Oral Health, Dental Care and Nutritional Habits of Children with Cerebral Palsy during Conductive Education.

OBJECTIVE: Regarding the 2011 census in Hungary, the number of children with movement deficiences can be around 7,000. These children with special health care needs are considered to be a vulnerable group even from a dental point of view. In our dental program, we gain comprehensive information about patients' oral health, health behavior, and monitor dental care. STUDY DESIGN: A total of 199 children went through a full pediatric dental examination, children with cerebral palsy were categorized into five different levels (GMFCS) and children without motor disfunction into two groups. We analyzed the df-t and DMF-T values. Oral hygiene routine, dental care, gingivitis, demographic characteristics, nutritional habits odds ratio to df-t and DMF-T were surveyed. RESULTS: The mean df-t and DMF-T was 1.87 and 1.15 out of a total of 199, and the group that scored worse was the GMFCS II. The mean RI (restorative index) was 18.12% and 27% for decidous and permanent teeth, respectively. The prevalence of gingivitis was 66.7%. CONCLUSION: The results of our research point to the fact that children with cerebral palsy have difficulties in developing and maintaining proper oral health due to their disadvantages and therefore require special care and attention.

Short communication: Upper critical temperature-humidity index for dairy calves based on physiological stress variables.

In this study, upper critical values of the temperature-humidity index (THI) were determined in Holstein bull calves (n = 16) based on noninvasive physiological variables. Meteorological and animal-based data were recorded for a 4-d period following a 24-h habituation. The estimated upper critical THI values based on the assessment of respiratory rate, rectal temperature, ear temperature, heart rate, and salivary cortisol concentrations were 82.4, 88.1, 83.0, 78.3, and 88.8, respectively. We inferred that welfare of young calves may be compromised above a THI of 78 and that calves experience significant heat stress above a THI of 88. Based on the present findings, upper critical THI should be considered to minimize the duration of impaired welfare during summer heat stress episodes.

Short communication: Heart rate variability, step, and rumination behavior of dairy cows milked in a rotary milking system.

Step behavior, heart rate (HR), the high-frequency (HF) component of heart rate variability (HRV), the ratio of the low-frequency (LF) and HF components (LF/HF ratio) as well as rumination behavior during milking were investigated in dairy cows milked in a high-capacity rotary milking system (n = 49) to study animals' stress responses to the milking process. Cardiac parameters were analyzed for undisturbed standing (baseline) and for the stages of the morning, afternoon, and evening milking processes (i.e., driving animals from the barn to the pre-milking holding pen, pre-milking holding pen, preparation, milking, and waiting after milking in the milking stall). During driving, HR was greater than during all other stages. After driving, a gradual decrease in HR was observed. The HF decreased during driving, indicating a decrease in vagal tone compared with baseline. When animals were in the holding pen, vagal tone decreased, whereas sympathetic tone increased with lower values than recorded for baseline and driving. During preparation, HF values were still lower than those recorded for baseline. The recovery of the autonomic activity was observed following preparation as indicated by increased HF and decreased LF/HF ratio during milking and waiting stages. During milking, 53.1% of the animals ruminated. The frequency of steps was greater during preparation (3.7 ± 1.8 steps/min) than during milking (0.7 ± 0.4 steps/min) and waiting after milking (1.6 ± 1.0 steps/min). Our results suggest that being in the holding pen is stressful for cows; however, vagal predominance from the onset of milking, the low frequency of steps, and the high prevalence of rumination during milking suggest a possible welfare benefit of the investigated rotary milking system.

Stress preconditioning of semen before cryopreservation improves fertility and increases the number of offspring born: a prospective randomised study using a porcine model.

