Influence of BPPV and Meniere's Disease on Cognitive Abilities: A Questionnaire-Based Study

The vestibular system connects the inner ear to the midbrain and subcortical structures and can affect cognition. Patients with vertigo often experience cognitive symptoms such as attention deficits, memory problems, and spatial perception difficulties. This study aimed to explore the cognitive impairments associated with Benign paroxysmal positional vertigo(BPPV) and Meniere's Disease(MD). A non-experimental group comparison design was used with 107 participants divided into three groups: Group I(clinically normal), Group II(BPPV), and Group III(MD). Participants completed a questionnaire with 10 cognition-related questions, and their responses were scored. The data were found to be non-normally distributed. The analysis revealed a significant difference in scores between Group I and both Group II and Group III. Chi-square tests showed that the responses to cognition-related questions varied among the groups, with Group II exhibiting more cognitive problems. Associated conditions like hypertension, diabetes, and hearing loss did not significantly influence the responses within each group. This study suggests a significant relationship between cognitive problems and patients with BPPV and MD. However, there was no association found between the cognitive problems experienced in BPPV and MD patients. These findings align with previous research indicating that vestibular disorders can lead to deficits in spatial memory, attention, and other cognitive functions. By understanding the link between cognition and vestibular disorders, we can improve diagnosis and rehabilitation services to enhance the quality of life for these patients.

Periodontal disease:A silent factor in the development and progression of diabetic retinopathy

The global increase in the prevalence of type 2 diabetes mellitus(T2DM)and its complications presents significant challenges to public health.Recently,periodontal disease(PD)was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress.In this editorial,we comment on the article published by Thazhe Poyil et al in the very recent issue of the World Journal of Diabetes in 2024,which investigated the correlation between PD and diabetic retinopathy(DR)in T2DM patients,with emphasis on the association between periodontal swollen surface area,glycated hemoglobin(HbA1c),interleukin-6(IL-6),and lipoprotein(a).The findings by Thazhe Poyil et al are significant as they demonstrate a strong link between PD and DR in T2DM patients.This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR,a complication of diabetes.The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients.A few studies have established an interconnection between PD and diabetic complication,specifically DR,in T2DM patients,which we aim to highlight in this editorial.Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM,where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms.This article highlights the importance of collaboration amongst diabetes specialists,ophthalmologists,periodontists,and public health professionals to advance the prevention,early detection,and treatment of PD and DR.This will improve the health and quality of life of T2DM patients.Moreover,the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR,with identification of common inflammatory biomarkers and signaling pathways.This is expected to facilitate effective direction of therapeutic objectives,thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.

Periodontitis and chronic kidney disease:A bidirectional relationship based on inflammation and oxidative stress

Chronic kidney disease(CKD)and chronic periodontitis(CP)are prevalent conditions which significantly impact public health worldwide.Both diseases share inflammatory and oxidative stress mechanisms,an indication of a likely bidirectional relationship.This editorial explored the association between CKD and CP by highlighting common inflammatory mechanisms and recent research findings that address this interrelationship.Through reviews of recent studies,we discussed how periodontal bacteria may activate systemic immune responses that affect both periodontal and renal tissues.Additionally,meta-analysis data indicated an increased risk of CKD development in patients with CP,and vice versa.The results suggest the need for more rigorous research in the future in order to address the confounding factors and evaluate specific periodontal health interventions and their direct effects on kidney function.We emphasized the importance of comprehensive and multidisciplinary care for the improvement of the overall health of patients affected by CP and CKD.

Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and fibrosis.NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma.The oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis.Gut dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and cyclopentane.Moreover,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation.In particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis.NAFLD,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and diabetes.Periodontal disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively.In this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome.In conclusion,it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease,gut microbiota,and metabolic syndrome.Thus,the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics,prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.

