Caries Incidence in Children With Regard to Their Oral Hygiene Habits and Past Caries Experience

Incidencija karijesa u djece često je u vezi s određenim životnim navikama svakoga pojedinca. Višečimbenična uzrokovanost zubnoga karijesa otežava nam djelovanje na njegove etiološke čimbenike nastanka, ali dobro poznavanje tih čimbenika može nom pomoći u prevenciji karijesa kao najhumanijem i najekonomičnijem načinu djelovanja protiv krijesa, danas još uvijek vrlo značajnog javnozdravstvenog problema. Svrha ovoga rada bila je prosuditi određene pravilnosti u incidenciji karijesa u djece u mliječnoj i trajnoj denticiji s obzirom na kliničke i nekliničke varijable koje se mogu prikupiti u svakodnevnom kliničkom radu. Istraživanje je provedeno na 301 ispitaniku, stanovnicima Petrinje i Topuskog. Dob ispitanika bila je od 3 do 6 i 11 do 14 godine. U mlađoj dobnoj skupini sudjelovalo je 74 ispitanika, a u starijoj 227. Svaki od ispitanika bio je podvrgnut istome postupku. Upitnikom se pojedinačno istražila razina i način provedbe oralne higijene, uporaba dodatnih sredstava za njezino održavanje (antimikrobna sredstva, fluoridi), prehrambene navike, sastav konzumiranih namirnica te društveno-ekonomski status. Klinički pregled napravio je iskusan ispitivač. Nalaz je obuhvaćao dentalni status, određivanje količine stimulirane sline, procjena indeksa oralne higijene (Green-Vermillion), a zabilježeno je i postojanje ortodontske anomalije. Na osnovi prikupljenih i statistički obrađenih podataka došlo se do sljedećih zaključaka: djeca ruralnog i subruralnoga dijela naše zemlje, a osobito iz ratnih područja, pokazuju vrlo visoke vrijednosti dmft/DMFT i i dmfs/DMFS indeksa. DMFT indeks iznosio je 6,67, a dmft 7,7. Dobivena vrijednost SiC indeksa iznosila je 10,89. Na temelju dobivenih rezultata možemo zaključiti da smo još veoma daleko od postavljenih ciljeva WHO i FDI za unapređenje oralnoga zdravlja .Postoji jako velik postotak ortodontskih anomalija, 68,72% u starijoj populaciji i 39,19% u mlađoj ispitnoj skupini. Istraživanjem je potvrđeno određeno pravilo distribucije karijesnih lezija prema zubu i čeljusti. Ta spoznaja, uz prikupljanje nekliničkih varijabli, može uvelike koristiti u svakodnevnoj kliničkoj praksi te omogućiti brzo i točno dijagnosticiranje. Tada se uz pravilnu preventivu i kurativnu skrb lakše može postići razina oralnoga zdravlja.Caries incidence in children is frequently connected to certain life habits of each individual. Multifactorial etiology of dental caries make it difficult to act on etiological factors, but if we get to know them better it can help us to prevent tooth decay as one of the most humane and economical ways of acting against caries, which is still an important issue of public health. The aim of this study was to establish certain regularities in caries incidence in children during primary and permanent dentition, with regard to clinical and nonclinical variables which can be gathered in everyday clinical work. The study was conducted on 301 subjects, inhabitans of Petrinja and Topusko. The subjects were age from 3-6 and 11-14 years. Seventy-four subjcts participated in the younger age group and 227 in the older. All the subjects were under the same protocol. The questionnaire examined the level of oral hygiene, use of additional supplements (antibacterial agents, fluorides), eating habits, nutrition and socio-economical status. Clinical examination was made by one experienced examiner. It consisted of a dental examination, determination of the quantity of stimulated saliva and evaluation of oral hygiene index (Green-Vermillion). Orthodontic anomaly was also noted. On the basis of the collected and statistically processed data we reached the following conclusion: children in rural an sub-rural areas of Croatia, especially in parts affected by the recent war, show very high values of dmft/DMFT. DMFT index was 6.67 and dmft 7.7. The obtained value of SiC index was 10.89. On the basis of these results we can conclude that we are still far away from the goals set by WHO and FDI to improve oral health.We also found a very high percentage of orthodontic anomalies, from 68.72% in the older group to 39.19% in the younger. The study confirmed the rule of the distribution of caries lesions towards the tooth and jaw. This knowledge, with the collecting of non-clinical variables, can be effectively used in everyday clinical practice and allows quick and accurate diagnosis with the right preventive and curative care to improve the level of oral health

