The influence of educational level and oral hygiene behaviours on DMFT index and CPITN index in an adult Italian population: an epidemiological study.

OBJECTIVES: To estimate the influence of educational level and oral hygiene behaviours on the prevalence and severity of dental caries and periodontal disease in an adult Italian population attending the Oral Hygiene department of a public Dental Clinic. METHODS: Dental caries was diagnosed according to the World Health Organization criteria. The DMFT index (decayed, missing, filled tooth) was used to record the dental caries' experience. The periodontal status was assessed using the community periodontal index of treatment needs (CPITN). Questionnaires on educational level and oral hygiene behaviours were also collected. RESULTS: A total of 350 patients were enrolled. The mean DMFT value reported was 4.37 ± 3.06, and higher values were observed for male patients (P < 0.05). Increased CPITN scores and DMFT values were significantly correlated with lower level of education (P < 0.05). Subjects of high educational status showed significantly better oral hygiene habits (P < 0.05). CONCLUSIONS: The oral health status, in terms of periodontal disease and dental caries, appears correlated with patients' educational level.

[Comparison of doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE) with conventional transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma]. / Quimioembolización del hepatocarcinoma: partículas cargadas frente a quimioembolización convencional.

OBJECTIVE: To compare conventional transarterial chemoembolization (TACE) with doxorubicin-eluting bead transarterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma, evaluating the tumor response, complications after treatment, and survival. MATERIAL AND METHODS: We present 72 patients diagnosed with hepatocellular carcinoma treated consecutively between January 2000 and December 2009. We studied 25 patients treated with TACE (Group A) and 47 patients treated with DEB-TACE (Group B); adriamycin (doxorubicin) was the chemotherapy agent used in both groups. All patients had compensated cirrhosis of the liver classified on the Child-Pugh score. The results were analyzed according to the RECIST criteria. Statistical analyses consisted of ANOVA, chi-square tests, Student's t-tests, and Kaplan-Meier log-rank tests. RESULTS: Patient's age, tumor size, number of tumors, and hepatic reserve were similar in the two groups. The mean number of sessions per patient was 1.32 ± 0.67 in Group A versus 2.13 ± 0.95 in Group B. The mean dose of adriamycin per patient was 50.60 ± 29.95 mg in Group A and 231.91 ± 110.2mg in Group B. A complete response of the tumor to treatment was observed in 5.6% of the patients in Group A and in 13.9% of those in Group B. According to the RECIST criteria, no significant differences were found. DEB-TACE was better tolerated and had fewer immediate complications (p=0.001). No significant differences were found in the survival of patients in the two groups (Group A: mean 686.24 days, median 709 days; Group B: mean 765.32 days, median 672 days. CONCLUSION: In patients with unresectable hepatocellular carcinoma, DEB-TACE is safe and better tolerated than conventional TACE; moreover, it seems to lead to greater necrosis of the tumors.

[Tenodesis for the treatment of chronic instability of the radioulnar joint]. / Tenodéza - resení chronické nestability distálního radioulnárního kloubu.

PURPOSE OF THE STUDY Distal radioulnar joint (DRUJ) instability often develops after distal forearm fracture or severe dislocation of the wrist with damage to its stabilising structures. The instability is usually diagnosed as a chronic condition and only rarely at the time of injury. When the stabilising structures are not treated adequately soon after injury, instability develops and is accompanied with pain, restricted range of motion and reduced grip strength. This study presents the option of chronic instability treatment by tenodesis with use of the palmaris longus tendon. Its aim is to remind the broad medical community of this issue. MATERIAL Between July 1994 and November 2000, tenodesis was performed in 15 patients with chronic DRUJ instability. The right and left sides were affected in 10 and five patients, respectively; of them 12 were dominant extremities. All injuries were diagnosed as dorsal subluxation of the ulnar head, with side dislocation in three patients. METHODS The diagnosis was based on a thorough medical history, and clinical and radiographic examination, including projections in forced maximum radial and ulnar duction, as recommended by Geyer and Luzius as early as in 1964. Tenodesis was done by the Jäger and Wirth method using the palmaris longus tendon. The patients were scored according to the Modified Mayo Wrist System. RESULTS Of the 15 patients treated by this method, 14 were evaluated. Eight patients regarded the results as very good, with no pain at maximal physical activity, and five considered them good, experiencing pain only at maximal but not at everyday activities. One patient reported a poor outcome. The average score increased from pre-operative 40 to 60 points post-operatively. All patients had a slight restriction of rotation movements of the forearm. Residual instability was found in one patient. DISCUSSION It is a common view that this condition is caused by subluxation or dislocation of the ulnar head, while in fact it is subluxation or dislocation of the radius turning around the ulna. As reported in the literature, dorsal dislocation is three-times as frequent as volnar dislocation, and this is in agreement with our findings. There is a wide variety of the operative methods for tenodesis which differ in the distribution of tunnels in bone. Restriction of the range of motion in our patients also agreed with the literature data. No effect of a distal radius fracture on the results of surgery was recorded. CONCLUSIONS Our results show that tenodesis is a method suitable to treat chronic DRUJ instability if the indication criteria are observed, i. e., if no arthritic lesions are present in the joint.

The use of hydrogen peroxide in the experimental therapy of cysts. An in vitro analysis.

AIM: Aim of the authors is to evaluate in vitro the histological alteration caused by hydrogen peroxide on a sample of radicular cysts. METHODS: Twelve radicular cysts were divided into 2 portions. The control group was histologically evaluated whereas the other portion, test, was treated with 3% hydrogen peroxide before histological analysis. Test and control portions were compared for integrity of the epithelium, inflammatory state of the cystic walls, presence of necrosis, stromal vacuolization and microvessel density (MVD). MVD was evaluated by immunohistochemistry using anti-CD34 monoclonal antibodies. RESULTS: Significantly lower epithelium integrity has been detected in the test group (p= or <0.007), (Wilcoxon test). Moreover, the test group presented a higher number of stromal vacuolization areas (p= or <0.004). However, necrosis and inflammation reported no significative differences. No significative differences were noticed for the MVD. CONCLUSION: Hydrogen peroxide showed a cytopathic and cytolytic activity in vitro. Those effects have been shown on both cysts tissues: epithelium and connective tissue. The present study did not reveal any statistically significant difference between the number of vessels in the control and in the test group. However, further in vitro and human studies are needed to validate this substance in the treatment of cysts.