Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment.

OBJECTIVE: To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia. BASIC RESEARCH DESIGN: Test-group: 74 12-29-year-olds receiving fixed-orthodontic treatment; reference-group: 63 12-29-year-olds before they started the orthodontic treatment. Visual examinations (one examiner) recorded the following: Ortho-plaque-Index (OPI) expressed per patient as good, fair and poor-oral-hygiene. Caries was scored with the modified-ICDAS-II criteria as: 0-sound; 1B/1W-brown/white-opacity-after-air-drying; 2B/2W-brown/white-opacity-without-air-drying; 3-microcavity; 4-underlying-shadow; 5/6-distinct/extensive-cavity. Filled/missing surfaces due-to-caries and caries-lesions on buccal surfaces at three sites around the brackets were recorded. A 7-item self-administered oral-hygiene habits' questionnaire was used. RESULTS: Chi-square test revealed that the oral-hygiene level was significantly better in the reference group compared to the test group (p < 0.05). The traditional mean DMF-S was 6.7 +/- 6.3 in the test- and 6.2 +/- 5.9 in the reference-group (p > 0.05). When adding modified-ICDAS-II lesions scores 1-4, the figure increased to 23.6 +/- 9.4 in the test- and to 13.6 +/- 10.3 in the reference-group (p < 0.001). A total of 96% had > or = 1 white-opacity in the test group versus 56% in the reference group (P < 0.001). In the test-group the buccal-surfaces accounted for most white-opacities and close to 1/3 of these lesions on the upper-anterior teeth were located around the brackets. The questionnaire disclosed that 58% in the test- vs. 44% in the reference-group did not accept having dental caries lesions during the orthodontic treatment. CONCLUSIONS: The results showed a high prevalence of white-opacities related to orthodontic appliances and indicate the need to implement preventive programmes at the dental clinic.

[Usefulness of the Guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) in identifying the causes of chronic cough]. / Eficacia de la normativa SEPAR en la identificación de las causas de tos crónica.

OBJECTIVE: The usefulness of the recently published guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the diagnosis and treatment of chronic cough has not yet been demonstrated. The objectives of the present study were a) to evaluate the usefulness of the SEPAR guidelines for identifying the possible causes of chronic cough, and b) to determine the most frequent causes of chronic cough treated by primary care physicians. METHODS: We carried out a prospective descriptive study that included 57 consecutive patients (mean age, 62 years) seeking medical attention for chronic cough in a primary health care area. The patients were evaluated using the algorithm proposed in the SEPAR guidelines, whereby the diagnostic procedure is divided into 3 phases in function of complexity. Phase I was carried out at the primary care level, and phases II and III at a hospital pneumology department. RESULTS: For 56 patients (98%), the potential cause of cough was identified: for 52 (91%) in phase I; for 3 (5%), in phase II; and for 1 (2%), in phase III. In 30 patients (53%), a single cause was identified; in 20 (36%), 2 causes; and in 6 (11%), more than 2 causes. Considered individually, the most common causes were postnasal drip in 26 cases (46%), the use of cough-inducing drugs (10 of them attributable to angiotensin-converting enzyme inhibitors) in 16 (28%), asthma in 15 (27%), infection in 13 (23%), gastroesophageal reflux in 12 (21%), and others in 9 (16%). CONCLUSIONS: The application of the SEPAR guidelines on chronic cough is useful for the identification of its causes. The use of angiotensin-converting enzyme inhibitors is a frequent cause of coughs diagnosed at the level of primary outpatient health care.

[Detection of preclinical Cushing's syndrome in overweight type 2 diabetic patients]. / Detección de síndrome de Cushing preclínico en pacientes con sobrepeso y diabetes mellitus tipo 2.

Preclinical Cushing's syndrome (PCS) is a condition in which cortisol excess is not associated to clinical features of Cushing's syndrome. The aim of this study was to detect PCS in 48 ambulatory overweight type 2 diabetic patients (DM). Controls were 40 normoglycemic obese (Ob) and 36 normo-weight healthy subjects (N). In DM (47/48) total urinary cortisol (UF) levels were similar to those found in Ob and N. Evening urinary cortisol (Spot F) was significantly higher than either Ob (p: 0.0001) or N (p: 0.03), although values did not overcome the upper normal limit (44 ng/mg creatinine). False positive results to the overnight 1 mg dexamethasone suppression test were found in 31% and 22% of DM and Ob, respectively. In a DM female an elevated UF and Spot F associated to absence of cortisol inhibition to the overnight 1 mg dexamethasone suppression test was repeatedly detected. Diagnosis of PCS was performed. Remission of hypercorticism and glycemic control were achieved after pituitary surgery. It would be useful to screen DM patients with poor glycemic control for PCS.

Bilateral hydatid cyst of pulmonary arteries: MR and CT findings.

