Prevalence of dental anxiety in an adult population in a major urban area in Sweden

The aims of the study were to describe the level of dental anxiety in a representative sample of an adult population, to evaluate different demographic variables in relation to dental anxiety, and to compare two measurement scales of dental anxiety. A random sample of residents (n = 830) of the city of Gothenburg (population 432,000) was selected for a telephone survey. The survey comprised different questions concerning demographic variables, dental care habits, and the level of dental anxiety. The methods of measurement of dental anxiety were a 10-point dental Fear Scale (FS) and the Corah Dental Anxiety Scale (DAS). A total of 620 interviews were completed giving a response rate of 74.7%. 41.4% of the respondents were males, 58.6% females. Females were significantly more likely to report a high dental anxiety compared with males. The prevalence of high dental anxiety in the sample as measured by the FS and DAS was 6.7% and 5.4% respectively. The correlation between the FS and DAS was 0.81. The distribution of high dental anxiety and age showed a clearly and significantly higher portion of dental anxiety in the age group 20-39 yr compared to both younger and older groups. The effect of dental anxiety on regularity of dental visits revealed a significant difference as measured by the FS. No significant correlation was found between dental anxiety and educational level or income. A majority of the respondents (82-95%) expressed a desire for establishment of a special dental fear treatment clinic without need for referral.     

Severe Preeclampsia and Maternal Self‐Report of Oral Health,Hygiene, and Dental Care

Background: Maternal periodontal disease diagnosed by a detailed oral health examination is associated with preeclampsia. Our objective was to measure the association between maternal self‐report of oral symptoms/problems, oral hygiene practices, and/or dental service use before or during pregnancy and severe preeclampsia. Methods: A written questionnaire was administered to pregnant females at the time of prenatal ultrasound and outcomes were ascertained by chart abstraction. The χ² test compared maternal oral symptoms/problems, hygiene practices, and dental service use between females with severe preeclampsia versus normotensive females. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for severe preeclampsia. Results: A total of 48 (10%) of 470 females reported ≥2 oral symptoms/problems in the 6 months before pregnancy and 77 (16%) since pregnancy. Fifty‐one (11%) reported previous periodontal treatment. Twenty‐eight (6%) of 470 developed severe preeclampsia. Females with a history of periodontal treatment were more likely to develop severe preeclampsia (aOR = 3.71; 95% CI = 1.40 to 9.83) than females without a history of periodontal treatment. Self‐reported oral health symptoms/problems, oral hygiene practices, or dental service use before or during pregnancy were not associated with severe preeclampsia when considered in the context of other maternal risk factors. Conclusion: Maternal self‐report of previous periodontal treatment before pregnancy is associated with severe preeclampsia.     

Psychotic Experiences,Childhood Trauma,and Alcohol-Related Self-Efficacy in a Nonpsychiatric Sample of Individuals in Alcohol Dependence Treatment: A Pilot Study

There is a substantial co-occurrence between alcohol dependence and psychiatric symptoms. Moreover, research suggests that such symptoms, including psychotic experiences, are continuously distributed in the population. There is a lack of research concerning psychotic symptoms in otherwise non-psychiatric populations with alcohol dependence. The aim of this study was to investigate the prevalence of psychotic symptoms in this population, and to relate this to childhood trauma and management of alcohol dependence. From a population with alcohol dependence two sub-groups were extracted, with low and high levels of psychotic experiences respectively. These were compared concerning childhood trauma and management of dependence using ANOVA, and the resulting model was examined using binary logistic regression. There was a sub-group of 14,3% of the population with elevated levels of psychotic experiences. This group displayed higher degree of self-reported childhood trauma as well as difficulties in managing alcohol dependence, when compared to a sub-group with low levels of psychotic experiences. There may be a substantial sub-group in the otherwise non-psychiatric population with alcohol dependence, with significant difficulties concerning psychotic symptoms, trauma and management of dependence, where anxiety may have a mediating function. If so, this group calls for broader assessment and treatment than standard alcohol interventions.     

