Oral health profile of Australian children from different immigrant backgrounds.

OBJECTIVES: To profile the oral health of Australian children from different immigrant backgrounds. METHOD: Cross-sectional data for Australian children were obtained from the 2012-14 National Child Oral Health Study (NCOHS). Three categories of immigrant status were created based on parents' country of birth and language (non-immigrant, non-visible immigrant, and visible immigrant). Descriptive analyses reported weighted estimates for experience of dental caries, self-rated oral health, and dental services utilisation separately for children aged 5-9 years and 10-14 years. RESULTS: The sample comprised 10,610 children aged 5-9 years (3,605 from immigrant backgrounds), and 8,741 children aged 10-14 years (3,074 from immigrant backgrounds). Children from non-visible immigrant backgrounds presented worse dental service utilisation and poorer self-rated oral health than children from non-immigrant and visible immigrant families. Greater inequalities in dental caries experience were observed in the 5-9-year-olds. Untreated caries was substantially higher among visible immigrant children aged 5-9 years (38.8%, 95% CI: 35.5-42.3) than non-immigrant (24.9%, 95% CI: 23.4-26.6) and non-visible immigrant children (21.0%, 95% CI: 17.7-24.7). CONCLUSIONS: Australian children from immigrant families constitute a highly heterogeneous group with substantial discrepancies in oral health outcomes.

Factors associated with ever use of mammography in a limited resource setting. A mixed methods study.

OBJECTIVE: To evaluate facilitators and barriers influencing mammography screening participation among women. DESIGN: Mixed methods study. SETTING: Three hospital catchment areas in Hidalgo, Mexico. PARTICIPANTS: Four hundred and fifty-five women aged 40-69 years. INTERVENTION: Three hundred and eighty women completed a survey about knowledge, beliefs and perceptions about breast cancer screening, and 75 women participated in semi-structured, in-person interviews. Survey data were analyzed using logistic regression; semi-structured interviews were transcribed and analyzed using elements of the grounded theory method. MAIN OUTCOME MEASURE: Women were categorized as never having had mammography or having had at least one mammogram in the past. RESULTS: From survey data, having had a Pap in the past year was associated with ever having had breast screening (odds ratio = 2.15; 95% confidence interval 1.30-3.54). Compared with never-screened women, ever-screened women had better knowledge of Mexican recommendations for the frequency of mammography screening (49.5% vs 31.7% P < 0.001). A higher percentage of never-screened women perceived that a mammography was a painful procedure (44.5% vs 33.8%; P < 0.001) and feared receiving bad news (38.4% vs 22.2%; P < 0.001) compared with ever-screened women. Women who participated in semi-structured, in-person interviews expressed a lack of knowledge about Mexican standard mammographic screening recommendations for age for starting mammography and its recommended frequency. Women insured under the 'Opportunities' health insurance program said that they are referred to receive Pap tests and mammography. CONCLUSIONS: Local strategies to reduce mammogram-related pain and fear of bad news should work in tandem with national programs to increase access to screening.

Circulating leptin and adiponectin, and breast density in premenopausal Mexican women: the Mexican Teachers' Cohort.

PURPOSE: Leptin and adiponectin are produced by the adipose tissue. Mammographic density (MD) is one of the strongest predictors of breast cancer (BC) and is highly influenced by adiposity. How the interplay between MD, obesity, and obesity-related biomarkers influences BC risk, however, is still unknown, especially in premenopausal women, where adiposity seems to be protective for BC. The aim of the present study was to explore the association between circulating leptin, adiponectin, and their ratio, with MD in Mexican premenopausal women who are part of the large Mexican Teachers' Cohort (MTC). METHODS: A subsample of 2,084 women from the MTC participated in a clinical evaluation. Of them, 574 premenopausal women were randomly selected, from four MD strata. Serum leptin and adiponectin concentrations were measured by immunoassays. Multivariate regression analyses were performed to compare means of MD by quartiles of adipokines and their ratio. RESULTS: High leptin and leptin/adiponectin ratio levels were significantly associated with lower percentage MD and higher absolute and non-absolute dense tissue areas. High adiponectin levels were significantly associated with lower absolute dense and non-dense tissue areas, but not with percentage MD. After adjustment for BMI, only the associations between percentage MD and absolute non-dense tissue area with leptin remained statistically significant. CONCLUSIONS: Leptin, adiponectin, and their ratio were associated with MD; however, only the positive association with leptin seemed to be independent from overall obesity.