Meta-analysis of the association between chronic periodontitis and chronic kidney disease

BACKGROUND Many scholars have performed several clinical studies have investigated the association between chronic periodontitis(CP)and chronic kidney disease(CKD).However,there are still differences between these research results,and there is no unified conclusion.Therefore,a systematic review is required to understand this issue fully.AIM To explore the correlation between CP and CKD.METHODS Literature on the correlation between CP and CKD,as well as the clinical attachment level(CAL)and pocket probing depth(PPD)of CKD and non-CKD,were retrieved from PubMed,Embase,the Cochrane Library,and Web of Science repositories until January 2024.After the effective data were extracted,data processing and statistics were performed using Stata 12.0.RESULTS Of the 22 studies,13 were related to CP and CKD,and 9 reported CAL and PPD in patients with CKD and healthy controls.Meta-analysis of the correlation between CP and CKD revealed that CKD probability in people with CP was 1.54 times that of healthy individuals[relative risk=1.54,95%confidence interval(CI):1.40-1.70],and CP incidence in patients with CKD was 1.98 times that of healthy individuals[overall risk(OR)=1.98,95%CI:1.53-2.57].Meta-analysis of CAL and PPD evaluations between CKD patients and healthy individuals showed that CAL and PPD levels were higher in CKD patients[standard mean difference(SMD)of CAL=0.65,95%CI:0.29-1.01;SMD of PPD=0.33,95%CI:0.02-0.63].CONCLUSION A bidirectional association exists between CP and CKD.CKD risk is increased in CP patients and vice versa.Periodontal tissue or tooth loss risks increase over time in CKD patients.

The role of periodontal disease in atherosclerotic cardiovascular disease

Atherosclerotic cardiovascular disease(ASCVD)includes a group of disorders of the heart and blood vessels and accounts for major morbidity and premature death worldwide.Periodontitis is a chronic inflammatory disease with the gradual destruction of supporting tissues around the teeth,including gingiva,periodontal ligament,alveolar bone,and cementum.Periodontitis has been found to potentially increase the risk of ASCVD.Generally,oral microorganisms and inflammation are the major factors for periodontitis to the incidence of ASCVD.Recently,evidence has shown that the loss of masticatory function is another important factor of periodontitis to the incidence of ASCVD.In this review,we illustrate the recent finding of the relationship between periodontitis and ASCVD,from a microscale perspective-oral microorganisms,inflammation,and tooth loss.With the high prevalence of periodontitis,it is important to add oral therapy as a regular ASCVD prevention strategy.Regular dental visits could be a helpful strategy for ASCVD patients or general medical practitioners.

Psychosocial and spiritual needs of patients with chronic diseases: validation of the Chinese version of the Spiritual Needs Questionnaire

OBJECTIVE： Even in secular societies, a small portion of patients find their spirituality to help cope with illness. But for the majority of patients, psychosocial and spiritual needs are neither addressed nor even considered a relevant factor by health care professionals. To measure such specific needs, the Spiritual Needs Questionnaire （SpNQ） was developed. The aim of this study was to validate the Chinese version of the SpNQ （SpNQ-Ch） and thus to measure psychosocial and spiritual needs of Chinese patients. METHODS： This was a cross-sectional study among 168 patients with chronic diseases who were recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China using standardized questionnaires. We performed reliability and factor analyses, as well as analyses of variance, first order correlations and regression analyses. RESULTS： The 17-item SpNQ-Ch had a similar factorial structure as the original version with two main and three minor factors which accounted for 64% of variance, and internal consistency estimates （Cronbach＇s a） ranging from 0.51 to 0.81. Included were the 4-item scale Inner Peace Needs, the 5-item scale Giving/Generativity （with 2 sub-constructs, Praying and Sources）, and a Needs, the 5-item scale Religious Needs 3-item scale Reflection/Release Needs. In Chinese patients with cancer （63%）, pain affections （10%）, or other chronic conditions （23%）, the needs for Giving/Generativity （which refer to categories of Connectedness and Meaning） and Inner Peace Needs scored highest, while Religious Needs and the Reflection/Release Needs scored lower. CONCLUSION： The SpNQ-Ch is congruent with its primary version, and can be used in future studies with the mostly nonreligious patients from China. First findings indicate specific psychosocial and spiritual needs which should be addressed by health care professionals to support patients in their struggle with chronic illness in terms of psycho-emotional stabilization, finding hope and meaning, and thus achieving peaceful states of mind despite chronic illness.

