Synergetic effect of hydrochar on the transport of anatase titanium dioxide nanoparticles in the presence of phosphate in saturated quartz sand

Abstract

The rapid development of nanomaterials has led to the unavoidable leakage and release of nanoparticles (NPs) into soil and the underlying groundwater. It is possible for chars and phosphate introduced into soil to improve crop soil properties by improving contact with NPs. In this study, the influences of hydrochar and/or phosphate on the anatase nTiO₂ transport behaviors were investigated under different conditions. The breakthrough curves (BTCs) and retention profiles were obtained by the saturated sand column experiments. The additional analysis of zeta potentials, sedimentation kinetics, Raman mapping, and the two-site kinetic attachment model (TSKAM) was conducted to explore the possible underlying mechanisms. The simultaneous presence of phosphate and hydrochar acted in a synergetic fashion to enhance the transport of nTiO₂ in a sand medium compared to the facilitated effect of single phosphate or hydrochar. The higher levels of hydrochar induce the more nTiO₂ in the high IC solution passing through the saturated sand columns in the co-presence of phosphate. It was attributed to the competitive adsorption of hydrochar with nTiO₂ to the sand site and the phosphate adsorption on nTiO₂ occurred simultaneously through the sand columns. The fitting results of BTCs using TSKAM showed that the value of k₂ for nTiO₂ (the irreversible attachment coefficient at site 2) was smaller than that of k_1d/k₁ (the first-order reversible detachment and attachment coefficient at site 1, respectively), suggesting irreversible retention of anatase nTiO₂ at site 1. The value of k_1d/k₁ could be better used to explain the retention of nTiO₂ with combined phosphate and hydrochar. This study provides insight into the implications of phosphate and/or hydrochar for nTiO₂ transport in crop soil environments.

Graphical abstract

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Mercury contamination in the sludge of drinking water treatment plants dumping into a reservoir in Rio de Janeiro, Brazil

Abstract

Although sludge piles from drinking water treatment plants can contain harmful substances, in many countries, their disposal methods are still unregulated. Besides aluminum, which is a major constituent in these residues, many other contaminants—like trace metals—can be present and may result from the quality of the raw materials used for water treatment. The application of these chemicals for the treatment of drinking water can generate toxic sludge and contaminate the produced water. In the present work, mercury contamination in the sludge piles of two drinking water treatment plants located along the margins of the Juturnaíba Reservoir, Southeast Brazil, was evaluated to verify whether contaminants are incorporated during water treatment. In the summer 2012, five cores were collected from the piles, and were analyzed for Eh, granulometry, total carbon, total nitrogen, and total mercury. The results indicated an anoxic environment, reflecting composition of the suspended matter. Carbon and nitrogen presented elevated concentrations, but also seemed to reproduce the characteristics of the suspended matter in the raw water. The concentrations of mercury were extremely variable but presented unexpectedly high values in some of the layers, reaching 18,484 ng g⁻¹. On the other hand, concentrations ten times lower than those observed in the natural system (8 ng g⁻¹) could be observed. It was concluded that the only possible source for the contamination of the sludge was the chemicals used for water treatment.

https://ift.tt/2B1eFqs

Environmental functions of biochar—a special issue for the 3 rd Asia Pacific Biochar Conference (APBC 2016)

https://ift.tt/2vBZNtv

Effectiveness of First‐Line Bevacizumab in Metastatic Colorectal Cancer: The Observational Cohort Study GRETA

AbstractBackground.Scant real‐world data exist on the clinical outcomes associated with the use of bevacizumab‐containing chemotherapy (B+CT) in patients with metastatic colorectal cancer (mCRC). The primary objective of the GRETA cohort study was to compare the overall survival (OS) of patients with mCRC treated with first‐line B+CT versus chemotherapy (CT) alone, in an Italian clinical practice setting.Materials and Methods.Incident patients with mCRC were identified during the period 2010–2012 from five population‐based cancer registries in Italy. Cases were linked to regional health care utilization databases to obtain the entire spectrum of health services provided to each patient. Patients starting a first‐line treatment with B+CT or CT alone within 90 days from the diagnosis were included in the study cohort. A propensity score (PS) method was applied to account for residual confounding.Results.Of 480 patients with mCRC included in the study cohort, 21.0 received first‐line B+CT, and 79.0% received CT. Patients receiving B+CT were younger (p < .001) and underwent surgery more frequently (p = .001). The median OS was 22.5 and 14.6 months for B+CT and CT, respectively (p = .011). The corresponding hazard ratios adjusted by multivariate modeling and PS matched analysis were 0.82 (95% confidence interval [CI], 0.62–1.08) and 0.86 (95% CI, 0.56–1.33), respectively. Similar results were observed after subgrouping by age and surgery.Conclusion.In this Italian real‐world setting of unselected mCRC, the OS of patients treated with B+CT was consistent with previous observational and patient‐registry studies. However, definitive evidence of an improvement in OS cannot be drawn.Implications for Practice.Bevacizumab is a well‐established first‐line treatment for metastatic colorectal cancer. However, there is scarce evidence in the literature about its effectiveness in clinical practice. Evaluating this topic should be of interest for both clinicians and regulatory agencies. In this study, the median overall survival of the bevacizumab cohort was strikingly coherent with that reported in large observational series of unselected patients, thus suggesting a consistent and reproducible effect of the drug in clinical practice. Although consistent results were observed both in the overall population and in age and surgery subgroups, the present study did not offer definitive evidence of an improvement in OS.

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Wide Range of Clinical Outcomes in Patients with Gliomatosis Cerebri Growth Pattern: A Clinical, Radiographic, and Histopathologic Study

AbstractBackground.The 2016 World Health Organization Classification of Central Nervous System Tumors categorizes gliomatosis cerebri growth pattern (GC) as a subgroup of diffuse infiltrating gliomas, defined by extent of brain involvement on magnetic resonance imaging (MRI). Clinical and radiographic features in GC patients are highly heterogeneous; however, prognosis has historically been considered poor.Subjects, Materials, and Methods.We performed a retrospective search for patients at our institution meeting radiographic criteria of primary, type I GC (defined as diffuse tumor infiltration without associated tumor mass and contrast enhancement on MRI) and analyzed their clinical, imaging, and histopathologic features.Results.A total of 34 patients met radiographic criteria of primary, type I GC, and 33 had a confirmed histologic diagnosis of an infiltrating glial neoplasm. Age >47 years at diagnosis was associated with worse overall survival (OS) compared with age ≤47 years (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.01–1.07, p = .003). Patients with grade 2 tumors demonstrated a trend for improved OS compared with those with grade 3 tumors (HR 2.65, 95% CI 0.99–7.08, p = .051). Except for brainstem involvement, extent or location of radiographic involvement did not detectably affect clinical outcome. IDH mutation status identified a subgroup of GC patients with particularly long survival up to 25 years and was associated with longer time to progression (HR 4.81, 95% CI 0.99–23.47, p = .052).Conclusion.Patients with primary, type I GC do not uniformly carry a poor prognosis, even in the presence of widespread radiographic involvement. Consistent with other reports, IDH mutation status may identify patients with improved clinical outcome. Molecular characterization, rather than MRI features, may be most valuable for prognostication and management of GC patients.Implications for Practice.Patients with gliomatosis cerebri growth pattern (GC) constitute a challenge to clinicians, given their wide range of clinical, histologic, and radiographic presentation, heterogeneous outcome patterns, and the lack of consensus on a standardized treatment approach. This study highlights that radiographic extent of disease—albeit category‐defining—does not detectably influence survival and that IDH mutations may impact clinical outcome. Practicing oncologists should be aware that select GC patients may demonstrate exceptionally favorable survival times and prognosticate patients based on molecular markers, rather than imaging features alone.

