The correlation between masticatory performance and satisfaction with oral health: a pilot study

The purpose of this study was to determine the correlation between masticatory function,
subjects’ perception of oral health and subjects’ perception of chewing ability. The
studied population comprised twenty subjects randomly selected from the patient files of
the University of Groningen Dental School.
They were asked to chew a two-colored wax tablet and the mixing index was determined.
Subjects’ perception of oral health was measured by means of the Oral Health Impact
Profile-14 (OHIP-14NL). In addition, subjects’ perception of chewing ability was rated
using a continuous scale ranging from 1 (very poor) to 10 (outstanding). Spearmans’
correlation coefficient was used to test the relationship between the mixing index,
subjective assessment of chewing ability and scores of the OHIP-14NL. Moderate,
significant correlations were found between the mean Mixing Index score and the
assessment of the chewing ability (Spearman’s Rho=-0.5, P=0.03), between the
assessment of the chewing ability and the OHIP-NL14 (Spearman’s Rho=-0.5, P=0.02)
and between the Mixing Index and the OHIP-NL14 (Spearman’s Rho=0.5, P=0.02).

Posted in Thesis | Tagged | Leave a comment

Biosfonaten en het ontstaan van osteonecrose : een Systematic Review

Background:
Bisphosphonate-related osteonecrosis is a complication in long-term
intravenous bisphosphonate use.
Objective: In this article the risk of developing osteonecrosis is reviewed, along with
de most important risk factors in de development of osteonecrosis and the
developing time of osteonecrosis.
Methods:
Relative articles are identified by searching the databases ‘Scopus’ and
‘Pubmed’.
Results/conclusion:
Bisphosphonate related osteonecrosis is a condition that is
thought to be related to the long-term administration of primarily intravenous
bisphosphonates in cancer patients. Various risk-factors are related to the
development of osteonecrosis of the jaw, for example the type of bisphosphonates
that are administered, undergoing an extraction or oral surgery, and the presence of
other oral manifestations. Further investigation is needed to decide if other
factors have influence in the development of osteonecrosis. The course of treatment
is thought to be the most important factor in the development of osteonecrosis.
In the administration of zoledronate the development of osteonecrosis can be
expected in a matter of months, whereas in the administration of pamidronate this
will be a matter of years.
Prior to the onset of the bisphosphonate treatment, the patient will be referred to
a specialist for a full oral examination. The focus will be on detecting any possible
future inflammation site, and remove it. This way, the need for (invasive) dental
treatment during bisphosphonate therapy will be restricted to a minimum.

Posted in Thesis | Tagged | Leave a comment

Biologische Breedte : Het valideren van een methode om, met behulp van een op de bite-wing foto te projecterenstandaard vlak, een betrouwbare indicatie van de biologische breedte aan de mesiale en distale zijde van een eerste molaar te verkrijgen

Introduction/aim of the study:
The reason for undertaking the present study is the difficulty
to map the biological width with the present method of measurement. This study aims to
find a method to give a reliable indication of the biological width on the mesial and distal
side of a first molar and to validate this by use of a standard square projected on a bite-wing
photo.
Material and method:
two bite-wing photos are made of each first molar of dry teethed
skulls to analyze these for a test-retest procedure. In total there are 48 bite-wing photos of
24 elements to be assessed. Two squares are projected on each element from the bone
comb towards the occlusale surface. One square indicates the estimated actual biological
width and is calculated using the magnification of the photo. The other square indicates the
standard indicative square in which an average has been used of all the bite-wing photo’s
that are made. By use of this method it is possible to indicate the difference between the
two squares. A clinical relevant difference of 0,3mm was chosen. The data has been
collected and entered into a codebook. Statistical tests (reliability interval, an intraclass
correlation coefficient and at-test) were performed using SPSS.
Results:
The reliability interval lies between 1,98 and 2,07mm. The indicative standard
square in the mandible is in 87% of cases bigger than 2,00mm and in the maxilla in 86%
smaller than 2mm. The found intraclass correlation coefficient is 0,7 and the similarity
between first and second bite-wing photo is adequate to good. The smallest detectable error
is O,lSmm. This is well below the clinically relevant difference, and therefore acceptable.
Discussion: The found difference between the maxilla and the mandible may be caused by
anatomical factors. Furthermore, there are many recommendations for further research.
Conclusion:
The method is suitable to give the biological width on mesial and distal side of a
first molar, by use of the bite-wing photo. It is important to conduct further investigation to
map the effective usability and expansion of a possible computer product.

