Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study

Dental caries is a pandemic infectious disease which can affect the quality of life and consumes considerable health care resources. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. No clinical study has simultaneously investigated the effectiveness of these gums when compared with a group receiving no chewing gum. A 40-month double-blind cohort study on the relationship between the use of chewing gum and dental caries was performed in 1989-1993 in Belize, Central America. One thousand two hundred and seventy-seven subjects (mean age, 10.2 years) were assigned to nine treatment groups: one control group (no supervised gum use), four xylitol groups (range of supervised xylitol consumption: 4.3 to 9.0 g/day), two xylitol-sorbitol groups (range of supervised consumption of total polyols: 8.0 to 9.7 g/day), one sorbitol group (supervised consumption: 9.0 g/day), and one sucrose group (9.0 g/day). The gum use during school hours was supervised. Four calibrated dentists performed the caries registrations by means of a modified WHO procedure. The primary endpoint was the development of an unequivocal caries lesion on a non-cavitated tooth surface. Compared with the no-gum group, sucrose gum usage resulted in a marginal increase in the caries rate (relative risk, 1.20; 95% confidence interval, 0.96 to 1.49; p = 0.1128). Sorbitol gum significantly reduced caries rates (relative risk, 0.74; 95% confidence interval, 0.6 to 0.92; p = 0.0074). The four xylitol gums were most effective in reducing caries rates, the most effective agent being a 100% xylitol pellet gum (relative risk, 0.27; 95% confidence interval, 0.20 to 0.36; p = 0.0001). This gum was superior to any other gum (p < 0.01). The xylitol-sorbitol mixtures were less effective than xylitol, but they still reduced caries rates significantly compared with the no-gum group. DMFS analyses were consistent with these conclusions. The results suggest that systematic usage of polyol-based chewing gums reduces caries rates in young subjects, with xylitol gums being more effective than sorbitol gums.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68231/2/10.1177_00220345950740121501.pd

Palmitate and oleate exert differential effects on insulin signalling and glucose uptake in human skeletal muscle cells

Saturated fatty acids are implicated in the development of insulin resistance, whereas unsaturated fatty acids may have a protective effect on metabolism. We tested in primary human myotubes if insulin resistance induced by saturated fatty acid palmitate can be ameliorated by concomitant exposure to unsaturated fatty acid oleate. Primary human myotubes were pretreated with palmitate, oleate or their combination for 12 h. Glucose uptake was determined by intracellular accumulation of [H-3]-2-deoxy-d-glucose, insulin signalling and activation of endoplasmic reticulum (ER) stress by Western blotting, and mitochondrial reactive oxygen species (ROS) production by fluorescent dye MitoSOX. Exposure of primary human myotubes to palmitate impaired insulin-stimulated Akt-Ser(473), AS160 and GSK-3 beta phosphorylation, induced ER stress signalling target PERK and stress kinase JNK 54 kDa isoform. These effects were virtually abolished by concomitant exposure of palmitate-treated myotubes to oleate. However, an exposure to palmitate, oleate or their combination reduced insulin-stimulated glucose uptake. This was associated with increased mitochondrial ROS production in palmitate-treated myotubes co-incubated with oleate, and was alleviated by antioxidants MitoTempo and Tempol. Thus, metabolic and intracellular signalling events diverge in myotubes treated with palmitate and oleate. Exposure of human myotubes to excess fatty acids increases ROS production and induces insulin resistance.Peer reviewe

Proteolytic profile of Treponema vincentii ATCC 35580 with special reference to collagenolytic and arginine aminopeptidase activity

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73401/1/j.1399-302X.1988.tb00096.x.pd

Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: A population-based study in France

