RESUMEN
Introduction: In the UK, one in 600700 infants is born with a cleft lip and/or palate (CL/P). Previous research has identified patients with CL/P to be at high risk of long-term oral health issues. Yet, few of these patients are currently accessing community dental care. Aims: To assess patients' dental treatment experiences and their suggestions for improving services. Materials and methods: Five focus groups were conducted with 24 adults with CL/P. Thematic analysis was performed on the data. Results: Participants perceived local dental practitioners to lack knowledge about CL/P and its treatment. Consequently, some participants had stopped visiting a dental practice altogether. Participants were also largely unaware of the specialist CL/P services they are entitled to. Discussion: Suggestions are made for the integration of improved training and resources for local dental practitioners. Closer communication between specialist cleft teams and local dental practitioners could also help to bridge the gap in knowledge and improve patients' engagement with dental services. The tertiary sector has a crucial role to play in empowering patients to take more control of their oral health and dental treatment.
Asunto(s)
Labio Leporino , Fisura del Paladar , Atención Odontológica/estadística & datos numéricos , Adolescente , Adulto , Anciano , Actitud del Personal de Salud , Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Utilización de Instalaciones y Servicios , Femenino , Grupos Focales , Humanos , Relaciones Interprofesionales , Masculino , Persona de Mediana Edad , Salud Bucal , Grupo de Atención al Paciente , Educación del Paciente como Asunto , Competencia Profesional , Investigación Cualitativa , Reino Unido/epidemiología , Adulto JovenRESUMEN
Adherens junctions (AD and tight junctions (TJ) play a key role in maintaining the apical-basolateral polarity and cohesive structure of epithelial cells. These epithelial junctions are maintained by the interaction of several key proteins including E-cadherin, claudins, occludin and zona-occludens. The zinc finger protein, Snail, has previously been identified as a possible regulator of several of these AJ and TJ proteins. Expression levels of ZO-1, occludin, claudins, E-cadherin, human Scribble protein and Snail were determined in HeLa and CaSki cervical carcinoma cell lines by imuunohistochemistry (IHC) and Western blotting. In tandem, tissue microarrays were utilised in the IHC-based detection of E-cadherin in 26 cases of non-cancerous cervical tissue, 15 cases of cervical intraepithelial neoplasia 1 (CIN1), 11 cases of CIN2, 12 cases of CIN3, 50 cases of squamous cell carcinoma and two cases of adenocarcinoma. This study found aberrant E-cadherin expression in CIN lesions and cases of squamous cell carcinoma compared to normal epithelium. HeLa cells were E-cadherin-negative while CaSki cells were positive, with HeLa cells showing a high level of Snail expression. Occludin and ZO-1 expression was detected in both cell lines. No expression was observed for claudin 1 or claudin 5 tight junction proteins in HeLa cells or CaSki cells. Loss of expression of claudin 1, claudin 5 and E-cadherin, with concomitant increase in Snail may be associated with loss of epithelial cell polarity and alterations in intercellular adhesion.