sobre una estructura en el territorio. Ha sido una mutación no sólo empírica sino que ha dado lugar a la confrontación teórica. El sistema urbano jerárquico ha reducido su valor interpretativo porque se han modificado los supuestos en los que se basaban las relaciones de dominio y dependencia de los centros principales, porque se han abaratado los costos de transporte y el efecto de la distancia ya no es una limitante absoluta, ahora los procesos productivos flexibles y descentralizados propician las relaciones técnicas horizontales con lo cual se consiguen economías de escala externas e internas a las empresas en un territorio ampliado y no sólo exclusivamente en la aglomeración económica (Precedo, 2003; Veltz, 1999; Boix, 2002; Camagni, 2005; De Santiago, 2008 y; Garmendia, 2010).El objetivo es examinar dentro de la descentralización del proceso urbano a la ciudad-territorio en América Latina, en particular en México. En contextos urbanos desarrollados se afirma la convergencia urbana con la apertura de las unidades funcionales de los sistemas urbanos donde operan redes e interrelaciones de desarrollo cualitativo en el territorio. América Latina registra evidencias empíricas poco claras, existe alta concentración de aquella economía que contribuye al crecimiento nacional, mientras la población se descentraliza rápidamente. México, es un caso de primacía urbana histórica aunque da paso a la formación de regiones urbanas, mismas que reproducen relaciones polarizadas y escasamente descentralizadas. De manera que, en tanto domine la concentración espacial económica, la ciudadterritorio se podrá presentar en el continente sólo con algunos rasgos en regiones urbanas con mayor desarrollo y crecimiento. Palabras claves: descentralización urbana, sistema urbano, ciudad-territorio

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Transport Planning and Sustainability : The Via Baltica Case

Road transport is most commonly used out of other modes in terms of freight and passenger transportation on local and regional levels. For European citizens it is a primary mean of their access to services, social activities and employment. The scope of road infrastructure differs in some regions. The major disparity appears when the East of Europe is compared with the West. Actions to link periphery with the core of Europe are being continuously performed, what in this case represents itself in constructing Pan-European Transport Corridors, which will contribute to the connection of the whole territory of Europe. The Via Baltica, chosen as a case for this thesis, is a route to connect Helsinki, Tallinn, Riga, Kaunas, Budzisko and Warsaw. It is the common initiative of Finland, Estonia, Lithuania, Latvia and Poland. In addition, it is to be an express road and part of the I Pan-European Transport Corridor, which is going to connect Baltic countries with the West and South part of Europe. We focus on presenting how the Via Baltica is introduced in official documents and compare it with the process in practice. Our final goal is to assess the planning process of the Via Baltica route in Poland according to top down planning approaches and sustainability criteria. We are trying to find out what are the advantages and disadvantages of the ongoing process. After introducing results of the analysis made for the Via Baltica by Polish experts, we present how stakeholders and local authorities try to reinforce the process, regardless of environmental issues, to achieve economic and social profits. As the result we try find out how are the dimensions of sustainable development handled in the Via Baltica case in Poland. The conclusions are based on our findings concerning several conflicts which appeared during the planning process. They are also based on one-dimension as well as multi-criteria [email protected] [email protected]

Coffee Industry and Ways of Using By-Products as Bioadsorbents for Removal of Pollutants

As a result of anthropological activities, various pollutants, for example heavy metals, enter the environment in significant quantities. They have the potential to accumulate in living organisms and are not biodegradable in the environment. This poses a major threat to the health and life of living organisms and the environment. Therefore, the search for effective technologies to reduce anthropic pollutants in the environment is so important. Currently, membrane techniques, chemical precipitation, electrolysis, coagulation, ion exchange and adsorption, among others, are used to remove heavy metal ions. The most versatile method is adsorption on adsorbents. It is a relatively simple method, but very expensive. This prompts a constant search for new, effective and inexpensive adsorbents. Coffee is one of the most important foodstuffs and agricultural commodities in the world. From the point of view of the circular economy, by-products from the processing of coffee beans have become a valuable raw material in other areas of life. An important way to manage waste from the coffee bean processing industry is to produce adsorbents using it. There are data from laboratory studies indicating that it is possible to produce effective and low-cost adsorbents using by-products from the agro-food industry to remove pollutants from the aquatic environment and wastewater. Laboratory studies prove the high efficiency of heavy metal removal when using coffee-processing waste as adsorbents. However, data from real-world studies are still lacking. In addition, there is a lack of data from analyses on the impact of alternative adsorbents on economic, environmental and social aspects

Gluten-free diet — remedy for infertility or dangerous trend?

