Research progress on salivary exosomes and oral diseases / 口腔疾病防治

@#Salivary exosomes are extracellular vesicles with a diameter of 30-50 nm in saliva. With the development of technology in recent years, many studies have revealed that salivary exosomes play an important role in the occurrence and development of various oral diseases. For example, salivary exosomal CD9 and CD81 promote tumor cell metastasis by regulating the cell adhesion and movement, salivary exosomal miR-24-3p promotes the tumor cell proliferation by acting on PER1, and salivary exosomal programmed cell death-ligand 1 (PD-L1) mRNA inhibits the destruction of inflammatory tissue, which can be biomarkers for the diagnosis of oral cancer, periodontitis and other oral diseases. Therefore, salivary exosomes can be used as potential prognostic and diagnostic markers for oral diseases. In addition to oral diseases, such as oral cancer, periodontitis, oral lichen planus, Sjogren’s syndrome, etc., salivary exosomes are closely related to distant tumors, such as pancreatic cancer, lung cancer, and systemic diseases, such as Parkinson’s disease, inflammatory bowel disease, etc. It is of great significance to study the role of salivary exosomes in the diagnosis and treatment of oral and systemic diseases and to develop the potential of salivary exosomes as biomarkers for disease diagnosis.

Research progress on the relationship between Fusobacterium nucleatum and periodontitis / 口腔疾病防治

@#Periodontitis is an infectious disease caused by a variety of microorganisms. Fusobacterium nucleatum is closely related to periodontitis with a high detection rate. Fusobacterium nucleatum is able to coaggregate with other microorganisms and attach and invade epithelial cells with the help of adhesins. It can also promote the occurrence and development of periodontal diseases and even systemic diseases by destroying periodontal tissues with virulence factors and metabolites and inducing a host immune response. However, at present, drugs assisting periodontal nonsurgical treatment clinically cannot target specific periodontal pathogens, such as Fusobacterium nucleatum, which may lead to problems such as dysbacteriosis or drug resistance. Therefore, studies on the pathogenic mechanism of Fusobacterium nucleatum provide new ideas for the prevention and treatment of periodontitis. The idea is to develop materials, drugs, or probiotics that target adhesins, virulence factors, and metabolites or cut off each pathogenic pathway of Fusobacterium nucleatum to inhibit its proliferation and inflammatory responses in deep periodontal pockets and achieve a balance with other oral microorganisms, and the host is beneficial for the control of periodontitis.

Research progress on the mechanism of C-reactive protein mediated periodontitis and systemic diseases / 口腔疾病防治

@#A large number of studies have confirmed that periodontitis is closely related to systemic multisystem diseases. Local inflammation of periodontal tissue may cause systemic inflammation. As an inflammatory factor, C-reactive protein (CRP) is widely used to monitor various inflammatory states. CRP is not only highly related to periodontitis but also closely related to systemic diseases. This article reviews the relationship between periodontitis and systemic disease epidemiology as well as the mechanism of CRP in the relationship between them. The literature review shows that periodontitis is closely related to cardiovascular diseases, diabetes, premature and low-birth-weight infants, chronic kidney disease, rheumatoid arthritis and other systemic diseases. Periodontitis, as a chronic inflammatory disease, can increase the level of serum CRP, thus increasing the risk of cardiovascular disease and affecting blood glucose control in diabetic patients, which may be related to the increased risk of premature delivery and low-birth-weight infants, may affect the development of chronic kidney disease, and may be used as one of the sensitive indicators of rheumatoid arthritis in the active stage. Through periodontal treatment, serum CRP levels can be reduced, which is helpful for the treatment of systemic diseases. CRP levels can be used as indicator for prevention, diagnosis and treatment of periodontitis and systemic diseases.

Multidisciplinary team model for patients with oral cancer and systemic diseases: an expert consensus / 华西口腔医学杂志

Large general hospitals currently play an increasingly important role in the diagnosis and treatment for acute critical patients and difficult diseases because of the development of dual referral system and hierarchical diagnosis, as well as the formation of medical treatment alliance. Patients with oral cancers are often associated with systemic diseases, which increases the complexity of the condition. Thus, meeting the demand through the traditional single medical model is difficult. As such, a multidisciplinary team (MDT) model has been proposed and has achieved a good clinical effect. To standardize the application of this model, we organized an event in which relevant experts discussed and formulated a consensus to provide standardized suggestions on the MDT process and the diagnosis and treatment of common systemic diseases as reference for clinical practice.

