Оral hygiene and fluoride influence on dental health in early childhood

Early childhood caries occurs immediately after the eruption of deciduous teeth. During this period, children are too young to be able to properly implement oral hygiene. Consequently, it is at a negligible level, with plenty of soft plaque on the deciduous tooth surfaces. The objective of this investigation was to determine the correlation between oral hygiene (shown with the OHI index) and the initial stages of early childhood caries: initial lesion (white spot) and superficial form, before and after local fluoride treatment. Material and methods: For determining the OHI index among our examinees we used the method of Green-Vermillion. It was determined in 117 examinees twice, during the first visit and immediately before physiological replacement of deciduous teeth. Patients were two to three years of age, diagnosed with initial stages of early childhood caries and fluoride preparate (amino fluoride solution) was applied once a week, for 6 months. Results: In 30 subjects treated with local fluoride treatment from both basic groups (with initial and superficial lesions), just before the physiological change of the teeth, we received a statistically significant improvement in the OHI index (p = 0.000038; p = 0.00006) at the end from the examination. Conclusion: From the conducted analysis of the obtained results, we can conclude that the level of oral hygiene is correlated with the progression of changes in the enamel. Oral hygiene and fluoride treatment significantly reduce soft tissue levels and improve the OHI index.

Optimal Carotid Plaque Features on Computed Tomography Angiography Associated With Ischemic Stroke

Background Stenosis has historically been the major factor used to determine carotid stroke sources. Recent evidence suggests that specific plaque features detected on imaging may be more highly associated with ischemic stroke than stenosis. We sought to determine computed tomography angiography (CTA) imaging features of carotid plaque that optimally discriminate ipsilateral stroke sources. Methods and Results In this institutional review board–approved retrospective cross‐sectional study, 494 ipsilateral carotid CTA‐brain magnetic resonance imaging pairs were available for analysis after excluding patients with alternative stroke sources. Carotid CTA and clinical markers were recorded, a multivariable Poisson regression model was fitted, and backward elimination was performed with a 2‐sided threshold of P <0.10. Discriminatory value was determined using receiver operating characteristic analysis, area under the curve, and bootstrap validation. The final CTA carotid‐source stroke prediction model included intraluminal thrombus (prevalence ratio, 2.8 [ P <0.001]; 95% CI, 1.6–4.9), maximum soft plaque thickness (prevalence ratio, 1.2 [ P <0.001]; 95% CI, 1.1–1.4), and the rim sign (prevalence ratio, 2.0 [ P =0.007]; 95% CI, 1.2–3.3). The final discriminatory value (area under the curve=78.3%) was higher than intraluminal thrombus (56.4%, P <0.001), maximum soft plaque thickness (76.4%, P =0.007), or rim sign alone (69.9%, P =0.001). Furthermore, NASCET (North American Symptomatic Carotid Endarterectomy Trial) stenosis categories (cutoffs of 50% and 70%) had lower stroke discrimination (area under the curve=67.4%, P <0.001). Conclusions Optimal discrimination of ipsilateral carotid sources of stroke requires information on intraluminal thrombus, maximum soft plaque thickness, and the rim sign. These results argue against the sole use of carotid stenosis to determine stroke sources on CTA, and instead suggest these alternative markers may better diagnose vulnerable carotid plaque and guide treatment decisions.

Circulating immune cell profiles detected by mass cytometry differ significantly between patients with predominantly calcified and predominantly non-calcified coronary atherosclerosis

Background/Introduction Inflammation is now a well-established component of the pathophysiology of coronary artery disease (CAD), but it is unknown whether atherosclerosis is associated with a distinct circulating immune cell profile. Mass cytometry time-of-flight (CYTOF) is a new precision technology which can be used to assess leukocyte populations comprehensively. Purpose To determine if patients with calcified and non-calcified (soft) coronary plaque have distinct circulating immune cell profiles when compared to healthy controls, and to assess whether this could be used to detect sub-clinical CAD. Methods Patients referred for a CT coronary angiogram were recruited; blood samples were collected and peripheral blood mononuclear cells (PBMCs) were isolated. Imaging data was analysed using a modified Gensini scoring system which incorporated plaque composition, with higher weighting given to soft plaque. The modified Gensini scores were then used to further segregate into calcified-predominant and soft-predominant disease groups. CYTOF analysis was performed on the PBMCs, with groups as outlined in Table 1. Results Age was significantly higher in the CAD+ group, but all other demographic features and risk factors did not differ between groups. Patients with predominantly calcified disease showed an increase in memory CD8 T cells (p=0.004), an increase in CD 39+ CD4 T cells (p=0.028), and a decrease in naïve CD8 T cells (p=0.005), which suggests an accumulated memory response in more quiescent disease. Patients with predominantly soft-plaque disease have higher pro-inflammatory monocyte populations (p=0.013) and proliferative CD4 T cell populations (p=0.011), suggesting acute innate and adaptive responses to biologically active plaque. Conclusions This pilot study has shown that further study should be pursued into the utility of CYTOF to identify sub-clinical CAD through differences in peripheral circulating immune cell profiles. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Health and Medical Research Council of Australia, Heart Research Australia

