Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. MethodsWe applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FindingsIn 2019, there were 12•2 million (95% UI 11•0-13•6) incident cases of stroke, 101 million (93•2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6•55 million (6•00-7•02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11•6% [10•8-12•2] of total deaths) and the third-leading cause of death and disability combined (5•7% [5•1-6•2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70•0% (67•0-73•0), prevalent strokes increased by 85•0% (83•0-88•0), deaths from stroke increased by 43•0% (31•0-55•0), and DALYs due to stroke increased by 32•0% (22•0-42•0). During the same period, age-standardised rates of stroke incidence decreased by 17•0% (15•0-18•0), mortality decreased by 36•0% (31•0-42•0), prevalence decreased by 6•0% (5•0-7•0), and DALYs decreased by 36•0% (31•0-42•0). However, among people younger than 70 years, prevalence rates increased by 22•0% (21•0-24•0) and incidence rates increased by 15•0% (12•0-18•0). In 2019, the age-standardised stroke-related mortality rate was 3•6 (3•5-3•8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3•7 (3•5-3•9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62•4% of all incident strokes in 2019 (7•63 million [6•57-8•96]), while intracerebral haemorrhage constituted 27•9% (3•41 million [2•97-3•91]) and subarachnoid haemorrhage constituted 9•7% (1•18 million [1•01-1•39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79•6 million [67•7-90•8] DALYs or 55•5% [48•2-62•0] of total stroke DALYs), high bodymass index (34•9 million [22•3-48•6] DALYs or 24•3% [15•7-33•2]), high fasting plasma glucose (28•9 million [19•8-41•5] DALYs or 20•2% [13•8-29•1]), ambient particulate matter pollution (28•7 million [23•4-33•4] DALYs or 20•1% [16•6-23•0]), and smoking (25•3 million [22•6-28•2] DALYs or 17•6% [16•4-19•0]...

and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEWThe GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCEThe results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

BackgroundAsymmetric dimethylarginine (ADMA) plays a crucial role in endothelial function and maybe a link for the known interaction of periodontitis and coronary heart disease (CHD). In this pilot study, we compared the impact of gingival health, periodontitis (CP), CHD, or of both diseases (CP + CHD) on salivary and serum ADMA levels.MethodsThe clinical and periodontal characteristics, serum, and saliva samples were collected from 35 patients with CP, 33 patients with CHD, 35 patients with both CP + CHD, and 35 healthy subjects. Levels of ADMA and C‐reactive protein (CRP) were assessed with a commercially available kit.ResultsThe median (25% and 75% percentile) concentrations of salivary and serum ADMA were significantly higher in the CHD group [serum: 1.5 (1.2 to 1.8) μmol/L; salivary 1.3 (1 to 1.7) μmol/g protein, P < 0.01] and in the CP + CHD [serum: 1.8 (1.4 to 2.0) μmol/L; salivary 1.5 (1.2 to 1.7) μmol/g protein, P < 0.001] group compared to CP patients and controls. In univariate models, CP (P = 0.034), CHD (P < 0.001), and hs‐CRP (P < 0.001) were significantly associated with serum ADMA, whereas in a multivariate model, hs‐CRP remained a significant predictor of serum ADMA (P < 0.001). In a multivariate model, the significant predictors of salivary ADMA levels were hs‐CRP (P < 0.001) and education socioeconomic status (P = 0.042).ConclusionsPatients with CHD and CP + CHD presented higher levels of salivary and serum ADMA compared to healthy subjects and CP patients. hs‐CRP was a significant predictor of increased salivary and serum ADMA levels.

Odontoma is considered to be the most common odontogenic tumor of the oral cavity. Most odontomas are asymptomatic and are discovered during routine radiographic investigations and can cause disturbances in the eruption of the teeth, most commonly delayed eruption or deflection. By a retrospective study design, demographic and clinical data regarding patients who presented odontomas from year 1995 to 2015 were obtained in order and the influence of active therapy on the dentition and on the treatment of impacted teeth was analyzed. Forty-five patients (mean age 14.2 years) with 29 complex and 16 compound odontomas were included in this retrospective study. Initial symptoms were delayed eruption of permanent teeth (n = 25), pain (n = 6), swellings (n = 4), and no symptoms (n = 10); 31 patients were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 2:1 (31/15). Thirty-two out of 45 odontomas were in close proximity of at least 1 tooth (n = 21 at incisive). A total of 12 teeth were extracted (complex: n = 8; compound: n = 4). Of the nonextracted teeth, 33 teeth were displaced and retained. Of those, 29 teeth were aligned through orthodontic-surgical approach and 4 teeth erupted spontaneously after surgery during the follow-up period. An early detection of odontoma is more likely an accidental radiological finding, hence the need for routine radiographic analysis should be emphasized. Early diagnosis of odontomas in primary dentition is crucial in order to prevent later complications, such as impaction or failure of eruption of teeth.

