A MAN whose jaw was broken during dental surgery he did not need has won A 15,000 in compensation. Clive Horsey, who lives in Radlett, has been left with permanent numbness and still struggles to eat certain foods after the shambolic procedure.
The purpose of this study was to analyze the characteristics of cracked teeth and to evaluate pulp status according to periodontal probing depth (PPD).
A total of 182 cracked teeth were included. The location and type of the cracked teeth, age and gender of the patients, restoration type, pulp status, PPD, and radiographic findings were analyzed.
Mandibular second molars (25.3%) were the most frequently involved teeth, followed by mandibular first molars (22.5%), maxillary first molars (22.0%), and maxillary second molars (17.6%). The patient age was most frequently 50–59 years. Cracks occurred mainly in nonbonded restorations, such as gold (26.9%), and were usually found in intact teeth (37.9%). A total of 103 teeth (56.6%) had an initial PPD of less than 3 mm, while 40 (22.0%) had a PPD of 4–6 mm, and 39 (21.4%) had PPD of 7 mm or more. A total of 33 cracked teeth (18.1%) were diagnosed with pulp necrosis, 40 (22.0%) with irreversible pulpitis, and 97 (53.3%) with reversible pulpitis. The incidence of pulp necrosis was 31.8% among cracked teeth with a PPD of 4–6 mm, and 28.6% among those with a PPD of 7 mm or more.
Cracks occurred mainly in molar teeth, and were commonly found in intact teeth with no restoration. Patients with cracked teeth were most frequently aged 50–59 years. Cracked teeth showing a PPD of more than 4 mm were more likely to show pulp necrosis.
Implementing community water fluoridation involves costs, but these need to be considered against the likely benefits. We aimed to assess the cost-benefit and cost-effectiveness of water fluoridation in New Zealand (NZ) in terms of expenditure and quality-adjusted life years.
Based on published studies, we determined the risk reduction effects of fluoridation, we quantified its health benefits using standardised dental indexes, and we calculated financial savings from averted treatment. We analysed NZ water supplies to estimate the financial costs of fluoridation. We devised a method to represent dental caries experience in quality-adjusted life years.
Over 20 years, the net discounted saving from adding fluoride to reticulated water supplies supplying populations over 500 would be NZ$1401 million, a nine times pay-off. Between 8800 and 13,700 quality-adjusted life years would be gained. While fluoridating reticulated water supplies for large communities is cost-effective, it is unlikely to be so with populations smaller than 500.
Community water fluoridation remains highly cost-effective for all but very small communities. The health benefits—while (on average) small per person—add up to a substantial reduction in the national disease burden across all ethnic and socioeconomic groups.
Lip repositioning is a conservative surgical technique used to treat excess gingival display. An array of modifications has been introduced to the technique over time and as studies show the technique and its modifications to be successful, there is little standardized information for clinicians to make informed decisions when choosing this technique for the treatment of patients with excessive gingival display (EGD).
To review the current literature on the topic of lip repositioning for the treatment of excessive EGD, exploring outcome, and result longevity.
A structured systematic search was carried out using the Ovid database and Web of Science to identify published studies on lip repositioning technique. Search was restricted to studies in the English language, describing a surgical intervention. Case reports were included as the number of published studies was limited.
The electronic search identified 93 articles, hand search identified 1 article, and reference search identified 1 article. After excluding duplicates and screening articles, a total of 22 articles met the inclusion criteria. An estimated mean improvement of 3.4 mm (95% confidence interval, 3.0-3.8 mm) was found possible with lip repositioning. Data analysis was performed using only 4 studies, amounting to a total of 33 patients. Potential risk of bias was identified in some of the studies included.
Despite the limited available studies on lip repositioning, an estimated mean improvement of 3.4 mm was found to be possible with surgical lip repositioning, suggesting that the technique could be used successfully to treat EGD. However, more studies are necessary to properly evaluate the treatment approach and stability of the technique.
Recently, the demand for esthetics has significantly increased, driven by increased patient awareness and the search for an ideal smile. Creating the perfect smile is an intricate process that requires a multidisciplinary approach, with careful consideration of the lips and the gingival outline. Excess gingival display results in an unaesthetic smile, lip repositioning offers a comparatively simple solution for this problem. While the quality literature on this topic is limited statistical analysis of collected studies show that an estimated mean improvement of 3.4 mm can be achieved with surgical lip repositioning.
