The influence of age on blood pressure evaluation of hypertensive subjects

The aim of this study was to determine whether age influences the concordance between different methods of blood pressure (BP) measurement and ambulatory BP monitoring (ABPM) in hypertensive subjects. We studied two groups: I, individuals younger than 50 years (n = 57), and II, individuals aged 60 years or older (n = 55). They were submitted to the performance of one ABPM, office BP measurements, home BP monitoring (HBPM), and BP measurements at a public health center (PHCBP). Student`s t-test, Fisher`s test and Lin coefficient were calculated. For Group II, systolic and diastolic pressures measured by HBPM were higher than by day ABPM (p < 0.01). The concordance between day ABPM and the other methods was lower for Group II than for Group I. There was a good concordance between systolic day ABPM and office BP, and between systolic ABPM and PHCBP only for Group I (Lin coefficient = 0.71 and 0.73). Group II reported better sleep quality after ABPM (p < 0.05). Considering 24-h ABPM, 52.6% of Group I and 29% of Group II were controlled (p < 0.01). Concluding, there was worse concordance between different methods of BP measurements and day ABPM in the older group, which had lower hypertension control rate and better tolerance of ABPM. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

An integrated database on ticks and tick-borne zoonoses in the tropics and subtropics with special reference to developing and emerging countries

Tick-borne zoonoses (TBZ) are emerging diseases worldwide. A large amount of information (e.g. case reports, results of epidemiological surveillance, etc.) is dispersed through various reference sources (ISI and non-ISI journals, conference proceedings, technical reports, etc.). An integrated database-derived from the ICTTD-3 project (http://www.icttd.nl)-was developed in order to gather TBZ records in the (sub-)tropics, collected both by the authors and collaborators worldwide. A dedicated website (http://www.tickbornezoonoses.org) was created to promote collaboration and circulate information. Data collected are made freely available to researchers for analysis by spatial methods, integrating mapped ecological factors for predicting TBZ risk. The authors present the assembly process of the TBZ database: the compilation of an updated list of TBZ relevant for (sub-)tropics, the database design and its structure, the method of bibliographic search, the assessment of spatial precision of geo-referenced records. At the time of writing, 725 records extracted from 337 publications related to 59 countries in the (sub-)tropics, have been entered in the database. TBZ distribution maps were also produced. Imported cases have been also accounted for. The most important datasets with geo-referenced records were those on Spotted Fever Group rickettsiosis in Latin-America and Crimean-Congo Haemorrhagic Fever in Africa. The authors stress the need for international collaboration in data collection to update and improve the database. Supervision of data entered remains always necessary. Means to foster collaboration are discussed. The paper is also intended to describe the challenges encountered to assemble spatial data from various sources and to help develop similar data collections.

Detection of Bartonella spp. in neotropical felids and evaluation of risk factors and hematological abnormalities associated with infection

Although antibodies to Bartonella henselae have been described in all neotropical felid species, DNA has been detected in only one species, Leopard us wiedii. The aim of this study was to determine whether DNA of Bartonella spp. could be detected in blood of other captive neotropical felids and evaluate risk factors and hematological findings associated with infection. Blood samples were collected from 57 small felids, including 1 Leopard us geoffroyi, 17 L wiedii, 22 Leopardus tigrinus, 14 Leopardus pardalis, and 3 Puma yagouaroundi; 10 blood samples from Panthera onca were retrieved from blood banks. Complete blood counts were performed on blood samples from small felids, while all samples were evaluated by PCR. DNA extraction was confirmed by amplification of the cat GAPDH gene. Bartonella spp. were assessed by amplifying a fragment of their 16S-23S rRNA intergenic spacer region; PCR products were purified and sequenced. For the small neotropical felids, risk factors [origin (wild-caught or zoo-born), gender, felid species, and flea exposure) were evaluated using exact multiple logistic regression. Hematological findings (anemia, polycythemia/hyperproteinemia, leukocytosis and leukopenia) were tested for association with infection using Fisher`s exact test. The 635 bp product amplified from 10 samples (10/67 = 14.92%) was identified as B. henselae by sequencing. Small neotropical felid males were more likely to be positive than females (95% CI = 0.00-0.451, p = 0.0028), however other analyzed variables were not considered risk factors (p > 0.05). Hematological abnormalities were not associated with infection (p > 0.05). This is the first report documenting B. henselae detection by PCR in several species of neotropical felids. (C) 2009 Elsevier B.V. All rights reserved.

