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1.
J Dent Res ; 98(7): 755-762, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30974070

RESUMO

Breastfeeding is important for health and development. Yet, the interaction between breastfeeding duration and usage of fluoridated water on caries experience has not been investigated. This study examined exposure to fluoridation as an effect modifier of the association between breastfeeding duration and caries. The 2012 to 2014 national population-based study of Australian children involved parental questionnaires and oral epidemiological assessment. Children were grouped by parent-reported breastfeeding duration into minimal (none or <1 mo), breastfed for 1 to <6 mo, breastfed for 6 to 24 mo, and sustained (>24 mo). Residential history and main water source used for the first 2 y of life were collected to group children into exposed (WF) and nonexposed (NF) to fluoridation. Socioeconomic status, infant formula feeding, and sugar-sweetened beverage (SSB) consumption data were collected. The prevalence and severity of caries in children aged 5 to 6 y were primary outcomes. Multivariable regression models with robust error estimation were generated to compute prevalence ratios (PRs) and mean ratios (MRs) for 3 breastfeeding groups against the reference (breastfed for 6-24 mo). Of the 5- to 6-y-old children, 2,721 were in the WF and 1,737 were in the NF groups. The groups had comparable distributions of socioeconomic factors, infant formula feeding, and SSB consumption. There were U-shape distributions of caries experience among breastfeeding groups, being more pronounced among NF children. Among NF children, the minimal and sustained breastfeeding groups had significantly higher PR (1.4 [1.1-1.9] and 1.8 [1.4-2.4]) and MR (2.1 [1.4-3.3] and 2.4 [1.4-4.1]) than the reference group. However, among the WF children, this association between breastfeeding duration and caries attenuated after adjustment for other factors. The study contributes evidence of a nonlinear (U-shape) association between breastfeeding duration and dental caries. Early life exposure to fluoridated drinking water attenuated the potential cariogenic effect of both lack of and sustained breastfeeding.

2.
Aust Dent J ; 64(1): 19-26, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30242843

RESUMO

To identify and map the caries risk management protocols with multiple strategies, which were used in Australia and New Zealand and reported in the existing literature, a scoping review was carried out by electronically searching PubMed, Web of Science, Scopus, Embase and Dentistry and Oral Science. Studies on caries risk management protocols, written in English, limited to Australia and New Zealand and published up to March 2018 were included in the review. There was no restriction on participants' age. Of 257 studies identified, seven were included in the review. These seven studies were reported in Australia and all but six were based on the caries management system (CMS). There were two descriptive studies, one 3-year multicentre cluster randomized controlled trial (RCT), one 2 to 4-year post-RCT follow-up and two cost-effective evaluations based on Markov decision analytic models. While concentrating on assessing individual behavioural risk factors for dental caries, studies indicated that the CMS would be more cost-effective if its protocol was properly adhered to. Future studies on caries risk management protocols are suggested to consider both the individual characteristics and the social context of different population groups in view of enhancing the effectiveness of oral care.


Assuntos
Cárie Dentária , Gestão de Riscos , Austrália , Análise Custo-Benefício , Cárie Dentária/prevenção & controle , Humanos , Nova Zelândia , Saúde Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
J Dent Res ; 97(3): 251-258, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29108500

RESUMO

Breastfeeding is a powerful health-promoting behavior. A 2016 Lancet global collaboration to review the health implications of breastfeeding was among the first to consider oral health outcomes. While a role was suggested for breastfeeding in preventing malocclusion, caries was the only included disease condition unfavorably associated with breastfeeding. The present critical review examines the evidence connecting breastfeeding practices to these outcomes and discusses the methodological challenges inherent in reaching causal conclusions. Published systematic reviews show some evidence of a protective effect of breastfeeding against primary dentition malocclusion but no supportive evidence for mixed dentition and permanent dentition malocclusions. Regarding caries, well-conducted studies report a benefit with breastfeeding up to 12 mo but a positive association between caries and breastfeeding of longer duration, at times that vary between 12 and 24 mo, as well as nocturnal feeding. Future studies would be methodologically stronger if focused on specific malocclusion traits that are plausibly associated with sucking movements rather than using general malocclusion indices. Studies should use detailed and consistent terminology for breastfeeding definition, including frequency, intensity, and timing. Analytical studies should be carried out to distinguish between confounders (e.g., prematurity) and mediators (e.g., use of pacifier). Regarding a link to caries, standard terminology for exposures (e.g., nocturnal feeding) is recommended. Statistical analyses must account for known confounding factors (e.g., socioeconomic conditions) but avoid inappropriate adjustment for variables on a causal path between exposure and outcome or for variables not associated with breastfeeding (e.g., tooth brushing), as can be guided using tools such as direct acyclic graphs. For dental practice, the potential caries risk of long-duration breastfeeding should be part of individual patient counseling that incorporates patient values and circumstances. Given the unquestioned overall health benefits of breastfeeding, the dental community should support World Health Organization guidelines that encourage and promote breastfeeding.