ObjectivesThe goals of this study were to document the prevalence of varicose veins, skin trophic changes, and venous symptoms in a sample of the general population of France, to document their main risk factors, and to assess relationships between them.MethodsThis cross-sectional epidemiologic study was carried out in the general population of 4 locations in France: Tarentaise, Grenoble, Nyons, and Toulon. Random samples of 2000 subjects per location were interviewed by telephone, and a sub-sample of subjects completed medical interviews and underwent physical examination, and the presence of varicose veins, trophic changes, and venous symptoms was recorded.ResultsPrevalence of varicose veins, skin trophic changes, and venous symptoms was not statistically different in the 4 locations. In contrast, sex-related differences were found: varicose veins were found in 50.5% of women versus 30.1% of men (P < .001); trophic skin changes were found in 2.8% of women versus 5.4% of men (P = NS), and venous symptoms were found in 51.3% of women 51.3% versus 20.4% of men (P < .001). Main risk factors for varicose veins were age and family history in both sexes, and pregnancy in women. Female sex was a significant factor only for non-saphenous varicose veins. Varicose veins, age, and pitting edema were the most significant risk factors for trophic skin changes. The risk factors for venous symptoms were female sex, varicose veins, and prolonged sitting or standing. A negative relationship with age was found in women.ConclusionOur results show a high prevalence of chronic venous disorders of the lower limbs in the general population of France, with no significant geographic variations. They also provide interesting insights regarding the association of varicose veins, skin trophic changes, and venous symptoms

Characterization of the “in vitro pulp chamber” using the cytotoxicity of phenol

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71980/1/j.1600-0714.1989.tb00744.x.pd

Xylitol gummy bear snacks: a school-based randomized clinical trial

Background: Habitual consumption of xylitol reduces mutans streptococci (MS) levels but the effect on Lactobacillus spp. is less clear. Reduction is dependent on daily dose and frequency of consumption. For xylitol to be successfully used in prevention programs to reduce MS and prevent caries, effective xylitol delivery methods must be identified. This study examines the response of MS, specifically S. mutans/sobrinus and Lactobacillus spp., levels to xylitol delivered via gummy bears at optimal exposures. Methods: Children, first to fifth grade (n = 154), from two elementary schools in rural Washington State, USA, were randomized to xylitol 15.6 g/day (X16, n = 53) or 11.7 g/day (X12, n = 49), or maltitol 44.7 g/ day (M45, n = 52). Gummy bear snacks were pre-packaged in unit-doses, labeled with ID numbers, and distributed three times/day during school hours. No snacks were sent home. Plaque was sampled at baseline and six weeks and cultured on modified Mitis Salivarius agar for S. mutans/sobrinus and Rogosa SL agar for Lactobacillus spp. enumeration. Results: There were no differences in S. mutans/sobrinus and Lactobacillus spp. levels in plaque between the groups at baseline. At six weeks, log10 S. mutans/sobrinus levels showed significant reductions for all groups (p = 0.0001): X16 = 1.13 (SD = 1.65); X12 = 0.89 (SD = 1.11); M45 = 0.91 (SD = 1.46). Reductions were not statistically different between groups. Results for Lactobacillus spp. were mixed. Group X16 and M45 showed 0.31 (SD = 2.35), and 0.52 (SD = 2.41) log10 reductions, respectively, while X12 showed a 0.11 (SD = 2.26) log10 increase. These changes were not significant. Post-study discussions with school staff indicated that it is feasible to implement an in-classroom gummy bear snack program. Parents are accepting and children willing to consume gummy bear snacks daily. Conclusion: Reductions in S. mutans/sobrinus levels were observed after six weeks of gummy bear snack consumption containing xylitol at 11.7 or 15.6 g/day or maltitol at 44.7 g/day divided in three exposures. Lactobacillus spp. levels were essentially unchanged in all groups. These results suggest that a xylitol gummy bear snack may be an alternative to xylitol chewing gum for dental caries prevention. Positive results with high dose maltitol limit the validity of xylitol findings. A larger clinical trial is needed to confirm the xylitol results. Trial registration: [ISRCTN63160504].Supported by Grant No. U54DE14254 from the National Institute of Dental and Craniofacial Research, and Grant No. 90YD0188 from the Office of Head Start

Modularity Facilitates Flexible Tuning of Plastic and Evolutionary Gene Expression Responses during Early Divergence

