Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174: 08/23/17

Τετάρτη 23 Αυγούστου 2017

Issue Information - Masthead

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Issue Information - Table of Contents

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What would Dr. James Parkinson think today? The role of genetics in Parkinson's disease

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Movement Disorders: Volume 32, Number 8, August 2017

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Is any job better than no job at all? Studying the relations between employment types, unemployment and subjective health in Belgium

This study focuses on the health impact of the labour market position, since recent research indicates that exposure to both unemployment and precarious employment causes serious harm to people's health and we...

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Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview- Part I: Vital pulp therapy

Abstract

Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration (FDA) to be used in the U.S. in 1997. A number of new Bioactive Endodontic Cements (BECs) have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium enriched mixture (CEM) cement, CAPSEAL, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT) including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy, and partial pulpectomy, have been reviewed and compared. Based on selected key words all papers regarding chemical composition and VPT applications of BECs had been reviewed.

Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term "bioactive endodontic cements (BECs)," which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect pulp capping, partial pulpotomy, and cervical pulpotomy. Most of these investigations used MTA for VPT.

In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is very limited. Most studies have had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.

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Erratum to: Comorbidities of Atopic Dermatitis: Beyond Rhinitis and Asthma

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White matter fiber integrity of the saccadic eye movement network differs between schizophrenia and healthy groups

Abstract

Recent diffusion tensor imaging (DTI) studies suggest that altered white matter fiber integrity is a pathophysiological feature of schizophrenia. Lower white matter integrity is associated with poor cognitive control, a characteristic of schizophrenia that can be measured using antisaccade tasks. Although the functional neural correlates of poor antisaccade performance have been well documented, fewer studies have investigated the extent to which white matter fibers connecting the functional nodes of this network contribute to antisaccade performance. The aim of the present study was to assess the white matter structural integrity of fibers connecting two functional nodes (putamen and medial frontal eye fields) of the saccadic eye movement network implicated in poor antisaccade performance in schizophrenia. To evaluate white matter integrity, DTI was acquired on subjects with schizophrenia and two comparison groups: (a) behaviorally matched healthy comparison subjects with low levels of cognitive control (LCC group), and (b) healthy subjects with high levels of cognitive control (HCC group). White matter fibers were tracked between functional regions of interest generated from antisaccade fMRI activation maps, and measures of diffusivity were quantified. The results demonstrated lower white matter integrity in the schizophrenia group than in the HCC group, but not the LCC group who showed similarly poor cognitive control performance. Overall, the results suggest that these alterations are not specific to the disease process of schizophrenia, but may rather be a function of uncontrolled cognitive factors that are concomitant with the disease but also observed in some healthy people.

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Association between left atrial enlargement and obstructive sleep apnea in a general population of 71-year-old men

Summary

Left atrial enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left atrial enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea–hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm² versus 21.6 ± 4.5 cm², P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left atrial enlargement after adjusting for overweight, atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left atrial area was 1.7 ± 1.5 cm² larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm² larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left atrial area was independently associated with prevalence and severity of obstructive sleep apnea.

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Use of antidepressants in dentistry: a systematic review

Abstract

Objective

Previous research has suggested that antidepressants can be used in oral health care. The aim of this systematic review was to search for scientific evidence of the efficacy of the use of antidepressants in dentistry.

Materials and Methods

The clinical question was as follows (PICO Question): dentistry patients (Patients); antidepressants (Intervention); no use or placebo or other drug (Comparison); efficacy in oral health problems (Outcome). An electronic search was conducted in seven databases, as well as a manual search without restriction regarding language and date of publication. Two independent reviewers selected studies based on eligibility criteria, extracted data and assessed methodological quality based on the PEDro Scale. The PROSPERO record is number CRD42016037442.

Results

A total of 15 randomized controlled trials were associated with the use of antidepressants to control chronic or acute pain in dentistry, among other conditions such as bruxism and burning mouth syndrome. The most commonly used drug in clinical trials was amitriptyline (more than 50% of studies).

Conclusions

Antidepressants may be effective in dentistry for acute and chronic pain, but there is a large amount of methodological heterogeneity among the evaluated studies. In summary, there is rationality for the indication of this class of medicine in dentistry in specific clinical situations.

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Bleeding After Tonsillectomy

Oropharyngeal hemorrhage after tonsillectomy is one of the most common post-procedural ENT emergencies which require immediate attention. Management choices depend on the severity of bleeding, underlying platelet/coagulation disorders, and the patient′s maturity and age. Treatment range from simple observation to an emergent need to both secure the airway and stop the hemorrhage. The work up of the hemorrhagic patient will be discussed from the pre-operative to post-operative time period. Surgical techniques in response to various acuity will be discussed to fully elucidate options to control the hemorrhage.

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Cervical and craniofacial necrotizing fasciitis

Cervical and craniofacial necrotizing fasciitis is an aggressive disease process that at times has subtle etiologies and physical findings. Involvement in the head and neck is rare; however, when present it can have extensive morbidity and mortality. High index of suspicion is paramount for early treatment and survival. We describe the presentation, diagnosis and treatment of cervical and craniofacial necrotizing fasciitis. We detail the typical physical exam findings as well as diagnosis based on imaging.

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Pediatric Airway Foreign Body

Foreign body aspiration in the pediatric population is a potentially life-threatening emergency that carries both diagnostic and management challenges. Children often present after a witnessed aspiration or choking event. For those children who are asymptomatic or have nonspecific findings, clinical symptoms, chest radiography and a thorough physical examination are critical for diagnosis. A reasonable suspicion of foreign body aspiration warrants a bronchoscopy. This article focuses on the management of pediatric airway foreign bodies, including the initial evaluation, preparation and treatment approach.

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Orbital complications of acute sinusitis

In the pre-antibiotic era, orbital complications of acute sinusitis were not infrequent, often leading to severe patient morbidity, including blindness. Today, treatment of orbital complications consists primarily of systemic antibiotic therapy with surgical intervention reserved for large or medically unresponsive orbital or subperiosteal abscesses. Staging systems have been created to assist physicians in management and prognosis of such complications, but do not replace clinical acumen. While powerful antibiotics have decreased the morbidity associated with orbital complications of acute sinusitis, the physician should remain aware of potential complications and ready to escalate treatment when necessary.

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Multimodal management for acute invasive fungal rhinosinusitis

Acute invasive fungal rhinosinusitis (IFRS) is an aggressive sinonasal infection that is associated with a high risk of morbidity and mortality. Acute IFRS typically affects individuals with a deficient immune system and is characterized by a fulminant proliferation of tissue invasion by opportunistic fungal species. The early diagnosis and management of acute IFRS play important roles in improving the disease prognosis. The management of acute IFRS requires a multimodal approach that relies on both medical and surgical interventions.

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Bleeding After Tonsillectomy

Oropharyngeal hemorrhage after tonsillectomy is one of the most common post-procedural ENT emergencies which require immediate attention. Management choices depend on the severity of bleeding, underlying platelet/coagulation disorders, and the patient′s maturity and age. Treatment range from simple observation to an emergent need to both secure the airway and stop the hemorrhage. The work up of the hemorrhagic patient will be discussed from the pre-operative to post-operative time period. Surgical techniques in response to various acuity will be discussed to fully elucidate options to control the hemorrhage.

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Cervical and craniofacial necrotizing fasciitis

Cervical and craniofacial necrotizing fasciitis is an aggressive disease process that at times has subtle etiologies and physical findings. Involvement in the head and neck is rare; however, when present it can have extensive morbidity and mortality. High index of suspicion is paramount for early treatment and survival. We describe the presentation, diagnosis and treatment of cervical and craniofacial necrotizing fasciitis. We detail the typical physical exam findings as well as diagnosis based on imaging.

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Emergency Operative Airway Techniques

The Otolaryngologist-Head and Neck surgeon must be adept at providing assistance and intervening surgically in airway management when adequate ventilation becomes challenging. A step-wise and logical approach to airway emergencies can prevent poor outcomes. It is therefore important to have both a strong understanding of airway anatomy as well as an armamentarium of strategies or techniques in securing the airway if ones initial approach is problematic. The present article discusses several surgical approaches to the patient with a difficult airway.

