Impact of socioeconomic inequalities on dental caries in deprived children: a multilevel analysis.

OBJECTIVES: Inequalities have been reported between high, middle and low socioeconomic position (SEP) children. However, the effect of contextual and individual SEP on existing inequalities among socioeconomically deprived children varies between local contexts. The aim of this study was to assess the impact of contextual and individual SEP on individual caries experience among socioeconomically deprived children in Chile. METHODS: Cross-sectional multilevel analysis of data from the 2015 electronic register of the National Board of School Aid and Scholarships (JUNAEB) of Chile. The contextual variables were the municipality Human Development Index (HDI) and rurality index. Individual variables included gender, living in extreme poverty and school grade. Multilevel negative binomial models assessed their impact on DMFT/dmft. RESULTS: 112,429 children in 255 municipalities were included. Overall, contextual SEP (HDI) was not associated with caries experience in the primary or permanent dentition. Individual SEP (living in extreme poverty) was associated with caries experience in both dentitions. The proportion of children living in extreme poverty with caries experience in the primary teeth was 17% higher than children not living in extreme poverty (PR 1.17; 95% CI 1.15-1.19), while for children with permanent teeth it was 9% higher (PR 1.09; 95% CI 1.08-1.11). CONCLUSION: These findings could support the development of health strategies focused on individual SEP to efficiently reduce oral health inequalities among socioeconomically deprived children.

Social gradients in dental attendance among older adults: Findings from the National Survey on Demographics and Health in Peru.

OBJECTIVE: To assess the presence of inequalities in attendance to dental services in relation to socio-economic position (SEP) in a national sample of older adults in Peru. BASIC RESEARCH DESIGN: A cross-sectional study using multivariate regression analysis of secondary data obtained from the National survey on demographics and family health in Peru (Encuesta Nacional en Demografía y Salud familiar, ENDES). PARTICIPANTS: 4749 ≥60-year-olds. MAIN OUTCOME MEASURE: Attendance at dental health services in the last 2 years. Independent variable: Wealth Index as a measure of SEP. Covariates: Sex, age, natural region of residence, place of residence and health insurance coverage. RESULTS: There was a social gradient for the association between attendance to dental health services and SEP, with older adults from the richest (fifth) quintile showing a 3.01 times higher probability of visiting dental services (95%CI 2.15-4.19), those in the fourth quintile PR=2.19 (95%CI 1.61-3.00), third quintile PR=2.00 (95%CI 1.49-2.69), and those in the second quintile PR=1.42 (95%CI 1.10-1.84), when compared to the poorest quintile after adjusting for sex, age, residence, natural region and health insurance coverage. CONCLUSIONS: There is a clear social gradient in dental attendance among older adults in Peru. This is important to provide further insights into current national programmes and relevant long-term policies.

Seroprevalence of Encephalitozoon cuniculi in dogs in the United States.

Encephalitozoon cuniculi is an obligate intracellular microsporidian parasite that can result in clinical and subclinical infection in many species. It is also considered the cause of a potential zoonotic disease. In the present study, a serological survey was conducted using samples from pet dogs in the state of Florida. Twenty-seven of 125 serum samples, or 21.6%, were found to demonstrate reactivity by ELISA, with titers ranging from 1:32 to 1:512. There were no significant differences by age or sex. This is the first report on the detection of E. cuniculi antibodies in dogs in the United States.

Subgenotype diversity of hepatitis B virus American genotype F in Amerindians from Venezuela and the general population of Colombia.

The objective of this study was the evaluation of the genetic diversity found in HBV circulating among Venezuelan Amerindians and the general population in Colombia. Phylogenetic analysis of the S region in 194 isolates showed that genotype F is highly predominant in Colombia and Venezuela. This might be related to the genetic background of the population. F3 is the main subgenotype which circulates in both countries. Phylogenetic analysis of 61 complete genome sequences of HBV American genotypes confirms the presence of two genotypes F and H, and 4 F subgenotypes. In Venezuela, subgenotypes F1, F2, and F3 circulate in East and West Amerindians, while only F3 was found among South Amerindians. Japreira community derived from Yucpa Amerindians around 150 years ago. However, several Japreira HBV sequences were forming a clade that can be classified as subgenotype 2b, differing from Yucpa sequences that belong mainly to subgenotype F3. The apparent absence of correlation between the phylogenetic groupings of HBV isolates with the ethnical origin in aboriginal populations might be suggesting a recent origin of HBV American subgenotypes, or a genetic drift effect.

The seroprevalences of anti-hantavirus IgG antibodies among selected Venezuelan populations.