It is hypothesized that peri-implant clinical and radiographic inflammatory parameters (probing depth [PD], bleeding on probing [BOP] and plaque index [PI]; and radiographic (crestal bone loss [CBL]) are worse among cigarette-smokers (CS) compared with never-smokers (NS) with short implants.
The present 6-year follow-up retrospective study compared the peri-implant clinical and radiographic parameters in CS and NS with short dental implants (6 mm in length).
Fifty-six male individuals were included. These individuals divided into 2 groups as follows: (a) Group-1: 29 self-reported systemically healthy CS with 48 short-implants; and (b) Group-2: 27 self-reported systemically healthy NS with 43 short implants. Peri-implant PD, PI, BOP, and CBL were measured. Group comparisons were done using the Kruskal-Wallis test and sample size was estimated. Level of significance was set at P values < .05.
In groups 1 and 2, the follow-up durations were 6.2 ± 0.1 years and 6.1 ± 0.3 years, respectively. A cigarette smoking history of 8.9 ± 3.6 pack years was reported by individuals in Group-1. At follow-up, scores of peri-implant PD, BOP, PI, and mesial and distal CBL were comparable around short implants in both groups.
Under strict oral hygiene maintenance protocols, short dental implants can remain functionally stable in CS in a manner similar to NS.
Hoar said he's been overcome with emotion each time he seeks another dental appointment to have the procedure completed. A grandfather has spoken of his horror after ending up in hospital to have a serrated metal file removed from his stomach following a routine dental procedure.
Improvements of soft tissue to the abutment surface results in more stable peri-implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials.
To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period.
Fifteen edentulous sites were treated with implants. Eight weeks later, peri-implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups.
There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group.
The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments.
Many studies have investigated the effectiveness of root canal irrigants and medicaments against Enterococcus faecalis. The aim was to compare the efficacy of commonly used medicaments against Enterococcus faecalis cultured as a biofilm on dentine substrate.
An E. faecalis biofilm was established on human dentine slices using a continuous flow cell. Each test medicament (Ledermix, Ca(OH)2, Odontoposte, 0.2% chlorohexidine and 50:50 combinations of Ledermix/Ca(OH)2 and Odontopaste/ Ca(OH)2) was introduced into the flow cell and biofilms were harvested and quantitated by determining cellular protein. Cellular viability was determined using serial plating and the number of colony forming units was normalised against cellular protein to allow treatment protocols to be compared. Qualitative SEM analyses of the biofilm were done after a 48-hour exposure to each test agent.
Sodium hypochlorite achieved total bacterial elimination. Ledermix and Odontopaste had no significant effect on the E. faecalis biofilm. Ca(OH)2 and 50:50 combinations of Ca(OH)2 /Ledermix or Ca(OH)2/Odontopaste reduced the viability by > 99% while 0.2% chlorhexidine reduced bacterial numbers by 97%.
Sodium hypochlorite remains the gold standard for bacterial elimination in root canal therapy. However, Ca(OH)2 in isolation and combined with Ledermix, and Odontopaste was highly effective in reducing bacterial viability.
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We investigated the prognosis after three years of treatment for recurrent dislocation of the temporomandibular joint with autologous blood given intravenously in 21 patients with a mean (range) age 64 (17-92) years of whom 16 had coexisting systemic disease. The mean (range) follow up from the first injection was 64 (41-99) months. Eighteen patients had no recurrence during the first 36 months after their first injection, which showed that this minimally-invasive treatment was effective, particularly for those who had conditions that made a mouthpiece or operation unsuitable.
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To describe and evaluate a training intervention for recruiting patients to randomized controlled trials (RCTs), particularly for those anticipated to be difficult for recruitment.
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Evaluate comparative harm-rates from medical interventions in pediatric randomized-trials (RCTs) from more-developed (MDCs) and less-developed countries (LDCs).
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To compare Clinical Queries (CQs) for randomized trials of therapy 'methods' and 'NOT' limits search filters with Cochrane methods filters (CSs).
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Tinnitus is an auditory sensation that can cause discomfort or even pain. Because patients with tinnitus frequently have psychological problems, self-reporting of the severity of tinnitus is unreliable. We developed a new grading system and practical protocol for the systematic treatment of tinnitus that accounts for its severity, patients' psychological problems, and the frequency of catastrophic episodes. The aim of this study is to employ and validate the new system in patients with tinnitus.