Periodontal therapy and glycaemic control among individuals with type 2 diabetes: reflections from the PerioCardio study.

OBJECTIVES: Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity. METHODS: This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention. RESULTS: There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m-2 ) versus 29.9 (6.0 kg m-2 ). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol-1 (95% CI -6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI -1.08, 2.37) or periodontal status at 3 months. CONCLUSIONS: Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.

Knowledge and recommendations regarding breast cancer early screening in an upper middle income country: Primary and secondary health care professionals.

OBJECTIVE: To compare the current breast cancer prevention and control Mexican standard with recommendations that health care professionals provide to women for breast self-exams, clinical breast exams and mammography, as well as health care professional knowledge of the risk factors for and main clinical signs of the disease. METHODS: In 2012, using a cross-sectional design, trained interviewers surveyed health care providers in a sample of 798 medical units, of which 756 corresponded to the first and second levels of medical care. One health care professional from each unit was interviewed for the study. The sampling method was systematic and representative of the national and regional levels. Relative frequencies and 95% confidence intervals (CI) were obtained using the weighting factor assigned to each medical unit. RESULTS: Regarding the indicator about recommendations provided to the population regarding early screening for and risk factors and clinical signs of breast cancer, the average number of health care professional responses in accordance with the Mexican standard was 10.7 (95% CI 10.0-11.4) out of a maximum of 28 points, which corresponds to an average rate of 38.2% of responses (95% CI 35.6-40.8). The percentage of correct answers increased in all areas of breast exam knowledge as training hours in the previous year increased. CONCLUSIONS: Health care professionals are unaware of the current standards on breast cancer; therefore, these recommendations are not routinely translated into health care practice, which is a barrier to increasing the coverage of screening programs in health care services.

The relationship between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children.

OBJECTIVE: This study aimed to test the association between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children. METHODS: Data were from the Longitudinal Study of Indigenous Children (LSIC); a population-based cohort study in Australia. Participants were 1,687 Indigenous Australian children aged 5 or less. Biological, social and behavioural variables were tested using log-linear modelling with binomial regression to determine the association with parental-reported experience of dental caries. Markov Chain Monte Carlo methods were used for multiple imputation of missing data. RESULTS: Overall 25.8% of Indigenous Australian children had dental caries as reported by a carer. In the multivariable model, increased prevalence of parental-reported caries was significantly associated with low maternal education levels (RR=1.60, 95%CI 1.17,2.20) and high sugar consumption (RR= 1.60, 95%CI 1.26,2.02). In the group of children whose mothers smoked tobacco during pregnancy, the association with parent-reported dental caries approached the threshold of significance, but was not significantly associated with caries status in children (RR=1.19, 95%CI 0.99,1.43). After multiple imputation, the most significant association was evident in children of the least educated mothers (RR=1.57, 95%CI 1.25,1.95), breastfeeding more than 12 months (RR=1.26, 95%CI 1.01,1.56), sweet intake more than 30% (RR=1.42, 95%CI 1.15,1.74) and 20-30% (RR=1.29 95%CI 1.04,1.59) and residing in outer regional (RR=1.56, 95%CI 1.19,2.05) or inner regional locations (RR=1.50, 95%CI 1.19,1.88). Mothers' tobacco smoking status showed a weak association with parent-reported dental decay (RR=1.42, 95%CI 1.20,1.68). CONCLUSION: This study suggests there is a weak association between maternal smoking during pregnancy and prevalence of parentally-reported dental caries in Indigenous Australian children.

