Evaluation of the transition from intravenous to subcutaneous vedolizumab in patients with inflammatory bowel disease. / Valoración de la transición de vedolizumab intravenoso a subcutáneo en pacientes con enfermedad inflamatoria intestinal.

AIMS: The aim of the study is to evaluate the clinical and biochemical response of inflammatory bowel disease patients treated with vedolizumab, 16 weeks after transitioning from intravenous (iv) to subcutaneous (sc). METHODS: An observational, prospective, single-center cohort study was performed. Patients with inflammatory bowel disease and maintenance treatment with vedolizumab, stable for at least 4 months, were offered to switch to sc formulation. At the same time of treatment administration a blood test was performed, with vedolizumab levels and fecal calprotectin. RESULTS: Forty-three patients were included, 12 of them (27.9%) chose to transition to sc formulation. All included patients remained in remission during follow-up. At week 16 no significant differences were found in terms of calprotectin levels in patients on iv treatment (mean 146.6±SD 45.9) vs. sc (159.26±53.9) (p=0.9). Vedolizumab serum levels at week 16 were higher in the sc group (22,364.3±5141.6) vs. iv (11,425.9±1514.2) (p=0.009). At week 16, 9 (75%) of the patients in the sc group were highly satisfied with the medication and 11 (91.7%) considered it easy to administer. Four patients (12.9%) in the iv group and 2 (16.6%) in the sc group presented mild adverse effects. The 2 cases (100%) of the sc group the adverse event was local inflammation at the injection site. CONCLUSION: In our experience, vedolizumab sc is a convenient alternative to iv administration. Vedolizumab serum levels in patients who transitioned to sc were higher than iv formulation.

Gastrointestinal bleeding due to disseminated histoplasmosis in a patient under anti-TNF treatment.

A 62-year-old woman, originally from Peru, with rheumatoid arthritis under treatment with anti-tumor necrosis factor (anti-TNF) therapy, was admitted due to constitutional syndrome and suspicion of neoplasia. Computed tomography (CT) scan revealed involvement of three segments of the colon, ascites, and likely peritoneal implants. Ascitic fluid analysis showed elevated adenosine deaminase (ADA) levels and lymphocytosis. The patient presented with hematemesis and hematochezia with hemodynamic instability. Upper gastrointestinal endoscopy identified an extensive ulcer in the middle esophagus with a granular base, elevated and defined edges, indeterminate for malignancy and without blood residues. Colonoscopy also revealed multiple extensive ulcers in the transverse colon, with whitish bases and thickened and necrotic-looking surrounding mucosal edges. Histology showed granulomas and yeast-like fungal structures with methenamine silver staining in both tissues, consistent with disseminated histoplasmosis. Antifungal treatment was initiated with good clinical evolution.

Diffuse large B-cell lymphoma and gastrointestinal Kaposi's sarcoma: a rare cause of upper gastrointestinal bleeding.

A 49-year-old man with a history of human immunodeficiency virus (HIV) infection, in a state of advanced immunosuppression and current antiretroviral therapy initiation. He was admitted to the hematology department after diagnosis of diffuse large B-cell lymphoma (DLBCL) associated with Epstein-Barr virus (EBV), disseminated cytomegalovirus (CMV) infection and cutaneous Kaposi's sarcoma (KS). During admission, he presented an episode of melena with anemization, so an urgent gastroscopy was performed. In the stomach there were multiple erythematous lesions, large and elevated, suggestive of subepithelial origin. Some of them presented an umbilicated center and other were ulcerated, covered with fibrin. The bulb and second duodenal portion showed similar involvement, large violaceous ulcerated lesions. Biopsies were taken and the anatomopathological diagnosis of the duodenal lesions was KS and of the gastric lesions KS and DLBCL associated with EBV. KS is an endothelial tumor associated with HIV. The stomach is the gastrointestinal organ most frequently affected and the typical endoscopic findings are nodular lesions. The stomach is the most common site of extranodal involvement in DLBCL. In both pathologies, the manifestation as upper gastrointestinal bleeding is exceptional and endoscopic biopsies can confirm the diagnosis.

Clinical predictors of NEDA-3 one year after diagnosis of pediatric multiple sclerosis: an exploratory single-center study.

