Clinical Epidemiological Studies Research Articles

Open population approach to identify risk factors and detection of cases of heart failure in Mexico

Abstract Heart failure (HF) is one of the cardiovascular diseases that in recent years has been a cause of high morbidity and mortality, worldwide it is estimated that 2% of the population lives with this heart condition. However, Mexico, despite having a high incidence of diseases associated with the development of HF, there are no clinical-epidemiological studies of the pathology. The present project is an epidemiological study on HF carried out by the civil association with the aim of identifying risk factors (RF) associated with the clinic that allow early diagnosis as well as transmitting guidelines that can prevent the development of the disease and/or its complications in the open population (OP) of Mexico. Cardiological assessments were conducted in some states of Mexico as a pilot test of the model designed by SL called Latidos Fest (LF). Each site had the following activities like vital signs, cardiac assessment, electrocardiogram and if indicated, echocardiogram. Those who attended the assessment had to sign an informed consent form and at the end received a summary with indications according to the clinical-epidemiological findings. With the data obtained, an Excel database was created in which descriptive analyses were also performed. The statistical model Factor Analysis of Mixed Data (FAMD) was generated to identify quantitative and qualitative variables associated with the presence of HF and a classification tree model to establish the hierarchical value of the variables and their predictive value for the risk and detection of HF cases. For both statistical models RStudio software was used. A total of 949 cardiac evaluations in OP were performed thanks to the NGO of the LF in 7 different states of Mexico during 2022. In 68.1% of the population, at least 1 RF for developing HF was detected, 16.33% were identified as having HF with no previous diagnosis (PD), 0.74% already had a PD and 14.12% were apparently healthy. The demographic variables with the highest percentage are shown in table 1. From the FAMD model, the variables in which the individuals coincided most are shown in figure 1-A. When performing the classification trees, the overall prediction associated (OPA) to cases with and without HF was 75% confidence of which, the accuracy of classifying a case with HF was 67.4% and without HF was 82.2%; for the OPA for the risk of developing HF and not having HF the confidence was 82%, in this the accuracy of classifying without HF was 15%, however, the accuracy of classifying someone at risk of developing HF was 95.8% (Figure 1-B). Thanks to the cardiology assessments in OP that were performed in each LF, risk factors and new cases of HF were identified. With the findings in the models, it is possible to intentionally search for people with the factors found, however, it is necessary to expand the cardiological screening in other populations to check if the clinical-epidemiological parameters match or are different.Table 1.Percentage of demographic variaFigure 1.Results of the models. A. FAMD

Diagnostic Utility of Endocan and Interleukins for Late-Onset Neonatal Sepsis

Summary The aim of this study was to determine the potential of early inflammatory markers to diagnose late-onset neonatal sepsis – interleukin 6 (IL-6), interleukin 8 (IL-8) and endocan (ESM-1), and to compare them with routinely used markers like C-reactive protein (CRP) and procalcitonin (PCT). A prospective (January, 2022 – January, 2023) clinical-epidemiological study was conducted in a third level NICU in Pleven, Bulgaria. Patients with suspected nosocomial infection and healthy controls were tested. A sandwich ELISA method was used to measure the serum concentrations. Sixty newborns with an average gestational age of 29.75±3.61 gestational weeks were included, of which 35% were symptomatic and infected, 33.3% were symptomatic but uninfected, and 31.7% were asymptomatic controls. The mean values of PCT and IL-6 differ significantly in the three groups. For ESM-1, IL-8 and CRP, the difference was statistically insignificant. The best sensitivity (78%) and negative predictive value (84%) was found for IL-6. The introduction into routine practice of indicators such as PCT and IL-6 may provide an opportunity to promptly optimize the diagnostic and therapeutic approach to LOS.

Outbreak of nosocomial sepsis in NICU by multidrug-resistant Klebsiella pneumoniae: Diagnostic challenges

