Ethnicity, Social Support and Oral Health Among English Individuals.

OBJECTIVE: To determine whether social support explains ethnic inequalities in oral health among English individuals. METHODS: Data from 42704 individuals across seven ethnic groups in the Health Survey for England (1999-2002 and 2005) were analysed. Oral health was indicated by self-reports of edentulousness and toothache. Social support was indicated by marital status and a 7-item scale on perceived social support. Confounder-adjusted regression models were fitted to evaluate ethnic inequalities in measures of social support and oral health (before and after adjustment for social support). RESULTS: Overall, 10.4% of individuals were edentulous and 21.7% of dentate individuals had toothache in the past 6 months. Indian (Odd Ratio: 0.50, 95% Confidence Interval: 0.32-0.78), Pakistani (0.50, 95%CI: 0.30-0.84), Bangladeshi (0.29, 95%CI: 0.17-0.47) and Chinese (0.42, 95%CI: 0.25-0.71) individuals were less likely to be edentulous than white British individuals. Among dentate participants, Irish (1.21, 95%CI: 1.06-1.38) and black Caribbean individuals (1.37, 95%CI: 1.18-1.58) were more likely whereas Chinese individuals (0.78, 95%CI: 0.63-0.97) were less likely to experience toothache than white British individuals. These inequalities were marginally attenuated after adjustment for marital status and perceived social support. Lack of social support was associated with being edentulousness and having toothache whereas marital status was associated with edentulousness only. CONCLUSION: The findings did not support the mediating role of social support in the association between ethnicity and oral health. However, perceived lack of social support was inversely associated with worse oral health independent of participants' sociodemographic factors.

The Role of Area Deprivation in Explaining Ethnic Inequalities in Adult Oral Health in England.

BACKGROUND: The circumstances of the area where people live may affect their health and ethnic minority groups are often overrepresented in deprived areas. This study explored ethnic inequalities in adult oral health and the contribution of area deprivation to explain such inequalities. METHODS: Data from 15667 adults across 8 ethnicities (White British, Irish, Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese) in the Health Survey for England 2010/2011 were analysed. Oral health was indicated by having a non-functional dentition, poor self-rated oral health and oral impacts on daily activities. Survey logistic regression and the Blinder-Oaxaca decomposition method were used. RESULTS: There were ethnic inequalities in the non-functional dentition, but not in self-rated oral health or oral impacts. Compared to White British adults (19.7%, 95% CI: 18.9, 20.6), a non-functional dentition was more common in Irish (33.1%, 95% CI: 25.9, 41.2) and less common in Black Caribbean (14.9%, 95% CI: 9.9, 21.7), Black African (6.9%, 95% CI: 3.9, 11.9), Indian (10.5%, 95% CI: 6.3, 17.2), Pakistani (7.2%, 95% CI: 4.5, 11.5), Bangladeshi (12.7%, 95% CI: 4.3, 32.3) and Chinese (2.2%, 95% CI: 0.6, 7.9) adults. In decomposition analysis, observed population characteristics explained over half of the ethnic inequalities in the non-functional dentition. Age, area deprivation and SEP were the main contributors, although results varied by ethnicity. CONCLUSION: Ethnic inequalities in adult oral health varied according to oral health measure and ethnicity. Area deprivation and SEP contributed to, but did not fully, explain such inequalities.

Is there a healthy migrant effect in relation to oral health among adults in England?

