bluuebunny/crossref_metadata_2025 huggingface dataset:
Changing Dentate Status of Adults, Use of Dental Health Services, and Achievement of National Dental Health Goals in Denmark by the Year 2000
Authors: Petersen Poul Erik , Kjøller Mette , Christensen Lisa Bøge , Krustrup Ulla
Published: May 2007

Objectives: This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Methods: Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self‐administered questionnaires. Results: In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65–74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35–44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65–74‐year‐olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Conclusions: Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35–44‐year‐olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.
Efficacy of Educational Interventions Targeting Primary Care Providers' Practice Behaviors: an Overview of Published Systematic Reviews
Authors: Sohn Woosung , Ismail Amid I. , Tellez Marisol
Published: May 2007

Objectives: Primary care providers (e.g., family physicians, pediatricians, registered nurses, physician assistants, and nurse practitioners) could play a pivotal role in the provision of preventive services, especially for very young children (younger than 3 years old) and population groups with limited access to dental care. Given the current problems with access to dental care among low‐income Americans, we contend there is a need to involve nondental primary health care providers in screening for and preventing oral health problems. The objective of this overview is to present findings from systematic reviews on the efficacy of continuing medical education, printed educational material, academic outreach, reminders, and local opinion leaders on the adoption of new knowledge and practices by primary care providers. Methods: A search was conducted using the Cochrane Library and MEDLINE. The search aimed to locate systematic reviews published between January 1988 and March 2003. Two researchers independently extracted data and assessed study quality using a modified version of the QUOROM statement. Results: Eleven systematic reviews were included in this overview. The evidence from the included systematic reviews showed that formal continuing medical education (CME) and distributing educational materials did not effectively change primary care providers' behaviors. There are effective interventions available to increase knowledge and change behaviors of primary care providers, such as small group discussion, interactive workshops, educational outreach visits, and reminders. Conclusion: There is a limited knowledge base on the efficacy of the selected interventions on oral health screening by primary care providers. Considering the potential role of primary care providers in improving oral health of underserved populations, this research area should receive more attention.
The Association Between Environmental Tobacco Smoke and Primary Tooth Caries
Authors: Shenkin Jonathan D. , Broffitt Barbara , Levy Steven M. , Warren John J.
Published: May 2007

Objective: Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. Methods: This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4–7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. Results: Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). Conclusions: Environmental tobacco smoke was associated with an increased risk of caries among children.
Effect of Different Diagnostic Thresholds on Dental Caries Calibration
Authors: Assaf Andrea Videira , Meneghim Marcelo de Castro , Zanin Luciane , Cortelazzi Karine Laura , Pereira Antonio Carlos , Ambrosano Glaucia Maria Bovi
Published: May 2007

Objectives: a)to analyze the intra‐ and inter‐examiner reproducibility (reliability) of a calibration trial, at different diagnostic thresholds of dental caries; b) to verify the accuracy (benchmark validity) though sensitivity (S), specificity (SP), positive (PPV) and negative predictive (NPV) values. Participants: A group of dental examiners (n=11), who had previous experience in epidemiological surveys and six to seven‐year‐old children. Children were selected according to the dmft and dental caries activity. Methods: Theoretical and clinical training and calibration exercises were arranged for a total of 28 hours. WHO criteria including the active initial lesions (IL) were used. Main outcome measures: WHO and WHO+IL diagnostic thresholds according to tooth and dental surface. Results: Excellent mean results of intra and inter‐examiner Kappa values were found for both diagnostic thresholds, according to tooth and surface, during the calibration phase. The most relevant errors were related to IL diagnosis and to the first permanent molars. When assessed against a benchmark examiner, moderate to high validity values were observed (0.71–1.00), with some loss mainly for sensitivity and positive predictive value, when including IL. Conclusion: It was possible and feasible to use the proposed methodology of this study in epidemiological surveys, even with the inclusion of IL. However, further examiner calibration studies are still needed in order to improve and establish a methodology of calibration with this new diagnostic threshold.
Assessment of the Relationship between Neighborhood Characteristics and Dental Caries Severity among Low‐Income African‐Americans: A Multilevel Approach
Authors: Tellez Marisol , Sohn Woosung , Burt Brian A. , Ismail Amid I.
Published: May 2007

Objectives: To assess the relationship between neighborhood effects and the severity of dental caries among low‐income African‐Americans. Methods: A multistage probability sample of African‐American families living in the poorest 39 census tracts in Detroit was drawn. During 2002–03, cross‐sectional data of a cohort that includes 1021 caregivers were collected in the first of three waves of interviews and examinations. Multilevel analyses focused on 27 neighborhood clusters and involved a combination of individual (Level‐1) and neighborhood (Level‐2) data including census and geocoded (address matching to census geographic areas) information. Results: There is significant variation in the severity of caries between low‐income neighborhood clusters. Caries severity decreases with a higher number of churches, while it increases with a higher number of grocery stores in the clusters after accounting for individual characteristics. Only 14% of the inter‐individual variability in caries was explained by classical individual risk factors for this condition. Conclusion: Neighborhoods contribute something unique to caregivers' oral health, beyond socioeconomic position and individual risk factors. Multilevel interventions are necessary to reduce disparities among African‐Americans and churches may offer a promising venue from which to conduct them.
The Relationship Between Cardiovascular Xerogenic Medication Intake and the Incidence of Crown/Root Restorations
Authors: Maupomé Gerardo , Peters Dawn , Rush William A. , Rindal D. Brad , White B. Alex
Published: May 2007

