Time Trends in Adolescent School Absences and Associated Bullying Involvement Between 2000 and 2019: A Nationwide Study.

Education is a central determinant of adolescent health. School absences and bullying involvement jeopardize wellbeing, mental health, and educational attainment. We analyzed time trends in school absenteeism over two decades and examined the association of absenteeism with bullying involvement.We analyzed data from the nationwide School Health Promotion study, with self-reported data from Finnish middle school students in grades 8 and 9 (ages 14-17, N = 1 000 970). Questionnaires assessed frequency of illness absences (IA), truancy, frequency of bullying victimization, bullying perpetration, and involvement in both bullying perpetration and victimization. Frequent school absences were defined as occurring on more than 3 days during the prior month (2000-2015), or at least weekly (2017-2019).Frequent IA increased from 12% to 2000 to 22% in 2015. In 2017-2019, frequent IA was reported by 3.5%. Frequent truancy declined from 9% to 2000 to 4% in 2015, and remained at 4% during 2017-2019. Bully victimization was reported at least weekly by 6.9%, perpetration by 5.4% and victimization-perpetration by 1.9% of participants in total. In a logistic regression model, every type of bullying involvement increased odds for both IA and truancy.Since bullying involvement was associated with both IA and truancy, particular concern should be raised for adolescents involved in bullying, and for their social and educational functioning. The concurrent increase in IA and decrease in truancy may reflect destigmatization of mental health problems or other changes in reporting absenteeism.

Radiation therapy strategies for skull-base malignancies.

INTRODUCTION: The management of skull base malignancies continues to evolve with improvements in surgical technique, advances in radiation delivery and novel systemic agents. METHODS: In this review, we aim to discuss in detail the management of common skull base pathologies which typically require multimodality therapy, focusing on the radiotherapeutic aspects of care. RESULTS: Technological advances in the administration of radiation therapy have led to a wide variety of different treatment strategies for the treatment of skull base malignances, with outcomes summarized herein. CONCLUSION: Radiation treatment plays a key and critical role in the management of patients with skull base tumors. Recent advancements continue to improve the risk/benefit ratio for radiotherapy in this setting.

Evaluation of fungal extracts to determine immunomodulatory properties.

BACKGROUND: Immunoglobulin E-mediated allergies have doubled in prevalence during recent decades in developed countries.This increase has been attributed, in part, to high hygiene standards, which have reduced exposure to microbes. The capacity of microbes to induce type 1 helper T cell (TH1) responses may imply suppression of TH2 responses. However, little research has been performed with fungal extracts. OBJECTIVES: To evaluate the TH1-inducing properties of fungal extracts. METHODS: A total of 24 fungal extracts, including Cetavlon-precipitated polysaccharides from different yeasts, molds, and mushrooms were prepared.The extracts were screened for production of interferon (IFN)gamma in human peripheral blood mononuclear cells. The active compounds were further purified by mild acid hydrolysis and by column chromatography and studied in human peripheral blood mononuclear cells. RESULTS: Expression of IFN-gamma was induced by several extracts. The strongest expression of IFN-gamma was induced by Candida albicans. The Cetavlon-precipitated mannans of fungi induced cytokine responses that were similar or superior to those induced by whole extracts, C albicans being the most potent inducer of IFN-gamma. Column chromatography-fractionated mild acid hydrolysis of Calbicans mannan was performed. Fractions containing oligosaccharides of 12-16 mannoses induced production of tumor necrosis factor. CONCLUSIONS: Several fungal extracts induce IFN-gamma. The most promising preparations were yeast-derived oligosaccharides. Further research should be focused on purification and eventual synthesis of the extracts.

