Social capital and its relationship to self-perceived health: National health survey in Colombia 2007

Objective:

To analyze the self-reported perceived health related to socio-demographic characteristics, social health inequalities and social capital in Colombia.

Methods:

This study is a cross-sectional design; data was obtained from the National Health Survey of Colombia 2007. Independent variables: socio-demographic characteristics; component variables: social health inequality and social capital. Dependent variable: self-reported health. Analysis of the relationship used logistic regression through OR and its confidence interval.

Results:

The determinant factors for a negative health perceptions are related to being a female (OR: 0.49 [0.47 to 0.52]), and in both genders being older than 37 years of age (OR: 0.72 [0.61 to 0.85]), living without a partner, black ethnicity, indigenous women (0.80 [0.69 to 0.94] and low economic incomes.

Discussion:

The relationship between social determinants and social capital in the perception of health shows inequities and indirectly reflects the level of health. Given the policies and the model of health, requires a rational adjustment of the goals, programs, and national and regional strategies with the object of improving the demand and quality of services.     

Effects of isometric training on the knee extensor moment–angle relationship and vastus lateralis muscle architecture

Purpose

To analyse the muscle adaptations induced by two protocols of isometric training performed at different muscle lengths.

Methods

Twenty-eight subjects were divided into three groups: one (K90) performed isometric training of the knee extensors at long muscle lengths (90° of knee flexion) for 8 weeks, and the second group (K50) at short muscle lengths (50°). The subjects of the third group acted as controls. Isokinetic dynamometry was utilized to analyse the net moment–angle relationship and vastus lateralis muscle thickness at three different locations, and pennation angles and fascicle length at 50 % of thigh length were measured at rest with ultrasonography.

Results

Only subjects from K90 group showed significant increases in isokinetic strength (23.5 %, P < 0.001), while K50 group showed no increases in isokinetic strength: (10 %, P > 0.05). There was a shift in the angle of peak torque of the K90 group to longer muscle lengths (+14.6 %, P = 0.002) with greater increases in isokinetic strength, while the K50 angle shifted to shorter muscle lengths (?7.3 %, P = 0.039). Both training groups showed significant increases in muscle thickness, (K90 9–14 % vs. K50 5–9 %) but only K90 significantly increased their pennation angles (11.7 %, P = 0.038). Fascicle lengths remained unchanged.

Conclusions

Isometric training at specific knee angles led to significant shifts of peak torque in the direction of the training muscle lengths. The greater strength gains and the architectural changes with training at long muscle lengths probably come from a combination of different factors, such as the different mechanical stresses placed upon the muscle–tendon complex.     

CO2 concentration in day care centres is related to wheezing in attending children

Poor ventilation at day care centres (DCCs) was already reported, although its effects on attending children are not clear. This study aimed to evaluate the association between wheezing in children and indoor CO₂ (a ventilation surrogate marker) in DCC and to identify behaviours and building characteristics potentially related to CO₂. In phase I, 45 DCCs from Lisbon and Oporto (Portugal) were selected through a proportional stratified random sampling. In phase II, 3 months later, 19 DCCs were further reassessed after cluster analysis for the greatest difference comparison. In both phases, children’s respiratory health was assessed by ISAAC-derived questionnaires. Indoor CO₂ concentrations and building characteristics of the DCC were evaluated in both phases, using complementary methods. Mixed effect models were used to analyze the data. In phase I, which included 3,186 children (mean age 3.1?±?1.5 years), indoor CO₂ concentration in the DCC rooms was associated with reported wheezing in the past 12 months (27.5 %) (adjusted odds ratio (OR) for each increase of 200 ppm 1.04, 95 % CI 1:01 to 1:07). In phase II, the association in the subsample of 1,196 children seen in 19 out of the initial 45 DCCs was not significant (adjusted OR 1.02, 95 % CI 0.96 to 1.08). Indoor CO₂ concentration was inversely associated with the practices of opening windows and internal doors and with higher wind velocity. A positive trend was observed between CO₂ and prevalence of reported asthma (4.7 %). Conclusion: Improved ventilation is needed to achieve a healthier indoor environment in DCC.     

Current management of late onset neonatal bacterial sepsis in five European countries

Late onset neonatal sepsis (LOS) has a high mortality and the optimal management is poorly defined. We aimed to evaluate new expert panel-derived criteria to define LOS and characterize the current management and antibiotic susceptibility of LOS-causing organisms in Europe. A prospective observational study enrolled infants aged 4 to 90 days in five European countries. Clinical and laboratory findings as well as empiric treatment were recorded and patients were followed until the end of antibiotic therapy. Failure was defined as a change of primary antibiotic, no resolution of clinical signs, appearance of new signs/pathogens or death. Antibiotic therapy was considered appropriate if the organism was susceptible to at least one empiric antibiotic. 113 infants (median age 14 days, 62 % ≤1500 g) were recruited; 61 % were culture proven cases (28 CoNS, 24 Enterobacteriaceae, 11 other Gram-positives and 6 Gram-negative non-fermentative organisms). The predictive value of the expert-panel criteria to identify patients with a culture proven LOS was 61 % (95 % CI 52 % to 70 %). Around one third of Enterobacteriaceae were resistant to ampicillin + or cefotaxime + gentamicin but only 10 % to meropenem. Empiric treatment contained a total of 43 different antibiotic regimens. All-cause mortality was 8 % with an additional 45 % classified as failure of empiric therapy, mainly due to change of primary antibiotics (42/60). Conclusions: The expert panel—derived diagnostic criteria performed well identifying a high rate of culture proven sepsis. Current management of LOS in Europe is extremely variable suggesting an urgent need of evidence-based guidelines.     

