Caries prevalence among schoolchildren in Zagreb, Croatia

Aim

To investigate the prevalence of dental caries and treatment needs in schoolchildren aged 7-14 years from Zagreb.

Methods

Dental examinations based on the World Health Organization criteria were performed on 1168 children in the period 2009-2010. The teeth were clinically examined with standard dental instruments using visual-tactile method under standard dental light. We recorded the clinical indexes of decayed, missed, and filled teeth (DMFT and dmft; upper-case letters refer to permanent and lower-case letters to primary teeth) and decayed, missed, and filled surfaces (DMFS), as well as the significant caries index (SiC).

Results

The median DMFT and DMFS of all children were 3 and 4, respectively. The median DMFT and DMFS of 12-year-old children were 4 and 5, respectively. The highest median DMFT score of 7 was found among 14-year-old children. There was a significant difference between age groups (7-10 years and 11-14 years) in DMFT and DMFS. Among 8-year-old children, the median dmft index was the highest (5.5) and SiC index was 7.4. As far as the location of caries on the surface of the first permanent molar is concerned, caries occurred mostly in the central occlusal surface (27.6%).

Conclusion

Our results showed a high caries prevalence among schoolchildren in Zagreb, indicating a need for an extensive program of primary oral health care.Dental caries is a public health problem that affects pre-school and high-school children throughout the world, leading to pain, chewing difficulties, speech problems, general health disorders, psychological problems, and lower quality of life (1-5). Although advanced preventive procedures significantly decrease the prevalence of caries in the population, fissure caries on occlusal surfaces and buccal/lingual surfaces is still a considerable problem (6). In permanent dentition, teeth with deep pits and fissures have a higher risk of caries than smooth tooth surfaces (7). Also, caries more frequently affects primary than permanent teeth due to difference in enamel structure, lack of oral hygiene, or absence of preventive measures in oral health (8). Information on caries prevalence and severity represents the basis for caries prevention programs and indicates treatment necessity in the population (9). Measures of caries prevalence are indexes of decayed (D), missed (M), and filled (F) permanent teeth (T) or surfaces (S), ie, DMFT and DMFS indexes, and decayed (d), missed (m), and filled (f) primary teeth (t) or surfaces (s), ie, dmft and dmfs indexes (10). Many reports have indicated that dental caries is decreasing in many European countries and the USA (7,11-21). With a reduction of interproximal smooth surfaces caries, an increased number of cases of occlusal caries inside pits and fissures was recorded (7). The risk of caries significantly increases among adolescents with a high frequency of cariogenic snack consumption. It is also influenced by maternal socio-economic background and educational level (11), as well as dietary, hygienic, and other socio-economic factors, which demonstrates the importance of preventive educational programs and a comprehensive caries prevention scheme for schoolchildren (12).The aim of this study was to assess the caries prevalence in two primary schools in Zagreb using the indexes for decayed, missed, and filled teeth/surfaces for primary and permanent teeth (DMFT, DMFS, dmft) and significant caries index (SiC).     

抗肝纤维化药物研究进展

HF是各种慢性肝病的共同病理学基础,也是肝硬化的必经阶段。积极的抗HF治疗可以控制多种肝组织疾病,尤其是肝硬化的病理进程。靶点明确、疗效显著的抗HF药物是治疗的首选。本研究从HF药物作用靶点、药物研究的体内外模型及药物研究3个方面展开阐述抗HF药物的最新研究进展。     

Comparison of four international cardiovascular disease prediction models and the prevalence of eligibility for lipid lowering therapy in HIV infected patients on antiretroviral therapy