Causal relationship between inflammatory bowel disease and gingivitis or periodontal disease:A two-sample Mendelian randomized analysis

Background:Observational studies have shown that inflammatory bowel disease(IBD),such as ulcerative colitis(UC)and Crohn disease(CD),is associated with gingivitis and periodontal disease(GP).This study aims to investigate whether there is a causal relationship between IBD and GP.Methods:This study assessed the causal relationship between IBD and GP through a two-sample Mendelian randomization(MR)study.The required data were obtained through the IEU OpenGWAS project.Instrumental variable screening and the MR and sensitivity analyses were performed using the“TwoSampleMR”R package.Results:IBD,UC,and CD may have a causal effect on GP(IBD,inverse variance weighting[IVW]OR=1.05,95%CI=1.00–1.10,P=0.03;UC,IVWOR=1.05,95%CI=1.00–1.11,P=0.03;CD,weighted median OR=1.06,95%CI=1.00–1.13,P=0.04;simple mode OR=1.15,95%CI=1.02–1.31,P=0.03).Scatterplots,forest plots,and funnel plots showed a significant relationship between IBD and GP and confirmed the robustness of the model.In sensitivity testing,no horizontal pleiotropy or heterogeneity was found in this study.Conclusions:This study found a possible causal relationship between IBD(UC and CD)and GP,which deserves to be considered in clinical practice.

Periodontal and inflammatory bowel diseases: Is there evidence of complex pathogenic interactions?

Periodontal disease and inflammatory bowel disease(IBD) are both chronic inflammatory diseases. Their pathogenesis is mediated by a complex interplay between a dysbiotic microbiota and the host immuneinflammatory response, and both are influenced by genetic and environmental factors. This review aimed to provide an overview of the evidence dealing with a possible pathogenic interaction between periodontal disease and IBD. There seems to be an increased prevalence of periodontal disease in patients with IBD when compared to healthy controls, probably due to changes in the oral microbiota and a higher inflammatory response. Moreover, the induction of periodontitis seems to result in gut dysbiosis and altered gut epithelial cell barrier function, which might contribute to the pathogenesis of IBD. Considering the complexity of both periodontal disease and IBD, it is very challenging to understand the possible pathways involved in their coexistence. In conclusion, this review points to a complex pathogenic interaction between periodontal disease and IBD, in which one disease might alter the composition of the microbiota and increase the inflammatory response related to the other. However, we still need more data derived from human studies to confirm results from murine models. Thus, mechanistic studies are definitely warranted to clarify this possible bidirectional association.

The Clinical Effects of Allantoin Powder for Gargle on Periodontal Diseases and Aphthous Ulcer

A newly developed mouthrinse, Allantoin Powder for Gargle, was clinically investigated. The compound of this agent is mainly allantoin, which is believed easy to penetrate into gingival sulcus and periodontal pockets as well as other places (such as tongue, soft palate, etc.) where it is inconvenient to use medication, 219 patients with various diseases of oral cavity were investigated in the double blind randomlized placebo controlled study. It was observed that apparent efficient rates of the experimental mouthrinse on periodontitis and marginal gingivitis were 81.25% and 56.86% respectively; and the efficient rate of it on aphthous ulcer was 68.57%. The data show that this agent has effective as an adjuctive on the treatments of periodontal diseases and aphthous ulcer.

Influence of periodontitis and nonsurgical periodontal intervention on atherosclerosis diseases

Objective: Periodontitis and atherosclerosis diseases are chronic inflammatory disorders which are highly prevalent in populations. Nonsurgical periodontal intervention belongs to the initial therapy strategy to periodontal diseases. Periodontal pathogen can enter into blood stream through the ulceration epithelial resulting in bacteraemia when periodontitis is severe. The objective is to investigate the relationship between periodontitis and atherosclerosis diseases, and the influence of nonsurgical periodontal intervention on atheroma and atherosclerosis diseases. Methods: This study reviewed and analyzed the papers which published in the world associated with periodontitis or periodontal intervention on atherosclerosis diseases. Results: Periodontitis and periodontal infectious are important risk factors for atherosclerotic diseases. Much evidence has proved the durative severe periodontitis can result in bacteraemia and systemic inflammation, elevated C-response protein in serum, gingival microcirculation changed, periodontal microorganism reproduced, and endothelial dys-function and endocarditis. Nonsurgical periodontal intervention can remove the pathogenesis bacteria and calculus to recover periodontal health. Effective periodontal therapy can reduce bacteraemia and stop the hurt to vessels. Nonsurgical periodontal therapy may interfere periodontal bacteria, inhibit inflammation response and C-response protein, improving gingival microcirculation and vessel epithelial function to prevent atherosclerosis. Conclusion: Nonsurgical periodontal intervention can improve or decrease the rate of atherosclerotic disease by interfere the severe periodontitis. The detailed mechanism of periodontal intervention on atheroma and atherosclerotic disease is still need to be explored.