Posted in Thesis | Tagged | Leave a comment

Mechanoreceptieve eigenschappen van tong en palatum.

Introduction:
The palate and the tongue are innervated in different ways. This could indicate various
mechanoreceptive qualities and particularly various types of pressure-sensibility within these
structures. Research shows that this sensibility is not spread out in a uniform manner on the surface
of tongue nor palate. However, a definitive approach of mechanoreceptive sensibility in terms of
quality and quantity is still missing. The purpose of this research accordingly is to gain more insight in
the mechanoreceptive qualities of the tongue and the palate.
Materials and methods: Twelve
subjects have been orally probed, using the Semmes and Weinstein filament test, to further specify
the sensory characteristics of the tongue and the palate. Hereby including the notion of possible
different threshold values on different regions on the tongue and the palate. Various diametres are
used for the filaments.
Results:
Significant differences in pressure-sensibility are found between the
tong and the palate. The tip of the tongue appears to be the most sensitive location. Also
asymmetries are found on the tong and the palate. The front part of the palate is less sensitive than
the other regions. Moreover, the left side of the tongue appears to be more sensitive for pressure
than the right side.
Conclusion: The tongue has a higher pressure-sensibility than the palate. This
indicates that the tongue’s mechanoreceptive qualities play a more important role in someone’s
perception of taste and texture than the palate’s, in particular the tip of the tongue.

Posted in Thesis | Tagged | Leave a comment

Lokale hemostatica binnen de tandheelkunde : Toegepast bij patienten met gecontinueerde antistollingstherapie

Background:
Current concepts in dentistry state that patients with anticoagulant
therapy, no longer discontinue their medication, previous to invasive dental
procedures. This is based on the findings that the risk for tromboembolic events
caused by (temporarily) discontinuation of anticoagulant medication outweighs the
risk for bleeding complications when the medication is continued. To prevent
bleeding complications, topical hemostatic agents can be used. Collagen, oxidized
cellulose, gelatin, fibrin glue, cyanoacrylate glues en chitosan are known hemostatic
agents. The use of local hemostatics has been reported in several surgical fields,
however there is no review of their application in dentistry.
Methods:
With the use of a PICO, a systematic search was performed in the
international literature. Used databases included EMBASE, PubMed and the
Cochrane Library. The search period ranged from 1966 to 201 0, only articles written
in English and Dutch language were included. The studies included patients with
anticoagulant therapy who underwent invasive dental procedures and were treated
with topical hemostatics. The study selection contains 25 articles and consists of
reviews, ACT’s, CCT’s and case-series, published between 1989 and 2010.
Results:
Since heterogenity existed between studies, the possibility of pooling was
limited. The fewest bleeding complications were reported after use of tranexamic
acid. Oxidized cellulose, gelatin and fibrin glue seem to be equally effective in
preventing bleeding complications. Chitosan looks a promising substance, however
more research after its properties is required. In cases where no hemostatic agent
was applied, 18o/o suffered from post-operative bleeding complications.
Discussion:
The extent of the current study is limited. A comparison between different
local hemostatic modalities is difficult to make and requires further research. Manual
usability and cost aspects have not been taken into account in this study.
Conclusion:
Tranexamic acid seems to be the best hemostatic agent to use in
patients who continue their anticoagulant medication and undergo invasive dental
procedures.

