Prevalence and determinants of early childhood caries in Italy.

AIM: Still limited data from representative surveys are available on the prevalence of Early Childhood Caries (ECC; i.e., the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child aged 71 months or younger), particularly for infant. We conducted a survey in Italian children aged 0 to 71 months. MATERIALS AND METHODS: A cross-sectional study on ECC was conducted in Italy in 2018 on a sample of parents who were members of an online panel. Using an online questionnaire, 2,522 parents provided information on a total sample of 3,000 children, representative of the Italian population aged 0-71 months. RESULTS: ECC prevalence was 8.2% overall, 2.9% in children aged 0-23 months, 6.2% in children aged 24-47 and 14.7% in children aged 48-71 months (p for trend<0.001). ECC was more frequently observed among children using baby bottle with milk to fall asleep (multivariate odds ratio, OR, 1.36, 95% confidence interval, CI: 1.03-1.78), baby bottle with sugary beverages (OR 2.87, 95% CI: 2.05-4.03) and pacifier with sugary substances (OR 2.49, 95% CI: 1.79-3.47), consuming beverages other than water (OR for ?1/day vs never 2.29, 95% CI: 1.35-3.90), a higher number of snacks between meals (OR for ?3 vs <2 meals 2.05, 95% CI: 1-38-3.06), a lower frequency of tooth brushing (OR for <1 vs ?2 times/day 2.26, 95% CI: 1.42-3.58) and a high number of siblings (compared to 0, OR for ?2 siblings 2.28, 95% CI: 1.56-3.34). ECC increased with parents' mean age (p for trend=0.048), parents' smoking habit (OR for at least one smoker 1.54, 95% CI: 1.17-2.03), parents' poor oral hygiene (OR for ?1 vs >1 time/day of tooth brushing 1.42, 95% CI: 1.03-1.96) and high number of caries (OR for ?7 vs 0 caries was 2.38, 95% CI: 1.35-4.20). CONCLUSION: The present large and representative survey for the first time shows that ECC might be frequent also among infants. We confirm that ECC might be prevented if parents follow simple good practices. Information campaign and intervention programmes are needed to inform parents about unfavourable habits that favour the onset of ECC.

Feeding practices of infants through the first year of life in Italy.

AIM: To investigate infant feeding practices through the first year of life in Italy, and to identify factors associated with the duration of breastfeeding and early introduction of solid foods. METHODS: Structured phone interviews on feeding practices were conducted with 2450 Italian-speaking mothers randomly selected among women who delivered a healthy-term singleton infant in November 1999 in Italy. Interviews were performed 30 d after delivery and when the infants were aged 3, 6, 9 and 12 mo. Type of breastfeeding was classified according to the WHO criteria. RESULTS: Breastfeeding started in 91.1% of infants. At the age of 6 and 12 mo, respectively, 46.8% and 11.8% of the infants was still breastfed, 68.4% and 27.7% received formula, and 18.3% and 65.2% were given cow's milk. Solids were introduced at the mean age of 4.3 mo (range 1.6-6.5 mo). Introduction of solids occurred before age 3 and 4 mo in 5.6% and 34.2% of infants, respectively. The first solids introduced were fruit (73.1%) and cereals (63.9%). The main factors (negatively) associated with the duration of breastfeeding were pacifier use (p < 0.0001), early introduction of formula (p < 0.0001), lower mother's age (p < 0.01) and early introduction of solids (p = 0.05). Factors (negatively) associated with the introduction of solids foods before the age of 3 mo were mother not having breastfed (p < 0.01), early introduction of formula (p < 0.01), lower infant bodyweight at the age of 1 mo (p = 0.05) and mother smoking (p = 0.05). CONCLUSION: The duration of breastfeeding in Italy is still inadequate, as well as compliance with international recommendations for timing of introduction of complementary foods. National guidelines, public messages and educational campaigns should be promoted in Italy.

Pituitary receptor sites for gonadotropin-releasing hormone: effect of castration and substitutive therapy with sex steroids in the male rat.

To examine the role of pituitary gonadotropin-releasing hormone (GnRH) receptors (pit GnRH-R) in the regulation of gonadotropin secretion, male rats were orchidectomized and then selectively received substitutive therapy with sex steroids. Pituitary content of GnRH-R was determined by saturation analysis, using radioiodinated [D-Trp6,(N-Et)Pro5,des-Gly10]GnRH as tracer. Castration produced a rapid and sustained increase of the number of GnRH-R, which doubled after 2 days, and after 10 days the pituitary content of GnRH-R was 258 +/- 23 fmol/pituitary compared to 103 +/- 12 fmol/pituitary for sham-operated control animals. No change of the affinity constant (Ka) was observed (Ka = 1.13 +/- 0.08 X 10(10) M-1; n = 14). Plasma LH increased 5- to 10-fold and FSH-2- to 3-fold after castration, and hypothalamic GnRH content was depleted by 30-60%. Immediate substitution of castrated rats with testosterone propionate (250 micrograms daily) prevented the increases of both plasma gonadotropins and of GnRH-R. Treatment of acutely castrated rats for 7 days with testosterone propionate (50-200 micrograms), 5 alpha-dihydrotestosterone propionate (25-400 micrograms), or estradiol benzoate (2 micrograms) prevented the rise in pit GnRH-R in a dose-related manner and normalized the other parameters studied except that plasma FSH remained slightly elevated. In contrast, when substitutive therapy was started 8 days after castration or later, the 7-day treatment with sex steroids reduced plasma gonadotropins, but pit GnRH-R remained elevated, and hypothalamic GnRH content remained depleted. These results indicate that the marked increase of gonadotropin secretion after castration is mediated at least in part, by an increase in the number of pit GnRH-R. Sex steroids were able to reverse all castration-induced endocrine changes in acutely castrated rats, but in long term castrated animals their action at higher centers to normalize hypothalamic GnRH content, and indirectly, to reduce pit GnRH-R content, was either delayed or ineffective. Thus, the rapid feedback action of sex steroids in long term castrated rats may be predominantly exerted at the pituitary level.

Epidemic of breast enlargement in an Italian school.

An outbreak of breast enlargement in girls and boys attending a school in Milan, first noted in November, 1977, was followed up until the end of 1978. 213 boys aged 3-14 years and 110 girls aged 3-7 years were studied; control children attending five other schools were also examined. In total 1647 boys and 476 girls were examined. Breast enlargement was significantly more common in boys (29.0%) and girls (21.6%) aged 3-5 years, boys (58.0%) aged 6-10, and girls (67.1%) aged 6-7 from the school in Milan, than in age and sex matched children at control schools. Breast enlargement was not pronounced and disappeared within 8 months. Hormonal determinations were within normal limits except for 17 beta-oestradiol which was slightly raised. Although oestrogen contamination was not detected when samples of school meals were tested, an uncontrolled supply of poultry and beef was suspected as being the cause of this outbreak.