Effects of mometasone furoate on the quality of life: a randomized placebo-controlled trial in persistent allergic rhinitis and intermittent asthma using the Rhinasthma questionnaire.

BACKGROUND: Allergic rhinitis, especially when persistent (PER) and associated with asthma heavily impairs patients' quality of life (QoL). OBJECTIVE: This study assessed the effect of mometasone furoate nasal spray (MFNS) on the QoL of patients with PER and asthma, using the Rhinasthma questionnaire (EUDRACT n. 2007-004683-45). METHODS: Patients with moderate/severe PER and intermittent asthma were randomized to MFNS (alcohol-free) 200 µg/day or placebo for 28 days. Rhinasthma was completed at baseline and at weeks 2 and 4. The total five symptom score (T5SS) for rhinitis, the asthma symptom score and the sum of the two [global symptoms score (GSS)] were recorded daily. The primary outcome was the change in the Rhinasthma global summary (GS) at the end of treatment. Secondary end-points were (a) the change from baseline to end of treatment of each Rhinasthma factor: upper airways (UAs), lower airways (LAs) and respiratory allergy impact; (b) the change from baseline to end of treatment of the T5SS and of the GSS and (c) the use of rescue medication. RESULTS: Fifty-two adults were randomized. Compared with placebo, MFNS produced a significant change in the Rhinasthma GS (-10.4 vs. 0.4; P<0.01). MFNS also achieved a significant improvement of the UA (-16.6 vs. 0.1; P<0.001), LA (-10.8 vs. 1.1; P<0.001) and GSS (-6.7 vs. -3.1; P=0.019). The change of the T5SS was greater in the MFNS group but did not reach statistical significance. CONCLUSION: In patients with PER rhinitis and intermittent asthma, MFNS improves the QoL and the burden of respiratory symptoms. Treating rhinitis may affect the asthma-related QoL.

Genetic and structural analysis of the Bacteroides conjugative transposon CTn341.

The genetic structure and functional organization of a Bacteroides conjugative transposon (CTn), CTn341, were determined. CTn341 was originally isolated from a tetracycline-resistant clinical isolate of Bacteroides vulgatus. The element was 51,993 bp long, which included a 5-bp coupling sequence that linked the transposon ends in the circular form. There were 46 genes, and the corresponding gene products fell into three major functional groups: DNA metabolism, regulation and antibiotic resistance, and conjugation. The G + C content and codon usage observed in the functional groups suggested that the groups belong to different genetic lineages, indicating that CTn341 is a composite, modular element. Mutational analysis of genes representing the different functional groups provided evidence for the gene assignments and showed that the basic conjugation and excision genes are conserved among Bacteroides spp. A group IIA1 intron, designated B.f.I1, was found to be inserted into the bmhA methylase gene. Reverse transcriptase PCR analysis of CTn341 RNA showed that B.fr.I1 was functional and was spliced out of the bmhA gene. Six related CTn-like elements were found in the genome sequences of Bacteroides fragilis NCTC9343 and Bacteroides thetaiotaomicron VPI5482. The putative elements were similar to CTn341 primarily in the tra and mob regions and in the exc gene, and several appeared to contain intron elements. Our data provide the first reported sequence for a complete Bacteroides CTn, and they should be of considerable benefit to further functional and genetic analyses of antibiotic resistance elements and genome evolution in Bacteroides.

Social, political, and economic factors responsible for the reemergence of trichinellosis in Serbia: a case study.

Over the past decade, eastern Europe has experienced a resurgence of trichinellosis. A recent outbreak in Serbia, Yugoslavia, from December 2001 to January 2002, involving 309 people, revealed many of the causes for this reemergence. Epidemiological investigations indicate that the immediate cause of the recent outbreak was the consumption of smoked sausages produced by a small slaughterhouse or meat processor. However, failure of in-house meat inspection procedures and quality assurance as well as oversight by official veterinary control were also responsible. Further analysis of this breakdown in the food safety net revealed additional general factors that have yielded a seriously deficient veterinary control system, and these are factors that are relevant to the problems experienced throughout eastern Europe and other regions. The recent civil war that led to the breakup of the former Federation of Yugoslavia resulted in severe economic and demographic changes, including high inflation and external economic sanctions. This led to (1) the loss of large numbers of experienced veterinary control officers and their replacement with inexperienced personnel, (2) a change in the swine industry with reduction in the number of large establishments with in-house inspection and replacement with more than 1,000 small abattoirs, too small to afford full-time in-house inspection, and (3) an increase in smallholder pig farming with reduced government oversight to ensure high standards in pig-rearing practices (infection risk management). The consequences of these events have been a 300% increase in Serbian pig infection and a concomittant large increase in human outbreaks. Before 1990, swine trichinellosis in Serbia was confined to 4 small districts, but today about one third of the Republic is considered endemic for trichinellosis. The reemergence of trichinellosis in Serbia illustrates the ability of this zoonosis to "leak" through a poorly maintained food safety barrier and the vulnerability of effective veterinary control to national and international events.

