Relationship between periodontal status and intellectual function among community-dwelling elderly persons

doi: 10.1111/j.1741‐2358.2011.00483.x
Relationship between periodontal status and intellectual function among community‐dwelling elderly persons Objective: The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. Background: Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. Materials and Methods: A total of 152 community‐dwelling elderly persons, aged 70–74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven’s Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. Results: Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. Conclusion: Intellectual function is considered a significant indicator of periodontal status among community‐dwelling elderly persons.     

Quality of life of HIV-infected persons in Croatia

The aim of this study was to examine health-related quality of life among Croatian HIV infected individuals, and to assess the impact of socio-demographic and disease-related variables on health-related quality of life. This was a crosssectional study of 111 HIV-infected adults who received care at the University Hospital for Infectious Diseases in Zagreb, Croatia. The World Health Organization Quality of Life Questionnaire for HIV brief version (WHOQOL-HIV BREF) was used to assess each patient's quality of life. Ratings of quality of life differed across age, marital status, level of education, health status and "currently ill" status. Subjects who perceived themselves as not ill and their health status as better reported better quality of life for all quality of life domains (p < 0.01). Subjects who were in relationships gave higher ratings for the social relationships domain (p < 0.01). Subjects with higher level of education gave significantly higher ratings within the independence (p < 0.05) and environment (p < 0.01) domains. Younger subjects perceived their psychological state as better (p < 0.05). The findings demonstrate a moderate degree of overall quality of life (X = 112.2; SD = 18.92) with main concerns related to social relationships. These results highlight the need for better access to psychosocial support and medical and legal services for people living with HIV/AIDS in Croatia.     

Dysregulation of proinflammatory and regulatory cytokines in HIV infected persons with active tuberculosis

Proinflammatory and regulatory cytokines have been implicated to play important role in immunopathology of HIV and tuberculosis (TB) infection. Capacity of unstimulated and mitogen-stimulated peripheral blood mononuclear cells (PBMCs) to secrete cytokines (interleukin (IL)-2, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), IL-4, IL-10 and IL-6) was estimated for 15 HIV-TB coinfected patients, 22 HIV seropositives without TB, 32 HIV negative TB patients, and 36 healthy subjects. Dually infected patients had suppression of both Th1 and Th2 cytokine secretion as evidenced by significantly lower production of IL-2, IFN-gamma and TNF-alpha as well as IL-4 and IL-10. Production of IL-2 and TNF-alpha was significantly decreased only in case of HIV infection. Significantly higher IL-6 secretion was found in unstimulated cultures in dually infected patients. The mitogen induced cytokine secretion was generally lower in HIV-TB coinfected patients indicating profound perturbation of both Th1 and Th2 responses.     

Assessment of nutritional status of gastroenterology patients in Croatia

Malnutrition is a common feature of gastroenterological diseases. In this study, nutritional status of the patients admitted to Department of Gastroenterology at University Hospital Center Zagreb was assessed. Anthropometric, dietetic, biochemical methods and method of Subjective Global Assessment (SGA) was used. The study group included 284 patients admitted to the Hospital. Malnutrition, as defined by SGA, was found in 61.1% of the patients, of whom 75% were moderately and 25% severely malnourished. Those patients classified as moderately and extremely malnourished by SGA were found to have statistically lower values of BMI, albumin, total proteins, calcium, iron, triglycerides, cholesterol, vitamin A and lymphocytes as compared to those who were adequately nourished. The prevalence of malnutrition in hospitalized patients treated at the Department of Gastroenterology is high. The use of nutritional screening with multiple measures would be important in the early identification and treatment of these patients and would help decrease this high prevalence.     

