Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Clinical rationale for the study. Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined.Aim of the study. The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS.Material and methods. 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records.Results. The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist’s surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010).Conclusions and clinical implications. Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care

Retinopathy of prematurity – etiopathogenesis and treatment

Retinopathy of prematurity belongs to the group of proliferative retinopathies. It affects preterm infants with very low birth weight, treated with high concentrations of oxygen. It is estimated that retinopathy of prematurity leads to blindness in approximately 50,000 children per year worldwide. There were two epidemics of retinopathy of prematurity in the 50s and 70s of the last century. Another increase in the incidence, referred to as the third epidemic in the literature, has been observed in recent years in developing countries. So far, high oxygen concentrations used in adjuvant oxygen therapy have been considered to be the major risk factor for retinopathy of prematurity. There are, however, reports on the development of the disease in patients who received no oxygen therapy. Low birth weight and early gestational age are well-known risk factors for retinopathy of prematurity. Other important risk factors include sex, multiple pregnancy, intraventricular haemorrhage and blood transfusions. The disease can be prevented by screening performed by an ophthalmologist within a few weeks after birth. Laser retinal photocoagulation, which is primarily aimed to inhibit fibrovascular proliferation, is the standard therapy in infants with retinopathy of prematurity. Surgical treatment is necessary in the case of disease progression despite laser photocoagulation. Attempts are also made to use vascular endothelial growth factor blockers. The aim of the paper is to present the pathomechanism and the main factors involved in the development of retinopathy of prematurity as well as the current therapeutic approaches for this disease. This information is intended to help family doctors update their knowledge on retinopathy of prematurity.Retinopatia wcześniaków należy do grupy retinopatii proliferacyjnych. Występuje u wcześniaków z bardzo niską masą urodzeniową, leczonych tlenem o wysokim stężeniu. Szacuje się, że jest przyczyną upośledzenia widzenia u około 50 000 dzieci rocznie. Lata 50. i 70. ubiegłego wieku to okresy wystąpienia dwóch epidemii retinopatii wcześniaków. W ostatnich latach w krajach rozwijających się następuje kolejny wzrost zachorowań, który w literaturze określa się mianem trzeciej epidemii. Wysokie stężenie tlenu w uzupełniającej tlenoterapii uważano dotychczas za główny czynnik ryzyka rozwoju retinopatii wcześniaków. Istnieją jednak doniesienia o pojawieniu się tej choroby u pacjentów, u których nie zastosowano terapii tlenem. Niska masa urodzeniowa i wczesny wiek ciążowy są dobrze znanymi czynnikami ryzyka rozwoju retinopatii wcześniaków. Do innych ważnych czynników należą płeć, ciąża mnoga, krwawienie dokomorowe i transfuzje krwi. Wystąpieniu tej choroby można zapobiegać dzięki badaniom przesiewowym wykonywanym przez okulistę w okresie kilku tygodni po urodzeniu. Za standardowe leczenie retinopatii wcześniaków uznaje się laserową fotokoagulację siatkówki, której zasadniczym celem jest zahamowanie rozwoju proliferacji włóknisto-naczyniowych. W przypadku wystąpienia progresji choroby pomimo zastosowania fotokoagulacji laserowej konieczne jest leczenie operacyjne. Podejmowane są również próby zastosowania leków blokujących czynniki wzrostu nieprawidłowych naczyń. Celem pracy jest przedstawienie patomechanizmu i czynników odgrywających ważną rolę w rozwoju retinopatii wcześniaków oraz opis aktualnych metod leczenia tej choroby. Informacje te mają pomóc pediatrom i lekarzom rodzinnym zaktualizować wiedzę na temat retinopatii wcześniaków

Histamine in cheeses – a potential danger?

