Anthocyanin Biosynthesis and DNA Methylation Dynamics in Sweet Orange Fruit [Citrus sinensis L. (Osbeck)] under Cold Stress

The blood red color of pigmented orange fruit varieties [Citrus sinensis L. (Osbeck)] is due to the presence of anthocyanin pigments that largely contribute to determine the high organoleptic qualities and the nutritional properties of the fruits. The content of pigments in sweet orange depends primarily on genetic factors and on environmental conditions. In particular, it has been extensively shown that cold temperature induces an increase of anthocyanin content that is achieved by the induction of the related gene expression. The purpose of our work is to understand the mechanism underlying the color variegation occurring inside the blood oranges during the cold induction of anthocyanin biosynthesis, despite the fact that the entire fruit is genotypically programmed to produce pigments. Therefore, the amount of anthocyanin and the expression of both structural and regulatory genes have been monitored in either high-pigmented (HP) or not/low pigmented (NP) segments of the same fruit during the storage at 4 °C for a total experimental period of 25 days. Our results clearly indicate that the anthocyanin content is directly correlated with the levels of gene transcription, with higher pigmented areas showing higher enhancement of gene expression. Furthermore, we analyzed the reshaping of the DNA methylation status at the promoter regions of genes related to anthocyanin biosynthetic pathway, such as DFR and Ruby. Our results unequivocally demonstrate that in the promoter regions of both DFR and Ruby, the amount of cytosine methylation strongly decreases along the cold storage in the HP areas, whereas it increases in the NP areas of the same fruit, probably causing a partial block of the gene transcription. Finally, by measuring the changes in the expression levels of the Citrus DNA demethylases, we found that DML1 might play a crucial role in determining the observed demethylation of DFR and Ruby promoters, with its expression induced by cold in the HP areas of the fruits. This is the first report in which different levels of gene expression implicated in anthocyanin production in blood orange fruit is correlated with an epigenetic control mechanism such as promoter methylation.

Transplanting hepatitis C virus-infected hearts into uninfected recipients: A single-arm trial

The advent of direct-acting antiviral therapy for hepatitis C virus (HCV) has generated tremendous interest in transplanting organs from HCV-infected donors. We conducted a single-arm trial of orthotopic heart transplantation (OHT) from HCV-infected donors into uninfected recipients, followed by elbasvir/grazoprevir treatment after recipient HCV was first detected (NCT03146741; sponsor: Merck). We enrolled OHT candidates aged 40-65 years; left ventricular assist device (LVAD) support and liver disease were exclusions. We accepted hearts from HCV-genotype 1 donors. From May 16, 2017 to May 10, 2018, 20 patients consented for screening and enrolled, and 10 (median age 52.5 years; 80% male) underwent OHT. The median wait from UNOS opt-in for HCV nucleic-acid-test (NAT)+ donor offers to OHT was 39 days (interquartile range [IQR] 17-57). The median donor age was 34 years (IQR 31-37). Initial recipient HCV RNA levels ranged from 25 IU/mL to 40 million IU/mL, but all 10 patients had rapid decline in HCV NAT after elbasvir/grazoprevir treatment. Nine recipients achieved sustained virologic response at 12 weeks (SVR-12). The 10th recipient had a positive cross-match, experienced antibody-mediated rejection and multi-organ failure, and died on day 79. No serious adverse events occurred from HCV transmission or treatment. These short-term results suggest that HCV-negative candidates transplanted with HCV-infected hearts have acceptable outcomes.

Early emergence of anti-HCV antibody implicates donor origin in recipients of an HCV-infected organ