The aim of the present study was to investigate the effect of applying sublethal stress treatment at room temperature, before cryopreservation (hydrostatic pressure (HP): 40MPa, 80min) of 34 boar ejaculate samples, on post-thawed motility and sow fertility. Sows (n=102) were randomly allocated into equal groups inseminated with HP-treated or untreated frozen-thawed semen. Sows were inseminated twice, 10h apart, with 6×10(9) spermatozoa per dose without oestrus synchronisation. Rates of non-return of oestrus and pregnancy, and total numbers of piglets and live piglets were significantly higher (P<0.05) in the HP-treated group. There was also a numerical, albeit non-significant (P>0.05), improvement in the farrowing rate in the HP-treated group. Although the number of live piglets per litter decreased approximately 15% in both groups by 42 days after farrowing, but this remained significantly higher in the HP-treated group. Although total and progressive sperm motility were significantly (P<0.001) higher in the HP-treated group, there were no significant differences (P>0.05) in these parameters between pregnant and non-pregnant sows in either group; thus motility can indicate, but not predict, improved fertility. In conclusion, HP treatment, with sperm cryopreservation, increases in vitro sperm motility and improves reproductive performance without adversely affecting the health of the piglets.

One mutation, two phenotypes: a single nonsense mutation of the CTSC gene causes two clinically distinct phenotypes.

BACKGROUND: Papillon-Lefévre syndrome (PLS; OMIM 245000) and Haim-Munk syndromes (HMS; OMIM 245010) are phenotypic variants of the same rare disease caused by mutations of the cathepsin C (CTSC) gene, and they exhibit autosomal recessive inheritance. AIMS: To identify diseases caused by mutations of the CTSC gene in two Hungarian patients and to perform haplotype analysis to elucidate any familial relationship between them. METHODS: Mutation screening and polymorphism analysis were performed by direct sequencing of the CTSC gene. RESULTS: Mutation screening of the CTSC gene from the two patients revealed the presence of the same homozygous nonsense mutation (c.748C/T; p.Arg250X). However, one patient exhibited the PLS phenotype and the other the HMS phenotype. Although these patients were not aware that they were related, haplotype analysis, especially the genotypes of the rs217116 and the rs217115 polymorphisms, clearly indicated that the patients carry the same haplotype, whereas the unrelated healthy controls carried several different haplotypes. CONCLUSIONS: Our results demonstrate that PLS and HMS are phenotypic variants of the same disease and, additionally, exclude the presence of a putative genetic modifier factor within the CTSC gene that is responsible for the development of the two phenotypes. We suggest that this putative genetic modifier factor is located outside the CTSC gene, or alternatively, that the development of the different phenotypes is the consequence of different environmental or lifestyle factors.

Smoking and Psoriasis as Synergistic Risk Factors in Periodontal disease.

In the literature both smoking and psoriasis are discussed as predisposing factors for chronic periodontal disease. It is also known that smoking leads to deterioration in both psoriasis and periodontal disease. However, up to now, the only study to address the question what effect the co-occurrence of psoriasis and smoking has on the periodontal status of the individual, was a previous study of ours. In the present study, we repeated our measurements in an extended sample. 82 psoriatic patients and 117 controls participated, who all received a full-mouth examination so that their periodontal status could be determined. The analysis was aimed at finding out about to what extent the individual risk factors (i.e. smoking and psoriasis) increased the chance of the occurrence of the advanced stages of periodontal disease. The odds ratio for smoking was 1,32 (p = 0,465), and 1,85 for psoriasis (p = 0,163). In those patients who smoked, the odds ratio was 6,22 (p < 0,001), which is three times higher than the simple combination of odds. This suggests that the risk factors are in a synergistic relationship.

A retrospective screening and epidemiological study of oncological and other diseases in the oral and maxillofacial region at the University of Szeged, Department of Oral Medicine (1960-2014).