Objectives: This retrospective, longitudinal cohort study quantified the strength of the association between xerogenic cardiovascular medication use and dental restorations, using the latter as a proxy measure for dental caries experience. Methods: Study data were collected from 11 years of electronic clinical/pharmacy records in two large dental group practices associated with managed care organizations (MCO). Records were extracted for all members who were at least 55 years old at the end of the 11 year window, and had at feast 48 months of concurrent dental, medical, and pharmacy coverage. The authors identified 4,448 individuals whose only xerogenic medication exposure was to drugs treating a cardiovascular condition. This group was compared to a group not taking any medications (n=1,183), and a group taking medications with no known xerostomic side effect (n=5,622). Poisson regression compared restoration incidence and mean restoration rates among the three groups. Results: MCO members taking cardiovascular or non‐xerogenic medications had higher restoration incidence and mean restoration rates than individuals taking no medications. A small difference in mean restoration rate between the non‐xerogenic medication group and the cardiovascular drug group was observed; no significant difference in restoration incidence was seen between these two groups. Conclusions: This study provides objective quantification of cardiovascular medication's long‐term effects on increased restorations in older adults. When grouped under a single category labeled “cardiovascular,” drugs with effects targeting the cardiovascular system did not appear to unequivocally lead to higher restorative experiences.
Are Oral Health Status and Care Associated with Anxiety and Depression? A Study of Portuguese Health Science Students
Authors: Marques‐Vidal Pedro , Milagre Virginia
Published: May 2007

The relationship between oral health and anxiety/depression were assessed in a cross‐sectional study conducted in 38% Portuguese students from the Health Sciences (age: 21 ± 3 years, 75% women). Oral health included prevalence of reported tooth pain/gum bleeding, dentist attendance, and dentifrice and dental floss use. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Subjects with anxiety or depression had a higher frequency of perceived gum bleeding and reported a higher dentist attendance than normal subjects. On multivariate analysis, anxiety was significantly and independently related to perceived toothache (OR=2.90, 95%CI: 1.25–6.72) and dentist attendance (OR=2.15, 95%CI: 1.18–3.91) whereas depression was associated with perceived gum bleeding (OR=4.96, 95%CI: 1.68–14.59), and no differences were found regarding teeth brushing or dental flossing. The author concludes that anxiety and depression are related to perceived toothache and gum bleeding, but this association cannot be explained by decreased dental care.
Dental Caries Experience and Factors among Preschoolers in Southeastern Mexico: A Brief Communication
Authors: Segovia‐Villanueva América , Estrella‐Rodríguez Ramón , Medina‐Solís Carlo Eduardo , Maupomé Gerardo
Published: May 2007

Objective: To examine the Association between dental caries prevalence and selected variables in preschool children. Methods: A cross‐sectional study was carried out with 1,303 preschoolers (ages 3–6 years old), and the mothers completed questionnaires. The children were examined by one of three standardized dental examiners. Logistic regression was performed to identify Associations between dental caries and other factors. Results: Mean dmft was 1.54+2.47, with 44.1% of children having dmft>O. Caries prevalence was Associated with older children (OR=1.39); medium (OR=1.66) and low (OR=2.41) socioeconomic levels; mediocre (OR=l.71) and inadequate (OR=2.25) hygiene; negative attitude toward oral health (OR=1.51); and the presence of enamel defects (OR= 1.74). Conclusion: Both overall caries prevalence and dmft index were relatively low. The results of this study substantiate previous reports in the international literature for clinical, behavior, socio‐demographic, and socio‐economic variables that contribute to dental caries in Mexican children.
Use of the Fluorosis Risk Index in a Cohort Study: The Iowa Fluoride Study
Authors: Levy Steven M. , Hong Liang , Warren John J. , Broffitt Barbara
Published: May 2007