Hepatitis C virus (HCV) seroconversion among HCV-uninfected transplant recipients from HCV-infected (NAT+/Antibody+) or HCV-exposed (NAT-/Antibody+) donors has been reported. However, the origin of anti-HCV antibody and the implications of seroconversion remain unknown. We longitudinally tested plasma from HCV-uninfected kidney (n = 31) or heart transplant recipients (n = 9) of an HCV NAT+ organ for anti-HCV antibody (both IgG and IgM isotypes). Almost half of all participants had detectable anti-HCV antibody at any point during follow-up. The majority of antibody-positive individuals became positive within 1-3 days of transplantation, and 6 recipients had detectable antibody on the first day posttransplant. Notably, all anti-HCV antibody was IgG, even in samples collected posttransplant day 1. Late seroconversion was uncommon (≈20%-25% of antibody+ recipients). Early antibody persisted over 30 days in kidney recipients, whereas early antibody dropped below detection in 50% of heart recipients within 2 weeks after transplant. Anti-HCV antibody is common in HCV-uninfected recipients of an HCV NAT+ organ. The IgG isotype of this antibody and the kinetics of its appearance and durability suggest that anti-HCV antibody is donor derived and is likely produced by a cellular source. Our data suggest that transfer of donor humoral immunity to a recipient may be much more common than previously appreciated.

Twelve-Month Outcomes After Transplant of Hepatitis C-Infected Kidneys Into Uninfected Recipients: A Single-Group Trial

BACKGROUND

Organs from hepatitis C virus (HCV)-infected deceased donors are often discarded. Preliminary data from 2 small trials, including THINKER-1 (Transplanting Hepatitis C kidneys Into Negative KidnEy Recipients), suggested that HCV-infected kidneys could be safely transplanted into HCV-negative patients. However, intermediate-term data on quality of life and renal function are needed to counsel patients about risk.

OBJECTIVE

To describe 12-month HCV treatment outcomes, estimated glomerular filtration rate (eGFR), and quality of life for the 10 kidney recipients in THINKER-1 and 6-month data on 10 additional recipients.

DESIGN

Open-label, nonrandomized trial. (ClinicalTrials.gov: NCT02743897).

SETTING

Single center.

PARTICIPANTS

20 HCV-negative transplant candidates.

INTERVENTION

Participants underwent transplant with kidneys infected with genotype 1 HCV and received elbasvir-grazoprevir on posttransplant day 3.

MEASUREMENTS

The primary outcome was HCV cure. Exploratory outcomes included 1) RAND-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) quality-of-life scores at enrollment and after transplant, and 2) posttransplant renal function, which was compared in a 1:5 matched sample with recipients of HCV-negative kidneys.

RESULTS

The mean age of THINKER participants was 56.3 years (SD, 6.7), 70% were male, and 40% were black. All 20 participants achieved HCV cure. Hepatic and renal complications were transient or were successfully managed. Mean PCS and MCS quality-of-life scores decreased at 4 weeks; PCS scores then increased above pretransplant values, whereas MCS scores returned to baseline values. Estimated GFRs were similar between THINKER participants and matched recipients of HCV-negative kidneys at 6 months (median, 67.5 vs. 66.2 mL/min/1.73 m2; 95% CI for between-group difference, -4.2 to 7.5 mL/min/1.73 m2) and 12 months (median, 72.8 vs. 67.2 mL/min/1.73 m2; CI for between-group difference, -7.2 to 9.8 mL/min/1.73 m2).

LIMITATION

Small trial.

CONCLUSION

Twenty HCV-negative recipients of HCV-infected kidneys experienced HCV cure, good quality of life, and excellent renal function. Kidneys from HCV-infected donors may be a valuable transplant resource.

PRIMARY FUNDING SOURCE

Merck.

Evaluation of recovery and quality of sexual activity in women during postpartum in relation to the different mode of delivery: a retrospective analysis

AIM

Aim of the study was to assess the recovery and quality of sexual activity of women during postpartum, in relation to delivery.

METHODS

We recruited 200 women at 8 weeks after delivery. For each patient we recorded mode of delivery, age, body mass index (BMI), parity and test Female Sexual Function Index (FSFI) score.

RESULTS

Sixty-four women (32%) had spontaneous deliveries without episiotomy, 48 (24%) had it with episiotomy, 88 (44%) had caesarean sections. The analysis of variance (ANOVA) test showed no significant differences among the 3 groups for age, BMI, parity. The test FSFI evidenced 68 cases (34%) of Regular Female Sexual Function (RFSF) and 132 (66%) of Female Sexual Dysfunction (FSD). The ANOVA test showed significant differences among the 3 groups in RFSF (F [2, 14]=8.075, P=0.005), but not in FSD (F [2, 30]=2.646, P=0.087). In RFSF, FSFI score was higher in women who had vaginal delivery with episiotomy compared with the other two groups. Conversely, in FSD (both with or without resumed sexual activity at 8 weeks postpartum) we evidenced that patients who had vaginal delivery with episiotomy showed lower FSFI score than the other two groups, with a decrease in lubrication, orgasm and satisfaction scores. Furthermore, we observed that most of the RFSF patients had a job and breastfed.

