Acceptance of the use of silver fluoride among Brazilian parents of children with special health care needs.

Background: Children with special health care needs including Down Syndrome, Autism Spectrum Disorder and Down Syndrome experience difficulties in receiving dental treatment. Silver Diamine Fluoride (SDF) and Silver Fluoride (SF) are a minimally invasive treatments options to arrest dental caries without sedation; local or general anaesthesia (GA). Aim: Evaluation of Brazilian's parents' acceptance of the use of SF in CSHCN. Methods: After receiving education on SF, 100 Parents of CSHCN completed a questionnaire concerning their acceptance of SF, in different dental situation. Result: Majority of parents (74,5%) agreed to the use of SF for their children. SF was more acceptable on posterior teeth (74,5%) when compared to its use on anterior teeth (43,1%). Parents accepted to use SF in order: to reduce infection and pain (82,4%); to avoid dental injection (72,5%) and treatment under GA (84,3%). The Majority of parents accepted the properties of SF (82,4%) and Silver (80,4%). Conclusion: Silver Fluoride was accepted as a treatment option for caries, by Brazilian parents of CSHCN. SF should be considered as a treatment option for caries limited to dentine for CSHCN, taking into consideration the individual needs and opinions with regard to aesthetics and exposure to fluoride and silver.

Parental acceptance of silver fluoride as a treatment option for carious lesions among South African children with special health care needs.

Providing dental care for children with neurological special health care needs, including Down syndrome, Cerebral palsy and Autism spectrum disorders, is challenging. They often require repeat exposure to sedation or general anaesthesia for routine dental care. 51 parents of children with special needs completed a questionnaire regarding the acceptance of Silver Fluoride as a treatment option. Background: Silver Diamine Fluoride has become popular as a minimally invasive treatment option for providing oral health care to young or uncooperative children. Silver Fluoride (SF) is a newer development with similar but improved properties. The aim was to determine the acceptance of SDF/SF as treatment option for Children with Special Health Care Needs (CSHCN), including Down Syndrome, Autism Spectrum Disorder and Cerebral Palsy. Methods: 51 Parents of CSHCN completed a questionnaire on the overall acceptance of SF; aesthetic concerns related to the location of application; the use of SDF as an alternative to general anesthesia; and the composition of SF. Results: The use of SF on posterior teeth were more acceptable (70.59%) as opposed to its application to anterior teeth (50.98%). Parents generally agreed/ strongly agreed to the use of SF to reduce infection and pain (82%); to avoid treatment under GA (26.70%); and to avoid an injection (78%). 64% of parents indicated their agreement in using SF because it has a reduced cost when compared to a conventional restoration. Majority of parents were in agreement to use SF even if it contains Fluoride (84%) and Silver (78%). Conclusion: The use of SF, as treatment option for caries, was well accepted by South African parents of CSHCN. Shared decision making should be applied when considering SF as treatment option for CSHCN.

The Prevalence and Severity of Dental Caries Among Pregnant Women in the State of Rio de Janeiro, Brazil.

AIM: To assess in a pilot study the prevalence and severity of dental caries among pregnant women compared to non-pregnant women in the state of Rio de Janeiro, Brazil. MATERIALS AND METHODS: A cross-sectional, observational study was conducted. Data collection consisted of clinical examinations and general questionnaires concerning oral hygiene habits and recent dental visits of pregnant and non-pregnant women. Prevalence and severity of caries was determined by the CAST index and the CAST severity score. Permission for this study was granted by the National Research Ethics Commission of Brazil. Written informed consent was obtained from all participants. RESULTS: In total, 67 pregnant women were included (mean age (SD) 25.5 ± 5.4 years) and 79 non-pregnant women (26.0 ± 5.3 years). Mean number of teeth with untreated caries (CAST 4-7) among pregnant women was significantly lower (1.2 ± 1.8) compared to non-pregnant women (2.7 ± 4.0; Mann-Whitney test, p = 0.027). In both groups, 40-60% were in need of curative treatment. There was no significant difference between the two groups in frequency of dental visits (p > 0.05), but pregnant women brushed their teeth more often (Mann-Whitney test, p < 0.001). CONCLUSION: Pregnant women in the state of Rio de Janeiro have fewer untreated caries and less severe dental caries compared to non-pregnant women. Still, half of all women in this study are in need of curative treatment for at least one tooth. Effective preventive programs should therefore be developed to stimulate preventive oral care among all women.