Objectives: Several studies have used the Fluorosis Risk Index (FRI) to assess risk factors for dental fluorosis. This study reports fluorosis prevalence estimates in a birth cohort using the FRI in different ways. Methods: Subjects (n=443) were participants in the Iowa Fluoride Study, a birth cohort study of fluoride exposures and intake, fluorosis, and caries. Early‐erupting permanent teeth were assessed for fluorosis using the FRI at approximately age 9. Fluorosis prevalence rates were calculated separately for specific teeth and different combinations of teeth, with varied FRI zones included and using different thresholds. Mean numbers of teeth with fluorosis were calculated. Results: Tooth‐specific fluorosis prevalence varied, with maxillary central incisor fluorosis most prevalent and mandibles incisors least affected. Considering three zones of each tooth (cervical zones excluded), 40.6% overall had at least one tooth with mild or more involved fluorosis, 30.2% were questionable fluorosis, and 29.1% had no fluorosis. When only FRI zone I areas were considered, the corresponding percentages were 33.2%, 29.3%, and 37.5%, respectively. When different combinations of teeth were used to define fluorosis cases, the prevalences estimated using three zones were generally 1 to 9 percentage points higher than those estimated from FRI zone I only. Most fluorosis was mild, with only 7 individuals (1.6%) having FRI severe fluorosis. Conclusions: The FRI has advantages for use in analytical epidemiologic studies of dental fluorosis. However, the population prevalence estimates vay, depending on the index and case definition used. Therefore, it is recommended that consideration be given to concurrent use of another index (i.e., TSIF; TE Dean's) if prevalence estimates are an important study outcome.
Determining Dental Utilization Rates for Children: An Analysis of Data from the Iowa Medicaid and SCHIP Programs
Authors: Damiano Peter , Momany Elizabeth T. , Crall James J.
Published: May 2007

Objective: Accessing dental care is a significant problem for children in Medic‐aid and SCHIP Evaluating the extent of the access problem is affected by the differential dental utilization rates as calculated by unique approaches used by national organizations. The problem is related to the intermittent enrollment in Medicaid and SCHIP for many children during the year. The objective of this study is to evaluate the effect of four different approaches for calculating dental utilization rates for children in Medicaid and SCHIP programs. Methods: All Iowa Medicaid and S‐SCHIP dental claims and enrollment files for CY 2001 were used to characterize the populations, calculate dental utilization rates and evaluate the types of services received by dental utilizers. Dental utilization rates were calculated four ways using the following different rate denominators: 1) any child enrolled during the year (Center for Medicare and Medicaid Services method), 2) children enrolled for 11–12 months (National Committee for Quality Assurance method), 3) a full‐time equivalents (FTE) method, 4) only newly enrolled children. Results: The methodology employed greatly affected the dental utilization rates. Rates varied from 18% for newly enrolled children in Medicaid to 58% for S‐SCHIP‐enrolled children using the FTE method. Methods that included children who were more likely to be in for more months during the year, such as the NCQA approach, produced the highest rates. Conclusions: The method used to determine the dental utilization rates for Medicaid and SCHIP enrollees should be clearly stated when these rates are being presented. This will allow the reader to be able to make a careful and appropriate interpretation of the results.
Adult Oral Health Inequalities Described Using Area‐based and Household‐based Socioeconomic Status Measures
Authors: Jamieson Lisa M. , Thomson W. Murray
Published: May 2007

Objectives: To describe adult oral health inequalities using an area‐based and household‐based measure of socioeconomic status (SES). Methods: Self‐report questionnaires (seeking information on sociodemographic, oral health and oral self‐care) were sent to a random sample of adults from the Dunedin South Electorate, New Zealand. Household‐ and area‐based SES measures were collected. The main outcome measures were edentulism prevalence, average‐poor self‐rated oral health and not having visited a dentist for 2+ years. Data were weighted to produce population‐based estimates. Results: The response rate was 78.2%; the sample mean age was 47 years (sd, 17; range 18–92 years) and females comprised 54.0%. Edentulism was most prevalent among those from low‐SES households who were resident in high‐deprivation areas (P>0.0001). Poor self‐rated oral health (P>0.0001) and 2+ years since the last dental visit (P>0.0001) were also most prevalent among these same individuals. In contrast, respondents from high‐SES households located in the least deprived areas had the lowest prevalence of edentulism, poor self‐repotted oral health or 2+ years since their last dental visit. Those from the other household/area SES combinations occupied intermediate positions. Conclusions: There may be added value to dental public health in using a dual socio‐economic measurement approach to population research, with greater oral health gains perhaps being possible by concentrating resources and clinical effort on people living in low‐SES households in highly—deprived areas, rather than those living in low‐SES households in areas that are not deprived.
Tooth Loss in a Young Population from South Brazil
Authors: Susin Cristiano , Haas Alex N. , Opermann Rui V. , Albandar Jasim M.
Published: May 2007