Risk assessment and prevention in clinical diagnosis and treatment in implant surgery associated with systemic diseases / 口腔疾病防治

@#Patients seeking implantation often have several systemic diseases, which will introduce complications to treatment. This paper reviews the risk assessments and prevention of systemic diseases in patients with oral implant therapy with the relevant literature. The patients with cardiovascular diseases are prone to stroke and cardiac arrest, and anticoagulants and antihypertensive drugs will complicate cases. The potential risks of endocrine system diseases are infections and crises caused by unstable hormone levels. The risks of respiratory diseases are dyspnea and swallowing devices. The difficulty of treating patients with neuropsychiatric diseases is attributable to poor cooperation and adverse effects of the drugs. Bone and joint system diseases may decrease the success of implantation. Hematological system, digestive system and kidney diseases may lead to hemorrhage. By inquiring about detailed medical and medication history, evaluating vital signs and detecting important objective indicators, performing targeted measures, discussing with specialists, and observing patients closely, clinicians can avoid the abovementioned risks.

Research progress of correlation between periodontal pathogens and systemic diseases / 南方医科大学学报

Periodontal pathogens are the main pathogenic factor of periodontitis. Periodontal pathogens have a large variety of virulence factors such as lipopolysaccharide, fimbriae and proteases, which enables the pathogens to infect periodontal tissues and stimulate the secretion of inflammatory cytokines, causing chronic systemic inflammation. Periodontal pathogens may invade multiple systems such as the circulatory system, immune system, respiratory system and digestive system to cause systematic diseases. Recent studies have shown that periodontal pathogens may have close relations with systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and cancer. Among the periodontal pathogens, can be found in atherosclerotic plaques to impairing the function of the vascular endothelium; may also increase the level of inflammatory factors such as TNF-α to promote insulin resistance and diabetes. Many of the periodontal pathogens such as , and can be detected in the synovial fluid of rheumatoid arthritis patients, suggesting their involvement in the pathogenesis of rheumatoid arthritis. may cause alterations in the intestinal microbiome in mice and promote the occurrence of intestinal tumors. Herein we review the recent progresses in the relationship between periodontal pathogens and systemic diseases.

Vasculites: desafio diagnóstico e terapêutico / Vasculitis: diagnostic and therapeutic challenge

As vasculites, como o próprio nome as define, são inflamações vasculares, podendo ser localizadas ou sistêmicas e, em sua maioria, idiopáticas. Costumam acometer diversos órgãos como pele, pulmões e rins. Dentre as classificações a mais usual foi definida no Consenso de Chapel Hill de 2012, que classificou as vasculites de acordo com o calibre do vaso acometido em grande, médio, pequeno e microvasos. As vasculites são um dos maiores desafios diagnósticos na medicina, por sua apresentação clínica inespecífica, que se desenvolve lentamente, durante semanas ou meses. Além da confirmação do diagnóstico requerer testes laboratoriais, por vezes, biópsia de artéria acometida ou sorologia são necessárias. A terapêutica é imprescindível para a melhora sintomática, indução e remissão da doença e para diminuição de morbimortalidade.

Vasculitis, as the name defines them, are vascular inflammation and may be localized or systemic and mostly idiopathic. Usually affect several organs such as skin, lungs and kidneys. Among the most common classifications is the Chapel Hill Consensus of 2012 rated vasculitis according to vessel size affected in large, medium, small and microvessels. Vasculitis is one of the biggest challenges in medical diagnostics, in nonspecific clinical presentation, which develops slowly over weeks or months. In addition to the diagnostic confirmation tests require laboratory sometimes biopsy of the affected artery or serology are required. Therapy is essential for symptomatic improvement, induction, remission and decreased mortality.