Assuntos
Aleitamento Materno , Cárie Dentária/prevenção & controle , Má Oclusão/prevenção & controle , Saúde Bucal , Aleitamento Materno/efeitos adversos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fatores de Tempo
4.
Acta Psychiatr Scand ; 136(3): 280-287, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28734121

RESUMO

OBJECTIVES: Based on seemingly contradictory results in the existing literature, the objective of our study was to investigate whether older individuals suffering from chronic psychiatric disorders show a more rapid decline in cognitive performances than their non-psychiatric counterparts, or if the pattern of decline through older age is similar in both groups. METHOD: A total of 820 older adults were selected from the Ageing Multidisciplinary Investigation (AMI) cohort study, which studies health-related issues of people over 65 years old living in rural areas. Among them, 30 suffer from chronic psychiatric disorders. Cognition was assessed with four neuropsychological tests: the Mini-Mental State Examination, the Digit Symbol Substitution Test, the Free and Cued Selective Reminding test and the Isaacs Set Test. Linear mixed models were used to compare the evolution of cognitive performances in the two groups between baseline and the four-year follow-up. RESULTS: Despite lower performances at baseline, the pattern of cognitive decline of the psychiatric group is similar to that of the control group. CONCLUSION: As suggested by this study conducted in rural communities, community-dwelling people suffering from chronic psychiatric disorders should not be considered at greater risk of age-related accelerated cognitive decline than the non-psychiatric older population.


Assuntos
Envelhecimento/fisiologia , Disfunção Cognitiva/fisiopatologia , Transtornos Mentais/fisiopatologia , População Rural/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Feminino , França/epidemiologia , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Estudos Prospectivos
5.
J Dent Res ; 96(8): 864-874, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28581891

RESUMO

The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of "high" and 6 of "medium" quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.


Assuntos
Doenças da Boca/complicações , Qualidade de Vida , Humanos
6.
Aust Dent J ; 62(4): 493-499, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28556949

RESUMO

BACKGROUND: The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. METHODS: Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. RESULTS: The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). CONCLUSIONS: Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions.


Assuntos
Renda/estatística & dados numéricos , Fatores Socioeconômicos , Odontalgia/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Prevalência , Estudos Prospectivos , Austrália do Sul/epidemiologia
7.
J Dent Res ; 95(12): 1350-1357, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27466396

RESUMO

The authors aimed to critically review the literature regarding the relationship between retention of teeth and oral health-related quality of life (OHRQoL) and the extent to which tooth retention can ensure OHRQoL among adults. The authors investigated studies that assessed the relationship between number of teeth and OHRQoL and how the position, type, and/or pattern of the teeth is related to OHRQoL. Relevant papers published in English from January 2004 to September 2015 were searched via PubMed and EMBASE. Twenty-nine papers-including cross-sectional, longitudinal, clinical trial, and case-control studies-were included and categorized according to 4 subthemes to achieve the stated aim: 1) number of teeth or missing teeth and OHRQoL, 2) occluding pairs or functional units and OHRQoL, 3) position of remaining or missing teeth and OHRQoL, and 4) shortened dental arches (SDAs) and OHRQoL. The main findings for each subtheme were as follows: 1) A significant association between number of teeth and OHRQoL was shown in most studies; however, those studies found different cutoff points regarding the number of teeth that affect OHRQoL, after adjusting for other factors in the analyses (e.g., age, sex, cultural background, and study locations). 2) The number of occluding pairs and the location of remaining teeth have great impacts on OHRQoL. 3) Having fewer anterior occluding pairs had a greater negative impact on aesthetics and thus affected OHRQoL. 4) Two randomized clinical trials on SDAs indicated that people with SDAs do not show worse OHRQoL than do those with removable dentures. The only 2 population-based studies on SDAs showed that adults with SDAs have no impaired OHRQoL when compared with those having more natural teeth. To conclude, this review found evidence that retention of teeth is associated with better OHRQoL. The number of occluding pairs and the location of remaining teeth have great impacts on OHRQoL. People with SDAs maintain an acceptable level of OHRQoL.


