This thesis presents studies on the epidemiology of vaccine preventable VIruS infections investigated by oral fluid testing. It involved studies of both rubella and hepatitis B virus infections by the detection of specific IgG in oral fluid and of rubella virus by PCR detection and genotyping of viral nucleic acid. To select an oral fluid collection device with optimal performance for these studies three (Orasure, Omni- SAL, Oracol) were compared. Each device collected oral fluid of sufficient quality for qualitative analysis of virus specific IgG, but DracoI was most acceptable to the subjects being tested. IgG capture ELISA (GACELISA) tests were developed for detection of rubella and anti-HBc specific IgG in oral fluid. Their sensitivity was less than that of corresponding serum ELiSAs, with sensitivity decreasing with increasing age of subjects. Whilst the performance of the rubella GACELISA was shown to be an improvement over the existing radioimmunoassay and was particularly sensitive with samples from paediatric populations, the performance of the anti-HBc GACELISA was not considered good enough for further use. The development of an RT-PCR assay targeting the El gene of rubella virus enabled the molecular epidemiology of rubella to be investigated using samples from the UK, China, Greece, and Brazil. By comparison to previously reported strains, the majority of strains were assigned to three banches of a phylogenetic tree. Those assigned to branches 1 (UK, Greece, China) and 2 (China) were not closely related to any previously reported strains. The timing of oral fluid collection and subsequent storage was critical for PCR detection. Ideally oral fluid samples should be collected within 14 days of the onset of symptoms and stored at least at -20°C prior to testing.

Made available in DSpace on 2019-03-29T23:50:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-10-18 / Introduction: Systemic and mouth changes are common in patients on hemodialysis. The observation of changes dental, periodontal and salivary is critical in the search for quality treatment and without complications. Hemodialysis patients often have reduced salivary flow rate and complain of symptoms of xerostomia, characterized by dry mouth. Systemic conditions and typical treatment can cause these changes. Objective: To assess the oral health conditions, including dental issues, soft tissue and saliva in patients undergoing hemodialysis treatment, identifying the risk factors and clinical implications. Methods: Cross-sectional study in two dialysis centers. We used a questionnaire to obtain demographic data and medical records to obtain clinical and laboratory data of the patients. Oral health parameters were measured: missing teeth, decayed and filled (DMFT and community periodontal index (CPI) according to World Health Organization (WHO). Saliva was stimulated salivary flow and evaluated before and after hemodialysis. The rates of xerostomia and thirst were assessed with validated scales relevant. Results: The study included 128 patients (66 men and 62 women) with a mean of 56.2 ± 17.1 years. It turned mean DMFT of 23 ± 9.14 with 32% prevalence of edentulous patients. Periodontal changes were observed in 94.3% of patients and 25.8% in the soft tissues. After dialysis, found a significant increase in salivary flow (0.39 ± 0.28ml/min vs 0.60 ± 0.34/min, p < 0.001). An association between mean DMFT and salivary flow (r= -0.228, p=0.011). Before dialysis serum urea was negatively correlated with salivary flow (r= 0.319, p=0.011). An association of the drug sevelamer and reduced salivary flow (0.32 ± 0:19 vs 0:44 ± 0:23, p=0.003) but not significant between salivary flow rate and xerostomia (r=0.092, p=0.368) and the rate of seat (r= 0.019, p=0.851). Conclusion: It was emphasized high prevalence of periodontal disease and high DMFT index, with a predominance of the missing component. Even with an increase in salivary flow after hemodialysis, this can still be considered low for the preservation of the oral tissues, and may be associated with various systemic factors. The serum urea, the calcium-phosphorus product and the use of sevelamer, besides age were independently associated with low salivary flow. Dental care in these patients should pay attention to prevention and rehabilitation. / Introdução: Alterações sistêmicas e bucais são comuns em pacientes sob tratamento de hemodiálise. A observação das mudanças dentárias, periodontais e salivares é fundamental na busca por um tratamento de qualidade e sem complicações. Pacientes hemodialisados geralmente têm reduzida taxa de fluxo salivar e queixam-se de sintomas de xerostomia, caracterizada pela sensação de boca seca. Condições sistêmicas e típicas do tratamento podem provocar essas alterações. Objetivo: Avaliar as condições de saúde bucal, incluindo aspectos dentais, tecidos moles e salivares em pacientes submetidos ao tratamento de hemodiálise, identificando fatores associados e suas implicações clínicas. Material e Método: Estudo transversal realizado em dois centros de diálise. Utilizou-se de questionário para obtenção dos dados demográficos e dos prontuários para obtenção de dados clínicos e laboratoriais dos pacientes. Parâmetros de saúde bucal foram mensurados: dentes perdidos, cariados e restaurados (CPOD) e índice periodontal comunitário (IPC) de acordo com a Organização Mundial de Saúde (OMS). A saliva foi estimulada e o fluxo salivar avaliado antes e após a hemodiálise. Os índices de xerostomia e sede foram avaliados com respectivas escalas validadas. Resultados: Participaram do estudo 128 pacientes (66 homens e 62 mulheres) com média de 56,2±17,1 anos. Detectou-se CPOD médio de 23 ±9,14 com 32% de prevalência de pacientes edêntulos. Observaram-se alterações periodontais em 94,3% dos pacientes e nos tecidos moles em 25,8%. Após diálise, detectou-se aumento significativo do fluxo salivar (0.39±0.28ml/min vs. 0.60±0.34/min, p<0.001). Houve associação entre o CPOD médio e o fluxo salivar (r= -0,228, p=0,011). A ureia sérica pré-hemodiálise foi negativamente correlacionada com fluxo salivar (r=0.319, p=0.011). Houve associação do uso do medicamento sevelamer e a redução do fluxo salivar (0.32±0.19 vs. 0.44±0.23, p=0.003), porém não significante entre fluxo salivar e o índice de xerostomia (r=0.092, p=0.368) e o índice de sede (r=0.019, p=0.851). Conclusão: Destacou-se alta prevalência de doenças periodontais e elevado índice CPO-D, com predominância do componente perdido. Mesmo havendo aumento do fluxo salivar após a hemodiálise, este ainda pode ser considerado baixo para preservação dos tecidos bucais, podendo estar associada a vários fatores sistêmicos. A ureia sérica, o produto cálcio-fósforo e o uso do sevelamer, além da idade, foram associados independentemente com o baixo fluxo salivar. A atenção odontológica nestes pacientes deve atentar para a prevenção e reabilitação.

Thesis--Ph. D., University of Hong Kong. / V.2 illustrations. Mimeographed.

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1975. / Bibliography: leaves 188-204. / xiii, 204 leaves ill. (some col.)

Thesis (M.D.S.) -- University of Adelaide, Dept. of Dentistry, 1999. / Bibliography: leaves 165-175.

Thesis (doctoral)--Malmö University, Sweden, 2002. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (M.S.)--Indiana University School of Dentistry. / Available also on microfilm, No. 133. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 18-21).

Thesis (M.S.)--Indiana University School of Dentistry. / Available also on microfilm, No. 133. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 18-21).

Thesis (doctoral)--University of Göteborg, 1991. / Extra t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Lunds Universitet, Malmö, 1994. / Added t.p. with thesis statement inserted. Includes bibliographical references.