AimTo compare four cardiovascular disease (CVD) risk models and to assess the prevalence of eligibility for lipid lowering therapy according to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, European AIDS Clinical Society Guidelines (EACS), and European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS) guidelines for CVD prevention in HIV infected patients on antiretroviral therapy.MethodsWe performed a cross-sectional analysis of 254 consecutive HIV infected patients aged 40 to 79 years who received antiretroviral therapy for at least 12 months. The patients were examined at the HIV-treatment centers in Belgrade and Zagreb in the period February-April 2011. We compared the following four CVD risk models: the Framingham risk score (FRS), European Systematic Coronary Risk Evaluation Score (SCORE), the Data Collection on Adverse Effects of Anti-HIV Drugs study (DAD), and the Pooled Cohort Atherosclerotic CVD risk (ASCVD) equations.ResultsThe prevalence of current smoking was 42.9%, hypertension 31.5%, and hypercholesterolemia (>6.2 mmol/L) 35.4%; 33.1% persons were overweight, 11.8% were obese, and 30.3% had metabolic syndrome. A high 5-year DAD CVD risk score (>5%) had substantial agreement with the elevated (≥7.5%) 10-year ASCVD risk equation score (kappa = 0.63). 21.3% persons were eligible for statin therapy according to EACS (95% confidence intervals [CI], 16.3% to 27.4%), 25.6% according to ESC/EAS (95% CI, 20.2% to 31.9%), and 37.9% according to ACC/AHA guidelines (95% CI, 31.6 to 44.6%).ConclusionIn our sample, agreement between the high DAD CVD risk score and other CVD high risk scores was not very good. The ACC/AHA guidelines would recommend statins more often than ESC/EAS and EACS guidelines. Current recommendations on treatment of dyslipidemia should be applied with caution in the HIV infected population.Observational studies found higher rates of myocardial infarction and cerebrovascular events in HIV infected than in uninfected persons (1-6). Hence, prevention of cardiovascular disease (CVD) in HIV infected patients should be an integral part of current clinical practice. In routine HIV clinical care in developed countries it is recommended to calculate the CVD risk using prediction models (7-9). Preventable and modifiable predisposing factors for CVD should be identified, and lifestyle and pharmacological interventions should be undertaken.CVD prevention in HIV-infected persons is mainly based on recommendations for the HIV uninfected population. The American College of Cardiology/American Heart Association (ACC/AHA) published the 2013 Guideline on the Assessment of Cardiovascular Risk (10) and the European Society of Cardiology and European Atherosclerosis Society (ESC/EAS) published one of the major European guidelines (11). The European AIDS Clinical Society (EACS) addresses many complications of HIV disease, including recommendations for lipid lowering therapy (7). All guidelines use different models for assessing cardiovascular risk. EACS recommends the Framingham Risk Scoring (FRS), while ESC/EAS recommends the European Systematic Coronary Risk Evaluation score (SCORE). The FRS has been widely used for estimation of coronary heart disease (angina, myocardial infarction, and coronary death), hard coronary events (myocardial infarction and coronary deaths), stroke, and global CVD (including CVD deaths, coronary disease, transient ischemic attack, and stroke) (12). SCORE estimates the 10-year risk of a first fatal atherosclerotic event (eg, myocardial infarction, stroke, aortic aneurysm), and calibrated versions exist to adjust for different death rates in European countries (13). These estimates have an important role in identifying high risk patients and in recommending lipid lowering therapy (7,11,14). ACC/AHA recommends the Pooled Cohort Equations for atherosclerotic cardiovascular disease (ASCVD) risk to evaluate the need for treatment of blood cholesterol levels in the non-HIV infected population (10).CVD risk estimation formulas are primarily intended to assist physicians in identifying high risk healthy persons older than 40 years with no signs of clinical atherosclerotic disease (7,10,11,14). Patients with diabetes are generally recommended more intensive interventions and considered at a higher risk for CVD (11,14). Cardiovascular risk models designed for the HIV infected population have also been developed, the most widely known is the Data Collection on Adverse Effects of Anti-HIV Drugs Study (DAD) risk equation, which also includes HIV-specific variables such as duration of indinavir or lopinavir use and current use of indinavir, lopinavir, or abacavir (15). However, the follow-up in the DAD Study is still relatively short and the DAD risk equation has yet not been formally recommended for CVD risk assessment in routine clinical care for HIV-infected persons.Southeastern European countries such as Bulgaria, Croatia, Hungary, Romania, and Serbia have high rates of age-standardized mortality from cardiovascular disease, (ie, ischemic heart disease and cerebrovascular disease) (16,17). The aim of our study was to analyze the agreement of the high DAD CVD score with other CVD scores (CVD-FRS, SCORE, ASCVD) developed for the non-HIV infected population in HIV infected patients receiving antiretroviral therapy (ART) in Croatia and Serbia. We also examined the prevalence of eligibility for lipid lowering therapy according to the 2013 ACC/AHA guidelines, EACS, and European ESC/EAS guidelines for cardiovascular disease prevention.     

Are TNC gene variants associated with anterior cruciate ligament rupture susceptibility?

Objectives

To investigate the role of inter-individual variations in a particular glycoprotein, TNC, and its potential contribution to anterior cruciate ligament (ACL) injury susceptibility in Polish Caucasian participants. ACL rupture is one of the most prevalent and severe knee injury that predominantly occurs during sports participation, primarily via a non-contact mechanism. Several polymorphisms in genes encoding glycoproteins either independently or as allelic combinations, modulate the risk of musculoskeletal soft tissue injuries. Specifically, the TNC rs1330363 (C > T), rs2104772 (T > A) and rs13321 (G > C) variants, independently or in haplotype combinations, were analysed in this context.

疏肝健脾汤治疗功能性消化不良78例疗效观察

目的：探讨疏肝健脾汤治疗功能性消化不良的临床疗效。方法：随机将我院156例消化不良患者分为两组,治疗组78例服用疏肝健脾汤,对照组78例口服雷尼替丁和吗丁啉,疗程均为4周。结果：治疗组治愈率为29.5%,总有效率为91.0%;对照组治愈率为15.4%,总有效率为75.6%。两组治愈率和总有效率比较,差异均有高度统计学意义（均P〈0.01）。两组治疗后各临床症候积分均较治疗前有明显改善（均P〈0.05）;治疗组治疗后的腹胀、烧心、恶心症状症候评分与对照组比较,差异均有统计学意义（均P〈0.05）。结论：疏肝健脾汤对功能性消化不良的临床治疗效果较好,且副作用小。