Prevalence assessment of periodontal disease in 3-6 year old children through PSR--a pilot study

Increasing amounts of information emphasise the relevance of prevention, early diagnosis and early treatment of periodontal diseases in children. Children and adolescents affected by periodontal disease, mainly those who present a fast and severe attachment loss, are considered to be at risk of developing early or advanced periodontitis. Alternatively they may be presenting a reflex of systemic conditions affecting the periodontium. This study was aimed at verifying the acceptability of the use of the Simplified PSR (Periodontal Screening and Recording) Index in a very young population since a previous study in Bahia, Brazil, indicated a very high need for periodontal treatment in adolescents and young adults. A total of 200 children aged 3-6 years from private schools in Bahia, Brazil, were examined by four trained undergraduate students. The screening system was well accepted by the subjects and the fact that it is a fast tool was considered important for the successful examination of all sextants without behavioural disturbance. A high prevalence and a low severity of parameters related to periodontal disease were found in this population. A statistically higher prevalence of PSR code 2 (61.5%) [54.50-68.49] CI 95% when compared to PSR codes 0 (23.5%) 117.93-30.10] CI 95%, 1 (14.5%) 110.07-20.32] CI 95% and 3 (0.5%) 10.02-3.18] CI 95% were shown. There was no statistically significant difference between female and male children for any PSR code. The finding of more parameters related to periodontal health in S5 when compared to sextants S6 and S4 showed statistical significance (CI 95%).

Functional activity of alveolar and peripheral cells in patients with human acquired immunodeficiency syndrome and pulmonary tuberculosis

We compared the peripheral and pulmonary response to assess the phagocytic activity of monocytes/macrophages and neutrophils and the lymphoproliferative response (LPR) against Mycobacterium tuberculosis antigens from 21 AIDS patients, presenting at diagnosis with active pulmonary tuberculosis (TB), other non-TB pulmonary infection, or no pulmonary infection, as well as patients with active pulmonary TB and healthy control subjects. Alveolar lymphocyte analysis demonstrated that AIDS/TB patients had more markedly reduced percentages of CD4(+) lymphocytes than AIDS/TB patients and an increase in the percentage of CD8(+) lymphocytes, probably reflecting the impairment of CD4(+) T lymphocytes in peripheral blood at the lungs. Moreover, alveolar lymphocytes from AIDS/TB patients demonstrated a two- to fourfold decrease in LPR against M. tuberculosis antigens. Interestingly, it was observed an enhanced migration of natural killer cells to the lungs in all patients group. The phagocytic activity in alveolar macrophages and neutrophils showed that AIDS/TB patients had a twofold decreased capacity to ingest inert particles compared with AIDS patients. Comparing the alveolar and peripheral lymphocyte number and functional activity to M. tuberculosis-antigens it was possible to demonstrate that in both sites these cells had similar profile. However, the innate immune response in lungs showed a reduced activation in the presence of HIV infection, regarding the M. tuberculosis coinfection. These findings suggest that the advanced impairment of CD4(+) T lymphocyte in HIV-1 infection may lead to a deactivation of alveolar macrophages, enhancing bacilli burden and HIV replication in the lungs and furthering dissemination.