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Review of Common Alternative Herbal “Remedies” for Skin Cancer

BACKGROUND Alternative herbal remedies for skin cancer are commonly found on the Internet. Many websites contain inaccurate or false information regarding side effects and efficacy. OBJECTIVE To review the evidence behind several commonly advertised herbal remedies that claim to cure skin cancer: black salve, eggplant, frankincense, cannabis, black raspberry, milk thistle, St. John's wort, and turmeric. METHODS A PubMed search was performed using the common and scientific names of frequently advertised herbal remedies along with the terms "nonmelanoma skin cancer," or "basal cell carcinoma" or "squamous cell carcinoma," or "melanoma." RESULTS Some preclinical studies have shown positive evidence that these substances can induce apoptosis in skin cancer, but clinical studies proving efficacy are either insufficient, nonexistent, or show negative evidence. Botanicals that were excluded are those that do not have published studies of their efficacy as skin cancer treatments. CONCLUSION Online advertising may tempt patients to use botanical agents while citing efficacy found in preclinical studies. However, many agents lack strong clinical evidence of efficacy. Dermatologists must be aware of common herbal alternatives for skin cancer treatment to maintain effective patient communication and education. Address correspondence and reprint requests to: Jeremy T. Kampp, MD, 4225 Roosevelt Way NE, 4th floor, Seattle, WA 98105, or e-mail: jkampp@uw.edu The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Phase 3 Study of OnabotulinumtoxinA Distributed Between Frontalis, Glabellar Complex, and Lateral Canthal Areas for Treatment of Upper Facial Lines

BACKGROUND Although commonly practiced, simultaneous onabotulinumtoxinA injections to multiple facial areas have not been investigated in prospective studies. OBJECTIVE Evaluate safety and efficacy of onabotulinumtoxinA for treatment of forehead lines (FHL) distributed between the frontalis (20 U) and glabellar complex (20 U), with or without simultaneous lateral canthal areas (crow's feet lines [CFL], 24 U) treatment. METHODS Subjects with moderate to severe FHL were randomized (2:2:1) to onabotulinumtoxinA 40 U, onabotulinumtoxinA 64 U, or placebo. After 180 days, subjects could receive up to 2 additional open-label onabotulinumtoxinA 64 U treatments. RESULTS The intent-to-treat (ITT) population comprised 787 subjects, and the modified ITT (mITT) population (subjects with psychological impact) comprised 568. After 30 days, onabotulinumtoxinA 40 U and 64 U significantly improved investigator- and subject-assessed FHL severity by at least 2 Facial Wrinkle Scale (FWS) grades in 45.6% and 53.0% of ITT subjects, respectively, versus 0.6% receiving placebo (both, p

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Efficacy of 1,550-nm Erbium-Glass Fractional Laser Treatment and Its Effect on the Expression of Insulin-Like Growth Factor 1 and Wnt/β-Catenin in Androgenetic Alopecia

BACKGROUND A new treatment for androgenetic alopecia (AGA) is 1,550-nm erbium-glass (Er:Glass) fractional laser. The wound healing process associated with this treatment is believed to be due to the stimulation of hair regrowth. Both the Wingless-related integration site (Wnt) proteins and insulin-like growth factor 1 (IGF-1) are important molecules that promote new hair growth. OBJECTIVE The aim of this study was to evaluate the efficacy of 1,550-nm Er:Glass fractional laser treatment and determine the gene expression of IGF-1 and Wnt/β-catenin in patients with AGA. METHODS Twenty-three patients with AGA were enrolled. They received 12 treatments at 2-week intervals. A scalp biopsy was performed to evaluate mRNA levels of Wnt10A and IGF-1. Histopathologic samples were collected. RESULTS Significant increases in hair count and shaft diameter that occurred from Month 4 until the end of the study were observed. Histological results showed increases in the follicular unit, anagen hair count, and the anagen:telogen ratio. No up-regulation of Wnt10A and IGF-1 mRNA was observed. CONCLUSION The 1,550-nm Er:Glass fractional laser treatment can increase hair density and shaft diameter in patients with AGA. The mechanisms by which 1,550-nm Er:Glass laser treatment induces new hair growth may not be limited to Wnt10A/β-catenin or IGF-1 expression. Address correspondence and reprint requests to: Jitlada Meephansan, MD, PhD, Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Rangsit Campus, Klong Luang, Pathum Thani 12120, Thailand, or e-mail: kae_mdcu@yahoo.com The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Clinical Application of Cultured Stratified Epithelial Sheets Grown Under Feeder or Feeder-Free Conditions for Stable Vitiligo

BACKGROUND Autologous cultured therapy has emerged as an effective treatment for stable vitiligo. However, culture methods may include harmful agents and be unsuitable for therapeutic use in humans. OBJECTIVE To investigate the safety and efficacy of autologous cultured epithelial sheets propagated under serum-free and feeder-free conditions for the treatment of stable vitiligo. METHODS Twenty-eight patients with stable vitiligo were included in this study. Keratinocytes and melanocytes from 14 patients were cultured under serum-free, feeder-free conditions (Group A). Epithelial cells from the remaining 14 patients were cultured according to Rheinward and Green's technique (Group B). Patients were followed up at 1, 3, 6, and 12 months after transplantation. RESULTS The epithelial sheets cultured in Group A were thinner and more fragile than Group B, but there were no significant differences in repigmentation between the 2 groups. At 12-month follow-up, in Group A, repigmentation at graft sites was classified as excellent in 9 patients and good in 2 patients. In Group B, repigmentation was excellent in 8 patients and good in 4 patients. Scars at the donor sites were the most frequent adverse events associated with the procedure. CONCLUSION Autologous epithelial sheet cultured in serum-free, feeder-free conditions is a safe and efficacious approach to cure stable vitiligo. Address correspondence and reprint requests to: Jinhua Xu, MD, PhD, Department of Dermatology, Huashan Hospital of Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai 200040, China, or e-mail: lijian1979@medmail.com.cn Supported by Medical Guide Subject of Shanghai Science and Technology Committee (subject number: 124119a1002) and Clinical Priority Specialized Subject of the Ministry of Health of China (2013). The authors have indicated no significant interest with commercial supporters. J. Li and S. Chen have contributed equally to this work. In this current study, patients and skin samples were collected according to Huashan Hospital of Fudan University Research Ethics Service Study Protocol (Ethical approval number: Huashan ethics committee 2012(007)), and this study was approved by Huashan Hospital of Fudan University ethics committee. Written informed consent was obtained from all patients. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Effect of cabergoline monotherapy in Cushing’s disease: an individual participant data meta-analysis

Abstract

Context

The primary treatment of choice for Cushing's disease (CD) is the removal of the pituitary adenoma by transsphenoidal surgery (TSS). The surgical failure is seen in up to 75% of cases depending on the experience of the surgeon in different studies. Medical therapy is one of the options for the treatment of recurrent or persistent CD.

Methodology

The primary outcome of this meta-analysis was to find the proportion of patients achieving normalisation of 24-h urinary free cortisol (remission of CD) following cabergoline monotherapy. Literature search was conducted in January 2018 in PubMed/MEDLINE database from its date of inception to 31st December 2017. The search strategy used was "[(cushing) OR Cushing's] AND cabergoline". Individual participant data were extracted from the included studies and risk of bias was analysed by review checklist proposed by MOOSE.

Results

The individual participant data of 124 patients from six observational studies were included in this meta-analysis. 92 patients (74.2%) had past pituitary surgery. The proportion of patients achieving remission of CD with cabergoline monotherapy was 39.4% (95% confidence interval 0.31–0.49; P = 0.026). The previous surgery [odds ratio (OR) 28.4], duration of cabergoline monotherapy (OR 1.31) and maximum cabergoline dose (OR 0.19) were predictors for remission of CD. Mild and severe side effects were reported in 37.3% and 5.6% of patients, respectively, during cabergoline monotherapy.

Conclusions

This meta-analysis shows that cabergoline monotherapy is a reasonable alternative for subjects with persistent or recurrent CD after TSS. It can also be used in CD patients either as a bridge therapy while waiting for surgery or in those unwilling for surgery or have contraindication to it.

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Treatment of erythematotelangiectatic rosacea, facial erythema, and facial telangiectasia with a 577-nm pro-yellow laser: a case series

Abstract

Various lasers have been used for the treatment of erythematotelangiectatic rosacea (ETR), facial erythema (FE), and facial telangiectasias (FT). The assessment of the treatments of all of these conditions with a 577-nm pro-yellow laser has not been reported yet. The aim of this work was to assess the efficacy and safety of the 577-nm pro-yellow laser in ETR, FE, and FT. Forty patients suffering from ETR, FE, and FT (25 female and 15 male) were enrolled in this study. All of the patients were treated with 577-nm pro-yellow laser (QuadroStarPRO YELLOW® Asclepion Laser Technologies, Germany) at 4-week intervals, for one to four sessions. The assessment of the treatment was made based on the digital photographs and the percentage of fading of the erythema and telangiectasias in the lesions. Significant clinical improvement (80–100%) was observed in the first or second sessions of the treatment in FE and ETR patients and in second and fourth sessions of the treatment in FT patients. The treatment was very well tolerated. No side effect was observed except for a few patients who had mild to moderate erythema fading away in 12–24 h. This case series has shown that the pro-yellow laser is a very effective, safe, and well-tolerated treatment for ETR, FE, and FT.

https://ift.tt/2vW3olG

Molecular and cellular pathogenesis of heparin-induced thrombocytopenia (HIT)

Publication date: Available online 10 August 2018

Source: Autoimmunity Reviews

Author(s): Lubica Raouva, Gowthamy Arepally, Mortimer Poncz, Douglas B. Cines

https://ift.tt/2M8rILW

Rheumatic immune-related adverse events in patients on anti-PD-1 inhibitors: Fasciitis with myositis syndrome as a new complication of immunotherapy

Publication date: Available online 10 August 2018

Source: Autoimmunity Reviews

Author(s): Javier Narváez, Pablo Juarez López, Judit LLuch, José Antonio Narváez, Ramón Palmero, Xavier García del Muro, Joan Miquel Nolla, Eva Domingo-Domenech

Abstract

Objective

To evaluate the prevalence and type of rheumatic immune-related adverse events (IRAEs) in patients receiving programmed cell death protein-1 (PD-1) inhibitors.