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Management of Parapharyngeal and Retropharyngeal Space Infections

Deep neck space infection is a relatively common condition with potentially catastrophic, life-threatening complications. A detailed understanding of the topography of the neck, relationships between compartments of the neck, and the propagation of infection is essential for accurate assessment and formulation of a propitious and timely treatment plan. This chapter focuses on approaches to the deepest spaces in the anterior neck – the parapharyngeal space (PPS) and retropharyngeal space (RPS). Treatment starts with assessment and assurance of a safe, stable airway, broad spectrum intravenous antibiotics, and contrasted imaging to formulate a surgical plan.

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Pediatric Airway Foreign Body

Foreign body aspiration in the pediatric population is a potentially life-threatening emergency that carries both diagnostic and management challenges. Children often present after a witnessed aspiration or choking event. For those children who are asymptomatic or have nonspecific findings, clinical symptoms, chest radiography and a thorough physical examination are critical for diagnosis. A reasonable suspicion of foreign body aspiration warrants a bronchoscopy. This article focuses on the management of pediatric airway foreign bodies, including the initial evaluation, preparation and treatment approach.

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Orbital complications of acute sinusitis

In the pre-antibiotic era, orbital complications of acute sinusitis were not infrequent, often leading to severe patient morbidity, including blindness. Today, treatment of orbital complications consists primarily of systemic antibiotic therapy with surgical intervention reserved for large or medically unresponsive orbital or subperiosteal abscesses. Staging systems have been created to assist physicians in management and prognosis of such complications, but do not replace clinical acumen. While powerful antibiotics have decreased the morbidity associated with orbital complications of acute sinusitis, the physician should remain aware of potential complications and ready to escalate treatment when necessary.

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Periodontal treatment modulates gene expression of endothelial progenitor cells in diabetic patients

Abstract

Background

Periodontitis is closely linked with type 2 diabetes mellitus (T2DM) and endothelial dysfunction. This study investigated the effects of periodontal treatment on immuno-inflammatory gene expression of endothelial progenitor cells (EPCs) in diabetic patients.

Methods

Eighteen T2DM patients with moderate to severe chronic periodontitis were randomly assigned to the Treatment group with oral hygiene instruction (OHI), scaling and root debridement (n=11), and Control group (n=7) with OHI alone. Peripheral blood samples were taken for biochemical analysis and culture of EPCs at baseline and 6 months after the treatment. PCR array-based profiling of 84 Toll-like receptor signaling-related genes in EPCs was firstly assessed for four randomly selected patients from the Treatment group. The differentially expressed genes were then further validated by qPCR in both groups.

Results

All subjects in the Treatment group significantly improved their periodontal conditions. Among the 84 genes tested, IL-6 and IL-8 transcripts were significantly down-regulated with over 2-fold change after the treatment, and this observation was further validated by qPCR in all subjects from both groups (p<0.05).

Conclusion

This preliminary study suggests that periodontal treatment may contribute to a notable reduction of immuno-inflammatory gene expression measured by IL-6 and IL-8 transcripts in EPCs.

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Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics - a randomized clinical trial

Abstract

Aims

To investigate clinical, radiographic and microbiological outcome over 12 months following open flap debridement of peri-implantitis with or without antibiotics.

Materials and methods

Peri-implantitis was surgically treated with or without Zithromax^® in 19 control and 20 test individuals. Probing pocket depth (PPD), gingival inflammation (BOP), intra-oral radiographs and microbial samples were studied. Per protocol, and intent to treat analyzes were performed.

Results

The mean difference (reduction) in PPD values between baseline and month 12 in the test and control groups were: 1.7 mm (SD ± 1.1, 95% CI: 1.1, 2.3, p < 0.001), and 1.6 mm (SD ± 1.5, 95% CI: 0.8, 2,4, p < 0.001), respectively. Data analysis failed to show study group differences for BOP, PPD, radiographic bone level, and microbial load.

Succesful treatment (per protocol: PPD≤ 5 mm, no BOP, no suppuration and no bone loss ≥ 0.5 mm) at 12 months in test and control groups were 7/15 (46.7%), and 4/16 (25.0%). Bacterial load reduction was similar in study groups with a temporary reduction following treatment.

Conclusions

Surgical treatment of peri-implantitis with adjunctive systemic azithromycin did not provide one-year clinical benefits in comparison to those only receiving open flap debridement.

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Association between dental visits for periodontal treatment and type 2 diabetes mellitus in an elderly Japanese cohort

Abstract

Aim

There is an association between type 2 diabetes mellitus (T2DM) and periodontitis. We examined the association between the dental visit status and diabetes status in the Japanese elderly population.

Materials and methods

In total, 14,551 participants, aged 75 or 80 years, who underwent systemic health examinations were analyzed. Three independent variables of dental visit status were investigated according to dental claims data, including whether dental treatment was received, type of dental treatment (no visit, periodontal treatment, or other dental treatment), and number of days of periodontal treatment (0, 1–4, or ≥5 days). We performed multivariate logistic and linear regression analyses to examine the relationship between dental visit status and diabetes status.

Results

The multivariate odds ratio (OR) for T2DM was significantly lower (0.74, 95% confidence interval: 0.66–0.82) for subjects who received periodontal treatment compared with those who did not receive dental treatment. Subjects who received periodontal treatment had a significantly lower OR for T2DM, regardless of the number of days of treatment. In the multivariate linear regression model, receiving periodontal treatment was significantly associated with decrease in A1c (P <0.05).

Conclusion

Dental visits to receive periodontal treatment were associated with a better diabetes status in the Japanese elderly population.

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Lactate Levels with Chronic Metformin Use: A Narrative Review

Abstract

Metformin has been associated with lactic acidosis. Lactate levels are not commonly tested in clinical practice, and it is unclear to what extent metformin would typically increase lactate levels with chronic use. The aim of this review was to determine whether regular monitoring of the plasma lactate level would be beneficial in avoiding lactate accumulation and, ultimately, minimising the incidence of lactic acidosis in metformin-treated patients.

A comprehensive search of PubMed, Embase, Web of Science, Cochrane and International Pharmaceutical Abstracts databases covering the period up to 30 May 2017 was performed. Search terms included combinations of terms and keywords, including "metformin", "lactate", "lactic acid" and "lactic acidosis". Cases series of lactic acidosis or metformin-associated lactic acidosis were excluded.

Of 1539 potentially relevant articles, a total of 52 reported lactate levels from routine/regular pathological tests in metformin users. The studies were subdivided into four themes, regarding metformin usage and the reported lactate levels in patients who: (1) did not have contraindications to the use of metformin; (2) had contraindications, or renal impairment but without other contraindications; (3) exercised; or (4) also received any nucleoside reverse transcriptase inhibitor. Studies have reported that metformin treatment could increase lactate level of users. However, most results showed that the lactate level remained in the normal range.

No definitive conclusions on the benefits of regular lactate monitoring in patients taking metformin can be made. Future research on larger populations focusing on the measurement of lactate levels with continuous metformin use is warranted.

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One stone two birds: novel carbon nanotube/Bi 4 VO 8 Cl photocatalyst for simultaneous organic pollutants degradation and Cr(VI) reduction

Abstract

In this work, visible light-responsive carbon nanotubes (CNTs)/Bi₄VO₈Cl composite photocatalysts have been prepared by a facile in situ hydrothermal method and characterized by various techniques. The photocatalytic properties of the photocatalysts are evaluated by the degradation of refractory azo-dye methyl orange (MO), hexavalent chromium Cr(VI), and bisphenol A (BPA) in water under visible light irradiation. It is found that the as-prepared composite with 4 wt% CNTs shows an optimal photocatalytic performance, and its photocatalytic activity is 30% higher than that of pure Bi₄VO₈Cl. The enhanced photocatalytic activity is ascribed to the synergetic effects induced by increased light absorption, increased adsorption efficiency for pollutant, and suppressed recombination rate of photogenerated charge carriers. Furthermore, efficient removals of Cr(VI), bisphenol A (BPA), and combined contamination of Cr(VI) and BPA over CNTs/Bi₄VO₈Cl composite further confirm that the degradation of organic pollutants is a photocatalytic mechanism rather than photosensitization of dye. Of particular importance is that removal efficiency of single pollutant can be promoted by the coexistence of the Cr(VI) and organics. The mechanism of synergetic promotion is discussed and attributed to the accelerated separation of charge carriers resulted from their simultaneously being captured by pollutants. Moreover, the CNTs/Bi₄VO₈Cl composite exhibits good stability and recycling performance in the photocatalytic degradation process. Therefore, the composite photocatalysts developed in the present work are expected to have the potential in purification of complex wastewater.