Comparison of two methods for the detection of urinary iodine used in epidemiological studies.

Two methods for the determination of iodine in urine or serum based on the Sandell-Kolthoff reaction were compared. The first was an autoanalyser method (AAII, Technicon) where the mineralisation takes place in a continuous flow manner. This procedure was used at the Department of Clinical Chemistry of the University Hospital of Berne (Switzerland) from 1968 until 1993. The second method was evaluated and adapted in our own laboratory. Each sample and the iodate-standards are mineralised in a Pyrex glass tube and the decolorisation reaction takes place in a 96-well-microtiter plate which was read by a PC-controlled photometer at 405 nm. This method, with a detection limit of 0.1 micromol/l showed good analytical recovery (90 to 110%) and a low imprecision (intra-assay coefficient of variation (CV) of 5% and an inter-assay CV of 7.5%). In contrast to the autoanalyser method, the microtiter plate-method is suitable both for series up to 24 samples (3-fold) and for single samples. A comparison of 87 samples in the range of 0.1 to 60 micromol/l which were measured with both Sandell-Kolthoff based methods showed no obvious discrepancy. These two methods showed a good agreement for the determination of urinary iodine. This guarantees that the results of earlier epidemiological studies can be compared with recent studies performed in our and many other laboratories.

Iodine supply in different geographical areas of Switzerland: comparison between rural and urban populations in the Berne and the Ticino regions.

OBJECTIVE: We studied the question of possible regional differences of iodine intake in the population of rural and urban areas north and south of the Alps. DESIGN: Transversal study. SETTING: Six different regions from northern (Canton Berne) and southern Switzerland (Canton Ticino). SUBJECTS: For each region 30 individuals were studied. RESULTS: While significant differences of urinary iodine between some regions were found (range from 79 microg iodine/g creatinine in Chiasso to 130 microg iodine/g creatinine in the Maggia Valley), no significant differences between rural and urban populations of north and south of Switzerland were observed. Mild iodine deficiency affected 35%, moderate iodine deficiency 12% and severe iodine deficiency 0.6% of the total population investigated. CONCLUSIONS: 49% of this population showed at least mild or moderate iodine deficiency. The mean urinary iodine was just at the lower recommended limits. Significant differences were found between individual regions (such as Chiasso and the Valley of Maggia), but not generally between rural and urban areas in the north and south of the Alps.

[The significance of periodic gastric and duodenal motor activity in the clinical picture and combined treatment of patients with chronic acalculous cholecystopancreatitis]. / Znachenie periodicheskoi motornoi deiatel'nosti zheludka i dvenadtsatiperstnoi kishki v klinicheskoi kartine i kompleksnom lechenii bol'nykh khronicheskim beskamennym kholetsistopankreatitom.

A total of 39 patients with chronic calculi-free cholecystopancreatitis were evaluated for the reoccurring motility (ROM) of the stomach and duodenum using the method of ionoballoonotensiocinesiography. All patients presented with different types ROM disturbances accompanied in most cases by duodenal hypertension, duodenogastric reflux and reflux-gastritis. The ROM state should be considered in prescribing pathogenetic combined conservative treatment. Principles allowing some judgement about the ROM state have been determined.

Beneficial metabolic effects of insulin-like growth factor I in patients with severe insulin-resistant diabetes type A.

Severe insulin resistance type A is due to mutations in the insulin receptor gene and is characterized by glucose intolerance or diabetes mellitus, despite extreme hyperinsulinemia, virilization and acanthosis nigricans. At present, there is no therapy for this condition. Recently, we showed that glucose levels in three such patients are promptly lowered by an i.v. bolus of recombinant human insulin-like growth factor I (rhIGF-I). In the present study, we investigated two of these rare patients again and determined fasting and postprandial glucose, insulin, C-peptide, proinsulin and lipid levels during five control, five treatment and three wash-out days while on a constant diet. Treatment consisted of 2 x 150 micrograms rhIGF-I/kg sc per day, which elevated total IGF-I levels 4.5-fold above the control. Fasting glucose levels (days 1-5) in the two patients were 9.6 +/- 1.3 and 9.2 +/- 1.2 mmol/l, respectively, and fell to 4.4 +/- 0.4 and 5.1 +/- 0.5 mmol/l on treatment days 8-10. Fasting insulin (2950 +/- 450 and 690 +/- 125 pmol/l), C-peptide (2217 +/- 183 and 1317 +/- 235 pmol/l) and proinsulin control levels (125 +/- 35 and 66 +/- 0 pmol/l) also decreased by approximately 65% during rhIGH-I treatment, as did the respective postprandial levels. Lipid levels hardly changed at all. In conclusion, IGF-I appears to correct partially some metabolic sequelae of severe insulin resistance and may, hence, be used as a new therapeutic agent.

