Synergism between obesity and poor oral health associated with diabetes in an elderly human population.

We investigated associations between type 2 diabetes (DM) and several variables, including poor oral health and overweight/obesity, among a group of elderly Hmong subjects (60 years and older) who emigrated to the United States following the Vietnam conflict. Each subject was interviewed and their weight, height and waist circumference were measured. Each subject had an oral health examination. Each subject's saliva was analyzed for seven components related to inflammation. The presence of DM was correlated with poor oral health (POH) and overweight/obesity (OW) separately. There was a strong correlation between concurrent POH and OW and the presence of DM: all subjects with both POH and OW had DM. Logistic multivariate analysis of OW, POH, age, years of residence in California, and stress level revealed a significant association between the presence of DM and concurrent OW and POH. A change in diet after immigration was excluded as an explanatory variable. Subjects with DM and concurrent OW and POH had significantly elevated salivary levels of five analyses related to chronic inflammation. The association between POH and OW and the presence of DM needs further study.

Interactions of overweight, poor oral health, and stress related to chronic disease in an aging population.

The prevalence of excess body mass (XBM), poor oral health (POH), and stress in a secluded population of aged (≥60 years) Hmong immigrants was surveyed. The findings were related to the prevalence of diabetes in the same population. Diabetes was associated separately with POH (OR 2.4; CL 1.3, 4.2) or with XBM (OR 2.5; CL 1.4, 4.8). The association of diabetes with the combination of XBM and POH was striking (OR 5.1; CL 3.4, 7.5); that apparent synergism has not been fully appreciated. We describe a mechanism that explains the synergism. The concept of "thrifty genotype" is a plausible explanation of XBM in the elderly Hmong immigrants and possibly the current older Laotian population. POH is common among elderly Laotians as it is in most developing countries. We conclude that synergism of XBM and POH significantly elevates the prevalence of diabetes among aging populations and probably other age groups as well.

Instruction in behavior modification can significantly alter soil-transmitted helminth (STH) re-infection following therapeutic de-worming.

Five elementary ("prototypic") schools located in five districts in central Java were selected and the children examined for helminth infections (Ascaris, Trichuris, hookworm). They were de-wormed with a course of mebendazole and provided with 6-7 months of "behavioral remediation instruction" (BRI). In other ("control") schools, children were treated with mebendazole but were not provided BRI. The objective was to determine the effectiveness of BRI in minimizing infection/re-infection following deworming. After the 6-7 month course of BRI in the prototypic schools, all the children (in both the prototypic and control schools) were re-examined for geohelminth infection. The schools in two of the five districts were omitted from further analysis because the overall prevalence of infection was low (<10%) and the infections were dominated by hookworm which are only moderately susceptible to mebendazole. Comparisons of prototypic and control schools in the other three districts provided compelling evidence that BRI was quite effective in reducing both the frequency and intensity of infection with Ascaris and Trichuris. We suggest that instructing children and adults corrects personal habits which are conducive to infection and can be an effective and safe substitute for repeated deworming, reducing the opportunity for the emergence of drug-resistant helminthes, which should prolong the time benzimidazoles may be used for treatment of geohelminth infection.

Behavioral and hygienic characteristics of primary schoolchildren which can be modified to reduce the prevalence of geohelminth infections: a study in central Java, Indonesia.

Five schools in central Java that enroll more than 500 students in grades one through six were chosen for a study of the prevalence of parasitic geohelminths and selected protozoan infections. The schools are located in regions that differ in geological features, density of vegetation and cultural and economic attributes. The prevalence of soil-transmitted helminths among children in the five schools ranged from 8.7% to 76.1%, and protozoan infections from 2.8% to 32.1%. The principal objective of the study was to identify physical, hygienic and behavioral characteristics of the children that increase the likelihood of becoming infected. Although most of the characteristics studied are considered to be contributing factors, few previous attempts have been made to rank them in order of importance in causing infection. The results of this study suggest that a systematic and sustained effort to teach children to (a) avoid certain types of behavior that favor infection, and (b) practice good personal hygiene, are the best approaches to significant and enduring reduction of the scourge of intestinal parasitism.

Aging of innate immunity: functional comparisons of NK/LAK cells obtained from bulk cultures of young and aged mouse spleen cells in high concentrations of interleukin-2.

The technique of bulk cultivation of aged mouse spleen cells in high concentration of IL-2 was employed to obtain NK/LAK cells in sufficient number and enrichment for studies on the effects of aging on their functions. The yield and enrichment were equivalent to that of young mouse spleen cells. The aged and young mouse NK/LAK cells were equivalent also in their functional competence to proliferate, kill target cells and produce IFNgamma; i.e. they did not display age-associated defects typical of freshly-isolated NK/LAK cells. In two respects, however, the NK/LAK cells derived from aged mouse spleen were altered: (a) in the efficiency of nuclear translocation of transcription factors STAT 5A and 5B, and (b) in the deficiency in production of mRNA transcripts representing several chemokines. We recommend caution in the use of bulk cultivation in IL-2 to obtain NK/LAK cells for studies on aging. However, it does appear from this study that aging may severely affect chemokine production, at least in the case of NK/LAK cells.