Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) (P= 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%-98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) (P< 0.001; relative risk reduction, 83; 95% confidence interval, 67%-91%). Thus, resin infiltration seems to be more efficacious in reducing lesion progression compared with individualized noninvasive measures alone over a period of 18 mo when performed in a private practice setting by various practitioners (German Clinical Trials Register / Deutsches Register Klinischer Studien DRKS00009963).

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Polychlorinated biphenyls (PCBs) are very persistent organic pollutants of severe environmental concern due to their toxic properties. Former underground miners might have been exposed to this substance group due to the widespread use of PCBs in hydraulic oils from the late 1960s to the mid 1980s. We have conducted a blinded case-control study in order to evaluate the possibility of retrospective exposure assessment of PCBs using human biomonitoring in former underground miners decades after the last possible exposure. We have identified n = 34 male former underground miners and n = 136 age-matched male control persons from the database of patients of our occupational outpatient clinic aged between 47.9 and 83.7 years  at the time of sampling (June 2006-June 2016). These archived plasma samples have been blinded and analysed for 21 different PCB-congeners using a validated and quality controlled procedure using GC/MS (LOQ: 0.01 μg/L). Highly significant differences between cases and age-matched controls were only found for the PCB-congeners PCB 74 and PCB 114. The median (95th percentile) levels of PCB 74 in cases and controls were 0.126 μg/L plasma (0.899 μg/L plasma) vs. 0.058 μg/L plasma (0.368 μg/L plasma) and the 95th percentile levels for PCB 114 were 0.039 μg/L plasma vs. 0.017 μg/L plasma. Linear regression models revealed that this difference in plasma levels was unequivocally attributed to the underground mining activity. Thus, retrospective exposure assessment for underground miners by use of human biomonitoring seems feasible and further studies with a particular focus on this special group of workers should be performed.

Our results confirm the well-known correlation between lung function, smoking habits, and BMI. However, we found no significant association between lung function and asbestos exposure.

BackgroundLow-dose spiral computed tomography (LDSCT) in comparison to conventional chest X-ray proved to be a highly sensitive method of diagnosing early stage lung cancer. However, centrally located early stage lung tumours remain a diagnostic challenge. We determined the practicability and efficacy of early detection of lung cancer when combining LDSCT and sputum cytology.MethodsOf a cohort of 4446 formerly asbestos exposed power industry workers, we examined a subgroup of 187 (4.2%) high risk participants for lung cancer at least once with both LDSCT and sputum cytology. After the examination period the participants were followed-up for more than three years.ResultsThe examinations resulted in the diagnosis of lung cancer in 12 participants (6.4%). Six were in clinical stage I. We found 10 non-small cell lung carcinomas and one small cell lung carcinoma. Sputum specimens showed suspicious pathological findings in seven cases and in 11 cases the results of LDSCT indicated malignancies. The overall sensitivity and specificity of sputum cytology was 58.0% and 98% with positive (PPV) and negative (NPV) predictive values of 70% and 97%. For LDSCT we calculated the sensitivity and specificity of 92% and 97%. The PPV and NPV were 65% and 99% respectively.ConclusionsOur results confirmed that in surveillance programmes a combination of sputum cytology and LDSCT is well feasible and accepted by the participants. Sputum examination alone is not effective enough for the detection of lung cancer, especially at early stage. Even in well- defined risk groups highly exposed to asbestos, we cannot recommend the use of combined LDSCT and sputum cytology examinations as long as no survival benefit has been proved for the combination of both methods. For ensuring low rates of false-positive and false-negative results, programme planners must closely cooperate with experienced medical practitioners and pathologists in a well-functioning interdisciplinary network.