OBJECTIVE: The aim of the study was to assess the healthy migrant effect in relation to oral health among adults in England. STUDY DESIGN: This is a secondary data analysis of a nationally representative survey. METHODS: Data from 13,373 adults of Irish, black Caribbean, Indian, Pakistani, Bangladeshi and Chinese ethnicity, who participated in the Health Survey for England, were analysed. The proportions of edentate and dentate adults with toothache in the last 6 months in first- and second-generation migrants within each ethnic group were compared with those in the white British (reference group) ethnic group in logistic regression models after adjusting for demographic factors and socio-economic position. Among first-generation migrants, the associations of age at arrival and length of residence with each oral health outcome were assessed in logistic regression models after adjusting for sociodemographic factors. RESULTS: Compared with white British migrants, first-generation black Caribbean (odds ratio [OR]: 1.42) and second-generation Pakistani (OR: 3.16) migrants had higher odds of being edentulous, whereas first-generation Indian (OR: 0.62), Pakistani (OR: 0.62), Bangladeshi (OR: 0.41) and Chinese (OR: 0.49) migrants had lower odds. Among dentate adults, second-generation Irish (OR: 1.51) migrants, first- and second-generation black Caribbean (OR: 1.61 and 1.54, respectively) migrants, first-generation Indian (OR: 1.24) migrants and second-generation Pakistani (OR: 1.34) migrants had higher odds of having toothache in the past 6 months, whereas second-generation Bangladeshi (OR: 0.51) migrants had lower odds than white British. Age at arrival and length of residence were positively associated with being edentulous among first-generation black Caribbean, Pakistani and Bangladeshi migrants. CONCLUSION: Evidence on the healthy migrant effect was mixed, with more consistent findings seen for edentulousness among Asian groups. Black Caribbean migrants were generally the ethnic group with the worst oral health when compared with white British.

Bioremediation of Cephalexin with non-living Chlorella sp., biomass after lipid extraction.

In this work, the removal of the Cephalexin by Chlorella sp., nonliving modified by extraction of lipids was evaluated. First, the microalga was grown to completing 20 days and later, the biomass of crop was centrifuged and the extraction of lipids was performed. Two adsorption experiments were performed: (1) with nonliving Chlorella sp. (control), and (2) the obtained biomass after lipid extraction. The high antibiotic removal, 71.19% and 82.77% (control), were obtained at the lowest initial concentration. The contact time between the biosorbent and the antibiotic was 2 h. The adsorption isotherm follows the Freundlich model and the obtained maximum absorption capacity was 63.29 mg of antibiotic/g of biosorbent for lipid-extracted biomass, while the control follows best to the Langmuir model with 129.87 mg/g in maximum absorption capacity. In summary, this biosorbent provides a potential alternative in the removal of Cephalexin.

Ethnic Disparities in Oral Health Related Quality of Life among Adults in London, England.

OBJECTIVE: To explore ethnic disparities in oral health related quality of life (OHQoL) among adults, and the role that socioeconomic factors play in that association. RESEARCH DESIGN: Data from 705 adults from a socially deprived, ethnically diverse metropolitan area of London (England) were analysed for this study. Ethnicity was self-assigned based on the 2001 UK Census categories. OHQoL was measured using the Oral Health Impact Profile (OHIP-14), which provides information on the prevalence, extent and intensity of oral impacts on quality of life in the previous 12 months. Ethnic disparities were assessed in logistic regression models for prevalence of oral impacts and negative binomial regression models for extent and intensity of oral impacts. RESULTS: The prevalence of oral impacts was 12.7% (95% CI: 10.2-15.1) and the mean OHIP-14 extent and severity scores were 0.27 (95% CI: 0.20-0.34) and 4.19 (95% CI: 3.74-4.64), respectively. Black adults showed greater and Asian adults lower prevalence, extent and severity of oral impacts than White adults. However, significant differences were only found for the extent of oral impacts; Black adults reporting more and Asian adults fewer OHIP-14 items affected than their White counterparts. After adjustments for socioeconomic factors, Asian adults had significantly fewer OHIP-14 items affected than White adults (rate ratio: 0.28; 95%CI: 0.08-0.94). CONCLUSION: This study found disparities in OHQoL between the three main ethnic groups in South East London. Asian adults had better and Black adults had similar OHQoL than White adults after accounting for demographic and social factors.

Perceived learned skills and professional development of graduates from a master in dental public health programme.