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Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey
Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey, Published online: 27 November 2017; doi:10.1038/s41371-017-0003-4
Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional surveyPrevalence and correlates of hypertension in a semi-rural population of Southern India
Prevalence and correlates of hypertension in a semi-rural population of Southern India, Published online: 27 November 2017; doi:10.1038/s41371-017-0010-5
Prevalence and correlates of hypertension in a semi-rural population of Southern IndiaTwo heart failure phenotypes in arterial hypertension: a clinical study
Two heart failure phenotypes in arterial hypertension: a clinical study, Published online: 27 November 2017; doi:10.1038/s41371-017-0017-y
Two heart failure phenotypes in arterial hypertension: a clinical studyThe healthcare industry is one of the most expansive in the world as it houses various types of companies. It's an industry that is naturally very closely tied to government regulation and interference which can result in volatile price swings as new legislative measures are proposed and sometimes implemented.
Consideration of drug benefits and harms is asymmetric. Approval of drugs is mainly based on efficacy, while the assessment of their safety is left to post-marketing commitments or spontaneous reporting. Benefits are overestimated as a result of pharmaceutical companies' advertisements, the paucity of independent information, and the scant understanding of the effectiveness of medicines in real life. Polypharmacy in older adults—even during the last period of their life—reflects the tendency to assign priority to efficacy and overlook harms, although nobody knows what happens when three or more drugs are given chronically. Medical journals and public research funding projects do not pay enough attention to drug toxicity. We call for a sense of purpose by all those involved in medicine to tackle this problem. European and national agencies and health authorities should promote and support independent information and experimental and clinical studies on drug toxicity. Information should rely not just on spontaneous reporting but also on active pharmacovigilance. The benefit-harm profile of drugs should be periodically reviewed in the light of toxic effects that come to light over the years. Potential interactions within polytherapies should be sought by re-assessing the pharmacokinetics and pharmacodynamics of their components.
In this study, we present a systematic characterization of hair cell loss and regeneration in the chicken utricle in vivo. A single unilateral surgical delivery of streptomycin caused robust decline of hair cell numbers in striolar as well as extrastriolar regions, which in the striola was detected very early, 6 h post-insult. During the initial 12 h of damage response, we observed global repression of DNA replication, in contrast to the natural, mitotic hair cell production in undamaged control utricles. Regeneration of hair cells in striolar and extrastriolar regions occurred via high rates of asymmetr ic supporting cell divisions, accompanied by delayed replenishment by symmetric division. While asymmetric division of supporting cells is the main regenerative response to aminoglycosi...
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AbstractDetection of medial olivocochlear-induced (MOC) changes to transient-evoked otoacoustic emissions (TEOAE) requires high signal-to-noise ratios (SNR). TEOAEs associated with synchronized spontaneous (SS) OAEs exhibit higher SNRs than TEOAEs in the absence of SSOAEs, potentially making the former well suited for MOC assays. Although SSOAEs may complicate interpretation of MOC-induced changes to TEOAE latency, recent work suggests SSOAEs are not a problem in non-latency-dependent MOC assays. The current work examined the potential benefit of SSOAEs in TEOAE-based assays of the MOC efferents. It was hypothesized that the higher SNR afforded by SSOAEs would permit detection of smaller changes to the TEOAE upon activation of the MOC reflex. TEOAEs were measured in 24 female subjects in t...
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Despite having normal hearing sensitivity, patients with chronic tinnitus may experience more difficulty recognizing speech in adverse listening conditions as compared to controls. However, the association between the characteristics of tinnitus (severity and loudness) and speech recognition remains unclear. In this study, the Quick Speech-in-Noise test (QuickSIN) was conducted monaurally on 14 patients with bilateral tinnitus and 14 age- and hearing-matched adults to determine the relation between tinnitus characteristics and speech understanding. Further, Tinnitus Handicap Inventory (THI), tinnitus loudness magnitude estimation, and loudness matching were obtained to better characterize the perceptual and psychological aspects of tinnitus. The patients reported low THI scores, with most participants in the slight handicap category. Significant between-group differences in speech-in-noise performance were only found at the 5-dB signal-to-noise ratio (SNR) condition. The tinnitus group performed significantly worse in the left ear than in the right ear, even though bilateral tinnitus percept and symmetrical thresholds were reported in all patients. This between-ear difference is likely influenced by a right-ear advantage for speech sounds, as factors related to testing order and fatigue were ruled out. Additionally, significant correlations found between SNR loss in the left ear and tinnitus loudness matching suggest that perceptual factors related to tinnitus had an effect on speech-in-noise performance, pointing to a possible interaction between peripheral and cognitive factors in chronic tinnitus. Further studies, that take into account both hearing and cognitive abilities of patients, are needed to better parse out the effect of tinnitus in the absence of hearing impairment.