AVALIAÇÃO DO CONHECIMENTO DE MÉDICOS SOBRE A RELAÇÃO ENTRE DOENÇAS PERIODONTAIS E DOENÇAS SISTÊMICAS / EVALUATION OF PHYSICIANS' KNOWLEDGE ON THE RELATIONSHIP BETWEEN PERIODONTAL AND SYSTEMIC DISEASES

Existe uma conexão entre a saúde bucal e a saúde sistêmica, principalmente no caso de paciente portadores de doenças periodontais. Objetivo: O objetivo deste estudo é avaliar o conhecimento de médicos, que trabalham no Hospital Adão Pereira Nunes, Saracuruna, Duque de Caxias, sobre a relação entre doenças periodontais e doenças sistêmicas. Metodologia: Questionários com 13 perguntas, que incluem questões sobre a relação entre as doenças orais e as metabólicas foram aplicados a 50 médicos que trabalham no Hospital Adão Pereira Nunes, Saracuruna, Duque de Caxias. Os participantes foram grupados em até 8 anos de formado (n = 26) e mais de 8 anos de formado (n = 24). Os dados foram testados pelos testes Mann-Whitney e do Qui-quadrado, ao nível de significância a 5%. Resultados: A grande maioria dos participantes, independentemente do grupo, já referiu paciente ao cirurgião-dentista, e o principal motivo foi a presença de lesão intra-oral. Maior parte dos respondentes apontou o sangramento gengival como sintoma primário da doença periodontal. Além disso, quase 100% dos participantes apontou existir relação entre doença periodontal e doenças sistêmicas, sendo doença cardiovascular a mais frequentemente citada. O principal meio de obtenção de informação sobre o assunto citado foram livros e periódicos. Conclusão: A grande maioria dos médicos, participantes do presente estudo, está ciente da relação existente entre doenças periodontais e doenças sistêmicas, principalmente, as doenças cardiovasculares. Isto foi evidenciado pela alta taxa de encaminhamento dos pacientes a dentistas e o conhecimento sobre os sinais clínicos da doença periodontal.

There is a connection between oral and systemic health, especially concerning patients with periodontal diseases. Aim: The objective of this study was to evaluate the knowledge of physicians working at the Adão Pereira Nunes Hospital, Saracuruna, Duque de Caxias, on the relationship between periodontal and systemic diseases. Methodology: Questionnaires with 13 questions, which include questions about the relationship between oral and metabolic diseases, were applied to 50 physicians working at Hospital Adão Pereira Nunes, Saracuruna, Duque de Caxias. Participants were distributed to 2 groups, according with years of graduation (up to 8 years, n = 26; and over 8 years, n = 24). Data were tested for significant differences by Mann-Whitney and Chi-square tests, at a significance level of 5%. Results: The majority of the participants, regardless of the group, referred patients to the dentist, and the main reason was the presence of intra-oral lesions. Most respondents pointed to gingival bleeding as a primary symptom of periodontal disease. Almost 100% of the participants indicated a relationship between periodontal disease and systemic diseases; moreover, cardiovascular disease was the most frequently cited. Books and scientific periodicals were the main source of obtaining information on the matter. Conclusion: The great majority of participants physicians are aware of the relationship between periodontal diseases and systemic diseases, mainly cardiovascular diseases. This was evidenced by the high referral rate of patients to dentists and the knowledge about the clinical signs of periodontal disease.

Arteritis de Takayasu / Takayasu arteritis

Introducción: La arteritis de Takayasu es una vasculitis sistémica considerada como una enfermedad rara. Su mecanismo etiopatogénico se basa en un proceso inflamatorio que afecta la arteria aorta y sus grandes ramas. La ausencia de pulso, la angiodinia, los trastornos hipertensivos y la presencia de nódulos en miembros inferiores se describen como sus principales manifestaciones clínicas. Objetivo: Dar a conocer las principales manifestaciones clínicas que permiten la sospecha diagnóstica de la arteritis de Takayasu en la atención primaria de salud. Caso clínico: Se presenta el caso de una paciente de 36 años de edad, la cual acude con manifestaciones clínicas que hace que se sospeche y finalmente se realice el diagnóstico de arteritis de Takayasu. Conclusiones: La sospecha clínica de la enfermedad se basa en una adecuada historia clínica, epidemiológica y hallazgos de laboratorio, los cuales son perfectamente detectables en la atención primaria de salud(AU)