INTRODUCTION: Assessing the impact of a training programme is important for quality assurance and further development. It also can helps with accountability and marketing purposes. This study evaluated the impact of King's College London (KCL) Master of Science programme in Dental Public Health in terms of graduates' perceived learned skills and professional development. METHODS: An online questionnaire was sent to individuals who completed successfully the KCL Master of Science programme in Dental Public Health and had a valid email address. Participants provided information on demographic characteristics, perceived learned skills (intellectual, practical and generic) and professional development (type of organisation, position in the organisation and functions performed at work before and after the programme). Learned skills' scores were compared by demographic factors in multiple linear regression models, and the distribution of responses on career development was compared using nonparametric tests for paired groups. RESULTS: Although all scores on learned skills were on the favourable side of the Likert scale, graduates reported higher scores for practical skills, followed by intellectual and generic skills. No differences in scores were found by sex, age, nationality or time since graduation. In terms of career development, there were significantly higher proportions of graduates working in higher education institutions and taking leadership/managerial roles in organisations as well as greater number and variety of functions at work after than before the programme. CONCLUSION: This online survey shows that the programme has had a positive impact on graduates in terms of perceived learned skills and professional development.

Comparing lifecourse models of social class and adult oral health using the 1958 National Child Development Study.

OBJECTIVE: To identify the lifecourse model that best describes the association between social class and adult oral health. METHODS: Data from 10,217 participants of the 1958 National Child Development Study were used. Social class at ages 7, 16 and 33 years were chosen to represent socioeconomic conditions during childhood, adolescence and adulthood, respectively. Two subjective oral health indicators (lifetime and past-year prevalence of persistent trouble with gums or mouth) were measured at age 33. The critical period, accumulation and social trajectories models were tested in logistic regression models and the most appropriate lifecourse model was identified using the structured modelling approach. RESULTS: The critical period model showed that only adulthood social class was significantly associated with oral health. For the accumulation model, a monotonic gradient was found between the number of periods in manual social class and oral health; and four out of eight social trajectories were found to be distinctive. Finally, the social trajectories model was not significantly different from the saturated model indicating that it provided a good fit to the data. CONCLUSION: This study shows the social trajectories model was the most appropriate, in terms of model fit, to describe the association between social class and oral health.

Budd-Chiari Syndrome in a Patient with JAK-2 V617F and Factor V G1691A Mutations.

Myeloproliferative neoplasms (MPN) are considered a risk factor for Budd-Chiari syndrome (BCS). The current classification of MPN by the World Health Organization is based on the presence of JAK-2 V617F somatic mutation, which is present in 40 to 60% of patients with BCS. Factor V Leiden mutation is found in around 53% of patients with BCS, representing the most common prothrombotic disease associated with the disorder. We describe a 48-year old woman with a past medical history of deep venous thrombosis in the left upper extremity and one episode in both lower extremities, one episode of transient ischaemic attack and essential thrombocythemia, who presented with jaundice, ascites and hepatomegaly. Budd-Chiari syndrome was diagnosed based on findings on Doppler ultrasound and liver biopsy. Doppler ultrasound showed narrowness of hepatic veins and inferior vena cava in its hepatic portion, diffuse echotexture and portal hypertension. Liver biopsy showed congestion of sinusoids and portal fibrosis. The patient was found to be a heterozygous carrier of Factor V and homozygous wild type G20210A prothrombin mutations. The JAK-2 V617F mutation was detected by allele-specific polymerase chain reaction (AS-PCR). The association of these mutations is rare, with only a few cases reported in the literature. The patient was treated with oral anticoagulation and antiplatelets with good results and proper follow-up. In conclusion, due to the possible coexistence of multiple prothrombotic factors in patients with Budd-Chiari syndrome, the approach to these patients must be focussed on searching for multiple factors and should include the JAK-2 V617F mutation.

Family income and tooth decay in US children: does the association change with age?