Introduction: Multiple sclerosis (MS) is an inflammatory and demyelinating disorder of central nervous system that can be diagnosed in pediatric age (<18 years) in 3-5% of the cases. This early onset is associated with higher relapse rates and earlier progression to neurological disability. By using NEDA-3 (No Evidence of Disease Activity-3) criteria, we aimed to identify clinical predictors associated with absence of disease activity and control of disease progression 12 months after the diagnosis, in a cohort of pediatric-onset MS (POMS) patients regularly followed-up in our center. Methods: We analyzed demographic, clinical, laboratorial and imaging variables of patients with POMS identified in our center, between 2010 and 2021, in two moments: at the diagnosis and 12 months after it. Statistical tests were applied to compare the distribution of those variables between groups defined by NEDA-3 status and by each one of its three variable components. Results: We included 27 patients in the study (18 female), with a mean age of 14.8 years (± 2.8), being all diagnosed with relapsing-remitting MS and with a median score of 1.5 at the Expanded Disability Status Scale (EDSS). The use of natalizumab (p = 0.017) and the negativity for anti-EBV IgG antibodies (p = 0.018) at diagnosis were associated with a higher achievement of NEDA-3 status 12 months after, in our cohort. Prescribed treatment was also associated with statistically significant differences in the "absence of MRI activity" component of NEDA-3 (p = 0.006): patients under treatment with natalizumab had a higher probability of achieving this status, and the opposite was observed in glatiramer acetate-treated children. Discussion and conclusion: Our exploratory results underline the pivotal importance that an early and more effective therapeutical approach may have in the control of disease activity, in POMS. Additionally, they also seem to suggest that the presence of anti-EBV antibodies is not innocent, as it can be related to a less favorable evolution of the disease, even at a very early stage. Further studies are needed to confirm the applicability of these variables as prognostic and personalized tools in this clinical setting.

X-Linked Myotubular Myopathy: A Novel Mutation Expanding the Genotypic Spectrum of a Phenotypically Heterogeneous Myopathy.

X-linked myotubular myopathy (XLMTM), a centronuclear congenital myopathy secondary to pathogenic variants in the MTM1 gene encoding myotubularin, is typically recognized for its classic and severe phenotype which includes neonatal hypotonia, severe muscle weakness, long-term ventilator dependence, markedly delayed gross motor milestones with inability to independently ambulate, and a high neonatal and childhood mortality. However, milder congenital forms of the condition and other phenotypes are recognized. We describe a 6-year-old boy with a mild XLMTM phenotype with independent gait and no respiratory insufficiency even in the neonatal period. The child has a hemizygous novel splice site variant in the MTM1 gene (c.232-25A > T) whose pathogenicity was confirmed by cDNA studies (exon 5 skipping) and muscle biopsy findings. We also compared the phenotype of our patient with the few reported cases that presented a mild XLMTM phenotype and no respiratory distress at birth, and discussed the potential mechanisms underlying this phenotype such as the presence of residual expression of the normal myotubularin transcript.

Influence of biologic therapy on cardiovascular risk factors in patients with inflammatory bowel disease. / Influencia del tratamiento biológico en los factores de riesgo cardiovascular de los pacientes con enfermedad inflamatoria intestinal.

INTRODUCTION: Chronic immune-mediated diseases, including inflammatory bowel disease (IBD), present an increased risk of developing early atherosclerosis and cardiovascular events (CVE) at early age. OBJECTIVE: To describe the baseline and 1-year cardiovascular profile of patients with IBD according to the biologic treatment received, taking into account the inflammatory activity. PATIENTS AND METHODS: It is a retrospective, observational study that included 374 patients. Cardiovascular risk factors (CVRF) and CVE were collected at the baseline visit and at one-year follow-up to describe the cardiovascular risk according to the biological treatment received, also assessing clinical and biological remission. RESULTS: A total of 374 patients were included: 146 (38.73%) were treated with Infliximab, 128 (33.95%) with adalimumab, 61 (16.18%) with ustekinumab and 42 (11.14%) with vedolizumab. The changes in blood glucose levels are [86.31mg/dL (84.57-88.06) vs. 89.25mg/dL (87.54-90.96), P=.001] for those treated with antiTNFα and [86.52mg/dL (83.48-89.55) vs. 89.44mg/dL (85.77-93.11), P=.11] in the other group. In the group treated with antiTNFα total cholesterol values at baseline visit are [169.40mg/dL (164.97-173.83) vs. 177.40mg/dL (172.75-182.05) at one year of treatment, P=<.001], those of HDL [50.22mg/dL (48.39-52.04) vs. 54.26mg/dL (52.46-56.07), P=<.001] and those of triglycerides [114.77mg/dL (106.36-123.18) vs. 121.83mg/dL (112.11-131.54), P=.054]. Regarding weight, an increase was observed, both in those patients treated with antiTNFα [71.39kg (69.53-73.25) vs. 72.87kg (71.05-74.70), P<.001], and in the group treated with ustekinumab and vedolizumab [67.59kg (64.10-71.08) vs. 69.43kg (65.65-73.04), P=.003]. Concerning CVE, no significant differences were observed neither according to the drug used (p=0.36), nor according to personal history of CVE (P=.23) nor according to inflammatory activity (P=.46). CONCLUSIONS: Our results on a real cohort of patients with IBD treated with biologic drugs show a better control of certain cardiovascular parameters such as CRP or HDL, but a worsening of others such as total cholesterol or triglycerides, regardless of the treatment. Therefore, it is possibly the disease control and not the therapeutic target used, the one that affect the cardiovascular risk of these patients.