A hearing has been scheduled for as early as this week for a sunrise application that some representatives feel could improve access to dental care for rural areas such as Yuma. At the beginning of September, Dental Care of Arizona filed a "sunrise" application with the Arizona Legislature for the licensure of dental therapists.
The government will encourage medical schools to introduce surgical training for practicing doctors and dentists using donated bodies in a bid to reduce malpractice, health ministry sources said Sunday. The ministry has requested A 500 million in the state budget for fiscal 2018 to subsidize universities introducing the training program, more than 10 times the amount allotted in the budget for the current fiscal year, the sources said.
Mountain Park Elementary School held a Health & Wellness Fair recently. Students learned about public safety, healthy eating, dental health, prescription drug awareness, personal hygiene, fire safety, fast foods/fats and opportunities with Surry County Parks & Recreation from guest speakers.
Genome editing for the reproduction and remedy of human diseases in mice
Genome editing for the reproduction and remedy of human diseases in mice, Published online: 27 November 2017; doi:10.1038/s10038-017-0360-4
Genome editing for the reproduction and remedy of human diseases in miceCombinations of chromosome transfer and genome editing for the development of cell/animal models of human disease and humanized animal models
Combinations of chromosome transfer and genome editing for the development of cell/animal models of human disease and humanized animal models, Published online: 27 November 2017; doi:10.1038/s10038-017-0378-7
Combinations of chromosome transfer and genome editing for the development of cell/animal models of human disease and humanized animal modelsTo explore the association between toothbrushing behaviour and change in periodontal pocketing among adults.
We pooled data from 1025 adults, aged 30-89 years, who participated in two national surveys in Finland (Health 2000 and Health 2011, BRIF8901) and reported their toothbrushing frequency. A cumulative measure of regular toothbrushing was created by counting the number of times participants reported brushing twice or more daily across the two surveys (ranging from 0 to 2). The association between toothbrushing behaviour and the number of teeth with periodontal pocket depth (PPD)≥4mm over 11 years was assessed in linear regression models adjusting for confounders.
There was a clear dose-response relationship between toothbrushing frequency (either at baseline or follow-up) and change in number of teeth with PPD≥4mm. There was also evidence of a cumulative effect of regular toothbrushing on change in number of teeth with PPD≥4mm. Participants who reported brushing twice or more a day in both surveys developed 1.99 (95% CI: 1.02 to 2.95) fewer teeth with PPD≥4mm than those who did not report this behaviour in any survey.
This 11-year prospective study showed that toothbrushing behaviour was associated with smaller increments in the number of teeth with periodontal pocketing.
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To quantify the impact of life course income trajectories on periodontitis in adulthood.
Data from the 1982 Pelotas Birth Cohort Study, Brazil was used. Information on family income was collected at birth and ages 15, 19, 23 and 30 years. Group-based trajectory modelling was used to identify income trajectories. Periodontal measures were assessed through clinical examination at age 31. Log-Poisson regression models were used to estimate prevalence ratios (PRs) of any and moderate/severe periodontitis, as outcomes.
Prevalence of any periodontitis and moderate/severe periodontitis was 37.3% and 14.3% (n=539). Income trajectories were associated with prevalence of moderate/severe periodontitis. Adjusted PR in participants in low and variable income trajectory was 2.1 times higher than in participants in stable high income trajectory. The unadjusted association between income trajectories and prevalence of any periodontitis was explained by the inclusion of behavioral and clinical variables in the model.
Low and variable life course income increased the prevalence of moderate/severe periodontitis at age 31 years. The findings may inform programs in identifying and targeting potentially at-risk groups during the life course in order to prevent periodontitis.
