Occlusal caries diagnosis in permanent teeth: an in vitro study

The reduction in caries prevalence has not occurred uniformly for all dental surfaces. As the occlusal surfaces are still the most likely sites for the development of lesions, new methods of diagnosis are still being evaluated. This study compared a laser fluorescence (LF) system (DIAGNOdent) with the Ekstrands visual system for in vitro detection of occlusal caries. A total of 57 extracted molars with macroscopically intact occlusal surfaces were selected. Two-examiners assessed 110 sites by visual inspection (VI) and LF. After ten days from the first measurement, all teeth were re-evaluated through the same methods by each examiner. Caries extension was histologically assessed (X 40). The methods were compared by means of sensitivity, specificity, intra- and inter-examiner reproducibility and area under the ROC curve. The kappas test showed good intra- and inter-examiner reproducibility for both methods. VI and LF showed similar sensitivities for both examiners, however, VI showed higher specificities than LF. The overall analysis, as demonstrated by the area under the ROC curve, showed that VI had a better performance than the LF device. It was concluded that the Ekstrands visual system is more reliable than the LF device. LF should be considered only as an adjuvant for occlusal caries diagnosis.     

Disclosure of HIV serostatus to male partner and use of modern contraceptives among women receiving HIV care services in Kampala,Uganda

Objective

To investigate whether disclosure of HIV status is associated with use of modern contraceptives (MCs) among women attending HIV care services at an AIDS Information Center (AIC) in an urban setting in Uganda.

Methods

In a cross-sectional study between March and April 2010, HIV-positive married women aged 15–49 years who had received their HIV-positive serostatus results at least 4 weeks previously were interviewed at the AIC, Kampala, Uganda. Female use of MCs was compared by HIV disclosure to male marital partners. Log–binomial regression models were used to obtain crude and adjusted prevalence risk ratios (PRRs) and corresponding 95% confidence intervals (CIs).

Results

Nearly three-quarters (72.6%) of the women had disclosed their HIV-positive status to their partner. Overall, use of MCs was reported by 41.0% of the participants. Use of only 1 MC method was similar between those disclosing (81.1%) and those not disclosing (84.3%), but use of dual methods tended to be higher among disclosers (14.4%) than among non-disclosers (10.8%). In adjusted analyses, MC use was 41.0% lower among disclosers than among non-disclosers (adjusted PRR, 0.59; 95% CI, 0.46–0.77).

Conclusion

HIV serostatus disclosure was associated with lower use of MCs among HIV-positive women in Kampala, Uganda.     

Effect of daily supplementation of fruits on oxidative stress indices and glycaemic status in type 2 diabetes mellitus

This study sought to examine whether consumption of two low-calorie fruit/day for 3-months can effectively improve oxidative stress, anthropometry, blood pressure and glycaemic control in type 2 diabetes mellitus. Study involved 123 patients who were assigned to receive either standard care or with additional dietary therapy. Dietary intervention resulted in significant reduction in malondialdehyde, plasma glucose, glycated haemoglobin and improvement in antioxidants like vitamin C and reduced glutathione when compared to controls. Mean plasma levels of vitamin C increased by 64% (p < 0.001). There were no differences in waist circumference, waist-to-hip ratio, blood pressure, vitamin E and superoxide dismutase in the intervention group at follow-up. Diet rich in fruits can improve some antioxidants which are likely to reduce oxidative stress in type 2 diabetes. Regular consumption of fruits can lower the glycaemic status in these patients. The study supports the usefulness of plasma vitamin C as a biomarker for fruit intake.     

Combined modality treatment with high-dose-rate brachytherapy boost for locally advanced prostate cancer

PURPOSE: This is a retrospective review of our experience using high-dose-rate (HDR) brachytherapy boost for prostate cancer. METHODS AND MATERIALS: During the study period, we recommended external beam radiotherapy (45 Gy) and HDR boost (18 Gy in three fractions) combined with hormonal therapy (HT) for 2 months before and during radiotherapy to patients with at least one of the following risk features: pretreatment prostate-specific antigen>10, Gleason score (GS)>or=7, and clinical T3 disease. Additional HT for 2 years after radiotherapy was recommended for patients with GS>7. To patients whose risk of positive nodes exceeded 15%, we recommended whole pelvic radiotherapy. We administered HDR via single implant, and all fractions were given within 24h. RESULTS: This report is based on our initial 64 patients treated with HDR boost. The median follow-up was 50 months (range 25-68 months). The 4-year estimates of overall and disease-free survival were 98% and 92%, respectively. One patient experienced late grade 4 gastrointestinal toxicity. CONCLUSIONS: HDR brachytherapy is an effective means of delivering conformal prostate radiotherapy, and may be used with whole pelvic radiotherapy and HT.