This study explored whether the association of family income with tooth decay changes with age among children in the United States. A second objective was to explore the role of access to dental health care services in explaining the interrelationships between family income, child age and tooth decay. Data from 7,491 2- to 15-year-old children who participated in the 1999-2004 National and Health and Nutrition Examination Survey were analyzed. The association of family income with the prevalence of tooth decay in primary, permanent and primary or permanent teeth was first estimated in logistic regression models with all children, and then, separately in four age groups that reflect the development of the dentition (2-5, 6-8, 9-11 and 12-15 years, respectively). Findings showed that the income gradient in tooth decay attenuated significantly in 9- to 11-year-olds only to re-emerge in 12- to 15-year-olds. The age profile of the income gradient in tooth decay was not accounted for by a diverse set of family and child characteristics. This is the first study providing some evidence for age variations in the income gradient in tooth decay among children in the United States.

Persistent microalbuminuria after treatment with renin-angiotensin axis blockers: causes and results of treatment intensification.

AIMS: The first phase of this study aimed to determine the causes of persistent microalbuminuria after treatment with renin-angiotensin axis (RAA) blocking drugs. In a second phase we tried to determine if strict control of blood pressure and intensive RAA blockade could induce remission or reduction of microalbuminuria in clinical (primary care) practice. PATIENTS AND METHODS: The study included both diabetic patients and non-diabetic hypertensive patients treated with RAA drugs in the presence of microalbuminuria. 211 patients were recruited (mean age 66.6±11.3 years, 111 men, 117 were diabetic). In the first phase treatment was optimized at standard doses. In the second phase treatment was increased during a three months period to reach a blood pressure (BP) < 130/80 mmHg by adding other antihypertensive treatment and to obtain maximal RAA blockade using long-acting drugs, increased dosage, or adding further medication at night. RESULTS: Initial mean BP was 141±16/81±11 mmHg. BP control was unsatisfactory (control of systolic blood pressure [SBP] 19.3%; diastolic blood pressure [DBP] 37.6%). Dosage of RAA blocking drugs was inadequate in 21% of patients. Only 27.4% of patients were taking antihypertensive drugs at night. 30.1% of patients took once daily short acting drugs. During the studymean SBP was reduced to 137±13 mmHg (p < .001) and DBP decreased to 79±10 mmHg (p < .001). Control of SBP improved to 24.5% and DBP control went to 44.4%. Mean microalbuminuria decreased from 64.4±47.0 mg/day to 50.1±53.0 mg/day (p < .001) and the prevalence of microalbuminuria was reduced to 59.1%. CONCLUSIONS: Persistent microalbuminuria was associated with poor blood pressure control and inadequate drug dosage. Low frequency of administration of drugs at night and inappropriate once-daily pills intake were frequent. Strict control of blood pressure and intensive RAA blockade significantly reduced the prevalence of microalbuminuria.

Effects of a progesterone-based oestrous synchronization protocol in 51- to 57-day postpartum high-producing dairy cows.

The aim of this study was to investigate the effect of applying a progesterone-based oestrous synchronization protocol at 51-57 days postpartum in high-producing dairy cows. The data analysed were derived from 1345 lactating cows. Cows between 51 and 57 days postpartum were assigned to the groups: control, PRID (receiving a progesterone-releasing intravaginal device for 9 days, and prostaglandin F(2α) 24 h before PRID removal) or GnRH-PRID (the same as the PRID group plus GnRH at PRID insertion). Oestrus was detected by using pedometers and confirmed by examination of the genital tract at AI. Oestrous and conception rates before days 71-77 postpartum, pregnancy loss in early pregnant cows or the cumulative conception rate registered on day 120 postpartum were considered as the dependent variables in four consecutive logistic regression analyses. Based on the odds ratios, the oestrous rate increased by a factor of 1.73 in cows showing oestrus before treatment for each unit increase in the number of previous oestruses; decreased by a factor of 0.44 in the control group with respect to the treatment groups; and by a factor of 0.61 in cows without luteal structures at treatment with respect to cows with corpora lutea. The conception rates of cows inseminated before days 71-77 postpartum remained similar across the groups, whereas the likelihood of pregnancy loss for cows becoming pregnant during this period was 0.11 times lower in the PRID group than in the control. Based on the odds ratio, the likelihood of a higher cumulative conception rate on day 120 postpartum: increased in cows showing oestrus before treatment by a factor of 1.41 for each unit increase in the number of previous oestruses, was reduced 0.56-fold in control cows compared with treated cows, and was also reduced by a factor of 0.98 for each kilogram of milk production increase recorded at treatment. In conclusion, although oestrous synchronization programmes performed in this study did not improve fertility, cows treated with progesterone could be inseminated earlier than untreated cows, such that the treatments increased the cumulative pregnancy rates determined on day 120 postpartum. In addition, fewer pregnancy losses were observed in early pregnant cows in the PRID group than the GnRH-PRID group.