Circulating concentrations of insulin-like growth factor-I, insulin-like growth factor-binding protein-3, genetic polymorphisms and mammographic density in premenopausal Mexican women: results from the ESMaestras cohort.

The insulin-like growth factor (IGF) axis plays an essential role in the development of the mammary gland. High circulating levels of IGF-I and of its major binding protein IGFBP3 have been related with increased mammographic density in Caucasian premenopausal women. Some common single nucleotide polymorphisms (SNPs) in genes of the IGF pathway have also been suggested to play a role in mammographic density. We conducted a cross-sectional study nested within the large Mexican ESMaestras cohort to investigate the relation between circulating levels of IGF-I, IGFBP-3, the IGF-I/IGFBP-3 ratio, five common SNPs in the IGF-1, IGFBP-3 and IGF-1R genes and mammographic density in 593 premenopausal Mexican women. Mean age at mammogram was 43.1 (standard deviation, SD = 3.7) years, and average body mass index (BMI) at recruitment was 28.5 kg/m(2). Mean percent mammographic density was 36.5% (SD: 17.1), with mean dense tissue area of 48.3 (SD: 33.3) cm(2) . Mean IGF-I and IGFBP-3 concentrations were 15.33 (SD: 5.52) nmol/l and 114.96 (SD: 21.34) nmol/l, respectively. No significant associations were seen between percent density and biomarker concentrations, but women with higher IGF-I and IGF-I/IGFBP-3 concentrations had lower absolute dense (p(trend) = 0.03 and 0.09, respectively) and nondense tissue areas (p(trend) < 0.001 for both parameters). However, these associations were null after adjustment by BMI. SNPs in specific genes were associated with circulating levels of growth factors, but not with mammographic density features. These results do not support the hypothesis of a strong association between circulating levels of growth hormones and mammographic density in Mexican premenopausal women.

Social Inequities in Access to Dental Care in Australian Adults over Time.

INTRODUCTION: Social inequities in dental caries are reflected by both inequities in the social structures that contribute to disease severity and inequities in the provision of dental care. This study aimed to describe social differentials in the dental caries experience among Australian adults across a 13-y period and to examine if the highest magnitude of oral health inequities persisted across dental caries prevalence (decayed teeth [DT]) or its management (missing teeth [MT], filled teeth [FT]). METHODS: Data were from 2 population-based cross-sectional surveys of Australian adult oral health conducted in 2004-2006 (National Survey of Adult Oral Health-1 [NSAOH-1], n = 5,505) and 2017-2018 (NSAOH-2, n = 5,022). In each survey, representative samples of adults were obtained through a 3-stage, stratified sample design within metropolitan and regional areas in each state/territory. Clinical outcomes included the prevalence and mean of DT, MT, FT, and DMFT. Equivalized household income was grouped into approximately quartiles from low to high. RESULTS: Across all income quartiles, the mean DT and % DT >0 was higher in NSAOH-2 than in NSAOH-1. The increase in prevalence was highest in the third highest income group (prevalence difference [PD] = 8.4, from 24.1 to 32.5). Similarly, % MT >0 was lower in NSAOH-2 than in NSAOH-1 across all income groups, with the decrease most marked for the lowest income group (PD = -6.5, from 74.1 to 67.8). Across all income quartiles, % FT >0 was lower in NSAOH-2 than in NSAOH-1. The decrease was the most marked for the lowest income group (PD = -8.9, from 81.1 to 72.2). CONCLUSION: The findings confirm that although oral health inequities decreased for the most extreme management outcome of dental caries (MT), inequities increased for experience of that disease (DT) and the more conservative management of dental caries (FT). For all D, M, and F components (DMFT), inequities between the lowest and highest household income groups increased from 2004-2006 to 2017-2018. KNOWLEDGE TRANSFER STATEMENT: This study found that social inequities in oral health (experience of untreated dental caries and missing teeth) increased between the most socially advantaged and disadvantaged groups between 2004-2006 and 2017-2018. This suggests that models of dental service provision in Australia are increasingly benefitting those who can afford and access the care and who arguably need the services less than their less socially advantaged counterparts do.