Insulin-like growth factor II signaling through the insulin-like growth factor II/mannose-6-phosphate receptor promotes exocytosis in insulin-secreting cells

The insulin-like growth factor II (IGF-II)/mannose-6-phosphate (M-6-P) receptor is known to participate in endocytosis as well as sorting of lysosomal enzymes and is involved in membrane trafficking through rapid cycling between cytosolic membrane compartments and the plasma membrane. Here we demonstrate that IGF-II, acting through the IGF-II/M-6-P receptor, promotes exocytosis of insulin in the pancreatic β cell. The effect of IGF-II was evoked at nonstimulatory concentrations of glucose, was mediated by a pertussis toxin sensitive GTP-binding protein, was dependent on protein kinase C-induced phosphorylation, and was independent of changes in cytoplasmic free Ca²⁺ concentration. Since the applied concentration of IGF-II is within the range normally found free in circulation in humans, this novel signaling pathway for the IGF-II/M-6-P receptor is likely to be involved in modulation of insulin exocytosis under physiological conditions.     

In situ activation of the type 2 ryanodine receptor in pancreatic beta cells requires cAMP-dependent phosphorylation

Molecular mechanisms that regulate in situ activation of ryanodine receptors (RY) in different cells are poorly understood. Here we demonstrate that caffeine (10 mM) released Ca²⁺ from the endoplasmic reticulum (ER) in the form of small spikes in only 14% of cultured fura-2 loaded beta cells from ob/ob mice. Surprisingly, when forskolin, an activator of adenylyl cyclase was present, caffeine induced larger Ca²⁺ spikes in as many as 60% of the cells. Forskolin or the phosphodiesterase-resistant PKA activator Sp-cAMPS alone did not release Ca²⁺ from ER. 4-Chloro-3-ethylphenol (4-CEP), an agent that activates RYs in other cell systems, released Ca²⁺ from ER, giving rise to a slow and small increase in [Ca²⁺]_i in beta cells. Prior exposure of cells to forskolin or caffeine (5 mM) qualitatively altered Ca²⁺ release by 4-CEP, giving rise to Ca²⁺ spikes. In glucose-stimulated beta cells forskolin induced Ca²⁺ spikes that were enhanced by 3,9-dimethylxanthine, an activator of RYs. Analysis of RNA from islets and insulin-secreting βTC-3-cells by RNase protection assay, using type-specific RY probes, revealed low-level expression of mRNA for the type 2 isoform of the receptor (RY₂). We conclude that in situ activation of RY₂ in beta cells requires cAMP-dependent phosphorylation, a process that recruits the receptor in a functionally operative form.     

Intestinal flora in very low-birth weight infants

Aim:  To study the early faecal microbiota in very low-birth weight infants (VLBW, <1500 g), possible associations between faecal microbiota and faecal calprotectin (f-calprotectin) and to describe the faecal microbiota in cases with necrotizing enterocolitis (NEC) before diagnosis.
Methods:  Stool samples from the first weeks of life were analysed in 48 VLBW infants. Bacterial cultures were performed and f-calprotectin concentrations were measured. In three NEC cases, cultures were performed on stool samples obtained before diagnosis.
Results:  Bifidobacteria and lactobacilli were often identified in the first stool sample, 55% and 71% of cases, respectively within the first week of life. A positive correlation between lactic acid bacteria (LAB) and volume of enteral feed was found. Other bacteria often identified were Escherichia coli , Enterococcus and Staphyloccus sp. F-calprotectin was not associated with any bacterial species. All NEC cases had an early colonization of LAB. Prior to onset of disease, all cases had a high colonization of non- E. coli Gram-negative species.
Conclusion:  In contrast to the previous studies in VLBW infants, we found an early colonization with LAB. We speculate that this may be due to early feeding of non-pasteurized breast milk.     