Graphical abstract

The separation of photogenerated charge carriers and adsorbing capacity as well as visible light absorption ability of Bi₄VO₈Cl are significantly promoted by coupling with carbon nanotubes. Simultaneous removal of Cr(VI) and organic pollutants can be achieved by CNTs/Bi₄VO₈Cl composite photocatalysts under visible light irradiation.

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Exposure of children aged 0–7 years to perfluorinated compounds in Foshan, China

Abstract

To evaluate the exposure of children to 14 perfluorinated compounds (PFCs) in a typical and representative industrial city, plasma samples from 476 children aged 0–7 years in Foshan, China, were analysed. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in 100% of the samples, accounting for 82.27 and 11.46% of the total PFC concentrations, respectively, while PFOS peaked at age 0–1 years, for which the mean and median concentrations were 113.71 and 83.65 ng/mL, respectively, while PFOA peaked at age 3–4 years, for which the mean and median concentrations were 10.68 and 6.58 ng/mL, respectively. The concentrations of PFOS, perfluorohexane sulfonate and perfluorohexanoic acid decreased with age among children aged 0–7 years, and no gender-related differences were found in the concentrations of PFCs. A high correlation was found among all PFCs, especially between PFCs of similar carbon chains (r = 0.161–0.695, p < 0.05). In addition, the concentrations of PFOS and PFOA in children's plasma in Foshan were up to 40-fold higher than those reported in China and other countries. In conclusion, children in Foshan have extensive exposure to PFCs, especially in infancy. Further studies are needed to explore the impact of PFCs on children who live in a typical and representative industrial city in China.

Graphical abstract

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Skeletal Myoblast-Seeded Vascularized Tissue Scaffolds in the Treatment of a Large Volumetric Muscle Defect in the Rat Biceps Femoris Muscle

Tissue Engineering Part A , Vol. 0, No. 0.

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Sacral anatomy of the phytosaur Smilosuchus adamanensis, with implications for pelvic girdle evolution among Archosauriformes

Abstract

The sacrum – consisting of those vertebrae that articulate with the ilia – is the exclusive skeletal connection between the hindlimbs and axial skeleton in tetrapods. Therefore, the morphology of this portion of the vertebral column plays a major role in the evolution of terrestrial locomotion. Whereas most extant reptiles only possess the two plesiomorphic sacral vertebrae, additional vertebrae have been incorporated into the sacrum multiple times independently among early-diverging archosaurian (crocodylians + birds) clades. Phytosauria was a diverse, abundant, and cosmopolitan clade of archosauriforms throughout the Late Triassic, but postcrania of this clade are rarely described and few species-level taxonomic placements of phytosaurian postcranial material are available, potentially hampering knowledge of morphological disparity in the postcranial skeleton among phytosaurs. Here, we describe the sacrum of Smilosuchus adamanensis, a phytosaur recovered from the Upper Triassic Chinle Formation of Arizona. This sacrum consists of the two primordial sacral vertebrae, but has a vertebra incorporated from the trunk into the sacrum (= a dorsosacral) and is therefore the first Late Triassic phytosaur and one of the first non-archosaurian archosauromorphs to be described with more than two sacral vertebrae. Our interpretation of this element as a dorsosacral is justified by the lateral extent of the dorsosacral ribs, clear surfaces of articulation between the distal ends of the dorsosacral ribs and the first primordial sacral ribs, and the scar on the medial surface of each ilium for articulation with each dorsosacral rib. Additionally, we provide the first detailed description of the vertebral junction formed by two anteriorly projecting flanges on the first primordial sacral ribs and their corresponding facets on the centrum of the dorsosacral. Computed tomographic (CT) imaging reveals that the two primordial sacrals are not co-ossified and that the dorsosacral morphology of this specimen is not the result of obvious pathology. We place this incorporation of a trunk vertebra into the phytosaurian sacrum in a broader evolutionary context, with this shift in vertebral identity occurring at least seven times independently among Triassic archosauriforms, including at least three times in early crocodylian-line archosaurs and at least four times among bird-line archosaurs. Additionally, anteriorly projecting flanges of sacral ribs which articulate with the anterior-adjacent centrum have evolved several times in archosauriforms, and we interpret 'shared' sacral ribs (= a sacral rib that articulates with two adjacent sacral centra more or less equally) present in some archosaurian clades as a more extreme example of this morphology. In extant taxa the highly conserved Hox gene family plays a central role in the patterning of the axial skeleton, especially vertebral identity; therefore, the independent incorporation of a trunk vertebra into the sacrum across multiple archosauriform lineages may suggest a homologous underlying developmental mechanism for this evolutionary trend.

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The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment

Head and neck cancer carries a high level of morbidity and mortality. So why could anyone find having such a disease a positive event? The adversity hypothesis of "what doesn't kill you makes you stronger" suggests that people can use adversity to develop as human beings. This positive psychological change has received little attention in relation to head and neck cancer. Responses to the Silver Lining Questionnaire, University of Washington Quality of Life Questionnaire, and Short-Form 12 were collected from a postal survey, 3 to 12 months after the completion of treatment for head and neck cancer.

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Relatively low invasive capacity of Porphyromonas gingivalis strains into human gingival fibroblasts in vitro

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Ju Young Jang, Keum Jin Baek, Youngnim Choi, Suk Ji
ObjectiveBacterial invasion into host cells is a common strategy to escape the host immune system. Gingival fibroblasts (GFs) are the most predominant non-phagocytic cell type in gingival connective tissue. Therefore, invasion into GFs was thought to be the first strategy for the survival of Porphyromonas gingivalis. The present study compared the invasive ability of P. gingivalis into GFs with those of other red-complex and relatively less pathogenic bacterial strains, especially Fusobacterium nucleatum.Materials and methodsInvasive ability of bacterial strains into GFs was measured using a flow cytometric invasion assay at a multiplicity of infection of 1000. The effect of dual infection with F. nucleatum CCUG 37843T on P. gingivalis ATCC 49417 invasion was investigated. The invasive ability of F. nucleatum and P. gingivalis was confirmed using confocal microscopy.ResultsThe invasive ability of red-complex bacteria was markedly lower than that of F. nucleatum or Campylobacter gracilis. The invasive ability of 4 types and 10 clinical strains of P. gingivalis was less than 6%, and that of F. nucleatum strains was greater than 45%. Confocal analysis revealed that the percentage of bacteria invading GFs in the cell-treated P. gingivalis and F. nucleatum were 0.0068% and 1.22%, respectively. Dual infection with F. nucleatum increased the invasive ability of P. gingivalis.ConclusionThe invasive capacities of P. gingivalis into GFs were comparatively lower than those of relatively less pathogenic bacteria. Invasion into GFs cannot be the first strategy for survival of P. gingivalis in gingival connective tissue.

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“Metabolism of Odontoblast-like cells submitted to transdentinal irradiation with blue and red LED”

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Leopoldina de Fátima Dantas de Almeida, Fernanda Gonçalves Basso, Ana Paula Silveira Turrioni, Carlos Alberto de-Souza-Costa, Josimeri Hebling
ObjectivesThe present study evaluated the trans-dentinal effect of light emitting diodes (LEDs) irradiation on the metabolism of odontoblast-like cells.MethodsSeventy-two dentin discs (0.2mm thick) were obtained from human molar teeth. MDPC-23 cells (20,000 cells/disc) were seeded on the pulpal side of the discs using DMEM, supplemented with 10% fetal bovine serum (FBS). After 12h, the culture medium was replaced with DMEM containing 0.5% FBS. After additional 12h, blue (455±10nm) or red (630±10nm) LEDs were used at irradiances of 80 and 40mW/cm², respectively, to irradiate the occlusal side of the discs. The energy doses were fixed at 2 or 4J/cm². Cell viability, alkaline phosphatase activity (ALP), total protein production and collagen synthesis were evaluated 72h after irradiation. Data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05).ResultsRed light promoted proliferative effects at the energy dose of 4J/cm². Conversely, cell cultures irradiated with 2J/cm² emitted by the blue light showed reduced viability. ALP production was stimulated by red light in comparison with blue light at 4J/cm². Total protein production was reduced after exposure to blue light at 4J/cm², while no effect was observed on collagen production.ConclusionsIrradiation with red LED at 4J/cm² bio-stimulated the viability of odontoblast-like cells, whilst blue light had unfavorable effects on the cellular metabolism.