The Department of Oral Medicine at the University of Szeged was responsible for the stomato-oncological care of the population of three counties (with a population of 1,7 M at an average) in the period 1960-201 4. The present report summarizes the incidence of oral medicine diseases during this period. The overall number of new out-patients at the Department of Oral Surgery between 1960 and 2014 was 338,200. These patients were dental and oral surgical patients who presented spontaneously or were referred from the general practice, or stomato-oncological patients referred from general dental practices in-the three counties. Of the 338,200 new cases, 9,482 (2.8%) were benign tumors, 5438 (1.6%) premalignancies and 5,145 (1.5%) malignant tumors. This means a total of 20,065 tumor cases (5.9%) in the examined period, of which 10,579 (3.1 %) were premalignancies and malignancies. 14,446 patients presented with other diseases of the oral mucous membrane (5.8%, data available from 1974). Data on the number of stomato-oncological control patients in any given year are available from 1970 on. In the period 1970-2014, the total number of check-up patients was 117,268, this is the 76,97% of the departments overall number of patients. As for the tendencies, in the representative period of 1960-2004, the number of new benign tumors 15-fold, premalignancies 30-fold, and malignant tumors exhibited an 25-fold increase, while the number of other conditions affecting the oral mucosa showed a 14-fold increase.

Hydrodynamic Trapping of Swimming Bacteria by Convex Walls.

Swimming bacteria display a remarkable tendency to move along flat surfaces for prolonged times. This behavior may have a biological importance but can also be exploited by using microfabricated structures to manipulate bacteria. The main physical mechanism behind the surface entrapment of swimming bacteria is, however, still an open question. By studying the swimming motion of Escherichia coli cells near microfabricated pillars of variable size, we show that cell entrapment is also present for convex walls of sufficiently low curvature. Entrapment is, however, markedly reduced below a characteristic radius. Using a simple hydrodynamic model, we predict that trapped cells swim at a finite angle with the wall and a precise relation exists between the swimming angle at a flat wall and the critical radius of curvature for entrapment. Both predictions are quantitatively verified by experimental data. Our results demonstrate that the main mechanism for wall entrapment is hydrodynamic in nature and show the possibility of inhibiting cell adhesion, and thus biofilm formation, using convex features of appropriate curvature.

Anti-irritant and anti-inflammatory effects of glycerol and xylitol in sodium lauryl sulphate-induced acute irritation.

BACKGROUND: Glycerol is known to possess anti-irritant and hydrating properties and previous studies suggested that xylitol may also have similar effects. OBJECTIVE: Our aim was to study whether different concentrations of these polyols restore skin barrier function and soothe inflammation in sodium lauryl sulphate (SLS)-induced acute irritation. METHODS: The experiments were performed on male SKH-1 hairless mice. The skin of the dorsal region was exposed to SLS (5%) for 3 h alone or together with 5% or 10% of glycerol respectively. Further two groups received xylitol solutions (8.26% and 16.52% respectively) using the same osmolarities, which were equivalent to those of the glycerol treatments. The control group was treated with purified water. Transepidermal water loss (TEWL) and skin hydration were determined. Microcirculatory parameters of inflammation were observed by means of intravital videomicroscopy (IVM). Furthermore, accumulation of neutrophil granulocytes and lymphocytes, the expression of inflammatory cytokines and SLS penetration were assessed, as well. RESULTS: Treatment with the 10% of glycerol and both concentrations of xylitol inhibited the SLS-induced elevation of TEWL and moderated the irritant-induced increase in dermal blood flow and in the number of leucocyte-endothelial interactions. All concentrations of the applied polyols improved hydration and prevented the accumulation of lymphocytes near the treatment site. At the mRNA level, neither glycerol nor xylitol influenced the expression of interleukin-1 alpha. However, expression of interleukin-1 beta was significantly decreased by the 10% glycerol treatment, while expression of tumour necrosis factor-alpha decreased upon the same treatment, as well as in response to xylitol. Higher polyol treatments decreased the SLS penetration to the deeper layers of the stratum corneum. CONCLUSION: Both of the analysed polyols exert considerable anti-irritant and anti-inflammatory properties, but the effective concentration of xylitol is lower than that of glycerol.

Fitness cost associated with resistance to fluoroquinolones is diverse across clones of Klebsiella pneumoniae and may select for CTX-M-15 type extended-spectrum ß-lactamase.