Purpose: Nosocomial infections are a serious problem in neonatal intensive care units (NICU) – they are one of the main causes of morbidity and mortality among preterm newborns. Material/methods: We present a prospective clinical-epidemiological study of an outbreak of 7 cases of culture-proven multidrug-resistant (MDR) Klebsiella pneumoniae late onset sepsis in a period of 2 months in a tertiary level NICU in Pleven, Bulgaria. The risk factors, early clinical presentation, laboratory changes, course of infection, treatment, and outcome were evaluated. Results: Three of our patients were term infants, the other four patients were preterm aged from 25 to 36 gestational weeks. The most possible routs of transmission of the infection were: venous lines, mechanical ventilation, tube feeding. Аll of the mentioned were present in one extremely immature patient. Early clinical signs included skin color changes, abnormal muscle tone, respiratory failure. Laboratory tests taken at the time of onset revealed leucopenia and/or thrombocytopenia in a half of the cases and usually C-reactive protein remained normal, but in all cases the I/T ratio increased significantly. The clinical course varied from fulminant deterioration to easily controlled condition. Treatment with Meropenem was started at the time of clinical suspicion of infection, according to the antibiogram of the first cases. No fatal outcome was observed. Conclusion: Main causes for the outbreak of hospital acquired infection were overcrowding of the NICU, admission of patients from lower-level hospitals, insufficient working staff, especially midwifes. The early diagnosis and proper antimicrobial treatment were crucial for the favorable outcome.

Mexican Americans agree to participate in longitudinal clinical research more than non-Hispanic whites

BackgroundThe National Institutes of Health has advocated for improved minority participation in clinical research, including clinical trials and observational epidemiologic studies since 1993. An understanding of Mexican Americans (MAs) participation in clinical research is important for tailoring recruitment strategies and enrollment techniques for MAs. However, contemporary data on MA participation in observational clinical stroke studies are rare. We examined differences between Mexican Americans (MAs) and non-Hispanic whites (NHWs) participation in a population-based stroke study.MethodsWe included 3,594 first ever stroke patients (57.7% MAs, 48.7% women, median [IQR] age 68 [58–79]) from the Brain Attack Surveillance in Corpus Christi Project, 2009–2020 in Texas, USA, who were approached and invited to participate in a structured baseline interview. We defined participation as completing a baseline interview by patient or proxy. We used log-binomial models adjusting for prespecified potential confounders to estimate prevalence ratios (PR) of participation comparing MAs with NHWs. We tested interactions of ethnicity with age or sex to examine potential effect modification in the ethnic differences in participation. We also included an interaction between year and ethnicity to examine ethnic-specific temporal trends in participation.ResultsBaseline participation was 77.0% in MAs and 64.2% in NHWs (Prevalence Ratio [PR] 1.20; 95% CI, 1.14–1.25). The ethnic difference remained after multivariable adjustment (1.17; 1.12–1.23), with no evidence of significant effect modification by age or sex (Pinteraction by age = 0.68, Pinteraction by sex = 0.83). Participation increased over time for both ethnic groups (Ptrend < 0.0001), but the differences in participation between MAs and NHWs remained significantly different throughout the 11-year time period.ConclusionMAs were persistently more likely to participate in a population-based stroke study in a predominantly MA community despite limited outreach efforts towards MAs during study enrollment. This finding holds hope for future research studies to be inclusive of the MA population.

Tobacco toxins induce osteoporosis through ferroptosis

Clinical epidemiological studies have confirmed that tobacco smoking disrupts bone homeostasis and is an independent risk factor for the development of osteoporosis. The low viability and inferior osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) are important etiologies of osteoporosis. However, few basic studies have elucidated the specific mechanisms that tobacco toxins devastated BMSCs and consequently induced or exacerbated osteoporosis. Herein, our clinical data showed the bone mineral density (BMD) values of femoral neck in smokers were significantly lower than non-smokers, meanwhile cigarette smoke extract (CSE) exposure led to a significant decrease of BMD in rats and dysfunction of rat BMSCs (rBMSCs). Transcriptomic analysis and phenotype experiments suggested that the ferroptosis pathway was significantly activated in CSE-treated rBMSCs. Accumulated intracellular reactive oxygen species activated AMPK signaling, furtherly promoted NCOA4-mediated ferritin-selective autophagic processes, increased labial iron pool and lipid peroxidation deposition, and ultimately led to ferroptosis in rBMSCs. Importantly, in vivo utilization of ferroptosis and ferritinophagy inhibitors significantly alleviated BMD loss in CSE-exposed rats. Our study innovatively reveals the key mechanism of smoking-related osteoporosis, and provides a possible route targeting on the perspective of BMSC ferroptosis for future prevention and treatment of smoking-related bone homeostasis imbalance.

Methods for measuring short-term geographical mobility used in infectious disease research: a scoping review protocol

IntroductionGeographical mobility, the movement of individuals or populations, may increase an individual’s risk of acquiring or transmitting infectious diseases, including HIV, tuberculosis, malaria and COVID-19. Many studies have collected information...

Air Pollution and Cardiac Diseases: A Review of Experimental Studies.