Assuntos
Arcada Parcialmente Edêntula , Saúde Bucal , Qualidade de Vida , Perda de Dente , Humanos , Arcada Parcialmente Edêntula/terapia , Perda de Dente/terapia
8.
Osteoporos Int ; 27(11): 3187-3195, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27311722

RESUMO

In this population-based elderly cohort, participants using selective serotonin reuptake inhibitor (SSRI) antidepressants have an increased risk of falls and fractures notably when the treatment was continued over 4 years. Among the various SSRI types, citalopram only was at significant risk for falls and fluoxetine for fractures. INTRODUCTION: Increased risk of falls and fractures has been reported in elderly users of SSRIs. However, biases were insufficiently addressed notably temporality between exposure and outcome and confounding by residual depression. Our objective was to examine the associations between SSRIs and fall or fracture incidence focusing on their chronic use and different types of SSRIs. METHODS: The population-based cohort included participants aged 65 years and above, who had not fallen before inclusion (n = 6599) or were free of recent fracture (n = 6823) and were followed up twice over 4 years. New fall and fracture events were self-reported and defined as at least two falls and one fracture, respectively, during the previous 2 years. SSRI users were compared with those taking no antidepressants. Hazard ratios (HRs) were estimated using Cox models with delayed entry and adjusted for many confounders including residual depressive symptoms. RESULTS: Incidence of falls was 19.3 % over 4 years and that of fractures 9.5 %. After multi-adjustment, SSRI intake was significantly associated with a higher risk of falls (HR, 95 % CI = 1.58, 1.23-2.03) and fractures (HR, 95 % CI = 1.61, 1.16-2.24). The risks were significantly increased by 80 % in those continuing the treatment over 4 years. Citalopram intake only was at significant risk for falls and fluoxetine for fractures. CONCLUSIONS: In this large community-dwelling elderly sample, SSRI users were at higher risk of falls and fractures. This association was not due to reverse causality or residual depressive symptoms. Different SSRI drugs may have specific adverse effects on falls and fractures.


Assuntos
Acidentes por Quedas , Antidepressivos/administração & dosagem , Fraturas Ósseas/epidemiologia , Inibidores de Captação de Serotonina/administração & dosagem , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco
9.
J Dent Res ; 95(8): 868-74, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27053119

RESUMO

Systematic reviews have found no evidence to support a benefit of water fluoridation (WF) to prevent dental caries in adult populations. The aim of this natural experiment was to investigate whether lifetime access to fluoridated water is associated with dental caries experience among adults from Florianópolis, Brazil. The data originated from a population-based cohort study (EpiFloripa Adult) initiated in 2009 (n = 1,720) when participants were aged 20 to 59 years. The second wave was carried out in 2012 (n = 1,140) and included a dental examination and a face-to-face questionnaire. Participants residing at the same address since the age of 7 y or before were included in the primary analyses. Sensitivity analyses were also performed. WF was implemented in the city in 2 different periods of time: 1982 (60% of the population) and 1996. Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. A combination of residential status, participant's age, and year of implementation of WF permitted the creation of participants' lifetime access to fluoridated water: >75%, 50% to 75%, and <50% of a participant's lifetime. Covariates included sex, age, socioeconomic mobility, educational attainment, income, pattern of dental attendance, and smoking. Participants who accessed fluoridate water <50% of their lifetime presented a higher mean rate ratio of DMFT (1.39; 95% CI, 1.05-1.84) compared with those living >75% of their lifetime with residential access to fluoridated water. Participants living between 50% and 75% and <50% of their lives in fluoridated areas presented a decayed and filled teeth mean ratio of 1.34 (95% CI, 1.02-1.75) and 1.47 (95% CI, 1.05-2.04) higher than those with residential access to fluoridated water >75% of their lifetime, respectively. Longer residential lifetime access to fluoridated water was associated with less dental caries even in a context of multiple exposures to fluoride.


