Geographical barriers to the use of toothpaste containing ≥1000 ppm fluoride in peruvian children / Barreras geográficas para el uso de pasta dental con fluoruro ≥1000 ppm en niños peruanos

Objective: The aim of this was to determine the geographical barriers for the use of equal or more than 1000 (≥1000) parts per million (ppm) of toothpaste with fluorine (F) in children aged 1 to 11 years in Peru in 2018. Material and Methods: This is a cross-sectional study, the database of Demographic and Family Health Survey (ENDES, for its Spanish acronym) of Peru in 2018 was used; the final sample was 25660 records of children between 1 and 11 years old. The variables evaluated were the use of ≥1000 ppm fluoride toothpaste, place of residence, natural region, area of residence, region, wealth index, access to dental service, whether information was received about oral hygiene, daily tooth brushing, age and sex. A descriptive, bivariate (Chi square) and multivariate (log-linear Poisson regression) analysis was performed. Results: An association was found between the use of toothpaste ≥1000 ppm F with place of residence: small city vs capital-large city with an adjusted prevalence ratio (RPa): 0.94; 95% confidence interval (95% IC): 0.90-0.98, town and country vs. capital-large city both with an RPa: 0.95; 95% CI: 0.91-0.99. With natural region: rest of the Coast vs Lima with RPa: 0.94; 95% CI: 0.91-0.98, Sierra vs Lima with RPa: 0.95; 95% CI: 0.92-0.99 and Jungle vs Lima with RPa: 0.94; 95% CI: 0.90-0.98). Conclusion: The place of residence and the natural region are geographic barriers to the use ≥1000 ppm fluoride toothpaste in children aged between 1 and 11 years in Peru in 2018.

Objetivo: El objetivo de este fue determinar las barreras geográficas para el uso de igual o más de 1000 (≥1000) partes por millón (ppm) de pasta dental con flúor (F) en niños de 1 a 11 años en Perú en 2018. Material y Métodos: Se trata de un estudio transversal, la base de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) del Perú en 2018 fue usada con una muestra de 25 660 registros de niños entre 1 y 11 años. Las variables evaluadas fueron el uso de pasta dental ≥1000 ppm F, lugar de residencia, región natural, área de residencia, región, índice de riqueza, acceso al servicio odontológico, si se recibió información sobre higiene bucal, cepillado diario de dientes, edad y sexo. Se realizó un análisis descriptivo, bivariado (Chi cuadrado) y multivariado (regresión loglineal de Poisson). Resultados: Se encontró una asociación entre el uso de pasta dental ≥1000 ppm F con el lugar de residencia: ciudad pequeña vs ciudad capital-grande con una razón de prevalencia ajustada (RPa): 0,94; intervalo de confianza de 95% (IC 95%): 0,90-0,98, ciudad y campo vs. capital-grande ciudad ambos con un RPa: 0,95; IC 95%: 0,91-0,99. Con región natural: resto de la Costa vs Lima con RPa: 0,94; IC 95%: 0,91-0,98, Sierra vs Lima con RPa: 0,95; IC 95%: 0,92-0,99 y Selva vs Lima con RPa: 0,94; 95% % CI: 0,90-0,98. Conclusión: El lugar de residencia y la región natural son barreras geográficas para el uso de pasta dental fluorada ≥1000 ppm en niños de 1 a 11 años en Perú en 2018.

Do Only Calcium and Vitamin D Matter? Micronutrients in the Diet of Inflammatory Bowel Diseases Patients and the Risk of Osteoporosis.

Osteoporosis is one of the most common extraintestinal complications among patients suffering from inflammatory bowel diseases. The role of vitamin D and calcium in the prevention of a decreased bone mineral density is well known, although other nutrients, including micronutrients, are also of extreme importance. Despite the fact that zinc, copper, selenium, iron, cadmium, silicon and fluorine have not been frequently discussed with regard to the prevention of osteoporosis, it is possible that a deficiency or excess of the abovementioned elements may affect bone mineralization. Additionally, the risk of malnutrition, which is common in patients with ulcerative colitis or Crohn's disease, as well as the composition of gut microbiota, may be associated with micronutrients status.

Reproducibility of 19 F-MR ventilation imaging in healthy volunteers.

PURPOSE: To assess the reproducibility of percentage ventilated lung volume (%VV) measurements in healthy volunteers acquired by fluorine (19 F)-MRI of inhaled perfluoropropane, implemented at two research sites. METHODS: In this prospective, ethically approved study, 40 healthy participants were recruited (May 2018-June 2019) to one of two research sites. Participants underwent a single MRI scan session on a 3T scanner, involving periodic inhalation of a 79% perfluoropropane/21% oxygen gas mixture. Each gas inhalation session lasted about 30 seconds, consisting of three deep breaths of gas followed by a breath-hold. Four 19 F-MR ventilation images were acquired per participant, each separated by approximately 6 minutes. The value of %VV was determined by registering separately acquired 1 H images to ventilation images before semi-automated image segmentation, performed independently by two observers. Reproducibility of %VV measurements was assessed by components of variance, intraclass correlation coefficients, coefficients of variation (CoV), and the Dice similarity coefficient. RESULTS: The MRI scans were well tolerated throughout, with no adverse events. There was a high degree of consistency in %VV measurements for each participant (CoVobserver1 = 0.43%; CoVobserver2 = 0.63%), with overall precision of %VV measurements determined to be within ± 1.7% (95% confidence interval). Interobserver agreement in %VV measurements revealed a high mean Dice similarity coefficient (SD) of 0.97 (0.02), with only minor discrepancies between observers. CONCLUSION: We demonstrate good reproducibility of %VV measurements in a group of healthy participants using 19 F-MRI of inhaled perfluoropropane. Our methods have been successfully implemented across two different study sites, supporting the feasibility of performing larger multicenter clinical studies.

