ObjectiveThis study was performed to identify a possible association of the clinical parameters of systemic sclerosis (SSc) and the socioeconomic status (SES) with oral health-related quality of life (OHrQoL) as measured by the Oral Health Impact Profile 49 (OHIP 49), taking into account the effect of educational level (as a proxy of SES) on oral health.MethodsSubjects were recruited from the Croatian SSc Center of Excellence cohort. Detailed dental and clinical examinations were performed according to standardized protocols. The associations of OHrQoL with disease characteristics and socioeconomic status were examined.ResultsThirty-one consecutive patients with SSc were enrolled (29 women; mean age, 56.45 ± 13.60 years). OHIP 49 scores were significantly correlated with disease activity and severity. Furthermore, OHrQoL was positively correlated with skin involvement as evaluated by the modified Rodnan skin score. Impaired OHrQoL was positively correlated with the severity of general, skin, gastrointestinal, and joint/tendon involvement. The OHIP 49 score differed between patients who were positive and negative for anti-topoisomerase I antibody. Higher OHIP 49 scores were detected in patients with lower SES (primary school educational level).ConclusionCollaboration between rheumatologists and dental professionals is required to improve dental care and oral health outcomes of SSc.

Despite high prevalence of patients with gastric disease in systemic sclerosis (SSc), its pathogenesis is still poorly understood. We immunohistochemically analysed biopsies of gastric mucosa (GM) in 5 controls and 15 patients with different forms of SSc: limited cutaneous (lc), diffuse cutaneous moderate (sys1) and severe (sys2). The number of positive cells was analysed by a Kruskall-Wallis test, P < 0.05 was considered statistically significant. Percentage of proliferating (Ki-67 positive) cells was highest in sys1 (3% in superficial and 4,6% in deeper parts of GM), which dropped to 1% in sys2. Percentage of α-smooth muscle actin (α-SMA) positive cells was 5% in controls, 9% in superficial GM, while in deeper GM rose from 7% to 19% in sys1 and sys2, thus indicating increased myofibroblast population. Caspase-3 positive apoptotic cells characterized 1,5–2% of controls, 8% of superficial and 6% of deeper GM cells in sys1. In sys2, apoptosis affected 50% of surface epithelial and gland cells and 30% of deeper glands, and correlated with increased fibrosis and decreased syndecan-1 expression. Our data demonstrate that sys1 is the most „active” proliferating form of SSc. Sys2 characterize collagen deposition, surface epithelium defects, extensive apoptosis and low proliferation, GM atrophy and loss of function.

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A B S T R A C TThe aim of this paper was to investigate the prevalence of smoking using selected anthropometric variables in a sample of hospitalized coronary heart disease (CHD) patients in Croatia (N=1,298

BackgroundSystemic sclerosis (SSc) is associated with decreased saliva production and interincisal distance, more missing teeth, and periodontal disease. Orofacial manifestations of SSc contribute greatly to overall disease burden and still are regularly overlooked and under-treated. Previous studies did not confirm correlation between disease severity and oral health-related quality of life in SSc patients.ObjectivesThe aim of this study was to determine possible correlation of the SSc clinical parameters with oral health-related quality of life measured with the Oral Health Impact Profile 49 (OHIP 49).MethodsSubjects were recruited from the Center of excellency for systemic sclerosis in Croatia cohort. Detailed dental by the same dentist and clinical examinations were performed according to standardized protocols. Associations between oral health-related quality of life and disease charachteristics were examined. We evaluated the disease severity using clinical and laboratory parameters according to the Medsger Severity Scale. The level of SSc activity was evaluated according to Valentini activity score. Oral quality of life was measured using the OHIP 49, which consists of 49 questions on the frequency of adverse oral conditions such as toothache, mouth pain, difficulty chewing or pronouncing words and discomfort related to appearance (higher scores indicating worse oral health-related quality of life). The study was approved by the University Hospital Split Ethics Committee.ResultsThirty-one SSc patients (29 women and 2 men, mean age 56.45±13.60 years, median disease duration 7 years with minimum–maximum range 1–28 years) were consecutively enrolled for this study between January 2014 and December 2015. All patients fulfilled the ACR criteria for the diagnosis of SSc. The distinction between limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) was made according to the Leroy et al. criteria (28 dcSSc, 3 lcSSc). OHIP 49 scores highly positively correlated with disease activity (p=0.005, r=0.4872, Spearman's rank coefficient) and severity (p=0.016, r=0.4303, Spearman's rank coefficient). Furthermore, oral health-related quality of life positively correlated with the skin involvement evaluated by modified Rodnan skin score (p=0.003, r=0. 5207, Spearman's rank coefficient). Impaired quality of oral health positively correlated with the severity of general involvement, skin, gastrointestinal and joint/tendon involvement (p=0.003, r=0.506 for general involvement, p=0.003, r=0.511; p<0.001, r=0.591 and p=0.02, r=0.391 for skin, gastrointestinal and joint/tendon involvement, respectively, Spearman's rank coefficient). OHIP 49 score was highly variable between anti-topoisomerase I antibodies positive or negative SSc patients (p<0.001, Fisher's exact test).ConclusionsContrary to previous studies in our study disease severity and activity were related to OHIP 49 scores. Our data suggest that OHIP scores correlate with severity of general involvement, skin, gastrointestinal, and joint/tendon involvement in SSc ...