Air pollution is associated with around 6.5 million premature deaths annually, which are directly related to cardiovascular diseases, and the most dangerous atmospheric pollutants to health are as follows: NO2, SO2, CO, and PM. The mechanisms underlying the observed effects have not yet been clearly defined. This work aims to conduct a narrative review of experimental studies to provide a more comprehensive and multiperspective assessment of how the effect of atmospheric pollutants on cardiac activity can result in the development of cardiac diseases. For this purpose, a review was carried out in databases of experimental studies, excluding clinical trials, and epidemiological and simulation studies. After analyzing the available information, the existence of pathophysiological effects of the different pollutants on cardiac activity from exposure during both short-term and long-term is evident. This narrative review based on experimental studies is a basis for the development of recommendations for public health.

Ménière's disease and allergy: Epidemiology, pathogenesis, and therapy.

The etiology of Ménière's disease (MD) remains controversial. Allergies are potential extrinsic factors that, in conjunction with underlying intrinsic factors, may cause MD. The link between allergies and MD was first described in 1923. For nearly a century, studies have demonstrated a possible link between allergies and MD, even though a causal relationship has not been definitively determined. Previous reviews have mainly focused on clinical epidemiology studies of patients. In this review, we shed light on the association between allergies and MD not only in terms of its epidemiology, but also from an immunology, pathophysiology, and immunotherapy perspective in both patients and animal models. Patients with MD tend to have a high risk of comorbid allergies or an allergy history, showing positive allergy immunology characteristics. Other MD-related diseases, such as migraine, may also interact with allergies. Allergy mediators such as IgE may worsen the symptoms of MD. Deposits of IgE in the vestibular end organs indicate the ability of the inner ear to participate in immune reactions. Allergic challenges can induce vertigo in animals and humans. Anti-allergy therapy plays a positive role in patients with MD and animal models of endolymphatic hydrops.

Communicating and understanding statistical measures when quantifying the between-group difference in competing risks.

Competing risks issues are common in clinical trials and epidemiological studies for patients in follow-up who may experience a variety of possible outcomes. Under such competing risks, two hazard-based statistical methods, cause-specific hazard (CSH) and subdistribution hazard (SDH), are frequently used to assess treatment effects among groups. However, the outcomes of the CSH-based and SDH-based methods have a close connection with the proportional hazards (CSH or SDH) assumption and may have an non-intuitive interpretation. Recently, restricted mean time lost (RMTL) has been used as an alternative summary measure for analysing competing risks, due to its clinical interpretability and robustness to the proportional hazards assumption. Considering the above approaches, we summarize the differences between hazard-based and RMTL-based methods from the aspects of practical interpretation, proportional hazards model assumption and the selection of restricted time points, and propose corresponding suggestions for the analysis of between-group differences under competing risks. Moreover, an R package 'cRMTL' and corresponding step-by-step guidance are available to help users for applying these approaches.

Early Diagnostic Markers of Late-Onset Neonatal Sepsis.

Early diagnosis of nosocomial infections in newborns is a great challenge, because in the initial phase of systemic infection, clinical symptoms are often non-specific, and routinely used hematological markers are not sufficiently informative. The aim of this study was to determine the potential of early inflammatory markers to diagnose late-onset neonatal sepsis-procalcitonin (PCT), interleukin 6 (IL-6), interleukin 8 (IL-8) and endocan (ESM-1). A prospective clinical-epidemiological study was conducted in a third-level NICU in Pleven, Bulgaria. Patients with suspected late-onset sepsis and healthy controls were tested. A sandwich ELISA method was used to measure the serum concentrations of biomarkers. Sixty newborns were included, of which 35% symptomatic and infected, 33.3% symptomatic but uninfected and 31.7% asymptomatic controls. The mean values of PCT, IL-6, I/T index and PLT differ significantly in the three groups. For ESM-1, IL-8 and CRP, the difference was statistically insignificant. The best sensitivity (78%) and negative predictive value (84%) was found for IL-6. The combinations of PCT + IL-6 and PCT + IL-6+ I/T+ PLT showed very good diagnostic potential. The introduction into the routine practice of indicators such as PCT and IL-6 may provide an opportunity to promptly optimize the diagnostic and therapeutic approach to LOS.

Iron deficiency in myocardial ischaemia: molecular mechanisms and therapeutic perspectives.