Gene expression changes have been recognized as important drivers of adaptation to changing environmental conditions. Little is known about the relative roles of plastic and evolutionary responses in complex gene expression networks during the early stages of divergence. Large gene expression data sets coupled with in silico methods for identifying coexpressed modules now enable systems genetics approaches also in nonmodel species for better understanding of gene expression responses during early divergence. Here, we combined gene coexpression analyses with population genetics to separate plastic and population (evolutionary) effects in expression networks using small salmonid populations as a model system. We show that plastic and population effects were highly variable among the six identified modules and that the plastic effects explained larger proportion of the total eigengene expression than population effects. A more detailed analysis of the population effects using a Q(ST)-F-ST comparison across 16,622 annotated transcripts revealed that gene expression followed neutral expectations within modules and at the global level. Furthermore, two modules showed enrichment for genes coding for early developmental traits that have been previously identified as important phenotypic traits in thermal responses in the same model system indicating that coexpression analysis can capture expression patterns underlying ecologically important traits. We suggest that module-specific responses may facilitate the flexible tuning of expression levels to local thermal conditions. Overall, our study indicates that plasticity and neutral evolution are the main drivers of gene expression variance in the early stages of thermal adaptation in this system

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK.

INTRODUCTION: The effect of sugarfree gum (SFG) on the prevention of dental caries has been established for some time. With increased constraints placed on healthcare budgets, the importance of economic considerations in decision-making about oral health interventions has increased. The aim of this study was to demonstrate the potential cost savings in dental care associated with increased levels of SFG usage. METHODS: The analysis examined the amount of money which would hypothetically be saved if the UK 12-year-old population chewed more SFG. The number of sticks chewed per year and the caries risk reduction were modelled to create a dose response curve. The costs of tooth restoration, tooth extraction in primary care settings and under general anaesthetic were considered, and the effects of caries reduction on these costs calculated. RESULTS: If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year. Sensitivity analyses of the key parameters demonstrated that cost savings would still be likely to be observed even in scenarios with less significant increases in SFG use. CONCLUSION: This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved

Effect of the fat composition of a single high-fat meal on inflammatory markers in healthy young women

The aim of the present study was to examine the effect of a single high-fat meal with different fat quality on circulating inflammatory markers and gene expression in peripheral blood mononuclear cells (PBMC) to elucidate the role of fat quality on postprandial inflammation. A postprandial study with fourteen healthy females consuming three test meals with different fat quality was performed. Test days were separated by 2 weeks. Fasting and postprandial blood samples at 3 and 6 h after intake were analysed. The test meal consisted of three cakes enriched with coconut fat (43 % energy as saturated fat and 1 % energy as a-linolenic acid (ALA)), linseed oil (14 % energy as ALA and 30 % energy as saturated fat) and cod liver oil (5 % energy as EPA and DHA and 5 % energy as ALA in addition to 31 % energy as saturated fat). In addition, ex vivo PBMC experiments were performed in eight healthy subjects investigating the effects of EPA and ALA on release and gene expression of inflammatory markers. The IL-8 mRNA level was significantly increased after intake of the cod liver oil cake at 6 h compared with fasting level, which was significantly different from the effect observed after the intake of linseed cake. In contrast, no effect was seen on circulating level of IL-8. In addition, ALA and EPA were shown to elicit different effects on the release and mRNA expression levels of inflammatory markers in PBMC cultured ex vivo, with EPA having the most prominent proinflammatory potentia

Immigration and recommended care after a suicide attempt in Europe: equity or bias?

This report describes the investigation of care recommendations in the medical system across European countries to immigrants who attempted suicide. Data from seven European countries with 8865 local and 2921 immigrant person-cases were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour and ensuing MONSUE (Monitoring Suicidal Behaviour in Europe) project. The relationship between immigrant status and type of aftercare recommended was analysed with binary logistic regression, adjusting for gender, age, method of attempt and the Centre collecting the data. Clear disparities were identified in the care recommendation practices toward immigrants, compared with hosts, over and above differing policies by the European Centres