Lowered fitness cost associated with resistance to fluoroquinolones was recently demonstrated to influence the clonal dynamics of methicillin-resistant Staphylococcus aureus (MRSA) in the health care setting. We investigated whether or not a similar mechanism impacts Klebsiella pneumoniae. The fitness of K. pneumoniae isolates from major international hospital clones (ST11, ST15, ST147) already showing high-level resistance to fluoroquinolones and of strains from three minor clones (ST25, ST274, ST1028) in which fluoroquinolone resistance was induced in vitro was tested in a propagation assay. Strains from major clones showed significantly less fitness cost than three of four fluoroquinolone-resistant derivatives of minor clone isolates. In addition, plasmids with CTX-M-15 type extended-spectrum ß-lactamase (ESBL) genes were all retained in both major and minor clone isolates, irrespective of the strains' level of fluoroquinolone resistance, while each plasmid harboring SHV-type ESBLs had been lost during the induction of resistance. Major clone K. pneumoniae strains harbored more amino acid substitutions in the quinolone resistance determining regions (QRDRs) of the gyrA and parC genes than minor clone isolates. The presence of an active efflux system could be demonstrated in all fluoroquinolone-resistant derivatives of originally SHV-producing minor clone isolates but not in any CTX-M-15-producing strain. Further investigations are needed to expand and confirm our findings on a larger sample. In addition, a long-term observation of our ciprofloxacin-resistant minor clone isolates is required in order to elucidate whether or not they are capable of restoring their fitness while concomitantly retaining high minimum inhibitory concentration (MIC) values.

Caries and ABO secretor status in a Hungarian population of children and adolescents: an exploratory study.

ABO blood group antigen (ABGA) secretion into the saliva and other body fluids is a well-known phenomenon, and there is evidence to suggest a link between secretor status and the appearance of caries. It has been proposed that secretion of these antigens into the saliva might be caries-preventive, however, this proposition is still a matter of debate. Our aim was to examine the relationship between caries experience and secretor status in a group of Hungarian children and adolescents in a cross-sectional study. Altogether 130 children and adolescents participated in the study (aged 6-18 years). Participants were divided into two groups according to dentition (i.e. mixed and permanent). ABGA were determined from saliva. The DMF-T and dmf-t (decayed, missing, and filled) indices were calculated, as well as the oral health hygiene index-simplified plaque index. Association of these indices with secretor status was examined. In mixed dentition, the mean dmf-t values were significantly lower in the secretor group (2.1 ± 0.52 SEM), as compared to the nonsecretor group (3.8 ± 0.93 SEM; p < 0.05, Mann-Whitney U test). The finding that children of mixed dentition are apparently better protected against caries suggests that the assumed protective effect might be associated with deciduous teeth, but given the general paucity of knowledge about this topic, further research is indicated.

Assessment of the hemolytic activity and cytotoxicity of different PEG-based solubilizing agents.

The hemolytic activity and the cytotoxicity of PEG-based solubilizing agents on Caco-2 monolayer were investigated. In vitro tests can predict the irritancy potential and the delayed toxicity of the surfactants. There were significant concentration dependent differences between the result of the MTT (3-(4,5-dimethylthiazol-2-yl))-2,5-diphenyltetrazolium bromide) test and the data of the hemolytic activity test. Our investigations show that safer and more applicable tensides can be selected in order to form a more biocompatible medicament.

A video feedback-based tobacco cessation counselling course for undergraduates-preliminary results.