Objectives: To assess the prevalence, extent, and risk indicators of tooth loss in a representative young urban population from south Brazil. Methods: A representative sample was drawn using a multi‐stage probability cluster sampling strategy, and consisted of 612 subjects 14–29 years of age in the metropolitan area of Porto Alegre, Brazil. A clinical examination was carried out by 4 calibrated examiners in a mobile examination center. Results: The prevalence of tooth loss was 44.8%, 26%, and 60%, and the mean tooth loss was 1.4, 0.6, and 2.4 teeth in the age groups 14–29, 14–19 and 25–29 years, respectively. First molars were the most frequently missing teeth, and the mandibular incisors and canines were the least missing teeth. Tooth loss increased sharply with age, and was similar in males and females. Having ≤4 missing teeth was significantly Associated with low Socioeconomic status and heavy smoking, and was significantly more likely in persons who had ≤2 teeth with caries/fillings and/or ≤5 mm attachment loss. Conclusion: Tooth loss is a dental health concern in this young Brazilian population. Community‐based oral diseases prevention programs targeting groups having these risk factors should be implemented to reduce tooth loss.
Is Regular Visiting Associated with Lower Costs? Analyzing Service Utilization Patterns in the First Nations Population in Canada
Authors: Leake James L. , Birch Stephen , Main Patricia A. , Ho Elsa
Published: May 2007

Objectives: Using an administrative database of dental service records from the Non‐Insured Health Benefits (NIHB) program of Health Canada for 1994–2001, the authors set out to test whether regular visitors had lower program expenditures. Methods: The age‐specific mean expenditures per client were compared among those with regular examinations in 8, 7 and fewer years. The study further examined the effect of regular visiting over the first 6 years on expenditures in the last 2 years. “Continuity of care” was measured by the numbers of consecutive years prior to 2000 in which clients had a regular examination. In a “gap analysis” individuals were classified according to the number of years prior to 2000 since they last had an initial or recall examination. Mean expenditures per client were analyzed by age group and type of service. Findings: Over the 8‐year period, clients with regular visits had the highest expenditures. In both the continuity of care and gap analyses, the findings were generally consistent; the more that clients visited over the first 6 years, the higher the expenditures in the final 2 years. Clients with more “regulaf (initial and recall) examinations received a relatively standard, age‐specific, pattern of service but incurred greater expenditures compared to clients with fewer regular, or longer gaps in, examinations. Conclusion: The observations of the authors in this client group do not support the thesis that regular visiting is Associated with lower expenditures on dental care.
Oral Health Status of Mississippi Delta 3– to 5‐Year‐Olds in Child Care: An Exploratory Study of Dental Health Status and Risk Factors for Dental Disease and Treatment Needs
Authors: Southward Linda H. , Robertson Angela , Wells‐Parker Elisabeth , Eklund Neva Penton , Silberman Stephen L. , Crall James J. , Edelstein Burton L. , Baggett Dorris H. , Parrish David R. , Hanna Heather
Published: May 2007

Objectives: For poor and minority young children, disparities exist in dental health and treatment. In rural impoverished areas, institutions that reach young children and potentially offer access to care are limited. In the current Mississippi Delta study, child care centers were examined as potential venues for oral health intervention and research, and potential risk factors for dental caries and treatment urgency in high‐risk preschool children were explored. Methods: Child care centers were selected and attending children recruited. Data on oral health practices were collected from surveys of center directors and parents/caregivers. Children were examined for caries and treatment urgency at centers by dentists. Bivariate and multivariate analyses with a 0.05 alpha were used to examine data. Results: A total of 346 preschool children at 15 participating centers were examined: 46% were female, 68% minority. Minority children and those with public insurance were more than twice as likely to have caries and urgent treatment needs as non‐minorities or those with private insurance. The odds of children having caries were half as great if parents reported using floss and nearly twice as great if the parent had experienced a dental abscess. For every soft drink the parent consumed daily, the odds of dental caries for children increased by 44%. Conclusions: Conducting oral health exams and research in child care venues was possible, yet presented challenges. The combined use of two parental variables, reported soft drink consumption and abscess history appears promising for caries prediction. Implementation of oral health programs and research in child care venues merits further exploration.
Role of African‐American Fathers in Child‐Rearing and Oral Health Practices in an Inner City Environment ‐ A Brief Communication
Authors: Broder Hillary , Reisine Susan , Johnson Robert
Published: May 2007

Objective: This study assesses parenting behaviors, health behaviors and attitudes in a sample of disadvantaged African‐American fathers and evaluates the potential of fathers as recipients of oral health promotion interventions. Methods: Participants were 60 African‐American fathers whose children were enrolled in a childhood caries prevention study at Women and Infant Child Program (WIC) (n=25) or who were members of a Young Fathers' Program (n=35) at an urban health center. Demographic factors, oral health knowledge, dental self‐efficacy parenting behaviors, readiness to change, and health promotion behaviors were assessed. Results: Participants averaged 30.8 years of age (sd=8.6); children averaged 2.I years (sd=0.9). Half of the fathers always have lived with their own children and 92% had regular physical contact with their children. Almost half of the sample reported ‘fair/poor’ oral health status, while less than 25% reported ‘fair/poor’ general health. Fathers had high oral health knowledge scores (X=7.7 correct of 9 items), and high readiness for change scores at the action stage (X=12.2 of 15; sd=1.9). dental self‐efficacy scores were moderate (X=15.7 of 24; sd=5.5). Half of the fathers shared or had sole responsibility for brushing their children's teeth; 90% report children's teeth were brushed daily. Conclusions: African‐ American fathers participated in childrearing and oral health promotion behaviors.
Predictors of Dental Pain and General Anesthetic Receipt for Hospital Dental Procedures Among New Zealand Children
Authors: Jamieson Lisa M. , Koopu Pauline I.
Published: May 2007