Efeito do dentifrício com alta concentração de flúor na desmineralização do esmalte dental relacionado à microdureza / Effect of high-fluoride dentifrice on the enamel demineralization related in concern to microhardness

Objetivo: Avaliar a efetividade do dentifrício de alta concentração de F na diminuição do processo de desmineralização do esmalte. Material e Métodos: Foram confeccionadas trinta amostras de esmalte bovino, as quais foram lixadas, polidas e obtida a microdureza (Knoop) inicial. As amostras foram distribuídas aleatoriamente em três grupos (G): DP - dentifrício sem F (placebo), DC - dentifrício convencional (1450 ppmF) e DAC - dentifrício de alta concentração (5000 ppmF). Para avaliar o processo dinâmico de desmineralização, cada grupo foi submetido a uma ciclagem de pH com solução desmineralizante e solução remineralizante. As amostras foram imersas durante 6 e 18h nas respectivamente soluções, durante cinco dias, a 37oC. O dentifrício correspondente a cada grupo foi diluído (1:3) e as amostras foram tratadas por 1 minuto, duas vezes ao dia. Após a ciclagem, foi realizada a análise da microdureza final e aplicado ANOVA e Tukey (p<0,05). Resultados: Os resultados mostraram que a microdureza final do DAC (247,4?39,4) comparada ao DC (211,9?53,5) mostrou diferença estatística (p?0,05). Conclusão: De acordo com os resultados, pode-se sugerir que o dentifrício de alta concentração de Flúor apresenta resultados superiores na inibição do processo de desmineralização do esmalte quando comparado ao dentifrício convencional

Introduction: The possibility of intervening in the dissolution of enamel, significantly reducing the loss of minerals, and of reversing the progress of demineralization makes fluoride an essential aid to oral health. Objective: To evaluate the effectiveness of high-fluoride dentifrice in decreasing the process of enamel demineralization. Material and Methods: Thirty samples of bovine enamel were confectioned, sanded, polished and tested for determining their initial Knoop hardness. The samples were randomly divided into 3 groups: PD ­ Placebo Dentifrice (dentifrice without fluoride), CD ­ Conventional Dentifrice (1,450 ppmF), and HFD ­ High-Fluoride Dentifrice (5,000 ppmF). To evaluate the dynamic process of demineralization, each group was subjected to pH cycling with demineralizing and remineralizing solutions. The samples were immersed for 6 and 18 hours respectively in those solutions for 5 days at 98.6ºF. The dentifrice corresponding to each group was diluted (1:3) and the samples were treated for 1 minute, twice a day. After cycling, a final microhardness analysis was performed, using ANOVA and Tukey's test (p<0.05). Results: The results showed that the hardness of the final HFD (247.4 ± 39.4 *) compared to CD (211.9 ± 53.5) showed no statistical difference (p ? .05). Conclusion: According to the results, it can be suggested that the high concentration of fluoride in dentifrice exhibited superior results in inhibition of enamel demineralization process than conventional dentifrice.

Dynamic susceptibility contrast 19 F-MRI of inhaled perfluoropropane: a novel approach to combined pulmonary ventilation and perfusion imaging.

PURPOSE: To assess alveolar perfusion by applying dynamic susceptibility contrast MRI to 19 F-MRI of inhaled perfluoropropane (PFP). We hypothesized that passage of gadolinium-based contrast agent (GBCA) through the pulmonary microvasculature would reduce magnetic susceptibility differences between water and gas components of the lung, elevating the T2∗ of PFP. METHODS: Lung-representative phantoms were constructed of aqueous PFP-filled foams to characterize the impact of aqueous/gas phase magnetic susceptibility differences on PFP T2∗ . Aqueous phase magnetic susceptibility was modulated by addition of different concentrations of GBCA. In vivo studies were performed to measure the impact of intravenously administered GBCA on the T2∗ of inhaled PFP in mice (7.0 Tesla) and in healthy volunteers (3.0 Tesla). RESULTS: Perfluoropropane T2∗ was sensitive to modulation of magnetic susceptibility difference between gas and water components of the lung, both in phantom models and in vivo. Negation of aqueous/gas phase magnetic susceptibility difference was achieved in lung-representative phantoms and in mice, resulting in a ~2 to 3× elevation in PFP T2∗ (3.7 to 8.5 ms and 0.7 to 2.6 ms, respectively). Human studies demonstrated a transient elevation of inhaled PFP T2∗ (1.50 to 1.64 ms) during passage of GBCA bolus through the lung circulation, demonstrating sensitivity to lung perfusion. CONCLUSION: We demonstrate indirect detection of a GBCA in the pulmonary microvasculature via changes to the T2∗ of gas phase PFP within directly adjacent alveoli. This approach holds potential for assessing alveolar perfusion by dynamic susceptibility contrast 19 F-MRI of inhaled PFP, with concurrent assessment of lung ventilation properties, relevant to lung physiology and disease.

Application of Trifluoroacetic Acid as a Theranostic Agent for Chemical Ablation of Solid Tissue.

PURPOSE: To evaluate trifluoroacetic acid (TFA) as a theranostic chemical ablation agent and determine the efficacy of TFA for both noninvasive imaging and tissue destruction. MATERIALS AND METHODS: Fluorine-19 magnetic resonance imaging (19F-MRI) was optimized at 7 T using a custom-built volume coil. Fluorine images were acquired with both rapid acquisition with relaxation enhancement and balanced steady-state free precession (bSSFP) sequences with varying parameters to determine the optimal sequence for TFA. The theranostic efficacy of chemical ablation was examined by injecting TFA (100 µL; 0.25, 0.5, 1.0, and 2.0M) into ex vivo porcine liver. 19F and proton MRI were acquired and superimposed to visualize distribution of TFA in tissue and quantify sensitivity. Tissue damage was evaluated with gross examination, histology, and fluorescence microscopy. RESULTS: The optimal 19F-MRI sequence was found to be bSSFP with a repetition time of 2.5 ms and flip angle of 70°. The minimum imageable TFA concentration was determined to be 6.7 ± 0.5 mM per minute of scan time (0.63×0.63×5.00 mm voxel), and real-time imaging (temporal resolution of at least 1 s-1) was achieved with 2M TFA both in vitro and in ex vivo tissue. TFA successfully coagulated tissue, and damage was locally confined. In addition to hepatic cord disruption, cytoskeletal collapse and chromatin clumping were observed in severely damaged areas in tissues treated with 0.5M or higher TFA concentrations. CONCLUSIONS: TFA was determined to be a theranostic agent for chemical ablation of solid tissue. Ablation was both efficacious and imageable in ex vivo healthy tissue, even at low concentrations or with high temporal resolution.