The location of hydatid cysts inside pulmonary arteries has been reported only on rare occasions in the literature and is caused, in the majority of cases, by embolization due to the rupture of hydatid cysts located in the heart; more rarely, hematogenous dissemination from a hepatic focus is the cause. We report a case of a 44-year-old patient with hydatid cysts located in both the right and left pulmonary arteries, whose first clinical reference was hemoptysis. The patient had undergone surgery because of a hepatic hydatid cyst 5 months previously. The importance of this case lies in the infrequent bilateral location in both pulmonary arteries and in the absence of intracardiac hydatid cysts.

Eficacia de la normativa SEPAR en la identificación de las causas de tos crónica / Usefulness of the guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) in identifying the causes of chronic cough

Objetivo: Recientemente, la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ha editado una normativa para el diagnóstico y tratamiento de la tos crónica, cuya eficacia aún no se ha demostrado. Los objetivos del presente estudio han sido: a) evaluar la eficacia de la normativa SEPAR en la identificación de las posibles causas de tos crónica, y b) determinar las causas de tos crónica más frecuentes en el nivel de la atención primaria sanitaria. Métodos: Se ha realizado un estudio descriptivo y prospectivo que incluyó consecutivamente a 57 pacientes (media de edad de 62 años) que consultaron por tos crónica en un área básica de salud. Se les evaluó según el algoritmo propuesto en la normativa SEPAR, que distribuye en 3 fases el proceso diagnóstico a seguir dependiendo de su complejidad. La primera de éstas, la fase I, se realizó en el nivel asistencial de la atención primaria, y las fases II y III, en la consulta de neumología hospitalaria. Resultados: En 56 pacientes (98%) se consiguió identificar la causa potencial de la tos, en 52 (91%) en la fase I, en 3 (5%) en la fase II y en uno (2%) en la fase III. En 30 pacientes (53%) se constató una sola causa de tos, en 20 (36%) se evidenciaron 2 y en 6 (11%), más de 2. Consideradas individualmente, las causas más frecuentes observadas fueron: en 26 casos (46%), goteo nasal posterior; en 16 (28%), ingesta de fármacos desencadenantes de tos (10 de ellos inhibidores de la enzima de conversión de la angiotensina); en 15 (27%), asma; en 13 (23%), infecciosa; en 12 (21%), reflujo gastro-esofágico, y en 9 (16%), otras. Conclusiones: La aplicación de la normativa SEPAR sobre la tos crónica es eficaz en la identificación de sus causas. La tos por la toma de inhibidores de la enzima de conversión de la angiotensina es una causa frecuente en el nivel extrahospitalario básico sanitario

Objective: The usefulness of the recently published guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the diagnosis and treatment of chronic cough has not yet been demonstrated. The objectives of the present study were a) to evaluate the usefulness of the SEPAR guidelines for identifying the possible causes of chronic cough, and b) to determine the most frequent causes of chronic cough treated by primary care physicians. Methods: We carried out a prospective descriptive study that included 57 consecutive patients (mean age, 62 years) seeking medical attention for chronic cough in a primary health care area. The patients were evaluated using the algorithm proposed in the SEPAR guidelines, whereby the diagnostic procedure is divided into 3 phases in function of complexity. Phase I was carried out at the primary care level, and phases II and III at a hospital pneumology department. Results: For 56 patients (98%), the potential cause of cough was identified: for 52 (91%) in phase I; for 3 (5%), in phase II; and for 1 (2%), in phase III. In 30 patients (53%), a single cause was identified; in 20 (36%), 2 causes; and in 6 (11%), more than 2 causes. Considered individually, the most common causes were postnasal drip in 26 cases (46%), the use of cough-inducing drugs (10 of them attributable to angiotensin-converting enzyme inhibitors) in 16 (28%), asthma in 15 (27%), infection in 13 (23%), gastroesophageal reflux in 12 (21%), and others in 9 (16%). Conclusions: The application of the SEPAR guidelines on chronic cough is useful for the identification of its causes. The use of angiotensin-converting enzyme inhibitors is a frequent cause of coughs diagnosed at the level of primary outpatient health care

Detección de síndrome de Cushing preclínico en pacientes con sobrepeso y diabetes mellitus tipo 2. / [Detection of preclinical Cushings syndrome in overweight type 2 diabetic patients]

Preclinical Cushings syndrome (PCS) is a condition in which cortisol excess is not associated to clinical features of Cushings syndrome. The aim of this study was to detect PCS in 48 ambulatory overweight type 2 diabetic patients (DM). Controls were 40 normoglycemic obese (Ob) and 36 normo-weight healthy subjects (N). In DM (47/48) total urinary cortisol (UF) levels were similar to those found in Ob and N. Evening urinary cortisol (Spot F) was significantly higher than either Ob (p: 0.0001) or N (p: 0.03), although values did not overcome the upper normal limit (44 ng/mg creatinine). False positive results to the overnight 1 mg dexamethasone suppression test were found in 31

and 22

of DM and Ob, respectively. In a DM female an elevated UF and Spot F associated to absence of cortisol inhibition to the overnight 1 mg dexamethasone suppression test was repeatedly detected. Diagnosis of PCS was performed. Remission of hypercorticism and glycemic control were achieved after pituitary surgery. It would be useful to screen DM patients with poor glycemic control for PCS.