Objectives: To predict experience of dental pain and hospital dental general anesthetic receipt among Maori, Pacific and New Zealand European or Other (NZEO) children in New Zealand. Methods: Data were from the 2002 National Child Nutrition Survey. Models representing demographic, socio‐economic status (SES), lifestyle, dietary, food security and oral health paradigms were tested using logistic regression. Results: Some 3275 children participated; 37.4 % Mäori, 32.3 % Pacific and 30.3% NZEO. Mäori children had higher odds of dental pain experience than NZEO children after adjusting for age, sex and length of time lived in New Zealand and with addition of household SES or physical factors. There were no differences in Pacific and NZEO child dental pain experience when the same factors were accounted for. The prevalence of dental general anesthetic receipt was similar among Maori, Pacific and NZEO children after adjusting for demographic, lifestyle, dietary, food security and dental factors in separate models. When such factors were investigated together, Pacific children were less likely to have received a dental general anesthetic than NZEO children. Conclusions: Maori children were more likely to experience dental pain and Pacific children were less likely to have received a dental general anesthetic than NZEO children after accounting for various behavioral and material factors. The latter may reflect issues pertaining to access and culturally insensitive services rather than demand for care per se.
Validation of the Geriatric Oral Health Assessment Index (GOHAI) in the Malay Language
Authors: Othman Wan‐Nasir W. , Muttalib Khairiyah A. , Bakri Rugayah , Doss Jennifer G. , Jaafar Nasruddin , Salleh Natifah C. , Chen Sharon
Published: May 2007

Objective: To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia. Methodology: The 6‐Liked scale GOHAI was translated into the Malay language and self‐administered on 189 subjects aged 60+. All subjects underwent oral status assessment, The measure was assessed for construct and discriminant validity, for test‐retest reliability and principal component factor. Findings: Mean GOHAI score was 46.2 (SD 9.7, range 17–60). The Cronbach's alpha was 0.79. Mean GOHAI scores increased with more positive self‐rated oral health and general health. The elderly with no perceived dental treatment need had higher mean GOHAI scores than those with perceived needs. There were slightly stronger inverse correlations between GOHAI scores and caries experience, number of teeth present, and number of pathologically mobile teeth. The measure demonstrated strong test‐retest reliability. Eight of the 12 items had Spearman's r3 0.7. Only one principal factor was found at eigenvalue > 1. Using ANCOVA, self‐rated perception of oral health and perceived need for dental treatment had the most significant impact on the GOHAI score. Conclusion and recommendations: The Malay language version of the GOHAI demonstrated acceptable validity and reliability and will be an important instrument to measure oral health‐related quality of life among Malay‐speaking Malaysians. Use of the Malay language version GOHAI should also be pursued among diverse adult age groups.
Patient Receptivity to Tobacco Cessation Counseling in an Academic Dental Clinic: A Patient Survey
Authors: Victoroff Kristin Zakariasen , Lewis Robert , Ellis Eric , Ntragatakis Milton
Published: May 2007

Objective: This study investigated dental patient attitudes towards tobacco cessation counseling in the dental school setting. Methods: Patients attending an academic dental clinic during a six‐week period were asked to complete a 22‐item self‐administered survey. Means and frequency distributions were assessed on all variables as appropriate. Results: Response rate was 71%. Twenty‐nine percent of respondents reported that they currently used tobacco. Seventy‐two percent of tobacco users agreed that the student dentist should ask patients whether or not they use tobacco, 67% agreed that the student dentist should advise tobacco users to quit, and 89% agreed that student dentists should offer quit tobacco information to patients who want to quit. Seventy percent of tobacco users were considering quitting or currently trying to quit, Of these, only 31% were aware of community resources to help them quit. Conclusions: The majority of tobacco users were positive in their attitudes toward delivery of tobacco cessation counseling and services in the dental setting. Many were considering or trying to quit, but few were aware of community resources to help them.
Absence of a Universal Mechanism of Mitochondrial Toxicity by Nucleoside Analogs
Authors: Lund Kaleb C. , Peterson LaRae L. , Wallace Kendall B.
Published: May 2007