Assuntos
Cárie Dentária/epidemiologia , Fluoretação/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Índice CPO , Cárie Dentária/prevenção & controle , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
10.
J Dent Res ; 95(4): 388-94, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26758380

RESUMO

There are no prospective studies investigating the effects of sugar-related feeding practices on changes in dental caries from early childhood to young adulthood. The aim of this study was to assess whether sugar-related feeding practices affect dental caries between the ages of 6 and 18 y. This birth cohort study was initiated in 1993 in Pelotas, Brazil. There were 3 dental clinical assessments; at ages 6 y (n = 359), 12 y (n = 339), and 18 y (n = 307). Sugar-related feeding practices were assessed at ages 4, 15, and 18 y. Covariates included sex and life course variables, such as family income, breast-feeding, mother's education, regularity of dental visit, and child's toothbrushing habits. Group-based trajectory analysis was performed to characterize trajectories of time-varying independent variables that had at least 3 time points. We fitted a generalized linear mixed model assuming negative binomial distribution with log link function on 3-time repeated dental caries assessments. One in 5 participants was classified as "high" sugar consumers, and nearly 40% were "upward consumers." "Low consumers" accounted for >40% of the sample. High and upward sugar consumers had higher dental caries prevalence and mean DMFT in all cohort waves when compared with low sugar consumers. Caries occurred at a relatively constant rate over the period of study, but in all sugar consumption groups, the increment of dental caries was slightly higher between ages 6 and 12 y than between 12 and 18 y. Adjusted analysis showed that dental caries increment ratio between ages 6 and 18 y was 20% and 66% higher in upward and high sugar consumer groups as compared with low consumers. The higher the sugar consumption along the life course, the higher the dental caries increment. Even the low level of sugar consumption was related to dental caries, despite the use of fluoride.


Assuntos
Cárie Dentária/epidemiologia , Sacarose na Dieta/administração & dosagem , Sacarose na Dieta/efeitos adversos , Adolescente , Brasil/epidemiologia , Aleitamento Materno , Criança , Pré-Escolar , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/etiologia , Escolaridade , Feminino , Humanos , Renda , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco , Escovação Dentária
11.
J Endocrinol Invest ; 39(4): 423-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26370671

RESUMO

PURPOSE: The role of thyroid-specific transcription factors in thyroid malignancy is still poorly understood, so we investigate thyroid-specific transcription factors gene expression both in benign and in malignant thyroid nodules, aiming to study a possible clinical utility of these molecules. METHODS: We quantified TTF-1, FOXE1 and PAX8 mRNA levels, relating their expression to diagnostic and prognostic features of thyroid tumors. RNA was extracted from 4 normal thyroid tissues, 101 malignant [99 papillary thyroid carcinomas (PTC) and 2 anaplastic thyroid carcinomas] and 99 benign thyroid lesion tissues [49 goiter and 50 follicular adenomas (FA)]. RESULTS: Levels of mRNA of both FOXE1 (P < 0.0001) and PAX8 (P < 0.0001) genes, but not TTF-1 (P = 0.7056), were higher in benign than in malignant thyroid lesions. FOXE1 was able to identify malignant nodules with 75.8 % sensitivity, 76.1 % specificity, 75.8 % positive predictive value, 76.1 % negative predictive value and 75.9 % accuracy. PAX8 was able to identify malignancy with 60.6 % sensitivity, 81.1 % specificity, 76.9 % positive predictive value, 66.4 % negative predictive value and 70.6 % accuracy. Both FOXE1 and PAX8 gene expression patterns were also able to differentiate FA from the follicular variant of PTC-FVPTC. However, the investigated gene expression was neither associated with any clinical feature of tumor aggressiveness nor associated with recurrence or survival. CONCLUSIONS: We suggest that FOXE1 and PAX8 gene expression patterns may help to diagnose thyroid nodules, identifying malignancy and characterizing follicular-patterned thyroid lesions, but are not determinants of thyroid tumor progression.