Analysis of a Bacteroides conjugative transposon using a novel "targeted capture" model system.

Large conjugative transposons (CTn's) are widespread among Bacteroides spp. and they are responsible for the high rates of Bacteroides tetracycline resistance, which is mediated by the tetQ gene. These elements are self-transmissible and conjugation can be induced up to 1000-fold by the addition of tetracycline to cultures prior to mating. In addition to self-transfer, the Bacteroides CTn's, such as CTn341, are able to mobilize unlinked genetic elements such as plasmids and mobilizable transposons in a tetracycline-inducible manner. To study the molecular properties of these unique elements, a vector was designed to capture CTn's for analysis in heterologous hosts. This plasmid, pFD670, consisted of the low-copy vector pWSK29, the RK2 oriT, an ermF gene, and a tetQ gene fragment containing the N-terminus and promoter. The vector was transferred into Bacteroides recipients containing CTn341 where it integrated into the tetQ gene by homologous recombination. This integrated construct then was transferred back into an Escherichia coli host where it replicated as a plasmid, pFD699, about 56 kb in size. Further analysis showed that pFD699 could be transferred into Bacteroides hosts where it displayed the same tetracycline-inducible properties as the native CTn341. The captured element appeared to utilize a circular intermediate in both transfer and transposition, and integration into the chromosome seemed to be random. Hybridization studies with a range of Bacteroides CTn's encoding tetracycline resistance revealed a great deal of homology between most of the CTn's but there was much variation seen in the restriction patterns of these elements, suggesting great diversity among this group.

In Vivo Characterization of Dimethylsulfoniopropionate Lyase in the Fungus Fusarium lateritium.

A fungus, Fusarium lateritium, with dimethylsulfoniopropionate (DMSP) lyase activity was isolated from both seawater and a salt marsh due to its ability to grow on DMSP (with the evolution of dimethyl sulfide) as the sole source of carbon. This is the first reported case of DMSP lyase activity in a fungus. Several other common fungal genera tested did not have DMSP lyase activity. DMSP was taken up more rapidly by F. lateritium than it was utilized, leading to its intracellular accumulation. Inhibitor studies with nystatin and cyanide indicated that DMSP uptake was an energy-dependent process. The lyase was inducible by its substrate, DMSP (K(m), 1.2 mM), and by the substrate analogs choline and glycine betaine. During induction, DMSP lyase activity increased with time and then dropped rapidly. This loss of activity could be prevented by spiking the culture with fresh DMSP or choline. The V(max) for DMSP lyase was 34.7 mU . mg of protein. The inhibitory effects of nystatin, and p-chloromercuriphenylsulfonate on DMSP lyase activity suggested that the enzyme is cytosolic. Because plants like Spartina (a marsh grass) and marine algae contain high concentrations of DMSP, we speculate that DMSP-utilizing fungi may be involved in their decay.

Release of dimethylsulfide from dimethylsulfoniopropionate by plant-associated salt marsh fungi.