Posted in Thesis | Tagged | Leave a comment

Tandje Hoger? : onderzoek naar de kennis en attitude van de specialist ouderengeneeskunde over de mondzorg bij vepleeghuisbewoners

Aim:
The aim of this study was to evaluate the knowledge and attitude of geriatrics
concerning dental healthcare of residents of a nursing home.
Materials and Methods:
Through Verenso a questionnaire circulated among
specialists in geriatric medicine. The questionnaire contained 17 questions about
knowledge, inclusion criteria was 13 correct answers. Data concerning attitude were
performed using explorative factor analysis and reliability analysis. In addition, for
both knowledge and attitude has been looked at the significance of a number of
independent variable, for example man/wife, using the Mann Whitney test (p=0,05).
Results: Through the newsletter of Verenso 1162 specialist in geriatric medicine were
asked to fill in a questionnaire. The outcome was that 47 questionnaires returned.
Respondents find, through the priority they give to the subject, oral health for elderly
in nursing homes important.
Conclusion:
On the basis of this study it is shown that the knowledge of geriatrics
about the influence of (bad) oral health on overall health is sufficient. However the
overall knowledge of oral health by elderly is insufficient. A majority of the
respondents consider it important that the coming year changes regarding the dental
care of nursing home residents take place. And that the issue becomes higher on the
agenda within the profession.
Keywords: Oral health, specialist in geriatric medicine, nursing home, knowledge,
attitude.

Posted in Thesis | Tagged | Leave a comment

Microbiologische evaluatie van het gebruik van een chloorhexidine spoelmiddel tijdens de chirurische behandeling van peri-implantitis

Introduction
The number of implants used in dental clinics is continuously increasing. Since periimplantitis
is known as a frequently occurring complication, there is an urgent need for a
reliable treatment. Surgical exploration in combination with mechanical scaling of the dental
implant surface and chemical decontamination with a chlorhexidine solution is often used for
the treatment of peri-implantitis. No evidence is available for which could be an effective
treatment for peri-implantitis. The goal of this study is to examine the clinical effect of the
use of a 0.12% chlorhexidine + 0.05% CPC solution during surgical treatment of periimplantitis
in comparison with rinsing the implant surface with a placebo solution.
Methods
In this clinical study 30 patients participated. The patients were randomly assigned to a test
group and a control group. All patient received apically positioned flap surgery followed by
mechanical scaling and rinsing with a 0.12% chlorhexidine + 0,05% CPC {Perio-aid®) solution
{test group) or a placebo solution {control group). A microbiologic sample was taken at 4
moments; at baseline {TO), at two moments during surgery: before {Tvoor) and after {Tna)
mechanical and chemical cleaning, and 3 months after surgical treatment {T3). The Mann
Whitney U Test and de Wilcoxen Signed Rank Test were used to analyze continuous variables
{total detectable bacterial load). The Chi Square Test en de Me Nemar Test were used to
analyze dichotome variables {frequency of detection of para-pathogens).
Results
Both the control group and the test group consisted of 15 patients. The control group
consisted of 48 dental implants with peri-implantitis and the test group of 31 dental
implants. At baseline {TO) no significant differences were observed between both groups.
Analyzing the microbiological composition of the biofilm of the dental implant surface both
the treatment for the control and the test group showed a significant positive effect (p <
0.001). The results of the test group at T3 were significantly better than the control group (p
< 0.05}. Analyzing the microbiological composition of the peri-implant sulcus gave at TO and
T3 no significant differences.
Conclusion
A short-term significant positive effect is observable for rinsing the implant surface with a
0.12% chlorhexidine + 0.05% CPC solution {Perio-aid®) during surgical treatment of periimplantitis
compared to rinsing the implant surface with a placebo solution. Three months
after treatment no significant effect is observable. It is not clear whether this microbiological
effect will lead to better clinical results in peri-implantitis treatment.