Triple Jeopardy in Oral Health: Additive Effects of Immigrant Status, Education, and Neighborhood.

PURPOSE: To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia. METHODS: Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI). RESULTS: Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI3: -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI3: 0.43; 95% CI: -2.08, 2.95). CONCLUSION: Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds. KNOWLEDGE TRANSFER STATEMENT: Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes.

Architectural interventions to mitigate the spread of SARS-CoV-2 in emergency departments.

INTRODUCTION: Emergency departments (EDs) are a critical entry gate for infectious agents into hospitals. In this interdisciplinary study, we explore how infection prevention and control (IPC) architectural interventions mitigate the spread of emerging respiratory pathogens using the example of SARS-CoV-2 in a prototypical ED. METHODS: Using an agent-based approach, we integrated data on patients' and healthcare workers' (HCWs) routines and the architectural characteristics of key ED areas. We estimated the number of transmissions in the ED by modelling the interactions between and among patients and HCWs. Architectural interventions were guided towards the gradual separation of pathogen carriers, compliance with a minimum interpersonal distance, and deconcentrating airborne pathogens (higher air exchange rates (AERs)). Interventions were epidemiologically evaluated for their mitigation effects on diverse endpoints. RESULTS: Simulation results indicated that higher AERs in the ED (compared with baseline) may provide a moderate level of infection mitigation (incidence rate ratio (IRR) of 0.95 (95% confidence interval (CI) 0.93-0.98)) while the overall burden decreased more when rooms in examination areas were separated (IRR of 0.78 (95% CI 0.76-0.81)) or when the size of the ED base was increased (IRR of 0.79 (95% CI 0.78-0.81)). The reduction in SARS-CoV-2-associated nosocomial transmissions was largest when architectural interventions were combined (IRR of 0.61 (95% CI 0.59-0.63)). CONCLUSIONS: These modelling results highlight the importance of IPC architectural interventions; they can be devised independently of profound knowledge of an emerging pathogen, focusing on technical, constructive, and functional components. These results may inform public health decision-makers and hospital architects on how IPC architectural interventions can be optimally used in healthcare premises.

SEVERE NEAR REFLEX SPASM IN A HEALTHY TEENAGER. A CASE REPORT.

INTRODUCTION: Spasm of the near reflex usually includes accommodative spasm, esophoria/tropia, and different degrees of miosis. Patients usually refer to distance blurred and fluctuating vision, ocular discomfort, and headaches. The diagnosis is established with refraction with and without cycloplegia; most of the cases have a functional etiology. However, some cases require neurological conditions to be ruled out; cycloplegics have an important diagnostic and therapeutic role. PURPOSE: To describe a case of bilateral severe accommodative spasm in a healthy 14-year-old teenager. CASE PRESENTATION: A 14-year-old boy with progressive diminished visual acuity attended for YSP consultation. The diagnosis of bilateral spasm of the near reflex was made, based on a gap refraction of 9.75 D between retinoscopy with and without cycloplegia and esophoria with normal keratometry and axial length. The spasm was eliminated with 2 drops of cycloplegic in each eye separated by 15 days; no clear etiology was found other than the start of school. CONCLUSION: Clinicians should be aware of pseudomyopia, especially in children with acute changes in visual acuity, who are usually exposed to myopigenic environmental factors that induce overstimulation of the parasympathetic third cranial nerve's innervation.

Immigrants experience oral health care inequity: findings from Australia's National Study of Adult Oral Health.

