Associated factors with health-compromising behaviors among patients treated for oral cancer.

BACKGROUND: To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated. MATERIAL AND METHODS: A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models. RESULTS: Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster. CONCLUSIONS: A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment.

Deterioro comportamental leve como antecedente de la demencia: presentación de los criterios diagnósticos y de la versión española de la escala MBI-C para su valoración / Mild behavioural impairment as an antecedent of dementia: presentation of the diagnostic criteria and the Spanish version of the MBI-C scale for its evaluation

Introducción. Los síntomas neuropsiquiátricos son frecuentes en la demencia y también en estadios previos, como el deterioro cognitivo leve. Su aparición se relaciona con mayor conversión a demencia en personas cognitivamente sanas o con deterioro cognitivo leve, en comparación con las personas que no los presentan. Objetivo. Dar a conocer la importancia en las fases previas a la demencia del concepto "deterioro comportamental leve" (DCoL) y mostrar los criterios consensuados de DCoL de la International Society to Advance Alzheimer’s Research and Treatment. Estos criterios permitirán identificar a pacientes con síntomas neuropsiquiátricos leves y cognición normal o deterioro cognitivo leve, y estudiar el riesgo ulterior de desarrollar demencia por cualquier causa. A su vez, se presenta una nueva escala, la Mild Behavioral Impairment-Checklist (MBI-C), para la valoración clínica y en investigación del DCoL. Desarrollo. Se muestran datos del mayor riesgo de demencia en presencia de síntomas neuropsiquiátricos para justificar el desarrollo del nuevo concepto de DCoL, que perfecciona los intentos previos de categorización de estos estados. Se describen los criterios diagnósticos de DCoL y el proceso de creación de la MBI-C, y se presenta su versión española. Finalmente, se plantean los próximos pasos en la investigación del concepto y medición del DCoL y sus perspectivas de futuro. Conclusiones. Los nuevos criterios de DCoL y su medición mediante la MBI-C resultan prometedores de cara a una mejor y más temprana identificación de los pacientes con riesgo de desarrollar demencia y una ayuda para la investigación de los procesos neurodegenerativos subyacentes (AU)

Introduction. Neuropsychiatric symptoms are common in dementia and also in previous stages such as mild cognitive impairment. Their presence is related to greater conversion to dementia in cognitively healthy people or with mild cognitive impairment compared to those who do not suffer them. Aim. An international working group pertaining to the Alzheimer Association has proposed the concept of "mild behavioral impairment" (MBI) to identify patients with mild neuropsychiatric symptoms and normal cognition or mild cognitive impairment and to study the further risk of developing dementia from any cause. A new scale, the Mild Behavioral Impairment- Checklist (MBI-C), has been developed for the assessment of MBI in clinical and research settings. Development. Data on the greater risk of dementia in the presence of neuropsychiatric symptoms are shown to justify the development of the new concept of MBI, improving the previous attempts of categorization of these states. Diagnostic criteria of MBI and the process of creation of the MBI-C scale are described. The Spanish version is presented in this article. Finally, the next steps in the investigation of the concept and measurement of MBI and its future prospects are suggested. Conclusions. The new MBI criteria and their measurement using the MBI-C scale are promising for a better and earlier identification of patients at risk of developing dementia and as an aid to investigate the underlying neurodegenerative processes (AU)

[Mild behavioural impairment as an antecedent of dementia: presentation of the diagnostic criteria and the Spanish version of the MBI-C scale for its evaluation]. / Deterioro comportamental leve como antecedente de la demencia: presentacion de los criterios diagnosticos y de la version española de la escala MBI-C para su valoracion.