Evaluation of Fungal Extracts to Determine Immunomodulatory Properties

Antecedentes: En los países desarrollados, la prevalencia de las enfermedades alérgicas mediadas por la inmunoglobulina E se han duplicado en las últimas décadas. Este aumento ha sido, en parte, atribuido a pautas de higiene excesivas que han reducido la exposición a microbios. La capacidad de los microbios para inducir la respuesta Th1 puede dar lugar a la supresión de la respuesta Th2. En este sentido, la investigación que se ha realizado con extractos fúngicos es escasa. Objetivos: Evaluar las propiedades inmunomoduladoras Th1 que inducen los extractos de hongos. Métodos: Se evaluaron un total de 24 extractos de hongos, incluyendo polisacáridos de diferentes levaduras, mohos y hongos. Se estudió la capacidad de estos extractos de inducir la producción de interferón- ƴ (IFN- ƴ) en células mononucleares de sangre periférica (PBMC) humanas. Los extractos fueron posteriormente sometidos a una hidrólisis ácida suave y a cromatografía en columnas. Resultados: Los extractos procedentes de diferentes levaduras, mohos y hongos indujeron un incremento en la expresión de la producción de IFN- ƴ. La expresión más enérgica fue la provocada por Candida albicans (C. albicans). Los mananos fueron también capaces de conseguir un incremento de la expresión de IFN- ƴ similar o superior a la inducida por los extractos enteros, siendo el manano de C. albicans el más potente de todos ellos. Mediante los estudios de estimulación celular, con fracciones obtenidas por cromatografía del manano C. albicans, se observó que aquellas que contenían oligosacáridos de 12-16 manosas indujeron una mayor producción de TNF. Conclusiones: Son varios los extractos fúngicos capaces de inducir la producción de IFN- ƴ. Los productos más potentes fueron los oligosacáridos derivados de las levaduras. Las investigaciones futuras deberían centrarse en la purificación y síntesis final de los mismos (AU)

Background: Immunoglobulin E–mediated allergies have doubled in prevalence during recent decades in developed countries. This increase has been attributed, in part, to high hygiene standards, which have reduced exposure to microbes. The capacity of microbes to induce type 1 helper T cell (TH1) responses may imply suppression of TH2 responses. However, little research has been performed with fungal extracts. Objectives: To evaluate the TH1-inducing properties of fungal extracts. Methods: A total of 24 fungal extracts, including Cetavlon-precipitated polysaccharides from different yeasts, molds, and mushrooms were prepared. The extracts were screened for production of interferon (IFN) ƴ in human peripheral blood mononuclear cells. The active compounds were further purified by mild acid hydrolysis and by column chromatography and studied in human peripheral blood mononuclear cells. Results: Expression of IFN- ƴ was induced by several extracts. The strongest expression of IFN-􀁡 was induced by Candida albicans. The Cetavlon precipitated mannans of fungi induced cytokine responses that were similar or superior to those induced by whole extracts, C albicans being the most potent inducer of IFN- ƴ. Column chromatography–fractionated mild acid hydrolysis of C albicans mannan was performed. Fractions containing oligosaccharides of 12-16 mannoses induced production of tumor necrosis factor. Conclusions: Several fungal extracts induce IFN- ƴ. The most promising preparations were yeast-derived oligosaccharides. Further research should be focused on purification and eventual synthesis of the extracts (AU)

Comparison of clinical and best-estimate research DSM-IV diagnoses in a Finnish sample of first-admission psychosis and severe affective disorder.

The purpose of this study was to investigate diagnostic agreement between clinicians and a research group in a sample of first-admission psychosis and severe affective disorder patients. Clinical DSM-IV discharge diagnoses and best-estimate DSM-IV research diagnoses were compared in 116 first-episode patients in the city of Turku, Finland. The best-estimate research diagnoses were made at consensus meetings by integrating longitudinal data; patients' medical records; and findings of a clinical interview, the structured SCAN-interview, and symptom severity ratings. Overall diagnostic agreement was moderate, with a kappa value 0.51 (95% confidence interval (CI), 0.39- 0.63). Of the diagnostic groups, schizophrenic disorders had the lowest kappa value of 0.44 (95% CI, 0.26-0.63). Clinicians had a tendency to miss depressive symptoms in psychotic patients; to overdiagnose psychotic symptoms in depressive patients; and to fail to discover earlier hypomanic or depressive episodes in depressive patients. In conclusion, hospital diagnoses were not reliable in first-episode patients. Inappropriate diagnoses may compromise both treatment and epidemiologic findings based on discharge diagnoses.

Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation.

The relationship between bacteriological findings and clinical treatment procedures was investigated in root canal treatment cases that were selected for bacteriological investigation by general dental practitioners in Finland. The cultures were sent to the Oral Microbiological Service Laboratory at the Institute of Dentistry in Helsinki. Two groups of teeth were selected based on the type of infection present in the root canal system. The 'enteric bacteria' group consisted of 40 sequential cases where Enterococcus faecalis and/or other facultative enteric bacteria or Pseudomonas sp. were found in the samples in pure culture (35%) or together with other types of bacteria. The group 'non-enteric bacteria' consisted of 40 sequential cases where only non-enteric bacteria were found. The dentists who had sent the bacteriological samples received a questionnaire where they were asked about the treatment protocol and procedures. A total of 70 out of 80 questionnaires were returned. If the root canals had been unsealed at some point during the treatment, enteric bacteria were found more frequently than in canals with an adequate seal between the appointments. Of cases with enteric bacteria 55% had been open during the treatment, while in the group where only non-enteric bacteria were found 30% had been open. Enteric bacteria were also more frequently isolated in cases with a high number of appointments before sampling. In the enteric bacteria group 35% of the samples were taken at the 10th visit or later, while the corresponding percentage in the non-enteric group was 3%. In addition, the number of retreatment cases was significantly higher, 12 out of 34, in the enteric bacteria group than in non-enteric bacteria group, which was five out of 36. Other clinical parameters showed no differences between the two groups. The results emphasize the importance of controlled asepsis throughout the root canal treatment.

Knowledge of AIDS and HIV infection displayed by Tanzanian operating dental staff in 1988 and 1989: a follow-up study.

In many urban areas of Central and Eastern Africa 20-30 per cent of the sexually active population has been infected with HIV. It can be assumed that every member of the operating dental staff in Tanzania frequently treats HIV-positive patients. The knowledge of AIDS and HIV infection was investigated by Tanzanian dental teams in 1988 and 1989. In both years almost one quarter of the dental officers and half the other operating team members chose incorrect information about the methods of transmission of HIV. Several respondents named health care workers as belonging to a high risk group. Fever and loss of weight were known to be early symptoms of AIDS. In 1989, when asked to identify oral manifestations of HIV, one quarter of all the dental staff could not mention any of them. The findings of the study emphasise the need for urgent further education of dental teams in Tanzania.

PIP: Dental officers, assistant dental officers, and dental assistants attending the Tanzanian Dental Association Annual meetings in 1988 and 1989 in Dar es Salaam were administered pre tested questionnaires on transmission, early symptoms, high-risk groups, and oral signs of HIV infection. 44 completed the confidential questionnaires in 1988 and 45 did so in 1989. The clinical tasks of each group are similar, but their educational requirements vary. While all respondents were aware of at least 1 major means of transmission, 23% and 26% in 1988 and 1989 marked incorrect answers on transmission, most often by articles such as toothbrushes. The total score of correct responses was around 27 both years, and did not differ between groups. For the question on high-risk groups, there were 7 multiple choices that were all correct except female homosexuals. Respondents more frequently checked homosexual men, people with multiple sex partners, and prostitutes, with varying scores for the other high-risk groups as well as lesbians. A higher percentage of dental officers said they had more than 1 sex partner than did junior staff. Similarly, the question on early symptoms of AIDS was a multiple check-off, and respondents also chose symptoms with varying frequencies in both years. Most commonly checked symptoms were weight loss, diarrhea, and weakness. The question on oral signs in 1989 was an open fill-in type question. Dental officers were able to write 1.9 answers on average, staff 2.2, most often candida infections, ulcers and gingivitis. The least often cited signs were angular cheilitis, Kaposi's sarcoma, and leukoplakia. Many could not remember any oral signs. Since oral manifestations of AIDS appear early, and dental practitioners in Tanzania have no gloves or any means of sterilizing instruments except boiling, it is imperative that the knowledge base of dental staff be improved.