BACKGROUND: Oral health service utilization contributes to positive oral health and indicates realised access to services. The study aimed to describe patterns of oral health service use among overseas-born and Australian-born populations and assess equity in access to services. METHODS: The study used data from Australia's National Study of Adult Oral Health 2017-2018 and was guided by the Aday and Andersen framework of access to health and Australia's National Oral Health Plan. Descriptive analyses of service use by perceived need, enabling and predisposing factors were compared between four groups: Australian-born and overseas-born who mainly speak English and Australian-born and overseas-born who mainly speak a language other than English. RESULTS: Overseas-born who mainly speak a language other than English experienced greater oral health care inequity, largely driven by financial difficulty (avoided care due to cost: 42% vs 27%-28%; avoided/delayed visiting due to cost: 48% vs. 37%-38%; cost prevented treatment: 32% vs. 18%-24%). The most favourable visiting patterns were among the Australian-born population who speak a language other than English. CONCLUSIONS: The study shows clear inequity experienced among immigrants in accessibility as measured through indicators of oral health care utilization and factors related to inequity, such as the ability to pay for services.

Comparative evaluation of phenoloxidase activity in different larval stages of four lepidopteran pests after exposure to Bacillus thuringiensis.

Microbial entomopathogen-based bioinsecticides are recognized as alternatives to synthetic pesticides. Insects defend themselves against microbial pathogens by innate mechanisms, including increased phenoloxidase (PO) activity, but its relationship with microbial bioinsecticides efficacy is little known. This study evaluated the differences in PO activity at different developmental stages of the tobacco budworm Heliothis virescens Fabricius (Lepidoptera: Noctuidae), Indian meal moth Plodia interpunctella (Hübner) (Pyralidae), beet armyworm Spodoptera exigua (Hübner) (Noctuidae), and cabbage looper Trichoplusia ni (Hübner) (Noctuidae). Additionally, 2(nd)- and 4(th)-instars were exposed to the LC(50) value of the commercial Bacillus thuringiensis (Bt) spray, Biobit(®). The percentage of insecticidal activity (IA%) on 2(nd)-instar Biobit-exposed larvae was approximately the predicted 50 % mortality for all species except S. exigua. With all 4(th) instar Biobit-exposed larvae, mortality was not significantly different from that of unexposed larvae. Unexposed insects had a significantly higher PO activity in pre-pupae and pupae than early-instar larvae and adults, whereas PO activity was higher in adult females than in males. Correlation analysis between IA% and PO activity revealed significant r-values (p < 0.01) in 2(nd) instar H. virescens (r = 0.979) and P. interpunctella (r = 0.930). Second instar Biobit-exposed P. interpunctella had 10 times more PO activity than unexposed larvae. Similarly, the amount of total protein was lower in 4(th) instar Biobit-exposed H. virescens and higher in S. exigua. Therefore, the results indicated a relationship between Biobit susceptibility and PO activity in some cases. This information may be useful if the Biobit application period is timed for a developmental stage with low PO activity. However, more studies are needed to determine the correlation of each insect with a particular bioinsecticide.

Self-rated oral and general health among Aboriginal adults in regional South Australia.

BACKGROUND: In Australia, Aboriginal adults experience higher levels of poor oral and general health than the non-Aboriginal population. This study compared self-rated oral and general health among Aboriginal adults in regional South Australia with participants in the National Survey of Adult Oral Health (NSAOH). METHODS: Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Three sub-populations from the NSAOH were utilised for comparison: National Aboriginal, National non-Aboriginal and South Australian Regional Non-Aboriginal adults. All data were standardised by age group and sex, utilising Census data. RESULTS: Just over 70% of South Australian Regional Aboriginal participants gave a rating of 'excellent, very good or good' for general health, more than 17% lower than each of the other groups. Just over 50% rated their oral health highly, 20% fewer than the proportion for each other group. Stratifying by key socio-demographic factors did not account for all differences. CONCLUSIONS: Proportionally fewer South Australian Regional Aboriginal adults had high ratings of oral and general health than the Aboriginal and non-Aboriginal adults from the national survey, indicating that national-level data might underestimate the proportion of regional Aboriginal Australians with poor oral health.

Effect of flutamide and two novel synthetic steroids on GABA, glutamine and some oxidative stress markers in rat brain and prostate.