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Domestic reptiles as source of zoonotic bacteria: a mini review

Publication date: Available online 23 August 2017
Source:Asian Pacific Journal of Tropical Medicine
Author(s): Valentina Virginia Ebani
Captive reptiles, always more often present in domestic environment as pets, may harbor and excrete a large variety of zoonotic pathogens. Among them, Salmonella is the most well-known agent, whereas there are very scant data about infections by mycobacteria, chlamydiae and leptospirae in cold-blooded animals. However, the investigations that found antibody reactions and/or the bacteria in samples collected from free-ranging and captive reptiles show that herpetofauna may be involved in the epidemiology of these infections. The present review reports the updated knowledge about salmonellosis, mycobacteriosis, chlamydiosis and leptospirosis in reptiles and underlines the risk of infection to which people, mainly children, are exposed.

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Influenza vaccination rates before and after admission to nursing homes in Germany

Abstract

Background

Influenza vaccination is highly recommended for nursing home residents. However, it is known that vaccination coverage is low in the general population.

Aims

We aim to find out whether influenza vaccination coverage differs for nursing home residents between the year before and after admission and factors determining the chance to receive vaccination.

Methods

Claims data of the health insurance fund DAK of at least 65-year-olds were used. The proportion of residents with influenza vaccination were compared in the year before and after the admission stratified by several covariates. A multivariate logistic regression analysis was conducted to obtain predictors for influenza vaccination after admission.

Results

Vaccination coverage was overall higher in the year after admission (53.0%) than before (38.3%). Differences in vaccination coverage between most covariates evened out after admission. Differences remained for region of residence and number of comorbidities. The strongest predictor for receiving a vaccination after admission was the vaccination status before admission (OR 3.5; 95% CI 3.3–3.6) followed by region and number of comorbidities.

Discussion

Overall, vaccination coverage of nursing home residents remains lower than recommended. Doctor–patient contacts whether due to care for comorbidities or as a continuation of the relation over the time of admission to the nursing home seem to assure vaccination for residents.

Conclusion

Clear and unambiguous evidence of vaccine safety and efficacy for different subgroups within the same age group as well as organizational efforts to increase vaccination within nursing homes would be recommended.

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Breast cancer drugs tamoxifen side effects - Symptoms of adverse reactions to antifungal medications - monroviaweekly

Breast cancer drugs tamoxifen side effects - Symptoms of adverse reactions to antifungal medications
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Glucocerebrosidase expression patterns in the non-human primate brain

Abstract

Glucocerebrosidase (GCase) is a lysosomal enzyme encoded by the GBA1 gene. Mutations in GBA1 gene lead to Gaucher's disease, the most prevalent lysosomal storage disorder. GBA1 mutations reduce GCase activity, therefore promoting the aggregation of alpha-synuclein, a common neuropathological finding underlying Parkinson's disease (PD) and dementia with Lewy bodies. However, it is also worth noting that a direct link between GBA1 mutations and alpha-synuclein aggregation indicating cause and effect is still lacking, with limited experimental evidence to date. Bearing in mind that a number of strategies increasing GCase expression for the treatment of PD are currently under development, here we sought to analyze the baseline expression of GCase in the brain of Macaca fascicularis, which has often been considered as the gold-standard animal model of PD. Although as with other lysosomal enzymes, GCase is expected to be ubiquitously expressed, here a number of regional variations have been consistently found, together with several specific neurochemical phenotypes expressing very high levels of GCase. In this regard, the most enriched expression of GCase was constantly found in cholinergic neurons from the nucleus basalis of Meynert, dopaminergic cells in the substantia nigra pars compacta, serotoninergic neurons from the raphe nuclei, as well as in noradrenergic neurons located in the locus ceruleus. Moreover, it is also worth noting that moderate levels of expression were also found in a number of areas within the paleocortex and archicortex, such as the entorhinal cortex and the hippocampal formation, respectively.

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Leucine-rich repeat-containing G protein-coupled receptor 4 facilitates vesicular stomatitis virus infection by binding vesicular stomatitis virus glycoprotein [Immunology]

Vesicular stomatitis virus (VSV) and rabies and Chandipura viruses belong to the Rhabdovirus family. VSV is a common laboratory virus to study viral evolution and host immune responses to viral infection, and recombinant VSV-based vectors have been widely used for viral oncolysis, vaccination, and gene therapy. Although the tropism of VSV is broad, and its envelope glycoprotein G is often used for pseudotyping other viruses, the host cellular components involved in VSV infection remain unclear. Here, we demonstrate that the host protein leucine-rich repeat-containing G protein-coupled receptor 4 (Lgr4) is essential for VSV and VSV-G pseudotyped lentivirus (VSVG-LV) to infect susceptible cells. Accordingly, Lgr4 deficient mice had dramatically decreased VSV levels in the olfactory bulb. Furthermore, Lgr4 knockdown in RAW 264.7 cells also significantly suppressed VSV infection, and Lgr4 overexpression in RAW 264.7 cells enhanced VSV infection. Interestingly, only VSV infection relied on Lgr4, whereas infections with Newcastle disease virus, influenza A virus (A/WSN/33), and herpes simplex virus were unaffected by Lgr4 status. Of note, assays of virus entry, cell ELISA, immunoprecipitation, and surface plasmon resonance indicated that VSV bound susceptible cells via the Lgr4 extracellular domain. Pretreating cells with an Lgr4 antibody, soluble LGR4 extracellular domain, or R-spondin 1 blocked VSV infection by competitively inhibiting VSV binding to Lgr4. Taken together, the identification of Lgr4 as a VSV-specific host factor provides important insights into understanding VSV entry and its pathogenesis and lays the foundation for VSV-based gene therapy and viral oncolytic therapeutics.

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Functional defects in Clostridium difficile TcdB toxin uptake identify CSPG4 receptor binding determinants [Membrane Biology]

Clostridium difficile is a major nosocomial pathogen that produces two exotoxins, TcdA and TcdB, with TcdB thought to be the primary determinant in human disease. TcdA and TcdB are large, multi-domain proteins, each harboring a cytotoxic glucosyltransferase domain that is delivered into the cytosol from endosomes via a translocation domain following receptor-mediated endocytosis of toxins from the cell surface. While there are currently no known host cell receptors for TcdA, three cell-surface receptors for TcdB have been identified: CSPG4, NECTIN3 and FZD1/2/7. The sites on TcdB that mediate binding to each receptor are not defined. Furthermore, it is not known whether the combined repetitive oligopeptide (CROP) domain, is involved in, or required for receptor binding. Here, in a screen designed to identify sites in TcdB that are essential for target cell intoxication, we identified a region at the junction of the translocation and the CROP domains that is implicated in CSPG4 binding. Using a series of C-terminal truncations, we show that the CSPG4 CSPG4-binding site on TcdB extends into the CROP domain, requiring three short repeats for binding and for full toxicity on CSPG4-expressing cells. Consistent with the location of the CSPG4-binding site on TcdB, we show that an anti-TcdB antibody, which binds partially within the first three short repeats, prevents CSPG4 binding to TcdB. In addition to establishing the binding region for CSPG4, this work ascribes, for the first time, a role the TcdB CROPs in receptor binding, and further clarifies the relative roles of host receptors in TcdB pathogenesis.

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The glycosyltransferase GnT-III activates Notch signaling and drives stem cell expansion to promote the growth and invasion of ovarian cancer [Molecular Bases of Disease]

Glycosylation changes associated with cellular transformation can facilitate the growth and progression of tumors. Previously we discovered that the gene Mgat3 encoding the glycosyltransferase GnT-III is elevated in epithelial ovarian carcinomas (EOC) and leads to the production of abnormal truncated N-linked glycan structures. In this study we are interested in discovering how these abnormal glycans impact the growth and progression of ovarian cancer. We have discovered using stable shRNA gene suppression that GnT-III expression controls the expansion of side-population cells or cancer stem cells. We found that GnT-III expression regulates the levels and activation of Notch in vitro and in vivo. Suppression of GnT-III in EOC cell lines and primary tumor-derived cells resulted in an inhibition of Notch signaling that was more potent than pharmacologic blockage of Notch activation via gamma secretase inhibition. The mechanism of this inhibition was novel resulting from the redirection of the Notch receptor to the lysosome. These findings demonstrate a new role for bisecting glycosylation in the control of Notch transport and demonstrate the therapeutic potential of inhibiting GnT-III as a treatment for controlling EOC growth and recurrence.

