A cross sectional study to evaluate the oral health status of children with intellectual disabilities in the National Capital Region of India (Delhi-NCR).

BACKGROUND: Children with intellectual disabilities (ID) have usually been reported to have poorer levels of oral hygiene and higher prevalence of dental caries than their compeers. The present study was conducted to assess the status of dental caries and oral hygiene in different categories of institutionalised children with ID (syndromic and non-syndromic) registered in various special schools of Delhi (National Capital Region, India). METHODS: The present cross sectional study was conducted on 269 children [52 with cerebral palsy (CP), 35 with Down syndrome (DS), 30 with autism and 152 with non-syndromic intellectual disability] attending nine special schools who were examined for dental caries [Decayed, Missing and Filled Teeth index for permanent teeth (DMFT); decayed, missing/indicated for extraction, filled index for primary teeth (dmft) and prevalence of caries] and oral hygiene status [Oral Hygiene Index-simplified (OHI-S)]. The levels of disability were classified according to Stanford Binet scale as severe (IQ ≤ 35), moderate (IQ = 36-51) and mild (IQ = 52-67). Statistical analysis was performed using one way analysis of variance and post hoc test to compare the levels between groups at a significance level of P < 0.05. RESULTS: Mean DMFT, dmft and OHI-S indices scores for all the children irrespective of the category and the level of ID were 2.12 ± 1.95, 0.97 ± 1.60 and 2.05 ± 1.07, respectively. As the level of ID increased among these children, the mean DMFT index and OHI-S index increased with no significant effect on dmft. However, children with severe ID had higher OHI-S and DMFT scores than children with mild or moderate ID. The dental caries prevalence was 86.53%, 68.57%, 76% and 86.18% in children with CP, DS, autism and non-syndromic intellectual disability, respectively. CONCLUSIONS: The level of caries in permanent teeth and oral hygiene deteriorated with the increasing severity of ID as indicated by DMFT and OHI-S scores (severe > mild, moderate). However, the level of caries (dmft) was not affected by the level of ID in primary dentition. The prevalence of dental caries was highest among children with CP and least among children with DS.

Fatty acid binding protein-4 is expressed in the mouse placental labyrinth, yet is dispensable for placental triglyceride accumulation and fetal growth.

INTRODUCTION: Fatty Acid Binding Protein-4 (FABP4) is a member of a family of FABP proteins that regulate intracellular lipid trafficking in diverse tissues. We recently showed that FABP4 regulates triglyceride accumulation in primary human trophoblasts. To assess the function of placental FABP4 in vivo, we tested the hypothesis that FABP4 is expressed in the murine placenta, and regulates placenta triglyceride accumulation. METHODS: C57Bl/6 wild type or Fabp4-null mice were time-bred, and fetuses and placentas harvested at different time points during pregnancy. Placental FABP4 expression was assessed at different gestational ages, using quantitative PCR, immunohistochemistry, immunofluorescence and western immunoblotting. FABPs expression was examined by RT-qPCR. Placental lipids were extracted using the Folch method and triglyceride levels determined using a colorimetric quantification kit. RESULTS: Using immunohistochemistry, we found that FABP4 was expressed in the placental labyrinthine layer, predominantly in endothelial cells in association with CD31 positive fetal capillaries. The level of placental FABP4 mRNA and protein increased from E12.5 to E16.5 and slightly decreased at E18.5. Breeding of Fabp4 heterozygous mice resulted in embryonic genotypes that followed a Mendelian distribution and exhibited normal weight and morphology, triglyceride content, and expression of other FABP family members. Exposure to hypoxia (O2 = 12%) between E12.5-E18.5 did not uncover a difference between wild type and Fabp4-null mice. CONCLUSIONS: FABP4 is expressed in the mouse placental labyrinth, with highest expression at E16.5. FABP4 is dispensable for feto-placental growth and placental lipid accumulation.

SU-E-T-183: Managing and Assessing Patients Receiving Radiotherapy with Implantable Cardiac Devices.

PURPOSE: To assess the effectiveness of the management of patients with cardiac electronic implantable devices (CEIDS) receiving radiotherapy. METHOD AND MATERIALS: In 2005, a formal communication process was established between Radiation Oncology and Cardiac Electrophysiology (EP) for the management of patients with permanent, implantable cardiac devices receiving radiotherapy. The process requires a pre-treatment consult with EP. This information is provided to a medical physicist, who works with the primary radiation oncologist and dosimetrist. Based on the estimated dose to the device, EP and Radiation Oncology will determine the appropriate oversight required for treatment. To assess the effectiveness of this program, a retrospective analysis of patients with implantable cardiac devices receiving radiotherapy between the years 2005 and 2011 was performed. RESULTS: Sixty-nine patients with CEIDs (19 implantable cardioverter defibrillators (ICDs) and 50 pacemakers) were treated in Radiation Oncology between 2005 and 2011. Patients were treated to a variety of sites, including 21 patients treated to multiple sites. Doses were estimated prior to radiotherapy, and in vivo measurements were obtained for patients near or exceeding our institutional device tolerance (ICDs = 1 Gy and ICPs = 2 Gy), or if the device was less than 10 cm from the edge of a treatment field. Of the patients evaluated, there were only two patients with ICD devices which had a partial reset of diagnostic data during their treatment. There were no major device failures of arrhythmia detection or treatment. CONCLUSIONS: Our multi-disciplinary team has worked together to develop a process to manage the care of patients with permanent implantable cardiac devices. There have been few device events noted in our patient cohort. The team will continue to follow our institutional management methodology to assess the appropriate amount of EP care necessary during radiation therapy. Laura Horwood is on the speakers bureau for Medtronic. Frank Pelosi is on the advisory board for Boston Scientific Corp and St. Jude Medical, is receiving an educational grants from Medtronic, St Jude, Boston Scientific, Biotronik, and a research grants from Medtronic.

Civilian vascular trauma: an experience of 54 cases.

Fifty-four patients with civilian vascular injuries of the extremities caused by blunt trauma in 41 patients and by penetrating trauma in 13 patients were evaluated. Twenty-nine patients (53.7%) had associated fractures/dislocations and 19 sustained concomitant venous injuries. Twenty-nine patients (53.7%) came with a lagging period of more than 12 hours. Vascular injuries were diagnosed both clinically and by Doppler examination. In patients with equivocal findings, arteriography was performed. Arterial repair was done in 19 patients and saphenous vein interposition grafting was done in 2 patients. Fifteen patients required fasciotomy. Amputation was done in 13 patients (24.07%). It is concluded that the time lag, incorrect and incomplete assessment, and the reluctance to perform fasciotomy early and completely are some of the factors responsible for poor results.