Flutamide is a steroid used to treat androgen-dependent disorders and as antiepileptic, but it induces a number of non-desirable side effects. This work was aimed at assaying the effect of flutamide and two novel synthetic steroids on the levels of GABA, glutamine and oxidative stress markers. Male Wistar rats (weight 180 g) received a single diazepam dose (5 mg/kg) 30 min prior to sacrifice (group A). Group B, flutamide; group C, 16ß-methyl-17α-benzoyloxypregnen-4-en-3,20-dione; group D, estrone-3-hemisuccinate; group E, testosterone; group F, progesterone; all administered intraperitoneally at 10 mg/kg, daily for 3 days. Brain and prostate were obtained to assess lipid peroxidation (TBARS), Na(+) , K(+) ATPase activity, reduced glutathione (GSH), γ-amino butiric acid (GABA), glutamine and serotonin (5-HT) concentrations through spectrophotometry, fluorescence and HPLC. GABA levels increased and glutamine decreased in group A (P < 0.05). Total ATPase activity increased in group F and TBARS decreased in group B (P < 0.05). GSH decreased in A, B and C groups. 5-HT increased in group A and the prostate weight was increased in group E. The conclusion is that 16ß-methyl-17α-benzoyloxypregnen-4-en-3,20-dione may be considered novel and promising to treat androgen-dependent diseases and epilepsy, since it showed an antioxidant effect and seemed to impair the GABAergic and serotonergic metabolism.

Effect of prostaglandin E1 (PGE1) and sildenafil on serotonin metabolism and some oxidative damage markers in rat prostate gland and brain.

The aim of this study was to evaluate the effect of sildenafil and prostaglandin E1 (PGE1) (drugs used in erectile dysfunction) on production of free radicals in prostate and brain of rat. A single dose of sildenafil (10 mg kg(-1) ) and PGE1 (20 µg kg(-1) ) was given to Sprague-Dawley rats (300 g weight) intraperitoneally. The levels of testosterone were measured in blood. Their brains and prostate glands were separated to measure lipid peroxidation, Na(+) and K(+) ATPase activity, reduced glutathione (GSH) and serotonin levels, by means of validated methods. The levels of testosterone increased slightly in animals treated with sildenafil and PGE1. The activity of total ATPase was increased in the prostate of animals treated with sildenafil + PGE1 but decreased in those that received sildenafil alone. PGE1 caused significant diminution of GSH levels in both organs. Sildenafil increased the levels of serotonine in brain, whereas in prostate they decreased instead. Our results suggest that sildenafil induced changes in GSH levels as well as in the serotonergic metabolism, alone or with PGE1 in prostate and brain, respectively. Thus, the combination therapy may be ideal to sustain the biochemical balance due to biphasic stimulation on brain and prostate.

Prevalence, Extent, and Severity of Oral Health Impacts Among Adults in Rural Karnataka, India.

INTRODUCTION: Oral health affects quality of life. Many studies have investigated the factors associated with oral health-related quality of life (OHRQoL). Little is known about OHRQoL of adults living in rural and remote areas of India, where many have lower levels of education and limited availability of oral health care services. OBJECTIVES: To determine the prevalence, extent, and severity of OHRQoL impacts associated with psychosocial factors, functional dentition, and patterns of dental visits among rural Indian adults between the ages of 35 and 54 y. METHODS: A cross-sectional study was conducted with a multistage stratified sampling strategy targeting 35- to 54-year-olds. Interviews and oral examinations were performed to collect data on sociodemographic variables, Oral Health Impact Profile-14 (OHIP-14), patterns of dental visits, stress, tobacco and alcohol use, and dentition status. Univariate, bivariate, and multivariable analyses were done to determine the factors associated with prevalence, extent, and severity of OHIP-14 using SAS version 9.3. RESULTS: There were 873 participants. Prevalence, extent, and severity of OHIP-14 were 13.4%, 0.5 (0.4-0.7), and 11.8 (11.2-12.5), respectively. The OHIP-14 impacts reported were not severe and mostly affected physical functioning. Levels of education, income, and number of functional teeth (FT) were inversely associated and last dental visit within the previous year was positively associated with prevalence, extent, and severity of OHIP-14. The prevalence of 1 or more oral health impacts was nearly 13% among rural middle-aged adults in India. CONCLUSIONS: Low socioeconomic conditions, dental visits, and FT ≤19 were positively associated with prevalence, extent, and severity of oral health impacts. KNOWLEDGE TRANSFER STATEMENT: This article provides data regarding OHRQoL of people in rural areas of a developing country. The study was intended to determine the factors associated with OHRQoL in rural people who are less educated and living in areas with minimal oral health care facilities. The findings of this study could potentially facilitate further research and health promotional activities for rural people of developing countries.