INTRODUCTION: Neuropsychiatric symptoms are common in dementia and also in previous stages such as mild cognitive impairment. Their presence is related to greater conversion to dementia in cognitively healthy people or with mild cognitive impairment compared to those who do not suffer them. AIM: An international working group pertaining to the Alzheimer Association has proposed the concept of 'mild behavioral impairment' (MBI) to identify patients with mild neuropsychiatric symptoms and normal cognition or mild cognitive impairment and to study the further risk of developing dementia from any cause. A new scale, the Mild Behavioral Impairment-Checklist (MBI-C), has been developed for the assessment of MBI in clinical and research settings. DEVELOPMENT: Data on the greater risk of dementia in the presence of neuropsychiatric symptoms are shown to justify the development of the new concept of MBI, improving the previous attempts of categorization of these states. Diagnostic criteria of MBI and the process of creation of the MBI-C scale are described. The Spanish version is presented in this article. Finally, the next steps in the investigation of the concept and measurement of MBI and its future prospects are suggested. CONCLUSIONS: The new MBI criteria and their measurement using the MBI-C scale are promising for a better and earlier identification of patients at risk of developing dementia and as an aid to investigate the underlying neurodegenerative processes.

TITLE: Deterioro comportamental leve como antecedente de la demencia: presentacion de los criterios diagnosticos y de la version española de la escala MBI-C para su valoracion.Introduccion. Los sintomas neuropsiquiatricos son frecuentes en la demencia y tambien en estadios previos, como el deterioro cognitivo leve. Su aparicion se relaciona con mayor conversion a demencia en personas cognitivamente sanas o con deterioro cognitivo leve, en comparacion con las personas que no los presentan. Objetivo. Dar a conocer la importancia en las fases previas a la demencia del concepto 'deterioro comportamental leve' (DCoL) y mostrar los criterios consensuados de DCoL de la International Society to Advance Alzheimer's Research and Treatment. Estos criterios permitiran identificar a pacientes con sintomas neuropsiquiatricos leves y cognicion normal o deterioro cognitivo leve, y estudiar el riesgo ulterior de desarrollar demencia por cualquier causa. A su vez, se presenta una nueva escala, la Mild Behavioral Impairment-Checklist (MBI-C), para la valoracion clinica y en investigacion del DCoL. Desarrollo. Se muestran datos del mayor riesgo de demencia en presencia de sintomas neuropsiquiatricos para justificar el desarrollo del nuevo concepto de DCoL, que perfecciona los intentos previos de categorizacion de estos estados. Se describen los criterios diagnosticos de DCoL y el proceso de creacion de la MBI-C, y se presenta su version española. Finalmente, se plantean los proximos pasos en la investigacion del concepto y medicion del DCoL y sus perspectivas de futuro. Conclusiones. Los nuevos criterios de DCoL y su medicion mediante la MBI-C resultan prometedores de cara a una mejor y mas temprana identificacion de los pacientes con riesgo de desarrollar demencia y una ayuda para la investigacion de los procesos neurodegenerativos subyacentes.

The role of personality traits in self-rated oral health and preferences for different types of flawed smiles.

Symmetric, aligned and luminous smiles are usually classified as 'beautiful' and aesthetic. However, smile perception is not strictly governed by standardised rules. Personal traits may influence the perception of non-ideal smiles. We aimed to determine the influence of personality traits in self-rated oral health and satisfaction and in the aesthetic preference for different strategically flawed smiles shown in photographs. Smiles with dark teeth, with uneven teeth, with lip asymmetry and dental asymmetry were ordered from 1 to 4 as a function of the degree of beauty by 548 participants, of which 50·7% were females with a mean age of 41·5 ± 17·6 years (range: 16-89 years). Self-assessment and oral satisfaction were recorded on a Likert scale. Personality was measured by means of the Big Five Inventory (extraversion, agreeableness, conscientiousness, neuroticism and openness), and the Life Orientation Test was used to measure optimism and pessimism. Of the four photographs with imperfect smiles, dental asymmetry was the most highly assessed in 63% of the sample, and the worst was lip asymmetry, in 43·7% of the sample. Some personality traits (above all conscientiousness and openness) were significantly correlated with the position assigned to the photographs with dental and lip asymmetry or with misaligned teeth. The extraversion, agreeableness and openness traits were correlated with the self-perceptions of oral health and aesthetics of the participants. Dental asymmetry seems to be better tolerated than lip asymmetry. Personality traits are weakly but significantly correlated with the aesthetic preference and oral health values, conscientiousness and openness being the most relevant domains in this sense.