The Impact of Age and Gender on Severity and Types of Periodontal Diseases among Patients from Two Regions in Saudi Arabia

Background: Periodontitis is the predominant disease in the oral cavity and there are alterations in the periodontal tissues associated with the aging and gender of the patient. Objective: The present study was designed to assess the impact of age and gender of the patient on severity and types of periodontal diseases among patients from two regions in Saudi Arabia. Materials and Methods: The current study was done on 600 Saudi patients from Aseer and Tabuk regions in Saudi Arabia (50% males and 50% females) and divided into three equal groups (n = 200) according to the patients age: children and young patients (1 - 24 years old), adults patients (25 - 64 years old) and seniors patients (more than 65 years old). Plaque index (PLI), gingival index (GI), periodontal pocket depth (PPD) and clinical attachment loss (CAL) were recorded from all participants. The data were collected and analyzed with SPSS to determine the mean and standard deviation (±SD) and the values of significance (P ≤ 0.005). Results: The results of the present study revealed that 340 patients (56.7%) were affected with gingivitis dental biofilm induced and 260 patients were affected by periodontitis. Gingivitis dental biofilm-induced is especially detected in children and young patients (33.3%), adult patients (16.7%) and seniors patients (6.7%) whereas periodontitis cases were seen among the adult and seniors patients (16.7%) and (26.6%) respectively. Furthermore, the present study displayed the higher severity and prevalence of gingivitis dental biofilm-induced and periodontitis among females more than males in group II and group III maybe due to hormonal changes. The present study saw that there are statistically significant differences in clinical findings in the comparison between groups of this study (P ≤ 0.005). Conclusion: We conclude that there is a relation between severity and types of periodontal diseases and the ages and genders of Saudi patients in Aseer and Tabuk regions, Saudi Arabia.

Racial Differences Effects on Oral Health and Periodontal Diseases Extent, Staging and Grading among the Multi-Ethnic Expatriates in Aseer Region, Saudi Arabia

Background: Given the increase in the numbers of expatriates in Saudi Arabia and the shortage of information about expatriates’ oral health and periodontal disease severity and progression. Objectives: This study aimed to evaluate the effects of the racial differences on oral health and periodontal disease extent, staging, and grading among the multi-ethnic expatriates in the Aseer region, Saudi Arabia. Materials and Methods: This cross-sectional study was carried out on 300 expatriates in Aseer region, Saudi Arabia. They were divided into three equal racial different groups (n = 100), Arabs (AR), Asians (AS), and Africans (AF). The interviews of all participants were completed then the clinical examinations of periodontal diseases extent, staging, and grading parameters were performed. Statistical analysis was done by ANOVA test, Tukey’s test, and Chi-square test. The statistical significance level was determined at p < 0.05. Results: There were statistically significant differences in the comparison between the three ethnic/racial groups in clinical parameters except in GBI, PCR, FI, TFO, and BC, where there were no statistically significant differences in the comparison between the three ethnic/racial groups. There were differences associated with age, gender, smoking, and diabetes, without statistically significant differences among the three racial groups. Conclusion: We concluded that most participants in this study had a generalized severe grade 4 plaque-induced gingivitis and localized periodontitis stage III grade B.

Risks Factors of Caries and Periodontal Diseases in the Patients, after 5 Years Use a Partial Removable Denture

Objective: The goal of the removable partial denture is to restore impaired esthetics and masticatory function by replacing missing teeth. The aim of this study was to establish a possible correla-tion between removable partial denture in acrylic resin use after 5 years and dental diseases. Materials and Methods: Partially edentulous patients presenting for removable denture treatment at the Prosthodontics service of the Affiliated Hospital of Kinshasa University, Democratic Republic of Congo were assessed in this study. Patients were randomly assigned into 2 groups: Denture and non-denture group. Caries and periodontal diseases were compared between both groups. Statistical significance was set at p < 0.05. Results: The average age in the denture and non-denture-group was 53.15 (±SD 22.05) and 31.59 (±SD 11.98) years. Out of 160 teeth were decayed, both 110 teeth (68.75%) in the denture-group and 50 teeth (31.25%) in the non-denture group. The DMFT index calculated at start time of the study was 0.2 for both groups, after five years was 7.1 for the denture-group and 2.6 for the non-denture-group. The plaque index in the denture-group had an index of 1 and that of non-denture-group was 0.5. Conclusion: The relationship has been found between patients’ wearers a RPD and dental diseases.