Beta-glucuronidase and hexosaminidase are marker enzymes for different compartments of the endo-lysosomal system in mussel digestive cells.

In environmental toxicology, the most commonly used techniques used to visualise lysosomes in order to determine their responses to pollutants (LSC test: lysosomal structural changes test; LMS test: lysosomal membrane stability test) are based on the histochemical application of lysosomal marker enzymes. In mussel digestive cells, the marker enzymes used are beta-glucuronidase (beta-Gus) and hexosaminidase (Hex). The present work has been aimed at determining the distribution of these lysosomal marker enzymes in the various compartments of the endo-lysosomal system (ELS) of mussel digestive cells and at exploring whether intercellular transfer of lysosomal enzymes occurs between digestive and basophilic cells. Immunogold cytochemistry has allowed us to conclude that beta-Gus is present in every compartment of the digestive cell ELS, whereas Hex is not so widely distributed. Moreover, Hex is intimately linked to the lysosomal membrane, whereas beta-Gus appears to be not necessarily membrane-bound. Therefore, two populations of heterolysosomes with different enzyme load and membrane stability have been distinguished in the digestive cell. In addition, heterolysosomes of different electron density have been commonly observed merging together by contact; we suggest that some might act as storage granules for lysosomal enzymes. On the other hand, beta-Gus seems to be released to the digestive alveolar lumen in secretory lysosomes produced by basophilic cells and endocytosed by digestive cells. Regarding the implications of the present study on the interpretation of lysosomal biomarkers, we conclude that beta-Gus, but not Hex, histochemistry provides an appropriate marker for the LSC test and that, although both lysosomal marker enzymes can be employed in the LMS test, different values would be obtained depending on the marker enzyme employed.

[Comparison and agreement of the Cockcroft-Gault and MDRD equations to estimate glomerular filtration rate in diagnosis of occult chronic kidney disease]. / Comparación y concordancia de las ecuaciones de estimación de filtrado glomerular de Cockcroft-Gault y MDRD en el diagnóstico de enfermedad renal crónica oculta.

INTRODUCTION AND OBJECTIVES: The estimation of Glomerular Filtration Rate (GFR) by Cockroft-Gault or simplified MDRD functions is a powerful tool for the Chronic Kidney Disease (CKD) diagnosis. The aims of the present study are: 1)-To analyze the accuracy between Cockcroft-Gault and simplified MDRD equations in the Hidden Renal Failure (HRF) diagnosis; and 2)-To know the profile and coronary risk of patients diagnosed of HRF for each equation. PATIENTS AND METHODS: Ten year follow-up of a cross sectional study. A total of 845 patients between 35 and 74 years old (average age 55 years, 56.7% female) without evidence of cardiovascular disease and taken care in a urban primary health center. HRF was defined as an estimated GFR <60 ml/min/1.73 m2 in patients with normal values of creatinine (<1.3 mg/dl in women and <1.4 mg/dl in men ) RESULTS: 8.3% of studied population had HRF by Cockroft-Gault formula and 11.6% using MDRD. The HRF patients diagnosticated with Cockroft-Gault function were older (67.4 vs 64.4 years, p<0.001) and had a higher coronary risk using either the original Framingham equation and REGICOR function. Furthermore, those HRF patients diagnosticated using MDRD function had a higher body mass index (29.6 vs 26.3 kg/m2, p<0.001) and were women in a greater percentage. Kappa index of agreement of these two equations for diagnosis of HRF was 0,55. The HRF patients diagnosticated exclusively by the use of Cockroft-Gault function were mainly men (75%), older (69.1 vs 61.9 years, p<0.001) and they had a high coronary risk in the Framingham equation (32.7%) and REGICOR function (13.1%) CONCLUSIONS: Cockroft-Gault and MDRD equations present a moderate agreement in HRF diagnosis (stage 3 of CKD) in patients between 35 and 74 years old. If we only use the MDRD function, a group of HRF patients would be excluded. This population was mainly male (75%), older (69 years old), with a high coronary risk estimated by original Framingham and REGICOR equations, and confirmed in the ten years follow-up of these patients.