Posted in Thesis | Tagged | Leave a comment

The accuracy of the digital Lava COS scanner for tooth width measurements in Orthodontics : A Pilot Study

Introduction: The purpose of this pilot-study was to determine the accuracy of the Lava COS
scanner. This was done by comparison of the results of tooth width measurements for Bolton
analyses obtained by digital Lava COS models and Digimodel. These measurements were
compared with measurements made on the plaster models (golden standard).
Methods: Two alginate impressions of both arches of 10 patients were taken; one was used to
make the conventional plaster model, the other to scan and produce the DigiModel. With the
Lava COS scanner an additional digital model was made. The mesio-distal widths of these
three models were measured to the nearest 0. 01 mm by three different examiners.
Reproducibility was assessed with the Intraclass Correlation Coefficient. The difference
between the methods was calculated, and a paired samples t-test was used to analyze the data.
Also the scanning time of the Lava Cos was recorded.
Results: The Intraclass Correlation Coefficient values all exceeded 0.75, demonstrating a
good interobserver correlation. The average difference of the tooth width between
measurements of the DigiModel and the plaster models was 0.004 mm, and for the Lava COS
model it was 0.04 mm. Most of the mean differences in tooth-size measurements were not
statistically significant (P>0.05).
The difference in Anterior Bolton Ratio was statistically not significant, for both the Lava
COS model as well as the DigiModel. But the differences in the Overall Bolton Ratio were
statistically significant; however comparison of absolute measurements of Overall Bolton
Discrepancies showed no statistical difference and these were considered not to be clinically
significant.
The average time needed to scan a patient with the Lava COS was 27.3 minutes. The last
measurement took 18 minutes. The fastest scan took 14 minutes. Since there was a learning
curve, at the end the needed scanning time seems practically comparable the time needed to
make two alginate impressions.
Conclusion: It appears that the Lava COS scanner is an accurate, reproducible and efficient
method for recording, storing and measuring dental study models that eventually may replace
the use of conventional plaster models and Digimodels in Orthodontics.

Posted in Thesis | Tagged | Leave a comment

The accuracy of the digital Lava COS scanner for tooth width measurements in Orthodontics : A Pilot Study

Introduction: The purpose of this pilot-study was to determine the accuracy of the Lava COS
scanner. This was done by comparison of the results of tooth width measurements for Bolton
analyses obtained by digital Lava COS models and Digimodel. These measurements were
compared with measurements made on the plaster models (golden standard).
Methods: Two alginate impressions of both arches of 10 patients were taken; one was used to
make the conventional plaster model, the other to scan and produce the DigiModel. With the
Lava COS scanner an additional digital model was made. The mesio-distal widths of these
three models were measured to the nearest 0. 01 mm by three different examiners.
Reproducibility was assessed with the Intraclass Correlation Coefficient. The difference
between the methods was calculated, and a paired samples t-test was used to analyze the data.
Also the scanning time of the Lava Cos was recorded.
Results: The Intraclass Correlation Coefficient values all exceeded 0.75, demonstrating a
good interobserver correlation. The average difference of the tooth width between
measurements of the DigiModel and the plaster models was 0.004 mm, and for the Lava COS
model it was 0.04 mm. Most of the mean differences in tooth-size measurements were not
statistically significant (P>0.05).
The difference in Anterior Bolton Ratio was statistically not significant, for both the Lava
COS model as well as the DigiModel. But the differences in the Overall Bolton Ratio were
statistically significant; however comparison of absolute measurements of Overall Bolton
Discrepancies showed no statistical difference and these were considered not to be clinically
significant.
The average time needed to scan a patient with the Lava COS was 27.3 minutes. The last
measurement took 18 minutes. The fastest scan took 14 minutes. Since there was a learning
curve, at the end the needed scanning time seems practically comparable the time needed to
make two alginate impressions.
Conclusion: It appears that the Lava COS scanner is an accurate, reproducible and efficient
method for recording, storing and measuring dental study models that eventually may replace
the use of conventional plaster models and Digimodels in Orthodontics.