[Significance of gastric and duodenal motor function in guaranteeing full functional value of cholecystectomy]. / Znachennia motornoï funktsiï shlunka i dvanadtsiatipaloï kyshky v otsintsi funktsional'noï povnotsinnosti kholetsistektomiï.

Gastric and duodenal motor function was studied using ionoballoono-tensiokinesiography method in 77 patients with chronic calculous cholecystitis. Various periodic motor activity (PMA) infringements, both hypo- and hyperkinetic types, were diagnosed, mainly associated with duodenal hypertension, duodenogastric reflux and reflux-gastritis. Principles of pre- and postoperative correction of the PMA state for the guarantee of cholecystectomy functional full value were determined.

[The role of hormones from the mucosa of the gastric antrum in regulating gastric secretion]. / Rol' gormonov slizistoi obolochki antral'nogo otdela zheludka v reguliatsii zheludochnoi sekretsii.

Removal of antral mucosa obviously reduced the sensitivity of glandulocytes to pentagastrin in dogs with Basov-Pavlov fistulae. Activation of the endocrinal cells of the antral mucosa after fundal and antral parts separation exerted an opposite effect. The data obtained suggest that, along with gastrin, there is another hormonal factor facilitating the action of gastrin in the antral mucosa.

Insulin-like growth factor-I improves glucose and lipid metabolism in type 2 diabetes mellitus.

Hyperglycemia, hyperinsulinemia, and insulin resistance cause vascular disease in type 2 diabetes mellitus. Dietary treatment alone often fails and oral drugs or insulin enhance hyperinsulinemia. In previous studies, an intravenous bolus of recombinant human insulin-like growth factor-I (rhIGF-I) caused normoglycemia in insulin-resistant diabetics whereas rhIGF-I infusions lowered insulin and lipid levels in healthy humans, suggesting that rhIGF-I is effective in insulin-resistant states. Thus, eight type 2 diabetics on a diet received on five treatment days subcutaneous rhIGF-I (2 x 120 micrograms/kg) after five control days. Fasting and postprandial glucose, insulin, C-peptide, proinsulin, glucagon, triglyceride, insulin-like growth factor-I and -II, and growth hormone levels were determined. RhIGF-I administration increased total IGF-I serum levels 5.3-fold above control. During the control period mean (+/- SD) fasting glucose, insulin, C-peptide, and total triglyceride levels were 11.0 +/- 4.3 mmol/liter, 108 +/- 50 pmol/liter, 793 +/- 250 pmol/liter, and 3.1 +/- 2.7 mmol/liter, respectively, and decreased during treatment to a nadir of 6.6 +/- 2.5 mmol/liter, 47 +/- 18 pmol/liter, 311 +/- 165 pmol/liter, and 1.6 +/- 0.8 mmol/liter (P < 0.01), respectively. Postprandial areas under the glucose, insulin, and C-peptide curve decreased to 77 +/- 13 (P < 0.02), 52 +/- 11, and 60 +/- 9% (P < 0.01) of control, respectively. RhIGF-I decreased the proinsulin/insulin ratio whereas glucagon levels remained unchanged. The magnitude of the effects of rhIGF-I correlated with the respective control levels. Since rhIGF-I appears to improve insulin sensitivity directly and/or indirectly, it may become an interesting tool in type 2 diabetes and other states associated with insulin resistance.

Insulin-like growth factors in lysosomal storage disease.

Recent data indicate that insulin-like growth factor II (IGF II) and lysosomal enzymes bind to a common receptor. We measured serum IGF I and II levels in 16 patients with various lysosomal storage disorders. The IGF serum concentrations were normal as long as no marked liver disease was present. Under these conditions no direct interconnection between the lysosomal system and the serum IGF levels was found.