Detection of TGIF1 homeobox gene in oral squamous cell carcinoma according to histologic grading

Objective. TGIF1 homeobox gene involvement in oral cancer has not yet been investigated. This study analyzed the expression of TGIF1 transcripts and protein in oral squamous cell carcinoma (OSCC). Study design. Snap-frozen samples from 16 patients were taken from both OSCC and nontumoral adjacent epithelium (NT) for in situ hybridization (ISH). Forty-six paraffin-embedded samples of OSCC were submitted to immunohistochemistry (IHC). A descriptive analysis of the transcript signal detection was accomplished, and TGIF1 immunoexpression was carried out considering protein levels, localization, and cellular differentiation. Results. ISH reactions showed TGIF1 transcripts with a signal that was frequently intense in NT, and generally weak in OSCC, and that had stronger transcript signal in well-differentiated areas of OSCC when compared with poorly differentiated ones. IHC reactions had poorly differentiated cases associated with TGIF1 protein expression in both the nucleus and cytoplasm (P = .05, Fisher test). Conclusions. TGIF1 gain or loss of function might possibly play a role in oral cancer cell differentiation. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111: 218-224)

Oral status and Candida colonization in patients with Sjogren`s Syndrome

Objective: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candida albicans colonization in several areas of the mouth in patients with primary and secondary Sjogren`s syndrome as opposed to those of healthy subjects. Study design: Thirty-seven patients with Sjogren`s syndrome (SS), [14 patients with primary SS (SS-1) and 23 patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth, pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prosthetic appliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicans colonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue`s dorsal surface were determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test. Results: No statistically significant difference was found between SS-1 and SS-2 groups based on the parameters analysed. Statistically significant differences were observed between patients with SS and healthy subjects in terms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candida carriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only one subject of SS subgroup. Conclusions: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis. C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization in different areas of the oral cavity in SS patients.

WNT-5A, but not matrix metalloproteinase 3 or beta-catenin protein, expression is related to early stages of lip carcinogenesis

Background: Oncogenic Wnt/beta-catenin signaling occurs in numerous types of cancers, but little is known about the role of the Wnt protein family member, WNT-5A, in lip carcinogenesis. The aim of this study was to investigate WNT-5A, beta-catenin, and matrix metalloproteinase (MMP)-3 protein expression in actinic cheilitis (AC), and lip squamous cell carcinoma (LSCC). Methods: Twenty-one cases of AC, and fifty-one cases of LSCC were analyzed, with normal lip mucosa used as a control. Qualitative and semi-quantitative analyses of WNT-5A, beta-catenin, and MMP-3 immunostaining pattern and cellular distribution were performed. Results: WNT-5A was observed in more than 50% of the cells, scattered in all layers of AC, in contrast to the absence of immunostaining in normal lip mucosa. AC presented a higher level of WNT-5A expression than LSCC (P = 0.0289, Fisher test), while MMP-3 immunoexpression was statistically more significant in LSCC than in AC (P = 0.0285, Fisher test). Immunolabeling of beta-catenin protein was differentially distributed between samples; the majority of AC cases (61.90%) demonstrated a membranous-cytoplasmic pattern, while a considerable number of LSCC cases (29.41%) revealed a cytoplasmic pattern, instead of the usual membranous pattern. Conclusions: The present results suggest that WNT-5A may be an important marker during initial events of AC malignant transformation, in which non-canonical and canonical Wnt/beta-catenin signaling pathways could be involved. Additionally, WNT-5A might recruit other events in LSCC, such as MMP-3 protein synthesis, as its presence is increased in established malignant processes without beta-catenin dependency.

Analysis of four gutta-percha techniques used to fill mesial root canals of mandibular molars

P>Aim To compare the percentage of gutta-percha, sealer and voids and the influence of isthmuses in mesial root canals of mandibular molars filled with different techniques. Methodology Canals in 60 mesial roots of mandibular first molars were prepared with ProTaper instruments to size F2 (size 25, 0.08 taper) and filled using a single-cone, lateral compaction, System B or Thermafil techniques. An epoxy resin sealer was labelled with Rhodamine-B dye to allow analysis under a confocal microscope. The percentage of gutta-percha, sealer and area of voids was calculated at 2, 4 and 6 mm from the apex, using Image Tool 3.0 software. Statistical analysis was performed using nonparametric Kruskal-Wallis and Dunn tests (P < 0.05). The influence of isthmuses on the presence or absence of voids was evaluated using the Fisher test. Results At the 2 mm level, the percentage of gutta-percha, sealer and voids was similar amongst the System B, lateral compaction and single-cone techniques. The single-cone technique revealed significantly less gutta-percha, more sealer and voids in comparison with the Thermafil technique at the 2 and 4 mm level (P < 0.05). The analysis of all sections (2, 4 and 6 mm) revealed that more gutta-percha and less sealer and voids were found in root canals filled with Thermafil and System B techniques (P < 0.05). The Fisher test revealed that the presence of isthmuses increased the occurence of voids in the lateral compaction group only (P < 0.05). Conclusion Gutta-percha, sealer filled area and voids were dependent on the canal-filling technique. The presence of isthmuses may influence the quality of root filling.