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Salivary gland neoplasms are rare tumors, with most arising in the parotid gland. Fine-needle aspiration cytology (FNAC) is a common method for pre-operative evaluation of parotid masses, although its usefulness is controversial. This study was designed to evaluate the accuracy of FNAC in a large cohort of patients, with emphasis on diagnosis of benign tumors and especially Warthin tumor which can be managed conservatively.
Retrospective case series with chart review.
Tertiary medical center.
From 1991 to 2014, all patients 18 or older with both pre-operative FNAC and post-operative pathology report were included. Patients with a history of head and neck malignancy, sialoadenitis or had undergone prior oncological treatment were excluded.
470 patients were available for analysis. Overall accuracy was 82.6%. Positive predictive value (PPV) varied between 88.6-94.3% for pleomorphic adenoma and 77.1-100% for Warthin tumor, with values varying depending on different patient charcteristics (e.g. age, smoking status). For pathologically proven malignant tumors, the FNAC diagnosis was benign or non-diagnostic in 26% of cases.
FNAC has limited utility in confirming a benign diagnosis of a parotid mass for most patients, although for some sub-populations the PPV may be high enough to defer surgery.
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Evaluation of assay performance on post-mortem blood specimens (obtained after cessation of the heartbeat) presents unique scientific and regulatory challenges. In the United States, assay performance is evaluated in part by spiking postmortem specimens.
Fifty-four specimens obtained from decedents known to be infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV), including some coinfections, were tested for each virus using Food and Drug Administration (FDA)-licensed donor screening tests for nucleic acid, antibody, and antigen.
For each disease, >95% of subjects who were reported to have an infection at the time of death had a positive test result on at least one of the donor screening assays for that infection.
Licensed donor screening tests were positive on postmortem specimens obtained within 24 hours of death from individuals dying with HIV, HCV, and/or HBV, and were able to detect presence of the virus. The use of multiple tests (including antibody and direct viral detection methods) is necessary to adequately evaluate donors.
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Dengue infection has been associated with multiple renal complications, including glomerulonephritis, acute tubular necrosis, tubulointerstitial nephritis, and thrombotic microangiopathy (TMA); the last one being a rare complication of dengue, with only a few reported cases. TMA associated with dengue can be explained by an alteration in the activity of the enzyme ADAMTS13, leading to thrombotic thrombocytopenic purpura; or it can be secondary to direct or indirect endothelial injury by the virus, which leads to hemolytic uremic syndrome. Here, we present a case of severe TMA, not related to ADAMTS13, which was clearly associated to dengue infection.
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To develop a core information set for informed consent to surgery for oral/oropharyngeal surgery. A core information set is baseline information rated important by patients and surgeons, and is intended to improve patients' understanding of the intended procedure.
A mixed methods study. Systematic reviews of scientific and written healthcare literature, qualitative interviews and observations, Delphi surveys, and group consensus meetings identified information domains of importance for consent.
A regional head and neck clinic in the United Kingdom. Questionnaire participants were recruited from around the UK.
Patients about to undergo, or who had previously undergone, surgery for oral/oropharyngeal cancer. Healthcare professionals involved in the management of head and neck cancer.
The main outcome was a core information set.
Systematic reviews, interviews and consultation observations yielded 887 pieces of information that were categorised into 87 information domains. Survey response rates were 67% (n=50) and 71% (n=52) for patient and healthcare professional groups in round one. More than 90% responded in each group in the second round. Healthcare professionals were more likely to rate information about short-term or peri-operative events as important while patients rated longer-term issues about survival and quality of life. The consensus-building process resulted in an agreed core information set of 13 domains plus two procedure-specific domains about tracheostomy and free flap surgery.
This study produced a core information set for surgeons and patients to discuss before surgery for oral/oropharyngeal cancer. Future work will optimise ways to integrate core information into routine consultations.
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To evaluate apical transportation and centring ability during root canal preparation in mesial root canals of mandibular molars associated with ProTaper Gold (PTG), ProDesign S (PDS), Hyflex CM (HCM), Hyflex EDM (HEDM) and ProDesign Logic (PDL).
Sixty first mandibular molars with two separete canals in the mesial root were selected after root anatomy pairing by microcomputed tomography (microCT). The teeth were randomly divided into 5 groups (n = 24); the root canal volume was calculated to ensure sample homogeneity. All the root canals were prepared up to size 25 in accordance with the instructions of each rotary system manufacturer. After root canal preparation, the teeth were scanned by microCT to analyse apical transportation, root canal centralization and the pre- and post-preparation root canal volume at the apical and cervical levels.