Systemic iron deficiency (SID), even in the absence of anaemia, worsens the prognosis and increases mortality in heart failure (HF). Recent clinical-epidemiological studies, however, have shown that a myocardial iron deficiency (MID) is frequently present in cases of severe HF, even in the absence of SID and without anaemia. In addition, experimental studies have shown a poor correlation between the state of systemic and myocardial iron. MID in animal models leads to severe mitochondrial dysfunction, alterations of mitophagy, and mitochondrial biogenesis, with profound alterations in cardiac mechanics and the occurrence of a fatal cardiomyopathy, all effects prevented by intravenous administration of iron. This shifts the focus to the myocardial state of iron, in the absence of anaemia, as an important factor in prognostic worsening and mortality in HF. There is now epidemiological evidence that SID worsens prognosis and mortality also in patients with acute and chronic coronary heart disease and experimental evidence that MID aggravates acute myocardial ischaemia as well as post-ischaemic remodelling. Intravenous administration of ferric carboxymaltose (FCM) or ferric dextrane improves post-ischaemic adverse remodelling. We here review such evidence, propose that MID worsens ischaemia/reperfusion injury, and discuss possible molecular mechanisms, such as chronic hyperactivation of HIF1-α, exacerbation of cytosolic and mitochondrial calcium overload, amplified increase of mitochondrial [NADH]/[NAD+] ratio, and depletion of energy status and NAD+ content with inhibition of sirtuin 1-3 activity. Such evidence now portrays iron metabolism as a core factor not only in HF but also in myocardial ischaemia.

Comparing the FDA's process for health claim submission and the FFC's guidelines for regulating functional foods

Health claims are essential for providing accurate information about the relationship between nutrients and health outcomes to consumers. They facilitate informed decision-making and support individuals in making healthy dietary choices. The U.S. Food and Drug Administration (FDA) regulates health claims to guide consumers in maintaining healthy dietary practices. Health claims on food labels help consumers understand the potential health benefits associated with specific products and make informed choices aligned with their health goals. These claims also promote transparency and trust in the food industry by providing evidence-based information. The process of submitting a health claim to the FDA involves complying with regulatory requirements and providing robust scientific evidence. Scientific evidence plays a crucial role in substantiating health claims and should be based on well-designed clinical trials, epidemiological studies, and mechanistic research. Adhering to FDA labeling requirements ensures the accurate and informative presentation of health claims on food labels. The Functional Food Center (FFC) is working on theoretical aspects of creating ideal functional food (FF) products as well as how these products should be identified with special FF labels. While the FDA focuses on evaluating health claims, the FFC emphasizes the safe and effective use of functional foods. Understanding the FDA's evaluation process and the FFC's guidelines is crucial for researchers, food manufacturers, and policymakers to navigate the regulatory landscape and promote informed consumer choices. Compliance with regulatory guidelines, adherence to scientific standards, and clear communication of health claims contribute to a more informed and health-conscious society.Keywords: Health claims, health outcomes, regulatory requirements, functional foods, health benefits

NFDI4Health Local Data Hubs for Finding and Accessing Health Data

To support federated data structuring and sharing for sensitive health data from clinical trial, epidemiological and public health studies in the context of the German National Research Data Infrastructure for Personal Health Data (NFDI4Health), we have developed Local Data Hubs (LDHs) based on the FAIRDOM-SEEK platform. Those LDHs connect to the German Central Health Study Hub (CSH) to make the health data searchable and findable. This decentralised approach supports researchers to make health studies with their data FAIR (Findable, Accessible, Interoperable and Reusable), and at the same time fully preserves data protection for sensitive data.

Distributed Privacy-Preserving Data Analysis in NFDI4Health With the Personal Health Train

Data sharing is often met with resistance in medicine and healthcare, due to the sensitive nature and heterogeneous characteristics of health data. The lack of standardization and semantics further exacerbate the problems of data fragments and data silos, which makes data analytics challenging. NFDI4Health aims to develop a data infrastructure for personalized medicine and health research and to make data generated in clinical trials, epidemiological, and public health studies FAIR (Findable, Accessible, Interoperable, and Reusable). Since this research data infrastructure is distributed over various partners contributing to their data, the Personal Health Train (PHT) complements this infrastructure by providing a required analytics infrastructure considering the distribution of data collections. Our research have demonstrated the capability of conducting data analysis on sensitive data in various formats distributed across multiple institutions and shown great potential to facilitate medical and health research.

Fructosamine is Not a Reliable Test for the Detection of Hyperglycemia: Insight from the Africans in America Study.