Identification and Analysis of the Fluoride Concentration in Toothpastes Intended for Children

Objective: To identify the commercially available toothpastes intended for children and their total soluble fluoride concentrations (TSF). Material and Methods: Twelve brands of toothpastes intended for children marketed in supermarkets and pharmacies were found and analyzed: Bitufo®; Colgate Smile®; Lilica Ripilica®; Even Baby®; Turma da Mônica Baby®; Loney Tunes®; Loney Tunes Baby®; Malvatrikds Baby®; Oral B Stages®; Sanifil Kids®; Tandy®; Tra-lálá Baby®. Duplicate samples of each toothpaste were weighed (+/- 90 to 110 mg) and diluted in 10 mL of distilled water under stirring. To evaluate soluble fluoride, duplicate aliquots of supernatant suspensions were evaluated on specific ion fluoride electrode calibrated with fluoride standard solutions and results expressed in ppm F according to established protocol. Results: According to information provided by manufacturers, 5 non-fluoridated toothpastes, 3 toothpastes with less than 1000 ppm F and 4 toothpastes with conventional fluoride concentration (1100 ppm F) were identified. After analysis of soluble fluoride of fluoridated toothpastes, only 02 presented TSF concentration equal to or greater than 1000 ppm F. The TSF concentration (mean ± SD) for all samples ranged from 8.2 ± 0.1 to 1065.9 ± 24.7 ppm F. Conclusion: Few toothpastes intended for children presented soluble fluoride concentrations capable of preventing dental caries. Additionally, regulatory measures need to be implemented for the marketing of toothpastes intended for children with at least 1000 ppm of soluble fluoride, especially in locations without other sources of fluoride (fluoridated water) for the population.

Comparación de concentración y excreción de flúor, con y sin fortificación de flúor en sal, costa rica 2005 / Comparison of fluoride concentration and excretion in fortified and non-fortified salt use. Costa Rica 2005

Resumen Objetivo: Determinar la concentración y excreción de flúor en orina de 24 horas en 4 grupos de edad y la exposición de flúor en uñas, sin y con fluoruración de la sal, después de un periodo de interrupción de siete meses. Cartago 2004-2005. Metodología: Muestra no probabilística y secuencial de 127 individuos distribuidos en cuatro grupos poblacionales (4-6, 10-12, 15-17 y 35-60 años de edad). El análisis de flúor en orina, agua y sal se realizó con el electrodo específico. El análisis de flúor en uñas se realizó mediante el análisis de difusión facilitada con hexametildisiloxano (HMDS). Se calculó la concentración de flúor en orina, uñas, agua y sal, así como la excreción de flúor en orina. Resultados: En el periodo sin sal fluorurada (fase 1), 90,5% de muestras de sal tenían menos de 15,8 mgF/kg (promedio 22,7 mgF/kg) y el agua un promedio de 0,25 mgF/l; en el periodo con sal fluorurada (fase 2) el promedio de flúor en sal fue de 143,5 mgF/kg, siempre con la concentración de agua de 0,25 mgF/l. La excreción urinaria de 24 horas y la concentración de flúor con 7 meses sin sal fluorurada en ambos casos fue menor en la fase I en los cuatro grupos de edad. Con sal fluorurada (fase II) la excreción aumentó en 80% en promedio, en todos los grupos de edad. Por el contrario, la concentración de flúor en uñas, fue más elevada durante la fase 1, sin diferencias significativas entre grupos ni entre fases. Conclusión: La interrupción de la fluoruración de la sal en Costa Rica permitió medir la presencia de éste elemento en la población centinela (control), confirmando que el organismo mantiene el flúor aún por 7 meses después de dejar de ingerir flúor independiente de la edad. La medición de la concentración de flúor en uñas podría constituirse en un método de medición de éste elemento para complementar el estudio de flúor en el organismo humano.

Abstract Objective: To determine the concentration and excretion of fluoride in urine of 24 hours in 4 age groups and fluoride exposure in nails, without and with fluoridation of the salt, after a period of interruption of seven months. Cartago 2004-2005. Methodology: Non-probabilistic and sequential sample of 127 individuals distributed in four population groups (4-6, 10-12, 15-17 and 35-60 years of age). The analysis of fluorine in urine, water and salt was performed with the specific electrode. Nail fluoride analysis was performed by diffusion analysis provided with hexamethyldisiloxane (HMDS). The concentration of fluoride in urine, nails, water and salt, as well as the excretion of fluoride in urine was calculated. Results: In the period without fluoridated salt (phase 1), 90.5% of salt samples had less than 15.8 mgF / kg (average 22.7 mgF / kg) and water averaged 0.25 mgF / L; In the period with fluorided salt (phase 2) the average fluoride in salt was 143.5 mgF / kg, always with the water concentration of 0.25 mgF / l. The 24-hour urinary excretion and fluoride concentration at 7 months without fluoridated salt in both cases was lower in phase I in all four age groups. With fluoridated salt (phase II) excretion increased by 80% on average in all age groups. In contrast, the fluoride concentration in nails was higher during phase 1, without significant differences between groups or between phases. Conclusion: The interruption of fluoridation of salt in Costa Rica allowed the measurement of the presence of this element in the sentinel population (control), confirming that the organism maintains the fluoride still for 7 months after stopping ingesting fluorine independent of age. The measurement of the concentration of fluoride in nails could constitute a method of measuring this element to complement the study of fluorine in the human organism.

[Electronic probe analysis of enamel remineralization effect of casein phosphopeptide-amorphous calcium phosphate promoted by different concentrations of fluorine].