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Cellular prion protein targets amyloid-{beta} fibril ends via its C-terminal domain to prevent elongation [Molecular Biophysics]

Oligomeric forms of the amyloid-β (Aβ) peptide are thought to represent the primary synaptotoxic species underlying the neurodegenerative changes seen in Alzheimer's disease. It has been proposed that the cellular prion protein (PrPC) functions as a cell-surface receptor, which binds to Aβ oligomers and transduces their toxic effects. However, the molecular details of the PrPC-Aβ interaction remain uncertain. Here, we investigated the effect of PrPC on polymerization of Aβ under rigorously controlled conditions in which Aβ converts from a monomeric to a fibrillar state via a series of kinetically defined steps. We demonstrated that PrPC specifically inhibited elongation of Aβ fibrils, most likely by binding to the ends of growing fibrils. Surprisingly, this inhibitory effect required the globular C-terminal domain of PrPC, which has not been previously implicated in interactions with Aβ. Our results suggest that PrPC recognizes structural features common to both Aβ oligomers and fibril ends, and that this interaction could contribute to the neurotoxic effect of Aβ aggregates. Additionally, our results identify the C-terminus of PrPC as a new and potentially more druggable molecular target for treating Alzheimer's disease.

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Conformational state interactions provide clues to the pharmacochaperone potential of serotonin transporter partial substrates [Membrane Biology]

Point mutations in SLC6 transporters cause misfolding, which can be remedied by pharmacochaperones. The serotonin transporter (SERT/SLC6A4) has a rich pharmacology including inhibitors, releasers (amphetamines, which promote the exchange mode) and more recently discovered partial substrates. We hypothesized that partial substrates trapped the transporter in one or several states of the transport cycle. This conformational trapping may also be conducive to folding. We selected napthylpropane-2-amines of the phenethylamine library (PAL) including the partial substrate PAL1045 and its congeners PAL287 and PAL1046. We analyzed their impact on the transport cycle of SERT by biochemical approaches and by electrophysiological recordings: substrate-induced peak currents and steady-state currents monitored the translocation of substrate and co-substrate Na+ across the lipid bilayer and the transport cycle, respectively. These experiments showed that PAL1045 and its congeners bound with different affinities (ranging from nM to μM) to various conformational intermediates of SERT during the transport cycle. Consistent with the working hypothesis, PAL1045 was the most efficacious compound in restoring surface expression and transport activity to the folding-deficient mutant SERT-601PG602-AA. These experiments provide a proof-of-principle for a rational search for pharmacochaperones, which may be useful to restore function to clinically relevant folding-deficient transporter mutants.

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Conserved functional consequences of disease-associated mutations in the slide-helix of Kir6.1 and Kir6.2 subunits of the ATP-sensitive potassium channel [Molecular Biophysics]

Cantu syndrome (CS) is a condition characterized by a range of anatomical defects, including cardiomegaly, hyper-flexibility of the joints, hypertrichosis, and craniofacial dysmorphology. CS is associated with multiple missense mutations in the genes encoding the regulatory SUR2 subunits of the ATP-sensitive K+ (KATP) channel, as well as two mutations (V65M and C176S) in the Kir6.1 (KCNJ8) subunit. Previous analysis of leucine and alanine substitutions at the Val-65 equivalent site (Val-64) in Kir6.2 indicated no major effects on channel function. In this study, we characterized the effects of both valine-to-methionine and valine-to-leucine substitutions at this position in both Kir6.1 and Kir6.2 using ion flux and patch-clamp techniques. We report that methionine substitution, but not leucine substitution, results in increased open state stability, and hence significantly reduced ATP sensitivity and marked increase of channel activity in the intact cell, irrespective of the identity of the co-assembled SUR subunit. Sulfonylurea inhibitors, such as glibenclamide, are potential therapies for CS. However, as a consequence of the increased open state stability, both Kir6.1-V65M and Kir6.2-V64M mutations essentially abolish high-affinity sensitivity to the KATP blocker glibenclamide in both intact cells and excised patches. This raises the possibility that, at least for some CS mutations, sulfonylurea therapy may not prove to be successful and highlights the need for detailed pharmacogenomic analyses of CS mutations.

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A conserved carboxy-terminal RxG motif in the NgBR subunit of cis-prenyltransferase is critical for prenyltransferase activity [Lipids]

cis-Prenyltransferases (cisPTs) constitute a large family of enzymes conserved during evolution and present in all domains of life. In eukaryotes and archaea, cisPT is the first enzyme committed to the synthesis of dolichyl phosphate (DolP), an obligate lipid carrier in protein glycosylation reactions. The homodimeric bacterial enzyme, undecaprenyl diphosphate synthase (UPPS), generates 11 isoprene units and has been structurally and mechanistically characterized in great detail. Recently, we discovered that unlike UPPS, mammalian cisPT is a heteromer consisting of NgBR (NUS1) and hCIT (DHDDS) subunits, and this composition has been confirmed in plants and fungal cisPTs. Here, we establish the first purification system for heteromeric cisPT and show that both NgBR and hCIT subunits function in catalysis and substrate binding. Finally, we identified a critical RxG sequence in the C-terminal tail of NgBR that is conserved and essential for enzyme activity across phyla. In summary, our findings show that eukaryotic cisPT is composed of the NgBR and hCIT subunits. The strong conservation of the RxG motif amongst NgBR orthologs implicates this subunit in the synthesis of polyprenol diphosphates critical for cellular function.

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Structural basis of the PE-PPE protein interaction in Mycobacterium tuberculosis [Microbiology]

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, has developed multiple strategies to adapt to the human host. The five type VII secretion systems, ESX-1-5, direct the export of many virulence-promoting protein effectors across the complex mycobacterial cell wall. One class of ESX substrates is the PE/PPE family of proteins, which is unique to mycobacteria and essential for infection, antigenic variation and host-pathogen interactions. The genome of Mtb encodes 168 PE/PPE proteins. Many of them are thought to be secreted through ESX-5 secretion system and to function in pairs. However, understanding of the specific pairing of PE-PPE proteins and their structure-function relationship is limited by the challenging purification of many PE/PPE proteins, and our knowledge of the PE-PPE interactions therefore has been restricted to the PE25-PPE41 pair and its complex with the ESX-5 secretion system chaperone EspG5. Here, we report the crystal structure of a new PE-PPE pair, PE8-PPE15, in complex with EspG5. Our structure revealed that the EspG5-binding sites on PPE15 are relatively conserved among Mtb PPE proteins, suggesting that EspG5-PPE15 represents a more typical model for EspG5-PPE interactions than EspG5-PPE41. A structural comparison with the PE25-PPE41 complex disclosed conformational changes in the four-helix bundle structure and a unique binding mode in the PE8-PPE15 pair. Moreover, homology-modeling and mutagenesis studies further delineated the molecular determinants of the specific PE-PPE interactions. These findings help develop an atomic algorithm of ESX-5 substrate recognition and PE-PPE pairing.

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Responsiveness of the PROMIS® measures to changes in disease status among pediatric nephrotic syndrome patients: a Midwest pediatric nephrology consortium study

Nephrotic syndrome represents a condition in pediatric nephrology typified by a relapsing and remitting course, proteinuria and the presence of edema. The PROMIS measures have previously been studied and valid...

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Split internal jugular vein: surgical and radiological implications

Publication date: Available online 23 August 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Satheesha B. Nayak

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Re: Re: Mandibular Wing Osteotomy: technical modification

Publication date: Available online 23 August 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R. Coopman, T. Aerden, G. De Temmerman, C. Politis

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Hard neck lumps: a review of uncommon and sometimes overlooked causes of these worrying presentations

Publication date: Available online 23 August 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): M.I. Ammar, R.S. Oeppen, C. Bowles, P.A. Brennan
While a neck lump is a common presentation that can raise suspicion of a potentially serious underlying disease, a hard lump, though less common, may be even more concerning for the patient, and prompt urgent investigation. Metastatic squamous cell carcinoma is the commonest underlying diagnosis that must be excluded, but other diseases or even normal anatomy of the neck can be associated with lumps that are hard or bony. Many of these presentations are relatively rare and may not be familiar to oral and maxillofacial surgeons (OMFS) (particularly more junior clinicians) as a differential diagnosis of a hard neck mass. We have reviewed these lesions to raise awareness of possible unusual causes, particularly when patients are not initially examined in a specialist neck lump clinic where ultrasound is readily available.