The range of types of microbes with dimethylsulfoniopropionate (DMSP) lyase capability (enzymatic release of dimethylsulfide [DMS] from DMSP) has recently been expanded from bacteria and eukaryotic algae to include fungi (a species of the genus Fusarium [M. K. Bacic and D. C. Yoch, Appl. Environ. Microbiol. 64:106-111, 1998]). Fungi (especially ascomycetes) are the predominant decomposers of shoots of smooth cordgrass, the principal grass of Atlantic salt marshes of the United States. Since the high rates of release of DMS from smooth cordgrass marshes have a temporal peak that coincides with peak shoot death, we hypothesized that cordgrass fungi were involved in this DMS release. We tested seven species of the known smooth cordgrass ascomycetes and discovered that six of them exhibited DMSP lyase activity. We also tested two species of ascomycetes from other DMSP-containing plants, and both were DMSP lyase competent. For comparison, we tested 11 species of ascomycetes and mitosporic fungi from halophytes that do not contain DMSP; of these 11, only 3 were positive for DMSP lyase. A third group tested, marine oomycotes (four species of the genera Halophytophthora and Pythium, mostly from mangroves), showed no DMSP lyase activity. Two of the strains of fungi found to be positive for DMSP lyase also exhibited uptake of DMS, an apparently rare combination of capabilities. In conclusion, a strong correlation exists between a fungal decomposer's ability to catabolize DMSP via the DMSP lyase pathway and the host plant's production of DMSP as a secondary product.

Source and cause of endothelin-1 release into cerebrospinal fluid after subarachnoid hemorrhage.

Despite years of research, delayed cerebral vasospasm remains a serious complication of subarachnoid hemorrhage (SAH). Recently, it has been proposed that endothelin-1 (ET-1) mediates vasospasm. The authors examined this hypothesis in a series of experiments. In a primate model of SAH, serial ET-1 levels were measured in samples from the perivascular space by using a microdialysis technique and in cerebrospinal fluid (CSF) and plasma during the development and resolution of delayed vasospasm. To determine whether elevated ET-1 production was a direct cause of vasospasm or acted secondary to ischemia, the authors also measured ET-1 levels in plasma and CSF after transient cerebral ischemia. To elucidate the source of ET-1, they measured its production in cultures of endothelial cells and astrocytes exposed to oxyhemoglobin (10 microM), methemoglobin (10 microM), or hypoxia (11% oxygen). There was no correlation between the perivascular levels of ET-1 and the development of vasospasm or its resolution. Cerebrospinal fluid and plasma levels of ET-1 were not affected by vasospasm (CSF ET-1 levels were 9.3 +/- 2.2 pg/ml and ET-1 plasma levels were 1.2 +/- 0.6 pg/ml) before SAH and remained unchanged when vasospasm developed (7.1 +/- 1.7 pg/ml in CSF and 2.7 +/- 1.5 pg/ml in plasma). Transient cerebral ischemia evoked an increase of ET-1 levels in CSF (1 +/- 0.4 pg/ml at the occlusion vs. 3.1 +/- 0.6 pg/ml 4 hours after reperfusion; p < 0.05), which returned to normal (0.7 +/- 0.3 pg/ml) after 24 hours. Endothelial cells and astrocytes in culture showed inhibition of ET-1 production 6 hours after exposure to hemoglobins. Hypoxia inhibited ET-1 release by endothelial cells at 24 hours (6.4 +/- 0.8 pg/ml vs. 0.1 +/- 0.1 pg/ml, control vs. hypoxic endothelial cells; p < 0.05) and at 48 hours (6.4 +/- 0.6 pg/ml vs. 0 +/- 0.1 pg/ml, control vs. hypoxic endothelial cells; p < 0.05), but in astrocytes hypoxia induced an increase of ET-1 at 6 hours (1.5 +/- 0.6 vs. 6.4 +/- 1.1 pg/ml, control vs. hypoxic astrocytes; p < 0.05). Endothelin-1 is released from astrocytes, but not endothelial cells, during hypoxia and is released from the brain after transient ischemia. There is no relationship between ET-1 and vasospasm in vivo or between ET-1 and oxyhemoglobin, a putative agent of vasospasm, in vitro. The increase in ET-1 levels in CSF after SAH from a ruptured intracranial aneurysm appears to be the result of cerebral ischemia rather than reflecting the cause of cerebral vasospasm.

VEGF165 expressed by a replication-deficient recombinant adenovirus vector induces angiogenesis in vivo.