Introduction: Takayasu arteritis is a systemic vasculitis considered a rare disease. Its etiopathogenic mechanism is based on an inflammatory process that affects the aorta and its large branches. The absence of pulse, the angiodynia, the hypertensive disorders and the presence of nodules in the lower limbs are described as their main clinical manifestations. Objective: To present the main clinical manifestations that allows the diagnostic suspicion of Takayasu arteritis in primary health care. Clinical case: 36-year-old female patient, which presents clinical manifestations that allow the diagnosis of Takayasu arteritis. Conclusions: The clinical suspicion of the disease is based on adequate clinical, epidemiological and laboratory findings, which are perfectly detectable in primary health care(AU)

Diagnóstico de Arteritis de Takayasu, un caso infrecuente / Diagnosis of Takayasu's Arteritis, an infrequent case

Introducción: la arteritis de Takayasu es considerada como una rara enfermedad que afecta fundamentalmente a mujeres jóvenes donde produce alteraciones en la aorta y sus principales ramas. Esta vasculitis tiene su sustento epidemiológico en la inflamación de las paredes de los vasos sanguíneos lo que determina la intensidad y severidad de las manifestaciones clínicas de la enfermedad. Objetivo: socializar las principales manifestaciones clínicas, elementos epidemiológicos y exámenes complementarios que permiten realizar el diagnóstico de la arteritis de Takayasu. Caso clínico: se presenta el caso de una paciente de 46 años de edad la cual es referida desde la atención primaria de salud, con manifestaciones clínicas y de laboratorio que permiten confirmar el diagnóstico de la arteritis de Takayasu. Conclusiones: Las manifestaciones generales, oftalmológicas y cardiovasculares fueron las más representativas en este caso. La identificación de la misma, unidos a los elementos epidemiológicos y los resultados de los exámenes complementarios constituyeron los pilares diagnósticos de la enfermedad. Los esteroides e inmunosupresores son los grupos farmacéuticos más utilizados en el tratamiento de la AT. Un elevado por ciento de pacientes requieren tratamiento quirúrgico(AU)

Introduction: Takayasu arteritis is considered a rare disease that affects mainly young women where it produces alterations in the aorta and its main branches. This vasculitis has its epidemiological sustenance in the inflammation of the walls of the blood vessels which determines the intensity and severity of the clinical manifestations of the disease. Objective: to socialize the main clinical manifestations, epidemiological elements and complementary tests that allow the diagnosis of Takayasu arteritis. Clinical case: the case of 46-year-old patient is presented, which is referred from primary health care, with clinical and laboratory manifestations that confirm the diagnosis of Takayasu's arteritis. Conclusions: The general, ophthalmological and cardiovascular manifestations were the most representative in this case. The identification of the same, together with the epidemiological elements and the results of the complementary tests constituted the diagnostic pillars of the disease. Steroids and immunosuppressants are the pharmaceutical groups most used in the treatment of TA. A high percentage of patients require surgical treatment(AU)

Associação entre a periodontite apical e o diabetes mellitus: uma revisão da literatura / Association between apical periodontitis and diabetes mellitus: a literature review

Objetivo: realizar uma revisão de literatura para verificar a relação entre o diabetes mellitus e a periodontite apical (PA). Revisão da literatura: a PA caracteriza-se por uma perda óssea na região do ápice dental, que decorre principalmente da contaminação do sistema de canais radiculares. Embora a PA seja um processo inflamatório local, na região do periápice radicular, sua progressão pode ser influenciada por patologias sistêmicas, como o diabetes. O diabetes melittus é uma patologia crônica na qual há alteração na produção de insulina ou resistência à ação desta, esse hormônio auxilia a manter a concentração normal de glicose sanguínea. O quadro de hiperglicemia crônica presente no paciente diabético descompensado ocasiona alterações fisiológicas, que permitem suspeitar de uma relação entre o diabetes e a progressão de lesões periapicais. Considerações finais: a literatura estudada sugere uma associação positiva entre a presença do diabetes e a progressão de lesões periapicais. Porém, apesar de os estudos apontarem que existe uma maior prevalência de periodontite apical em diabéticos, ainda são poucas as evidências científicas sobre o assunto. (AU)