BACKGROUND: Hungary has one of the highest rates of tobacco use and decayed, missing and filled teeth in Europe, and the number of lung cancer-related deaths per annum is amongst the highest globally. As it is estimated that the rate of smokers who see their dentist or physician annually is about 70%, to involve all healthcare providers in tobacco intervention seems to be a promising strategy to reduce tobacco use in countries like Hungary. Such an intervention should obviously include the dental health team. It has already been suggested by experts on this topic that instruction in tobacco use prevention and cessation counselling for dental professionals and students of dentistry should be included in under- and postgraduate curricula. OBJECTIVES: To present a novel, video feedback-based undergraduate cessation counselling programme, which has recently been introduced to the dental curriculum at the Faculty of Dentistry, Szeged, Hungary. METHODS: Applying a problem-based learning approach, the programme consists of three main activities: a small-group interactive training session led by a faculty member, where students learn about the basic science and clinical aspects of tobacco use, including counselling skills; student interactions with professional actors (i.e. standardised patients) simulating real-life dental situations, which are recorded for post hoc evaluation; and finally an evaluation of the recorded performance of each student, with the participation of the actor, the student and a faculty member. RESULTS: With the help of this new approach, students had the chance to learn about and develop a deeper understanding of tobacco-related professional dental communication in realistic, case-based dental scenarios. Students have reported increased confidence in tobacco counselling after having participated in this programme. Furthermore, this method appears to be an ideal tool for the evaluation of both verbal and non-verbal tobacco counselling skills. CONCLUSION: To our knowledge, we are the first to have applied video feedback combined with behavioural modification methods in the teaching of tobacco cessation counselling. We conclude that teaching method can help dentists better understand smokers, gain confidence in tobacco cessation counselling and become more effective promoters of a smoke-free lifestyle. In addition, this method can be easily adapted to other healthcare educational settings, including other oral health training programmes.

Preparation and properties of nanoscale containers for biomedical application in drug delivery: preliminary studies with kynurenic acid.

The main purpose of this study was to facilitate the delivery of kynurenic acid (KYNA) across the blood-brain barrier (BBB) by applying micelles as nanoscale containers. Non-ionic amphiphilic molecules were used for preparation of spherical micelles for delivery of kynurenic acid in aqueous solution in physiological condition. It was established that Triton X 100 and Lutensol AP 20 non-ionic surfactants are able to produce stable nanocontainers for delivery of kynurenic acid molecules. The incorporation of KYNA molecules was investigated by dynamic light scattering and the size of micelles were calculated between 5 and 10 nm in 150 mM NaCl and pH 7.5-7.6 solutions. Encapsulated kynurenic acid showed a significantly higher blood-brain barrier permeability compared with non-encapsulated kynurenic acid. The in vivo experiments showed that the encapsulated kynurenic acid is able to display effects within the central nervous system, even after its peripheral administration.

Varying fitness cost associated with resistance to fluoroquinolones governs clonal dynamic of methicillin-resistant Staphylococcus aureus.

The purpose of this study was to investigate the impact of fluoroquinolone resistance on the existence and dynamic of MRSA clones. Resistance to ciprofloxacin was induced in strains of community-acquired (CA) MRSA from various sequence types and the fitness cost suffered by mutant derivatives measured in a propagation assay. In addition, the fitness of fluoroquinolone resistant health care-associated (HA) MRSA isolates from major clones prevalent in Hungary were compared with each other and with those of the CA-MRSA derivatives. The genetic background of fluoroquinolone resistance and fitness cost in CA-MRSA was investigated. The fitness cost observed in the CA-MRSA derivatives proved diverse; the derivatives of the ST30-MRSA-IV strain suffered significantly greater fitness cost than those of the ST8-MRSA-IV and ST80-MRSA-IV isolates. Strains from the New York-Japan (ST5-MRSA-II), South German (ST228-MRSA-I) and EMRSA-15 (ST22-MRSA-IV) HA-MRSA clones proved more viable than CA-MRSA derivatives with similar MIC values to ciprofloxacin and HA-MRSA strains from the Hungarian/Brazilian clone (ST239-MRSA-III). Our strains from the New York-Japan, South-German and EMRSA-15 clones seem to have a competitive edge over the tested CA-MRSA isolates in the health care setting. The greater fitness observed in our New York-Japan and South-German strains could account for the replacement by them of the Hungarian/Brazilian clone in Hungary about ten years ago. Alterations in relevant genes were detected. The Ser80 → Phe mutation in the grlA gene may have seriously compromised viability. Surprisingly silent nucleotide substitutions in the grlB gene seemed to impact fitness in derivatives of the ST30-MRSA-IV isolate.

Significance of methicillin-teicoplanin resistant Staphylococcus haemolyticus in bloodstream infections in patients of the Semmelweis University hospitals in Hungary.