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If trainers regularly validate trainees’ eLogbook records, they will spot a trainee who is not keeping theirs up-to-date

Publication date: Available online 23 August 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): P. Magennis, A. Begley

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Laying the Foundations of Lifelong Health at the Beginning of Life: Islamic Perspective

Abstract

In this systematic literature review, all the Shiite-Islamic documents (Quran and Hadith) without any time limitation were surveyed, analyzed and synthesized for the purpose of determining the foundations of lifelong health. The data were analyzed and combined using inductive qualitative content analysis method. Two main categories were emerged from the analysis: "prevention of health problems" and "health maintenance and promotion." In conclusion based on Islamic perspective, the foundations of comprehensive health of a person, i.e., health in all physical, mental, social, and spiritual dimensions, are begun to form at four stages: the time of marriage of his parents, the moment of their conception, when he is unborn in his mother womb, and during infancy period. Observing religion instructions in this regard is not the sufficient condition for being completely healthy; however, such instructions can provide a base for being a healthy person.

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Melancholy, Acculturation, and Relief: A Brief Essay on the Religion of Ordinarity

Abstract

Han is not an idiosyncratic, psychological experience that is peculiar to Koreans, but a multifaceted mode of melancholy experienced by many and various people. What makes this psychological experience particularly familiar to Koreans, however, is that this phenomenon is colored by various, macroscopic factors common in the Korean context, such as sociocultural rigidness, historical instability, political feudality, and economic vulnerability. In this sense, han is an acculturated, multifaceted melancholy. Not only that, it has developed its own religiousness, the goal of which is the restoration of ordinarity, because the state of han premises extraordinary, abnormal, or tension-provoking situations. The explicit and implicit religious idioms developing in the religion of han, such as tongsung-kido and wishing-for-blessing, evolve around this religious telos, helping individuals in Korea restore and live ordinarity.

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Agreement between venous and arterial blood gas analysis of acid-base status in critical care and ward patients: a retrospective cohort study

Abstract

Purpose

To determine whether the use of venous blood gases can be a suitable alternative to arterial sampling to evaluate acid-base status.

Methods

The database of the clinical laboratory in a large academic hospital was searched for records of venous blood gas analysis and an arterial sample taken within ten minutes from the same patient. Bland-Altman analyses of pH, pCO₂, and lactate were performed for samples obtained from patients separately from within and outside the intensive care unit (ICU).

Results

In 2,296 paired arterial-venous samples from 351 ICU patients, the bias was 0.044, −6.2 mmHg, and −0.07 mEq·L⁻¹ for pH, pCO₂, and lactate, respectively. The range of agreement centred on this bias (upper minus lower level of agreement) was 0.134, 16.7 mmHg, and 1.35 mEq·L⁻¹ for pH, pCO₂, and lactate, respectively. Intraclass correlation coefficients (ICCs) were 0.79, 0.76, and 0.99 for pH, pCO₂, and lactate, respectively, indicating excellent agreement. Multiple samples obtained from the same patient had a median standard deviation of 0.02, 2.77 mmHg, and 0.18 mEq·L⁻¹ for pH, pCO₂, and lactate, respectively. Similar agreement was observed in samples from patients outside the ICU, although the ICC was only 0.53 for pCO₂.

Conclusions

Venous gases are suitable for initial evaluation of acid-base status in critically ill patients. Based on clinical evaluation, an arterial sample may then be considered for confirmation, and thereafter, venous blood gases could be sufficient for monitoring response to treatment.

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Efficacy of Extended Adjuvant Therapy with Aromatase Inhibitors in Early Breast Cancer among Common Clinicopathologically-defined Subgroups: A Systematic Review and Meta-analysis

The role of adjuvant endocrine therapy for women with hormone receptor positive early breast cancer is well established [1]. Aromatase inhibitors (AIs) have been shown to improve breast cancer outcomes for postmenopausal women, and their use in this population is a gold standard [1]. The risk of recurrence persists for more than a decade after the initial 5 years of adjuvant hormonal therapy [2]. This suggests a potential benefit from extended endocrine treatment. While extending treatment beyond 5 year of tamoxifen appears beneficial [3], there remains uncertainty regarding the optimal duration of adjuvant AIs treatment.

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Pancreatic Ductal Adenocarcinoma: State-of-the-Art 2017 and New Therapeutic Strategies

The most common malignant cancer arising from the pancreas is pancreatic ductal adenocarcinoma (PDAC). PDAC has a major public health impact as it is the fourth-leading cause of cancer-related death, with approximately 53,670 new cases and 43,090 deaths anticipated in 2017 in the US[1]. This latter number is projected to increase and before 2030 PDAC is anticipated to be the second-leading cause of cancer-related deaths second only to lung cancer[2]. More than a half of patients with PDAC present with locally advanced or metastatic disease at diagnosis, with the main metastatic sites being the liver, the lungs and the peritoneum, limiting therapeutic options to systemic therapy and optimal supportive care with the aim to induce disease regression, extend life and alleviate symptoms[1].

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Immunosenescence and immunecheckpoint inhibitors in non-small cell lung cancer patients: does age really matter?

Non-small cell lung cancer (NSCLC) is a disease predominantly reported in older adults. A recent analysis from the Surveillance Epidemiology End Result (SEER) database reported that 50% of lung cancers are diagnosed in people aged more than 70 years and 15% are diagnosed in patients older than 80 [1]. Currently, the highest mortality rate is seen in these age groups [1], due to decreased physiologic reserve, reduced benefit of cancer treatment and increased risks of iatrogenic toxicities and death.

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Immune checkpoint blockade for unresectable or metastatic uveal melanoma: a systematic review

Uveal melanoma (UM) is an ocular malignancy which originates from melanocytes residing in the choroid layer of the eye. With an incidence of 4-7 cases per million in Europe, it is much rarer than cutaneous melanoma [1]. Several risk factors for the development of UM have been identified in observational studies, including the presence of choroidal or cutaneous nevi, fair skin, light eye color, and exposure to ultraviolet radiation [2].

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Efficacy of Extended Adjuvant Therapy with Aromatase Inhibitors in Early Breast Cancer among Common Clinicopathologically-defined Subgroups: A Systematic Review and Meta-analysis

Pancreatic Ductal Adenocarcinoma: State-of-the-Art 2017 and New Therapeutic Strategies

Immunosenescence and immunecheckpoint inhibitors in non-small cell lung cancer patients: does age really matter?

Immune checkpoint blockade for unresectable or metastatic uveal melanoma: a systematic review

Are heart toxicities in breast cancer patients important for radiation oncologists? A practice pattern survey in German speaking countries

To assess the personal beliefs of radiation oncologists regarding heart sparing techniques in breast cancer patients.

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Development of nomograms to predict axillary lymph node status in breast cancer patients

Prediction of axillary lymph node (ALN) status preoperatively is critical in the management of breast cancer patients. This study aims to develop a new set of nomograms to accurately predict ALN status.

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Vitamin D supplementation in cutaneous malignant melanoma outcome (ViDMe): a randomized controlled trial

Previous studies have investigated the protective effect of vitamin D serum levels, at diagnosis and during the follow-up period after treatment, on melanoma outcome. In the present study we assess whether vit...

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A parallel-group randomized clinical trial of individually tailored, multidisciplinary, palliative rehabilitation for patients with newly diagnosed advanced cancer: the Pal-Rehab study protocol

The effect of early palliative care and rehabilitation on the quality of life of patients with advanced cancer has been only sparsely described and needs further investigation. In the present trial we combine ...

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Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC)

The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative str...

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Comment on “An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity”

We have read the article entitled "An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity," published by Bilal N et al. with great interest [1]. The authors evaluated the levels of oxidative and nitrosative stress by comparing a stuttering group and a control group and evaluated the relationship between the oxidative and nitrosative stress levels and the severity of the stutter. They examined malondialdehyde (MDA), 3-nitrotyrosine (3-NT), nitric oxide (NO), catalase (CAT), and superoxide dismutase (SOD) concentrations in blood.