Assuntos
Adenocarcinoma Folicular/diagnóstico , Carcinoma Papilar/diagnóstico , Proteínas de Ligação a DNA/genética , Fatores de Transcrição Forkhead/genética , Fator de Transcrição PAX8/genética , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Adenocarcinoma Folicular/genética , Adolescente , Adulto , Idoso , Biomarcadores Tumorais/genética , Carcinoma Papilar/genética , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/genética , Fatores de Transcrição , Adulto Jovem
12.
J Oral Rehabil ; 43(3): 190-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26506211

RESUMO

This study described the prevalence of adults with shortened dental arches (SDA) in Brazil, specifically assessing the differences of oral health-related quality of life [the prevalence and severity of oral impacts on daily performance (OIDP)] by dentition status. We analysed data from the 2010 National Survey of Oral Health in Brazil, including home interviews and oral examinations. The assessment of SDA used two alternative definitions: having 3-5 natural occlusal units (OUs) in posterior teeth or having 4 OUs in posterior teeth. Both definitions included having intact anterior region and no dental prosthesis. The analysis was weighted, and a complex sampling design was used. Negative binomial regression models assessed associations as adjusted for socio-demographic conditions and dental outcomes. A total of 9779 adults (35-44 years old) participated in the study. A non-negligible proportion had SDA: 9·9% and 3·8% for the first and second definition, respectively. Individuals with SDA (first definition) ranked higher in OIDP prevalence [count ratio (CR) 1·22; 1·09-1·36, 95% confidence interval (CI)] and severity (CR = 1·43; 1·19-1·72, 95% CI) than those with more natural teeth. This difference was not statistically significant when adjusted for socio-demographic and dental covariates: OIDP prevalence (CR = 1·04; 0·92-1·17, 95% CI) and severity (CR = 1·09; 0·91-1·30, 95% CI). Analogous results were obtained when the second definition of SDA was adopted. These findings suggest that a considerable contingent of adults may function well without dental prostheses, despite having several missing teeth. This conclusion challenges the traditional approach of replacing any missing tooth and instructs the allocation of more dental resources to preventive, diagnostic and restorative services.


Assuntos
Arco Dental/fisiopatologia , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Modelos Estatísticos , Prevalência , Análise de Regressão
13.
Med Hypotheses ; 84(6): 596-600, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25801483

RESUMO

Chronic periodontal disease (CPD) is a highly prevalent, multifactorial, bacterially induced inflammatory disease, characterized by pathologic loss of periodontal attachment and alveolar bone with onset mostly in adulthood. While cross-sectional data have demonstrated significant associations between adverse socioeconomic position (SEP) and poor periodontal conditions, there is a gap in the literature on the understanding of how SEPs in different life stages impact on the occurrence of this disease later on. Life-course epidemiology offers different theoretical models to study the pathway of health and illness during the lifespan, and the hypothesis of the present study is that the relationship between SEP and CPD can be explained based on different life-course epidemiology theories: (a) critical period model; (b) critical period with modifier effect model; (c) accumulation of risk model; (d) chain-of-risk model. Under the first theoretical model, the association between SEP and CPD may be explained by an inflammatory hypothesis, considering that childhood adverse socioeconomic backgrounds alter the immunoinflammatory response that leads to disease in adulthood regardless of conditions later in life. The second model postulates that the early life SEP modifies the host immunoinflammatory response, and the risk of disease will be modified over the life-course by socio-behavioural influences. The third, "accumulation of risk model", may explain such relationship taking into account exposures during different periods of life. However, this model does not consider the moment when the exposure occurred, only taking into consideration the number of episodes during the life cycle. Finally, the potential explanation to the role of socioeconomic position on chronic periodontal disease, using a chain-of-risk model, is that early low SEP may cause social stress related to social hierarchies, what may, in turn, trigger endocrine, neural and immune changes, that reflect on elevated levels of cytokines, consequently turning these individuals more likely to develop periodontal disease. To summarize, this paper suggests potential explanations of the relationship between SEP during the lifespan and the occurrence of chronic periodontal disease in adult life, under a life-course framework. Longitudinal studies focusing on such relationship should be conducted, aiming to provide evidence regarding the hypotheses here called in question.