Influence of Preflaring on the Accuracy of Length Determination With Four Electronic Apex Locators

Introduction: The aim of this study was to compare the influence of preflaring on the accuracy of 4 electronic apex locators (EALs): Root ZX, Elements Diagnostic Unit and Apex Locator, Mini Apex Locator, and Apex DSP. Methods: Forty extracted teeth were preflared by using S1 and SX ProTaper instruments. The working length was established by reducing 1 mm from the total length (TL). The ability of the EALs to detect precise (-1 mm from TL) and acceptable (-1+/-0.5 mm from TL) measurements in unflared and preflared canals was determined. Results: The precise and acceptable (P/A) readings in unflared canals for Root ZX, Elements Diagnostic Unit and Apex Locator, Mini Apex and Apex DSP were 50%/97.5%, 47.5%/95%, 50%/97.5%, and 45%/67.5%, respectively. For preflared canals, the readings were 75%/97.5%, 55%/95%, 75%/97.5%, and 60%/87.5%, respectively. For precise criteria, the preflared procedure increased the percentage of accurate electronic readings for the Root ZX and the Mini Apex Locator (P < .05). For acceptable criteria, no differences were found among Root ZX, Elements Diagnostic Unit and Apex Locator, and Mini Apex Locator (P > .05). Fisher test indicated the lower accuracy for Apex DSP (P < .05). Conclusions: The Root ZX and the Mini Apex Locator devices increased significantly the precision to determine the real working length after the preflaring procedure. All the EALs showed an acceptable determination of the working length between the ranges of+/-0.5mm except for the Apex DSP device, which had the lowest accuracy. (J Endod 2009;35:1300-1302)

The 434(G > C) polymorphism in the eosinophil cationic protein gene and its association with tissue eosinophilia in oral squamous cell carcinomas

Objective: The aim of this study was to investigate the prevalence of the Eosinophil cationic protein (ECP)-gene polymorphism 434(G > C) in oral squamous cell carcinoma (OSCC) patients and its association with tumor-associated tissue eosinophilia (TATE), demographic, clinical, and microscopic variables. Methods: The ECP genotypes of 165 healthy individuals and 157 OSCC patients were detected by PCR-RFLP analysis after cleavage of the amplified DNA sequence with enzyme PstI. TATE was obtained by morphometric analysis. Chi-square test or Fisher`s exact test was used to analyze the association of ECP-gene polymorphism 434(G > C) with TATE, demographic, clinical, and microscopic variables in OSCC patients. Disease-free survival and overall survival were calculated by the Kaplan-Meier product-limit actuarial method and the comparison of the survival curves were performed using log rank test. Results: Most of healthy individuals (53.33%) and OSCC patients (57.97%) were heterozygous for the ECP 434(G > C) polymorphism. Based on numerical differences, our results showed that OSCC patients with intense TATE and at least one C allele had a higher frequency of bilateral neck dissection, local recurrence, vascular embolization, involved resection margins, and postoperative radiotherapy. No statistically significant differences on survival rates were found in OSCC patients presenting different ECP 434(G > C) genotypes. Conclusions: These results suggest a tendency towards a poor clinical outcome in OSCC patients with intense TATE and 434GC/CC genotypes, probably due to an ECP genetic variant with altered cytotoxic activity.

A Randomized Clinical Evaluation of a One- and Two-step Self-etch Adhesive Over 24 Months

Objective: To evaluate the performance of All Bond SE used in a one- or two-step protocol in a 24-month randomized clinical study. Methods: Thirty-three patients with two similarly sized non-carious cervical lesions participated in this study. A total of 66 restorations were placed, half using the one-step All Bond SE protocol (SE-1) and the other half using the two-step All Bond SE protocol (SE-2). The restorations were evaluated at baseline and after 6, 12 and 24 months following the modified USPHS criteria and analyzed by the McNemar`s test and Fisher`s exact test (alpha=0.05). Results: After 24 months, six SE-1 and four SE-2 restorations were rated as Bravo in marginal discoloration The retention rates for SE-1 and SE-2 were 84.8% and 90.9%, respectively, after 24 months. Compared to baseline, the retention rate for SE-1 was statistically lower. Conclusions: All Bond SE used in the one- or two-step protocol resulted in high retention rates after 24 months.