To evaluate the concept that localized delivery of angiogenic factors via virus-mediated gene transfer may be useful in the treatment of ischemic disorders, the replication-deficient adenovirus (Ad) vector AdCMV.VEGF165 (where CMV is cytomegalovirus and VEGF is vascular endothelial growth factor) containing the cDNA for human VEGF165, a secreted endothelial cell-specific angiogenic growth factor, was constructed. Human umbilical vein endothelial cells (HUVECs) and rat aorta smooth muscle cells (RASMCs) infected with AdCMV.VEGF165 (5 and 20 plaque-forming units [pfu] per cell) demonstrated VEGF mRNA expression and protein secretion into the supernatant. Furthermore, the conditioned medium from these cells enhanced vascular permeability in vivo. In contrast, neither VEGF mRNA nor secreted protein was found in uninfected HUVECs or RASMCs or in cells infected with the control vector AdCMV.beta gal (where beta gal is beta-galactosidase). Assessment of starved HUVECs at 14 days demonstrated sixfold more cells for AdCMV.VEGF165-infected HUVECs (20 pfu per cell) than for either infected or uninfected control cells. RASMC proliferation was unaffected by infection with AdCMV.VEGF165. When plated in 2% serum on dishes precoated with reconstituted basement membrane (Matrigel), HUVECs infected with AdCMV.VEGF165 (20 pfu per cell) differentiated into capillary-like structures. Under similar conditions, both uninfected HUVECs and HUVECs infected with AdCMV.beta gal did not differentiate. To evaluate the ability of AdCMV.VEGF165 to function in vivo, either AdCMV. VEGF165 or AdCMV.beta gal (2 x 10(10) pfu) was resuspended in 0.5 mL Matrigel and injected subcutaneously into mice. Immunohistochemical staining demonstrated VEGF in the tissues surrounding the Matrigel plugs containing AdCMV.VEGF165 up to 3 weeks after injection, whereas no VEGF was found in the control plugs with AdCMV.beta gal. Two weeks after injection, there was histological evidence of neovascularization in the tissues surrounding the Matrigel containing AdCMV.VEGF165, whereas no significant angiogenesis was observed in response to AdCMV.beta gal. Furthermore, the Matrigel plugs with AdCMV.VEGF165 demonstrated hemoglobin content fourfold higher than the plugs with AdCMV.beta gal. Together, these in vitro and in vivo studies are consistent with the concept that Ad vectors may provide a useful strategy for efficient local delivery of VEGF165 in the treatment of ischemic diseases.

Identification of Pseudomonas aeruginosa glpM, whose gene product is required for efficient alginate biosynthesis from various carbon sources.

In a mucB (algN) genetic background, insertion of an omega element approximately 200 bp downstream of glpD, encoding sn-glycerol-3-phosphate dehydrogenase from Pseudomonas aeruginosa, had an adverse effect on alginate biosynthesis from various carbon sources. The insertion inactivated glpM, a gene encoding a 12,040-M(r) hydrophobic protein containing 109 amino acids. This protein, which was expressed in a T7 RNA polymerase expression system, appears to be a cytoplasmic membrane protein.

Differential expression of vascular endothelial growth factor (vascular permeability factor) forms in rat tissues.

Vascular endothelial growth factor (VEGF)/vascular permeability factor (VPF), exists as multiple forms due to alternative splicing of mRNA. VEGF165/164 (human/rodent homologue) is often assumed to be the predominant form, although truly quantitative assessments are lacking. We have used the RNase protection assay to directly quantitate the relative abundance of VEGF mRNA forms in five rat tissues (brain, kidney, lung, spleen, and heart) and two rat glioma cell lines (C6 and 9L). The three major forms, which code for proteins of 188, 164, and 120 amino acids, were observed in all of the tissues and cells examined. However, the relative abundance differed among the samples. VEGF188 was the predominant form (> 50% of total VEGF mRNA) in heart and lung, but was the least abundant form (6-15%) in all other samples. VEGF164 was lower (approximately 25%) in heart and lung, but was predominant (> 50%) in brain and kidney. VEGF164 and VEGF120 were present in equimolar amounts (each form approximately 46% of total) in the spleen, C6, and 9L. VEGF120 was also present in kidney (38%) and lung (27%) and was least abundant (approximately 15%) in brain and heart. A rat homologue of VEGF206 was not observed. VEGF mRNA splicing occurs in a tissue-specific manner. The assumption that the predominant physiologic form of VEGF is a VEGF165/164 homodimer should be viewed with caution.

[Zoonoses in Vojvodina. II. Epidemiologic characteristics of leptospirosis in Vojvodina]. / Zooantroponoze u Vojvodini. II. Epidemioloske karakteristike leptospiroza u Vojvodini.