Carotid Thrombosis in a Crack Cocaine Smoker Woman

Introduction. We report a case of stroke in a crack smoker with occlusion of the middle cerebral artery and a large thrombus in the carotid artery. Case Presentation. A 34-year-old female presented with left upper arm weakness, associated with paresthesia with onset of symptoms more than 24 hours before. Angio-RM sequences showed an area of ischemia, with occlusion of the M2 segment of the middle cerebral artery. Carotid ultrasound showed a soft plaque with distal end floating. Anticoagulant treatment was started, and seriated ultrasound evaluations showed its gradual dissolution. Conclusions. In atherothromboembolic stroke from carotid thrombosis, repeated ultrasound studies may be useful for either diagnosis and monitoring the efficacy of anticoagulant therapy.

Comparative analysis of microbiota of oral fluid in patients with psychoneurological disorders using toothpaste with the enzyme «bromelain»

Relevance. The complex of actions for decrease in growth of diseases of the maxillofacial region includes the reorganization of the mouth, creating an individual program for hygiene and prevention. Among the large number of types of therapeutic and preventive hygiene products for patients with neuropsychiatric disorders, given the burdened somatic status, the program should include safe for use basic and additional means.Purpose. Comparative assessment of oral fluid microorganisms in patients with psychoneurotic disorders before and after 6 months of using toothpastes with the enzyme «bromelain».Materials and methods. A comparative analysis of the oral fluid microflora in patients with high intensity and activity of the cariosity, with positive (psychoneurological disorders) anamnesis and without comorbidities has been carried out. The mouths of all studied patients were sanitized, and a program of personal oral hygiene using hygienic toothpastes and with the enzyme «bromelain» was developed.Results. The conducted research does not prove the bactericidal effect of the enzyme «bromelain» on oral microflora, however, a significant decrease of the total number of viable bacteria, changes in the species composition, and the degree of hemolecular properties indicates an indirect bacteriostatic effect of this enzyme in the composition of the toothpastes, which can be considered as a positive effect on the decrease of caries activity in patients with «negative» dental status (caries intensity index > 9, hygiene index by the method of Yu.A. Fedorov and V.V. Volodkina > 2 points, 3rd degree of caries activity by T.F. Vinogradova), including in patients with psychoneurological disorders.Conclusion. The use of enzyme «bromelain» in toothpastes in patients with neuropsychiatric disorders contributes not only to the safe and intensive cleavage of soft plaque, but also to a positive effect on the microbiota of the oral fluid, which is a favorable prognostic criterion for reducing the activity of the carious process.

Inflammation-Related MicroRNAs Are Associated with Plaque Stability Calculated by IVUS in Coronary Heart Disease Patients

Objectives. This study aimed to investigate the association between inflammation-related microRNAs (miR-21, 146a, 155) and the plaque stability in coronary artery disease patients. Methods. The expression of miR-21, 146a, and 155 was measured by real-time PCR in 310 consecutive patients. The level of hs-CRP, IL-6, and IL-8 was measured by ELISA. The plaque stability of coronary stenotic lesions was evaluated with intravascular ultrasound (IVUS). Results. (1) The levels of hs-CRP, IL-6, and IL-8 were significantly increased in the UAP and AMI groups compared with the CPS group (P<0.01). (2) The expression of miR-21 and miR-146a in peripheral blood mononuclear cells (PBMCs) and plasma was significantly higher in CAD patients compared with non-CAD patients, whereas the miR-155 expression in PBMCs and plasma was significantly lower in patients with CAD. (3) The miR-21 expression in PBMCs was higher in UAP and AMI groups compared with CPS group. The miR-146a expression in PBMCs was higher in SAP, UAP, and AMI groups than in CPS group. Although the level of miR-155 in PBMCs was lower in SAP, UAP, and AMI groups than in CPS group. The expression patterns of miR-21, miR-146a, and miR-155 in plasma were consistent with those of PBMCs. (4) The expressions of miR-21 and miR-146a in PBMCs and plasma were significantly higher in the vulnerable plaque group than those in stable plaque group. While miR-155 in PBMCs and plasma was significantly lower in vulnerable plaque group compared with stable plaque group. (5) The levels of miR-21 and miR-146a in PBMCs and plasma were significantly higher in soft plaque group than in fibrous plaque group and calcified plaque group. However, miR-155 in PBMCs and plasma was significantly lower in soft plaque group. Conclusions. The expression of miR-21 and miR-146a are associated with the plaque stability in coronary stenotic lesions, whereas miR-155 expression is inversely associated with the plaque stability.