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On the other hand, the immune system can also cause cancer - Medical Xpress

On the other hand, the immune system can also cause cancer
Medical Xpress
Infection with human papillomavirus (HPV) is the primary cause of cervical cancer and a subset of head and neck cancers worldwide. A University of Colorado ...

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Non-battle injury among repatriated UK armed forces since cessation of combat operations: a prospective observational study

Aim

To describe the mechanisms, burden of injury, inpatient management and rehabilitation requirements of wounded military personnel at the UK Role 4 (R4) facility within the first 12 months following cessation of combat operations in Afghanistan.

Methods

All aeromedical evacuations were recorded prospectively between October 2014 and October 2015. Demographic, logistical and clinical data were derived manually from referring medical unit and patient movement requests in addition to host nation and R4 medical records.

Results

Ninety-five patients were repatriated to R4 following traumatic injury: 98.9% (n=94) were male, and median age was 27 years (IQR 25–36 years). The most common mechanisms of injury (MOIs) were sports 26.3% (n=25), falls <2 m 11.6% (n=11) and road traffic collisions 9.8% (n=9). The most common anatomical regions of injury were isolated lower limb 24.1% (n=22), isolated hand 20.0% (n=19) and polytrauma 14.7% (n=14). Median Injury Severity Score was 4 (IQR 4–9), mean 8 (range 1–41). Eleven patients (11.6%) were discharged to rehabilitation units, of whom 7 (63.6%) required neurorehabilitation.

Conclusion

Although service personnel sustain civilian-type injuries, the specific rehabilitation goals and shift in the acute rehabilitation requirements for military personnel must be considered in the absence of enduring combat operations. It is notable that permanent medical downgrading secondary to trauma still occurs outside of warfare. The colocation of civilian major trauma services and R4 has ensured a mutually beneficial partnership that contributes to institutional memory and improves the coordination of patient pathways. The importance of relevant resource allocation, training, support and logistical considerations remain, even during the current scale of military activity overseas.

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Revisiting the in vivo GlnR-binding sites at the genome scale in Bacillus subtilis

In Bacillus subtilis, two major transcriptional factors, GlnR and TnrA, are involved in a sophisticated network of adaptive responses to nitrogen availability. GlnR was reported to repress the transcription of th...

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Anti-inflammatory effects of hypoxic-preconditioned human periodontal ligament cells secretome in an experimental model of multiple sclerosis: a key role of IL-37 [Research]

Recent research has widely investigated the anti-inflammatory effects of mesenchymal stem cells and their secretory products, termed secretome, in the treatment of multiple sclerosis (MS). The present study examined the capacity of the conditioned medium (CM) collected from human periodontal ligament cells under hypoxic condition medium (H-hPDLSCs-CM) to suppress experimental autoimmune encephalomyelitis (EAE), a murine model of MS. To induce EAE, female C57BL/6 mice were immunized with myelin oligodendroglial glycoprotein peptide_35–55. At the onset of symptoms, H-hPDLSCs-CM was infused via the tail vein of mice. Our results demonstrate the efficacy of H-hPDLSCs-CM treatment in diminishing clinical and histologic disease score. A key finding from this study is the marked expression of anti-inflammatory cytokine IL-37, paralleled by the suppression of proinflammatory cytokines in mice with EAE that were treated with H-hPDLSCs-CM. In addition, a consequent modulation of oxidative stress, autophagic, and apoptotic markers was observed in mice with EAE after hPDLSCs-CM administration. In addition, to provide additional evidence of the molecular mechanisms that underlie H-hPDLSCs-CM, we investigated its therapeutic action in scratch injury–exposed NSC-34 neurons, an in vitro model of injury. This model reproduces severe inflammation and oxidative stress conditions as observed after EAE damage. In vitro results corroborate the ability of hPDLSCs-CM to modulate inflammatory, oxidative stress, and apoptotic pathways. Taken together, our findings suggest H-hPDLSCs-CM as a new pharmacologic opportunity for the management of MS.—Giacoppo, S., Thangavelu, S. R., Diomede, F., Bramanti, P., Conti, P., Trubiani, O., Mazzon, E. Anti-inflammatory effects of hypoxic-preconditioned human periodontal ligament cells secretome in an experimental model of multiple sclerosis: a key role of IL-37.

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A postal worker faked cancer and got paid to miss two years of work. Here's how a judge punished her. - Washington Post

2014-11-10T161758Z_01_TOR101_RTRIDSP_3_C

Washington Post

A postal worker faked cancer and got paid to miss two years of work. Here's how a judge punished her.
Washington Post
The tale that Caroline Boyle started spinning in 2015 was grim. She told colleagues that cancer attacked her white blood cells and ravaged her immune system, leaving Doyle too weak to come into work at the U.S. Postal Service office in Aurora, Colo.

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South Canterbury District Health Board hits half of health targets - Taranaki Daily News

Taranaki Daily News

South Canterbury District Health Board hits half of health targets
Taranaki Daily News
The South Canterbury District Health board's failure to meet a key cancer treatment target needs to be investigated, the chairman of the district health board says. The latest quarterly report as to how New Zealand's DHBs performed alongside a series ...

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'Lilypalooza' in Mont Clare to benefit little girl with cancer - The Mercury

'Lilypalooza' in Mont Clare to benefit little girl with cancer
The Mercury
Lily Pagnotta, 6, poses for a photo with Warren Birch, left, and C.J. Santangelo, both of the A-Team, a nonprofit that will host "Lilypalooza" Sunday, Aug. 27, 2017, at St. Michael's picnic grounds, Mont Clare. Lily was diagnosed with Hodgkin's ...

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Buckled Thyroid Cartilage: An Anatomic Variant

Anatomic abnormalities in the larynx can cause significant and bothersome symptoms. Identified here is an anatomical variant of the thyroid cartilage.

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Immediate loading of subcrestally placed dental implants in anterior and premolar sites

Immediate loading of dental implants has been evolving into an appropriate procedure for the treatment of partially edentulous jaws. The purpose of this study was to evaluate the clinical success and radiological outcome of immediately and delayed loaded dental implants in anterior and premolar sites.

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Split internal jugular vein: surgical and radiological implications

The close association of the internal jugular vein (IJV) with the lower four cranial nerves, carotid vessels, and deep cervical lymph nodes makes it functionally, surgically, and radiologically important. Variants of the IJV are rare, and even less commonly, it could be absent. Partial or complete duplication of the vein have been reported, and occasionally it has had fenestrations along its course, with the spinal accessory nerve passing through the fenestration.

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Distance-dependent accuracy in Le Fort I maxillary repositioning procedures

It has been hypothesised that, in maxillary repositioning procedures, longer distances correlate with less accurate transfers and particularly the repositioning forces of facial skin and muscles that increase exponentially. However, this has not to our knowledge been confirmed. The purpose of this study was to search for differences in the accuracy of transfer from maxillary repositioning procedures parallel to the three orthogonal planes and with respect to three different anatomical landmarks of the first molar left and right (M1L and M1R) and the first incisor (I).

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Scarless total maxillectomy: midfacial degloving with extended transconjunctival retrocaruncular approach

Large benign and malignant tumours of the maxillary sinus may require a total maxillectomy as part of their treatment.1 Traditionally access has been by the Weber-Fergusson incision, or one of its modifications. This gives excellent exposure, particularly if the resection needs to extend above the orbital floor, but can be associated with extensive complications that include ectropion, shortening of the lip, breakdown of the wound, and facial scars. The midfacial degloving approach avoids these visible scars, but usually does not provide sufficient access to resect as far as the lamina papyracea and ethmoids.

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Pitfalls in monitoring of the facial nerve during operations for parotid cancer

The facial nerve splits into branches within the parotid gland and innervates the muscles of facial expression. Damage to it can result in temporary or permanent facial deformity, asymmetry of the smile, and ocular keratosis. Studies have shown that intraoperative use of a facial nerve monitor can reduce paralysis of the nerve.