Methods

This is a single-center prospective observational study, including all cancer patients receiving PD-1 inhibitors between January 2016 and January 2018.

Results

During the period analyzed, we evaluated a total of 11 patients. No patient had pre-existing rheumatic or autoimmune disease. In this period, a total of 220 patients were treated with PD1 inhibitors in our center; therefore, the estimated minimum prevalence of rheumatic IRAEs related to these therapies in our population was 5%.

The rheumatic IRAEs evaluated included 5 cases of oligo- or polyarthritis, 1 with a polymialgia rheumatica-type syndrome, 2 cases of immunotherapy-induced sicca syndrome, 2 patients who presented symptomatic inflammatory myositis with fasciitis in lower extremities, and 1 patient with a paraneoplastic acral vascular syndrome. The median time to IRAE after anti-PD1 exposure was 8 weeks (range: 2–24). In 5 patients, immunotherapy was discontinued (due to the adverse effect in three and cancer progression in two).

In general terms the symptoms resolved completely with symptomatic treatment. Disease-modifying antirheumatic drugs were needed for 2 patients.

Conclusion

Rheumatic IRAEs should be kept in mind during the follow-up and evaluation of patients treated with PD-1 inhibitors. The concomitant development of symptomatic inflammatory myositis with fasciitis in lower extremities appears to be a new adverse effect of anti-PD-1 immunotherapy. Additional studies are needed to determine how to adequately control and manage these complications.

https://ift.tt/2OlWQ7a

Clinical and immunological parameters of Sjögren's syndrome

Publication date: Available online 10 August 2018

Source: Autoimmunity Reviews

Author(s): Konstantia Psianou, Ioannis Panagoulias, Anastasios D. Papanastasiou, Anne-Lise de Lastic, Maria Rodi, Panagiota I. Spantidea, Søren E. Degn, Panagiotis Georgiou, Athanasia Mouzaki

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune disease that primarily affects the exocrine glands, resulting in their functional impairment. In SS, lymphocytic infiltration of salivary and lacrimal glands, and deposition of several types of autoantibodies, mainly anti-SS-A (anti-Ro) and anti-SS-B (anti-La), lead to chronic inflammation, with xerostomia and keratoconjunctivitis sicca. In its primary form (pSS), SS does not involve additional connective tissue diseases, whereas in its secondary and more common form (sSS), SS presents in association with other rheumatic autoimmune diseases, mainly rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). As in most autoimmune diseases, environmental, hormonal and genetic factors are implicated in SS pathogenesis. In SS T cells predominate in mild lesions, whereas B cells predominate in advanced lesions. Th1, Th2, Th17, follicular helper T (Tfh) cells and regulatory cells (Tregs/Bregs), with their characteristic cytokine profiles, have been implicated in the pathogenesis of SS. It has been suggested that Th1 and Th17 cells initiate SS and, as the disease progresses, Th2 and Tfh cells predominate. It is assumed that, as in all autoimmune and inflammatory conditions, tolerance defects contribute to SS pathogenesis. It is intriguing that in SS it remains unclear which types of regulatory cells are functional and whether they ameliorate or worsen the disease. In this review we present a comprehensive update on SS with emphasis on immune system involvement, and suggest new insights into SS immunopathogenesis.

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Letter to the Editor: New insights into the etiology of Hashimoto's Thyroiditis: the role of genetics and epigenetics

Publication date: Available online 10 August 2018

Source: Autoimmunity Reviews

Author(s): Massimo Ralli, Armando De Virgilio, Marco Artico, Lucia Longo, Marco de Vincentiis, Antonio Greco

https://ift.tt/2KJHh73

Transgenerational Epigenetic Mechanisms in Adipose Tissue Development

Publication date: Available online 10 August 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Simon Lecoutre, Paul Petrus, Mikael Rydén, Christophe Breton

An adverse nutritional environment during the perinatal period increases the risk of adult-onset metabolic diseases, such as obesity, which may persist across generations. Adipose tissue (AT) from offspring of malnourished dams has been shown to display altered adipogenesis, lipogenesis, and adipokine expression, impaired thermogenesis, and low-grade inflammation. Although the exact mechanisms underlying these alterations remain unclear, epigenetic processes are believed to have an important role. In this review, we focus on epigenetic mechanisms in AT that may account for transgenerational dysregulation of adipocyte formation and adipose function. Understanding the complex interactions between maternal diet and epigenetic regulation of the AT in offspring may be valuable in improving preventive strategies against the obesity pandemic.

https://ift.tt/2nrGRsU

Frontmatter

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 8
Pages: i-iv

https://ift.tt/2McFjRL

Resistance exercise alone improves muscle strength in growth hormone deficient males in the transition phase

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 8
Pages: 887-894

https://ift.tt/2Or61mO

Molecular genetics of tetrahydrobiopterin deficiency in Chinese patients

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 8
Pages: 911-916

https://ift.tt/2MfEuHF

Next-generation sequencing as a second-tier diagnostic test for newborn screening

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 8
Pages: 927-931

https://ift.tt/2MwsPRI

Refractory hypoglycemia in a pediatric patient with desmoplastic small round cell tumor

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 8
Pages: 947-950

https://ift.tt/2vzheen

Novel combined method of biosorption and chemical precipitation for recovery of Pb 2+ from wastewater

Abstract

A novel combined biosorption-precipitation process has been designed and applied to recycle Pb²⁺ from low concentration lead containing wastewater. Pb²⁺ was firstly removed selectively from wastewater by pyromellitic dianhydride (PMDA) modified sugarcane bagasse (SB) fixed-bed column, and then, it was desorbed into the concentrated eluate and recycled by adding chemical precipitant. Adsorption performance of the column and optimum desorption and precipitation condition for Pb²⁺ were investigated in detail. Results showed that the as-prepared column could efficiently remove Pb²⁺ from aqueous solution and optimum condition for Pb²⁺ precipitation in eluate was at pH 3.0 and molar ratio of precipitant to Pb²⁺ of 5:1 by using Na₃PO₄ as precipitant. Recovery experiment illustrated that Pb²⁺ was selectively removed from wastewater containing ions of Pb²⁺, Zn²⁺, Cd²⁺, Ca²⁺, K⁺, and Na⁺ through competitive substitution adsorption on the modified SB, and mass ratio of the five metal ions in eluate was 96.8:0.7:0.7:0.7:0.5:0.5. Pb²⁺ in this concentrated and purified eluate solution was recycled efficiently by adding Na₃PO₄. The combined method had great potential in application of heavy metal recovery from wastewater.

https://ift.tt/2nqPl3t

Mutations of deubiquitinase OTUD1 are associated with autoimmune disorders

Publication date: Available online 10 August 2018

Source: Journal of Autoimmunity

Author(s): Dan Lu, Jia Song, Yizhe Sun, Fang Qi, Liang Liu, Yan Jin, Michael A. McNutt, Yuxin Yin

Abstract

Dysregulation of innate immunity accompanied by excessive interferon production contributes to autoimmune disease. However, the mechanism by which the immune response is modulated in autoimmune disorders is largely unknown. Here we identified loss-of-function mutations of OTUD1 associated with multiple autoimmune diseases. Under inflammatory conditions, inducible OTUD1 acts as an immune checkpoint and blocks RIG-I-like receptors signaling. As a deubiquitinase, OTUD1 directly interacts with transcription factor IRF3 and removes the K63-linked poly-ubiquitin chains on IRF3 Lysine 98, which inhibits IRF3 nuclear translocation and transcriptional activity. In contrast, OTUD1 mutants impair its suppressive effects on IRF3 via attenuating the OTUD1 deubiquinase activity or its association with IRF3. Moreover, we found FOXO3 signaling is required for OTUD1 induction upon antigenic stimulation. Our data demonstrate that OTUD1 is involved in maintaining immune homeostasis and loss-of-function mutations of OTUD1 enhance the immune response and are associated with autoimmunity.