In Venezuela, the isolation of hantaviruses from rodents and the detection, in 1999, of a clinically confirmed human case of hantavirus infection led to increased interest in these viruses. In an attempt to estimate the problem posed by such viruses in Venezuela, ELISA based on purified, recombinant, nucleoprotein were used to check 1380 human serum samples for the presence of IgG antibodies to hantavirus. The ELISA results, as confirmed by indirect immunofluorescence and Western-blot assays, indicated that 23 (1.7%) of the serum samples contained antibodies to hantaviruses. Seroprevalences were similar among all age-groups and for both genders and were no higher among rural populations with a relatively high risk of exposure to rodents than among the overall study population. Although the numbers of samples involved were small, the seroprevalence among the subjects who were residents of Carabobo state was much higher than the overall value (10.3% v. 1.7%; P < 0.01). Human infection with hantavirus appears uncommon but widely distributed in Venezuela.

[Jejunal interposition by the Merendino technique. Report of a case]. / La interposición yeyunal a manera de Merendino. A propósito de un caso.

A jejunal interposition, as a Merendinos' Technic, was made in a benign esophageal stenosis secondary to acid-peptic disease in the Hospital Central de Valencia, Venezuela. The esophago-jejunal junction was performed by an E.E.A. instrument No. 28. We emphasized the jejunum functional and anatomic advantages as an esophageal substitution organ. We believe that the jejunum, in short esophagus resections, is a good alternative, even though the stomach is the first substitution organ in these procedures, followed by the colon.

[Surgical treatment of toxic megacolon in ulcerative rectocolitis. Analysis of 16 patients]. / Tratamiento quirúrgico del megacolon tóxico en la rectocolitis ulcerosa. Analisis de 16 pacientes.

The clinical aspects, surgical treatment and outcome of 16 consecutive patients treated for toxic megacolon secondary to ulcerative colitis at the 1st department of surgery at the university of Rome between 1976 and 1987 were reviewed. The surgical management consisted in total colectomy and immediate ileo-rectal anastomosis, without protective ileostomy in 14 patients and total colectomy with terminal ileostomy and ileorectal anastomosis in 2 patients, 5 months later. No postoperative mortality was observe the immediate complications were: anastomotic leakage, (one case) and rectal bleeding (three cases). The late complications were: ileo-anastomotic stump fistula and perforation (two cases). Protectomy, due to colitis recrudescence, in the rectal remnant 10 months after surgery. These results encourage the total colectomy with immediate ileorectal anastomosis for the treatment of toxic megacolon.

[Changes of serum lipids during parenteral feeding with a 10 percent of soy oil solution (author's transl)]. / Modificaciones de los lípidos séricos durante la alimentación parenteral con aceite de soya a1 10 p

The purpose of this investigation was the knowledge of certain events related with the intravenous administration of lipids in patients with parenteral nutrition such as tolerance, clearence and changes in the plasmatic lipid fractions and the effect of heparin as capilar lipoprotein-lipase stimulant and of the insulin as lipogenetic hormone. With intralipid the authors observed elevation of serum total lipid, triglicerids and fatty acids; in this patients the fatty acids went up after addition of heparin because triglicerid elucidation but went down after insulin administration which favor the tisular captation of fatty acids. They do not found alteration in serum cholesterol. The results with heparin and insulin suggest a greater and more rapid clearence of plasmatic lipids probably by incorporation of them to the tissues. This feature minimize the risk of exogen hyperlipemia, hyperosmolarity and metabolic acidosis.

Regulatory effects of steroids on the pituitary response to LH-RH.

PIP: The effects of continuous intravenous administration of luteinizing hormone-release hormone in conjunction with physiological or pharmacolog ical doses of estradiol (E2), progesterone (P), 17alphaOH-progesterone (17-P), 20alphaOH-progesterone (20-P), chlormadinone acetate (CA), testosterone (T) and 5alpha-dihydrotestosterone (5-DHT) on pituitary response was evaluated in normal and postmenopausal women, normal men, and 1 patient with Klinefelter's syndrome. An all subjects, except the Klinefelter's syndrome patient, 132 mcg/hour/6 hours of E2 blocked the pituitary response to LH-RH, although a dose of 6.6 mcg/hour/6 hours was not markedly effective. None of the progestational steroids blocked the pituitary response to LH-RH. However, the dual administration of CA with E2 antagonized the pituitary response in normal and postmenopausal women. 600 mcg/hour/6 hours of T partially inhibited the pituitary resp onse in men, but had little effect on postmenopausal women and the Klinefelter's syndrome patient. The pituitary response to LH-RH was not inhibited by 5-DHT. The results indicate that sex steroids can modulate the hypothalamic-pituitary axis, though estradiol by itself does not appear to increase the pituitary response to LH-RH since it is not solely responsible for the pituitary responsiveness to LH-RH at the mid-luteal phase.^ieng