HIV risks among female sex workers in Croatia and Montenegro

The study analyzed the prevalence and determinants of HIV-risks among female sex workers (FSWs) in Croatia and Montenegro. Face-to-face interviews were carried out in Zagreb, Split, and Podgorica during the 2006-2008 period. Croatian participants (n = 154) reported fewer clients, more consistent condom use, higher rates of HIV testing, and greater HIV knowledge. The participants interviewed in Montenegro (n = 119) were more likely to have injected drugs and to have experienced sexual abuse in the previous year. Although Montenegrin FSWs were more exposed to HIV-risks than Croatian FSWs, they reported lower HIV-risk self-assessment. Consistent condom use was significantly associated with education and HIV-risk self-assessment in the Croatian and the experience of physical/sexual abuse in the Montenegrin sample. In spite of a number of methodological limitations, the empirical insights provided by this study may assist in improving the existing HIVV prevention initiatives.     

HIV infection in children perinatally infected

During the period from 1987 to the middle of 1996 only 20 children were born of HIV-infected women, while during the following 1.5 years the number of such children were 59, the maximum number of seropositive children being registered in Kaliningrad and the Kaliningrad region, in the Krasnodar Territory, Stavropol and Nizhny Novgorod (altogether 46 children). Out of 79 children born of HIV-infected mothers during the whole period of the epidemic, 8 children died. Out of the children born before 1995 who remained alive, 9 children were struck off the register after 3 years of observation due to the absence of HIV infection. By the end of 1997 63 children were registered, the majority of them born in 1996-1997.     

Dietary habits and folate status in women of childbearing age in Croatia

Folic acid and folates have an important role in prevention of neural tube defect that appears in the first weeks of pregnancy, when women are still not aware of their pregnancy, especially when pregnancy is not planned. Since ensuring sufficient quantities of folates and folic acid in this period is essential, dietary habits of childbearing age women are very important. In line with that the intake of folates and folic acid in nutrition of women age group 20-30 years is examined, as well as the frequency of consumption of foodstuffs rich in vitamins and folic acid supplements. Values of folates in serum are presented, dependent on their nutritional habits. Obtained results indicate that in spite of inadequate intake of folates and folic acid from foodstuffs, clinical deficit is not recorded, which is the result of frequent consumption of dietary supplements. In accordance with these dietary habits, differences in the folates status of examinees were observed.     

Prevalence of periodontal diseases in Zagreb population, Croatia, 14 years ago and today

The aim of this study was to assess prevalence of periodontal diseases within Zagreb adult population in 2000. The sample comprised of 412 examinees of both sexes and all age groups. World Health Organization (WHO) methodology and Community Periodontal Index (CPI), (1997) were used. The data gained was statistically assorted and compared with the data from previously conducted research in 1986. Results showed relatively high prevalence of periodontal diseases. No healthy periodontium was recorded in the 45-and-above age group. Shallow periodontal pockets was registered in 12% of nineteen-year-olds, whereas this symptom was very evident in 45-54 age group (45.7%) and in older than 65 (48.2%). Over 90% of participants had insufficient oral hygiene and 80% required initial periodontal therapy. Approximately 20% needed complex periodontal treatment. Comparison of this data with the previous 1986 research showed improvement of periodontal status in up-to-44 age group due to more healthy persons and more subjects with the initial stages of disease. The possible reason for periodontal health improvement in the last 14 years, evident specially in younger age groups, were the effects of large preventive program measures conducted on schoolchildren in Croatia in 1980-ties and terminated in 1990-ties when the war in Croatia started. Following studies are needed to monitor whether deterioration in oral health will occur regarding to absence of organized preventive programs since 1990-ties.     

The legal status of Russian HIV-infected persons

According to the data, presented by the author and based on the study of opinions expressed by HIV-infected persons, 80% of them are subjected to discrimination. The article deals with the problem of the legal protection of HIV-infected persons in the Russian Federation. Additions and changes in the current legislation regarding foreign citizens and persons in places of confinement are proposed.     

Fuzzy modeling in symptomatic HIV virus infected population

This paper introduces a model for the evolution of positive HIV population and manifestation of AIDS (acquired immunideficiency syndrome). The focus is on the nature of the transference rate of HIV to AIDS. Expert knowledge indicates that the transference rate is uncertain and depends strongly on the viral load and the CD4+ level of the infected individuals. Here, we suggest to view the transference rate as a fuzzy set of the viral load and CD4+ level values. In this case the dynamic model results in a fuzzy model that preserves the biological meaning and nature of the transference rate λ. Its behavior fits the natural history of HIV infection reported in the medical science domain. The paper also includes a comparison between the fuzzy model and a classic Anderson’s model using data reported in the literature.     