https://ift.tt/2AZJyf7

Scholar : Acta Oto-Laryngologica, Volume 138, Issue sup1, September 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Acta Oto-Laryngologica, Volume 138, Issue sup1, September 2018 is now available online on Taylor & Francis Online. Chinese Translation of Acta Oto-Laryngologica 100 Years This new issue contains the following articles: Miscellany Chinese version - Jubliee issue Pages: 1-161 | DOI: 10.1080/00016489.2018.1501150 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Scholar : Autophagy, Volume 14, Issue 6, 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Autophagy, Volume 14, Issue 6, 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Editor's Corner Autophagy, Inflammation, and Metabolism (AIM) Center of Biomedical Research Excellence: supporting the next generation of autophagy researchers and fostering international collaborations Vojo Deretic, Eric Prossnitz, Mark Burge, Matthew J. Campen, Judy Cannon, Ke Jian Liu, Larry A. Sklar, Lee Allers, Sally Ann Garcia, Eric H. Baehrecke, Christian Behrends, Francesco Cecconi, Patrice Codogno, Guang-Chao Chen, Zvulun Elazar, Eeva-Liisa Eskelinen, Bernard Fourie, Devrim Gozuacik, Wanjin Hong, Gokhan Hotamisligi, Marja Jäättelä, Eun-Kyeong Jo, Terje Johansen, Gábor Juhász, Adi Kimchi, Nicholas Ktistakis, Guido Kroemer, Noboru MIzushima, Christian Münz, Fulvio Reggiori, David Rubinsztein, Kevin Ryan, Kate Schroder, Anne Simonsen, Sharon Tooze, Maria I. Vaccaro, Tamotsu Yoshimori, Li Yu, Hong Zhang & Daniel J. Klionsky Pages: 925-929 | DOI: 10.1080/15548627.2018.1465784 Research Paper - Basic Science Alterations of autophagy in the peripheral neuropathy Charcot-Marie-Tooth type 2B | David Colecchia, Mariangela Stasi, Margherita Leonardi, Fiore Manganelli, Maria Nolano, Bianca Maria Veneziani, Lucio Santoro, Eeva-Liisa Eskelinen, Mario Chiariello & Cecilia Bucci Pages: 930-941 | DOI: 10.1080/15548627.2017.1388475 TP53 is required for BECN1- and ATG5-dependent cell death induced by sphingosine kinase 1 inhibition Santiago Lima, Kazuaki Takabe, Jason Newton, Kumar Saurabh, Megan M. Young, Andreia Machado Leopoldino, Nitai C. Hait, Jane L. Roberts, Hong-Gang Wang, Paul Dent, Sheldon Milstien, Laurence Booth & Sarah Spiegel Pages: 942-957 | DOI: 10.1080/15548627.2018.1429875 HSP90 inhibition targets autophagy and induces a CASP9-dependent resistance mechanism in NSCLC Jie Han, Leslie A. Goldstein, Wen Hou, Suman Chatterjee, Timothy F. Burns & Hannah Rabinowich Pages: 958-971 | DOI: 10.1080/15548627.2018.1434471 Antimycobacterial effect of IFNG (interferon gamma)-induced autophagy depends on HMOX1 (heme oxygenase 1)-mediated increase in intracellular calcium levels and modulation of PPP3/calcineurin-TFEB (transcription factor EB) axis Nisha Singh, Pallavi Kansal, Zeeshan Ahmad, Navin Baid, Hariom Kushwaha, Neeraj Khatri & Ashwani Kumar Pages: 972-991 | DOI: 10.1080/15548627.2018.1436936 Delipidation of mammalian Atg8-family proteins by each of the four ATG4 proteases Karlina J. Kauffman, Shenliang Yu, Jiaxin Jin, Brian Mugo, Nathan Nguyen, Aidan O'Brien, Shanta Nag, Alf Håkon Lystad & Thomas J. Melia Pages: 992-1010 | DOI: 10.1080/15548627.2018.1437341 Ciliogenesis is reciprocally regulated by PPARA and NR1H4/FXR through controlling autophagy in vitro and in vivo Zhi-qiang Liu, Joon No Lee, Myeongjoo Son, Jae-Young Lim, Raghbendra Kumar Dutta, Yunash Maharjan, SeongAe Kwak, Goo Taeg Oh, Kyunghee Byun, Seong-Kyu Choe & Raekil Park Pages: 1011-1027 | DOI: 10.1080/15548627.2018.1448326 Rapamycin-induced autophagy protects proximal tubular renal cells against proteinuric damage through the transcriptional activation of the nerve growth factor receptor NGFR D. Vizza, A. Perri, G. Toteda, S. Lupinacci, I. Perrotta, D. Lofaro, F. Leone, P. Gigliotti, A. La Russa & R. Bonofiglio Pages: 1028-1042 | DOI: 10.1080/15548627.2018.1448740 Importance of TFEB acetylation in control of its transcriptional activity and lysosomal function in response to histone deacetylase inhibitors Jianbin Zhang, Jigang Wang, Zhihong Zhou, Jung-Eun Park, Liming Wang, Shuai Wu, Xin Sun, Liqin Lu, Tianru Wang, Qingsong Lin, Siu Kwan Sze, Dongsheng Huang & Han-Ming Shen Pages: 1043-1059 | DOI: 10.1080/15548627.2018.1447290 Protocol Measuring autophagosome flux Andre du Toit, Jan-Hendrik S. Hofmeyr, Thomas J. Gniadek & Ben Loos Pages: 1060-1071 | DOI: 10.1080/15548627.2018.1469590 Autophagic Punctum SQSTM1/p62 (sequestosome 1) senses cellular ubiquitin stress through E2-mediated ubiquitination Jiao Yang, Hong Peng, Yumin Xu, Xiaoduo Xie & Ronggui Hu Pages: 1072-1073 | DOI: 10.1080/15548627.2017.1332566 Commentary AIM/LIR-based fluorescent sensors—new tools to monitor mAtg8 functions Katarzyna Zientara-Rytter & Suresh Subramani Pages: 1074-1078 | DOI: 10.1080/15548627.2018.1454238 Autophagic Punctum Crosstalk between translation and the aggresome–autophagy pathway Yeonkyoung Park, Joori Park & Yoon Ki Kim Pages: 1079-1081 | DOI: 10.1080/15548627.2017.1358849 WIPI β-propellers function as scaffolds for STK11/LKB1-AMPK and AMPK-related kinase signaling in autophagy Daniela Bakula, Amelie J. Mueller & Tassula Proikas-Cezanne Pages: 1082-1083 | DOI: 10.1080/15548627.2017.1382784 Mitochondria: The hub of energy deprivation-induced autophagy Cong Yi, Jing-Jing Tong & Li Yu Pages: 1084-1085 | DOI: 10.1080/15548627.2017.1382785 PIK3C3/VPS34 control by acetylation Hua Su & Wei Liu Pages: 1086-1087 | DOI: 10.1080/15548627.2017.1385676 Mutations in ATP6AP2 cause autophagic liver disease in humans Magda Cannata Serio, Maria A. Rujano & Matias Simons Pages: 1088-1089 | DOI: 10.1080/15548627.2018.1434370 CCPG1, a cargo receptor required for reticulophagy and endoplasmic reticulum proteostasis | Matthew D. Smith & Simon Wilkinson Pages: 1090-1091 | DOI: 10.1080/15548627.2018.1441473 Oxidative stress impairs autophagy through oxidation of ATG3 and ATG7 Joseph Robert Burgoyne Pages: 1092-1093 | DOI: 10.1080/15548627.2018.1444311 Signaling and induction of chaperone-mediated autophagy by the endoplasmic reticulum under stress conditions Wenming Li, Qian Yang & Zixu Mao Pages: 1094-1096 | DOI: 10.1080/15548627.2018.1444314 Release the autophage brake on inflammation: The MAPK14/p38α-ULK1 pedal Hua She, Yingli He, Yingren Zhao & Zixu Mao Pages: 1097-1098 | DOI: 10.1080/15548627.2018.1446626 Nuclear TP53: An unraveled function as transcriptional repressor of PINK1 Frédéric Checler, Thomas Goiran & Cristine Alves da Costa Pages: 1099-1101 | DOI: 10.1080/15548627.2018.1450022 Detection of a vita-PAMP STINGs cells into reticulophagy Julien Moretti & J. Magarian Blander Pages: 1102-1104 | DOI: 10.1080/15548627.2018.1441471 The Rag GTPase-Ragulator complex attenuates TOR complex 1 signaling in fission yeast Tomoyuki Fukuda & Kazuhiro Shiozaki Pages: 1105-1106 | DOI: 10.1080/15548627.2018.1444313 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Organic contaminants in the effluent of Chinese wastewater treatment plants

Abstract

The effluents of wastewater treatment plants (WWTPs) are the important sources for pollutants. These pollutants may entry into surface water, groundwater, and soil by recharging and irrigation then pose risk to human beings. Using reports from the past 20 years (n = 58), we conducted this review of organic contaminants (OCs) in the effluent of Chinese WWTPs. All the studies were during 2005 to 2017 and more than two papers were conducted in every year. Nineteen provinces (20 cities) were covered and most of the studies were located in the eastern part of China, especially the most developed and highest density of population areas. Two hundred eighty-four OCs were contained. E antibiotics, endocrine-disrupting chemicals (EDCs), and pharmaceuticals were the most commonly studied groups of OCs, and ofloxacin, norfloxacin, and sulfamethoxazole were the three most commonly reported OCs. The highest concentration appeared for bisphenol A (BPA). The relative standard deviations (RSDs) of concentrations of the most commonly studied compounds were high. In the future, more studies should pay attention on national analysis and more pollutants.

https://ift.tt/2MbrLGX

Effect of amendments on contaminated soil of multiple heavy metals and accumulation of heavy metals in plants