Objective: the present study aims to review the lit-erature to verify the relationship between diabetes mellitus and apical periodontitis (AP). Literature Review: the AP is characterized by bone loss in the tooth apex region, mainly resulting from the contamination of the root canal system. Although AP is a local inflammatory process in the root peri-apex region, its development may be affected by systemic pathologies such as diabetes. Diabetes mellitus is a chronic condition that causes chang-es in insulin production or the resistance to its action, considering this hormone helps maintain-ing the normal concentration of blood glucose. The chronic hyperglycemia condition in decom-pensated diabetic patients causes physiological changes that allow establishing a relationship be-tween diabetes and the development of the peri-apical lesions. Final considerations: the literature studied suggests a positive association between the presence of diabetes and the development of periapical lesions. However, although studies in-dicate a higher prevalence of apical periodontitis in diabetics, there is still little scientific evidence on the subject. (AU)

Porphyromonas gingivalis and its impact on periodontal health and systemic diseases: a concise review

Periodontitis is defined as a multifactorial chronic inflammatory disease, associated to a dys-biotic biofilm and characterized by the progressive destruction of the periodontal attachment. Clinical studies have revealed the presence of 10 to 15 bacterial species that are potential periodontal pathogens in adults. From these, the most cited are Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Tannerella forsythia. The aim of this article is to review P. gingivalis' characteristics and impact on periodontal and systemic health. Different studies have reported a relation between the presence of P. gingivalis and periodontal disea-se. P. gingivalis was one of the most frequently detected species in aggressive and chronic periodontitis. This is due to its unique ability to avoid the host's immune response and con-tribute to the development of the destructive process. P. gingivalis, although only present in low frequency, is pathogenic because of its ability to induce dysbiotic microbial communities. There is more evidence that P. gingivalis might invade cardiovascular cells and tissues causing inflammation. It has been suggested that NLRP3 inflammasome plays a key role in the deve-lopment of vascular inflammation and atherosclerosis. The repeated exposure to P. gingiva-lis, produces neuroinflammation, neurodegeneration and formation of intra and extracellular amyloid plaques, which are pathognomonic signs of Alzheimer's disease

Research status of the relationship between periodontitis and systemic disease / 口腔疾病防治

@#Periodontitis is a common infectious disease that is harmful to human oral health and is the main cause of tooth loss. Periodontal inflammation can damage the integrity of the epithelium, causing periodontal pathogens to spread to the systemic circulation, and the periodontal pocket contains a large number of inflammatory mediators, especially those related to chronic inflammation, such as tumor necrosis factor-α, interleukins and prostaglandins, which will enter the blood circulation system from periodontal pocket and cause systemic inflammatory response. Periodontitis is closely related to the occurrence and development of systemic diseases, including cardiovascular, endocrine, respiratory, immune, and nervous systems. Inflammatory responses and inflammatory factors may be the mechanism of the association between periodontitis and multiple systemic diseases. This article reviews the current research on the relationship between periodontitis and systemic disease.

Doença sistêmica relacionada à IgG4 com linfopenia: relato de caso e breve revisão de literatura / IgG4-related systemic disease associated with lymphopenia: case report and brief literature review

A doença sistêmica relacionada à IgG4 é uma doença emergente, recentemente descrita, caracterizada clinicamente por aumento parcial ou total de um órgão, e, por isso, com amplo espectro de manifestações clínicas. Esta é uma doença sistêmica fibroinflamatória, patologicamente provocada pela infiltração de plasmoblastos IgG4 positivos que levam à inflamação eosinofílica do tecido e, consequentemente, fibrose estoriforme. Quando o diagnóstico é precoce, a melhora clínica e resposta sustentada com corticosteroides sistêmicos é impressionante. O diagnóstico é baseado em critérios patológicos, mas, recentemente, alguns trabalhos têm descrito que plasmoblastos no soro podem servir como um fator independente para auxiliar no diagnóstico da doença. Este artigo descreve uma apresentação atípica da doença relacionada à IgG4, em um paciente linfopênico com medição inconclusiva de plasmoblastos no soro.