Assuntos
Inflamação/epidemiologia , Modelos Teóricos , Doenças Periodontais/epidemiologia , Doenças Periodontais/etiologia , Adulto , Fatores Etários , Humanos , Inflamação/fisiopatologia , Estudos Longitudinais , Fatores de Risco , Fatores Socioeconômicos
14.
Neuroscience ; 284: 590-600, 2015 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-25453776

RESUMO

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by synaptic loss and cognitive impairments. Although AD is the most prevalent aging-related neurodegenerative disease, therapeutic strategies remain palliative. Recent studies have shown that probucol presents neuroprotective effects in experimental models of neurodegenerative disease. The present study aimed to investigate the potential protective effects of probucol against streptozotocin (STZ)-induced cognitive impairment and hippocampal biochemical changes (oxidative stress-related parameters, acetylcholinesterase (AChE) activity, cholesterol levels and ß-secretase (BACE) protein levels) in mice. Adult Swiss mice received STZ [150 µg/bilateral, i.c.v.], and treated daily with probucol (≅10 mg/kg/day, in drinking water, for 5 weeks,). Twenty-one days after i.c.v. administrations, STZ-infused animals displayed significant deficits in cognition (evaluated in the displaced and new object recognition tasks), which were paralleled by a significant increase in hippocampal AChE activity. Moreover, STZ-infused mice showed increased levels of BACE and decreased glutathione reductase (GR) activity in the hippocampus compared with the control group. Probucol treatment significantly protected against the behavioral and hippocampal biochemical changes induced by STZ. However, it was unable to prevent STZ-induced increase of hippocampal BACE levels and did not change hippocampal cholesterol levels. It is noteworthy that probucol treatment increased the glutathione peroxidase (GPx) activity per se independent of STZ injection. The present findings are the first to show that i.c.v. STZ infusions are able to increase hippocampal BACE expression. Moreover, the results also show that probucol can counteract STZ-induced cognitive impairments and biochemical parameters independently of potential modulator effects toward BACE levels. The study is the first to report the protective effects of probucol against STZ-induced biochemical hippocampal changes and behavioral impairments, rendering this compound a promising molecule for further pharmacological studies on the search for therapeutic strategies to treat or prevent AD.


Assuntos
Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/metabolismo , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Nootrópicos/farmacologia , Probucol/farmacologia , Acetilcolinesterase/metabolismo , Administração Oral , Doença de Alzheimer , Secretases da Proteína Precursora do Amiloide/metabolismo , Animais , Antioxidantes/farmacologia , Ácido Aspártico Endopeptidases/metabolismo , Colesterol/sangue , Modelos Animais de Doenças , Glutationa Peroxidase/metabolismo , Glutationa Redutase/metabolismo , Masculino , Camundongos , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , /fisiologia , Estreptozocina
15.
J Nutr Health Aging ; 18(10): 876-82, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25470802

RESUMO

OBJECTIVE: To investigate the association of the change in practice of leisure and social activities with dementia risk taking into account the evolution of cognitive performances. DESIGN, SETTING, AND PARTICIPANTS: From the PAQUID prospective cohort re-examined every 2 years until the 20-year follow-up since 1988, 1461 subjects were seen at 10th year of follow-up. Engagement in 10 leisure and social activities was collected at baseline and at the 10-year follow-up visit for 805 subjects. Four categories of change in activity engagement were considered: subjects who remained active; remained inactive; became inactive and became active. Adjustment on confounders (age, gender, educational level, diabetes, stroke and depression) and rate of evolution of cognitive performances was made with the multivariate Cox proportional hazards model. MAIN OUTCOME MEASURES: Time to incident cases of dementia occurring between the 10th and the 20th year of follow-up. RESULTS: A total of 258 incident dementia cases were documented. The risk of dementia was lower for subjects remaining or becoming active (cumulative risk of dementia: 30%) compared to those remaining or becoming inactive (52% and 42%, respectively) (p<0.0001). Multivariate adjustment including rate of cognitive decline during the first decade of FU did not change these relationships. CONCLUSION: This prospective cohort study suggests a significant association between change in leisure and social activities during old age and risk of dementia.


Assuntos
Demência/psicologia , Atividades de Lazer , Comportamento Social , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Demência/complicações , Feminino , Seguimentos , Humanos , Atividades de Lazer/psicologia , Masculino , Modelos de Riscos Proporcionais , Estudos Prospectivos , Risco
16.
J Nutr Health Aging ; 18(7): 698-704, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25226109