Comparación y concordancia de las ecuaciones de estimación de filtrado glomerular de Cockcroft-Gaulty MDRD en el diagnóstico de enfermedad renalcrónica oculta / Comparison and agreement of the Cockcroft-Gault and MDRD equations to estimate glomerular filtration rate in diagnosis of occult chronic kidney disease

Introducción y objetivos: La estimación del filtrado glomerular(FG) mediante fórmulas como la de Cockcroft-Gault o la derivada del estudio Modification of Diet in Renal Disease(MDRD) es una de las estrategias recomendadas en el diagnóstico de la enfermedad renal crónica (ERC). Los objetivos del presente trabajo son: 1) Analizar el grado de concordancia de las ecuaciones de Cockcroft-Gault y MDRD en el diagnóstico de ERC oculta en una cohorte seguida durante10 años de pacientes de 35-74 años, adscritos a un centro de salud urbano, sin antecedentes de enfermedad cardiovascular y cifras normales de creatinina plasmática, y 2) Conocer el perfil y riesgo coronario de los pacientes diagnosticados de ERC oculta en cada ecuación. Pacientes y métodos: Un total de 845 pacientes (edad media55,5 años, 56,7% mujeres). Se consideró ERC oculta la presencia de un FG < 60 ml/min/1,73 m2 en pacientes con creatinina< 1,3 mg/dl en mujeres y < 1,4 mg/dl en varones. Resultados: Un 8,3% de la población tenía ERC oculta usando la fórmula de Cockcroft-Gault y un 11,6% según MDRD. Los pacientes con ERC oculta en la función de Cockcroft-Gault tenían más edad (67,4 años frente a 64,4,p < 0,001) y un mayor riesgo coronario, tanto en la función de Framingham original como en REGICOR, mientras (..) (AU)

Introduction and objectives: The estimation of Glomerular Filtration Rate (GFR) by Cockroft-Gault or simplified MDRD functions is a powerful tool for the Chronic Kidney Disease (CKD)diagnosis. The aims of the present study are: 1) To analyze the accuracy between Cockcroft-Gault and simplified MDRD equations in the Hidden Renal Failure (HRF) diagnosis, and 2) To know the profile and coronary risk of patients diagnosed of HRF for each equation. Patients and methods: Ten year follow-up of a cross sectional study. A total of 845 patients between 35 and 74 years old(average age 55 years, 56.7% female) without evidence of cardiovascular disease and taken care in a urban primary health center. HRF was defined as an estimated GFR < 60 ml/min/1.73m2 in patients with normal values of creatinine (< 1.3 mg/dl in women and < 1.4 mg/dl in men).Results: 8.3% of studied population had HRF by Cockroft-Gault formula and 11.6% using MDRD. The HRF patients diagnosticated with Cockroft-Gault function were older (67.4 vs64.4 years, p < 0.001) and had a higher coronary risk using either the original Framingham equation and REGICOR function. Furthermore, those HRF patients diagnosticated using MDRD function had a higher body mass index (29.6 vs 26.3 kg/m2, p< 0.001) and were women in a greater percentage. Kappa index of agreement of these two equations for diagnosis of HRF was 0,55. The HRF patients diagnosticated exclusively by (..) (AU)

[Clinical and radiologic assessment of vertebroplasty]. / Valoración clínico-radiológica de las vertebroplastias.

INTRODUCTION: Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. OBJECTIVE: To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. PATIENTS AND METHODS: This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. RESULTS: The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. CONCLUSION: Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs.