IgG4-related systemic disease is a recently described, emerging condition, clinically characterized by partial or total enlargement of an organ, with a broad spectrum of clinical manifestations. It is a systemic fibroinflammatory condition caused by the infiltration of IgG4-positive plasmablasts that lead to eosinophilic inflammation of tissues and consequently storiform fibrosis. When diagnosis is early, clinical improvement and maintained response achieved with systemic corticosteroids is impressive. Diagnosis is based on pathological criteria, but recent papers have described that serum plasmablasts may serve as an independent factor to aid in diagnosis. This paper describes an atypical presentation of IgG4-related disease in a lymphopenic patient with inconclusive serum plasmablast measurement.

Influence of periodontal treatment on rheumatoid arthritis: a systematic review and meta-analysis / Influência do tratamento periodontal na artrite reumatoide: revisão sistemática e metanálise

ABSTRACT Objective: To evaluate the influence of periodontal treatment on rheumatoid arthritis activity. Methods: MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5. Results: Four articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: -1.18; 95% CI: -1.43, -0.93; p < 0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend toward reduction (not statistically significant). Conclusions: The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.

RESUMO Objetivo: Avaliar a influência do tratamento periodontal sobre a atividade da doença na artrite reumatoide. Métodos: Pesquisaram-se as bases de dados Medline/PubMed, The Cochrane Library, Clinical Trials, SciELO e Lilacs em busca de estudos publicados até dezembro de 2014. Incluíram-se estudos prospectivos que avaliaram pacientes com mais de 18 anos diagnosticados com periodontite e artrite reumatoide submetidos a tratamento periodontal não cirúrgico; os estudos deveriam ter também um grupo controle não submetido a tratamento periodontal. Os resultados dos estudos deveriam contar com pelo menos um marcador da atividade da doença na artrite reumatoide. A qualidade metodológica dos estudos foi avaliada com a escala PEDro. Reuniram-se os dados quantitativos em uma metanálise estatística com o uso do Review Manager 5. Resultados: Incluíram-se quatro artigos. O tratamento periodontal não cirúrgico esteve associado a uma redução significativa no DAS-28 (OR: -1,18; IC 95%: -1,43 a -0,93; p < 0,00001). A velocidade de hemossedimentação, a proteína C-reativa, a avaliação da atividade reumatoide pela escala visual analógica e as contagens de articulações sensíveis e inchadas apresentaram uma tendência de redução (não estatisticamente significativa). Conclusões: A redução no DAS-28 em pacientes com artrite reumatoide após tratamento periodontal sugere que a melhoria na condição periodontal é benéfica a esses pacientes. São necessários mais ensaios clínicos randomizados controlados para confirmar esse achado.

Recent progression on tear fluid markers in systemic disease / 眼科新进展

Tear is a complex fluid mainly secreted by lacrimal gland.It is a complex body fluid,which may contain thousands of protein/peptides and other molecules.Studies have determined that the changes in the chemical compositions of tears play an important role in some diseases and their progression.Tear components including protein,lipid and metabolites,which is easy to be obtained,not only can be used for biomarkers,can also be used to study an eye the onset of systemic disease process.Measuring the changes in composition of tear may be used to determine the critical path of the disease development,provide a new possibility for prevention and treatment.This article reviews the ophthalmic applications of tear markers in the systemic disease,which has not been determined so far.

How Can We Treat Cancer Disease Not Cancer Cells? / Journal of the Korean Cancer Association, 대한암학회지

Since molecular biology studies began, researches in biological science have centered on proteins and genes at molecular level of a single cell. Cancer research has also focused on various functions of proteins and genes that distinguish cancer cells from normal cells. Accordingly, most contemporary anticancer drugs have been developed to target abnormal characteristics of cancer cells. Despite the great advances in the development of anticancer drugs, vast majority of patients with advanced cancer have shown grim prognosis and high rate of relapse. To resolve this problem, we must reevaluate our focuses in current cancer research. Cancer should be considered as a systemic disease because cancer cells undergo a complex interaction with various surrounding cells in cancer tissue and spread to whole body through metastasis under the control of the systemic modulation. Human body relies on the cooperative interaction between various tissues and organs, and each organ performs its specialized function through tissue-specific cell networks. Therefore, investigation of the tumor-specific cell networks can provide novel strategy to overcome the limitation of current cancer research. This review presents the limitations of the current cancer research, emphasizing the necessity of studying tissue-specific cell network which could be a new perspective on treating cancer disease, not cancer cells.

Knowledge and Attitude of General Dentists and Last-year Students Regarding the Management of Medically Compromised Patients in Shiraz, Iran.