CONCLUSION

Our results did not evidence a direct and significant correlation between mode of delivery and onset of female postpartum sexual dysfunction, even if FSD patients who underwent episiotomy during delivery markedly showed low FSFI scores.

A systematic review of powered vs manual toothbrushes in periodontal cause-related therapy

BACKGROUND

Power-driven toothbrushes (PDT) have been designed to improve the efficacy of oral hygiene. It is not clear how they compare in efficacy with manual toothbrushes in cause-related periodontal therapy.

OBJECTIVES

To evaluate the effectiveness of the use of a PDT as compared with a manual toothbrush (MT), in terms of gingival bleeding or inflammation resolution, in cause-related periodontal therapy.

MATERIAL AND METHODS

An electronic (MEDLINE and Cochrane Oral Health Group Specialised Trials Register) and a manual search were made to detect studies which permitted the evaluation of the efficacy of PDT in the reduction of gingival bleeding or inflammation, and their effect on other secondary variables. Only randomized studies in adults, published in English up to June 2001, which compared a PDT with an MT, and evaluated the evolution of gingival bleeding or inflammation were included. The selection of articles, extraction of data and assessment of validity were made independently by several reviewers.

RESULTS

Twenty-one studies were finally selected. The heterogeneity of the data prevented a quantitative analysis. A higher efficacy in the reduction of gingival bleeding or inflammation in the PDT patients was detected in 10 studies. This effect appears to be related to the capacity to reduce plaque, and is more evident in counter-rotational and oscillating-rotating brushes. No solid evidence was found for a higher efficacy of sonic brushes. In short-term studies with prophylaxis after initial examination, independently of the type of PDT tested, no significant differences were found.

CONCLUSION

The use of PDT, especially counter-rotational and oscillating-rotating brushes, can be beneficial in reducing the levels of gingival bleeding or inflammation. There is a need for methodological homogeneity in future studies in this field to enable quantitative analysis of their results.

Evaluation of the precision obtained with a fixed surgical template in the placement of implants for rehabilitation of the completely edentulous maxilla: a clinical report

The fabrication of a complete maxillary implant-supported prosthesis in a patient with slight resorption of the alveolar ridge and a high lip line presents a professional challenge. The implants must be placed with high precision to achieve good esthetics, phonetics, and function. A fixed surgical template using microimplants has been developed for this purpose. The objective of this investigation was to compare a fixed surgical template (FST) to a conventional movable surgical template (MST) for the precise placement of implants in the slightly resorbed edentulous maxilla. Three patients (28 implants), edentulous in the maxilla, with slight ridge resorption, in whom the implants were placed with an FST, were compared with 5 controls having the same characteristics and implants placed with an MST (35 implants). After completion of the prosthesis, occlusal photographs (1:1) were taken, and these images were scanned and transferred to a drawing program in which the contours of the teeth, the ideal emergence position of the occlusal hole of the abutment screw, and its real position were drawn. A blind evaluation was made using the following variables: frequency of location of the abutment screw hole outside of the tooth contour, and the relative measurements of the area of coincidence between the circle that represents the ideal position and real position. A significantly smaller frequency of implants outside the tooth contour was seen with the FST (7%) than with the MST (46%) (P < .0008). Also, a significantly higher relative area of coincidence was observed between ideal position and real position in the FST (0.61) than in the MST (0.38) (P < .003). This study revealed that considerably higher precision was associated with the use of an FST.

[Spiral computerized tomography in the diagnosis of acute occlusion of the abdominal aorta. A case report]

Aim of this report is to present a case of acute occlusion of the abdominal aorta recognized by spiral-CT. After a brief description of the etiology and pathology of abdominal aorta acute occlusion, stress is laid on diagnostic role of spiral-CT, based on personal and literature data. The advantage of spiral respect to non-spiral CT is the quicker examination time which is very important, mostly in emergencies. On the contrary, the diagnosis of acute abdominal aorta occlusion is not modified by volumetric CT respect to non-spiral and it is based on the absence of aorta contrast enhancement above the occlusion level.

Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report

This article describes a surgical periodontal plastic procedure for the coverage of multiple adjacent gingival recessions. This surgical technique is based on the construction of a tunnel under the gingival tissue by means of a sulcular incision beyond the mucogingival line without raising the papillae. A large connective tissue graft obtained from the palatal mucosa is introduced through this tunnel, covering the adjacent gingival recessions. A suturing technique to allow this graft to slip through the tunnel under the gingival tissues and to secure and stabilize the graft covering the recessions is described. Twelve-month postoperative results are presented from 21 teeth that were treated with this technique: 100% root coverage was achieved in 66.7% of the recessions treated, with a mean root surface coverage of 91.6%. This study suggests that the use of this surgical procedure allows the treatment of multiple adjacent recessions in a single procedure with adequate early healing and highly predictable root coverage results.

Profile surgical template: a systematic approach to precise implant placement. A technical note

The precise placement of dental implants is essential to designing a prosthesis that fulfills the esthetic and functional requirements of the patient, and simultaneously allows clear phonetics and facilitates oral hygiene. To achieve this, an effective surgical template is essential: it must provide good orientation, be comfortable, have adequate intraoral fixation, allow freedom of choice to the surgeon, and be capable of use during image-diagnostic procedures. In accordance with this criteria, the profile surgical template, based on utilization of the buccal contour of missing teeth, has been designed.

Guided tissue regeneration in human Class II furcations and interproximal infrabony defects after using a bioabsorbable membrane barrier

This study clinically evaluated a bioabsorbable barrier membrane designed for periodontal regeneration. Ten Class II furcations and 12 interproximal infrabony defects were treated by flap debridement and placement of a bioabsorbable barrier membrane using the principles of guided tissue regeneration. Treatment was evaluated in terms of changes in vertical probing depth, horizontal attachment level, clinical attachment level, and recession. Baseline data were collected on the day of surgery, and outcome measurements were performed at the 1-year appointment. The mean initial probing depth for Class II furcations was 6.5 mm. At 1 year, the mean probing depth was reduced to 2.9 mm, a 3.6 mm change. These differences were clinically and statistically significant (P < 0.01). There was a mean gain of 2.4 mm in clinical attachment level (P < 0.01) and a mean 3.4-mm change in horizontal attachment level (P < 0.01). Recession increased 1.2 mm. For interproximal infrabony defects, there was a mean probing depth reduction of 5.0 mm (P < 0.01), a mean gain of clinical attachment level of 3.8 mm (P < 0.02), and a mean increase of 1.2 mm in recession (P < 0.04). The results indicate that significant improvements occurred after treatment of Class II furcations and interproximal infrabony defects with the use of a bioabsorbable barrier membrane and guided tissue regeneration.

[Magnetic resonance in primary bone tumors: a review of 10 years of activities]

All the MR exams of primary bone tumors performed during ten years were reviewed by three different radiologists. In all, 484 exams in 220 patients were considered--namely, 160 exams (33.1%) for staging purposes, 219 (45.2%) during therapy and 105 (21.7%) performed more than 8 months after the last treatment. Its well-known accuracy in the assessment of intra/extraosseous spread confirms the major role of MRI in the staging of primary bone tumors. During treatment, the overall accuracy of this method decreased to 88.8% because of the presence of therapy-induced tissue changes. MRI was 95.2% reliable in the detection of persistent disease or relapse in the exams performed long after therapy. Conventional radiology is still the method of choice in the study of primary bone tumors at presentation as it detects the lesion, differentiates malignant tumors and usually suggests the possible histotype. Nevertheless, MRI seems to be needed to depict actual tumor extent and to find the correct therapeutic approach. In the follow-up, MRI is the best single method to assess the response to therapy and to detect tumor persistence.