Reasons for choosing dentistry as a career: a study involving male and female first-year students in Peru.

The aim of this study was to compare the reported reasons to choose dentistry as a career between Peruvian male and female first-year students. A self-completion questionnaire was administered to 75 first-year students registered at the Faculty of Dentistry of the Universidad Peruana Cayetano Heredia, Lima, Peru. The questionnaire comprised 16 items grouped into four categories (economic, professional, vocational and personal background). Students rated the importance of each item for selecting dentistry as a career on a Likert-type scale of five points. The Mann-Whitney test was used to compare groups and item scores by gender. A male/female proportion of 1/2.1 was found in the pool of participating students. When group and item scores were compared between genders, statistically significant differences were only found for vocational and personal background reasons (P < 0.05); however, the three reasons that obtained higher scores for each gender were found to be different. It is recommended that further studies be conducted to increase the sample, by extending the study and evaluating not only reasons for choosing dentistry, but also other factors that may influence the decision.

Valoración clínico-radiológica de las vertebroplastias / Clinical and radiologic assessment of vertebroplasty

Introducción. La vertebroplastia percutánea consiste en la inyección de cemento acrílico en los cuerpos vertebrales debilitados, con el fin de obtener un efecto analgésico y la estabilización mecánica de la columna vertebral. Objetivo. Valorar las características y efectividad de las vertebroplastias realizadas en el Hospital Universitario Miguel Servet de Zaragoza. Pacientes y métodos. Se han estudiado, de forma retrospectiva, 147 vertebroplastias efectuadas entre 1994 y 2003, a 95 pacientes (60 mujeres y 35 hombres), con un rango de edad entre 19 y 84 años. La vía de abordaje utilizada actualmente es la transpedicular oblicua, que con una sola punción consigue una buena expansión del cemento dentro del cuerpo vertebral. Resultados. La lesión ósea más frecuentemente tratada con vertebroplastia es la fractura secundaria a osteoporosis, con un 65% de los casos, le sigue con un 23% los hemangiomas y, en menor proporción, las metástasis osteolíticas, fracturas traumáticas, linfomas y mielomas. Para valorar la reducción del dolor empleamos la escala analógica visual (VAS), pasando de un VAS previo a la vertebroplastia de 8,88 a un VAS de 2,78 después del tratamiento. Solamente el 7,4% de los pacientes tuvieron complicaciones sintomáticas. Conclusión. La vertebroplastia es un procedimiento seguro y eficaz, de elección en el tratamiento del dolor vertebral refractario a la medicación, que permite una rápida incorporación del paciente a su vida habitual y una reducción de los costes hospitalarios

Introduction. Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. Objective. To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. Patients and methods. This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. Results. The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. Conclusion. Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs

Glycosylation and sorting pathways of lysosomal enzymes in mussel digestive cells.

Our aim was to contribute to the understanding of the synthesis, maturation and activation of lysosomal enzymes in an invertebrate cellular model: the endo-lysosomal system (ELS) of mussel digestive cells. The activities of 5'-nucleotidase (AMPase), arylsulphatase (ASase) and acid phosphatase (AcPase), which are transported towards acidic compartments as membrane proteins, were localised by enzyme cytochemistry. AcPase activity was found within large heterolysosomes and residual bodies. ASase was located in endosomes, endolysosomes and heterolysosomes. AcPase and ASase activities were recorded within small vesicles and cisterns of the trans-Golgi network. Conversely, AMPase activity was primarily found in microvilli and apical vesicles and, less conspicuously, in lysosomes and the cis-side of the Golgi and the cis-Golgi network (CGN). In order to understand the processes of synthesis and maturation of these lysosomal enzymes, selected glycoconjugates were localised after lectin cytochemistry. N-acetylglucosamine, mannose and fucose residues were almost ubiquitous in the ELS, as were galactose residues, which were apparently less abundant. N-acetylglucosamine residues occurred in the inner membrane co-localised with mannose residues within the lysosomal and pre-lysosomal acidic compartments. Based on these results, glycosylation and sorting pathways are proposed for both soluble and membrane enzymes. Unlike in mammalian cells, O-glycosylation is fully completed in the CGN, mannose addition in N-glycosylation extends beyond the CGN and galactose addition is fully achieved at the intermediate side. Sorting of soluble lysosomal enzymes, as in crustaceans, is mediated by the indirect transport of membrane-linked proteins with GlcNAc1-P6Man residues that are removed in endolysosomes and heterolysosomes.