[Effect of various types of vagotomy on gastric secretion of histamine in dogs]. / Vliianie razlichnykh vidov vagotomii na gistaminovuiu zheludochnuiu sekretsiiu u sobak.

The chronic experiments on dogs with fundal fistulas have revealed that the partial stomach denervation (selective proximal, selective distal and subcardial vagotomies) decreases the gastric secretory responses caused by submaximal and maximal doses of histamine. Selective and extragastral vagotomies do not change the histamine gastric secretion in dogs, stimulated by the maximal histamine dose.

Selective pharmacological blockade of parasympathetic and enteric ganglia.

The blocking effects of two newly synthetized compounds, diisopropyldecylammonium iodide (IEM-1194) and 2,2,6,6-tetramethyldecylpiperidinium chloride (IEM-1559), on insulin- and pentagastrin-induced gastric secretion in chronic dogs, on stress-induced changes in gastric mucosa in rats, on vagus-induced effects in heart and intestine, on arterial blood pressure and on synaptic transmission through isolated ciliary and superior cervical ganglia in cats were studied. The effects observed were compared with those produced by hexamethonium (C6), a conventional ganglionic blocking agent. Both IEM-1194 and IEM-1559 inhibited gastric secretion and acid output for a much longer time than C6 did and effectively protected gastric mucosa against stress-induced erosions and hemorrhages. IEM-1194 blocked the vagus-induced decrease in heart rate and increase in duodenal motility for a longer time than did C6 and also, in contrast to C6, did not reduce the arterial blood pressure. The blockade of synaptic transmission through isolated ciliary and superior cervical ganglia produced by IEM-1194 and IEM-1559 was characterized by lower EC50 and was more prolonged than that produced by C6. In addition, both IEM-1194 and IEM-1559 were more potent blocking agents in ciliary ganglion than in superior cervical ganglion. It is suggested that IEM-1194 and IEM-1559 are selective blocking agents for parasympathetic and enteric ganglia versus sympathetic ganglia.

[The effect of extragastric vagotomy on gastric emptying and motility of the small intestine]. / Vliianie ékstragastral'noi vagotomii na zheludochnuiu évakuatsiiu i motoriku tonkoi kishki.

Selective parasympathetic denervation of small and some large intestine has been performed in dogs. Chronic experiment on these dogs has revealed that this operation: has no effect on frequency and amplitude of intestine contractions during the first phase of the digestive process but it is accompanied by significant relaxation of the motor intestine activity in the second phase, causes a retardation of the rate of evacuation from stomach by 56.0% in dogs subjected to extragastric vagotomy as well as pH of chyme in the duodenum by 1-1.5 units above the norm.

[Preganglionic parasympathetic innervation of the intact and partially denervated rat stomach]. / Preganglionarnaia parasimpaticheskaia innervatsiia intaktnogo i partsial'no denervirovannogo zheludka u krys.

The preganglionic parasympathetic innervation of normal and vagotomized rat stomach have been investigated by the horseradish peroxidase (HRP) technique. After the HRP injection into the antrum and fundus muscles the labelled cells were revealed in nuclei dorsalis nervi vagi bilaterally, but preferentially in the left nucleus. The most numerous labelled cells were observed after injection into the region of the curvatura minor. When HRP was injected into the vagotomized stomach one, three, four and six months after the surgery procedures the labelled cells in the nuclei nervi vagi were not revealed. Mechanisms of regeneration of nervi vagi efferents and normalization of the stomach activity are discussed.

Polar surface distribution of type II insulin-like growth factor receptor in rat hepatocytes.

We describe the distribution of type II insulin-like growth factor receptors among canalicular (cLPM) and basolateral (bLPM) subfractions of rat liver plasma membranes (LPM). BLPM bound 3 times more 125I-IGF II than cLPM. The number of receptors was (1.3 +/- 0.15) X 10(-12) mol/mg in bLPM, and (0.4 +/- 0.17) X 10(-12) mol/mg in cLPM. Insulin-like growth factor II (IGF II) was 10 times more potent than insulin-like growth factor I (IGF I) in displacing 125I-IGF II from both basolateral and canalicular binding sites. Insulin did not interfere with binding of 125I-IGF II in either LPM preparations. Our findings point to an asymmetrical hepatocellular distribution of type II IGF receptors, thus extending the concept of surface polarization of hepatocytes to growth promoting hormone receptors.