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Evolutionary Network Games: Equilibria from Imitation and Best Response Dynamics

We consider games of strategic substitutes and complements on networks and introduce two evolutionary dynamics in order to refine their multiplicity of equilibria. Within mean field, we find that for the best-shot game, taken as a representative example of strategic substitutes, replicator-like dynamics does not lead to Nash equilibria, whereas it leads to a unique equilibrium for complements, represented by a coordination game. On the other hand, when the dynamics becomes more cognitively demanding, predictions are always Nash equilibria: for the best-shot game we find a reduced set of equilibria with a definite value of the fraction of contributors, whereas, for the coordination game, symmetric equilibria arise only for low or high initial fractions of cooperators. We further extend our study by considering complex topologies through heterogeneous mean field and show that the nature of the selected equilibria does not change for the best-shot game. However, for coordination games, we reveal an important difference: on infinitely large scale-free networks, cooperative equilibria arise for any value of the incentive to cooperate. Our analytical results are confirmed by numerical simulations and open the question of whether there can be dynamics that consistently leads to stringent equilibria refinements for both classes of games.

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Doing meth raises the risk of strokes in young people

Strokes aren't common under the age of 45, but people who use methamphetamine are almost five times more likely to have a type of stroke that can be fatal

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Experimental Characterization of Damped CFRP Materials with an Application to a Lightweight Car Door

This paper presents a complete design procedure for defining a dynamic model of a Carbon Fibre Reinforced Polymer (CFRP) component with an embedded damping material layer. The experiment to determine the mechanical characteristics of the materials is performed by the Oberst beam technique to provide precise material properties for a Finite Element (FE) model. The technique implemented, namely, the Linear Identification by Polynomial Expansion in the Z-domain (LIPEZ) method, is used to compare the experimental data with the numerical simulation results provided by the modal parameters to be compared with the numerical results. Two automotive components (a leaf spring and an outer shell of front door) have been tested. The research revealed the utter importance of a correct definition of the geometry for the numerical models. Finally, the positive effects for acoustic performance with a thin layer of KRAIBON® SUT9609/24 damping material, included in the stacking sequence of the CFRP component, are highlighted.

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Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

Objectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg−1 or levobupivacaine (0.5%) 0.4 mg·kg−1 + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy. This trial is registered with Australian New Zealand Clinical Trial Registry ACTRN: ACTRN12617001167358.

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The “e-Generation”: The Technological Usage and Experiences of Medical Students from a Developing Country

Background. The medical community is increasingly using Portable Electronic Devices (PEDs). We evaluated usage of PEDs and medical apps among medical students from Sri Lanka. Methods. This descriptive cross-sectional study was conducted at Faculty of Medicine, University of Colombo. Medical students from 2nd to 5th year were invited for the study. A self-administered questionnaire was used to collect details of PEDs availability, accessibility, and usage, perceived advantages/barriers of PEDs, and availability, accessibility, and usage of medical apps. Results. Sample size was 505 (response rate, 61.8%). Mean age was years and majority were females (60.4%, ). Majority (87.5%, ) of students owned a PED. Nonaffordability was the most common reason for having not owning a PED (46%). Nonaffordability and lack of knowledge were key determinants of the usage of PEDs and medical "apps." Doubts about reliability and lack of knowledge regarding reliable electronic sources of information were other significant barriers. Conclusions. Our results show that a significant majority of students owned a PED, a higher percentage than what is reported elsewhere. Considering barriers identified, it is important for institutions to promote usage of PEDs and medical apps by providing financial support, training, and knowledge to build confidence in technology.

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Two-Stage Heuristic Algorithm for Aircraft Recovery Problem

This study focuses on the aircraft recovery problem (ARP). In real-life operations, disruptions always cause schedule failures and make airlines suffer from great loss. Therefore, the main objective of the aircraft recovery problem is to minimize the total recovery cost and solve the problem within reasonable runtimes. An aircraft recovery model (ARM) is proposed herein to formulate the ARP and use feasible line of flights as the basic variables in the model. We define the feasible line of flights (LOFs) as a sequence of flights flown by an aircraft within one day. The number of LOFs exponentially grows with the number of flights. Hence, a two-stage heuristic is proposed to reduce the problem scale. The algorithm integrates a heuristic scoring procedure with an aggregated aircraft recovery model (AARM) to preselect LOFs. The approach is tested on five real-life test scenarios. The computational results show that the proposed model provides a good formulation of the problem and can be solved within reasonable runtimes with the proposed methodology. The two-stage heuristic significantly reduces the number of LOFs after each stage and finally reduces the number of variables and constraints in the aircraft recovery model.

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Multispeed Lattice Boltzmann Model with Space-Filling Lattice for Transcritical Shallow Water Flows

Inspired by the recent success of applying multispeed lattice Boltzmann models with a non-space-filling lattice for simulating transcritical shallow water flows, the capabilities of their space-filling counterpart are investigated in this work. Firstly, two lattice models with five integer discrete velocities are derived by using the method of matching hydrodynamics moments and then tested with two typical 1D problems including the dam-break flow over flat bed and the steady flow over bump. In simulations, the derived space-filling multispeed models, together with the stream-collision scheme, demonstrate better capability in simulating flows with finite Froude number. However, the performance is worse than the non-space-filling model solved by finite difference scheme. The stream-collision scheme with second-order accuracy may be the reason since a numerical scheme with second-order accuracy is prone to numerical oscillations at discontinuities, which is worthwhile for further study.

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Study on Dynamic Response of Downhole Tools under Perforation Impact Load

A model of a multibody system is established to investigate the dynamic response of an oil tube-shock absorber-perforating gun system in downhole perforation-test joint operation. In the model, the oil tube and perforating gun are modeled as elastic rods and the shock absorber is modeled as single particle system with damping and a spring. Two force continuity conditions are used to simulate the interactions among the three components. The perforation impact load is determined by an experiment of underwater explosion of perforating bullets. Using the model, the effects of charge quantity of perforating bullet, the number of shock absorbers, and the length of oil tube on the dynamic response of oil tube and packer are investigated. On this basis, a basic principle of the combination design of shock absorber and oil tube is proposed to improve the mechanical state of downhole tools. The study results can provide theoretical support for the design of downhole perforation-test joint operation.

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Immediate loading of subcrestally placed dental implants in anterior and premolar sites

Immediate loading of dental implants has been evolving into an appropriate procedure for the treatment of partially edentulous jaws. The purpose of this study was to evaluate the clinical success and radiological outcome of immediately and delayed loaded dental implants in anterior and premolar sites.

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Doing meth raises the risk of strokes in young people

Stroke and methamphetamine use in young adults: a review

Background

Methamphetamine use and stroke are significant public health problems. Strokes among people aged below 45 years are much less common than in older age groups but have significant mortality and morbidity. Methamphetamine is a putative cause of strokes among younger people.

Methods

A review of methamphetamine-related strokes was conducted. Bibliographic databases were searched until February 2017 for articles related to methamphetamine and stroke. Both haemorrhagic and ischaemic strokes were considered.

Results

Of 370 articles screened, 77 were selected for inclusion. There were 81 haemorrhagic and 17 ischaemic strokes reported in case reports and series. Both types were approximately twice as common in males. Route of administration associated with haemorrhagic stroke was typically oral or injecting, but for ischaemic stroke inhalation was most common. Haemorrhagic stroke was associated with vascular abnormalities in a third of cases. One quarter of individuals completely recovered, and a third died following haemorrhagic stroke. One-fifth completely recovered, and one-fifth died following ischaemic stroke.

Conclusions

There is a preponderance of haemorrhagic strokes associated with methamphetamine use in young people, and methamphetamine-related stroke is associated with poor clinical outcomes. Mechanisms of methamphetamine-associated stroke include hypertension, vasculitis, direct vascular toxicity and vasospasm. In a period of rising worldwide methamphetamine use, the incidence of methamphetamine-related stroke will increase, with a consequent increase in the burden of disease contributed by such events.

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Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review

We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

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Long noncoding RNA UCA1 promotes tumour metastasis by inducing GRK2 degradation in gastric cancer

Increasing evidence demonstrates that long noncoding RNAs (lncRNAs) regulate gene and protein expression by exerting an influence on transcriptional and post-transcriptional processes. Here, we report that the lncRNA UCA1 increases the metastatic ability of gastric cancer (GC) cells by regulating GRK2 protein stability by promoting Cbl-c-mediated GRK2 ubiquitination and degradation. This process then activates the ERK-MMP9 signalling pathway. Furthermore, we demonstrate that GRK2 is downregulated in GC cells and that silencing of GRK2 might cause similar phenotypic changes and signalling pathway activation as those induced by elevated UCA1 in GC cells.

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Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review

We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

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Αρχειοθήκη ιστολογίου

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Τετάρτη 23 Αυγούστου 2017

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Αναζήτηση αυτού του ιστολογίου

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