A De Novo BSCL2 Gene S90L Mutation in a Progressive Tetraparesis with Urinary Dysfunction and Corpus Callosum Involvement.

A Silver syndrome is a rare autosomal dominant spastic paraparesis in which spasticity of the lower limbs is accompanied by amyotrophy of the small hand muscles. The causative gene is the Berardinelli-Seip congenital lipodystrophy 2 ( BSCL2) , which is related to a spectrum of neurological phenotypes. In the current study, we presented a 14-year-old male with a slowly progressive spastic paraparesis with urinary incontinence that later on exhibited atrophy and weakness in the thenar and dorsal interosseous muscles. Magnetic resonance imaging (MRI) revealed discrete atrophy of the corpus callosum isthmus and an extended next-generation sequencing panel identified a de novo heterozygous mutation in BSCL2 gene, c.269C > T p.(S90L). Various clinical expression and incomplete penetrance of BSCL2 gene mutations complicate the establishment of a genetic etiology for these cases. Therefore, Silver syndrome should be included in the differential diagnosis if the initial presentation is a spastic paraparesis by urinary involvement with childhood-onset, even with MRI atypical findings. This report described the first Iberian Silver syndrome case carrying a de novo c.269C > T p. (S90L) BSCL2 gene mutation.

Spinal cord ischaemic injury while playing in a playground.

Spinal cord ischaemia is a rare condition in children in which imaging diagnosis can be difficult and treatment guidelines are not well established. We describe a case of a previously healthy 13-year-old girl admitted to the emergency department with an acute flaccid paralysis of the lower limbs, abdominal and dorsal pain, and bladder dysfunction. A few hours earlier, she had been playing on a swing with hyperextension and an arched back position. Spinal cord MRI was normal in the first hours, but ischaemic signs were described in a second examination performed some hours later. We discuss the extensive investigation for differential diagnosis and the management of this case.

Kresoxim-methyl and famoxadone as activators of toxigenic potential of Aspergillus carbonarius.

Ochratoxin A (OTA) is a secondary metabolite produced by filamentous fungi species belonging to the genera Penicillium and Aspergillus. The contamination of grapes by ochratoxigenic species occurs worldwide in regions of tropical and temperate climates. Better control of fungal growth is achieved through good cultural practice and proper selection of fungicides. Kresoxim-methyl and famoxadone are the most common fungicides used in vineyards. This study aimed at analysing the OTA production and toxigenic potential of Aspergillus carbonarius under fungicide treatment with famoxadone and kresoxim-methyl. The growth rate of A. carbonarius was evaluated by measuring the glucosamine content and the diameter of the fungal colonies. OTA production was quantified by HPLC analysis. The treatment with fungicides, kresoxim-methyl and famoxadone, significantly reduced the fungal growth, by 76% and 60%, respectively. However, the mycotoxin production was greater in the fungicide-treated groups than the control group, showing that even though the fungicides were effective in controlling fungal growth, they were ineffective against mycotoxin production.

Evaluation of protective effect of different dietary fibers on polyphenolic profile stability of maqui berry (Aristotelia chilensis (Molina) Stuntz) during in vitro gastrointestinal digestion.