Background: An increase in the number of medically compromised patients in dental clinics may cause serious problems for practicing dentists all over the world. When a dentist does not understand well the relationship between oral and systemic diseases, dental care may become a quite complicated issue. The present study was conducted to analyse the level of general dentists’ knowledge about systemic disease management in Shiraz, Iran. Materials and Methods: As a cross-sectional descriptive survey of private dental practitioners, the current study was conducted in Shiraz, Iran, from September through November 2010. In order to evaluate general dentists' knowledge, experience and perceptions of medical emergencies in dental offices, a cross-sectional questionnaire approach was applied. Results: Out of 120 general dentists, only 57 filled out the questionnaire. Among these, 15 dentists (25.86%) had good knowledge, 21 (36.20%) had moderate knowledge and 22 (37.93%) had a poor level of knowledge. The knowledge score differences of males and females were not statistically significant (p=0.439). No significant relationship was observed between the dentists' knowledge and their school of graduation (p=0.256). When treating patients with systemic diseases, 43% of the dentists mentioned that they consulted with their medical colleagues. A total of 68 last-year students also filled out the questionnaire. Among them, 65 students (95.58%) had good knowledge about systemic disease management and only three (4.42%) were at the moderate level. The knowledge scores of the students were significantly higher than that of practitioner dentists (p=0.005). Conclusion: The knowledge of some Iranian dentists regarding the management of medically compromised patients is not at an acceptable level, and continuing post-graduate education courses beyond dental school seems necessary. It is also recommended to think about broadening the scenario for practice during undergraduate courses.

Diffusion of Knowledge Related to Systemic Disease among Dental Hygienists / 치위생과학회지

This study was aimed to identify the diffusion of systemic disease-related knowledge among dental hygienists. Two hundreds and eleven dental hygienists were selected for the study. Data was collected between August 31, 2015 and September 20, 2015 by handing out questionnaires. Returned questionnaires were analyzed by descriptive statistics, t-test, and ANOVA. Dental hygienists showed overall mean of 0.64 on the systemic disease related knowledge. Age, education level, career, and educational experience showed significant influence on the systemic disease knowledge (p<0.01). Dental hygienists revealed overall mean of 0.61 (full mark=1) on the usefulness recognition of systemic disease related knowledge. Age (p<0.001), education level (p<0.01), career (p<0.001), and educational experience (p<0.01) showed significant effects on the usefulness recognition of systemic disease knowledge. Degree of how dental hygienists apply the systemic disease-related knowledge to the service was mean 0.86 (full mark=2). Age (p<0.01), education level (p<0.01), career (p<0.01), and educational experience (p<0.001) had significant impacts on how dental hygienists apply the systemic disease related knowledge to the service. The diffusion of systemic disease knowledge among dental hygienists was 2.17, which represented ‘persuade’. These results indicated that a study is needed to understand the diffusion of systemic disease knowledge among dental hygienists and to identify obstacles in the process. Moreover, an education program should be developed to offer practical training on the systemic disease-related knowledge. Further studies should evaluate the effectiveness of the program.

The association between periodontitis and systemic disease among Korean adults / 대한구강보건학회지

OBJECTIVES: Periodontal disease has developed not only as a localized factor of oral disease, but also as an important factor related to diabetes, cardiovascular disease, hypertension, and smoking. The aim of this study was to investigate the association between periodontitis and systemic disease by utilizing the representative national health nutrition survey in Korea. METHODS: Study participants without any missing data were selected from the sixth (2014) national health nutrition survey, which included 5,604 individuals with periodontal pocket depth. To determine that periodontal disease was associated not only with localized factors but with various factors interacting with each other, parameters such as hypertension, diabetes, heart disease, dyslipidemia, alcohol intake, smoking, age, level of education, income, regular visits to a dentist, frequency of toothbrushing, and presence of a dental cavity were investigated and evaluated anemic factors with CPITN. The associations were analyzed using the chi-square test and multiple logistic regression. RESULTS: Only hypertension was found to influence periodontitis independently [95% confidence interval: 0.6-0.9]. CONCLUSIONS: A statistically significant association between hypertension and periodontal disease was noted and this association is expected to be fundamental data for future studies.