Evolución de la salud bucal en niños de 3-5 años de edad de al ciudad de Córdoba. Argentina. Estudio CLACYD1 / Evolution of oral health in 3-5 year-old hildren of Cordoba city. Argentina. CLACID1

Se analiza la salud bucal en niños de 3-5 años de la ciudad de Córdoba participantes del estudio CLACYD. La prevalencia de caries observada en la población fue de: 18,4 por ciento (3 años), 43,3 por ciento (4 años) y 59,4 por ciento (5 años) con diferencias mayores en los niños varones y de menores recursos (estrato II). Los índices de caries se incrementaron un 327,3 por ciento en la población. Según el Sistema de Análisis para Caries (SAC) se observó mayor prevalencia y severidad en el patrón de fosas y fisuras (FF), un avance de la enfermedad en los patrones proximal posterior (PP) y bucal lingual (BL) en los varones y en el estrato II. A los dos años de estudio se observaron diferencias estadísticamene significativas en todos los patrones de caries. Los índices de higiene oral y salud gingival y la proporción de niños en las categorías de alto riesgo de niveles de St mutans y actividad de lactobacilos, se incrementaron en toda la población. El análisis de correlación simple aplicado a los 3 y 5 años de edad reveló un incremento del coeficiente de correlación positiva, entre el índice de caries (ceo-d) y las siguientes variables: higiene oral r=0,40-0,55 (p=0,02), salud gingival 0,42-0,54 (p=0,08), St mutans r=0,22-0,45 (p=0,01) respectivamente. Se concluye que la salud bucal de esta población muestra un temprano deterioro y con condiciones del ambiente bucal desfavorables que en un futuro inmediato comprometería la dentición permanente con la aparición de la caries dental y de enfermedades periodontales, por lo que es relevante destacar las necesidades inmediatas de atención odontológica que requieren los niños de la ciudad de Córdoba (AU)

Evolución de la salud bucal en niños / Evolution of buccodental health in children

Se analiza la salud bucodental en niños de 3-4 años de edad participantes del Estudio CLACYD. El modelo de predicción de caries consideró a las variables clínicas (índices ceo-d y ceo-s y al Sistema de Análisis para Caries [ISACI) y sociodemográticas (condición socioeconómica v hábitos de higiene dental, y [alimentarios en base a datos ya publicados] ). A la edad de 4 años esta población registró un incremento de fa prevalencia del 1.39.1 por ciento, (varones: 43.9 por ciento, mujeres: 41.5 por ciento, estrato 1: 33.7 por ciento y estrato 11: 52.9 por ciento) El grupo de varones mostró mayor severidad en los patrones FF, MA y PP. La variable sociodemográfica influyó en la prevalencia de los patrones FE, PP y BL en el estrato II, en el grado de avance de la enfermedad, en la higiene oral, salud gingival y salud bucal. El estudio longitudinal de esta población reveló diferencias significativas en los índices ceo-d y ceo-s según sexo y condición socioeconómica. La población registró incremento en la prevalencia de los patrones FF, PP y BL en ambos sexos, registrando el grupo de varones mayor severidad en la experiencia de caries. Si bien la prevalencia mostró diferencias significativas en ambos estratos socioeconómicos, los niños de menores recursos mostraron un deterioro temprano de los elementos dentarios. EI sexo y la condición socioeconómica incidieron notablemente en las condiciones de higiene oral y en el ambiente bucal, lo que estaría asociado con la experiencia de caries (AU)

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Proceso salud-enfermedad: una propuesta interdisciplinaria para el Ciclo de Introducción y Nivelación de la Facultad de Odontología (CINFO). Universidad Nacional de Córdoba, Argentina / Health-disease process: an interdisciplinary proposal for the cycle of introduction and grading of and odontology faculty. Universidad Nacional de Córdoba, Argentina