Fibril protein fragmentation pattern in systemic AL‐amyloidosis

Immunoglobulin light chain (AL)‐amyloidosis was one of the first types of amyloidosis discovered and still little is known about its pathogenic mechanisms. One major obstacle is the very heterogeneous condition; in fact, every patient could be considered to have their own disease since symptoms and outcome vary enormously. The reason for this is not known but intrinsic factors of the immunoglobulin light chain (LC) and the fact that every LC is unique seem to be important. Post‐translational modifications such as glycosylation and proteolysis are most certainly involved. By using western blotting, we studied in detail the proteolytic pattern in six patients with AL‐amyloidosis of kappa type with the aid of three peptide antisera against two domains in the constant segment and one conserved domain in framework 3 of the variable region. Materials from one to five organs were analysed. The result clearly demonstrates that the fragmentation pattern was similar in amyloid of different organs in one patient but differed greatly between patients. Full‐length, N‐, and C‐terminal fragments were detected with the three antisera. The results strongly support the hypothesis that proteolytic cleavage occurs after fibril formation. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Severe neonatal respiratory distress syndrome treated with the isolated phospholipid fraction of natural surfactant

Ten newborn infants (795-1680 g) with severe respiratory distress syndrome (RDS) were treated with the isolated phospholipid fraction of bovine or porcine surfactant, which was administered via the airways (dose 200 mg/kg), at a median age of 10.5 h. Before receiving surfactant, all the infants were on artificial ventilation (FiO2 0.6-1.0). Within 2 h after surfactant replacement, the arterial-to-alveolar PO2 ratio increased from 0.1 to 0.35. There was a concomitant improvement in lung aeration on the chest roentgenograms and a significant reduction in the right-to-left shunt. Four patients died of cerebral hemorrhage; two of them also had a patent ductus arteriosus. One surviving infant developed bronchopulmonary dysplasia, and another succumbed 8 months later to the sudden infant death syndrome. No antibodies against surfactant were detected in the sera of the survivors. Since our results show a significant improvement in lung function after replacement therapy, the efficacy of this new surfactant preparation should be further tested in randomized clinical trials.     

Cellular basis of ectopic germinal center formation and autoantibody production in the target organ of patients with Sjögren's syndrome

OBJECTIVE: To investigate functional properties of the germinal center (GC)-like structures observed in salivary glands of patients with Sj?gren's syndrome (SS) and to determine the frequency with which such structures develop. METHODS: Hematoxylin and eosin-stained sections from 165 minor salivary gland biopsy samples were screened for GC-like structures. Expression of markers for GCs (CD3, CD20, Ki-67, CD35, CD31), adhesion molecules (intercellular adhesion molecule 1, lymphocyte function-associated antigen 1, vascular cell adhesion molecule 1, very late activation antigen 4), chemokines (CXCL13, CCL21, CXCL12), and production of autoantibodies (anti-Ro/SSA and anti-La/SSB) was investigated by immunohistochemistry. Apoptosis was investigated by TUNEL staining. RESULTS: GC-like structures were observed in 28 of 165 patients (17%). When GCs were defined as T and B cell aggregates with proliferating cells with a network of follicular dendritic cells and activated endothelial cells, such microenvironments were found in all patients in whom structures with GC-like morphology were observed. The defined microenvironments were not found in patients without apparent GC-like structures. The GCs formed within the target tissue showed functional features with production of autoantibodies (anti-Ro/SSA and anti-La/SSB) and apoptotic events (by TUNEL staining), and the local production of anti-Ro/SSA and anti-La/SSB autoantibodies was significantly increased (P = 0.04) in patients with GC development. CONCLUSION: Lymphoid neogenesis and functional ectopic GC formation take place in salivary glands of a subset of patients with SS. Our data suggest that the ectopic secondary lymphoid follicles contain all elements needed for driving the autoimmune response. Our findings underscore a key role for the target organ in recruitment of inflammatory cells and propagation of the disease process.