Objective: To evaluate the remineralization effect and mechanism of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with different concentrations of fluorine on demineralized enamel using electronic probe. Methods: Extracted premolar teeth for orthodontic purpose were immersed into lactic acid gel to prepare artificial white spot lesions (10 teeth in each group). Then the specimens were randomly assigned to three groups: Control group, with 5% of the CPP-ACP+deionized water; Group A with 5% CPP-ACP+500 mg/L F(-) and Group B with 5% CPP-ACP+900 mg/L F(-). The teeth in each group were soaked in different solutions for 4 days and then were measured using electron probe tester. The changes of contents among the three groups were compared. Results: No statistically significant difference in the percentage of fluorine was found in the control group before and after treatment (P=0.06), and the difference in the percentage of fluorine quality in the other two groups was statistically significant (P<0.05). Statistically significant difference was found between calcium oxide and phosphorus peroxide in the three groups before and after mineralization (P<0.05). The percentage change of fluorine mass in group B [(0.107±0.035)%] was significantly greater than that in group A [(0.057±0.038)%] (P<0.05), while fluorine mass in group A was significantly greater than that in control group [(0.013±0.019)%] (P<0.05). In group A and group B, the change in quality of calcium oxide and phosphorus peroxide was significantly greater than that in control group (P<0.05), while no significant difference was found between group A and group B (P>0.05). Conclusions: The addition of fluorine in CPP-ACP increased the transport and penetration of calcium, phosphorus and fluorine on enamel surface.

Development of [18F]AlF-NOTA-NT as PET Agents of Neurotensin Receptor-1 Positive Pancreatic Cancer.

Several studies have suggested that neurotensin receptors (NTRs) and neurotensin (NT) greatly affect the growth and survival of pancreatic ductal adenocarcinoma (PDAC). Developing NTR-targeted PET probes could therefore be important for the management of a pancreatic cancer patient by providing key information on the NTR expression profile noninvasively. Despite the initial success on the synthesis of 18F-labeled NT PET probes, the labeling procedure generally requires lengthy steps including azeotropic drying of 18F. Using a straightforward chelation method, here we report the simple preparation of aluminum-18F-NOTA-NT starting from aqueous 18F. The cell binding test demonstrated that [19F]AlF-NOTA-NT maintained high receptor-binding affinity to NTR1. This probe was then further evaluated in NTR1 positive pancreatic tumor models (AsPC-1 and PANC-1). After the administration of [18F]AlF-NOTA-NT, small animal PET studies showed a high contrast between tumor and background in both models at 1 and 4 h time points. A blocking experiment was performed to demonstrate the receptor specificity: the tumor uptake in AsPC1 without and with blocking agent was 1.0 ± 0.2 and 0.1 ± 0.0%ID/g, respectively, at 4 h post injection. In summary, a NTR specific PET agent, [18F]AlF-NOTA-NT, was prepared through the simple chelation method. This NTR-targeted PET probe may not only be used to detect NTR1 positive pancreatic tumors (diagnosis), but also it may be fully integrated to NTR target therapy leading to personalized medicine (theranostic).

Fluoride concentrations in a range of ready-to-drink beverages consumed in Heilongjiang Province, north-east China.

Consumption of ready-to-drink beverages, as a potential source of fluoride (F), has increased considerably in China over the last decade. To help inform the public and policy makers, this study aimed to measure F concentration of ready-to-drink beverages on sale in Heilongjiang province, north east China. Three batches of 106 drink products manufactured by 26 companies were purchased from the main national supermarkets in Harbin, Heilongjiang province, China. The F concentration of all samples was determined, in triplicate, using a fluoride ion-selective electrode in conjunction with a meter and a direct method of analysis. The products were categorised into 10 groups according to product type. F concentrations of the samples ranged from 0.012-1.625 mg/l with a mean of 0.189 mg/l and a median of 0.076 mg/l. More than half of the products (55%) had an F concentration of ≤0.1 mg/l, while <5% had a F concentration of >0.7 mg/l. The 'tea with milk' group contained the highest mean F concentration (1.350 mg/l), whereas the lowest mean F concentration (0.027 mg/l) was found for the 'fruit juice' group. For some products, such as tea, fruit juice and carbonated beverages, there were substantial variations in F concentration between batches, manufacturers and production sites. In conclusion, ready-to-drink products (apart from tea), sold in Heilongjiang province, China, when consumed in moderation are unlikely to constitute a substantial risk factor for the development of dental or skeletal fluorosis.

[Application study on regional infusion chemotherapy by celiac trunk during operation in advanced gastric cancer patients].

OBJECTIVE: To explore the feasibility, safety and efficacy of intraoperative regional infusion chemotherapy by celiac trunk in advanced gastric cancer patients. METHODS: One hundred and twenty-six patients with advanced gastric cancer(stageII(-III() were screened from database of Gastrointestinal Surgery Department of Taizhou People's Hospital between January 2008 and December 2010 who underwent R0 resection and D2 lymphadenectomy, received postoperative chemotherapy(XELOX or FOLFOX), and had complete follow-up data. They were divided into infusion chemotherapy group (65 cases) and control group (61 cases) according to regional infusion chemotherapy or not (fluorine 1 000 mg and cisplatin 60 mg). The side effects of chemotherapy, parameters related to the operation, long-term survival and relapse rate were compared between the two groups. RESULTS: The baseline data between the two groups were comparable(all P>0.05). Postoperative III( and IIII( adverse reaction of chemotherapy was not significantly different between the two groups (P>0.05). The time of postoperative intestinal function recovery [(67.9±14.8) hours vs. (68.9±15.0) hours, t=-0.380, P=0.705), volume of postoperative 1-week drainage [(66.1±17.1) ml vs.(61.9±18.2) ml, t=1.478, P=0.142], recent morbidity of complications[55.4%(36/65) vs. 49.2%(30/61), χ2=0.256, P=0.613], and the long-term morbidity of complications [16.9% (11/65) vs. 14.8% (9/61), χ2=0.111, P=0.739] were all not significantly different between the two groups. The 3-year survival rate and 3-year relapse-free survival rate in infusion chemotherapy group were significantly higher than those in control group(58.4% vs. 37.7%, χ2=5.382, P=0.020; 58.4% vs. 34.4%, χ2=6.636, P=0.010). CONCLUSION: Regional infusion chemotherapy by celiac trunk during operation for advanced gastric cancer patients is safe and feasible, and can reduce the risk of local recurrence and improve survival rate.