Abstract

The contamination of soil with heavy metals is a severe problem due to adverse impact of heavy metals on environmental safety and human health. It is essential to remediate soil contaminated with heavy metals. This study has evaluated the effects of pine biochar, kaolin, and triple super phosphate (TSP) on multiple heavy metals (Ni, Zn, Cu, and Cd) in contaminated soil and accumulation of heavy metals in plants. The amendments can reduce availability of heavy metals in soil by increasing pH, adsorption, complexation, or co-precipitation. Different amendments have variable effects on accumulation of heavy metals in plants and in soil due to its diverse mechanism of stability. The results showed that application of triple super phosphate (TSP) has significant reduced soil Cd exchangeable (EXC) fraction from 58.59 to 21.30%. Bound to carbonates (CAR) fraction decreased from 9.84 to 5.11%, and bound to Fe-Mn oxides (OX) fraction increased from 29.61 to 69.86%. The triple super phosphate (TSP) has the ability to stabilize Cu and especially Cd. However, triple super phosphate (TSP) has enhanced ecological risk of Zn and Ni. Application of pine biochar has significantly enhanced soil pH. The kaolin has significantly reduced EXC fraction of Cd and increased OX fraction of Cu. The amendments and heavy metals have not caused significant effect on SPAD value of Buxus microphylla Siebold & Zucc (B. microphylla). The triple super phosphate (TSP) has significant decreased biomass of B. microphylla and bamboo-williow (Salix sp.) by 24.91 and 57.43%, respectively. Pine biochar and kaolin have increased the accumulation of Zn and Cd in plants. It is concluded that triple super phosphate (TSP) was effective in remediation of Cd and kaolin was effective in remediation of Cd and Cu. Pine biochar was effective in remediation of Cd, Cu, and Zn.

https://ift.tt/2OsHy0O

Short-term efficacy of high intensity group and individual education in patients with type 2 diabetes: a randomized single-center trial

Abstract

Purpose

The aim of this randomized study was to examine the efficacy of two high intensity educational programs: the conversation maps-based (CM™) education and the individual education (IE), compared to usual care (UC) in a cohort of type 2 diabetic (T2DM) patients.

Methods

Ninety T2DM outpatients (30 per group) were randomized and 79 finished the study and were analyzed. The CM™ and IE groups received four educational sessions at 0, 4, 8 and 12 weeks, while the UC group received two brief individual sessions at 0 and 12 weeks. We evaluated glycemic control (HbA1c), diabetes treatment, body mass index (BMI) and carried out a questionnaire survey at three time points (before intervention, at 12 and at 32 weeks) to assess patients' satisfaction, attitudes toward diabetes and dietary knowledge.

Results

All the three groups showed a significant and comparable reduction of both HbA1c and BMI. Diabetes therapy needed to be reinforced in a higher percentage of cases (39.3%) among UC patients compared to the IE (14.8%; p = 0.04) and the CM™ (8.3%; p = 0.01) groups. At 32 weeks Diabetes Treatment Satisfaction (DTSQ Q1 + Q4–8) significantly improved in the CM™ group (25.8 ± 4.5 vs. 22.4 ± 6.0; p < 0.01) and attitudes toward diabetes (ATT19) significantly improved in the IE group (58.0 ± 4.7 vs. 55.3 ± 5.1; p = 0.02).

Conclusions

Our trial provides preliminary data regarding the efficacy of structured group and individual education on achieving better glyco-metabolic control without drug therapy reinforcement and with positive effects on patients' attitude and treatment satisfaction.

https://ift.tt/2Oukij1

Follow up for Patients With Thyroid Cancer Planed for Radioiodine Scan or Treatment

Condition:   Thyroid Cancer
Intervention:   Radiation: radioiodine
Sponsor:   Taichung Veterans General Hospital
Recruiting

https://ift.tt/2MAkNaH

Assessment of the Effects of Concussion on Adolescent Rugby Union Players

Conditions:   Concussion, Mild;   Concussion, Intermediate;   Concussion, Severe
Intervention:  
Sponsor:   Sports Surgery Clinic, Santry, Dublin
Recruiting

https://ift.tt/2Miq4qe

Feasibility & Efficacy of Durvalumab+Tremelimumab+RT and Durvalumab+RT in Non-resect. Locally Advanced HPVnegativ HNSCC

Condition:   Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: Durvalumab;   Drug: Tremelimumab;   Radiation: Radiotherapy
Sponsors:   Ulrich Keilholz;   Charite University, Berlin, Germany;   AstraZeneca
Not yet recruiting

https://ift.tt/2MAxHoV

Combination Study With Soluble LAG-3 Fusion Protein Eftilagimod Alpha (IMP321) and Pembrolizumab in Patients With Previously Untreated Unresectable or Metastatic NSCLC, or Recurrent PD-X Refractory NSCLC or With Recurrent or Metastatic HNSCC

Conditions:   NSCLC;   HNSCC
Interventions:   Drug: Eftilagimod alpha;   Drug: Pembrolizumab
Sponsors:   Immutep S.A.;   Merck Sharp & Dohme Corp.
Not yet recruiting

https://ift.tt/2MilKY0

Twice-daily red and blue light treatment for Candida albicans biofilm matrix development control

Abstract

Phototherapy has been proposed as a direct means of affecting local bacterial infections. However, the use of phototherapy to prevent fungal biofilm development has received comparatively less attention. This study aimed to determine the effects of red light treatment and blue light treatment, without a photosensitizer, on the development of Candida albicans biofilm. During the development of 48-h biofilms of C. albicans SN 425 (n = 10), the biofilms were exposed twice-daily to noncoherent blue and red light (LumaCare; 420 nm and 635 nm). The energy density applied was 72 J cm⁻² for blue light and 43.8 J cm², 87.6 J cm², and 175.5 J cm² for red light. Positive control (PC) and negative control (NC) groups were treated twice-daily for 1 min with 0.12% chlorhexidine (CHX) and 0.89% NaCl respectively. Biofilms were analyzed for colony forming units (CFU), dry-weight, and exopolysaccharides (EPS-soluble and EPS-insoluble). Data was analyzed by one-way ANOVA and Tukey post hoc test (α = 0.05). Dry-weight was lower than NC (p < 0.001) and approached PC levels with both red and blue light treatments. CFU were also lower in groups exposed to blue light and higher durations of red light (p < 0.05). EPS-soluble and EPS-insoluble measures were variably reduced by these light exposures. In conclusion, twice-daily exposure to both blue and red lights affect the biofilm development and physiology of polysaccharide production and are potential mechanisms for the control of C. albicans biofilm matrix development.

https://ift.tt/2MaWiVi

MECHANISMS IN ENDOCRINOLOGY: Rare defects in adrenal steroidogenesis

Congenital adrenal hyperplasia (CAH) is a group of genetic disorders of adrenal steroidogenesis that impair cortisol synthesis, with compensatory increases in ACTH leading to hyperplastic adrenals. The term 'CAH' is generally used to mean 'steroid 21-hydroxylase deficiency' (21OHD) as 21OHD accounts for about 95% of CAH in most populations; the incidences of the rare forms of CAH vary with ethnicity and geography. These forms of CAH are easily understood on the basis of the biochemistry of steroidogenesis. Defects in the steroidogenic acute regulatory protein, StAR, disrupt all steroidogenesis and are the second-most common form of CAH in Japan and Korea; very rare defects in the cholesterol side-chain cleavage enzyme, P450scc, are clinically indistinguishable from StAR defects. Defects in 3β-hydroxysteroid dehydrogenase, which also causes disordered sexual development, were once thought to be fairly common, but genetic analyses show that steroid measurements are generally unreliable for this disorder. Defects in 17-hydroxylase/17,20-lyase ablate synthesis of sex steroids and also cause mineralocorticoid hypertension; these are common in Brazil and in China. Isolated 17,20-lyase deficiency can be caused by rare mutations in at least three different proteins. P450 oxidoreductase (POR) is a co-factor used by 21-hydroxylase, 17-hydroxylase/17,20-lyase and aromatase; various POR defects, found in different populations, affect these enzymes differently. 11-Hydroxylase deficiency is the second-most common form of CAH in European populations but the retention of aldosterone synthesis distinguishes it from 21OHD. Aldosterone synthase deficiency is a rare salt-losing disorder. Mild, 'non-classic' defects in all of these factors have been described. Both the severe and non-classic disorders can be treated if recognized.

https://ift.tt/2MgoyVL

GENETICS IN ENDOCRINOLOGY: Genetic diagnosis of endocrine diseases by NGS: novel scenarios and unpredictable results and risks

The technological advancements in genetics produced a profound impact on the research and diagnostics of non-communicable diseases. The availability of next-generation sequencing (NGS) allowed the identification of novel candidate genes but also an in-depth modification of the understanding of the architecture of several endocrine diseases. Several different NGS approaches are available allowing the sequencing of several regions of interest or the whole exome or genome (WGS, WES or targeted NGS), with highly variable costs, potentials and limitations that should be clearly known before designing the experiment. Here, we illustrate the NGS scenario, describe the advantages and limitations of the different protocols and review some of the NGS results obtained in different endocrine conditions. We finally give insights on the terminology and requirements for the implementation of NGS in research and diagnostic labs.

