Candidiasis is common in children with cancer, particularly during periods of severe immunosuppression and neutropenia. Our aim was to study the microbiological changes in the oral cavity of children with newly diagnosed cancer. The study group consisted of 30 consecutive children and adolescents, 16 with acute lymphoblastic leukemia and 14 with solid tumors. Oral cultures to detect fungi and bacteria were conducted for all patients before treatment, during and after neutropenic episodes. In 23 patients developing fever simultaneous throat, urine and blood sampling was carried out. No pathogens were found in the cultures taken before the outset (30 cultures) or after recovery from (30 cultures) the neutropenic episodes. In the 45 oral cultures taken during the neutropenic episodes 38 (84.4%) proved positive. Fungi were the most frequently isolated oral pathogens: 33/38 yeast and 6/38 bacterial infections were identified. There was no association between the underlying malignancy and the occurrence of the positive cultures. Of the 30 patients, all 23 (76.7%) who have developed moderate-to-severe neutropenia, developed oral fungal colonization or clinically obvious fungal infection at least on one occasion during the study. In addition to oral samples, fungi were identified in 9/23 pharyngeal swabs, 6/23 urine and 1/23 blood cultures. The initial fungal pathogen was exclusively (33/33) Candida albicans. In extended severe neutropenic states, C. albicans was replaced by non-albicans species (C. kefyr, C. lusitaniae, C. sake, C. tropicalis) in 5 patients between 4 to 6 days of the neutropenic episodes. Four of the nonalbicans Candida strains were resistant to azole-type antifungal agents. Neutropenic episodes of children with cancer are associated with an increased risk of developing oral and even systemic infections with C. albicans that can be replaced by azole-resistant nonalbicans strains in prolonged neutropenia contributing to morbidity of these patients.

No abstract

Dental caries is one of the most widespread childhood diseases worldwide, although it is largely preventable. In Europe, there is an observable difference between caries prevalence in Eastern and Western European states. This study aimed to gather data on the characteristics of publicly financed dental preventive services for children in European Union (EU) member states. Methods: Data on important indicators were collected through an online survey. National and international professional bodies specializing in pediatric dentistry and dental services were invited to participate in the study. Descriptive statistics and information gain were applied in the analysis to identify the strongest indicators of the availability and content of childhood caries services. Additionally, the reimbursement characteristics were examined. Results: We received responses from 27 EU member states. The accessibility and assessment of dental preventive services among the member states vary notably. The frequency of screenings and the screened age groups differ by country and free screenings for preschool children are not common. Monitoring systems were present in only 37% of the responding countries, but brief dental interventions are available to promote caries prevention in 25 of the 27 countries. However, these interventions are mainly focused on basic oral health education. Regarding the reimbursement characteristics, we found that the amount of reimbursement is larger for higher-cost treatments targeting already developed caries than for cost-effective preventive treatments, which are less likely publicly financed. Conclusions: The prevention of dental caries is part of oral health promotion and education efforts in the EU; unlike the treatment of already developed dental caries, the accessibility of clinical prevention services is limited and usually not free for children. Further comprehensive studies are necessary to identify key indicators for international assessment and facilitate the standardization of the screening process, thus promoting the collection of comparable data.

The aim of this study was to investigate whether primary vestibular afferent fibers establish direct connections with the motor and sensory trigeminal system in the brainstem of the frog. The experiments were carried out on Rana esculenta. In anaesthetized animals the trigeminal and vestibular nerves were prepared, and their proximal stumps were labeled either with fluorescein binding dextran amine (trigeminal nerve) or tetramethylrhodamine dextran amine (vestibulocochlear nerve). With a confocal laser scanning microscope we could detect close connections between the vestibular fibers and branches of the dorsal dendritic array of the jaw-closing motoneurons, suggestive of monosynaptic contacts. In the other parts of the brainstem, vestibular terminals were detected in the termination areas of the mesencephalic trigeminal nucleus and of the Gasserian (Vth) ganglion and they were probably involved in polysynaptic connections. In agreement with the results obtained in mammalian species, the present findings suggest that the vestibulotrigeminal relationship is quite complex and uses multiple pathways to connect the vestibular apparatus with the motor and sensory nuclei of the trigeminal nerve in the anurans as well.

Please cite this article in press as: Kovalecz, G., et al., Termination of trigeminal afferent fibers on facial motoneurons: Possible neural network mediating jaw opening during prey-catching behavior of the frog. Brain Res. Bull. (2015) a b s t r a c tThe prey-catching behavior of the frog is a complex, well-timed sequence of stimulus response chain of movements. After visual analysis of the prey, a size dependent program is selected in the motor pattern generator of the brainstem. Besides this predetermined feeding program, various direct and indirect sensory inputs provide flexible adjustment for the optimal contraction of the executive muscles. The aim of the present study was to investigate whether trigeminal primary afferents establish direct contacts with the jaw opening motoneurons innervated by the facial nerve. The experiments were carried out on Rana esculenta (Pelophylax esculentus), where the trigeminal and facial nerves were labeled simultaneously with different fluorescent dyes. Using a confocal laser scanning microscope, close appositions were detected between trigeminal afferent fibers and somatodendritic components of the facial motoneurons.Quantitative analysis revealed that the majority of close contacts were encountered on the dendrites of facial motoneurons and approximately 10% of them were located on the perikarya. We suggest that the identified contacts between the trigeminal afferents and facial motoneurons presented here may be one of the morphological substrate in the feedback and feedforward modulation of the rapidly changing activity of the jaw opening muscle during the prey-catching behavior.