Teething and affecting factors: experiences from Turkey.

BACKGROUND: The aim of this study was to investigate the experiences of Turkish mothers in teething period and the factors affecting teething. METHODS: This study was performed by filling in questionnaire forms with a face-to-face interview technique with the mothers of 792 patients presenting to the outpatient clinics of pediatrics of Fatih (Turgut Ozal) University Faculty of Medicine between 1 April and 31 July 2012. RESULTS: This study was conducted in a total of 792 children (mean age: 24.2±7.9, range 12-42 months; 430 males). Of the study population, 6.1% had a family history of premature teething, 9.7% had a family history of delayed teething, 98% had been breastfed, 91.9% had used vitamin D, 67.6% had used iron supplements, and 3.9% had fluorine use. The first teething was at 7.8±2.5 months and the first teeth to appear was the anterior lower incisor (58.7%). The symptoms the patients had during teething were irritability (64.9%), fever (64.1%), increased mastication (61.6%), increased salivation (58.2%), and diarrhea (45.6%). The rate of admission to a physician with these complaints was 19.6%. The factors affecting the teething time were a family history of premature or delayed teething and birth with natal tooth, and male gender. CONCLUSIONS: In this study we found that nutritional or local factors were not effective on teething time. Teething period was characterized by nonspecific symptoms including irritability, subfebrile fever, increased mastication and salivation, and diarrhea. Linear regression analysis revealed that male gender and a family history of premature teething were the factors responsible from a shortening in teething time.

Concentração de fluoreto nos dentifrícios a base de MFP/CaCO3 mais vendidos no Brasil, ao final dos seus prazos de validade / Fluoride concentration in most sold MFP/CaCO3 -based Brazilian toothpastes at the expiration time

Dentifrício fluoretado deve conter pelo menos 1.000 ppm (mg F/kg) do seu flúor total (FT) na forma quimicamente solúvel (FST) para ter o potencial máximo de interferir com o processo de cárie. Em formulações de dentifrícios contendo cálcio no abrasivo, a concentração de FST (íon flúor + íon MFP) diminui em função do tempo de armazenamento. Os quatro dentifrícios a base de MFP/CaCO3 mais vendidos no Brasil são capazes de manter 1.000 ppm de FST nos produtos pelo prazo de um ano de fabricação, mas não é conhecido o que ocorre até o final do prazo de validade. Assim, o objetivo deste estudo foi avaliar a concentração de FST nesses dentifrícios ao final do seu prazo de validade. Após as análises iniciais realizadas em 2010, os cremes dentais (n=30) foram armazenados à temperatura laboratorial (25°C) e as concentrações de FT e FST foram novamente determinadas em 2012, próximo a data de vencimento (36 meses). As análises foram feitas utilizando protocolo validado de extração, as determinações foram feitas com eletrodo íon específico e os resultados expressos em ppm F (mg F/kg). A concentração (média±dp;n=30) de FT encontrada (1.415,2±62,8) estava de acordo com o declarado pelo fabricante (1.450 ppm F), porém a de FST foi 44% menor (814,7±74,7). Ao final do prazo de validade, os dentifrícios brasileiros mais vendidos não mantêm uma concentração de FST máxima desejável, mostrando tanto a importância do Cirurgião-Dentista na orientação do paciente como a necessidade da revisão da resolução Anvisa nº 79 que regulamenta a matéria sobre dentifrícios

Fluoride toothpaste should contain at least 1,000 ppm (mg F/kg) of fluoride chemically soluble to have the maximum potential to interfere with the caries process. In formulations containing calcium--based abrasives, the concentration of total soluble fluoride (TSF = fluoride ion + MFP ion) decreases according to the storage time. The four MFP/CaCO3-based toothpastes most consumed in Brazil are able to maintain 1,000 ppm of TSF throughout one year of manufacturing, but it is not known if it would be maintained up to the expiration date. Thus, this study evaluated the concentration of TSF in these toothpastes at the end of expiration date. As control, the total fluoride (TF) concentration was also determined. After the analysis of fresh samples conducted in 2010, the toothpastes tube (n=30) were stored at temperature of 25°C and the determinations of TF and TSF concentrations were again assessed in 2012, close to the expiration date of the toothpastes (3 years). The analyses were made using a validated protocol of extraction, the determinations were made with an ion specific electrode and the results were expressed in ppm F (mg F/kg). The concentration (mean±SD;n=30) of TF found (1.415.2±62.8) was according to the declared by the manufacturer (1.450 ppm), but the TSF was 44% lower (814.7±74.7). At expiration, the most sold MFP/CaCO3-based brazilian toothpastes do not maintain the maximum TSF concentration required, showing not only the relevance of the Dentist to advise the patients about this subject, but also the necessity to review the Brazilian regulation about toothpastes

Comparación de barnices y dentífrico con flúor en la prevención de caries en escolares / Comparison of varnishes and fluoridated toothpaste for the prevention of dental caries in school children