Crisis económica y Odontología en España. Propuesta de soluciones por grupo nominal de dentistas / Economic crisis and Dentistry in Spain. Solution proposals made by a nominal group of dentists

INTRODUCCIÓN: En un contexto de más de dos décadas de crecimiento espectacular del número de dentistas en España, se suma la presión que la actual crisis económica ejerce sobre una profesiónque es eminentemente privada. El objetivo es proponer soluciones al efecto de la crisis económica en la profesión odontológica. MATERIAL Y MÉTODOS: Se realizó una Técnica de Grupo Nominal en Granada capital en marzo de 2011. Los expertos (n=9) fueron dentistas que cubrían un amplio espectro socio-profesional. La pregunta fue "¿Qué medidas cree usted que habría que adoptar ante la influencia negativa de la crisis económica en Odontología?”, aclarando que una posible respuesta fuera considerar que no había tal influencia. Las fases fueron: 1. Generación de ideas por parte los expertos, 2. Su enunciado y explicación, 3. Discusión y fusión de ideas por consenso, 4. Priorización por votación secreta entre las diez ideas colapsadas resultantes. RESULTADOS: Las cinco ideas más votadas, por orden, fueron: 1. Reducción del número de nuevos licenciados en España, 2. Concienciación en salud oral a la población pues mejoraría la demanda, 3. Apoyo legal-laboral a los nuevos licenciados por ser considerado el colectivo más castigado, 4. Mayor eficiencia de los programas públicos odontológicos, y 5. Desarrollo adecuado con estándares de calidad de las especialidades odontológicas y la formación posgraduada y a precios asequibles. CONCLUSIONES: Existe unanimidad al identificar la crisis económica como elemento negativo sobre la profesión y la necesidad de tomar medidas (AU)

INTRODUCTION: In a context of more than two decades of spectacular growth in the number of dentists in Spain, it is added pressure that the current economic crisis has on a profession that is predominantly private. The aim of this study is to propose solutions to the impact of economic crisis in the dental profession. METHODS: Nominal Group Technique was conducted in Granada city in March 2011. Experts (n = 9) were dentists covering a broad social and professional. The question was "What measures do you think should be taken to the negative influence of the economic crisis in dentistry?" Clarifying that a possible answer was to consider that there was no such influence. The phases were: 1. Generation of ideas by experts, 2. Their statement and explanation, 3. Discussion and fusion of ideas by consensus, 4. Secret votation by prioritization among the ten resulting ideas. RESULTS: The five most voted ideas, orderly, were 1.Reducing the number of new graduates in Spain, 2. Oral health awareness in the population as it would improve the demand, 3. Legal and labor support for new graduates to be considered the hardest hit group, 4. More efficient public dental programs, and 5. Developing adequate quality standards of the dental specialities and postgraduate training with affordable prices. CONCLUSIONS: There is unanimity to identify the economic crisis as a negative element about the profession and the need to take action (AU)

Percepción y hábitos de salud bucodental en niños y adolescentes de Navarra, 2007 / Oral health perception and oral habits in children and teenagers in Navarre, 2007