Background and Objective Vitamin D has been considered to possess anti‐inflammatory and antimicrobial activity, which may be a link for the known interaction of periodontitis (CP) and coronary heart disease (CHD). This study investigated the association between serum vitamin D levels and periodontitis in patients with CP and with CHD. Furthermore, the objective was to determine whether periodontitis and CHD had an impact on serum vitamin D levels. Material and Methods Using a cross‐sectional design, a total of 46 patients with CP, 45 patients with CHD, 45 patients with both CP and CHD, and 43 healthy patients were enrolled in the present study. Results Patients in the CP (17.4 ± 5.2 ng/mL) and in the CP + CHD (16.5 ± 5.6 ng/mL) group presented a significantly lower mean serum level of 25(OH)vitamin D compared to patients in the CHD (24.6 ± 3.7 ng/mL) and healthy control groups (29.9 ± 5.4 ng/mL) (P < .001). 25(OH)vitamin D levels were positively correlated with the number of teeth and negatively with C‐reactive protein (CRP) and all periodontal parameters (P < .001). In all patients, there was a proportional increase of 25(OH)vitamin D levels with a progressive increase in number of teeth (P‐trend <.001) while there were a proportional decrease in 25(OH)vitamin D levels with a progressive increase in clinical attachment level (CAL, P‐trend = .001), probing depth (PD, P‐trend = .006), and bleeding sites (BOP, P‐trend <.001) levels. Conclusion Patients with CP and CP + CHD presented significantly lower serum levels of vitamin D compared to CHD and healthy controls. Moreover, the presence of CP negatively influenced serum vitamin D levels.

Endothelin 1 (ET-1) has been shown to have a key role in homeostasis and function of endothelium and maybe fundamental in the relationship between coronary heart disease (CHD) and periodontitis. In this trial, we assessed the influence on serum and salivary ET-1 levels of gingival health, CHD, periodontitis, or a combination of periodontitis-CHD. Clinical and periodontal parameters, were collected from periodontitis patients (n = 34), CHD patients (n = 34), periodontitis + CHD patients (n = 34), and from healthy patients (n = 34) together with saliva and serum samples. The median concentrations of salivary and serum ET-1 were significantly higher in the CHD patients [serum: 1.4(1.1-1.6) pg/ml; saliva 1.2 (0.9-1.6) µmol/g, p < 0.01] and in the periodontitis + CHD patients [serum: 1.7 (1.2-21.8) pg/ml; salivary 1.4(1-1.6) µmol/g, p < 0.001] respect to periodontitis and control patients. Through a univariate regression analysis, c-reactive protein (CRP) and CHD (both p < 0.001) and periodontitis (p = 0.029) were statistically correlated with ET-1 in serum. The multivariate regression analysis demonstrated that only CRP was the statistically predictor of ET-1 in serum(p < 0.001). The multivariate regression analysis in saliva demonstrated that, regarding ET-1 levels the only predictor were CRP (p < 0.001) and total cholesterol (p = 0.042). The present study evidenced that subjects with CHD and periodontitis plus CHD had higher serum and salivary levels of ET-1 compared to subjects with periodontitis and healthy controls. Moreover, only CRP remained a major predictor of increased ET-1 concentrations in both serum and saliva.

Background: Nod-like receptor family pyrin domain-containing protein-3 (NLRP3) complex inflammasome has potentially been shown to play an important role in the development of periodontitis and diabetes. The objective of this study was to analyze the association between serum and salivary NLRP3 concentrations in patients with periodontitis and type-II diabetes mellitus (DM) and to evaluate whether this association was influenced by potential confounders. Methods: : For the present study, a cohort of healthy controls (n = 32), and patients with periodontitis (n = 34), type-II DM (n = 33), and a combination of periodontitis + type-II DM (n = 34) were enrolled. Patients were characterized on the basis of their periodontal status and analyzed for demographic characteristics, serum mediators, and for serum and salivary concentrations of NLRP3. A uni-and multivariate model was established to analyze whether periodontitis, type-II DM, and CRP influenced serum and salivary NLRP3 concentrations. Results:In comparison to type-II DM patients and healthy controls, patients with periodontitis (serum, P = 0.003; saliva P = 0.012) and periodontitis + type-II DM (serum, P = 0.028; saliva, P = 0.003) had elevated serum and salivary NLRP3 concentrations. The multivariate regression model showed that periodontitis (P = 0.029) and HDL-cholesterol (P = 0.012) were significant predictors of serum NLRP3 concentrations whereas periodontitis (P = 0.036) and CRP (P = 0.012) were significant predictors of salivary NLRP3. Conclusion:The results of the present study showed that periodontitis and periodontitis + type-II DM patients had higher serum and salivary NLRP3 concentrations in comparison to healthy controls and patients with type-II DM. Periodontitis was demonstrated to be a significant predictor of both serum and salivary NLRP3 concentrations.

JIA patients with TMJ arthritis presented higher functional disability and lower OHRQoL scores compared with JIA patients without TMJ arthritis. TMJ arthritis was strongly associated with JIA duration and activity, especially in female patients.