RESUMO

OBJECTIVES: To describe the sequence of basic activities of daily living (ADL) loss to determine whether there is a hierarchical structure of ADL in dementia in two epidemiological prospective studies: the Paquid study and the Three City Study (3C). DESIGN: Two prospective population-based cohort studies: Paquid (over 22 years of follow-up) and 3C (over 10 years of follow-up). SETTING: Paquid Study, Gironde, Dordogne, France; The Three Cities Study, Bordeaux, Montpellier, Dijon, France. MAIN OUTCOMES MEASURES: We analyzed four ADL of the Katz scale: bathing, dressing, transferring and feeding. The a priori hierarchical relationship of the 4 activities tested was 1) no ADL-disability at all four activities; 2) moderate ADL-disability, or disability at bathing and/or dressing (and no disability in transferring nor feeding); and 3) severe ADL-disability, or disability in bathing and/or dressing and transferring and/or feeding. We performed a Guttman scale analysis to establish the hierarchical properties scale. RESULTS: In total, 845 incident cases of dementia were included, among which 838 cases (99.2%) were without any missing data for ADL. Upon diagnosis of dementia, 564 subjects (67.3%) had no ADL-disability, 236 (26.2%) had moderate ADL-disability, and 38 subjects (4.5%) had severe disability. The a priori hierarchy was respected with non-discordance. CONCLUSION: We defined 3 simple relevant stages of ADL functional decline in dementia that would be easy to collect in clinical practice: stage 1, subjects with no major ADL disabilities; stage 2, subjects with complete disability in bathing and/or dressing; and stage 3, subjects with complete disability in all 4 tasks.


Assuntos
Atividades Cotidianas , Demência/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Seguimentos , França , Humanos , Masculino , Estudos Prospectivos , Autocuidado/estatística & dados numéricos
17.
Caries Res ; 48(4): 263-70, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24503491

RESUMO

OBJECTIVE: This study aimed to investigate the prevalence of dental fear in preschool children and to estimate its association with maternal and children characteristics. METHODS: The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Dental fear was investigated using a validated instrument through the question 'Do you think that your child is afraid of going to the dentist?'. The possible answers were (1) 'no', (2) 'yes, a little', (3) 'yes' and (4) 'yes, a lot'. The outcome was dichotomized as 'children without dental fear' (answers 1 and 2) and 'children with dental fear' (answers 3 and 4). Exploratory variables included demographic characteristics, socioeconomic status, maternal oral health status and maternal behaviors. The main explanatory variables were caries and dental pain. Data were analyzed using multivariable Poisson regression. RESULTS: The prevalence of dental fear was 16.8% (95% confidence interval 14.6-19.0). Multivariate analysis showed that the lower the family income at birth and the higher the severity of dental caries, the higher the prevalence of dental fear. Children who never visited the dentist and those who frequently experienced dental pain were positively associated with higher dental fear prevalence. CONCLUSIONS: Presence of dental caries and dental pain were associated with dental fear regardless of socioeconomic origin and lack of dental service use in childhood.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Cárie Dentária/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Estudos de Coortes , Índice CPO , Assistência Odontológica/estatística & dados numéricos , Escolaridade , Feminino , Nível de Saúde , Humanos , Renda/estatística & dados numéricos , Masculino , Comportamento Materno , Mães/educação , Saúde Bucal , Vigilância da População , Prevalência , Classe Social , Odontalgia/epidemiologia
18.
J Nutr Health Aging ; 17(10): 881-92, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24257572

RESUMO

OBJECTIVES: To identify factors associated with survival to the age of 90 years old in 70+ elderly people. DESIGN: The PAQUID prospective cohort on brain and functional ageing. SETTING: 75 randomly selected administrative communities in Gironde and Dordogne (France). PARTICIPANTS: A sub-sample of 2,578 community dwellers aged 70 years and over at baseline in 1988 and followed-up over 20 years, all participants of the PAQUID study. MEASUREMENTS: Data on socio-material environments, lifestyle, health, perceived health, and family background were collected at home every 2-3 years over 20 years, with a prospective update of vital status. Participants were compared according to their survival status (subjects who reached 90 compared to those who did not). The factors associated with survival were investigated separately for men and women by Cox regression with, as much as possible, time-dependent variables. RESULTS: Some factors associated with survival were common to both genders, whereas some others appeared gender specific. For men, tenant status (HR=1.46), former or current smoking (HR=1.17), disability (respective HR of 1.50, 1.78 and 2.81 for mild, moderate and severe level), dementia (HR=1.51), a recent hospitalisation (HR=1.32), dyspnoea (HR=1.32), and cardiovascular symptoms (HR=1.15) were associated with lower chance of becoming nonagenarian. Conversely, regular physical activity (HR=0.74) was associated with higher chance of survival. For women, the presence of a professional help (HR=1.19), living arrangements (HR=1.29 and HR=1.33), disability (respective HR of 1.55, 1.95 and 2.70 for mild, moderate and severe disability), dementia (HR=1.54), a recent hospitalisation (HR=1.19), diabetes (HR=1.49), and dyspnoea (HR=1.20) were associated with lower chance of becoming nonagenarian. Conversely, satisfaction of level income (HR=0.87), comfortable housing (HR=0.81), length of living in the dwelling (HR=0.80 upper to 6 years), regular physical activity (HR=0.89) and a medium (HR=0.79) or good (HR=0.68) subjective health, were associated with higher chance of becoming nonagenarian. CONCLUSION: Our findings confirm that survival up to 90 is a multifactorial phenomenon with similarities and specificities by gender. Consequently, primary prevention and global consideration of ageing (social, material, financial, psychological) are necessary to promote not only longevity but also successful ageing in order to face the future societal challenges due to demographic ageing.