Implantation of sepiolite-collagen complexes in surgically created rat calvaria defects

The response of osseous tissue to the implantation of sepiolite-collagen complexes has been studied. Sepiolite, sepiolite-collagen complex and 0.5% glutaraldehyde-treated sepiolite-collagen complex were implanted in created circular defects in rat calvaria. The tissue reactions were analysed using light, transmission and scanning electron microscopies. The patterns of bone growth were radiographically analysed and the bone activity was indirectly quantified by using a point-count method. The reaction against the three implanted materials is characteristic of a foreign body reaction with abundant macrophages and giant cells. Implanted products have been detected in macrophages, which suggest the involvement of phagocytosis in the resorptive process. Bone grew at the implantation sites originating excrescences or sometimes a thin bridge at the defect margins. The studied materials, after implantation in contact with bone tissue, did not produce any toxic effect or necrosis, allowing bone activity.

Initial stress induced in periodontal tissue with diverse degrees of bone loss by an orthodontic force: tridimensional analysis by means of the finite element method

This study was undertaken to determine the stress that appears in tooth, periodontal ligament and alveolar bone, when a labiolingual force of 100 gm is applied in a labiolingual direction in a midpoint of the crown of an inferior digitalized canine, and its changes depending on the degree of loss of the supporting bone. The analysis of tensions was carried out by means of the finite element method (FEM) for a normal case and after reducing the periodontal support bone 2, 4, 6, and 8 mm. Three-dimensional images in false color in which intensity of tensions and its areas of extension are generated. Special attention was paid to changes at level D (apical transversal section) to which maximum, mean, minimum, and Von Mises tensions are calculated. After applying the labiolingual force in the canine, a progressive increase of the stress in the labial and lingual zones of the tooth, periodontal membrane and alveolar bone was observed when the alveolar bone was reducing. In the mesial and distal zones, no compensating forces appear, which could provoke a tooth rotation during the tipping movements.

Placebo-controlled comparison of piroxicam-beta-cyclodextrin, piroxicam, and indomethacin on gastric potential difference and mucosal injury in humans

The acute gastroduodenal mucosa injury and gastric potential difference (GPD) drops provoked by 14-day administration of 20 mg/day of a new piroxicam formulation (piroxicam-beta-cyclodextrin), 20 mg/day standard piroxicam and 100 mg/day indomethacin were evaluated and compared in a randomized, double-blind, placebo-controlled study carried out on 64 volunteers. Endoscopic examinations, performed after 14-day treatment, demonstrated that piroxicam-beta-cyclodextrin was less gastrolesive (mean endoscopic score +/- SE = 0.56 +/- 0.2) than either piroxicam (2.06 +/- 0.5) or indomethacin (2.25 +/- 0.5) (p < 0.01). The drop in GPD after a single dose of the assigned drug was considerably greater for piroxicam and indomethacin than for piroxicam-beta-cyclodextrin (p < 0.01), which registered similar values to placebo. Since GPD is an expression of the anatomo-functional integrity of the gastric barrier, the results indicate that piroxicam-beta-cyclodextrin exerts less direct acute damage on the gastric mucosa. Therefore, when administered short-term, piroxicam-beta-cyclodextrin appears to be less gastrolesive than either indomethacin or the standard piroxicam formulation.

Analysis of oral health information in the Spanish mass media

The purpose of this study was to evaluate oral health information delivered by the Spanish mass media. The study was composed of two parts. In a quantitative study three media were selected: press, radio, and television. The study was carried out between December 1987 and March 1988, and the media with largest numbers and audience were selected. Information variables were: politics/economy-labor/culture-education/interviews-events-reports/sport s/ leisure/publicity/health/oral health/miscellaneous. The mass media studied dedicated a very small percentage of their space/time to health information, with a clear predominance of other themes such as publicity, politics, and sports (17/1). In relation to oral health, results were even more significant because the space/time dedicated to health in relation to oral health was 180/1 (P less than 0.01). Most of the oral health time was given via promotional or politico-professional issues (P less than 0.05). In a qualitative study all available information relating in any way with oral health was selected from a survey of all written news by the non-specialized Spanish press that appeared during 1 yr (Jan 1987-Jan 1988). Reports dedicated to education were only 170 (31.48%) of the total (540) oral health reports. From 170 reports dedicated to oral health, 33 (19.41%) presented some sort of error and 137 (80.59) had an adequate educative content. Caries was the topic more frequently covered, 77.06% of the data, in contrast to periodontal disease, dealt with by only 33.53%. The qualitative level of data using a Score Level Index (SLI) was 42.73% of the highest possible level. Implications for public health dentistry are discussed.