https://ift.tt/2MzDcnV

MECHANISMS IN ENDOCRINOLOGY: Hormonal regulation of spermatogenesis: mutant mice challenging old paradigms

The two pituitary gonadotrophins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and in particular LH-stimulated high intratesticular testosterone (ITT) concentration, are considered crucial for spermatogenesis. We have revisited these concepts in genetically modified mice, one being the LH receptor (R)-knockout mouse (LuRKO), the other a transgenic mouse expressing in Sertoli cells a highly constitutively active mutated Fshr (Fshr-CAM). It was found that full spermatogenesis was induced by exogenous testosterone treatment in LuRKO mice at doses that restored ITT concentration to a level corresponding to the normal circulating testosterone level in WT mice, 5 nmol/L, which is 1.4% of the normal high ITT concentration. When hypogonadal LuRKO and Fshr-CAM mice were crossed, the double-mutant mice with strong FSH signaling, but minimal testosterone production, showed near-normal spermatogenesis, even when their residual androgen action was blocked with the strong antiandrogen flutamide. In conclusion, our findings challenge two dogmas of the hormonal regulation of male fertility: (1) high ITT concentration is not necessary for spermatogenesis and (2) strong FSH stimulation can maintain spermatogenesis without testosterone. These findings have clinical relevance for the development of hormonal male contraception and for the treatment of idiopathic oligozoospermia.

https://ift.tt/2MfpQ3o

Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT?

Polycystic ovary syndrome (PCOS) is common in premenopausal women. The majority of women with PCOS have insulin resistance and the risk of type 2 diabetes mellitus (T2D) is higher in women with PCOS compared to controls. In non-pregnant women with PCOS, glycemic status may be assessed by oral glucose tolerance test (OGTT), fasting plasma glucose (FPG) or HbA1c. OGTT has been reckoned gold standard test for diagnosing T2D, but OGTT is rarely used for diagnostic purpose in other non-pregnant individuals at risk of T2D, apart from PCOS. OGTT has questionable reproducibility, and high sensitivity of the 2-h glucose value is at the expense of relatively low specificity, especially regarding impaired glucose tolerance (IGT). Furthermore, lean women with PCOS are rarely diagnosed with T2D and only few percent of normal-weight women have prediabetes. Glycemic status is necessary at diagnosis and during follow-up of PCOS, especially in women with high risk of T2D (obesity, previous gestational diabetes (GDM)). We suggest that OGTT should be used in the same situations in PCOS as in other patient groups at risk of T2D. OGTT is indicated for diagnosing GDM; however, OGTT during pregnancy may not be indicated in lean women with PCOS without other risk factors for GDM.

https://ift.tt/2KHrsxO

Should 45,X/46,XY boys with no or mild anomaly of external genitalia be investigated and followed up?

Objective

Few studies of patients with a 45,X/46,XY mosaicism have considered those with normal male phenotype. The purpose of this study was to evaluate the clinical outcome of 45,X/46,XY boys born with normal or minor abnormalities of external genitalia, notably in terms of growth and pubertal development.

Methods

Retrospective longitudinal study of 40 patients followed between 1982 and 2017 in France.

Results

Twenty patients had a prenatal diagnosis, whereas 20 patients had a postnatal diagnosis, mainly for short stature. Most patients had stunted growth, with abnormal growth spurt during puberty and a mean adult height of 158 ± 7.6 cm, i.e. –2.3 DS with correction for target height. Seventy percent of patients presented Turner-like syndrome features including cardiac (6/23 patients investigated) and renal malformations (3/19 patients investigated). Twenty-two patients had minor abnormalities of external genitalia. One patient developed a testicular embryonic carcinoma, suggesting evidence of partial gonadal dysgenesis. Moreover, puberty occurred spontaneously in 93% of patients but 71% (n = 5) of those evaluated at the end of puberty presented signs of declined Sertoli cell function (low inhibin B levels and increased FSH levels).

Conclusion

This study emphasizes the need to identify and follow-up 45,X/46,XY patients born with normal male phenotype until adulthood, as they present similar prognosis than those born with severe genital anomalies. Currently, most patients are diagnosed in adulthood with azoospermia, consistent with our observations of decreased testicular function at the end of puberty. Early management of these patients may lead to fertility preservation strategies.

https://ift.tt/2OWDMxF

MRI texture analysis as a predictor of tumor recurrence or progression in patients with clinically non-functioning pituitary adenomas

Background

There are limited predictors of prognosis in patients with clinically non-functioning pituitary adenomas (NFPAs). We hypothesized that MRI texture analysis may predict tumor recurrence or progression in patients with NFPAs undergoing transsphenoidal pituitary surgery (TSS).

Objective

To characterize texture parameters on preoperative MRI examinations in patients with NFPAs in relation to prognosis.

Methods

Retrospective study of patients with NFPAs who underwent TSS at our institution between 2009 and 2010. Clinical, radiological and histopathological data were extracted from electronic medical records. MRI texture analysis was performed on coronal T1-weighted non-enhanced MR images using ImageJ (NIH). MRI texture parameters were used to predict tumor recurrence or progression. Both logistic regression and Cox proportional hazard analyses were conducted to adjust for potential confounders.

Results

Data on 78 patients were analyzed. On both crude and multivariable-adjusted analyses, mean, median, mode, minimum and maximum pixel intensity were associated with the risk of pituitary tumor recurrence or progression after TSS. Patients whose tumor mean pixel intensity was above the median for the population had a hazard ratio of 0.44 (95% CI: 0.21–0.94, P = 0.034) for recurrence or progression in comparison with tumors below the median.

Conclusions

Our data suggest that MRI texture analysis can predict the risk of tumor recurrence or progression in patients with NFPAs.

https://ift.tt/2KELBo9

Gender disparities in screening for congenital hypothyroidism using thyroxine as a primary screen

Objective

Newborn screening for congenital hypothyroidism (CH) is based on testing for the markers thyroxine (T4) and/or thyroid-stimulating hormone (TSH). Diagnosis of CH is complicated because many factors affect the levels of these hormones including infant birth weight, prematurity and age at specimen collection. We investigated whether the sex of the newborn affected the levels of T4 and TSH and consequently the outcome of newborn screening.

Design

In New York State, the Newborn Screening program initially tests all infants for T4 and any baby with a result in the lowest 10% is triaged for TSH screening. We analyzed data from 2008 to 2016 to determine mean and median T4 and TSH values and how these results correlate with the sex of infants who are reported as borderline, referred and confirmed with CH.

Methods

T4 and TSH concentrations in dried blood spots were measured using commercially available fluoroimmunoassays.

Results

From 2008 to 2016, of the 2.4 million specimens tested for thyroxine, 51.5% were from male and 48.5% were from female infants. Male infants constituted 60% of specimens triaged for TSH testing, 64.9% of repeat requests and 59.6% of referrals, but only 49% of confirmed CH cases. The mean and median T4 values were lower (a difference of approximately 0.8–1.1 μg/dL each year) and the median TSH values were higher in male compared to female infants.

Conclusions

Natural differences in thyroid hormone levels in male and female infants leads to male infants being disproportionately represented in the false-positive category.

https://ift.tt/2MiaYky

Long-acting FC-fusion rhGH (GX-H9) shows potential for up to twice-monthly administration in GH-deficient adults

Objective

Hybrid Fc-fused rhGH (GX-H9) is a long-acting recombinant human growth hormone (GH) under clinical development for both adults and children with GH deficiency (GHD). We compared the safety, pharmacokinetics and pharmacodynamics of weekly and every other week (EOW) dosages of GX-H9 with those of daily GH administration in adult GHD (AGHD) patients.

Design

This was a randomized, open-label, active-controlled and dose-escalation study conducted in 16 endocrinology centers in Europe and Korea.

Methods

Forty-five AGHD patients with or without prior GH treatment were enrolled. Patients with prior GH treatments were required to have received the last GH administration at least 1 month prior to randomization. Subjects were sequentially assigned to treatment groups. Fifteen subjects were enrolled to each treatment group and randomly assigned to receive either GX-H9 or Genotropin (4:1 ratio). GX-H9 dosage regimens for Groups 1, 2 and 3 were 0.1 mg/kg weekly, 0.3 mg/kg EOW and 0.2 mg/kg EOW, respectively. All Genotropin-assigned subjects received 6 µg/kg Genotropin, regardless of treatment group. Main outcome analyses included measurements of serum insulin-like growth factor 1 (IGF-I), safety, pharmacokinetics, pharmacodynamics and immunogenicity.

Results

Mean GX-H9 peak and total exposure increased with an increase in dose after a single-dose administration. The mean IGF-I response was sustained above baseline over the intended dose interval of 168 h for the weekly and 336 h for the EOW GX-H9 groups. Safety profiles and immunogenicity were not different across the treatment groups and with Genotropin.