On the basis of reported cases of sickness--death due to leptospirosis and the epidemiologic investigation of 38 sick individuals, epidemiologic characteristics of anthropozoonosis in Vojvodina were analyzed. It has been established that this disease is registered in the form of individual cases, mostly in persons belonging to the productive population. Infection usually happens during the summer months and due to contact with contaminated water. High lethality and antibodies of leptospirosis icterohaemorrhagiae in 55.3% of samples of the serum of the sick point to the fact that only clinically severe forms of the disease were registered.

[Zoonoses in Vojvodina. III. Results of a seroepidemiologic study of leptospirosis in Vojvodina]. / Zooantroponoze u Vojvodini. III. Rezultati seroepidemioloskog ispitivanja leptospiroza u Vojvodini.

2697 persons professionally exposed to leptospira working in contaminated waters and grounds or due to contact with infected animals or their products were seroepidemiologically examined. It was established that the presence of leptospirosis in certain categories of examined persons is three to more than ten times higher in relation with it's presence in the control groups. The most frequent serotype was Leptospira pomona. None of the seropositive persons gave data about having leptospirous infection which might be the consequence of asymptomatic infection or unidentified and not registering of the clinically manifested diseases.

Differential expression of carboxyl terminal derivatives of amyloid precursor protein among cell lines.

Understanding the pathway for amyloid percursor protein (APP) catabolism has become an important line of investigation. APP is a ubiquitous membrane bound protein that is rapidly cleaved at the membrane, yielding a secreted protein identical to protease nexin II and an internalized 11.5 kDa 100 residue C terminal derivative (CTD). The levels of CTDs in a variety of cell lines have been examined and were found to differ. Cell types associated with the pathology of Alzheimer's disease (AD), such as olfactory neuroblasts (ON) and cortical vascular endothelial cells, have higher levels of CTDs than lymphoblasts and melanoma cells. The mechanism of CTD catabolism appears to involve the lysosome because blockade of lysosomal but not endosomal or mitochondrial function results in increased levels of CTDs. Under these conditions, production of larger, amyloidogenic CTDs is also seen. In cells possessing higher levels of CTDs we find that the mechanism for production of amyloidogenic CTDs may involve the internalization of intact full-length APP. Thus, inhibition of the lysosomal system appears capable of generating amyloidogenic peptides. The amount of amyloidogenic peptides appears to vary among cell lines. Such variation may shed light on why amyloid accumulates around specific cell types such as vascular endothelial cells, neurons, and glia. Finally, disfunction of the lysosomal system may play a role in the pathogenesis of Alzheimer's disease.

[Dentin hypersensitivity: etiology and methods of treatment]. / Dentinska preosjetljivost: etiologija i metode lijecenja.

This work presents review on etiology of dentinal hypersensitivity and mechanisms of dentin desensitization. The main theories on dentin sensitivity are discussed in details. Particularly are stressed hydrodynamic and transducer theories. Two main approaches to the dentin desensitization by tubule occlusion and blocking pulpal nerve activity by altering the sensory nerves excitability are presented. The aim of dentin desensitization is to apply various agents that occlude dentinal tubules and so decrease dentin sensitivity or to apply agents that reduce nerve excitability. Between many different agents in use the most wide use and best results in decreasing dentin sensitivity have topical application of oxalate salts and application of unfilled resins. Different toothpaste with strontium chloride or potassium nitrate as active ingredients have been commonly used as very effective desensitizing agents.

The association between palatal grooves in upper incisors and periodontal complications.

Palatal groove is a rare morphological defect of upper incisors, frequently associated with localized destruction of periodontal tissue with endodontic complications. In this study, a sample of 1,081 male, young adult subjects, aged 20 to 22, palatal grooving was recorded in 11 (1.01%) subjects, affecting 15 incisors. Among 634 adult subjects, aged 35 to 50, with periodontal disease, palatal groove was found in 5 (0.79%) incisors. Second incisors were more frequently (75%) associated with this anomaly. In the young adults, the mean probing pocket depth in the groove region and around other teeth of the intercanine area was 3.8 mm and 1.2 mm, respectively. In the group of periodontal patients, the mean probing pocket depth was significantly greater at the site of palatal groove (8.8 mm vs. 4.0 mm).

Dental status in a group of adult diabetic patients.