La presente propuesta interdisciplinaria analiza el proceso salud-enfermedad en el ambiente bucal desde las disciplinas que conforman el Ciclo de Introducción y Nivelación (CINFO) según el modelo epidemiológico (huésped, agente y sustrato). Se considerarán como eje principal de la salud las medidas preventivas: higiene dental, velocidad de flujo salival, disminución del consumo de hidratos de carbono, ingestión de sustitutos del azúcar y uso de fluoruros. Desde la enfermedad, la caries dental, gingivitis y la enfermedad periodontal se considerarán las entidades nosológicas bucodentales de mayor prevalencia, producidas por la interacción de los componentes del modelo bajo estudio, con efectos biológicos y químicos importantes. La interacción de las bases conceptuales de los diferentes campos disciplinarios, juntamente con estrategias metodológicas, permitirá una mayor comprensión, una mayor significación, un proceso mental más coherente y la humanización del contenido, lo que contribuirá a una concienciación temprana de la salud en la comunidad (AU)

Evolution of saliva and serum components in patients with oral candidosis topically treated with Ketoconazole and Nystatin.

The present study involves the analysis of some saliva components (SC) and serum components in patients with oral candidosis topically treated with Ketoconazole 2% (K) or Nystatin 100,000 IU (N). Twenty-four male and female patients, age range 39-82 years, were included in the study. A double-blind study was undertaken in which the patients were divided into 2 treatment groups. These groups were compared with a control group (CG) of 16 healthy patients, both male and female, age-matched with the treated groups. The parameters evaluated were oral mucous membrane lesion index (MLI), CFU of Candida, saliva flow rate, protein-bound Fe (Fe-prot), Fe-prot binding capacity (Fe-prot cap), IgAs, peroxidase activity (PA), hypothiocyanite and thiocyanite. The values of Candida CFU and MLI were significantly reduced in patients treated with K and N. The pre-treatment values of SC as compared to the CG revealed a reduction in Fe-prot and Fe-prot cap. These parameters reach values similar to control towards the end of the treatment. The PA was significantly higher in candidosis patients and fell to control values with treatment. The other SC and serum components did not exhibit significant differences with the CG. Patients with oral candidosis treated locally exhibit not only an improvement in clinical manifestations but also a return to control values of altered SC.

Caries experience in 3 year old children of Cordoba, Argentina.

The results of a study of caries in a 3 year old cohort of children performed by the CLACyD (Spanish abbreviation by initials for Nutrition, Growth and Development Program of Córdoba) are analysed. The prevalence of caries was 19.7% for boys and 16.1% for girls. Dmf-t and dmf-s values were 0.55-0.75% for girls and 0.73-1.22% for boys. The most affected element was the first mandibular molar (16.30% of the population). Extracted and filled elements accounted for 1.8 and 5.9% of the dmf-t index. According to the Caries Analysis System, a higher prevalence of the PF (pits and fissures) pattern and the AM (anterior maxillary bone) pattern was observed as compared to the PP (proximal posterior) and BL (buccolingual) patterns. The percentage distribution of BL lesions over all the patterns exhibited statistically significant (p = 0.05) differences between girls and boys. The PF and PP patterns were more severe in boys (p = 0.0006 and p = 0.002 respectively). Based on the present data we conclude that this population exhibits marked prevalence which can rapidly increase and pose a threat to temporary and mixed dentitions. We herein recommend preventive measures of widespread use (regarding toothbrushing, and eating habits with particular reference to carbohydrate consumption) and preventive-therapeutic treatments for diseased patients (topical applications of fluoride, sealing agents and active treatment of caries).

[Oral health status evaluation of pre-school children: longitudinal epidemiologic study (1993-1994), Córdoba, Argentina]. / Evaluación del estado de salud bucodental en preescolares: estudio epidemiológico longitudinal (1993-1994), Córdoba, Argentina.