The role of the neuroprotective factor Npas4 in cerebral ischemia

Stroke is one of the leading causes of death and adult disability in the world. Although many molecules have been documented to have a neuroprotective effect, the majority of these molecules failed to improve the neurological outcomes for patients with brain ischemia. It has been proposed that neuroprotection alone may, in fact, not be adequate for improving the prognosis of ischemic stroke. Neuroprotectants that can regulate other processes which occur in the brain during ischemia could potentially be targets for the development of effective therapeutic interventions in stroke. Neuronal Per-Arnt-Sim domain protein 4 (Npas4) is an activity-dependent transcription factor whose expression is induced in various brain insults, including cerebral ischemia. It has been shown that Npas4 plays an important role in protecting neurons against many types of neurodegenerative insult. Recently, it was demonstrated that Npas4 indeed has a neuroprotective role in ischemic stroke and that Npas4 might be involved in modulating the cell death pathway and inflammatory response. In this review, we summarize the current knowledge of the roles that Npas4 may play in neuroinflammation and ischemia. Understanding how ischemic lesion size in stroke may be reduced through modulation of Npas4-dependent apoptotic and inflammatory pathways could lead to the development of new stroke therapies.Fong Chan Choy, Thomas S. Klari, Simon A. Koblar and Martin D. Lewi

“I'm Still Fighting for the Two of Us”: How Partners of UK Veterans Construct Their Experience of Living with Combat‐Related Trauma

There has been little qualitative research into the experiences of UK partners of veterans with PTSD. This study therefore aimed to explore how partners constructed their experiences of living with the condition. Fifteen female partners of male UK veterans were recruited and interviewed. Using a social constructionist thematic analysis, five themes were constructed: the women's need to subdue own emotional and behavioral responses; dilemmas about whether the veteran was unwell or ‘bad’; attempts at negotiating multiple roles; challenging the narrative of veterans as heroes; and the relational struggle with the transition to nonmilitary life. This study highlighted the importance of considering the veteran as existing within a relational and cultural context, and the need to include partners in therapeutic interventions

Replication of fifteen loci involved in human plasma protein N-glycosylation in 4,802 samples from four cohorts

Human protein glycosylation is a complex process, and its in vivo regulation is poorly understood. Changes in glycosylation patterns are associated with many human diseases and conditions. Understanding the biological determinants of protein glycome provides a basis for future diagnostic and therapeutic applications. Genome-wide association studies (GWAS) allow to study biology via a hypothesis-free search of loci and genetic variants associated with a trait of interest. Sixteen loci were identified by three previous GWAS of human plasma proteome N-glycosylation. However, the possibility that some of these loci are false positives needs to be eliminated by replication studies, which have been limited so far. Here, we use the largest set of samples so far (4,802 individuals) to replicate the previously identified loci. For all but one locus, the expected replication power exceeded 95%. Of the sixteen loci reported previously, fifteen were replicated in our study. For the remaining locus (near the KREMEN1 gene) the replication power was low, and hence replication results were inconclusive. The very high replication rate highlights the general robustness of the GWAS findings as well as the high standards adopted by the community that studies genetic regulation of protein glycosylation. The fifteen replicated loci present a good target for further functional studies. Among these, eight genes encode glycosyltransferases: MGAT5, B3GAT1, FUT8, FUT6, ST6GAL1, B4GALT1, ST3GAL4, and MGAT3. The remaining seven loci offer starting points for further functional follow-up investigation into molecules and mechanisms that regulate human protein N-glycosylation in vivo

Izloženost alergenima plijesni u unutarnjem okolišu

Humid indoor environments may be colonised by allergenic fi lamentous microfungi (moulds), Aspergillus spp., Penicillium spp., Cladosporium spp., and Alternaria spp. in particular. Mould-induced respiratory diseases are a worldwide problem. In the last two decades, mould allergens and glucans have been used as markers of indoor exposure to moulds. Recently, mould allergens Alt a 1 (Alternaria alternata) and Asp f 1 (Aspergillus fumigatus) have been analysed in various environments (residential and occupational) with enzyme-linked immunosorbent assays, which use monoclonal or polyclonal antibodies. Household Alt a 1 and Asp f 1 levels were usually under the limit of the method detection. By contrast, higher levels of mould allergens were found in environments with high levels of bioaerosols such as poultry farms and sawmills. Data on allergen Alt a 1 and Asp f 1 levels in agricultural settings may provide information on possible colonisation of respective moulds and point out to mould-related diseases in occupants.Vlažni, unutarnji prostori mogu biti kolonizirani alergogenim, filamentoznim mikrogljivicama (plijesni) uglavnom rodova Aspergillus, Penicillium, Cladosporium i Alternaria. Respiratorne bolesti uzrokovane plijesnima zdravstveni su problem diljem svijeta. U posljednja dva desetljeća, neki sastavni dijelovi plijesni kao alergeni i glukan rabe se kao pokazatelji izloženosti plijesni u unutarnjem okolišu. Nedavno su alergeni plijesni Alt a 1 (Alternaria alternata) i Asp f 1 (Aspergillus fumigatus) određivani u različitom okolišu (kućnom i profesionalnom) enzim-imunokemijskom metodom koja rabi monoklonska ili poliklonska antitijela. Razina Alt a 1 i Asp f 1 u kućnoj prašini ispod je granice detekcije. Nasuprot tomu, alergeni plijesni su određeni u okolišu s visokom razinom bioaerosola kao peradarnici i pilane. Razine alergena Alt a 1 i Asp f 1 u nekim poljoprivrednim objektima pružaju informaciju o mogućoj kolonizaciji plijesnima, što upućuje na moguće zdravstvene učinke kod zaposlenika