Objetivo Comparar el efecto preventivo de caries dental de dos frecuencias de aplicación de barniz fluorado (BF) con un grupo que utilizó instrucciones de cepillado con dentífrico fluorado. Materiales y Método Se siguieron durante 22 meses a 203 niños de una escuela primaria en la delegación Tláhuac, Ciudad de México, quienes fueron asignados aleatoriamente a uno de los siguientes grupos: 1) instrucciones de cepillado con dentífrico fluorado 3 veces al año, 2) BF semestral, 3) BF tres aplicaciones semanales al año. El BF contenía fluorosilano (1000 ppm F), el dentífrico NaF (1450 ppm F). Se registró el índice de caries CPOD y la presencia de manchas blancas usando los criterios del ICDAS (International Caries Detection and Assessment System). Resultados Al inicio del estudio, el promedio de edad fue 9,3 (DE 0,76) años, el promedio de lesiones blancas 0,63 (DE 1,48) y del CPOD 0,70 (DE 1,11). CPOD inicial y final en los tres grupos fueron: instrucciones de cepillado usando dentífrico fluorado 0,67 y 1,17, BF semestral 0,77 y 1,46 y grupo BF 3 aplicaciones 0,67 y 1,03, respectivamente.. De acuerdo a los resultados del modelo GEE (Generalized Estimating Equations), no se detectaron diferencias significativas en el incremento de lesiones blancas o en el CPOD para el índice de caries (CPOD) entre los tres grupo; para el CPOD las aplicaciones semestrales mostraron RR=1,24 (p=0,178) y para 3 aplicaciones RR=0,83, (p=0,298), comparando con el grupo de instrucciones de cepillado con dentífrico fluorado, controlando por edad, sexo, cpod inicial y frecuencia de cepillado. Conclusiones Los escolares mostraron una baja incidencia de caries utilizando cualquiera de los tres regímenes preventivos aplicados.(AU)

Objective To compare preventive effect on dental caries of two frequencies of fluoridated varnish (FV) applications and a group given brushing instructions and using fluoridated toothpaste. Materials and Methods Follow-up study of 203 children attending an elementary school in the municipality of Tláhuac, Mexico City. The children were followed for 22 months. The students were randomly assigned to one of the following groups: 1) brushing instructions with fluoridated toothpaste, 2) FV every six months, 3) three FV applications per week per year. The FV contained fluorosilane (1000 ppm F) and NaF dentifrice (1450 ppm F). The DMFT-caries index and the presence of white spots were recorded (ICDAS, International Caries Detection and Assessment System). Results At baseline, the mean age of the children was 9.3 (SD 0.76) years, white lesions 0.63 (SD 1.48) and DMFT =0.70 (SD 1.11). Averages of the initial and final DMFT scores in the three groups were 0.67 and 1.17 for the toothpaste group, 0.77 and 1.46 for FV twice a year group, and 0.67 y 1.03 for the three-applications-FV group. According to the results of the GEE (Generalized-Estimating Equations) model, there were no significant differences in the rate of white lesions or the increase of the DMFT index. The results for the DMFT were: for bi-annual applications of FV, RR=1.24 (p=0.178) and for the three consecutive applications of FV, RR=0.83, (p=0.298) in comparison with the brushing-instructions group using fluoridated toothpaste, among the three treatment groups, controlling for age, sex, and initial-caries index in primary teeth and brushing frequency. Conclusions Schoolchildren showed a low incidence of caries using any of the three preventive regimens applied.(AU)

FV-162 is a novel, orally bioavailable, irreversible proteasome inhibitor with improved pharmacokinetics displaying preclinical efficacy with continuous daily dosing.

Approved proteasome inhibitors have advanced the treatment of multiple myeloma but are associated with serious toxicities, poor pharmacokinetics, and most with the inconvenience of intravenous administration. We therefore sought to identify novel orally bioavailable proteasome inhibitors with a continuous daily dosing schedule and improved therapeutic window using a unique drug discovery platform. We employed a fluorine-based medicinal chemistry technology to synthesize 14 novel analogs of epoxyketone-based proteasome inhibitors and screened them for their stability, ability to inhibit the chymotrypsin-like proteasome, and antimyeloma activity in vitro. The tolerability, pharmacokinetics, pharmacodynamic activity, and antimyeloma efficacy of our lead candidate were examined in NOD/SCID mice. We identified a tripeptide epoxyketone, FV-162, as a metabolically stable, potent proteasome inhibitor cytotoxic to human myeloma cell lines and primary myeloma cells. FV-162 had limited toxicity and was well tolerated on a continuous daily dosing schedule. Compared with the benchmark oral irreversible proteasome inhibitor, ONX-0192, FV-162 had a lower peak plasma concentration and longer half-life, resulting in a larger area under the curve (AUC). Oral FV-162 treatment induced rapid, irreversible inhibition of chymotrypsin-like proteasome activity in murine red blood cells and inhibited tumor growth in a myeloma xenograft model. Our data suggest that oral FV-162 with continuous daily dosing schedule displays a favorable safety, efficacy, and pharmacokinetic profile in vivo, identifying it as a promising lead for clinical evaluation in myeloma therapy.

Avaliação in situ do potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2, em prevenir a erosão em esmalte dental bovino / In situ assessment of the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation, on preventing dental enamel erosion

Apesar de vários estudos terem demonstrado resultados promissores do uso da solução de AmF/NaF/SnCl2 no controle da erosão do esmalte dental, não existem relatos da sua associação com a irradiação do substrato com o laser de CO2, de comprimento de onda de 9,6 ?m. Desta forma, o presente estudo teve como objetivo avaliar o potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2 (4,5 J/cm2, 20 Hz, 20 ?s), em controlar a erosão em esmalte dental bovino. Treze voluntários participaram desse estudo in situ, de delineamento cruzado, em 02 fases (04 dias cada), onde 04 tratamentos foram testados utilizando réplicas (n = 13): GC - nenhum tratamento (controle negativo); GF - solução de AmF/NaF/SnCl2 (controle positivo); GL - irradiação com laser de CO2 (9,6 ?m); GLF - laser de CO2 associado à solução de AmF/NaF/SnCl2. Os voluntários usaram dispositivos intra-bucais removíveis contendo 08 amostras de esmalte bovino. Na primeira fase, 07 voluntários utilizaram dispositivos intra-bucais contendo amostras dos grupos GC e GL, e outros 06 voluntários utilizaram dispositivos contendo amostras dos grupos GF e GLF. Na segunda fase, os voluntários foram cruzados, permitindo que todos os grupos experimentais fossem avaliados no meio bucal dos 13 voluntários da pesquisa. Os dispositivos intra-bucais foram removidos da boca para ciclagem erosiva ex-situ em ácido cítrico 0,65%, pH 3,6, durante 4 minutos, 2x/dia, em horários pré-determinados. As amostras foram avaliadas em perfilômetro óptico de não-contato (n = 13) para análise da perda de tecido mineral após o desafio erosivo, e um ensaio de ultramicrodureza transversal (n = 13) foi realizado com o objetivo de determinar a profundidade da área de desmineralização abaixo da superfície do esmalte erodido. A análise morfológica foi realizada utilizando microscopia eletrônica de varredura (MEV) (n = 3).