A one-year longitudinal survey was carried out on a sample of the Cordoba City 4-year old kindergarten population (n = 820); so as to determine the role of several variables upon the incidence of caries. The dmf-t, dmf-s, oral hygiene and oral health indexes as well as incidence rates and caries relative risks of caries were inversely related to the socioeconomic level (SEL) of the children involved. Thus in the SEL III (typical proletariat, non-typical proletariat and sub-proletariat) children, the relative risk of caries was almost five times higher (RR = 4.9) than in the SEL I (entrepreneureal and managerial bourgeoisie) children. In SEL I, almost all new lesions occurred on smooth surfaces (61.2%), while in SEL III the molar occlusal faces were mainly affected (66.3%). Daily sugar intake was higher in SEL III children but experience of caries showed poor correlation to the amount (r = 0.40) and frequency (r = 0.52) of carbohydrate intake. No significant interlevel differences were observed in the biochemical salivary parameters analyzed. Assisted toothbrushing and fluoride topications strongly lowered the incidence of caries among SEL III children, also making the corresponding rates fall almost to SEL I values (0.31, 0.23 and 0.22 vs. 0.21). In conclusion, SEL III children should be treated prophylactically with effective preventive measures, because of their susceptibility to caries. Such preventive measures include assisted toothbrushing and fluoride topications.

Evaluation of serum and saliva components in candidosis patients.

The serum and saliva components of 36 chronic Candidosis patients, both male and female, ages 38-82 who attended the Department of Clinical Stomatology were studied. Total Mucous Lesion Index (TMLI) and salivary flow rate were assessed. The following parameters were evaluated: iron bound protein, unsaturated iron binding capacity, peroxidase activity, protein content, OSCN-, SCN-, IgAs, Candida and St. mutans levels and lactobacilli activity. Candidosis patients exhibited higher Candida CFU values and increased activity of the peroxidase system (p < 0.05) whereas unsaturated iron binding capacity was significantly lower as compared to healthy subjects (p < 0.05). Furthermore, TMLI and Candida CFU values were higher in diseased subjects wearing complete prosthesis as compared to those without complete prosthesis. Diseased subjects with < 1.2 ml/min salivary flow rate exhibited even greater differences with control. This subgroup exhibited a marked reduction in IgAs. The serum components assayed were iron bound protein, unsaturated iron binding capacity, IgG, IgA and IgM. Unsaturated iron binding capacity was significantly lower in the Candidosis group (p = 0.03). Subjects suffering from oral Candidosis display deficiencies in some of their saliva components, evidencing impaired oral defense capacity.

Bucodental health condition in patients with Down syndrome of Cordoba City, Argentina.

The oral health condition of children and youngsters with Down Syndrome (DS) was evaluated on a sample of 86 mongolic subjects ages 3 to 19, both sexes, residents in the city of Córdoba (Argentina), and compared with control groups. Those persons were attended special educational institutions for the care of that type of disabled individuals. In every age group, the dmf-t and dmf-s indexes were higher in the mongolic children than in the control population, while from the age of 10 onwards the DMF-T and DMF-S of the control population were higher than those of the DS individuals. In spite of this, the scarce participation of the DF component in the mentally disabled showed deficiencies in their dental care. This population exhibited a high frequency of retarded eruption, agenesis, conoidism, Angle's type III malocclusion, posterior cross bite and deficient gingival health. A positive correlation was found between tha activity of Lactobacillus and the amount of Streptococcus and the caries indicators. A high concentration of calcium and secretory IgA was found in the group of mongolic subjects. Our analysis evidences that DS patients are at a disadvantage in relation with healthy individuals in terms of oral health. An early program of preventive measures is proposed (dental hygiene, anti-plaque agents, Therapy of Orofacial Regulation) which would involve the education of parents and teachers.

Hepatic glycogen depletion in fed female rats induced by piroxicam.

The effects of i.p. piroxicam administration on hepatic glycogen levels and enzymatic activities of key enzymes involved into glycogen metabolism in fed female rats were studied. Liver glycogen concentrations in treated rats decreased with increasing time of treatment and doses of piroxicam administered. The fall in glycogen caused by piroxicam persisted for several days after it was discontinued. Neither nadolol nor phenobarbital administration were able to prevent the depleting effect of piroxicam. In the treated rats, glucose-6-phosphatase, glycogen phosphorylase and glycogen synthase activities remained unchanged respect to control. Also, proportion of phosphorylase in the active (a) form was not significantly affected by successive piroxicam daily doses. In contrast, we demonstrated a decrease in the glycogen synthase in the active I form. This reduction was time-dependent on piroxicam treatment. Further, glucose loads were not capable to restore activity in the synthase enzyme and liver glycogen synthesis in animals treated with piroxicam. The impairment into glycogen metabolism produced by piroxicam administration suggests liver becomes unable to maintain glucose homeostasis. Furthermore, glycogen depletion might produce an impairment in the metabolism of drugs administered simultaneously with piroxicam, because biotransformation of xenobiotics is a process depending on glycogen storage in the liver cells.

