Dental trauma in children in Budapest. A retrospective study

Traumatic dental injuries (TDIs) are among the most serious dental public health problems in childhood. This study aimed to determine the prevalence of anterior tooth TDIs in 7- to 18-year-old children who presented for treatment over a period between January 2007 and December 2016, and to survey the effect of an increased health awareness and educational campaign about the risk of TDIs and the importance of prevention methods in decreasing their prevalence compared with data published in the years 1985-1999.The current study was carried out on 454 children who presented for treatment at the Department of Paediatric Dentistry and Orthodontics in Budapest, Hungary.The prevalence of TDIs was 1%. Males experienced more dental injuries than females. The incidence of dental trauma peaked at 9 years of age. The most observed injury was luxation. Most accidents occurred during playtime at home. TDIs occurred most frequently in the spring.The increased health awareness, a wide educational campaign about the risk of TDIs and the importance of prevention methods have essentially contributed to the decrease in the prevalence of TDIs, with an increase of luxation injuries and a decrease of teeth fractures

Foghiányokat kísérő egyszerű nukleotid polimorfizmusok hypodontiában = Single nucleotide polymorphisms in hypodontia

Komplex megközelítéssel tanulmányoztuk a fogcsírahiányban feltehetőleg résztvevő több egyszerű nukleotid polimorfizmust (SNP) a magyar populációban. A PAX9, az MSX1, az FGFR1, az IRF6 és az AXIN2 nyolc polimorfizmusát vizsgáltuk 192 hipodonciás, 17 oligodonciás és 260 egészséges önkéntes esetében. Az eset-kontroll analízisben mind az allél, mind a genotípus asszociációk gyakoriságát, valamint a haplotípus szintű asszociációk gyakoriságát tanulmányoztuk. Többváltozós Bayes hálózat alapú többszintű valószínűségi analízist (BN-BMLA) és logisztikus regressziót végeztünk. A hagyományos statisztikák azt mutatták, hogy a PAX9 -912-es SNP és az MSX1 SNP megváltoztatta a hipodoncia előfordulását, de korrekció után a hatások csak marginális tendenciát mutattak. A többszörös hipotézis tesztelésre alkalmasabb BN-BMLA analízist használva a PAX9 SNP-k szinergikus hatást adtak. Ezt megerősítette más többváltozós analízis is, és az összefüggés szignifikáns maradt a többszörös hipotézis tesztelés után is . A PAX9-1031-A-PAX9-912-T haplotípus volt a legjelentősebb kombináció ami csírahiányt okozott. PAX9 és MSX1 között az együtthatás gyengébb volt, míg más SNP-nek nem volt hatása a hipodonciára. Komplex analízisünk megmutatta a PAX9 és MSX1-es SNP-k együtthatásának fontos szerepét a fogcsírahiányra, míg az IRF6, FGFR1 és Axin2 SNP-knek nem volt detektálható szerepe a magyar populációban. A mi eredményeink is rávilágítanak a populációk közötti eltérések jelentőségére. | We studied the role of multiple single nucleotide polymorphisms (SNP) in tooth agenesis in the Hungarian population using a complex approach. Eight SNPs of PAX9, MSX1, FGFR1, IRF6 and AXIN2 were studied in 192 hypodontia and 17 oligodontia cases and in 260 healthy volunteers. Case-control analysis was performed to test both allelic and genotypic associations as well as associations at the level of haplotypes. Multivariate exploratory Bayesian network based multilevel analysis of relevance (BN-BMLA) as well as logistic regression analysis were performed. Conventional statistics showed that PAX9 SNP -912 C/T and the MSX1 SNP changed the incidence of hypodontia, although after correction the effects were only borderline tendencies. Using a statistical analysis better suited for handling multiple hypotheses, the BN-BMLA, PAX9 SNPs clearly showed a synergistic effect. This was confirmed by other multivariate analyses and it remained significant after corrections for multiple hypothesis testing. The PAX9-1031-A-PAX9-912-T haplotype was the most relevant combination causing hypodontia. Interaction was weaker between PAX9 and MSX1, while other SNPs had no joint effect on hypodontia. Our complex analysis shows the important role of PAX9 and MSX1 SNPs and of their interactions in tooth agenesis, while IRF6, FGFR1 and AXIN2 SNPs had no detectable role in the Hungarian population. Our results also reveal the variations of risk factors in hypodontia

Invalidity of Tokyo guidelines in acute biliary pancreatitis : A multicenter cohort analysis of 944 pancreatitis cases