Os dados foram analisados estatisticamente por meio do modelo ANOVA 2 fatores para medidas repetidas, com subsequente comparação entre os diferentes tratamentos (? = 0,05). A ciclagem ácida realizada no presente estudo provocou perda de esmalte significativamente maior (p < 0,001) nos grupos GC (4,8 ± 1,4A ?m) e GL (4,4 ± 2,0A ?m). Não houve diferença estatística entre a perda de superfície nos grupos GF (1,9 ± 0,9B ?m) e GLF (1,7 ± 0,9B ?m). Os resultados de ultramicrodureza transversal mostraram que as amostras tratadas com a solução fluoretada (grupo GF) apresentaram uma zona parcialmente desmineralizada com média de dureza semelhante às amostras do grupo que não recebeu qualquer tipo de tratamento (grupo GC), com ambos os grupos apresentando média de dureza significativamente maior que os grupos que foram irradiados com o laser de CO2 (GL e GLF) (p < 0,001). As micrografias mostraram que as características morfológicas superficiais do esmalte nos grupos irradiados com laser de CO2 apresentaram-se semelhantes nos grupos GL e GLF, verificando-se a presença de áreas sugestivas de derretimento, resolidificação, microporos e microtrincas, sem evidências de precipitados fluoretados no grupo GFL. Uma camada amorfa pôde ser observada nas superfícies de esmalte tratadas apenas com a solução fluoretada contendo estanho. Pode-se concluir que o uso do enxaguatório bucal fluoretado contendo estanho (500 ppm F-, 800 ppm Sn2+, pH = 4,5) mostrou potencial de prevenção da erosão de esmalte dental. A irradiação do esmalte dental com o laser associado à solução fluoretada mostrou-se eficaz, mas seu efeito não foi sinérgico. O laser de CO2 (9,6 ?m), nos parâmetros utilizados, não foi capaz de prevenir a erosão em esmalte causada por ácido cítrico.

Although several studies have shown promising results using the AmF/NaF/SnCl2 solution in preventing the erosion of dental enamel, there are no reports of their association with the irradiation of the substrate with the CO2 laser, working at 9.6 ?m. Thus, this study aimed to evaluate the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation (4.5 J/cm2, 20 Hz, 20 ?s), to prevent erosion on dental enamel. Thirteen volunteers participated in this 2-phase (4 days each), crossover study, where 04 treatments were tested using replicas (n = 13): GC - no treatment (negative control); GF - AmF/NaF/SnCl2 solution (positive control); GL - CO2 laser irradiation (9.6 ?m); GLF - CO2 laser irradiation associated with AmF/NaF/SnCl2 solution. The volunteers wore removable intra-buccal appliances containing eight bovine enamel samples. In the first phase, seven volunteers used intra-oral appliances containing samples of groups GC and GL and 6 volunteers, appliances containing samples of groups GF and GLF. In the second phase volunteers were crossed over, allowing all experimental groups were evaluated in the buccal environment of the 13 volunteers. Intra-buccal appliances were removed from the mouth and were exposed to a daily ex-situ erosive cycling (0.65% citric acid, pH 3.6, for 4 minutes, 2x/day) at pre-determined times. Samples were evaluated for surface loss using an optical non-contact profilometer (n = 13) for analysis of loss of mineral after the erosive challenge and a cross-sectional nanohardness test (n = 13) was carried out in order to determine the depth of demineralized area below the erosive lesion. Morphological analysis was carried out using scanning electron microscopy (SEM) (n = 3).

Avaliação in situ do potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2, em prevenir a erosão em esmalte dental bovino / In situ assessment of the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation, on preventing dental enamel erosion