Conclusions

GX-H9 has the potential for up to twice-monthly administration.

https://ift.tt/2MAjbNS

Possible delayed diagnosis and treatment of metastatic differentiated thyroid cancer by adopting the 2015 ATA guidelines

Objective

According to the 2015 American Thyroid Association (ATA) guidelines, thyroid ablation by iodine-131 (I-131) therapy is absolutely recommended only in patients with high-risk differentiated thyroid cancer (DTC). Often distant metastases are not recognized early and they can stay silent for long time. The aim of our study was to retrospectively analyze the prevalence of metastatic disease before and after I-131 and to evaluate the influence of the new ATA guidelines in the management of DTC.

Methods

We retrospectively analyzed 140 patients showing distant metastases. All metastases were detected by whole-body scan after I-131 and confirmed by histology and/or other imaging modalities.

Results

In 26/140 patients metastases were detected before I-131, while in 114/140 were discovered after I-131. Comparing patients with metastases detected before and after I-131, no differences were demonstrated considering age, sex, histotype, tumor size, multifocality of cancer and metastatic localization. Metastatic DTC discovered before radioiodine had higher thyroglobulin and received a higher radioiodine total activity and number of treatments. Considering patients with distant metastases, according to the 2015 ATA guidelines, 38 patients would have been categorized as high risk, 22 as low risk and 80 as intermediate risk. Among intermediate-risk patients, only in 25 cases (31%) I-131 treatment would have been appropriate according to 2015 ATA recommendations; in the remaining 56 cases (69%), I-131 would not have been recommended.

Conclusions

According to the 2015 ATA guidelines, most of metastatic patients would not have been treated after surgery, with the risk of late diagnosis and delayed treatment.

https://ift.tt/2P01Tf1

Do aggressive variants of papillary thyroid carcinoma have worse clinical outcome than classic papillary thyroid carcinoma?

Objective

Evidence for unfavorable outcomes of each type of aggressive variant papillary thyroid carcinoma (AV-PTC) is not clear because most previous studies are focused on tall cell variant (TCV) and did not control for other major confounding factors contributing to clinical outcomes.

Design

Retrospective cohort study.

Methods

This study included 763 patients with classical PTC (cPTC) and 144 with AV-PTC, including TCV, columnar cell variant (CCV) and hobnail variants. Disease-free survival (DFS) and dynamic risk stratification (DRS) were compared after two-to-one propensity score matching by age, sex, tumor size, lymph node metastasis and extrathyroidal extension.

Results

The AV-PTC group had significantly lower DFS rates than its matched cPTC group (HR = 2.16, 95% CI: 1.12–4.16, P = 0.018). When TCV and CCV were evaluated separately, there was no significant differences in DFS and DRS between patients with TCV (n = 121) and matched cPTC. However, CCV group (n = 18) had significantly poorer DFS than matched cPTC group (HR = 12.19, 95% CI: 2.11–70.33, P = 0.005). In DRS, there were significantly more patients with structural incomplete responses in CCV group compared by matched cPTC group (P = 0.047). CCV was an independent risk factor for structural persistent/recurrent disease in multivariate analysis (HR = 4.28; 95% CI: 1.66–11.00, P = 0.001).

Conclusions

When other clinicopathological factors were similar, patients with TCV did not exhibit unfavorable clinical outcome, whereas those with CCV had significantly poorer clinical outcome. Individualized therapeutic approach might be necessary for each type of AV-PTCs.

https://ift.tt/2KDpOgN

DNA methylation profiling in MEN1-related pancreatic neuroendocrine tumors reveals a potential epigenetic target for treatment

Objective

Epigenetic changes contribute to pancreatic neuroendocrine tumor (PanNET) development. Hypermethylation of promoter DNA as a cause of tumor suppressor gene silencing is a well-established oncogenic mechanism that is potentially reversible and therefore an interesting therapeutic target. Multiple endocrine neoplasia type 1 (MEN1) is the most frequent cause of inherited PanNETs. The aim of this study was to determine promoter methylation profiles in MEN1-related PanNETs.

Design and methods

Methylation-specific multiplex ligation-dependent probe amplification was used to assess promoter methylation of 56 tumor suppressor genes in MEN1-related (n = 61) and sporadic (n = 34) PanNETs. Differences in cumulative methylation index (CMI), individual methylation percentages and frequency of promoter hypermethylation between subgroups were analyzed.

Results

We found promoter methylation of a large number of potential tumor suppressor genes. CMI (median CMI: 912 vs 876, P = 0.207) was the same in MEN1-related and sporadic PanNETs. We found higher methylation percentages of CASP8 in MEN1-related PanNETs (median: 59% vs 16.5%, P = 0.002). In MEN1-related non-functioning PanNETs, the CMI was higher in larger PanNETs (>2 cm) (median: 969.5 vs 838.5; P = 0.021) and in PanNETs with liver metastases (median: 1036 vs 869; P = 0.013). Hypermethylation of MGMT2 was more frequent in non-functioning PanNETs compared to insulinomas (median: 44.7% vs 8.3%; P = 0.022). Hypermethylation of the Von Hippel–Lindau gene promoter was observed in one MEN1-related PanNET and was associated with loss of protein expression.

Conclusion

Promoter hypermethylation is a frequent event in MEN1-related and sporadic PanNETs. Targeting DNA methylation could be of therapeutic value in MEN1 patients with advanced PanNETs.

https://ift.tt/2OUPGIa

Cyclic fatigue using severely curved canals and torsional resistance of thermally treated reciprocating instruments

Abstract

Objectives

To evaluate the cyclic fatigue using severely curved canals and torsional resistance of ProDesign R (Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil), Reciproc Blue (VDW, Munich, Germany), and WaveOne Gold (Dentsply Maillefer, Ballaigues, Switzerland) reciprocating instruments

Materials and methods

Twenty instruments of the ProDesign R (25/0.06) system, 20 instruments of the Reciproc Blue (25/0.08v) system, and 20 instrument of the WaveOne Gold (25/0.07v) system were used. Cyclic fatigue resistance was tested measuring the time to fracture and the number of cycles to fracture in an artificial stainless steel severely curved canal with 80° angle and a 3-mm radius of curvature (n = 10). Torque and angle of rotation at failure of new instruments (n = 10) were measured according to ISO 3630-1. The fracture surfaces of all fragments were examined with a scanning electron microscope. Results were statistically analyzed using one-way ANOVA and Tukey's test at a significance level of p < 0.05.

Results

ProDesign R instruments showed a significantly longer cyclic fatigue life than the other tested instruments (p < 0.05). Reciproc Blue showed longer cyclic life than WaveOne Gold (p < 0.05). Reciproc Blue showed the higher torsional strength, followed by WaveOne Gold and ProDesign R instruments (p < 0.05). Moreover, Reciproc Blue showed significantly higher angular rotation to fracture than ProDesign R (p < 0.05). WaveOne Gold showed intermediary results regarding angular rotation to fracture with no differences when compared to Reciproc Blue or ProDesign R instruments (p < 0.05).

Conclusions

ProDesign R presented the highest cyclic fatigue resistance in severely curved canals when compared with Reciproc Blue and WaveOne Gold. However, Reciproc Blue showed the higher torsional strength overall and higher angular rotation to fracture when compared to ProDesign R.

Clinical relevance

Despite the numerous advantages of reciprocating instruments, these instruments still have some risk of fracture during its use, especially in severely curved canals. The present study evaluated the cyclic fatigue and torsional resistance of thermally treated reciprocating instruments.

https://ift.tt/2GDM6Ow

Effects of an oral bisphosphonate and three intravenous bisphosphonates on several cell types in vitro

Abstract

Objective

To analyze the influence of an oral bisphosphonate and compare the potency to intravenous bisphosphonates on various cell types as regards the rarity of bisphosphonate-associated osteonecrosis of the jaw (BP-ONJ) caused by oral bisphosphonate.

Materials and methods

A viability assay (MTT), a migration assay (Boyden chamber), and an apoptosis assay (Caspase-Glo® 3/7) were performed to analyze the effect of bisphosphonates on human fibroblasts, umbilical vein endothelial cells (HUVEC), and osteoblasts.

Results

Alendronate and intravenous bisphosphonates suppressed cell viability and migration, and induced apoptosis in all tested cell types. Alendronate had a greater impact than ibandronate on the characteristics in fibroblasts and osteoblasts but not as strong as zoledronate.

Conclusions

The incidence of BP-ONJ in oral bisphosphonate treatment is reported to be much lower than that in intravenous bisphosphonates. However, the influences of alendronate on human cells were at least as strong as ibandronate, although it was lower than zoledronate.

Clinical relevance

Alendronate showed strong enough effects to suppress human somatic cells and was comparable to certain intravenous bisphosphonates in potency. This study suggests that the lower incidence of BP-ONJ in alendronate treatment is not originated by its potency, but might be due to the low bioavailability of alendronate, lower dosing on a daily basis, and having no additional therapies.

https://ift.tt/2DQuKAp

Stability of maxillary protraction therapy in children with Class III malocclusion: a systematic review and meta-analysis

Abstract

Objective

The objective of this study was to evaluate the stability of treatment effects of maxillary protraction therapy in Class III children.