To improve detection of abnormal glucose tolerance (Abnl-GT), attention has moved beyond the oral glucose tolerance test (OGTT), to non-fasting markers of glycemia, specifically, HbA1c, fructosamine (FA) and glycated albumin (GA). Emerging data suggest that in African descent populations, the combination of HbA1c and GA is superior to the combination of HbA1c and FA. However, the diagnosis of Abnl-GT is usually based on tests which are performed only once. As reproducibility of Abnl-GT diagnosis by HbA1c, fructosamine (FA) and glycated albumin (GA) is unknown, reproducibility of Abnl-GT diagnosis by HbA1c, FA and GA were assessed in 209 African-born Blacks living in America. At Visits 1 and 2 (9 ± 4 days apart), samples were obtained for HbA1c, FA and GA levels. Glucose tolerance status was determined at Visit 1 by OGTT. Reproducibility was based on the К-statistic and paired t-tests. Thresholds for the diagnosis of Abnl-GT by FA and GA which corresponded to an HbA1c of 5.7% were 235umol/L and 14.6%, respectively. Abnl-GT occurred in 38% (80/209). Diagnostic reproducibility was excellent for HbA1c (К≥0.86) and GA (К≥0.89), but only moderate for FA (К=0.59). Neither HbA1c nor GA levels varied between visits (both P≥0.3). In contrast, FA was significantly lower at Visit 2 than Visit 1(P<0.01). As HbA1c and GA provided similar diagnostic results on different days and FA did not, HbA1C and GA are superior to FA in both clinical care settings and epidemiologic studies.

The Intersection Between COVID-19, Cardiovascular Disease, and Diet: a Review.

Cardiovascular disease (CVD) is one of the top comorbidities associated with COVID-19-both pre- and post-infection. This review examines the relationships between COVID-19 infection and cardiovascular health, with a specific focus on diet as an important modifiable risk factor. Pandemic era studies of individuals battling and recovering from COVID-19 infection suggest a strong link between metabolic diseases, such as CVD, and SARS-CoV-2 infection susceptibility and severity. Other studies also demonstrate how COVID-19 lockdown policies and quarantine recommendations led to drastic lifestyle changes associated with increased CVD risk, such as reduced physical activity and lower diet quality. At the same time, new research is emerging that plant-based diets, which have previously been associated with lower CVD risk, may lower COVID-19 infection rates and severity of symptoms. Diet, COVID-19, and CVD intersect through complex biological mechanisms and related behavioral factors evidenced by clinical trials and epidemiological studies. Diet may be a critical tool for modifying risk of communicable and non-communicable conditions in the post-pandemic world.

Hypopharyngeal cancer trends in a high-incidence region: A retrospective tertiary single center study.

Hypopharyngeal cancer has the bleakest prognosis among head and neck cancers due to its extensive submucosal involvement, advanced tumor stage, and limited surgical reconstruction options. Its primary causes include alcohol consumption, tobacco use, genetic predisposition, 1` diet, and socioeconomic conditions. While squamous cell carcinoma (SCC) accounts for 95% of hypopharyngeal tumors, it remains a rare form, comprising only 3%-5% of all SCC cases in the head and neck region. Globally, Central and Eastern Europe have the highest incidence rates for males (3.9 per 100000) and the third highest for females (2.26 per 100000), underscoring the significance of this seemingly uncommon condition. In Romania, hypopharyngeal cancer ranked 24th in incidence rate, with 634 new cases in 2020. To study the incidence, treatment and survival rates of hypopharyngeal tumor cases in a major ear, nose, throat (ENT) surgical center. A retrospective epidemiological clinical study was conducted on patients diagnosed and treated for hypopharyngeal cancer at the ENT department of "Carol Davila Central University Emergency Military Hospital" in Bucharest between January 2018 and August 2022. The study included 53 patients and was authorized by the Ethics Committee of Titu Maiorescu Doctoral School (Bucharest, Romania) and the Ethics Committee of Carol Davila Central University Emergency Military Hospital (Bucharest, Romania). Inclusion criteria required a positive histopathological diagnosis of hypopharyngeal cancer, tumor localization in the hypopharyngeal region, and informed consent for data usage. Exclusion criteria involved major psychiatric pathologies and disagreement for data usage. Diagnosis was based on ENT assessment, imaging reports, and laboratory data. Treatment methods were determined based on various factors. Additional tools, such as Adult Comorbidity Evaluation-27 and Karnofski Performance Status Scale, were used for risk assessment and functional capacity evaluation. Quality of life aspects were measured using the European Organisation for Reasearch and Treatment of Cancer Quality of Life Questionnaire Head and Neck-35 questionnaire. Our retrospective study examined 53 patients with hypopharyngeal cancer between January 2018 and August 2022. The majority of patients were male (94.3%), with an average age at diagnosis of 62.5 years. Among the patients, 20.75% were employed, 66.03% were retired, and 9.43% were unemployed. Smoking was prevalent among 69.81% of patients, while alcohol consumption was frequent in 32.07% of cases. The tumors were mostly diagnosed at an advanced stage (stage IV) and were predominantly SCC. Comorbidities were present in 83.01% of patients, with cardiovascular diseases being the most common. Dysphagia and neck mass were the most common symptoms reported. Treatment methods included surgery, radiation therapy, and chemotherapy. A favorable treatment response was observed in 22.64% of cases, while relapse occurred in 6 cases. Follow-up data was unavailable for some patients. In summary, our findings align with existing literature; however, we observed a higher severity.