A 24-month randomized clinical trial of a two- and three-step etch-and-rinse technique

Purpose This 24-month randomized paired tooth clinical study evaluated the performance of All Bond 3 used in the simplified (2-step) and full (3-step) versions Methods 33 patients, with at least two similar sized non-carious cervical lesions participated in this study A total of 66 restorations were placed, half using the 2-step All Bond 3 (AB3-2) and the other half using 3-step All Bond 3 (AB3-3) The restorations were placed incrementally using the composite resin Aelite The restorations were evaluated at baseline and after 6, 12 and 24 months following the modified USPHS criteria Statistical differences between the adhesive were tested using with McNemar`s test and clinical performance over time for each material with the Fisher`s exact test (alpha= 0 05) Results After 24 months, six AB3-2 and four AB3-3 were rated as bravo for marginal discoloration but did not differ from each other significantly (P> 0 05) The retention rates at 24 months of AB3-2 and AB3-3 were 90 9% and 97 0%, respectively (P> 0 05) (Am J Dent 2010,23 231-236)

Clinical evaluation of two packable posterior composites A five-year follow-up

Background. Research has suggested that packable resin-based composites inserted with a placement technique similar to amalgam condensation can reduce the sensitivity associated with posterior restorations. The authors evaluated the clinical performance, including associated sensitivity, of two packable composites in a randomized five-year clinical trial. Methods. A single operator randomly placed two restorations in each of 33 patients: one restoration consisting of Alert (Jeneric/Pentron, Wallingford, Conn.) and the other consisting of SureFil (Dentsply/Caulk, Milford, Del.). There were 30 Class I and 36 Class II restorations. Two independent evaluators evaluated the restorations by using modified U.S.; Public Health Service criteria. The authors analyzed data by means of the Fisher, chi(2) and McNemar tests at P < .05. Results. Of 60 restorations evaluated at five years, two Class II restorations (one SureFil, one Alert) failed. All other restorations received the highest score possible for sensitivity and vitality. The only difference between the composites at the five-year recall was the significantly better surface texture of SureFil. The authors observed significantly different scores between the baseline and at five years for marginal discoloration (Alert and SureFil), surface texture (Alert and SureFil) and color (SureFil). Conclusions. Both packable resin-based composites showed excellent durability during the five-year follow-up. Clinical Implications. The investigated resin-based composites are suitable for posterior restorations.

Association between breastfeeding duration and non-nutritive sucking habits

Objective To evaluate the relationship between breastfeeding duration and the prevalence of non-nutritive Sucking habits in children with deciduous dentition. Method A cross-sectional survey was conducted on the mothers of 551 children aged 3 to 6 years, randomly selected from public pre-schools in Sao Paulo, Brazil. Mothers were asked to complete a questionnaire that included items regarding their children`s age, gender, race, method and duration of infant feeding, as well as pacifier use and/or digit-sucking habits. According to the answers pertinent to the method and duration of infant feeding, children were assigned to five groups: 1 - never breastfed, 2 - breastfed for a period shorter than 3 months of life, 3 - breastfed for 3 to 6 months, 4 - breastfed for 6 to 9 months, and 5 - breastfed for 9 months or longer. Data were submitted to the Fisher`s exact test with Bonferroni correction for multiple comparisons to analyse possible associations between breastfeeding duration period categories and non-nutritive sucking behaviours. Results Pacifier use frequency was high in groups 1, 2, 3 and 4 (85%, 87.6%, 78% and 70%, respectively), in comparison with that in group 5 (38.6%). The prevalence of non-nutritive sucking habits was significantly reduced in children who were breastfed for nine months or longer (p=0.000). There were no statistically significant differences in the frequencies of pacifier use and/or digit-sucking habits between genders, regardless of the breastfeeding duration period. Conclusion Children aged 3-6 years who were breastfed for nine months or longer had a lower prevalence of non-nutritive sucking habits.

Influence of occlusal access on demineralized dentin removal in the Atraumatic Restorative Treatment (ART) approach

Purpose: To verify the influence of cavity access diameter on demineralized dentin removal in the ART approach. Methods: 40 non-carious human premolars were randomly divided into four groups. The occlusal surface was ground flat and the teeth were sectioned mesio-distally. The hemi-sections were reassembled and occlusal access preparations were carried out using ball-shaped diamonds. The resulting size of the occlusal opening was 1.0 mm, 1.4 mm, 1.6 mm and 1.8 mm for Groups A, B, C, and D, respectively. Standardized artificial carious lesions were created and demineralized dentin was excavated. After excavation, the cavities were analyzed using: (a) the tactile method, (b) caries-detection dye to stain demineralized dentin, as proposed by Smales & Fang, and (c) Demineralized Tissue Removal index, as proposed in this study. Statistical analysis was performed using Fisher, Spearman correlation coefficient, kappa, Kruskal-Wallis and Miller tests (P < 0.05). Results: The three methods of evaluation showed no significant difference between Groups A vs. B, and C vs. D, while statistically significant differences were observed between Groups A vs. C, A vs. D, B vs. C and B vs. D. Based on the results of this study, the size of occlusal access significantly affected the efficacy of demineralized tissue removal.