Posted in Thesis | Tagged | Leave a comment

Mondzorg voor dak- en thuislozen: Tale quale : Een onderzoek naar de besluitvorming over de zorgrichting in de mondzorgvoor dak- en thuislozen; het afwegen van de mondgezondheid en sociaal/maatschappelijke aspecten.

Background
Since 1998 the UMCG CTM offers dental aid to addicts within a special project
called: ‘Oak- en Thuislozen’. There is little literature available about this population
and their special needs. However, it is well known that there are more problems than
just oral problems alone. This population has more psychosocial problems because
of their drugs needs. Furthermore, this group demonstrates a higher percentage of
dental anxiety and has an increased sugar intake and increased sugar craving. They
also have an increased risk on dental caries and periodontal problems through their
drug use induced by immunosupression and dry mouth. This study is investigating if
there is a link between the social factors, oral factors and the chosen treatment plan.
The process of choosing the treatment plan is not transparent at the moment.
Particularly in cases where there is doubt about the possible treatment plans, the
choosing process is unclear. This study wants to clarify the criteria used when
choosing a treatment plan. The research question for this study is: Which criteria
are influencing the chosen treatment plan for patients in the Oak- en
Thuislozenproject of the UMCG Centrum voor Tandheelkunde en
Mondzorgkunde?
Methods
Data is collected on patients who have been treated within the project and have
finished the whole treatment plan for at least half a year and are known within social
services. The measured factors are: Housing; Work; State of addiction; Overall
received care; Relationship; Judicial history ; Sugar intake; Hygiene; Dental anxiety;
Esthetics; Importance of the oral health; Eichner classification; Plaque; Periodontal
status; Dental caries; Function-Esthetics; Function-Use; Treatment. The data is
analyzed with Excel® and SPSS®. A Chikwadraattest was preformed, by a Fisher’s
Exact Test (p<0,05).
Results
From 120 collected patients 24were included in this study. The following factors
demonstrated an significant influence(p<0,05) on the chosen treatment plan:
periodontal diseases (p=,035); the caries activity(p=,011) and functionality( use)(
p=,011 ).
Conclusion
These data are consistent with current published dental reports, but should be
interpreted with care because of the few people included in this study. This study
could not find any social factors that where influencing the treatment plan. This study
indicated that the treatment plan was based on the oral health status. Reference has
been made to the need for long lasting, well designed dental investigations in this
area.

Posted in Thesis | Tagged | Leave a comment

Age estimation based on pulp/tooth ratio analysis of Cone Beam Computed Tomography images

Age estimation is an important issue in both anthropological and forensic fields. One of the most difficult problems facing forensic medicine is that of estimating the age of living subjects, as in cases where individuals are undergoing criminal proceedings, or are requesting asylum. Biological age
estimation based on dental records was previously conducted using conventional orthopantography (OPG) radiographs. However, the reliability of this technique is within ±6 months. The aim of this study is to investigate the reliability of using pulp/tooth volume ratio (PTR) to estimate
chronological age. The study sample consists of 30 patients scanned with the I-CAT Cone Beam Computed Tomography system. Selected teeth in each
dataset will be manually segmented using AMIRA software to assess the
volume of the pulp and dentine to analyze PTR. Linear regression analysis
will be performed to assess the correlation between PTR and chronological
age. The test hypothesis is that there is a positive correlation between PTR
and chronological age.

Posted in Thesis | Tagged | Leave a comment

Influenza vaccination-induced B cell response in monoclonal gammopathy of undetermined significance (MGUS)

No description abstract

Posted in Thesis | Tagged | Leave a comment

MCAD deficiency

No description abstract

Posted in Thesis | Tagged | Leave a comment

DNAJ proteins: more than just “co-chaperones”

No description abstract

Posted in Thesis | Tagged | Leave a comment

Clinical and epidemiological aspects of viral infections: a molecular approach

No description abstract

Posted in Thesis | Tagged | Leave a comment

Performance-enhancing strategies for deceased donor kidneys

No description abstract

Posted in Thesis | Tagged | Leave a comment

The microenvironment in classical Hodgkin lymphoma: an actively shaped and essential tumor component.