Assessment of mycobacteremia detection as a complementary method for the diagnosis of tuberculosis in HIV-infected patients.

The purpose of this investigation was to assess the usefulness of mycobacteremia detection in human immunodeficiency virus (HIV) patients with suspected tuberculosis. The study included 47 patients with suspected tuberculosis and confirmed HIV infection. A first blood sample was incubated in a BACTEC 9050 MB system, while white blood cells isolation was performed on a second blood specimen before incubation in a BACTEC MGIT 960 system. The third specimen was taken from the affected organs of each patient according to their clinical profile. Twelve (25.5%) patients were positive for mycobacterial infection identified by any of the methods used. Ten (21.2%) were positive for Mycobacterium tuberculosis and 2 (4.3%) for M. avium. Six patients were diagnosed by the culture of specimen from affected organs only, whilst three other patients were positive exclusively for blood cultures. Three additional patients were diagnosed by both methods. Four patients with negative cultures were ultimately diagnosed with tuberculosis by measuring the adenosine deaminase levels. Mycobacteremia detection can be used to increase the sensitivity of the diagnosis of tuberculosis and other mycobacteria in patients with HIV. However, it cannot be used as the sole diagnostic method. Clinical specimen cultures do not provide 100% diagnostic accuracy and it is, therefore, critical to further improve the mycobacteria detection sensitivity.

Effect of sibutramine on Na+, K+ ATPase activity and tryptophan levels on male and female rat brain.

Some drugs that are clinically used in weight control, like sibutramine, act on the serotonergic metabolism, but its relation with free radical (FR) production in the CNS is still unknown. The aim of the work was to evaluate the effect of sibutramine on FR production. Female and male Wistar rats (250 g weight) were used; the animals received sibutramine (10 mg/kg each 36 hours) intraperitoneally during 15 days. At the end of the study, the rats were sacrificed and their brains used to measure lipid peroxidation (TBARS), Na+, K+ ATPase activity, reduced glutathione (GSH), and tryptophan (TRP) levels, by means of validated methods. The activity of Na+, K+ATPase and total ATPase was increased in males and decreased in females. GSH concentration was increased and the levels of TBARS decreased by an effect related to sibutramine in the female group. Sibutramine decreased TRP concentration in the female group, but increased it in the male one, with respect to the control group. Our results suggest that sibutramine produce an antioxidant effect stimulated by the endogenously produced tryptophan and it protects the fluidity of plasma membrane in rat brain.

Comparison of adult oral health in Australia, the USA, Germany and the UK.

BACKGROUND: Australian adults reportedly have poor oral health when compared to 28 other OECD countries. The Australian ranking was based on edentulism and caries experience data from selected age groups that apparently were collected in 1987-88. The objective of this study was to compare the oral health of Australian adults with that of three other western countries that have comprehensive oral health survey data. METHODS: Published data were obtained from the NHANES 2003-2004, the Fourth German Oral Health Study 2005 and the UK Adult Dental Health Survey 1998. Data from the Australian NSAOH 2004-06 were analysed to generate comparable age-specific estimates using nine dental clinical indicators, two measures of oral hygiene behaviour and two of dental attendance. RESULTS: Australia had the best oral health based on two clinical indicators, was equal first on three indicators and ranked second in the remaining clinical indicators. Australia ranked first or second based on dental flossing, use of mouthwash and frequency of dental attendance. CONCLUSIONS: The oral health of the Australian adult population was among the best of the four nations studied.