Assessment of potential interactions between phytase and glycosidase enzyme supplementation on nutrient digestibility in broilers.

The effects of microbial 3-phytase and glycosidase enzymes, and their interactions, on energy values and nutrient digestibility in diets rich in nonstarch polysaccharides (NSP) were studied in diets based on corn, wheat, or barley. Four diets were prepared with each cereal grain. One had no enzymes, a second had 500 units of phytase, a third had glycosidase enzyme, and a fourth had phytase and glycosidase. The glycosidases used were alpha-galactosidase (corn diet), xylanase (wheat), and beta-glucanase (barley). Glycosidase decreased intestinal viscosity, whereas phytase increased this parameter in corn diets. Phytase increased AME in corn diets, whereas beta-glucanase in barley diets improved AME and AMEn, and digestibility of dry matter, starch, beta-glucans, and lipid. Xylanase in wheat diets improved dry matter and starch digestibility. Phytase increased total phosphorus retention in all diets, and significant interactions between glycosidase enzymes and phytase were detected in wheat and barley diets. Phytase decreased phosphorus excretion in corn and barley diets, whereas alpha-galactosidase increased phosphorus excretion in corn diets. Phytase in corn diets and beta-glucanase in barley diets increased calcium retention, whereas inclusion of xylanase decreased calcium retention in wheat diets. Phytase and beta-glucanase decreased calcium excretion in corn- and barley-based diets, respectively. An interaction was detected between phytase and beta-glucanase in barley diets, in which calcium excretion was reduced. In general, no negative interactions between phytase and glycosidase enzymes were found, indicating that both types of enzymes may be used together in feeds based on corn, wheat, or barley.

Comparative effects of fosinopril and irbesartan on hematopoiesis in essential hypertensives.

OBJECTIVE: To compare the response of erythropoiesis to an angiotensin receptor blocker, irbesartan with an angiotensin conversing enzyme inhibitor, fosinopril, in essential hypertensive patients with normal renal function. DESIGN AND METHODS: Thirty patients were randomized to receive either irbesartan (150 mg once daily) (n = 15, mean age 65.2+/-8.7 years) or fosinopril (20 mg once daily) (n = 15, mean age 57.4+/-11.5 years, difference is not significant) during 12 weeks. Plasma erythropoietin, hemoglobin (Hb) and hematocrit (Hc) levels were measured at start and monthly after receiving the treatment. All values are expressed as mean+/-1SD. RESULTS: Irbesartan decreased erythropoietin levels (baseline 20.7+/-1.3 vs. 18.1+/-3.7 mU/mL, p=0.019), but they remained unchanged with fosinopril (baseline 18.8+/-1.3 vs. 18.6+/-1.6 mU/mL). Hb levels lowered in irbesartan group (baseline 13.8+/-1.2 vs. 13.5+/-1.1 g/dL, p=0.029), but they did not change in fosinopril-treated patients (baseline 14.6+/-1.3 vs. 14.5+/-1.3 g/dL). Hc did not show any change neither in irbesartan group (baseline 40.9+/-3.7 vs. 40.8+/-3.3 %) nor in fosinopril group (baseline 14.6+/-1.3 vs. 14.5+/-1.3 %). CONCLUSIONS: Irbesartan lowered erythropoietin secretion and hemoglobin levels in essential hypertensives. Fosinopril can neither influence erythropoietin secretion nor decrease hemoglobin levels. Angiotensin receptor blockers seem to get higher efficacy for antagonism angiotensin effects. Safety of angiotensin receptor blockers in anemic hypertensive patients should be studied.