Cheeses are complex products with high content of fat, protein and other inorganic compounds. It is a food product, which may differ because of their origin, the manufacturing conditions, the microbiological flora and enzymatic activity. All these parameters can affect the efficiency analysis, which in turn may constitute an impediment to the determination of the cheese histamine concentration. The main factors influencing the formation of biogenic amines, including histamine, are: bacteria presence (LAB), starter cultures, the availability of free amino acids, a cheese puberty, a proteolytic activity, pH, temperature and the concentration of NaCl. The comparison of the relationship between the negative effects and the content of amines in food showed no dependency. It can be assumed that the histamine content higher than 100 mg/kg in food products is not recommended. Thanks to strict technological regimes – during food production – the frequency of a histamine food poisoning (resulting from bacterial contamination) is sporadic.Sery należą do produktów o wysokiej zawartości tłuszczu, białka i innych związków nieorganicznych. Są wyrobem spożywczym, który może różnić się jednostkowo w zależności od swojego pochodzenia, warunków wytwarzania, flory mikrobiologicznej i aktywności enzymatycznej. Wszystkie te parametry mogą oddziaływać na skuteczność analityczną, w konsekwencji stanowiąc utrudnienie w oznaczaniu stężenia histaminy w serach. Do głównych czynników wpływających na powstawanie w produktach spożywczych amin biogennych, w tym histaminy, należą: obecność bakterii (LAB), kultury starterowe, dostępność wolnych aminokwasów, okres dojrzewania sera, aktywność proteolityczna, pH, temperatura i stężenie NaCl. Nie wykazano korelacji pomiędzy niekorzystnymi skutkami a zawartością amin w żywności. Można przypuszczać, że stężenie histaminy powyżej 100 mg/kg w produktach spożywczych nie jest zalecane. Dzięki ścisłym reżimom technologicznym podczas produkcji żywności częstość zatruć pokarmowych histaminą, wynikających z zanieczyszczeń bakteryjnych, jest sporadyczna

The Usefulness of Optical Coherence Tomography in Disease Progression Monitoring in Younger Patients with Relapsing-Remitting Multiple Sclerosis: A Single-Centre Study

The purpose of the study was to assess the usefulness of optical coherence tomography (OCT) in the detection of the neurodegenerative process in younger patients with multiple sclerosis (MS). The study group consisted of 61 patients with a relapsing remitting course of MS (mean age 36.4 ± 6.7 years) divided into two groups: short (≤5 years) and long (>10 years) disease duration. OCT, P300 evoked potential, Montreal Cognitive Assessment, and performance subtests (Picture Completion and Digit Symbol) of the Wechsler Adult Intelligence Scale were performed in all patients. Mean values of most parameters assessed in OCT (pRNFL Total, pRNFL Inferior, pRNFL Superior, pRNFL Temporalis, mRNFL, GCIPL, mRNFL+GCIPL) were significantly lower in MS patients in comparison to controls. And in patients with longer disease duration in comparison to those with shorter. Most OCT parameters negatively correlated with the EDSS score (p < 0.05). No significant correlation was found between OCT results and both P300 latency and the results of psychometric tests. OCT, as a simple, non-invasive, quick, and inexpensive method, could be useful for monitoring the progression of disease in MS patients

Situational factors shape moral judgments in the trolley dilemma in Eastern, Southern, and Western countries in a culturally diverse sample

Much research on moral judgment is centered on moral dilemmas in which deontological perspectives (i.e., emphasizing rules, individual rights and duties) are in conflict with utilitarian judgements (i.e., following the greater good defined through consequences). A central finding of this field Greene et al. showed that psychological and situational factors (e.g., the intent of the agent, or physical contact between the agent and the victim) play an important role in people’s use of deontological versus utilitarian considerations when making moral decisions. As their study was conducted with US samples, our knowledge is limited concerning the universality of this effect, in general, and the impact of culture on the situational and psychological factors of moral judgments, in particular. Here, we empirically test the universality of deontological and utilitarian judgments by replicating Greene et al.’s experiments on a large (N = X,XXX) and diverse (WEIRD and non-WEIRD) sample across the world to explore the influence of culture on moral judgment. The relevance of this exploration to a broad range of policy-making problems is discussed

Situational factors shape moral judgments in the trolley dilemma in Eastern, Southern, and Western countries in a culturally diverse sample

Much research on moral judgment is centered on moral dilemmas in which deontological perspectives (i.e., emphasizing rules, individual rights and duties) are in conflict with utilitarian judgements (i.e., following the greater good defined through consequences). A central finding of this field Greene et al. showed that psychological and situational factors (e.g., the intent of the agent, or physical contact between the agent and the victim) play an important role in people’s use of deontological versus utilitarian considerations when making moral decisions. As their study was conducted with US samples, our knowledge is limited concerning the universality of this effect, in general, and the impact of culture on the situational and psychological factors of moral judgments, in particular. Here, we empirically test the universality of deontological and utilitarian judgments by replicating Greene et al.’s experiments on a large (N = X,XXX) and diverse (WEIRD and non-WEIRD) sample across the world to explore the influence of culture on moral judgment. The relevance of this exploration to a broad range of policy-making problems is discussed