Nucleoside analogs are associated with various mitochondrial toxicities, and it is becoming increasingly difficult to accommodate these differences solely in the context of DNA polymerase gamma inhibition. Therefore, we examined the toxicities of zidovudine (AZT) (10 and 50 μM; 2.7 and 13.4 μg/ml), didanosine (ddI) (10 and 50 μM; 2.4 and 11.8 μg/ml), and zalcitabine (ddC) (1 and 5 μM; 0.21 and 1.1 μg/ml) in HepG2 and H9c2 cells without the presumption of mitochondrial DNA (mtDNA) depletion. Ethidium bromide (EtBr) (0.5 μg/ml; 1.3 μM) was used as a positive control. AZT treatment resulted in metabolic disruption (increased lactate and superoxide) and increased cell mortality with decreased proliferation, while mtDNA remained unchanged or increased (HepG2 cells; 50 μM AZT). ddC caused pronounced mtDNA depletion in HepG2 cells but not in H9c2 cells and increased mortality in HepG2 cells, but no significant metabolic disruption in either cell type. ddI caused a moderate depletion of mtDNA in both cell types but showed no other effects. EtBr exposure resulted in metabolic disruption, increased cell mortality with decreased cell proliferation, and mtDNA depletion in both cell types. We conclude that nucleoside analogs display unique toxicities within and between culture models, and therefore, care should be taken when generalizing about the mechanisms of nucleoside reverse transcriptase inhibitor toxicity. Additionally, mtDNA abundance does not necessarily correlate with metabolic disruption, especially in cell culture; careful discernment is recommended in this regard.
Efficacy of Fluoroquinolones againstLeptospira interrogansin a Hamster Model
Authors: Griffith Matthew E. , Moon James E. , Johnson Erica N. , Clark Kyra P. , Hawley Joshua S. , Hospenthal Duane R. , Murray Clinton K.
Published: May 2007

Ciprofloxacin, gatifloxacin, and levofloxacin were evaluated for their abilities to prevent mortality in hamsters infected with a lethal inoculum ofLeptospira interrogansserovar Portlandvere. Each agent produced a statistically significant survival advantage compared to no treatment and demonstrated survival similar to that seen with doxycycline therapy.
Characterization of an Integron Carrying
bla
IMP-1
and a New Aminoglycoside Resistance Gene,
aac(6′)-31
, and Its Dissemination among Genetically Unrelated Clinical Isolates in a Brazilian Hospital
Authors: Mendes Rodrigo E. , Castanheira Mariana , Toleman Mark A. , Sader Helio S. , Jones Ronald N. , Walsh Timothy R.
Published: May 2007

Seven
bla
IMP-1
-harboring
Acinetobacter
sp. isolates and one
Pseudomonas putida
clinical isolate were recovered from hospitalized patients. All isolates possessed a class 1 integron, named In86, carrying the same cassette array [
bla
IMP1
,
aac(6
′
)-31
, and
aadA1
], which was plasmid located in five of the isolates. This report describes the ability of nonfermentative nosocomial pathogens to acquire and disseminate antimicrobial resistance determinants.
Reversal of the Antichlamydial Activity of Putative Type III Secretion Inhibitors by Iron
Authors: Slepenkin Anatoly , Enquist Per-Anders , Hägglund Ulrik , de la Maza Luis M. , Elofsson Mikael , Peterson Ellena M.
Published: May 2007

INPs, which are chemically synthesized compounds belonging to a class of acylated hydrazones of salicylaldehydes, can inhibit the growth ofChlamydiaceae. Evidence has been presented that inYersiniaandChlamydiaINPs may affect the type III secretion (T3S) system. In the present study 25 INPs were screened for antichlamydial activity at a concentration of 50 μM, and 14 were able to completely inhibit the growth ofChlamydia trachomatisserovar D in McCoy and HeLa 229 cells. The antichlamydial activities of two of these INPs, INPs 0341 and 0400, were further characterized due to their low cytotoxicity. These compounds were found to inhibitC. trachomatisin a dose-dependent manner; were not toxic to elementary bodies; were cidal at a concentration of ≥20 μM; inhibited allChlamydiaceaetested; and could inhibit the development ofC. trachomatisas determined by the yield of progeny when they were added up to 24 h postinfection. INP 0341 was able to affect the expression of several T3S genes. Compared to the expression in control cultures,lcrH-1,copB, andincA, all middle- to late-expressed T3S genes, were not expressed in the INP 0341-treated cultures 24 to 36 h postinfection. Iron, supplied as ferrous sulfate, as ferric chloride, or as holo-transferrin, was able to negate the antichlamydial properties of the INPs. In contrast, apo-transferrin and other divalent metal ions tested were not able to reverse the inhibitory effect of the INPs. In conclusion, the potent antichlamydial activity of INPs is directly or indirectly linked with iron, and this inhibition ofChlamydiahas an effect on the T3S system of this intracellular pathogen.
Molecular Analysis of Erythrocyte Invasion in
Plasmodium falciparum
Isolates from Senegal
Authors: Jennings Cameron V. , Ahouidi Ambroise D. , Zilversmit Martine , Bei Amy K. , Rayner Julian , Sarr Ousmane , Ndir Omar , Wirth Dyann F. , Mboup Souleymane , Duraisingh Manoj T.
Published: May 2007