Dental students' knowledge of AIDS and HIV infection in Helsinki, Finland, and in Dar es Salaam, Tanzania.

The purpose of this investigation was to study the knowledge about HIV infection and AIDS among dental students in Helsinki, Finland, and in Dar es Salaam, Tanzania. All respondents knew that HIV is not transmitted via hand-shaking, drinking water, or breathing air. More than half of the students in both countries did not know that HIV can be transmitted via breast-feeding. A higher proportion of students in Dar es Salaam than in Helsinki believed that all HIV-positive persons will get AIDS. Tanzanians recognized the early symptoms of HIV infection better than the Finnish students. Many students in both countries did not mention bisexual men as belonging to the high-risk group. Most of the dental students in Dar es Salaam but only one in five in Helsinki believed that dentists belong to the at-risk group.

Familial hypodontia associated with Dupuytren's disease.

A three-generation Finnish family exhibited hypodontia associated with Dupuytren's disease (contracture). Of the known 32 members of the family, contracture has been diagnosed thus far in 5 individuals, 4 of these also with hypodontia. No other connective tissue involvement was found. For comparison, three other families were studied, also showing incomplete penetrance of hypodontia. Bearing in mind the genetic isolation of the Finnish population, this finding may be coincidental. The possibility of partially common genetic background cannot, however, be excluded.

Association between acid fumes in the work environment and dental erosion.

The effect of inorganic acid fumes from the work environment on the erosion of teeth was studied blindly. A sample of 186 workers was drawn from four factories. Among the 157 dentulous participants, 76 were working in departments containing acid fumes, and 81 had never worked under such conditions and were used as referents. Of the acid workers 18.4% had one or more teeth with erosion, and the corresponding figure for the referents was 8.6%. With a longer duration of exposure the proportion of subjects with erosion increased. The acid workers had more teeth with erosion than the referents, especially upper anterior teeth. The findings suggest that even today exposure to inorganic acid fumes from the work environment may increase the erosion of teeth, especially the upper anterior teeth, which are not continuously protected by saliva and the lips.

Wearing of removable partial dentures in relation to periodontal pockets.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).

Wearing of removable partial dentures in relation to dental caries.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.

Ultrastructure of a novel anaerobic gram-positive nonsporing rod from dental root canal.

A novel anaerobic Gram-positive rod, strain ES4C, was isolated from a dental root canal infection. The isolate did not produce acids from carbohydrates and showed no glycosidase activity. Most biochemical reactions were identical to Clostridium malenominatum with the exception of the production of three aminopeptidases. In addition, no spores were detected. A tetragonally arranged surface layer was consistently found by electron microscopy. The ultrastructure of closely related Eubacterium spp. was also studied, but no crystalline surface structures were found. The physiologic and ultrastructural characteristics of ES4C did not allow identification as any known species. The periapical lesion responded to routine root canal therapy, but after 18 months observation the radiologic signs indicated partial healing only.

Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment.

The microbiology and treatment of apical periodontitis was studied in 62 patients, followed-up for 1 year. The clinical treatment and the radiological technique were standardized. One third of the patients received no systemic antibiotics, one third received phenoxymethylpenicillin for 1 week, and one third for 3 months. On the average, 0-2 facultatively anaerobic and 4-6 anaerobic bacteria were isolated from periapical infections. The genera Bacteroides and Fusobacterium in addition to anaerobic gram-positive cocci were found most frequently. Minimum inhibitory concentrations of benzylpenicillin against 269 strains were tested. 12 strains were resistant at the concentration 2.4 micrograms/ml, including 4 strains of Fusobacterium sp. All patients were free of symptoms 1 month after the admission. Only 1 patient failed to show any progress in radiological healing. No differences between the groups in relation to penicillin therapy were found.