Određivanje alergena Asp f 1 (Aspergillus fumigatus) u peradarniku enzimimunokemijskom metodom

Poultry farms contain high levels of allergenic fungi, and Aspergillus spp. is the most common genus of moulds. Aspergillus fumigatus antigens are responsible for the development of several respiratory diseases including asthma. The aim of this study was to measure the mass fraction of Asp f 1, a major allergen of Asperillus fumigatus in 37 indoor dust samples collected from four poultry farms in a rural area of the Zagreb County (Croatia) using the enzyme-linked immunosorbent assay. More than 62 % of dust samples had detectable Asp f 1 levels (limit of detection 3.6 ng g-1). The overall mean Asp f 1 level was 17.9 ng g-1 [range (3.8 to 72.4) ng g-1]. Satisfactory results were obtained for analytical within-run imprecision (6.7 %), between-run imprecision (10.5 %), and accuracy (91 % to 115 %). Microclimate parameters (air temperature, relative humidity, and velocity) were within the recommended ranges in all poultry farms. This study has shown that Asp f 1 settles on dust at poultry farms and that occupational exposure to this allergen deserves monitoring in livestock buildings.Peradarnici sadržavaju veliku koncentraciju alergenih plijesni, a rod Aspergillus najčešće je zastupljen. Antigeni soja Aspergillus fumigatus odgovorni su za nastanak nekoliko respiratornih bolesti uključujući astmu. Cilj ovoga rada bio je odrediti masenu frakciju Asp f 1, glavnog alergena soja Asperillus fumigatus u 37 uzoraka prašine uzorkovanih u četiri peradarnika sa šireg područja Zagrebačke županije rabeći enzimimunokemijsku metodu. Više od 62 % uzoraka prašine u tri peradarnika imalo je mjerljivu koncentraciju Asp f 1 (granica detekcije = 3.6 ng g-1). Ukupni srednji maseni udio Asp f 1 iznosio je 17.9 ng g-1 (raspon od 3.8 ng g-1 do 72.4 ng g-1). Dobiveni su zadovoljavajući rezultati za analitičku nepreciznost u seriji (6.7 %), nepreciznost iz dana u dan (10.5 %) i točnost (91 % do 115 %). Mikroklimatski parametri (temperatura zraka, relativna vlaga i protok zraka) u svim peradarnicima bili su u okviru preporučenih vrijednosti. Rezultati ovoga rada pokazuju da Asp f 1 sedimentira na prašinu u peradarnicima te da profesionalnu izloženost tom alergenu treba pratiti u jedinicama za uzgoj stoke

Laringofaringealni refluks - noivosti u liječenju

Više od četrdeset godina u medicinskoj literaturi postoji klinički entitet poznat kao laringofaringealni refluks (LPR) ili „tihi refluks“. LPR je česta bolest, dio je kompleksne refluksne bolesti, ima karakteristike epidemije, a posljedica je loših prehrambenih navika, stresa, ali i djelovanja prehrambene industrije koja, da bi produljila vijek trajanja namirnica, svu hranu dodatno zakiseljava. Definicija LPR-a od prvotne je proširena tako da se LPR danas definira kao upala sluznice gornjeg aerodigestivnog trakta koja nastaje izravnim ili neizravnim djelovanjem želučanog ili duodenalnog refluksa i uzrokuje morfološke promjene sluznice gornjeg aerodigestivnog trakta i donjih dišnih putova. Važno je naglasiti da LPR nije ekstraezofagealni refluks, jer većina bolesnika s LPR-om nema simptome niti znakove gastroezofagealnog refluksa. Dijagnosticiranje LPR-a u našoj je zemlji izuzetno teško jer nam temeljne dijagnostičke metode, poput utvrđivanja razine pepsina u slini i multikanalne intraluminalne impedance s 24-satnom pH-metrijom nisu dostupne, te se sumnja na postojanje LPR-a još uvijek temelji na upitnicima po Belafskom (Reflux Symptom Indeks – RSI, Reflux Finding Score – RFS). Nedostatak upitnika RSI je što ne razmatra česte simptome LPR-a, poput boli u grlu, bolnoga gutanja i neugodnog zadaha, te ne razmatra učestalost javljanja simptoma. Upitnik RFS obuhvaća samo kliničke znakove u grkljanu, a ne obuhvaća kliničke znakove LPR-a izvan grkljana. Stoga se novosti u dijagnostici LPR-a, koje su dostupne u našoj zemlji, prvenstveno odnose na primjenu novih upitnika za postavljanje sumnje na LPR-a (Reflux Symptom Score - RSS i Reflux Sign Assessment - RSA). Liječenje LPR-a, u većini slučajeva, još uvijek započinjemo primjenom medikamenata, što je krivo i neučinkovito. Novosti u liječenju LPR-a uključuju obaveznu primjenu nutritivne terapije, uz regulaciju stresa, te potrebu da se u multidisciplinarni tim, koji sudjeluje u liječenju oboljelih od LPR-a, uključe nutricionist, psiholog i psihijatar