Related Articles

The microenvironment in classical Hodgkin lymphoma: an actively shaped and essential tumor component.

Semin Cancer Biol. 2014 Feb;24:15-22

Authors: Liu Y, Sattarzadeh A, Diepstra A, Visser L, van den Berg A

Abstract

Classical Hodgkin lymphoma (cHL) is characterized by a minority of tumor cells derived from germinal center B-cells and a vast majority of non-malignant reactive cells. The tumor cells show a loss of B-cell phenotype including lack of the B-cell receptor, which makes the tumor cells vulnerable to apoptosis. To overcome this threat, tumor cells and their precursors depend on anti-apoptotic and growth stimulating factors that are obtained via triggering of multiple membrane receptors. In addition, tumor cells shape the environment by producing a wide variety of chemokines and cytokines. These factors alter the composition of the microenvironment and modulate the nature and effectiveness of the infiltrating cells. The attracted cells enhance the pro-survival and growth stimulating signals for the tumor cells. To escape from an effective anti-tumor response tumor cells avoid recognition by T and NK cells, by downregulation of HLA molecules and modulating NK and T-cell receptors. In addition, the tumor cells produce immune suppressive cytokines that inhibit cytotoxic responses. In this review the relevance of the microenvironment in the pathogenesis of cHL will be discussed.

PMID: 23867303 [PubMed - indexed for MEDLINE]

Posted in Semin Cancer Biol | Leave a comment

Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease.

Related Articles

Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease.

Eur J Cardiothorac Surg. 2014 Jan;45(1):83-9

Authors: van Slooten YJ, Freling HG, van Melle JP, Mulder BJ, Jongbloed MR, Ebels T, Voors AA, Pieper PG

Abstract

OBJECTIVES: In patients with acquired valvar disease, morbidity and mortality rates after tricuspid valve replacement (TVR) are high. However, in adult patients with congenital heart disease, though data concerning outcome after TVR are scarce, even poorer results are suggested in patients with Ebstein anomaly. To investigate the applicability of these results to a broader array of congenital heart disease patients, we report the long-term follow-up of prosthesis-related complications, including re-replacement of patients with a tricuspid valve prosthesis and congenital heart disease.

METHODS: From the Dutch Congenital Corvitia (CONCOR) registry, we identified 20 patients with a biological or mechanical tricuspid valve prosthesis implanted between 1977 and 2012 (total of 31 prostheses). We analysed the tricuspid valve-related complications and mortality.

RESULTS: Ten patients with a median age of 16.2 years at the time of surgery (interquartile range 13.2-28.2 years) received a bioprosthesis while 10 patients with a median age of 36.4 years (interquartile range 14.0-47.0) at the time of surgery received a mechanical prosthesis (P = 0.28). During a mean follow-up of 14 years, 50% needed a re-replacement because of valve-related complications (e.g. valve degeneration or valve thrombosis). The yearly percentage of patients with valve-related complications was 4.2% in patients with a bioprosthesis and 2.7% in those with a mechanical prosthesis. Within 20 years of implantation, the median duration of event-free survival was significantly shorter in 3 patients with a prosthesis-patient mismatch (PPM; 1.0 year; interquartile range 0.01-2.6), compared with 7 without mismatch (8.0 years; interquartile range 5.1-12.3; P = 0.02).

CONCLUSIONS: Compared with previous literature on acquired valvar disease, we found a higher incidence of valve-related complications in patients with congenital heart disease that was unrelated to prosthesis material. Our data suggest that PPM may have a negative effect on the event-free interval.

PMID: 23686501 [PubMed - indexed for MEDLINE]

Posted in Eur J Cardiothorac Surg | Leave a comment

Discovery of a novel activator of 5-lipoxygenase from an anacardic acid derived compound collection.

Related Articles

Discovery of a novel activator of 5-lipoxygenase from an anacardic acid derived compound collection.