Hepatic glycogen depletion in fed female rats induced by piroxicam.

The effects of i.p. piroxicam administration on hepatic glycogen levels and enzymatic activities of key enzymes involved into glycogen metabolism in fed female rats were studied. Liver glycogen concentrations in treated rats decreased with increasing time of treatment and doses of piroxicam administered. The fall in glycogen caused by piroxicam persisted for several days after it was discontinued. Neither nadolol nor phenobarbital administration were able to prevent the depleting effect of piroxicam. In the treated rats, glucose-6-phosphatase, glycogen phosphorylase and glycogen synthase activities remained unchanged respect to control. Also, proportion of phosphorylase in the active (a) form was not significantly affected by successive piroxicam daily doses. In contrast, we demonstrated a decrease in the glycogen synthase in the active I form. This reduction was time-dependent on piroxicam treatment. Further, glucose loads were not capable to restore activity in the synthase enzyme and liver glycogen synthesis in animals treated with piroxicam. The impairment into glycogen metabolism produced by piroxicam administration suggests liver becomes unable to maintain glucose homeostasis. Furthermore, glycogen depletion might produce an impairment in the metabolism of drugs administered simultaneously with piroxicam, because biotransformation of xenobiotics is a process depending on glycogen storage in the liver cells.

Hepatic glycogen depletion in fed female rats induced by piroxicam.

The effects of i.p. piroxicam administration on hepatic glycogen levels and enzymatic activities of key enzymes involved into glycogen metabolism in fed female rats were studied. Liver glycogen concentrations in treated rats decreased with increasing time of treatment and doses of piroxicam administered. The fall in glycogen caused by piroxicam persisted for several days after it was discontinued. Neither nadolol nor phenobarbital administration were able to prevent the depleting effect of piroxicam. In the treated rats, glucose-6-phosphatase, glycogen phosphorylase and glycogen synthase activities remained unchanged respect to control. Also, proportion of phosphorylase in the active (a) form was not significantly affected by successive piroxicam daily doses. In contrast, we demonstrated a decrease in the glycogen synthase in the active I form. This reduction was time-dependent on piroxicam treatment. Further, glucose loads were not capable to restore activity in the synthase enzyme and liver glycogen synthesis in animals treated with piroxicam. The impairment into glycogen metabolism produced by piroxicam administration suggests liver becomes unable to maintain glucose homeostasis. Furthermore, glycogen depletion might produce an impairment in the metabolism of drugs administered simultaneously with piroxicam, because biotransformation of xenobiotics is a process depending on glycogen storage in the liver cells.

Impairment of human antipyrine metabolism by piroxicam.

The pharmacokinetics of a single oral dose of antipyrine was determined in healthy young volunteers (18-28 years), both 3 days before piroxicam, ketoprofen, or naproxen administration and on the following day of their discontinuation. In all subjects treated with piroxicam (10, 20, and 40 mg daily) for 5 consecutive days, the rate of salivary antipyrine elimination slowed. Antipyrine half-life was prolonged and metabolic clearance was reduced significantly (p less than 0.01) proportional to the dose administered. After piroxicam was discontinued, both pharmacokinetic parameters of antipyrine returned toward normal. No significant modification in antipyrine half-life or metabolic clearance rate was demonstrated after pretreatment with ketoprofen (50, 100, and 200 mg daily) or naproxen (250 and 500 mg daily). The impairment on antipyrine disposition produced by piroxicam has been interpreted as a consequence of a reduction in the activity of hepatic microsomal drug-metabolizing enzymes, particularly the cytochrome P-450 system. These results suggest the possibility of drug accumulation and toxicity when certain other therapeutic agents are administered simultaneously with piroxicam. For the same reason, it is recommended to bear in mind the potential danger of long-term piroxicam therapy on the oxidative degradation of steroid hormones and other endogenous compounds that are metabolized by the mixed-function oxidase system.