The purpose of this study was to quantify the impact of Staphylococcus haemolyticus in the epidemiology of the blood stream infection (BSI) and to characterize the rates and quantitative levels of resistance to antistaphylococcal drugs. During an eight-year period, 2967 BSIs of the patients hospitalized in different clinical departments of the Semmelweis University, Budapest, Hungary were analyzed. One hundred eighty-four were caused by S. haemolyticus, amounting to 6% of all infections. The antibacterial resistance of S. haemolyticus isolates was investigated by the broth microdilution method, vancomycin agar screen, population analysis profile and PCR for mecA, vanA and vanB genes detection. Epidemiological investigation was processed by determining phenotypic antibiotic resistance patterns and PFGE profiles. Extremely high MIC levels of resistance were obtained to oxacillin, erythromycin, clindamycin, gentamicin and ciprofloxacin. The incidence of teicoplanin reduced susceptibility revealed 32% without possessing either the vanA or vanB gene by the strains. PFGE revealed 56 well-defined genotypes indicating no clonal relationship of the strains. The propensity of S. haemolyticus to acquire resistance and its pathogenic potential in immunocompromised patients, especially among preterm neonates, emphasise the importance of species level identification of coagulase-negative staphylococci and routinely determine the MIC of proper antibacterial agents for these isolates.

Synthesis and biological effects of some kynurenic acid analogs.

The overactivation of excitatory amino acid receptors plays a key role in the pathomechanism of several neurodegenerative disorders and in ischemic and post-ischemic events. Kynurenic acid (KYNA) is an endogenous product of the tryptophan metabolism and, as a broad-spectrum antagonist of excitatory amino acid receptors, may serve as a protective agent in neurological disorders. The use of KYNA is excluded, however, because it hardly crosses the blood-brain barrier. Accordingly, new KYNA analogs which can readily cross this barrier and exert their complex anti-excitatory activity are generally needed. During the past 6 years, we have developed several KYNA derivatives, among others KYNA amides. These new analogs included one, N-(2-N,N-dimethylaminoethyl)-4-oxo-1H-quinoline-2-carboxamide hydrochloride (KYNA-1), that has proved to be neuroprotective in several models. This paper reports on the synthesis of 10 new KYNA amides (KYNA-1-KYNA-10) and on the effectiveness of these molecules as inhibitors of excitatory synaptic transmission in the CA1 region of the hippocampus. The molecular structure and functional effects of KYNA-1 are compared with those of other KYNA amides. Behavioral studies with these KYNA amides demonstrated that they do not exert significant nonspecific general side-effects. KYNA-1 may therefore be considered a promising candidate for clinical studies.

Cytotoxicity testing of carrier-based microcomposites for DPI application.

Inhalation is an attractive delivery route for systemic and local therapy. High local drug concentrations may permit non-invasive delivery, lower therapeutic doses, reduced systemic side-effects, and reduced metabolic degradation of the drug in the liver. In our earlier study, carrier-based microcomposites were prepared and investigated. The present study introduces studies of the cytotoxicity of meloxicam-containing microcomposites on monolayers of Calu-3 cells, in order to acquire information on its availability in pulmonary formulations. By relating cytotoxicity and drug dissolution, the appropriate amount of meloxicam for dry powder inhalation could be determined.

Assessing the digital economy: aims, frameworks, pilots, results, and lessons.

The article discusses the motivations for a holistic assessment of the digital economy. It outlines the pilot assessment program initiated by the World Bank Group and describes the assessment frameworks, tools, and processes deployed in selected pilot countries. It identifies the common challenges faced and lessons learned from applying these assessments in different contexts. These challenges include prioritizing digital diagnosis objectives, addressing inequality and poverty issues, securing participation and partnership of stakeholders, addressing implementation challenges, and integrating digital transformation strategy into a country development strategy. Other challenges include harnessing digital innovation and entrepreneurship, mobilizing local demand for the new technologies, engaging business in digital diagnosis, and adopting multi-disciplinary and whole-of-society approaches. The article addresses the implications of these challenges and draws broad lessons and practical recommendations for developing countries and aid agencies.