There were no significant differences in apical transportation among the rotary systems (P > 0.05). All the systems created apical transportation; values ranging from 0.031 mm (PDL) to 0.072 mm (PTG), and enlargements between 39% (HCM) and 91.1% (PDS) were observed. In relative to cervical transportation, significant differences were observed among the systems (P < 0.05). Mean transportation values between 0.07 mm (HCM) and 0.172 mm (PTG) were found, with enlargements between 35.4% (HCM) and 51.5% (PDS). Kruskal-Wallis and Dunn tests were used for comparisons among groups for transportation values. For volume changes, the parametric ANOVA and Tukey's tests were used.
All the thermally treated systems resulted in similar apical transportation. In the cervical region, the Hyflex CM and Prodesign Logic systems provided more centred preparations.
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To investigate in situ Enterococcus faecalis biofilm removal from the lateral canal of a simulated root canal system using passive or active irrigation protocols.
Root canal models (n = 43) were manufactured from transparent resin materials using 3D-printing. Each canal was created with an 18 mm length, apical size 30, a .06 taper, and a lateral canal of 3 mm length, 0.3 mm diameter. Biofilms were grown on the lateral canal and apical 3 mm of the main canal for 10 days. Biofilm of three models was examined using SEM. The other forty models were divided to four groups (n = 10). The models were observed under a fluorescence microscope. Following 60 s of 9 mL of 2.5% NaOCl irrigation using syringe and needle, the irrigant was either left stagnant in the canal or activated using gutta-percha, sonic or ultrasonic methods for 30 s. Images were then captured every second using an external camera. The residual biofilm percentages were measured using image analysis software. The data were analyzed using generalized linear mixed models. A significance level of 0.05 was used throughout.
The greatest level of biofilm removal was with ultrasonic agitation (66.76%) followed by sonic (45.49%), manual agitation (43.97%), and passive irrigation groups (38.67%) respectively. The differences were significant between the residual biofilm in the passive irrigation and both sonic & ultrasonic groups (P = 0.001).
Agitation resulted in better penetration of the 2.5% NaOCl into the lateral canal of an artificial root canal model. Ultrasonic agitation of NaOCl improved the removal of biofilm.
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South Dakota Investment Council bought a new position in shares of Patterson Companies, Inc. during the third quarter, according to its most recent Form 13F filing with the SEC. The fund bought 38,500 shares of the company's stock, valued at approximately $1,488,000.
Alemtuzumab as part of the conditioning protocol is effective in reducing graft-versus-host disease (GvHD), but may be associated with increased infection rates, especially when using high doses (ie, 100 mg).
We performed a retrospective, single-centre, case–control study analysing the rates of neutropenic fever, cytomegalovirus (CMV) reactivation, Epstein-Barr virus (EBV) reactivation, clinical manifest toxoplasmosis, and clinical manifest human herpesvirus-6 (HHV6) infection using low-dose alemtuzumab in comparison with anti-thymocyte globulin (ATG) as GvHD prophylaxis before allogeneic stem cell transplantation. Forty-four patients transplanted from unrelated donors between 2001 and 2012 were matched by age, diagnosis, and conditioning regimen and treated either with alemtuzumab 10 mg at day -2 (respectively 20 mg in case of mismatch transplantation) or ATG. ATG Fresenius (10 mg/kg for 3 days) or Thymoglobulin (2 mg/kg for 3 days) were used.
Rates of CMV reactivation, EBV reactivation, and clinical manifest HHV6 infection or toxoplasmosis did not differ significantly between both groups until 2 years after transplantation. No case of post-transplant lymphoproliferative disorder was observed. Also, rates of neutropenic fever during inpatient treatment after transplantation did not differ significantly in both groups.
We saw no indication of increased infections rates when using low-dose alemtuzumab as GvHD prophylaxis before allogeneic stem cell transplantation in this retrospective analysis.
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T-cell depletion (TCD) effectively reduces severe graft-versus-host disease in recipients of HLA-mismatched allografts. However, TCD is associated with delayed immune recovery and increased infections. We hypothesized that specific depletion of CD45RA+ naïve T cells, rather than broad depletion of CD3+ T cells, can preserve memory-immunity in the allografts, and confer protection against important viral infections in the early post-transplant period.
