Randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website: cost-effectiveness analysis

To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a standard face-to-face brief intervention (BI)

Antibacterial properties of novel dental composites for paediatric dentistry

Aim: To assess the antibacterial properties of novel dental composite formulations containing the antibacterial polylysine and varying type or amounts of monomer/glass/calcium phosphate. / Methods: Minimum inhibitory/bactericidal concentrations of polylysine against Streptococcus mutans UA159 were determined. The antibacterial activity of composite discs with polylysine was determined by immersing the discs into a suspension of S. mutans and carrying out bacterial counts. All the results were compared with commercial materials. Mass and volume change of the material as well as polylysine release were determined over time and compared for multiple formulations containing polylysine. Bacterial growth was visualised on the discs using LIVE/DEAD staining with confocal microscopy and using scanning electron microscopy. / Results: The addition of a minimum 1% polylysine to the novel formulations inhibited bacterial growth at low inoculum density and the addition of a minimum 2% polylysine inhibited bacterial growth at all inoculum densities in air. In an atmosphere of air enriched with 5% carbon dioxide and in the presence of sucrose there was a bacteriostatic effect with 5% polylysine addition. None of the commercial materials showed any antibacterial properties. Increasing the amount of polylysine in the novel composite formulations increased mass change over two months and increased polylysine release over three weeks. Volume was not significantly affected. Using SEM, bacterial growth was seen on composite discs after 4 days incubation in a suspension of S. mutans at 37oC in air with 5% carbon dioxide. It appeared that a biofilm was formed under these conditions for all formulations and commercial materials whereas in air, there was minimal growth. Using confocal microscopy an increase in dead bacteria was seen as the polylysine concentration increased in both air and in air with 5% CO2. / Conclusion: Novel composites with added polylysine are capable of reducing the load of Streptococcus mutans. These above experimental composites have novel characteristics that make them more suitable for minimally invasive tooth restorations. Key words: polylysine, composite, restoration, antibacterial propertie

Polonium and Lung Cancer

The alpha-radioactive polonium 210 (Po-210) is one of the most powerful carcinogenic agents of tobacco smoke and is responsible for the histotype shift of lung cancer from squamous cell type to adenocarcinoma. According to several studies, the principal source of Po-210 is the fertilizers used in tobacco plants, which are rich in polyphosphates containing radio (Ra-226) and its decay products, lead 210 (Pb-210) and Po-210. Tobacco leaves accumulate Pb-210 and Po-210 through their trichomes, and Pb-210 decays into Po-210 over time. With the combustion of the cigarette smoke becomes radioactive and Pb-210 and Po-210 reach the bronchopulmonary apparatus, especially in bifurcations of segmental bronchi. In this place, combined with other agents, it will manifest its carcinogenic activity, especially in patients with compromised mucous-ciliary clearance. Various studies have confirmed that the radiological risk from Po-210 in a smoker of 20 cigarettes per day for a year is equivalent to the one deriving from 300 chest X-rays, with an autonomous oncogenic capability of 4 lung cancers per 10000 smokers. Po-210 can also be found in passive smoke, since part of Po-210 spreads in the surrounding environment during tobacco combustion. Tobacco manufacturers have been aware of the alpha-radioactivity presence in tobacco smoke since the sixties

Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization

Molar incisor hypomineralization (MIH) is a developmental defect of dental enamel that shares features with hypomineralized second primary molars (HSPM). Prior to permanent tooth eruption, second primary molars could have predictive value for permanent molar and incisor hypomineralization. To assess this possible relationship, a cross-sectional study was conducted in a sample of 414 children aged 8 and 9 years from the INMA cohort in Valencia (Spain). A calibrated examiner (linear-weighted Kappa 0.83) performed the intraoral examinations at the University of Valencia between November 2013 and 2014, applying the diagnostic criteria for MIH and HSPM adopted by the European Academy of Paediatric Dentistry. 100 children (24.2%) presented MIH and 60 (14.5%) presented HSPM. Cooccurrence of the two defects was observed in 11.1% of the children examined. The positive predictive value was 76.7% (63.9-86.6) and the negative predictive value 84.7% (80.6-88.3). The positive likelihood ratio (S/1-E) was 10.3 (5.9-17.9) and the negative likelihood ratio (1-S/E) 0.57 (0.47-0.68). The odds ratio was 18.2 (9.39-35.48). It was concluded that while the presence of HSPM can be considered a predictor of MIH, indicating the need for monitoring and control, the absence of this defect in primary dentition does not rule out the appearance of MIH

Early Polylysine Release from Dental Composites and Its Effects on Planktonic Streptococcus mutans Growth

The study aim was to assess the effect of incorporating polylysine (PLS) filler at different mass fractions (0.5, 1 and 2 wt%) on PLS release and Streptococcus mutans planktonic growth. Composite containing PLS mass and volume change and PLS release upon water immersion were assessed gravimetrically and via high-performance liquid chromatography (HPLC), respectively. Disc effects on bacterial counts in broth initially containing 8 × 10^{5} versus 8 × 10^{6} CFU/mL Streptococcus mutans UA159 were determined after 24 h. Survival of sedimented bacteria after 72 h was determined following LIVE/DEAD staining of composite surfaces using confocal microscopy. Water sorption-induced mass change at two months increased from 0.7 to 1.7% with increasing PLS concentration. Average volume increases were 2.3% at two months whilst polylysine release levelled at 4% at 3 weeks irrespective of composite PLS level. Early percentage PLS release, however, was faster with higher composite content. With 0.5, 1 and 2% polylysine initially in the composite filler phase, 24-h PLS release into 1 mL of water yielded 8, 25 and 93 ppm respectively. With initial bacterial counts of 8 × 10^{5} CFU/mL, this PLS release reduced 24-h bacterial counts from 10^{9} down to 10^{8}, 10^{7} and 10^{2} CFU/mL respectively. With a high initial inoculum, 24-h bacterial counts were 10^{9} with 0, 0.5 or 1% PLS and 10^{7} with 2% PLS. As the PLS composite content was raised, the ratio of dead to live sedimented bacteria increased. The antibacterial action of the experimental composites could reduce residual bacteria remaining following minimally invasive tooth restorations