Bioorg Med Chem. 2013 Dec 15;21(24):7763-78

Authors: Wisastra R, Kok PA, Eleftheriadis N, Baumgartner MP, Camacho CJ, Haisma HJ, Dekker FJ

Abstract

Lipoxygenases (LOXs) and cyclooxygenases (COXs) metabolize poly-unsaturated fatty acids into inflammatory signaling molecules. Modulation of the activity of these enzymes may provide new approaches for therapy of inflammatory diseases. In this study, we screened novel anacardic acid derivatives as modulators of human 5-LOX and COX-2 activity. Interestingly, a novel salicylate derivative 23a was identified as a surprisingly potent activator of human 5-LOX. This compound showed both non-competitive activation towards the human 5-LOX activator adenosine triphosphate (ATP) and non-essential mixed type activation against the substrate linoleic acid, while having no effect on the conversion of the substrate arachidonic acid. The kinetic analysis demonstrated a non-essential activation of the linoleic acid conversion with a KA of 8.65 μM, αKA of 0.38μM and a β value of 1.76. It is also of interest that a comparable derivative 23d showed a mixed type inhibition for linoleic acid conversion. These observations indicate the presence of an allosteric binding site in human 5-LOX distinct from the ATP binding site. The activatory and inhibitory behavior of 23a and 23d on the conversion of linoleic compared to arachidonic acid are rationalized by docking studies, which suggest that the activator 23a stabilizes linoleic acid binding, whereas the larger inhibitor 23d blocks the enzyme active site.

PMID: 24231650 [PubMed - indexed for MEDLINE]

Posted in Bioorg Med Chem | Leave a comment

Prenatal exposure to acid-suppressive drugs and the risk of allergic diseases in the offspring: a cohort study.

Related Articles

Prenatal exposure to acid-suppressive drugs and the risk of allergic diseases in the offspring: a cohort study.

Clin Exp Allergy. 2014 Feb;44(2):261-9

Authors: Mulder B, Schuiling-Veninga CC, Bos HJ, De Vries TW, Jick SS, Hak E

Abstract

BACKGROUND: Recent studies reported increased risks for the development of asthma in children after prenatal exposure to acid-suppressive drugs. As a result of common pathogenesis, associations could also be present for other allergic diseases.

METHODS: Using the prescription database IADB.nl, we conducted a cohort study amongst 33 536 children in the Netherlands, with a maximum follow-up of 8 years. Maternal exposure was defined as ≥1 dispensed prescription for proton pump inhibitors (PPIs) and/or Histamine 2-antagonists (H2As) during pregnancy. Children were considered to have a drug-treated allergic disease if they received either ≥2 prescriptions for dermal (atopic dermatitis), inhaled (asthma) or nasal (allergic rhinitis) steroids within a 12-month period. Clustered Cox proportional hazard regression was used to estimate crude and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CI).

RESULTS: The aHR for the development of any allergic disease was 1.37 (95% CI: 1.14-1.66) for children exposed to PPIs or H2As. Prenatal exposure to PPIs and/or H2As was associated with atopic dermatitis, asthma and allergic rhinitis with aHRs of 1.32 (95% CI 1.06-1.64), 1.57 (95% CI 1.20-2.05) and 2.40 (95% CI 1.42-4.04), respectively. The aHR for the development of two or more (aHR 2.13 95% CI: 1.43-3.19) and three allergic diseases (aHR 5.18 95% CI: 2.16-12.42) were even more elevated after prenatal exposure to PPIs or H2As.

CONCLUSION: Prenatal exposure to PPIs and H2As appeared associated with an increased risk for the development of atopic dermatitis, asthma and allergic rhinitis in the offspring, especially with the development of multiple allergic diseases. Because our study has limitations inherent to observational studies, prospective studies are now warranted to confirm our findings.

PMID: 24164287 [PubMed - indexed for MEDLINE]

Posted in Clin Exp Allergy | Leave a comment