Association between celiac disease (CD) and infertility has been a point of consideration for many years. There are lots of studies which present contradictory results. It is accepted that women with unexplained infertility have three times higher risk of CD compared to the healthy women. This finding leads to the conclusion that a gluten-free diet (GFD), as the only effective method of treatment CD, is important to improve fertility. It is observed that women diagnosed with CD and treated by GFD, have positive pregnancy outcomes including better effects of assisted reproductive technology (ART). Excluding gluten from diet by women without CD diagnosis could bring adverse outcomes, because the risk of malnutrition if diet is unbalanced. On the other hand, some research show that not only GFD but CD is related to malnutrition which could be the cause of problems with getting pregnant or with termination of pregnancy. Regarding CD influence on women's reproductive system, it is not only connected with unexplained infertility and adverse pregnancy outcomes, but also with delayed menarche, early menopause and decrease of anti-Müllerian hormone (AMH). What is more, non-celiac wheat sensitivity affects the reproductive system by increasing risk of menstrual disorders too. The main aim of this paper is presenting scientific facts about the link between gluten elimination and fertility. It is very important to provide patients with reliable fact-checked information in the context of their symptoms

Table_1_Personality traits and health-related behaviors in medical students facing a stressful event.DOCX

BackgroundIt is believed that personality traits have an impact on the propensity to change and maintain favorable lifestyle habits. This issue has been raised by multiple studies, however, none of them appeared to focus on population under severe psychological stress. The aim of the present study was to investigate the link between personality traits and health-related behaviors and measures such as dietary intake of specific food products, physical activity, body-mass index and the use of cigarettes in medical students facing a stressful event.MethodsThe study included a cohort of third-year medical students from the Medical University of Lodz, Poland, facing a stressful subject exam during the first COVID-19-related lockdown. At baseline, personality traits were evaluated with the use of the Polish version of the Big Five Inventory-Short questionnaire. Then, consumption of selected food products was monitored with the use of seven-day electronic dietary record. Also, some other health-related data was collected (body-mass index, physical activity and the use of cigarettes). General Linear Modeling techniques, logistic regression and exploratory factor analysis were applied to analyze the data.ResultsFour hundred and forty-four students completed the study. A two-factor pattern of food consumption was discovered by the exploratory factor analysis in the study group (34% of the variance explained). Higher conscientiousness, but not the other personality traits, was found to be significantly associated with generally healthier lifestyle manifested by higher consumption of vegetables, wholegrain products, fruits and nuts (adjusted beta 0.16, 95%CI 0.06 to 0.26, pη2 = 2.3%, p = 0.0015) and lower cigarette smoking (adjusted odds ratio 0.84, 95%CI 0.75 to 0.94, p = 0.0020), but insignificantly with physical activity and body-mass index.ConclusionSeverely stressed medical students expressing high conscientiousness tend to present healthier behaviors. Therefore, interventions aimed at improving lifestyle habits in students with low conscientiousness might be useful.</p

Clinical Usefulness of Non-Invasive Metabolic-Associated Fatty Liver Disease Risk Assessment Methods in Patients with Full-Blown Polycystic Ovary Syndrome in Relation to the MRI Examination with the Ideal IQ Sequence

The coexistence of polycystic ovary syndrome (PCOS) and liver steatosis has been studied for years. The gold standards for the diagnosis of liver steatosis are liver biopsy and magnetic resonance imaging (MRI), which are invasive and expensive methods. The main aim of this study is to check the usefulness of lipid accumulation product (LAP) and free androgen index (FAI) in the diagnosis of liver steatosis. The Ideal IQ MRI was performed in 49 women with PCOS phenotype A to assess the degree of liver steatosis, which was expressed with the proton density fat fraction (PDFF). Anthropometric examination and laboratory tests were performed, and the LAP and FAI were calculated. The correlation between MRI results and LAP, FAI, and one of the FAI components, sex hormone binding globulin (SHBG), was checked using statistical tests. There is a statistically significant correlation between PDFF and LAP and also between PDFF and FAI. LAP = 70.25 and FAI = 5.05 were established as cut-offs to diagnose liver steatosis. The SHBG is not a statistically significant parameter to predict liver steatosis. The study showed that especially LAP, but also FAI, can be used to predict liver steatosis with high specificity and sensitivity