The aim of this work was to determine the protective effect of different dietary fibers on (i) the recovery and bioaccessibility indexes, and (ii) the stability of polyphenolic compounds (phenolic acids, flavonoids and anthocyanins) of maqui berry powder subjected to in vitro gastrointestinal digestion (GID). The extracts obtained in each phase (oral, gastric and intestinal) of GID were used to analyze the stability of polyphenolic compounds by HPLC, and the bioaccessibility of these compounds was also determined. At the end of the GID process, the mixture of maqui berry with the different fibers increased the bioaccessibility index of the phenolic and flavonoid compounds in all cases. The results obtained suggest that the anthocyanins and phenolic acids and flavonoid compounds present in maqui are stabilized through dietary fiber interactions, which might provide sufficient levels for absorption during gastrointestinal digestion. The gums sodium carboxymethyl cellulose, xanthan gum and guar gum provided the best protective effect.

Assessment of Antioxidant and Antibacterial Properties on Meat Homogenates of Essential Oils Obtained from Four Thymus Species Achieved from Organic Growth.

In the organic food industry, no chemical additives can be used to prevent microbial spoilage. As a consequence, the essential oils (EOs) obtained from organic aromatic herbs and spices are gaining interest for their potential as preservatives. The organic Thymus zygis, Thymus mastichina, Thymus capitatus and Thymus vulgaris EOs, which are common in Spain and widely used in the meat industry, could be used as antibacterial agents in food preservation. The aims of this study were to determine (i) the antibacterial activity using, as culture medium, extracts from meat homogenates (minced beef, cooked ham or dry-cured sausage); and (ii) the antioxidant properties of organic EOs obtained from T. zygis, T. mastichina, T. capitatus and T. vulgaris. The antioxidant activity was determined using different methodologies, such as Ferrous ion-chelating ability assay, Ferric reducing antioxidant power, ABTS radical cation (ABTS•+) scavenging activity assay and 2,2'-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging method; while the antibacterial activity was determined against 10 bacteria using the agar diffusion method in different meat model media. All EOs analyzed, at all concentrations, showed antioxidant activity. T. capitatus and T. zygis EOs were the most active. The IC50 values, for DPPH, ABTS and FIC assays were 0.60, 1.41 and 4.44 mg/mL, respectively, for T. capitatus whilst for T. zygis were 0.90, 2.07 and 4.95 mg/mL, respectively. Regarding antibacterial activity, T. zygis and T. capitatus EOs, in all culture media, had the highest inhibition halos against all tested bacteria. In general terms, the antibacterial activity of all EOs assayed was higher in the medium made with minced beef than with the medium elaborated with cooked ham or dry-cured sausage.

Evaluation of the antibacterial and antioxidant activities of chitosan edible films incorporated with organic essential oils obtained from four Thymus species.

The aims of this study were to evaluate, (1) the antibacterial properties, (2) the total phenol content and (3) the antioxidant activity, of chitosan edible films incorporated with certified organic essential oils (EOs) obtained from Thymus zygis, Thymus mastichina, Thymus capitatus and Thymus vulgaris. The agar disc diffusion method was used to determine the antibacterial activities of chitosan edible films while for the antioxidant activity, two different analytical assays were used (DPPH and FRAP). As regard antibacterial activity, films containing only chitosan were not effective against any of tested bacteria. Chitosan films containing T. capitatus EO (CH + TCEO) was more effective against Listeria innocua and Alcaligenes faecalis whilst chitosan films containing T. mastichina EO (CH + TMEO) had the highest inhibition halos against Serratia marcescens. For and Enterobacter amnigenus no antibacterial activity was achieved. Chitosan films added with Thymus essential oils showed antioxidant activity, at all concentrations and with all methods assayed. CH + TZEO had the highest antioxidant activity revealed with DPPH assay. However in CH + TCEO showed best antioxidant effect when assessed with FRAP assay. The results showed that chitosan edible films incorporated with organic Thymus EOs could be used as active films in food industry due to its antibacterial and antioxidant activities.

Autosomal recessive axonal neuropathy with neuromyotonia: a rare entity.

BACKGROUND: Autosomal recessive axonal neuropathy with neuromyotonia is a recently described entity associated to the HINT1 gene, encoding histidine triad nucleotide-binding protein 1. PATIENT: The authors report a Portuguese 16-year-old girl of Roma ethnicity, descendant of consanguineous parents, with progressive distal muscular atrophy and weakness, beginning at age 6. After several years of extensive investigation with inconclusive results, clinical myotonia was identified. Electrophysiologic studies revealed neuromyotonia associated with a severe chronic predominantly motor axonal neuropathy and homozygous mutation (c.334 C > A, p.H112 N) in HINT1 was detected. CONCLUSION: This report emphasizes the late onset of clinical myotonia essential to the diagnosis.