Apesar de vários estudos terem demonstrado resultados promissores do uso da solução de AmF/NaF/SnCl2 no controle da erosão do esmalte dental, não existem relatos da sua associação com a irradiação do substrato com o laser de CO2, de comprimento de onda de 9,6 ?m. Desta forma, o presente estudo teve como objetivo avaliar o potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2 (4,5 J/cm2, 20 Hz, 20 ?s), em controlar a erosão em esmalte dental bovino. Treze voluntários participaram desse estudo in situ, de delineamento cruzado, em 02 fases (04 dias cada), onde 04 tratamentos foram testados utilizando réplicas (n = 13): GC - nenhum tratamento (controle negativo); GF - solução de AmF/NaF/SnCl2 (controle positivo); GL - irradiação com laser de CO2 (9,6 ?m); GLF - laser de CO2 associado à solução de AmF/NaF/SnCl2. Os voluntários usaram dispositivos intra-bucais removíveis contendo 08 amostras de esmalte bovino. Na primeira fase, 07 voluntários utilizaram dispositivos intra-bucais contendo amostras dos grupos GC e GL, e outros 06 voluntários utilizaram dispositivos contendo amostras dos grupos GF e GLF. Na segunda fase, os voluntários foram cruzados, permitindo que todos os grupos experimentais fossem avaliados no meio bucal dos 13 voluntários da pesquisa. Os dispositivos intra-bucais foram removidos da boca para ciclagem erosiva ex-situ em ácido cítrico 0,65%, pH 3,6, durante 4 minutos, 2x/dia, em horários pré-determinados. As amostras foram avaliadas em perfilômetro óptico de não-contato (n = 13) para análise da perda de tecido mineral após o desafio erosivo, e um ensaio de ultramicrodureza transversal (n = 13) foi realizado com o objetivo de determinar a profundidade da área de desmineralização abaixo da superfície do esmalte erodido. A análise morfológica foi realizada utilizando microscopia eletrônica de varredura (MEV) (n = 3). Os dados foram analisados estatisticamente por meio do modelo ANOVA 2 fatores para medidas repetidas, com subsequente comparação entre os diferentes tratamentos (? = 0,05). A ciclagem ácida realizada no presente estudo provocou perda de esmalte significativamente maior (p < 0,001) nos grupos GC (4,8 ± 1,4A ?m) e GL (4,4 ± 2,0A ?m). Não houve diferença estatística entre a perda de superfície nos grupos GF (1,9 ± 0,9B ?m) e GLF (1,7 ± 0,9B ?m). Os resultados de ultramicrodureza transversal mostraram que as amostras tratadas com a solução fluoretada (grupo GF) apresentaram uma zona parcialmente desmineralizada com média de dureza semelhante às amostras do grupo que não recebeu qualquer tipo de tratamento (grupo GC), com ambos os grupos apresentando média de dureza significativamente maior que os grupos que foram irradiados com o laser de CO2 (GL e GLF) (p < 0,001). As micrografias mostraram que as características morfológicas superficiais do esmalte nos grupos irradiados com laser de CO2 apresentaram-se semelhantes nos grupos GL e GLF, verificando-se a presença de áreas sugestivas de derretimento, resolidificação, microporos e microtrincas, sem evidências de precipitados fluoretados no grupo GFL. Uma camada amorfa pôde ser observada nas superfícies de esmalte tratadas apenas com a solução fluoretada contendo estanho. Pode-se concluir que o uso do enxaguatório bucal fluoretado contendo estanho (500 ppm F-, 800 ppm Sn2+, pH = 4,5) mostrou potencial de prevenção da erosão de esmalte dental. A irradiação do esmalte dental com o laser associado à solução fluoretada mostrou-se eficaz, mas seu efeito não foi sinérgico. O laser de CO2 (9,6 ?m), nos parâmetros utilizados, não foi capaz de prevenir a erosão em esmalte causada por ácido cítrico.

Although several studies have shown promising results using the AmF/NaF/SnCl2 solution in preventing the erosion of dental enamel, there are no reports of their association with the irradiation of the substrate with the CO2 laser, working at 9.6 ?m. Thus, this study aimed to evaluate the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation (4.5 J/cm2, 20 Hz, 20 ?s), to prevent erosion on dental enamel. Thirteen volunteers participated in this 2-phase (4 days each), crossover study, where 04 treatments were tested using replicas (n = 13): GC - no treatment (negative control); GF - AmF/NaF/SnCl2 solution (positive control); GL - CO2 laser irradiation (9.6 ?m); GLF - CO2 laser irradiation associated with AmF/NaF/SnCl2 solution. The volunteers wore removable intra-buccal appliances containing eight bovine enamel samples. In the first phase, seven volunteers used intra-oral appliances containing samples of groups GC and GL and 6 volunteers, appliances containing samples of groups GF and GLF. In the second phase volunteers were crossed over, allowing all experimental groups were evaluated in the buccal environment of the 13 volunteers. Intra-buccal appliances were removed from the mouth and were exposed to a daily ex-situ erosive cycling (0.65% citric acid, pH 3.6, for 4 minutes, 2x/day) at pre-determined times. Samples were evaluated for surface loss using an optical non-contact profilometer (n = 13) for analysis of loss of mineral after the erosive challenge and a cross-sectional nanohardness test (n = 13) was carried out in order to determine the depth of demineralized area below the erosive lesion. Morphological analysis was carried out using scanning electron microscopy (SEM) (n = 3).

External control over fluoridation of the public water supply in São Luís, MA, Brazil

Objective:To tomonitor fluoride concentrations in the public water supply of São Luís, Maranhão, Brazil, from February 2008 to January 2009. Material and Method:Forty sampling points representing 39 neighborhoods of São Luís were conveniently selected. The points were selected based on the sites where the public water supply is provided by the local water supply company and also considering the proximity of elevated water reservoir tanks. The analysis of the fluoride concentration was performed in triplicate using an ion-specific electrode for fluoride connected to a previously calibrated potentiometer. After analysis, the samples were considered adequate when the fluoride concentration was within recommended limits from 0.60 up to 0.80 ppm F (criterion I) or within the stipulated range from 0.55 ppm up to 0.84 ppm F (criterion II). Results:The results showed a large variation between minimum and maximum concentrations. Considering all samples, the average values (± SD) for the municipality was 0.58 ppm F (± 0.24) and median value was 0.61 ppm F, with minimum and maximum value of 0.02 and 1.33 ppm F, respectively. Of the 480 samples, 62.9% was considered inadequate by criterion I, while using criterion II, the percentage was 48.3%. Conclusion:The fluoridation program in São Luís-MA needs improvement. Therefore, surveillance based on external control and operational control becomes essential to ensure that the method is efficient and effective

Effect of remineralizing agents on the prevention of enamel erosion: a systematic review

Introduction: Due to the increasing prevalence of dental erosion in the last years, it is relevant to evaluate the potential of different remineralizing agents to prevent this dental alteration. Objective: To perform a systematic literature review to investigate whether products containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) remineralizing agents are effective in preventing enamel erosion in order to provide information to health professionals who deal with patients at risk of erosion. Materials and Methods: A search was performed in the PUBMED database for scientific studies in journals published in English from January 01, 2003 to March 30, 2012. A total of 230 articles were found and 32 of these were selected. Results: All fluoride agents (dentifrices, fluoride gels, varnishes and solutions) were effective in preventing erosion and the higher the concentration and lower the pH of agents, the greater their prevention. Although several fluoride compounds have been investigated, titanium tetrafluoride has shown the greatest protection against erosion, regardless of the agent. With respect to CPP-ACP agents, these were effective in preventing mineral loss after erosive challenge. Conclusions: The majority of studies were conducted in vitro. The composition, fluoride concentration and pH of remineralizing agents have influenced the effectiveness in preventing enamel erosion. It is important to conduct in vivo studies and clinical protocols for the application of products against erosion...