[Periodontal treatment needs in a Spanish school population. 2. Intraoral distribution of different signs]

The aim of this study was to assess the prevalence of the different periodontal disease indicators used in the C.P.I.T.N. per sextant in the Spaniard population under 20 years of age. We have examined a randomly chosen sample of 1450 school-aged individuals, 7, 12 and 15 to 19 years old. We have observed a healthy periodontium more frequently in the upper anterior region, calculus predominates in the lower incisors close followed by molars, and periodontal pockets of 4 mm or deeper were commonly found in the molar regions. We could'nt detect important deviations from this distribution pattern in the different age groups or between males and females.

[Presence of caries and periodontal disease in Spanish students. Overview of results obtained in different localities]

Results of our survey in 11 locations of Spain are assembled in an overview showing percentages of persons according to the highest C.P.I.T.N. code defected for each one, the prevalence of caries-free-children and mean D.M.F.T. scores. We have also studied the differences between urban and rural populations. Rural children presented higher D.M.F.T. an D.T. scores.

[Relationship of dental treatment and oral hygiene to caries prevalence and need for periodontal treatment]

The aim of this study was to examine the relationship between differences in dental attendance and oral hygiene patterns and dental caries and periodontal treatment needs. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated. Dental caries and periodontal treatment needs were registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria of W.H.O. Regular dental attendance was observed in 16.6% of subjects examined, and only 9.4 saw a dentist regularly for dental prophylaxis. Statistical analyses showed that while the more frequent the dental visits, the lower the rate of caries, and periodontal treatment needs, the higher, however, the average number of fillings and the D.M.F.T. scores. These individuals had the higher number of functioning teeth, restored or sound, but they also had the disadvantage of having higher levels of disease experience. By the other way the individuals who saw the dentist regularly for dental prophylaxis presented the lower caries rate and periodontal treatment needs, the fewer tooth loss, and also an important reduction in the D.M.F.T. scores. Similar observations had been made in the individuals who brush their teeth frequently or with a correct technique. The results suggested that while frequent dental visits do not apparently help to prevent the onset of further dental disease, we can achieve this goal with regular preventive oriented dental therapy.

[Periodontal treatment needs in a Spanish school population]

The aim of this study was to assess the periodontal treatment needs of the population under 20 years of age in Spain. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated using the Community Periodontal Index of Treatment Needs (C.P.I.T.N.). In the first age group (7 years), 12% presented calculus or overhanging restorations, and 45% had bleeding upon probing only. In the age group of 12 years the proportion of individuals with calculus, overthanging restorations or moderate pocket depths was 39%, while 38% had gingivitis as their highest treatment need. In the oldest group (15-19 years) the number of subjects with bleeding upon probing decreased to 17%, while the percentage of individuals having moderate pockets, calculus or overhanging restorations increased to 67%. 1% of this youngsters had pockets of 6 mm. or over. At age 7, only 30% had "acceptable gingival health", and no more than 15% of the 18 year-olds reached this condition.

[Prevalence of caries in Spanish school children and youth of 7, 12 and 15 to 19 years of age]

The aim of this study was to assess the dental caries prevalence and severity of the population under 20 years of age in Spain. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated, registering the decayed, extracted or filled teeth for primary and permanent dentition. Average D.M.F.T. for 7, 12 and 15-19-years-old were 1.5, 3.5 and 6.6 respectively. A comparison of the results with those of previous studies showed that the average D.M.F.T. scores have decreased since 1984. We have also observed an increment in the number of caries-free children reaching the 57.9% in the age group of 7 years. But this excitement over the increase in the number of caries-free children must be tempered by the recognition that 35% of these individuals had 70% of the caries. We still need educational, preventive and restorative programs, and focus our efforts in detecting and treating the highly susceptible children.