In vitro evaluation of co-exposure of arsenium and an organic nanomaterial (fullerene, C60) in zebrafish hepatocytes.

Taking into account the concept of the "Trojan Horse", where contaminants may have its entry into specific organs potentiated by its association with nanomaterials, the aim of this study was to analyze the joint toxic effects induced by an organic nanomaterial, fullerene (C(60)) with the metalloid arsenic (As(III)). Hepatocytes of zebrafish Danio rerio were exposed to As(III) (2.5 or 100 µM), C(60) or As+C(60) for 4h, not altering cells viability. Intracellular reactive oxygen species concentration was reduced in cells exposed only to the C(60) (1mg/L) and in the treatment of 100 µM As(III)+C(60). Co-exposure with C(60) abolished the peak of the antioxidant glutathione (GSH) registered in cells exposed to the lowest As(III) concentration (2.5 µM). A similar result was observed in terms of lipid damage (TBARS). Total antioxidant capacity was significantly higher at both As(III) concentrations co-exposed to C(60) when compared with the control group. Activity of glutathione-S-transferase omega, a limiting enzyme in the methylation pathway of As(III), was reduced in the 100 µM As(III)+C(60) treatment. Cells co-exposed to C(60) had a significantly higher accumulation of As(III), showing a "Trojan Horse" effect which did not result in higher cell toxicity. Instead, co-exposure of As(III) with C(60) showed to reduce cellular injury.

Left ventricular noncompaction: analysis of a pediatric population.

INTRODUCTION: Left ventricular noncompaction (LVNC) is a rare and potentially progressive cardiomyopathy, characterized by the persistence of multiple trabeculations and deep intratrabecular recesses in the ventricular myocardium. Although two-dimensional and color Doppler echocardiography are the most useful diagnostic modalities, cardiac magnetic resonance imaging has proved to have high sensitivity and specificity in the diagnosis of this anomaly. OBJECTIVE: To characterize the clinical and imaging features of LVNC in a pediatric population and to assess their evolution. METHODS AND RESULTS: We performed a retrospective chart review of five pediatric patients with LVNC, followed at Coimbra Pediatric Hospital between January 1999 and December 2007. Median age at presentation was five months (ranging from one day to 13 years), and they were mainly male (1.5:1). Two of the children had a family history of sudden death. In one case the clinical presentation was cardiac arrest due to ventricular fibrillation and in three others, congestive cardiac failure. None of the five cases had associated congenital cardiac anomalies. Involvement of the ventricular apical region was found in all cases. Four children additionally had ventricular dysfunction which improved with diuretic and vasodilator therapy. Mean follow-up was 34 months, ranging from six months to seven years. In one case a change in the morphological phenotype was noted, from a dilated to a hypertrophic form. In this case and in the child's father a mutation in the MYBPC3 gene was identified, which is associated with hypertrophic cardiomyopathy. No thromboembolic phenomena or deaths occurred during the study period. CONCLUSION: In the pediatric population, congestive cardiac failure is the most common clinical presentation of LVNC, which can coexist with other cardiomyopathies, particularly dilated and hypertrophic forms. The sample presented in this analysis is statistically non-significant due to its limited size and the authors highlight the need for larger prospective studies in the pediatric population in order to clarify this disease and its diagnostic criteria.

[BabyCare: decision support system for primary child care using personal digital assistant]. / BabyCare: apoio à decisão na atenção primária materno-infantil com computadores de mão.

The purpose of this work was to develop a digital device - referred as BabyCare System - for the collection, storage, and decision support for healthcare professionals and other concerned people, in order to assist patients in primary child care in deprived communities. This system is based on handheld device technologies to be used locally in basic healthcare units in deprived communities, whether assisted or not by the Family Health Program/Strategy (PSF), as well as in ambulatory facilities and hospitals. Java was used as programming language. Evaluations have been conducted regarding 62 users at São Paulo city including volunteers from the Pastoral da Criança, an ecumenical institution for children. The applied questionnaires resulted in a high level of general acceptance (98.3%); the on-site training was considered as appropriate (91.9%); a perception of routine improvement and decrease in the time of consultation (100.0%), and a decrease in the volume of paperwork (96.7%). The prototype has proven to be robust and effective for the use in deprived communities with precarious computer and telecommunication infrastructure.