Intermittent Parathyroid Hormone Administration Improves Periodontal Healing in Rats

Background: Intermittent administration of parathyroid hormone (PTH) promotes new bone formation in patients with osteoporosis and bone fractures. It was shown previously that PTH also reduces periodontitis‐related bone loss. The aim of this study is to evaluate the effect of treatment with PTH on periodontal healing in rats. Methods: Fenestration defects were created at the buccal surface of the distal root of the mandibular first molars, and both periodontal ligament (PDL) and cementum were removed. Animals were then assigned to two groups (eight animals per group): group 1: control, placebo administration; and group 2: test, human PTH (hPTH) 1‐34 administration at a concentration of 40 μg/kg. For both groups, the animals were injected every 2 days, and the animals were sacrificed at 14 and 21 days after surgery. Specimens were harvested and processed for routine decalcified histologic sections. The following parameters were assessed: 1) remaining bone defect extension (RBDE); 2) newly formed bone density (NFBD); 3) total callus area (TCA); 4) osteoclast number (ON) in the callus region; and 5) newly formed dental cementum‐like tissue (NFC). Birefringence of root PDL reattachment was also evaluated. Results: Birefringence analysis showed root PDL reattachment for both groups 21 days after treatment. Intermittent hPTH 1‐34 administration decreased RBDE (P <0.01) and increased NFBD (P <0.01), TCA (P <0.01), area of NFC (P <0.01), and ON in the callus region (P <0.01). Conclusion: Within the limits of the present study, intermittent administration of hPTH 1‐34 led to an enhanced periodontal healing process compared with non‐treated animals.     

Efficacy of red and infrared lasers in treatment of temporomandibular disorders — a double-blind,randomized, parallel clinical trial

Aim:

Low-level laser therapy has still not been well established, and it is important to define a standardized protocol for the treatment of temporomandibular disorders (TMDs) using low level laser. There is no consensus on controlled clinical trials concerning the best option for laser therapy with regard to wavelength. The aim of this study was to evaluate the efficacy of red and infrared laser therapy in patients with TMD, using a randomized parallel-group double-blind trial.

Methodology:

Each hemiface of 19 subjects was randomized to receive intervention, in a total of 116 sensitive points. Pain was measured at baseline and time intervals of 24 hours, 30 days, 90 days, and 180 days after treatment. Irradiation of 4 J/cm² in the temporomandibular joints and 8 J/cm² in the muscles was used in three sessions.

Results:

Both treatments had statistically significant results (P<0·001); there was statistical difference between them at 180 days in favor of the infrared laser (P?=?0·039). There was improvement in 24 hours, which extended up to 180 days in both groups.

Conclusion:

Both lasers are effective in the treatment and remission of TMD symptoms.     

Periradicular lesions in HIV-infected patients attending the faculty of dentistry: clinical findings,socio-demographics status,habits and laboratory data - seeking an association

OBJECTIVE:

The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status.

METHOD:

One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth were evaluated for the presence of periradicular lesions, caries lesions, coronal restorations, pulp cavity exposure and endodontic treatment.

RESULTS:

The prevalence of periradicular lesions was 46%. There were no significant differences between individuals with or without periradicular lesions with respect to their socio-demographic status, habits, laboratory data and route of HIV infection. However, the presence of a periradicular lesion was statistically correlated with the number of teeth with endodontic treatment (p = 0.018), inadequate endodontic treatment (p = 0.025), images suggesting pulp cavity exposure (p = 0.002) and caries lesions (p = 0.001).

CONCLUSIONS:

The prevalence of periradicular lesions in HIV-infected individuals was 46% and was not related to HIV infection.     

Fear extinction and acute stress reactivity reveal a role of LPA1 receptor in regulating emotional-like behaviors

LPA₁ receptor is one of the six characterized G protein-coupled receptors (LPA_1–6) through which lysophosphatidic acid acts as an intercellular signaling molecule. It has been proposed that this receptor has a role in controlling anxiety-like behaviors and in the detrimental consequences of stress. Here, we sought to establish the involvement of the LPA₁ receptor in emotional regulation. To this end, we examined fear extinction in LPA₁-null mice, wild-type and LPA₁ antagonist-treated animals. In LPA₁-null mice we also characterized the morphology and GABAergic properties of the amygdala and the medial prefrontal cortex. Furthermore, the expression of c-Fos protein in the amygdala and the medial prefrontal cortex, and the corticosterone response following acute stress were examined in both genotypes. Our data indicated that the absence of the LPA₁ receptor significantly inhibited fear extinction. Treatment of wild-type mice with the LPA₁ antagonist Ki16425 mimicked the behavioral phenotype of LPA₁-null mice, revealing that the LPA₁ receptor was involved in extinction. Immunohistochemistry studies revealed a reduction in the number of neurons, GABA+ cells, calcium-binding proteins and the volume of the amygdala in LPA₁-null mice. Following acute stress, LPA₁-null mice showed increased corticosterone and c-Fos expression in the amygdala. In conclusion, LPA₁ receptor is involved in emotional behaviors and in the anatomical integrity of the corticolimbic circuit, the deregulation of which may be a susceptibility factor for anxiety disorders and a potential therapeutic target for the treatment of these diseases.