Social Media as an Opportunity for Public Health Interventions: The #Metoo Movement as an Exemplar

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of communication for users around the world. One of the most popular free social media networks is Twitter, with more than 100 million active users per day worldwide. Purpose: The aim of this study was to analyse a sample of the public conversations generated, using the hashtag #MeToo, around the topic of sexual abuse on Twitter.  Methods:  Using social media marketing software, the use of the #MeToo hashtag was analysed over a period of 60 days (14 September 2017 to 13 November of 2017). Results: The #MeToo conversation was mainly in English (79.3%), located in the United States (48.2% of cases), but with global repercussions. The volume of mentions of the #MeToo hashtag was far greater (97.7%), compared with other hashtags related to violence over this period of time, using mostly Twitter (96.2%). Conclusions: These results suggest that it is possible to describe different groups using the social media, and analyse their conversations to identify opportunities for successful public health interventions.  If the topic is relevant for the general public, it will generate interest and conversations at the global level, supported by a universal and borderless channel such as Twitter

Communication with the patient in General Practice

Patient communication plays an essential role in everyday clinical practice in General Practice (GP). It is possible to observe the communication skillstechniques in European countries, during the exchange programmes for GP trainees, which are organised by the Vasco da Gama Movement. The patientagenda often does not match the physician’s and sometimes is also neglected or misinterpreted. This may lead to low patient satisfaction and suboptimalclinical practice. Knowing how to approach the patient’s problems and fears, besides managing his/hers expectations, is of high importance in order toenhance satisfaction and quality of care. Furthermore, GP’s unique position should be considered, as he/she can discuss difficult and sensible topicswith his/her patients. The ICE (Ideas, Concerns and Expectations) model is an example of holistic and patient-centred approach, which is appropriatefor GPs, and explores the patient’s point of view concerning diagnosis and treatment. The importance of medical communication is also emphasised ineducation. For instance, a correct and consistent assessment of the communication skills in GP is possible with the use of the MAAS-Global scale

An enigmatic hypoplastic defect of the maxillary lateral incisor in recent and fossil orangutans from Sumatra (Pongo abelii) and Borneo (Pongo pygmaeus)

Developmental dental pathologies provide insight into health of primates during ontogeny, and are particularly useful for elucidating the environment in which extant and extinct primates matured. Our aim is to evaluate whether the prevalence of an unusual dental defect on the mesiolabial enamel of the upper lateral incisor, thought to reflect dental crowding during maturation, is lesser in female orangutans, with their smaller teeth, than in males; and in Sumatran orangutans, from more optimal developmental habitats, than in those from Borneo. Our sample includes 49 Pongo pygmaeus (87 teeth), 21 P. abelii (38 teeth), Late Pleistocene paleo-orangutans from Sumatra and Vietnam (67 teeth), Late Miocene catarrhines Lufengpithecus lufengensis (2 teeth), and Anapithecus hernyaki (7 teeth). Methods include micro-CT scans, radiography, and dental metrics of anterior teeth. We observed fenestration between incisor crypts and marked crowding of unerupted crowns, which could allow tooth-to-tooth contact. Tooth size does not differ significantly in animals with or without the defect, implicating undergrowth of the jaw as the proximate cause of dental crowding and defect presence. Male orangutans from both islands show more defects than do females. The defect is significantly more common in Bornean orangutans (71 %) compared to Sumatran (29 %). Prevalence among fossil forms falls between these extremes, except that all five individual Anapithecus show one or both incisors with the defect. We conclude that maxillary lateral incisor defect is a common developmental pathology of apes that is minimized in optimal habitats and that such evidence can be used to infer habitat quality in extant and fossil apes

Best clinical practise guidance for the use of antibiotics in children: an EAPD policy document

Purpose: The European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance on the use of antibiotics in pediatric dentistry, aiming to address challenges posed by antimicrobial resistance (AMR) and promote the responsible use of antibiotics. // Methods: A comprehensive review of existing literature and global policies was conducted to evaluate antibiotic-prescribing practices for children. Recommendations were developed through a consensus process involving experts in pediatric dentistry during the EAPD policy workshop in Prague in May 2023. // Results: The guidelines highlight the critical role of prudent antibiotic use to mitigate the growing threat of AMR. Specific recommendations include no routine antibiotic use for localized pulpitis or abscess without systemic involvement and targeted use for odontogenic infections with systemic signs. Detailed dosage protocols are provided, accounting for age, weight, and clinical context. Prophylaxis is recommended only for high-risk patients undergoing specific invasive procedures. Significant variations in national practices were noted, underlining the need for harmonized evidence-based protocols. // Conclusion: These guidelines serve as a framework to optimize antibiotic use in children, emphasizing the importance of targeted prescribing practices and the implementation of preventive strategies in pediatric dental care