Relationship between children's first dental visit and their dental anxiety in the Veneto Region of Italy

The aim of this study was to explore the association between negative experiences during children's first dental visit and any subsequent dental anxiety and related factors in three dental clinics in the Veneto Region of Italy. For this purpose, parents of 378 children filled out a questionnaire. Factors related to child dental anxiety (none-some/fairly much-very much) were explored by means of logistic regression analysis. The independent variables were: problems with tht first dental visit (no/yes), parental dental anxiety (none-some/fairly much-very much), number of previous visits (0-3/4 < or =) site visited (public/private) and age of the child (< 10 years/10 < or = years). Parental anxiety was associated with child's anxiety (OR = 2.3, 95% CI = 1.1-4.9). A problematic first visit was a strong predictor of dental anxiety. However, this effect was modified by the number of subsequent visits. Children with 4 or more visits after the first visit were less likely to be anxious after a problematic first visit (OR = 4.6, 95% CI = 1.5-14.1) than children with 3 visits or less after the first visit (OR = 19.8, 95% CI = 7.2-54.5). Thus, the negative effect of a problematic first visit may fade during subsequent dental visits.     

Probing the human hippocampus using rCBF: contrasts in schizophrenia.

Regional cerebral blood flow (rCBF) data from two PET-15O water schizophrenia studies were analyzed using individually placed, magnetic resonance (MR)-guided hippocampal volumes of interest (VOI). In one study, normal (N = 10) and schizophrenic (N = 18) volunteers performed an overlearned auditory discrimination task in rest, control, and decision conditions. In the other study, schizophrenic and normal volunteers received the noncompetitive NMDA receptor antagonist ketamine and placebo and had sequential rCBF evaluations. Moreover, the schizophrenic volunteers were off drug in one study and on antipsychotic drug in the second study, allowing an additional comparison of medication status. VOIs were placed on anterior, middle, and posterior hippocampal areas in each PET image from both studies, redirected from an MR scan, and individually adjusted. While no hippocampal activation was apparent in either the normal or schizophrenic group in the task vs. condition comparison, rCBF was higher in the schizophrenic than in the normal hippocampus in both task and control conditions, independently. In addition, at rest rCBF was significantly higher in the unmedicated group of schizophrenics than in the group of medicated patient volunteers and higher than in the normal comparison group. This suggests that schizophrenia is associated with elevated rCBF in the hippocampus, which "normalizes" with antipsychotic drug treatment. Ketamine, the noncompetitive NMDA receptor antagonist, was more potent in reducing rCBF in the schizophrenic group compared to the normal volunteer group. These data are consistent with a previous report from our laboratory of reduced NMDA receptor NR1 subunit expression and possible abnormal NMDA receptor composition in schizophrenia. These data show an abnormality of hippocampal function in schizophrenia and suggest that this abnormality may be associated with the pathophysiology of the illness.     

Association between dental fear and dental attendance among adults in Finland

OBJECTIVE: Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. MATERIAL AND METHODS: The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: "How afraid are you of visiting a dentist?" Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. RESULTS: Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. CONCLUSION: Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.     

Microcirculatory response of skin to benzoic acid and methyl nicotinate in patients with diabetes.

AIMS: In view of the relationship between microvascular pathology and organ complications in diabetes mellitus, the aim of the present study was to examine the microvascular response of upper arm skin to non-immunological contact irritants in 17 insulin-dependent diabetic patients and 11 non-diabetic controls. METHODS: Non-immunological contact urticaria, an inflammatory reaction mediated in a unique way, not previously studied in diabetic patients, was examined. The test agents were benzoic acid and methyl nicotinate. The intensity of the reactions was measured using laser-Doppler flowmetry and colorimetry. The patients were divided into two groups, depending on whether they had had diabetes for less or more than 10 years. RESULTS: There were no differences in the maximal blood flow responses between the groups, but the diabetic patients showed increased blood flow responses to the lowest irritant concentrations compared to the controls. The reactions in the two groups of diabetic patients were similar. CONCLUSIONS: The present study suggests that the microvascular reactivity of diabetic skin to non-immunological contact irritants is increased.     

Anti-anginal therapy and quality of life. A comparison of the effects of transdermal nitroglycerin and long-acting oral nitrates

A total of 112 male patients with severe effort-induced angina pectoris (New York Heart Association functional classes II and III) participated in a randomized open trial consisting of a 6 month phase with 3 month treatment cross-overs. The aim of the study was to compare the effect of transdermal nitroglycerin (TN) patches and long-acting oral nitrates (LAON) on quality of life (QL). During the cross-over period 30 patients (20 on TN and 10 on LAON) withdrew from the study, over half of them within the first month. Although the results should be interpreted with some caution, they showed that improvement in QL was present for both treatments but greater during the transdermal therapy (unadjusted p = 0.07, adjusted p = 0.03). Anginal attacks were associated with improved QL scores, and fewer attacks occurred on TN (p = 0.06). Improvement in QL was most pronounced in patients whose recorded duration of angina was less than 8 years.     