Periodontal Diseases in Pregnant Women in Prenatal Consultation

Background: The relationship between pregnancy and periodontal health had well documented in the literature. Of many studies of periodontal diseases in the Democratic Republic of Congo, no study had evaluated these diseases in pregnant women during Prenatal Consultation (PC). This study aimed to describe the occurrence and clinical profile of periodontal diseases in pregnant women admitted to the PC at the General Military Hospital of BOBILA. Materials and Methods: It is a cross-sectional and analytical study of pregnant women admitted to the PC from August to December 31, 2018, at the General Reference Military Hospital of BOBILA/Kinshasa City. The data were collected through a survey combined with the stomatological interview. Sociodemographic data, clinical and periodontal indices included Oral Hygiene Index Simplified (OHI-S), Bleeding on Probing (BOP), and Periodontal Disease Index (PDI) were assessed. The statistical analyses were carried out using the SPSS version 20.0 software. The Chi-square tests, Student t-test were used to determine differences in the distribution of variables, and the odd Ratio with a confidence interval (IC) at 95% was used to estimate the degree of association. The results were significant at p < 0.05. Results: Of the 105 pregnant women received at the PC, 83 were included in this study. The age group between 20 - 29 was the most represented, with a predominance of stay-at-home mothers (75.9%) and married cases (73.4%), they had an average economic status (56.6%) and a secondary education level (63.8%). Gingival bleeding (44.6%) was the main complaint of the pregnant. Gestational age was a significant factor associated with gum bleeding (p < 0.005). Most of the pregnant had poor oral hygiene, localized gravidities (69.6%) during the third semester. Conclusion: A significant proportion of women had experienced periodontal diseases during the pregnancy period, mostly in the third trimester, and was associated with a gestational age of pregnant women.

Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The“BE-FIT-IBD”study

BACKGROUND The place regular physical activity(PA)should occupy in managing patients with inflammatory bowel diseases(IBD)is unclear.AIM To assess PA levels and barriers in a southern Italian IBD population.METHODS IBD patients with non-severe disease activity[assessed with partial Mayo score for ulcerative colitis(UC)and Harvey-Bradshaw index for Crohn’s disease]were approached to receive an anonymous online questionnaire to assess PA levels using the International Physical Activity Questionnaire(IPAQ)and to assess disease activity as patient-reported outcomes 2(PRO-2)and finally to assess habits,beliefs and barriers in conducting regular PA.Clinical,anthropometric and demographic data of patients were also collected.PA was expressed as continuous units of resting metabolic rate(Met)in min/wk.Three PA groups were identified:Inactive(<700 Met min/wk),sufficiently active(700-2500 Met min/wk)and health enhancing PA(HEPA)(i.e.,HEPA active,>2500 Met min/wk)patients.RESULTS Included patients(219)showed overall PA levels of 834.5 Met min/wk,with a large proportion(94,42.9%)classified as inactive while only a minority(9,4.1%)as health-enhancing PA.Patients without dyslipidaemia(P<0.0001)or on biologics therapy(P=0.022)showed better IPAQ scores in moderate activities.UC PRO-2 correlated negatively with IPAQ intense activities scores(τ=-0.156,P=0.038).PRO-2 did not show notable sensitivity/specificity in predicting IPAQ inactivity(AUC<0.6).IBD activity did not differ between active and inactive patients(P>0.05).Active patients expressed the need to discuss PA with their gastroenterologist.Some barriers(e.g.,diagnosis of IBD and fear of flare-ups after PA)are significantly more reported by inactive patients.CONCLUSION A significant rate of physical inactivity was recorded in this setting.IPAQ showed good feasibility.PA should be an element of discussion in IBD visits assessed quickly with non-invasive questionnaires.