Sixty-seven patients who received TCD haploidentical donor transplantation for hematologic malignancy on three consecutive trials were analyzed.
Patients receiving CD45RA-depleted donor grafts had 2000-fold more donor T cells infused, significantly higher T-cell counts at Day +30 post transplant (550/μL vs 10/μL; P< .001), and higher T-cell diversity by Vbeta spectratyping at Day +100 (P < .001). Importantly these recipients experienced a significant reduction in both the incidence (P = .002) and duration (P = .02) of any viremia (cytomegalovirus, Epstein-Barr virus, or adenovirus) in the first 6 months post transplant. Specifically, recipients of CD3-depleted grafts were more likely to experience adenovirus viremia (27% vs 4%, P = .02).
CD45RA-depletion provided a large number of donor memory T cells to the recipients, and was associated with enhanced early T-cell recovery and protection against viremia.
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Before the 2014 policy change pertaining to infectious disease screening, many organ procurement organizations (OPOs) were supplementing serologic screening of deceased organ donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), and hepatitis C virus (HCV). The number of seronegative, NAT-positive donors has not been directly measured.
HIV, HBV, and HCV screening results of 11 229 donor referrals evaluated from 2010 to 2013 were obtained from three OPO-affiliated laboratories, capturing 35% of all donors in the United States. Laboratories used either polymerase chain reaction assay or transcription-mediated amplification assay to test 9643 deceased donors by NAT.
NAT results were positive in 21 (0.2%), 1 (0.02%) and 11 (0.1%) donors who were seronegative for HIV, HBV, and HCV, respectively. All discordant HIV-1 results were from one laboratory using a polymrease chain reaction assay. Thirteen of the reactive HIV NAT results in seronegative referrals were repeated and were non-reproducibly positive (NRP). Ten (0.1%), 452 (7.8%), and 197 (2.2%) of HIV, HBV, and HCV seropositive donors, respectively, were negative by NAT.
This study highlights the importance of robust quality-assurance to minimize NRP NAT results. NAT may allow for increased utilization of organs from HBV- and HCV- seropositive, NAT-negative donors.
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A group of engineers at the University of Victoria (UVic) in Canada has received a $100,000 seed grant for the development of 3D printed back braces and orthoses. The medical devices are to be introduced as part of a non-profit initiative in low-income communities around the globe, helping treat children suffering from birth defects such […]
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I am a big fan of the Jiffy Polishing System from Ultradent which is a universal system that allows you to polish any ceramic material on the market including zirconia. Now don't get me wrong, there are *a lot of good polishing systems out there* and I'm a big proponent of advising people that when it comes to polishing, use what you are comfortable with. Good systems are available from Coltene, Dentsply, and many other companies. However, for me I've always liked the Jiffy System. I've found that it gives me a really great shine that lasts. Yet, if there was one thing I would change about Jiffy, it would be the access it provides to grooves as well as small nooks & crannies. The Jiffy Brush provides access to these areas, but as a final polish only and it works much better with composite than porcelain.
So the Ultradent choices have been the ones below which consist of an intraoral kit that works with a latch grip and an extra oral kit that works with a straight nose cone:
In the past couple of years dentistry has seen the development of what I call "saw shape" polishers which are the wheels on the right side in the top picture in this post. The little "tines" in the wheels flex and go into all of those hard to read areas. They are available in several different grits and work really well.
Now Ultradent has brought this style of polisher to the Jiffy line. Here is the link to order, otherwise read on for the details:
Ultradent Products, Inc., proudly introduces the Jiffy® Natural Universal Finishing System—a complement to Ultradent's renowned Jiffy® Universal Finishing System. The polishers in the Jiffy Natural Universal Finishing System are designed to efficiently and easily reach all tooth surface areas to give a natural finish on all ceramic materials, including zirconia. They can also be used to temper super high-gloss finishes to create the look of natural enamel.
The Jiffy Natural Universal System consists of malleable spiral-shaped wheels that are designed to easily conform to tooth anatomy. Their pliable, finger-like extensions easily reach where cups and points can't, including occlusal anatomy. The system is designed to be used in conjunction with the Jiffy Universal Finishing System to give clinicians options and versatility to achieve the right esthetic look for their patient. The efficient two-step process allows clinicians to easily get the most natural finish they desire on any ceramic material, including zirconia, lithium disilicate, and porcelain.