A summary index for the assessment of quality of life in angina pectoris

When exploring the effects of anti-anginal therapy on quality of life (QL), it is essential to use concise, reliable, outcome measures which focus on those aspects of the disease which are affected by the anginal pain, and which are expected to be responsive to medical intervention. Analysis based on a single comprehensive index is preferable to the use of several indexes as it avoids the potential for conflicting inferences from multiple comparisons. In this paper, we describe the development of a QL index which summarizes the three questionnaires used in the North Karelian Quality of Life (KarQuol) study. The summary index (SI) will be used to compare transdermal and oral nitrate therapy in patients with angina pectoris, and represents the first stage in the construction of a disease-specific evaluative index for future trials.     

Ketamine effects on eye movements.

In order to determine if the N-methyl-D-aspartate antagonist ketamine would reproduce eye movement dysfunction in schizophrenia, we studied 12 normal control subjects with low dose (0.1 mg/kg) bolus injection of ketamine in a double-blind placebo-controlled study. Oculomotor measures were obtained during smooth pursuit that included closed loop gain and measures of gain during masking conditions. Measures during initiation of smooth pursuit included latency, open loop acceleration and velocity. Ketamine disrupted closed loop gain and open loop acceleration but not measures during the masking conditions. The ketamine partly reproduced some abnormalities seen in schizophrenia but not measures that may be more specifically linked to familial abnormalities found in family members of subjects with schizophrenia.     

Dopaminergic synapses in the caudate of subjects with schizophrenia: Relationship to treatment response

The typical symptoms of schizophrenia (SZ) are psychotic symptoms (hallucinations, delusions, disorders of thought or speech, grossly disorganized behavior) as well as cognitive impairments and negative symptoms. Not all patients respond to treatment and in those who do, only psychotic symptoms are usually improved. Imaging studies have shown that SZ subjects with high striatal dopamine release are far more responsive to antipsychotic drugs than those patients who have dopamine levels lower than or comparable to that of normal controls. In the present study we hypothesized that there was a link between psychosis and the number of dopaminergic synapses in the caudate nucleus in SZ. We examined dopaminergic synapses at the electron microscopic level in postmortem caudate from cases obtained from the Maryland Brain Collection. SZs were subdivided based on treatment response or resistance. The tissue was processed for the immunocytochemical localization of tyrosine hydroxylase (TH), the synthesizing enzyme for dopamine, and prepared for electron microscopy. The density of all TH labeled synapses was 43% greater in treatment responders than in controls and 62% greater in than in treatment resistant SZ. Axodendritic, but not axospinous, TH‐labeled synapses showed this increase. TH‐labeled axodendritic synapses in treatment responders were elevated in density (1.95 ± 0.093/10 μm³) compared to treatment resistant SZ (0.04 ± 0.017/10 μm³) and controls (0.11 ± 0.044/10 μm³). The results of the present study suggest that one anatomical underpinning of good treatment response may be a higher density of dopaminergic synapses and support a biological basis to treatment response and resistance. Moreover, these data have important implications for linking specific neuropathology with particular symptoms. Synapse 63:520–530, 2009. © 2009 Wiley‐Liss, Inc.     

Comparative neuroanatomical distribution of the kappa and mu opioid receptors in guinea pig brain sections

The opiate family of receptors is believed to consist of the mu, delta, kappa and sigma subtypes. Autoradiographic studies have been conducted to define the distribution of the mu and delta receptors. However, due to the lack of a selective ligand definitive studies have not been reported for the kappa receptor. Recently such a ligand was discovered and characterized. Results are presented in which the distribution of kappa receptors in guinea pig brain slices were determined using autoradiographic techniques and its distribution compared to that of a typical mu ligand. The results demonstrate numerous differences between the two opioid systems. The kappa receptors predominate in the prefrontal cortex, the nucleus accumbens, and deep cortex; whereas the mu receptors have a more intense, broader and different distribution.     

The Nordic Reference Interval Project 2000: recommended reference intervals for 25 common biochemical properties

Each of 102 Nordic routine clinical biochemistry laboratories collected blood samples from at least 25 healthy reference individuals evenly distributed for gender and age, and analysed 25 of the most commonly requested serum/plasma components from each reference individual. A reference material (control) consisting of a fresh frozen liquid pool of serum with values traceable to reference methods (used as the project "calibrator" for non-enzymes to correct reference values) was analysed together with other serum pool controls in the same series as the project samples. Analytical data, method data and data describing the reference individuals were submitted to a central database for evaluation and calculation of reference intervals intended for common use in the Nordic countries. In parallel to the main project, measurements of commonly requested haematology properties on EDTA samples were also carried out, mainly by laboratories in Finland and Sweden. Aliquots from reference samples were submitted to storage in a central bio-bank for future establishment of reference intervals for other properties. The 25 components were, in alphabetical order: alanine transaminase, albumin, alkaline phosphatase, amylase, amylase pancreatic, aspartate transaminase, bilirubins, calcium, carbamide, cholesterol, creatine kinase, creatininium, gamma-glutamyltransferase, glucose, HDL-cholesterol, iron, iron binding capacity, lactate dehydrogenase, magnesium, phosphate, potassium, protein, sodium, triglyceride and urate.