Fundamento. Conocer la auto-percepción del nivel desalud oral y de las necesidades de tratamiento, los hábitosde higiene y la frecuencia de asistencia al dentistade los escolares de Navarra.Material y métodos. La población de estudio fue la de6, 12 y 14 años de edad. La muestra se obtuvo de loscolegios de 1º y 6º de Enseñanza Primaria (EP) y 2º deEnseñanza Secundaria Obligatoria (ESO) y la recogidade datos se hizo mediante cuestionarios auto-cumplimentados.Resultados. El 92%, a los 6 y 12 años, y el 82,9% a los 14años está satisfecho con su salud oral. El 13,1% de losde 12 años y el 19,3% de 14 están descontentos, sobretodo por el mal alineamiento dental. Aproximadamente,un tercio cree necesitar algún tratamiento, sobre todoobturaciones a los 6 años y ortodoncia a los 12 y 14.Casi dos tercios dicen cepillarse los dientes más de unavez al día y entre el 80 y el 90% dicen haber ido al dentistaen el último año. Más del 75% de los responsables delos escolares de 6 y 12 años valoran positivamente lasprestaciones del Programa de Atención Dental Infantil(PADI) y más del 95% está satisfecho con la asistenciaque el dentista del PADI presta a sus hijos. El sexo, mediode residencia y nivel socioeconómico apenas influyenen la percepción de salud, frecuencia de cepillado onecesidades de tratamiento sentidas.Conclusión. El estudio revela que la percepción subjetivade salud dental es buena y que un tercio de los encuestadoscreen necesitar algún tipo de tratamiento. Es muypositivo que la mayoría digan que hayan ido al dentistaen el último año y que se cepillan la boca más de una vezal día, mejorando los resultados de estudios anteriores(AU)

Background. To determine the self-perception of oralhealth levels and the need for treatment, hygienichabits and frequency of visits to the dentist amongstschoolchildren in Navarre.Methods. The population of the study was aged 6, 12and 14 years. The sample was obtained from schoolsteaching 1st and 6th year in Primary Education and 2ndyear in Compulsory Secondary Education. The datawas gathered through self-answering questionnaires.Results. Ninety-two percent of 6 and 12 year olds, and82.9% of 14 year olds are satisfied with their oral health.Thirteen point one percent of 12 year olds and 19.3% of14 year olds are dissatisfied, above all with misalignedteeth. Approximately one-third think they need sometreatment, above all fillings at age 6 and orthodontics at12 and 14 years. Nearly two-thirds say they brush theirteeth more than once a day and between 80 and 90% saythey have visited the dentist in the last year. More than75% of those responsible for the schoolchildren aged 6and 12 years make a positive evaluation of the contributionsof the child dental care program (PADI) and morethan 95% are satisfied with the care given by PADI dentiststo their children. Sex, average residence and socioeconomiclevel barely influence the perception of health,frequency of brushing teeth or need for treatment.Conclusion. The study reveals that the subjective perceptionof oral health is good and that one-third of thosesurveyed think they need some type of treatment. Itis very positive that they majority say that they havebeen to the dentist in the last year and that they brushtheir teeth more than once a day, which is an improvementon the results of previous studies(AU)

[Dental health of children and adolescents of Navarra, 2007 (4th edition)]. / La salud dental de los niños y adolescentes de Navarra, 2007 (4 feminine edición).

BACKGROUND: With five years having passed since the last survey (2002), a new survey was carried out, the 4th since 1987. The aim is to determine the state of oral health of children and adolescents in Navarre and its evolution. POPULATION AND METHODS: The sample (n=1.397) was selected through multistage probability sampling, taking as a unit the classrooms of the 1st and 6th year of Primary Education and the 2nd of Compulsory Secondary Education. The fieldwork was carried out in the months of April and May 2007 by two calibrated teams of examiners. Health variables studied: caries (measured with WHO criterion and extended criterion), periodontal state and malocclusion. The data were computerised with Access XP 2003 SP3; the statistical analysis with SPSS Windows v.15.0. RESULTS: Ten point eight percent of the sample is of foreign origin. The prevalence of caries in temporary dentition at 6 years is 35.9% with a DFT of 1.26, in permanent dentition, 28.5% and 46.4% at 12 and 14 years; the average of affected teeth 0.63 and 1.28 respectively. The index of restoration is 26.1% in temporary dentition and 68.9 and 74.1% in permanent; those of foreign origin show more caries (p<0.05) and less treatment (p<0.05) than those of Spanish origin. Sixty-two point eight percent of 14 year olds show gingival bleeding and 16.8%, calculus; 14.7% malocclusion and 19.1% wear orthodontic appliances. Conclusions. Caries are stabilised in temporary dentition in the general population, but fall significantly amongst natives (those of Spanish origin); in permanent dentition they continue their tendency to fall, although more moderately. Navarre is amongst the regions with a lower level of caries and a higher index of restoration. Immigrants show significantly more caries. The index of restoration falls slightly with respect to previous years. The periodontal health figures are poor. Malocclusion and orthodontic appliance wearers are stabilised.