To learn more about the Jiffy Natural Universal System, please call 800.552.5512, or visit ultradent.com.
Individuals with anxiety/depression often have exaggerated cardiovascular responses to stressful stimuli and a comorbidity with hypertension. Alternatively, individuals with hypertension can be more anxious. In the present study cardiovascular changes were evaluated during behavioral testing of anxious behavior on the elevated plus maze (EPM) in the spontaneously hypertensive rat (SHR), a rodent model of neurogenic hypertension, and compared to the response of the more anxious, but normotensive, Wistar-Kyoto rat (WKY). Manganese-enhanced magnetic resonance imaging (MEMRI) was used to identify regional differences in baseline brain activity. Parallel to indicators of elevated behavioral anxiety on the EPM, WKYs had a greater increase in blood pressure but not heart rate when compared to the SHR while on the EPM. Associated with differences in anxiety-related behavior and autonomic responses, we observed increased baseline activity in the amygdala, central gray, habenula and interpeduncular nucleus with MEMRI of the WKY compared to the SHR. Conversely, elevated baseline brain activity was found in regions associated with blood pressure control and system arousal, including the hypothalamus, locus coeruleus and pedunculopontine tegmental nucleus, in the SHR vs WKY, in-line with increased resting blood pressure and increased mobility in this strain. Lastly, reduced activity in hippocampal regions was identified in the SHR compared to the WKY and may be associated with cognitive impairment previously reported in the SHR. Thus, autonomic reactivity may be a true measure of stress in rodent models of anxiety and MEMRI presents a powerful technique to uncover novel brain mechanisms of blood pressure control.
The aim of this analysis is to compare the pharmacokinetics of drug substrates in healthy Chinese and European subjects of aligned CYP2C9, CYP2C19, or CYP2D6 enzyme activity, providing further insight into drivers of interethnic differences in pharmacokinetics.
Following identification of appropriate drug substrates, a comprehensive and structured literature search was conducted to identify single-dose pharmacokinetic data in healthy Chinese or European subjects with reported CYP2C9, CYP2C19, or CYP2D6 activity (genotype or phenotype). The ratio of drug AUC in the Chinese and European subjects classified with aligned enzyme activity was calculated (ethnicity ratio (ER)).
For 22/25 drugs identified, the ERs calculated indicated no or only limited interethnic differences in exposure (<twofold) in Chinese and European subjects with aligned polymorphic enzyme activity. The interethnic differences observed can reflect differences across populations in additional determinants of pharmacokinetics, although the notable between study variation and change over time in methods used to assign enzyme activity may also be contributing factors. There was no association between drug substrate fraction metabolized (fm) for CYP2C9, CYP2C19, or CYP2D6 and the ERs calculated.
The spectrum of pharmacokinetic determinants for each drug substrate and their differences across ethnic groups must be considered on a case-by-case basis in addition to metabolism by CYP2C9, CYP2C19, or CYP2D6. This analysis has also highlighted the challenges which arise when comparing published datasets if consistent methods to assign polymorphic enzyme activity have not been used.
Figures from the American College of Prosthodontists show 178 million Americans are missing at least one tooth, and 35 million Americans are missing all their teeth on one or both arches. A transplant from New Orleans has opened a new local dental practice to help provide affordable dentals and implants.
ASXL1 frameshift mutations drive inferior outcomes in CMML without negative impact in MDS
<i>ASXL1</i> frameshift mutations drive inferior outcomes in CMML without negative impact in MDS, Published online: 27 November 2017; doi:10.1038/s41408-017-0004-0
ASXL1 frameshift mutations drive inferior outcomes in CMML without negative impact in MDSMinimal residual disease by either flow cytometry or cytogenetics prior to an allogeneic hematopoietic stem cell transplant is associated with poor outcome in acute myeloid leukemia
Minimal residual disease by either flow cytometry or cytogenetics prior to an allogeneic hematopoietic stem cell transplant is associated with poor outcome in acute myeloid leukemia, Published online: 27 November 2017; doi:10.1038/s41408-017-0007-x
Minimal residual disease by either flow cytometry or cytogenetics prior to an allogeneic hematopoietic stem cell transplant is associated with poor outcome in acute myeloid leukemia