The human malaria parasite,
Plasmodium falciparum
, utilizes multiple ligand-receptor interactions for the invasion of human erythrocytes. Members of the reticulocyte binding protein homolog (PfRh) family have been shown to be critical for directing parasites to alternative erythrocyte receptors that define invasion pathways. Recent studies have identified gene amplification, sequence polymorphism, and variant expression of PfRh paralogs as mechanisms underlying discrimination between pathways for invasion. In this study, we find considerable heterogeneity in the invasion profiles of clonal, uncultured
P. falciparum
parasite isolates from a low-transmission area in Senegal. Molecular analyses revealed minimal variation in protein expression levels of the PfRh ligands, PfRh1, PfRh2a, and PfRh2b, and an absence of gene amplification in these isolates. However, significant sequence polymorphism was found within repeat regions of PfRh1, PfRh2a, and PfRh2b. Furthermore, we identified a large sequence deletion (∼0.58 kb) in the C-terminal region of the Pf
Rh2b
gene at a high prevalence in this population. In contrast to findings of earlier studies, we found no associations between specific sequence variants and distinct invasion pathways. Overall these data highlight the importance of region-specific elaborations in PfRh sequence and expression polymorphisms, which has important implications in our understanding of how the malaria parasite responds to polymorphisms in erythrocyte receptors and/or evades the immune system.
Characterization of Prostaglandin E2Production byCandida albicans
Authors: Erb-Downward John R. , Noverr Mairi C.
Published: May 2007

Candida albicansproduces lipid metabolites that are functionally similar to host prostaglandins. These studies, using mass spectrometry, demonstrate thatC. albicansproduces authentic prostaglandin E2(PGE2) from arachidonic acid. Maximal PGE2production was achieved at 37°C in stationary-phase culture supernatants and in cell-free lysates generated from stationary-phase cells. Interestingly, PGE2production is inhibited by both nonspecific cyclooxygenase and lipoxygenase inhibitors but not by inhibitors specific for the cyclooxygenase 2 isoenzyme. TheC. albicansgenome does not possess a cyclooxygenase homolog; however, several genes that may play a role in prostaglandin production fromC. albicanswere investigated. It was found that aC. albicansfatty acid desaturase homolog (Ole2) and a multicopper oxidase homolog (Fet3) play roles in prostaglandin production, withole2/ole2andfet3/fet3mutant strains exhibiting reduced PGE2levels compared with parent strains. This work demonstrates that the synthesis of PGE2inC. albicansproceeds via novel pathways.
Leishmania majorAbrogates Gamma Interferon-Induced Gene Expression in Human Macrophages from a Global Perspective
Authors: Dogra Nisha , Warburton Corinna , McMaster W. Robert
Published: May 2007

Infection withLeishmania majortriggers several pathways in the host cell that are crucial to initial infection as well as those that are used byLeishmaniato enhance its replication and virulence. To identify the molecular events of the host cell in response toLeishmania, the global gene expression of the human monocytic cell line THP-1 either infected withLeishmania majorin the presence and absence of gamma interferon (IFN-γ) or in the presence of IFN-γ alone was analyzed using high-density human oligonucleotide microarrays, followed by statistical analysis. The persistence of the parasite despite an extensive response to IFN-γ, added 24 h after infection withL. major, suggests thatL. majorcan survive in an IFN-γ-enriched environment in vitro. Results demonstrate thatL. majorcounteracts the IFN-γ response in macrophages on a large scale. Expression of genes involved in the innate immune response, cell adhesion, proteasomal degradation, Toll-like receptor expression, a variety of signaling molecules, and matrix metalloproteinases was significantly modulated.
Transcriptional Profiling of
Bacillus anthracis
during Infection of Host Macrophages
Authors: Bergman Nicholas H. , Anderson Erica C. , Swenson Ellen E. , Janes Brian K. , Fisher Nathan , Niemeyer Matthew M. , Miyoshi Amy D. , Hanna Philip C.
Published: May 2007

The interaction between
Bacillus anthracis
and the mammalian phagocyte is one of the central stages in the progression of inhalational anthrax, and it is commonly believed that the host cell plays a key role in facilitating germination and dissemination of inhaled
B. anthracis
spores. Given this, a detailed definition of the survival strategies used by
B. anthracis
within the phagocyte is critical for our understanding of anthrax. In this study, we report the first genome-wide analysis of
B. anthracis
gene expression during infection of host phagocytes. We developed a technique for specific isolation of bacterial RNA from within infected murine macrophages, and we used custom
B. anthracis
microarrays to characterize the expression patterns occurring within intracellular bacteria throughout infection of the host phagocyte. We found that
B. anthracis
adapts very quickly to the intracellular environment, and our analyses identified metabolic pathways that appear to be important to the bacterium during intracellular growth, as well as individual genes that show significant induction in vivo. We used quantitative reverse transcription-PCR to verify that the expression trends that we observed by microarray analysis were valid, and we chose one gene (GBAA1941, encoding a putative transcriptional regulator) for further characterization. A deletion strain missing this gene showed no phenotype in vitro but was significantly attenuated in a mouse model of inhalational anthrax, suggesting that the microarray data described here provide not only the first comprehensive view of how
B. anthracis
survives within the host cell but also a number of promising leads for further research in anthrax.
Development of Fatal Colitis in FVB Mice Infected with
Citrobacter rodentium
Authors: Borenshtein Diana , Nambiar Prashant R. , Groff Elizabeth B. , Fox James G. , Schauer David B.
Published: May 2007