BabyCare: apoio à decisão na atenção primária materno-infantil com computadores de mão / BabyCare: decision support system for primary child care using personal digital assistant

O objetivo desta pesquisa foi desenvolver um instrumento digital - aqui denominado Sistema BabyCare - para coleta, armazenamento e apoio à decisão dos profissionais de saúde e demais envolvidos na assistência primária infantil em comunidades carentes. Esse sistema baseia-se em tecnologias de dispositivos móveis para utilização local em unidades básicas de saúde em comunidades carentes, assistidos ou não pelo Programa/Estratégia Saúde da Família (PSF), organizações não governamentais, ambulatórios e hospitais. Utilizou-se Java como linguagem de programação. Foram realizadas avaliações sobre o uso do sistema na cidade de São Paulo, envolvendo 62 usuários com diferentes formações, incluindo voluntários da Pastoral da Criança e do PSF. Os questionários aplicados resultam em alto índice de aceitação geral (98,3 por cento); treinamento in loco considerado adequado (91,9 por cento); percepção na melhoria na rotina e na redução de tempo da consulta (100,0 por cento) e na redução no volume de documentos (96,7 por cento). Conclusão: o protótipo apresentou-se robusto e eficiente para uso em comunidades carentes com infraestrutura precária de informática e telecomunicação.

The purpose of this work was to develop a digital device - referred as BabyCare System - for the collection, storage, and decision support for healthcare professionals and other concerned people, in order to assist patients in primary child care in deprived communities. This system is based on handheld device technologies to be used locally in basic healthcare units in deprived communities, whether assisted or not by the Family Health Program/Strategy (PSF), as well as in ambulatory facilities and hospitals. Java was used as programming language. Evaluations have been conducted regarding 62 users at São Paulo city including volunteers from the Pastoral da Criança, an ecumenical institution for children. The applied questionnaires resulted in a high level of general acceptance (98.3 percent); the on-site training was considered as appropriate (91.9 percent); a perception of routine improvement and decrease in the time of consultation (100.0 percent), and a decrease in the volume of paperwork (96.7 percent). The prototype has proven to be robust and effective for the use in deprived communities with precarious computer and telecommunication infrastructure.

[Children's oral hygiene: healthy mouth, families supervise?]. / Higiene oral na criança: boca sã, família vigilante?

UNLABELLED: Dental caries results from a complex interaction between the host and environmental factors and it is an important public health issue. AIMS: To determine the prevalence of dental caries in a school population of six and 12 years old children from Leiria; to establish a relationship between dental caries and related known risk factors; parental dental health care, parental control of their children oral hygiene and to compare our results with the National Dental Care Study of 1999. METHODS: Descriptive and statistical analysis based on a questionnaire and dental examination. RESULTS: In our sample of 248 children, 43% were six years old and 57% 12 years old; 52% were female and 72% reside in a suburban area. The prevalence of dental caries was 42% (48% for the six year and 33% for the 12 years old groups. Dental caries were more prevalent in males (p = 0, 01) and 25% of these had three or more caries. Analysis of the questionnaire revealed that 87% of children brushed their teeth daily, findings that were unrelated to gender, age or residential area. Of this group, 68% brushed their teeth twice or more daily (p = 0,008). This routine was commenced in 32% of children prior to the age of three and these had less dental caries (p = 0,022). With regard to the children's dietary habits, we found them to be similar in both groups. The children who did not sweeten their milk (23 and 24% of the six and 12 years group, respectively) had fewer dental caries (p = 0,031). Dental treatment was required in 53% of 12 year old group and in 41% of six year old group. Dental caries was also less prevalent in children who also had taken fluoride (p = 0,045). We found a significant statistical relationship between parental and their children's dietary habits (p = 0,000). Parents who brushed their teeth twice daily had children with similar oral hygiene habits and had fewer caries (p = 0,002). Parents who oversee their children's dental care (52%) include the group of parents and children that brush their teeth at least twice daily (p = 0,003). CONCLUSIONS: Dental caries was more prevalent in the six year old group with a male predominance. Children who brushed their teeth twice a day had less caries and the 12 year old group had more visits to the dentist. To ensure adequate oral hygiene habits it is important that parents supervise their children' habits.