La salud dental de los niños y adolescentes de Navarra, 2007 (4ª edición) / Dental health of children and adolescents of Navarra, 2007 (4th edition)

Fundamento. Transcurridos 5 años desde la última encuesta(2002), se procede a una nueva edición que supone la 4ªdesde 1987. El objetivo es conocer el estado de salud oral deniños y adolescentes de Navarra y su evolución.Población y métodos. La muestra (n=1.397) fue seleccionadamediante muestreo probabilístico polietápico, tomandocomo unidad las aulas de 1º y 6º de Enseñanza Primaria y de2º de Enseñanza Secundaria Obligatoria. El trabajo de campose realizó entre los meses de abril y mayo de 2007 pordos equipos examinadores calibrados.Variables de salud estudiadas: caries (medida con criterioOMS y con criterio ampliado), estado periodontal y maloclusión.Los datos fueron informatizados con Access XP 2003SP3; el análisis estadístico, con SPSS Windows v.15.0.Resultados. El 10,8% de la muestra es de origen extranjero.La prevalencia de caries en dentición temporal a los 6 añoses 35,9% con cod 1,26; en dentición permanente, 28,5% y46,4% a los 12 y 14 años; la media de dientes afectados 0,63y 1,28 respectivamente. El índice de restauración es 26,1%en dentición temporal y 68,9 y 74,1% en permanente; los deorigen extranjero presentan más caries (p<0,05) y menostratamiento (p<0,05) que los de origen español. El 62,8% de14 años presentan sangrado gingival y el 16,8%, cálculo; el14,7% maloclusión y el 19,1% lleva ortodoncia.Conclusiones. La caries está estabilizada en denticióntemporal en población general, pero desciende significativamenteentre los autóctonos (origen España); en denticiónpermanente continúa con su tendencia descendente,aunque más moderada. Navarra está entre las regiones conmenor nivel de caries y más alto índice de restauración. Losinmigrantes presentan significativamente más caries. El índicede restauración desciende ligeramente respecto a añosanteriores. Las cifras de salud periodontal son pobres. Maloclusióny portadores de ortodoncia están estabilizados(AU)

Background. With five years having passed since the lastsurvey (2002), a new survey was carried out, the 4th since1987. The aim is to determine the state of oral health of childrenand adolescents in Navarre and its evolution.Population and methods. The sample (n=1.397) was selectedthrough multistage probability sampling, taking as aunit the classrooms of the 1st and 6th year of Primary Educationand the 2nd of Compulsory Secondary Education. Thefieldwork was carried out in the months of April and May2007 by two calibrated teams of examiners.Health variables studied: caries (measured with WHOcriterion and extended criterion), periodontal state andmalocclusion. The data were computerised with Access XP2003 SP3; the statistical analysis with SPSS Windows v.15.0.Results. Ten point eight percent of the sample is of foreignorigin. The prevalence of caries in temporary dentition at6 years is 35.9% with a dft of 1.26; in permanent dentition,28.5% and 46.4% at 12 and 14 years; the average of affectedteeth 0.63 and 1.28 respectively. The index of restorationis 26.1% in temporary dentition and 68.9 and 74.1% in permanent;those of foreign origin show more caries (p<0.05)and less treatment (p<0.05) than those of Spanish origin.Sixty-two point eight percent of 14 year olds show gingivalbleeding and 16.8%, calculus; 14.7% malocclusion and 19.1%wear orthodontic appliances.Conclusions. Caries are stabilised in temporary dentition inthe general population, but fall significantly amongst natives(those of Spanish origin); in permanent dentition they continuetheir tendency to fall, although more moderately. Navarreis amongst the regions with a lower level of caries and a higherindex of restoration. Immigrants show significantly morecaries. The index of restoration falls slightly with respect toprevious years. The periodontal health figures are poor. Malocclusionand orthodontic appliance wearers are stabilised(AU)

Sodium transport across the caecal and colonic epithelium of germfree and specific-pathogen free rats.