Management of Coronary Artery Disease in Older Adults: Recent Advances and Gaps in Evidence.

Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors. Recent randomized clinical trials and epidemiological studies have provided new data on optimal management of complex patients with CAD. However, frail older adults are still underrepresented in the literature. This narrative review aims to highlight the importance of assessing frailty as an aid to guide therapeutic decision-making and tailor CAD management to the specific needs of older adults, taking into account age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and potential drug interactions. We also discuss gaps in the evidence and offer perspectives on how best in the future to optimize the global strategy of CAD management in older adults.

COMPARING THE FREQUENCY OF MANIFESTATION OF HYPERDONTIA AND HYPODONTIA

Introduction: Hypodontia and hyperdontia are two dental phenomena with deviations in the number of teeth - reduction and increase of tooth germs. The aim of the study is to compare the frequency of manifestation of hyperdontia and hypodontia, their distribution by tooth groups among Bulgarian orthodontic patients. Materials and methods: The prospective clinical-epidemiological study covered 2676 patients: 1705 (63.7%) female and 971 (36.3%) male. They were detected and diagnostically proven with supernumerary and missing teeth. The findings were distributed according to their localization to make a comparative analysis. Results: The patients established with hypodontia were 5.79% with average age of 15.17±5.34 years, and hyperdontia in 3.13% of patients with average age of 11.80±4.65 years. Statistically credible, hyperdontia was more frequently observed in males, while hypodontia was significantly more frequently observed in females. The hypodontia was the most commonly observed in the mandibular distal segment - second premolars (46.5%), next affected was the maxillary lateral (37.4%), followed by the maxillary distal segment (32.3%), and the least was the mandibular frontal segment (12.9%). The supernumerary teeth found in the maxillary frontal segment were incisors and mesiodens (91%) compared to the maxillary distal segment (9%) was significant. In the mandible, the difference between the frontal (42.3%) and distal segment (57.7%) was without statistical significance. Conclusions: Knowledge of the clinical characteristics of hypodontia and hyperdontia are important for targeted early diagnosis and treatment. Both of these specific problems have an effect on an individual's function and psychosocial well-being.

Chronic Mg2+ Deficiency Does Not Impair Insulin Secretion in Mice.

Magnesium is an essential mediator of a vast number of critical enzymatic cellular reactions in the human body. Some clinical epidemiological studies suggest that hypomagnesemia accounts for declines in insulin secretion in patients with type 2 diabetes (T2D); however, the results of various experimental studies do not support this notion. To address this discrepancy, we assessed the short- and long-term effects of hypomagnesemia on β-cell function and insulin secretion in primary mouse islets of Langerhans and in a mouse model of hypomagnesemia known as Trpm6Δ17 /fl;Villin1-Cre mice. We found that lowering the extracellular Mg2+ concentration from 1.2 mM to either 0.6 or 0.1 mM remarkably increased glucose-induced insulin secretion (GIIS) in primary islets isolated from C57BL/6 mice. Similarly, both the plasma insulin levels and GIIS rose in isolated islets of Trpm6Δ17 /fl;Villin1-Cre mice. We attribute these rises to augmented increases in intracellular Ca2+ oscillations in pancreatic β-cells. However, the glycemic metabolic profile was not impaired in Trpm6Δ17 /fl;Villin1-Cre mice, suggesting that chronic hypomagnesemia does not lead to insulin resistance. Collectively, the results of this study suggest that neither acute nor chronic Mg2+ deficiency suppresses glucose-induced rises in insulin secretion. Even though hypomagnesemia can be symptomatic of T2D, such deficiency may not account for declines in insulin release in this disease.