Citrobacter rodentium
is the causative agent of transmissible murine colonic hyperplasia. The disease is characterized by severe but temporary epithelial hyperplasia with limited inflammation in the descending colon of adult mice on a variety of genetic backgrounds. The natural history of infection with this murine pathogen has been characterized in outbred Swiss Webster (SW) mice but not in the cognate inbred FVB strain. In contrast to subclinical infection in SW mice, 12-week-old FVB mice developed overt disease with significant weight loss and mortality beginning by 9 days postinoculation (dpi). By 21 dpi, more than 75% of infected FVB mice died or had to be euthanized, whereas no mortality developed in SW mice. Mortality in FVB mice was fully prevented by fluid therapy. Fecal shedding of bacteria was similar in both groups through 9 dpi; however, a slight but significant delay in bacterial clearance was observed in FVB mice by 12 to 18 dpi. SW mice developed hyperplasia with minimal inflammation in the descending colon. FVB mice developed epithelial cell hyperproliferation, severe inflammation with erosions and ulcers, and epithelial atypia by 6 dpi in the descending colon. In the majority of surviving FVB mice, colonic lesions, including epithelial atypia, were reversible, although a small percentage (5 to 7%) exhibited chronic colitis through 7 months postinoculation. The existence of susceptible and resistant lines of mice with similar genetic backgrounds will facilitate the identification of host factors responsible for the outcome of infection and may lead to the development of novel strategies for preventing and treating infectious colitis.
Toxicity of copper to larvalPimephales promelasin the presence of photodegraded natural dissolved organic matter
Authors: Brooks Marjorie L , Meyer Joseph S , Boese Connie J
Published: May 2007

Copper (Cu) complexation with natural dissolved organic matter (DOM) mitigates Cu bioavailability to aquatic biota by decreasing the activity of the cupric ion ({Cu2+}). However, DOM is photochemically unstable. In a previous study, we demonstrated that irradiation (~13 days sunlight) of DOM collected from a river decreased its binding-site density for Cu by 45%, but increased binding-site density in wetland DOM by 147%. Binding-site densities correlated positively with ketones and aldehydes (C-II groups). Herein, we determined the mortality of larval fathead minnows (FHM; Pimephales promelas) as a function of {Cu2+} in 96 h static-renewal toxicity tests without DOM. Next, we calculated {Cu2+} in control and photooxidized DOM and then predicted mortality of larval FHM in toxicity tests. Observed mortalities agreed with predictions (r2≈ 0.96) in treatments with lowest binding-site densities and proportions of C-II groups (highest {Cu2+}). However, treatments with ~50% lower {Cu2+}, containing higher proportions of C-II groups, had equally high mortalities and poorer fits with predictions (r2≈ 0.75), possibly indicating that Cu bound to C-II groups are bioavailable. To our knowledge, this study is the first to predict and then directly test the effects of DOM photooxidation on Cu toxicity.
The influence of eutrophication and population biomass on common whitefish (Coregonus lavaretus) growth — the Lake Constance example revisited
Authors: Thomas Gregor , Eckmann Reiner
Published: May 2007

Accelerated growth of freshwater fish during anthropogenic eutrophication has been attributed almost exclusively to the increased nutrient content, while density-dependent effects have been largely neglected. We evaluated the relative importance of these factors by studying the growth of 43 consecutive year classes of common whitefish (Coregonus lavaretus) from Upper Lake Constance. This prealpine lake underwent eutrophication from the 1950s to 1970s, followed by reoligotrophication. Because whitefish are harvested with gill nets in a strongly size-selective way, we used back-calculated lengths of average fast-growing fish to compare growth among cohorts. Standing stock biomass was estimated based upon virtual year-class strengths. Multiple linear regression analysis revealed that growth of whitefish during their second year was most strongly related to standing stock biomass followed by PO4-P content during spring turnover and by calendar year, which was incorporated as a third independent variable (adjusted R2 = 0.84). The negative correlation between whitefish growth rate and calendar year is interpreted as evidence of an evolutionary response to the highly size-selective fishery during at least four decades. We conclude that density-dependent effects on whitefish growth are more important than had been realized previously and that the impact of eutrophication on growth of whitefish needs to be reconsidered.