[Caries prevalence and periodontal treatment needs in the same individuals]

The aim of this study was to determine whether dental caries and periodontal disease occur frequently in the same subjects 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated. Dental caries and periodontal treatment needs were registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria of WHO. We have found a highly significant relation between both variables, average D.M.F.T. scores increased as periodontal treatment needs were more advanced. Those subjects with lower codes of C.P.I.T.N. presented also lower D.M.F.T. scores, while these individuals with higher D.M.F.T. scores, based on a great number of open carious lesions, were more affected for periodontal disease. It does not support either a directly synergistic or antagonistic correlation in the prevalence of these two diseases in the same subjects. Dental health status is at a certain time an end result of years of varying dental health behaviour. In industrialized countries a variety of factors seems to determine the prevalence of dental caries and/or periodontal disease: dietary habits, access to fluorides, efficacy of oral hygiene measures, utilization of dental health care services. These data and ideas supported the strategy of preventing the dental caries and periodontal disease simultaneously.

[Validity of partial systems of periodontal examination in epidemiological studies]

The purpose of the present study was to determine the representativeness of partial examination in the assessment of the average severity and the prevalence of periodontal disease. 343 subjects aged 7, 12 and 15-19 years were examined for the presence or absence of gingival bleeding after gentle probing, supra or subgingival calculus and pocket depths of 4-5 mm., or 6 mm. and over, of each tooth. Three sets of average severity and prevalence scores were prepared: based on the full mouth examination, on observations made from the index teeth of the P.D.I., and on the six teeth utilized for the C.P.I.T.N. in this age group. Partial indices tended to underestimate the real prevalence of the different signs, and slightly overestimate severity, being these observations statistically significant. Average severity scores were obtained more accurately with the six Ramfjord teeth, while real prevalence rates were better determined with the C.P.I.T.N. teeth. From an epidemiological point of view, the real significance of the differences observed should be further determined.

[Control using omeprazole in a case of upper digestive hemorrhage, induced by erosive uremic hemorrhagic gastritis resistant to conventional therapy]

Erosive and/or ulcerative lesions of the digestive tract often complicate chronic renal failure. These lesions usually cause only chronic bleeding. In the rare cases of massive digestive bleeding, conventional therapy is frequently unsatisfactory. A case of massive bleeding, due to anti-H2 therapy resistant erosive haemorrhagic uremic gastritis is reported, where repeated transfusions failed to correct a marked anaemia (Hb = 0.8 g/dl). Considerable improvement of the endoscopy, clinical and hemato-biochemical pictures was achieved with 40 mg/day omeprazole. Three-months follow-up confirmed the efficacy and safety of the drug.

[Epidemiological study of periodontal disease in an Oviedo school population]

1,276 young people, between 6-20 years old, representing the urban school population from Oviedo (Spain) were evaluated by the Community Periodontal Index of Treatment Needs (C.P.I.T.N.). From this population: 1. 66.1% were found to have bleeding on probing, without evidence of attachment loss (gingivitis), or presence of local irritants. This population represented a treatment need of improving oral hygiene. 2. 29.6% had moderate attachment loss (probing pocket depths between 4-5 mm.) and/or presence of local irritants. They were determined to need scaling and root planing. 3. 0.7% had probing pocket depths higher than 6 mm., which requires a more complex specialized type of therapy. Based on these treatment needs, the number of treatment hours was determined, estimating that it would be necessary to spend 1649 hrs. to diagnose and treat this detected periodontal conditions. 93% of this time could be provided by dental auxiliary personnel. The therapeutic needs were higher in males and clearly augmented with age.

Levels of iron, vitamin B12, folic acid and their binding proteins during pregnancy

One hundred pregnant women, not anemic and not receiving iron or vitamin supplements, were chosen at random among the three trimesters of pregnancy to determine the incidence of unexpected iron, plasma folate and/or cobalamin deficiency, and the significance of fluctuating levels of their respective binding proteins. Pregnant females had a nonsignificant fall in serum iron and a fourfold decline in serum ferritin in the 3rd trimester compared with 1st trimester values. There was a steady decrease in plasma cobalamin and cobalophilin levels in every trimester but no difference in transcobalamin II values. Unsaturated cobalamin (UBBC) and unsaturated transcobalamin binding capacity (UTCBC) were lower in the 1st trimester fully recovering afterwards. Plasma folate levels were not lower, although there was a steady reduction in total and unsaturated folate binding capacity throughout pregnancy.