It was assumed that the enlarged caecum and the accumulation of semiliquid contents in germfree rats is accompanied by changes in sodium absorption. Transepithelial sodium fluxes were studied under Ussing chamber conditions across epithelial sheets of the caecum and colon of germfree (GF) and specific-pathogen free (SPF) rats. Net sodium transport was highest in the proximal colon and in the proximal segment of the distal colon; it was considerably lower in the caecum and in the distal segment of the distal colon. In the caecum and proximal colon of the GF rats, the electroneutral sodium absorption was increased as compared to the SPF rats. In the proximal segments of the distal colon, no differences were seen. In the distal segment of the distal colon, the mainly electroneutral sodium transport in the SPF rats was changed into electrogenic transport in the GF rats. These differences may be due to the increased aldosterone levels of the GF rats.

Comparative views of electrophysiological parameters of large intestinal segments in pig, sheep, pony, guinea pig and rat.

Short circuit current (ISC) and transepithelial conductance (gt) across sheets of epithelia were measured in the caecum, the proximal and the distal colon of pig, sheep, pony, rat and guinea pig. The electrical parameters underline the basic segmental and species differences. The diversity of ISC demonstrates the different nature of electrogenic transport mechanisms, and data clearly show the heterogeneity with respect to transport mechanisms along the large intestine in the various species. The great differences in amiloride sensitive ISC indicate the variabilities in the electrogenic Na transport. Whereas in the pig, sheep and pony caecum, in the guinea pig proximal colon and in all segments of the rat hindgut no indications for a major electrogenic Na transport was seen, in all other segments amiloride caused a marked decrease in ISC. Electrogenic Na transport seems to be highest in sheep distal colon and in pig proximal and distal colon, somewhat less in guinea pig and in pony distal colon. The epithelium with the lowest Powest transepithelial conductance clearly is that of the pony caecum. Except in sheep, gt-values are not much different from those in pony and also pig and guinea pig. By far the epithelium with the highest conductance is that of the rat proximal colon. gt was similar in the proximal and the distal colon of pig, sheep and pony; in guinea pig values were slightly, in rat much lower.

Evidence for the presence of endogenous 19-nortestosterone in the cow peripartum and in the neonatal calf.

Urine samples were collected from five Brown Swiss cows during the 18 days prior to and 11 days after parturition and were analysed for 19-nortestosterone using an enzyme immunoassay. Nortestosterone concentrations ranged from 70 to 130 nmol/l in all samples taken before parturition. The levels declined within two days, and 11 days post partum no nortestosterone was detectable. In urine from newborn calves, maximal nortestosterone concentrations were determined during the first day of life (10.9-120 nmol/l), declining below 7.3 nmol/l until day 3 in most animals and remaining below the detection limit (less than 3.6 nmol/l) after day 8 in all animals. There was no obvious difference between cows carrying a male or a female calf nor between newborn male or female calves. Using the combined methods high performance liquid chromatography/enzyme immunoassay and high performance liquid chromatography/gas chromatography-mass spectrometry, the immunoreactivity in urine was identified to be 19-nortestosterone-17 alpha. Although there is unequivocal evidence for the endogenous production of nortestosterone in pregnant cows, its function for placenta physiology, pregnancy anabolism and parturition remains unclear. However, new threshold levels for residue control of nortestosterone need to be fixed in accordance with the endocrine status of the animals.