There is a noteworthy overlap between the clinical picture of biliary acute pancreatitis (AP) and the 2018 Tokyo guidelines currently used for the diagnosis of cholangitis (AC) and cholecystitis (CC). This can lead to significant antibiotic and endoscopic retrograde cholangiopancreatography (ERCP) overuse.We aimed to assess the on-admission prevalence of AC/CC according to the 2018 Tokyo guidelines (TG18) in a cohort of biliary AP patients, and its association with antibiotic use, ERCP and clinically relevant endpoints.We conducted a secondary analysis of the Hungarian Pancreatic Study Group's prospective multicenter registry of 2195 AP cases. We grouped and compared biliary cases (n = 944) based on the on-admission fulfillment of definite AC/CC according to TG18. Aside from antibiotic use, we evaluated mortality, AC/CC/AP severity, ERCP performance and length of hospitalization. We also conducted a literature review discussing each criteria of the TG18 in the context of AP.27.8% of biliary AP cases fulfilled TG18 for both AC and CC, 22.5% for CC only and 20.8% for AC only. Antibiotic use was high (77.4%). About 2/3 of the AC/CC cases were mild, around 10% severe. Mortality was below 1% in mild and moderate AC/CC patients, but considerably higher in severe cases (12.8% and 21.2% in AC and CC). ERCP was performed in 89.3% of AC cases, common bile duct stones were found in 41.1%.Around 70% of biliary AP patients fulfilled the TG18 for AC/CC, associated with a high rate of antibiotic use. Mortality in presumed mild or moderate AC/CC is low. Each of the laboratory and clinical criteria are commonly fulfilled in biliary AP, single imaging findings are also unspecific-AP specific diagnostic criteria are needed, as the prevalence of AC/CC are likely greatly overestimated. Randomized trials testing antibiotic use are also warranted

Comparison of Streptococcus mutans strains from children with caries-active, caries-free and gingivitis clinical diagnosis by pulsed-field gel electrophoresis

A study was conducted to compare the DNA structure of Streptococcus mutans strains in children with caries-active, caries-free, and gingivitis clinical diagnosis. Twenty-eight Streptococcus mutans strains from 100 children’s plaques were examined by pulsed-field gel electrophoresis (PFGE) method. The classified strains were closely related to one another, though the strains originated from different disease groups. Three identical pairs were found, but the pairs in two cases belonged to different disease groups.The results of the PFGE experiments suggest that there is no correlation between the different DNA patterns of S. mutans strains and their cariogenecity. So the different DNA strains of S. mutans are not the only determining factor in the development of dental caries

Novel Possible Pharmaceutical Research Tools: Stem Cells, Gene Delivery and their Combination.

Both stem cell research and gene delivery are very promising fields of today's biomedical research. In the present review we first attempt to summarize the state of the art in stem cell research. We describe the major categories of stem cells based on cell sources: embryonic, fetal, postnatal and induced pluripotent stem cells. We then present new data on stem cell cultures of dental pulp origin as examples of the progress of postnatal stem cell research. Afterwards, we briefly summarize the most promising achievements in the field of gene delivery. As an example of such advances, we describe novel in vitro and in vivo gene delivery studies to demonstrate that salivary glands are highly potential targets for gene therapy: they can be used to produce therapeutic peptides delivered either into the oral cavity or into the systemic circulation. Finally, we describe and compare studies combining the use of stem cells and gene delivery. We conclude that stem cell therapy and gene delivery alone are both very exciting research areas, and they may act in synergy when used in combination

Echocardiographic findings in patients with Williams-Beuren syndrome.

BACKGROUND: Williams-Beuren syndrome is a multisystem developmental disorder caused by a microdeletion at chromosome 7q11.23. In its classic form it includes dysmorphic facial features, joint contractures, retardation of growth and mental development, gregarious personality, visuospatial cognitive deficits, hypercalcemia, primary or secondary hypertension and cardiovascular disorders. AIM: Clinical diagnosis of Williams-Beuren syndrome can be a challenge in young patients if none of the characteristic cardiovascular features, i.e. supravalvular aortic stenosis or pulmonary artery stenosis, are present. Our aim was to demonstrate the changes in cardiovascular lesions during the postnatal development of Williams-Beuren patients and to follow all cardiovascular findings beyond the most common ones. METHODS: The cardiovascular status of 29 patients with Williams-Beuren syndrome (mean age 12.8 years) was recorded in correlation with age. RESULTS: Cardiovascular diagnoses changed in the majority (72.4%) of patients. Interestingly, 44.8% of the patients had periods with no reported cardiovascular disease. Furthermore, 65.5% of the patients experienced periods when none of the typical cardiovascular lesions, i.e. diffuse or localized supravalvular aortic stenosis and/or pulmonary artery stenosis, were detected. Spontaneous regression and progression of both supravalvular aortic stenosis and pulmonary artery stenosis were observed. An unexpectedly high frequency (41%) of mitral valve disorders was found. CONCLUSIONS: Our study showed that temporary absence of and changes in cardiovascular findings are frequent in Williams-Beuren syndrome. These results could contribute to the refinement of diagnostic criteria and recommendations for cardiovascular follow-up of patients with this syndrome

Skull base chordoma mimicking a preauricular neoplasm in a child: Clinicopathological features and biological behaviour

Introduction: The extreme rarity of chordomas in childhood, the slow growing nature of these tumours and the diverse symptoms may cause many diagnostic problems. Patient: A 9-year-old girl presented with an unusual manifestation of a skull base chordoma. The clinical and pathological features were analysed. Result: In the present case, the initial symptoms of the skull base tumour were completely misleading. The otodynia, the masticatory difficulties and the mass in the preauricular region were not characteristic of skull base chordomas. The female sex, the young age, the large tumour size and the atypical histological pattern of the tumour all indicated a very poor prognosis. Conclusion: The rarity of this tumour in childhood and the atypical lateral and intracranial spread resulted in a serious delay of the diagnosis and in a fatal outcome