Assuntos
Envelhecimento/fisiologia , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Longevidade/fisiologia , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Demência/epidemiologia , Feminino , Seguimentos , França/epidemiologia , Nível de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , Atividade Motora , Satisfação Pessoal , Estudos Prospectivos , Características de Residência , Distribuição por Sexo , Fumar/epidemiologia
19.
Public Health ; 127(6): 530-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23706706

RESUMO

OBJECTIVES: To identify the clustering of physical inactivity in leisure, work, commuting and household contexts, and the sociodemographic factors associated with the clustering of inactive behaviour in different domains among Brazilian adults. STUDY DESIGN: Cross-sectional population-based study. METHODS: The study was performed in Florianopolis, capital of Santa Catarina, one of the southern states of Brazil, from September 2009 to January 2010. Adults aged 20-59 years were interviewed. Physical inactivity in each domain was defined as non-participation in specific physical activities, using a validated Brazilian questionnaire. Clustering of physical inactivity was identified by the ratio between observed prevalence and expected prevalence of 16 different combinations. Multinomial logistic regression was used in the analysis of sociodemographic factors associated with clustering of physical inactivity. RESULTS: Of the 1720 interviewees, the greatest differences between the observed and expected proportions were observed in simultaneous physical inactivity in the leisure and household domains for men, and physical inactivity in the leisure domain alone for women (59% and 88%, respectively); these differences were higher than expected if the behaviours were independent. Physical inactivity in two or more domains was observed more frequently in men and in individuals with a higher per-capita family income. Ageing was associated with physical inactivity in three or four domains. CONCLUSIONS: Physical inactivity was observed in different domains according to gender. Men and older individuals with a higher per-capita family income were more likely to exhibit physical inactivity when all domains were considered together.


Assuntos
Renda/estatística & dados numéricos , Atividades de Lazer/psicologia , Comportamento Sedentário , Transportes , Trabalho/psicologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Análise por Conglomerados , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Pesquisa Qualitativa , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
20.
Neuroepidemiology ; 41(1): 20-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23548733

RESUMO

BACKGROUND/AIMS: This study was designed to develop a practical risk score for predicting 5-year survival after the diagnosis of dementia. METHODS: Using the Paquid Study (prospective, population-based, long-term cohort study), we created a prognosis score with incident cases of dementia and validated it in another prospective, population-based, long-term cohort study, the Three City Study. - RESULTS: Among the 3,777 subjects enrolled in the Paquid Study, 454 incident cases of dementia were included in this study. After a 5-year follow-up period, 319 (70.3%) were deceased. The score was constructed from three independent prognostic variables (gender, age at diagnosis and number of ADL restricted). The discriminant ability of the score was good with a c index of 0.754. Sensitivity was 64.7% and specificity 76.3%. In the validation cohort, the discriminant ability of the prognostic score with c statistics was 0.700. Sensitivity was 26.3% and specificity 95.4%. CONCLUSIONS: The prognostic factors selected in the predictive model are easily assessable, so this simple score could provide helpful information for the management of dementia, particularly to identify patients with duration of the disease greater than 5 years.


Assuntos
Demência/epidemiologia , Atividades Cotidianas , Idoso , Demência/diagnóstico , Demência/mortalidade , Feminino , Humanos , Incidência , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Sensibilidade e Especificidade , Taxa de Sobrevida
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