Psychometrics of chronic liver disease questionnaire in Chinese chronic hepatitis B patients

AIM: To evaluate psychometrics of the Chinese (mainland) chronic liver disease questionnaire (CLDQ) in patients with chronic hepatitis B (CHB). METHODS: A cross-sectional sample of 460 Chinese patients with CHB was selected from the Outpatient Department of the Eighth Hospital of Xi'an, including CHB (CHB without cirrhosis) (n = 323) and CHB-related cirrhosis (n = 137). The psychometrics includes reliability, validity and sensitivity. Internal consistency reliability was measured using Cronbach's α. Convergent and discriminant validity was evaluated by item-scale correlation. Factorial validity was explored by principal component analysis with varimax rotation. Sensitivity was assessed using Cohen's effect size (ES), and independent sample t test between CHB and CHB-related cirrhosis groups and between alanine aminotransferase (ALT) normal and abnormal groups after stratifying the disease (CHB and CHB-related cirrhosis).RESULTS: Internal consistency reliability of the CLDQ was 0.83 (range: 0.65-0.90). Most of the hypothesized item-scale correlations were 0.40 or over, and all of such hypothesized correlations were higher than the alternative ones, indicating satisfactory convergent and discriminant validity. Six factors were extracted after varimax rotation from the 29 items of CLDQ. The eligible Cohen's ES with statistically significant independent sample t test was found in the overall CLDQ and abdominal, systematic, activity scales (CHB vs CHBrelated cirrhosis), and in the overall CLDQ and abdominal scale in the stratification of patients with CHB (ALT normal vs abnormal). CONCLUSION: The CLDQ has acceptable reliability, validity and sensitivity in Chinese (mainland) patients with CHB.

Relationship between vascular endothelium and periodontal disease in atherosclerotic lesions: Review article

Inflammation and endothelial dysfunction are linked to the pathogenesis of atherosclerotic disease. Recent studies suggest that periodontal infection and the ensuing increase in the levels of inflammatory markers may be associated with myocardial infarction, peripheral vascular disease and cerebrovascular disease. The present article aimed at reviewing contemporary data on the pathophysiology of vascular endothelium and its association with periodontitis in the scenario of cardiovascular disease.

MicroRNAs and immunity in periodontal health and disease

MicroRNAs(miRNAs) are critical regulators of the host immune and inflammatory response against bacterial pathogens. In the present review, we discuss target genes, target gene functions, the potential regulatory role of miRNAs in periodontal tissues, and the potential role of miRNAs as biomarkers and therapeutics. In periodontal disease, miRNAs exert control over all aspects of innate and adaptive immunity, including the functions of neutrophils, macrophages, dendritic cells and T and B cells. Previous human studies have highlighted some key miRNAs that are dysregulated in periodontitis patients. In the present study, we mapped the major miRNAs that were altered in our reproducible periodontitis mouse model relative to control animals. The miRNAs that were upregulated as a result of periodontal disease in both human and mouse studies included miR-15 a, miR-29 b, miR-125 a, miR-146 a,miR-148/148 a and miR-223, whereas miR-92 was downregulated. The association of individual miRNAs with unique aspects of periodontal disease and their stability in gingival crevicular fluid underscores their potential as markers for periodontal disease progression or healthy restitution. Moreover, miRNA therapeutics hold great promise for the future of periodontal therapy because of their ability to modulate the immune response to infection when applied in conjunction with synthetic antagomirs and/or relatively straightforward delivery strategies.

Translation and validation of the Greek chronic liver disease questionnaire

AIM:To translate into Greek and validate the chronic liver disease questionnaire (CLDQ).METHODS:Two hundred and six consecutive adult patients with the diagnosis of a chronic liver disease from 2 general hospitals in Athens were enrolled in the study from May to September 2008.In order to assess their quality of life (QOL) the CLDQ was applied.The instrument was translated from English,back translated and reviewed in focus groups within the framework of a large multicenter study.The measurements that were performed included:2 independent sample t tests,oneway analysis of variance,reliability coefficients,explanatory factor analysis using a varimax rotation and the principal components method.RESULTS:One hundred and twenty five (61%) patients were men,half were aged 40-59 years and > 33% were > 60 years old.Among the patients,48 (23%) were hospitalized and 97 (47%) were cirrhotic according to the Child-Pugh score.The internal consistency of the Greek CLDQ version using Cronbach's alpha coefficient was found to be 0.93.Exploratory factor analysis identified 7 domains accounting for 65% of the variance of CLDQ items and only partially overlapping with those found in the original version.The area under the receiver operating characteristics curve was calculated at 0.813 and the logistic estimate for the threshold score of 167.50 provided a sensitivity of 74.3% and a specificity of 71.6% for the model.CONCLUSION:Our data confirmed the validity of the Greek version of the CLDQ in identifying the QOL among patients with chronic liver disease.