Dental status of Portuguese HIV+ patients and related variables: a multivariate analysis

Oral Diseases (2010) 16 , 176–184 Objective: The aim of this cross‐sectional study was to evaluate the dental status of 101 Portuguese HIV+ subjects aged 22–71 years (mean = 39) and its association with clinical, socioeconomic, and behavioral variables. Materials and Methods: A calibrated dentist performed clinical examination and collected data on dental caries, periodontal status, dental plaque levels, prosthetic conditions, and need. The volunteers completed questionnaires on socioeconomic and behavioral variables as well as the Oral Health Impact Profile (OHIP‐14) questionnaire. Univariate and multiple logistic regression (MLR) analyses were performed. Results: The mean number of decayed, missing or filled teeth index (DMFT index) was 16.44, standard deviation (s.d.) = 8.42. MLR demonstrated that salaried employee and those with OHIP‐14 ≤4.22, or any/no dental plaque were less prone to have DMFT > median (=17). As regards prosthetic status, 28.8% of the examined individuals used dental prosthesis. MLR demonstrated that HIV+ with DMFT >17 or those who knew they were HIV‐positive for longer than 5 years were more prone to need dental prostheses. The mean OHIP‐14 index was 5.83 (s.d. = 7.79). Conclusions: The dental health status of HIV‐infected Portuguese patients was unsatisfactory and related to clinical, socioeconomic, and behavioral variables.     

Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests

Background

We assessed ovarian cancer screening outcomes in women with a positive family history of ovarian cancer divided into a low-, moderate- or high-risk group for development of ovarian cancer.

Methods

545 women with a positive family history of ovarian cancer referred to the Ovarian Screening Service at the Royal Marsden Hospital, London from January 2000- December 2008 were included. They were stratified into three risk-groups according to family history (high-, moderate- and low-risk) of developing ovarian cancer and offered annual serum CA 125 and transvaginal ultrasound screening. The high-risk group was offered genetic testing.

Results

The median age at entry was 44 years. The number of women in the high, moderate and low-risk groups was 397, 112, and 36, respectively. During 2266 women years of follow-up two ovarian cancer cases were found: one advanced stage at her fourth annual screening, and one early stage at prophylactic bilateral salpingo-oophorectomy (BSO). Prophylactic BSO was performed in 138 women (25.3%). Forty-three women had an abnormal CA125, resulting in 59 repeat tests. The re-call rate in the high, moderate and low-risk group was 14%, 3% and 6%. Equivocal transvaginal ultrasound results required 108 recalls in 71 women. The re-call rate in the high, moderate, and low-risk group was 25%, 6% and 17%.

Conclusion

No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.     

PPARα polymorphisms as risk factors for dyslipidemia in a Brazilian population

Background and aimsPeroxisome proliferator-activated receptor α is a nuclear receptor involved in the regulation of several biochemical pathways. Polymorphisms within its gene have been associated with several metabolic traits. We aimed to investigate the association of L162V and Intron 7G > C polymorphisms with serum level markers and common morbidities affecting an older adult/elderly cohort from Cuiaba City, Mato Grosso State, Brazil, as well as to compare the results with a previously studied population from São Paulo City, Brazil.Methods and resultsThe studied population consisted of 570 subjects from Cuiaba City, Brazil, who were subjected to clinical interviews and blood collection for laboratory examinations and DNA extraction. Dyslipidemia was defined when participants were taking oral hypolipemiants or those with total cholesterol above 200 mg/dL, HDL-c below 40 mg/dL, LDL-c above 130 mg/dL and TG above 150 mg/dL. Restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) was used for polymorphism genotyping. Individual polymorphism and haplotype data were available for analyses. In the studied sample, allele frequencies were 0.052 and 0.292 for 162V and Intron 7C, respectively. In brief, 162V allele was associated with dyslipidemia (p = 0.025), and after correction for alcohol consumption and waist-to-rip ratio, a tendency of association could still be observed (p = 0.050). In addition, Intron 7C allele was associated with dyslipidemia even after correction for the same variables (p = 0.029). When compared to our previous study from São Paulo, we found some divergences regarding these results, which may be explained by differences between the two populations. Haplotype association analyses revealed an association between L/C haplotype and dyslipidemia (p = 0.021) and between V/C haplotype and lower LDL-c levels when compared to L/G haplotype (p = 0.044).ConclusionThese results may help to clarify the role of PPARα gene in lipid and lipoprotein metabolism and the evaluation of its polymorphisms and haplotypes as being characterized as genetic risk factors for metabolic disturbances.     

1141099968Immunization under the influence of estradiol leads to non-sterile protection against genital herpes infection

Hormones play an important role in the induction of protective immune responses after intravaginal (IVAG) immunization with an attenuated strain of herpes simplex type 2 (HSV-2 TK-). Previously we reported that ovariectomized (OVX) mice receiving estradiol (E) prior to immunization were not protected, while mice receiving progesterone (P) had sterile protection after IVAG HSV-2 challenge. Protection correlated with the ability of TK- to cause productive infection. Lack of protection in the E group was associated with the effect of E on thickening of vaginal epithelium. In the current study, we examined the effect of E on immunization after the thickening of vaginal epithelium subsided. OVX, C57BL/6 mice were given P, E or saline (S) for 3 days. The P and S groups were then immunized with IVAG TK-. To determine the time point at which E mice could be successfully immunized, TK- was given between days 1 and 7 (E1–E7) post-E treatment. Three weeks after immunization, mice were challenged with IVAG HSV-2. Protection was absent in E1–E4 groups, 100% in E6 and E7 and partially successful in E5. While the protection in P and S was sterile, protected mice in E5 and E6 groups had non-sterile protection. The presence of HSV-2 specific IgG antibodies in the vaginal washes after challenge closely correlated with sterile immunity. After challenge, vaginal associated lymphoid tissues (iVALTs) were seen in the vaginal tract of the protected groups, except for the E5 group. The cytokine environment after challenge was also examined. The results show that while immunization under the effect of E may lead to clearance of virus, the mechanism is quite different than that seen under other hormonal conditions. Local hormonal influences must be considered when designing vaccines for STDs.     

Identification of three mutations and associated haplotypes in the protoporphyrinogen oxidase gene in South African families with variegate porphyria

Mutation analysis of genomic DNA samples obtained from 17 unrelated South African patients with variegate porphyria (VP) revealed three novel missense mutations in the protoporphyrinogen oxidase (PPOX) gene. A common C to T transition at nucleotide position 452 (R59W) was identified in 15 of the patients analysed, while base changes at positions 336 (H20P) and 779 (R168C) were identified in the remaining two patients. Using protein analysis software we were able to predict that all three mutations have a similar biophysical effect on the protein, being the disturbance of amphiphatic regions within the protein, which might result in misfolding of the protein. Mutation R59W, identified in the majority of South African VP families, was shown to create a Styl restriction site, while mutation R168C would abolish a Dsal restriction site in genomic DNA of affected individuals. As 100% of the index patients analysed were molecularly characterized, the combined use of restriction enzyme and single-strand conformation polymorphism (SSCP) analysis now allows a rapid and accurate diagnosis of VP in South Africa. Mutation R59W was furthermore shown to be in association with one of four potential haplotypes defined by two newly described polymorphisms in exon 1 of the PPOX gene. Our molecular data thus strongly support the founder hypothesis for VP in South Africa.