The aim of this study was to determine the prevalence of dental caries, DMFT score and treatment needs in a group of diabetic patients (n = 222), mean age 46.9 yr, and to compare them to those recorded in a control group (n = 189), mean age 43.9 yr, using WHO criteria. Relations between the type and duration of diabetes mellitus, diabetic complications (retinopathy and neuropathy), diabetic control, and the subjects' DMFT status were separately studied. The results obtained revealed no difference in the prevalence of caries between the group of diabetics and the control group. Neither was any difference found in the mean numbers of teeth with fillings, but the number of extracted teeth per subject was significantly higher in the group of diabetics (12.3) than in the control group (9.7) (P less than 0.01). Type I diabetics were found to have a significantly higher number of teeth with fillings (4.05 vs. 2.22) than the non-insulin dependent diabetics (P less than 0.001). Type II diabetics, however, had a significantly higher number of extracted teeth (14.1 vs. 10.4) (P less than 0.001). There was no difference in the caries experience regarding duration of diabetes, diabetic control, or diabetic complications.

Hereditary gingival fibromatosis: report on three families and dermatoglyphic analysis.

Some syndromes that include gingival fibromatosis are associated with abnormalities of the hands and feet. The purpose of this work was to establish whether gingival fibromatosis, as an isolated disease, can be connected with disturbances in the development of the digitopalmar structures. In three families with 40 members, fibromatosis manifested in 16 (7 males and 9 females). The disease was transmitted as an autosomal dominant trait. Dermatoglyphics were analyzed in the proband in each family and in their fathers who had fibromatosis. The analysis showed the presence of patterns in IV interdigital areas in all patients. The fathers of 2 probands had double loops in the IV interdigital area, which is very rare in the general population (frequency, 0.6%). The position of the axial triradius was moderately distal (t') in 1, and markedly distal (t") in another, and in 4 it was borderline (tb). Total finger ridge count was increased, which indicated the increased size of the volar embryonal pads. Distorted dermatoglyphic findings may be considered microform abnormalities of the fingers and hands. Since dermatoglyphics are highly genetically controlled and reflect the status of the embryonal pads, the results suggest disharmony in the development of the mesodermal structures of the hands.

[The incidence of enamel projections on the roots of the permanent teeth]. / Häufigkeit von Schmelzformationen an Wurzeln bleibender Zähne.

In this study we examined the incidence of enamel pearls, projections islets and drops on account of 7388 extracted human permanent teeth. According to the macroscopic examination there were 54 (1.6%) enamel pearls situated on the molars of the upper and lower jaw. Pairs of enamel pearls were observed on three teeth, i.e. in 0.09% of the patients. Three enamel pearls were diagnosed on one tooth. Enamel pearls were most frequently found in the cervical third of the mesio- and disto-approximal root surfaces. However, they were not so frequent in the area of the tooth neck, i.e. on the passage to the root furcation. Enamel pearls were 0.3 to 2.8 mm in diameter. Enamel projections, islets and drops were identified on account of stereomicroscopic examinations of the tooth neck and the root furcation. These paraplastic enamel formations were observed in 560 teeth, i.e. in 14.1% of the patients. Enamel pearls and islets were most often situated on the buccal surface of the tooth neck along the inter-radicular groove and enamel drops on the buccal surface of the furcation roof.

CPITN assessment of periodontal disease in diabetic patients.

The aim of this study was to investigate, using the CPITN system, the periodontal treatment needs in diabetic patients, and to shed additional light on the possible effects of the duration and control of diabetes on the periodontal status in these patients. A comparison was made between 222 diabetic patients (mean age, 46.9 years) and 189 control subjects (mean age, 43.9 years). Edentulous patients were not included in the study. The results indicated that diabetic patients demonstrated significantly more missing teeth (P less than 0.001). The mean number of missing sextants was also significantly higher in diabetics. Pathologic pockets of 6 mm or more were found in 1.3 and 0.3 sextants in the diabetic and control group subjects, respectively (P less than 0.001). Up to the age of 34, no differences were observed between the diabetic and control group subjects regarding pathologic pockets of 6 mm or more. Above this age, diabetics demonstrated significantly more sextants with deep pockets (P less than 0.001). Concerning the type of diabetes, no differences related to CPITN score were found between insulin dependent and non-insulin dependent diabetics. Neither were any differences found in the periodontal condition related to the duration and control of diabetes, whereas diabetics with advanced retinopathy demonstrated more sextants with deep pockets. Oral hygiene instructions and scaling were required in all patients from both study groups. On an average, 1.3 sextants in 50.9% of diabetics and 0.3 sextants in 17.9% of control subjects required complex treatment.