2 articles
Dental caries is one of the most widespread diseases in the human population, and the causes of increased susceptibility to dental caries remain of continuing interest to researchers. Active immunological components of oral fluid significantly influence the evolution of dental caries. The aim of this research is to study the relationship between zinc levels, the antimicrobial peptide LL-37, and transforming growth factor beta-1 in oral fluid, and the incidence of dental caries in children.
In this observational cohort study, 398 children aged between 3 and 15 years were clinically examined. The research group included 132 children with dental caries, and the control group consisted of 266 caries-free children. The Plaque Index (PI) and caries experience indices were evaluated. Caries risk was assessed using the Cariogram software. The levels of zinc, the antimicrobial peptide LL-37, and transforming growth factor beta-1 in oral fluid were determined using standard EliTeh kits, in accordance with the manufacturer’s recommendations. The study was conducted in compliance with ethical standards and with written informed consent obtained from the children's parents. Data were processed automatically using the open-source software RStudio, version 2024.09.1+394.
In children from the research group, a significant decrease in the levels of zinc, the antimicrobial peptide LL-37, and transforming growth factor beta-1 was detected in oral fluid, showing an inverse relationship with caries morbidity indicators.
Significantly decreased levels of zinc, the antimicrobial peptide LL-37 and transforming growth factor beta-1 in oral fluid of caries-susceptible children may indicate an increased risk of caries. Low levels of zinc, the antimicrobial peptide LL-37, and transforming growth factor beta-1 in oral fluid may also serve as indicators of rapid progression of dental caries – a fact that should be taken into account when planning individualized preventive measures.
Multiple sclerosis is an autoimmune disease characterized by chronic inflammation with progressive demyelination and axonal dysfunction. The disease affects about 1 million young adults, 2/3 of which are women of childbearing age, with all patients developing irreversible neurological dysfunction. There is observed a stagnation of the disease during pregnancy, with the return of exacerbations in the postpartum period. Contemporary specialty textbooks neither confirm nor deny the safety of neuraxial anesthesia in patients with central nervous system diseases.
We present the clinical case of a 25-year-old nullipara pregnant (36 weeks and 6 days gestation age), known with relapsing-remitting multiple sclerosis and epilepsy. The woman has relapsing multiple sclerosis symptoms during the last 6 days, reason why is urgently consulted by the anesthesiologist for cesarean delivery.
The article describes the technique of epidural anesthesia for the obstetrical patient with multiple sclerosis and the course of the perianesthetic evolution, including 1-year follow-up after cesarean section.
With the aim of avoiding potential influences on the evolution and progression of the disease, clinical judgment and the choice of anesthetic technique (general vs. neuraxial) depends on several factors: vaginal delivery or caesarean section, the presence of contextual clinical modifiers (native or drug-induced coagulopathy, infection), the urgency of the intervention, and the patient’s cooperation. In case of parturients with multiple sclerosis, all the risks should be rigorously evaluated: on one hand - the additional risk of general anesthesia (risk of aspiration, potential loss of airway control, critical desaturations) and on the other hand - the risk of hypothetical local anesthetic toxicity in the case of neuraxial techniques.
Neuraxial epidural anesthesia is a safe technique in obstetric patients with multiple sclerosis.