Anti-interferon-gamma antibodies in sera from HIV infected patients

High serum levels of antibodies to interferon-gamma (IFN-gamma) have been found in patients infected with human immunodeficiency virus (HIV). A radioimmunoassay (RIA) with a recombinant IFN-gamma protein or an affinity purified IFN-gamma preparation as antigens, was developed to detect the specific anti-IFN-gamma antibodies. Reactivity of sera to IFN-gamma was confirmed by Western blot analysis. These antibodies, however, do not seem to recognize the active site of the molecule, since they do not neutralize the antiviral IFN-gamma activity in a biological assay. These results enforce the hypothesis of the role of autoimmunization during the course of the disease.     

Neurotoxicity of macrophages infected by HIV1

Conclusion Neuronal astrocytes and perhaps oligodendrocytic lesions occur during the course of HIVinfection of CNS cells. Most of the results suggest that these lesions are indirectlyinduced by infected macrophages, probably monocytes, present in the brain. Twomechanisms of neurotoxicity have been studied to date, one testing soluble factors presentin supernatant of infected monocytes and the other the direct effect of adhering HIV-infected monocytes to neurons and astrocytes. These two mechanisms are not mutually exclusive. They both indicate a major role for monocytes in the induction of brain lesionsand the crucial importance of the neurotoxic approach in the study of HIV inducedencephalopathy.     

Self-image and refugee status in adolescents from Bosnia and Herzegovina and Croatia

The first aim is focused in refugees comparing them with a comparison group in clinical characteristics. In addition, the authors compared scores on the self-image (S-I) scale of refugees and comparison subjects, after they had stratified them into four groups by gender and age. Subjects were 133 refugees from Bosnia and Herzegovina and comparison subjects were from Zagreb, Croatia (n = 189). The subjects were assessed by psychotherapeutic interview, Offer Self-Image Questionnaire (OSIQ), questionnaires of depressive symptoms, war stressors, posttraumatic reactions (PTS-reactions) and general data. Refugees had significantly higher scores on the questionnaires of war stressors and PTS-reactions (p < 0.001). Refugees didn't differ in the majority of 12 scales of OSIQ from comparison subjects, in all four groups. Younger male refugees had the most scales with significantly higher raw scores in S-I, four in total. S-I can give us useful insight into different dimensions of personality of refugees.     

Periodontal microflora of HIV infected patients with periodontitis

The aim of this study was to determine the microbial profile of periodontal lesions in HIV seropositive patients and to compare it with rapidly progressing periodontal lesions in systemically healthy patients. The subgingival microflora of 20 CDC II, 20 CDC III, 20 CDC IV/V and 20 systemically healthy patients with rapidly progressing periodontitis was examined. Four sites with greatest probing depth in each patient were selected for microbiological sampling. The samples were cultured aerobically and anaerobically for bacterial isolation using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and various identification kits. The microflora of periodontitis lesions within the three stages of the HIV infection was similar to that of progressing periodontitis in systemically healthy adults including Campylobacter rectus, Capnocytophaga spp., Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Selenomonas spp. and Peptostreptococcus micros. However, HIV seropositive periodontitis lesions harboured a range of exogenous pathogens rarely associated with common types of periodontitis including Staphylococcus aureus, Enterobacter cloaca, Pseudomonas aeruginosa, Candida albicans, Enterococcus faecalis, Enterococcus avium, Clostridium difficile, Aspergillus fumigatus, Klebsiella pneumoniae and Mycoplasma incognitum. The lack of immune effector and regulatory cells in HIV infected patients could in fact explain the increase of some opportunistic pathogens and the characteristic and rapidly progressing nature of the periodontal disease in these patients.