Materials and methods

Multiple electronic databases were searched from 01/1996 to 10/2016. Randomized clinical trials, controlled clinical trials, and cohort studies with untreated Class III controls and a follow-up over 2 years were considered for inclusion. The methodological quality of the studies and publication bias were evaluated. Mean differences and 95% confidence intervals (CI) of six variables (SNA, SNB, ANB, mandibular plane angle, overjet, and lower incisor angle) were calculated.

Results

Ten studies were included in the qualitative analysis, and four studies were included in the quantitative analysis. Compared with the control group, after treatment, the treated group showed significant changes: SNA +1.79° (95% CI: 1.23, 2.34), SNB −1.16° (95% CI −2.08, −0.24), ANB +2.92° (95% CI 2.40, 3.44), mandibular plane angle +1.41° (95% CI 0.63, 2.20), overjet +3.94 mm (95% CI 2.17, 5.71) and lower incisor angle −3.07° (95% CI −4.92, −1.22). During follow-up, the changes in five variables reflected significant relapse. Overall, the treated group showed significant changes only in ANB +1.66° (95% CI 0.97, 2.35) and overjet +2.41 mm (95% CI 1.60, 3.23).

Conclusions

Maxillary protraction can be a short-term effective therapy and might improve sagittal skeletal and dental relationships in the medium term. But some skeletal and dental variables showed significant relapse during the follow-up period. Long-term studies are still required to further evaluate its skeletal benefits.

Clinical relevance

The study evaluated the medium-term stability of skeletal and dental effects of maxillary protraction in Class III children and discussed whether the therapy can reduce the need for orthognathic surgery.

https://ift.tt/2C7VxCl

The influence of management of tooth wear on oral health-related quality of life

Abstract

Objective

The purpose of this study was to identify the level of oral health-related quality of life and orofacial appearance in patients with moderate to severe tooth wear. Patients with and without a request for restorative treatment were included.

Methods

One hundred twenty-four patients (98 men, 26 women, mean age: 40.5 ± 8.8 years) with moderate to severe tooth wear were included. Patients without a request for help received a non-restorative treatment of counseling and monitoring. Patients with a request for restorative treatment were treated with a full rehabilitation using composite resin restorations. Oral Health Impact Profile (OHIP-NL) and Orofacial Esthetic Scale (OES-NL) questionnaires were filled in at baseline and after 1 year.

Results

Counseling and monitoring group: baseline OHIP-NL score was 0.4 ± 0.3, baseline summary score of OES-NL was 48 ± 7.0, and baseline impression score was 7.1 ± 1.2. Scores had not changed significantly after 1 year (p = 1.00 after Bonferroni correction).Restoration group: baseline OHIP-NL score was 0.8 ± 0.6, baseline summary score of OES-NL was 38 ± 10, and baseline impression score was 5.9 ± 1.5. Scores had improved significantly after 1 year (p < 0.001 after Bonferroni correction).

Conclusions

Counseling and monitoring did not result in a significant deterioration and restorative treatment resulted in a significant improvement of oral health-related quality of life (OHRQoL) and orofacial appearance in this patient group.

Clinical significance

In patients with moderate to severe tooth wear, without functional and esthetical problems, counseling and monitoring may be an appropriate treatment option. Restorative treatment in patients with a need for treatment results in an improved OHRQoL. OHIP and OES questionnaires may be used to monitor changes in clinically relevant symptoms.

https://ift.tt/2BQCDQy

Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study

Abstract

Objectives

The objective of this study was to investigate the relationship of the incidence of aspiration pneumonia to cognitive impairment and the oral condition.

Materials and methods

A total of 1174 elderly patients were analyzed in a cross-sectional study. Cognitive function was evaluated by the Clinical Dementia Rating scale and the oral condition was evaluated by inspection and palpation. Swallowing was examined in 196 patients by video-endoscopic evaluation. The Mann-Whitney U test or chi-square test was used for statistical analysis. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI).

Results

Loss of posterior occlusion, impaired tongue movements, and impaired cognition were factors significantly related to aspiration pneumonia. The incidence of aspiration pneumonia was higher in patients with both cognitive impairment and loss of posterior occlusion compared with those having either factor alone (OR: 5.16). There was no statistical association between impaired swallowing and the incidence of aspiration pneumonia in elderly patients with normal cognitive function (cognitive impairment, OR: 3.45; normal function, OR: 0.94).

Conclusion

Co-existence of cognitive impairment and oral frailty significantly enhances the risk of aspiration pneumonia.

Clinical relevance

Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.

https://ift.tt/2GAf6GO

Evaluation of the genotoxic effects of formocresol application in vital pulp therapy of primary teeth: a clinical study and meta-analysis

Abstract

Objectives

This in vivo research investigated whether pulp treatments using formocresol for 7 days would cause mutagenic changes in children's lymphocytes.

Materials and methods

The mutagenicity was tested in lymphocyte cultures established from the peripheral blood of children living in Brazil. The samples consisted of 2000 cells from teeth undergoing formocresol pulpotomies in which the formocresol pellet was sealed in the primary tooth for 7 days. It was removed on the seventh day, the base was placed, and the tooth was restored. Two venous blood samples (6–8 ml) were collected from each child; the first was prior to pulp therapy, and the second was 7 days later. Two thousand metaphases were analyzed. The level of significance adopted for the statistics was P < 0.05, and a random effects meta-analysis was performed combining this and two previous studies.

Results

There was no significant difference found in the metaphase analysis between the blood samples taken before and after the pulpotomy treatment (Wilcoxon signed rank test); however, the meta-analysis showed a significant difference between the combined studies.

Conclusions

This study did not reveal any mutagenic effects, but based on the combined meta-analysis, we recommend the careful use of formocresol.

Clinical relevance

This research helps to bring scientific evidence of the safe use of formocresol in deciduous pulpotomy treatments.

https://ift.tt/2E4wNRr

Expression and localization of CRAMP in rat tooth germ and during reparative dentin formation

Abstract

Objectives

Cathelicidin-related antimicrobial peptide (CRAMP) is an antimicrobial peptide in mice and rats homologous to LL-37 in humans. In addition to its antibacterial activity, CRAMP has various physiological functions by binding to formyl peptide receptor 2 (FPR2). However, the role of these peptides in teeth is unknown. Therefore, we investigated the role of CRAMP and FPR2 in tooth development, reparative dentin formation, and defense response.

Material and methods

First, we examined the localization of CRAMP and FPR2 during tooth development by immunohistochemical analysis. Next, we investigated the localization of CRAMP, FPR2, and CD68-positive macrophages by immunohistochemical analysis during pulp inflammation and reparative dentin formation after cavity preparation. Finally, we analyzed the effect of lipopolysaccharide (LPS) on the expression of CRAMP and FPR2 in dental pulp cells by real-time reverse transcription PCR.

Results

At the late bell stage in tooth development, CRAMP was detected in odontoblasts, and FPR2 was observed in the sub-odontoblastic layer. In mature teeth, CRAMP was not detected, but FPR2 continued to be localized in the sub-odontoblastic layer. After cavity preparation, CRAMP-positive cells and macrophages were found in dental pulp tissues below the cavity at an early stage of repair. At subsequent stages of reparative dentin formation, CRAMP was observed in odontoblast-like cells that contacted reparative dentin. FPR2 immunoreactivity was also detected in odontoblast-like cells and neighboring cells. LPS stimulated the expression of CRAMP mRNA in dental pulp cells in vitro.

Conclusions

Localization of CRAMP and its receptor FPR2-positive cells were observed during physiological and reparative dentin formation.

Clinical relevance

CRAMP/LL-37 has a possibility that induce reparative dentin formation.

https://ift.tt/2BOuo7D

Health and quality of life differ between community living older people with and without remaining teeth who recently received formal home care: a cross sectional study

Abstract

Objective

To assess oral health, health, and quality of life (QoL) of care-dependent community-living older people with and without remaining teeth who recently received formal home care.

Materials and methods

For this cross-sectional observational study, community-living older people (≥ 65 years), who recently (< 6 months) received formal home care, were interviewed with validated questionnaires and underwent an oral examination. Oral health, general health, medicines usage, frailty (Groningen Frailty Indicator), cognition (Minimal Mental State Examination), QoL (RAND 36), and oral health-related QoL (Oral Health Impact Profile-14) were assessed.

Results

One hundred three out of 275 consecutive eligible older people (median age 79 [IQR (Inter Quartile Range) 72–85 years] participated in the study. Thirty-nine patients had remaining teeth and 64 were edentulous. Compared with edentulous older people, older people with remaining teeth scored significantly better on frailty, QoL, physical functioning, and general health. No significant differences were seen in cognition. Dental and periodontal problems were seen in more than half of the patients with remaining teeth. Two third of the edentulous patients did not visit their dentist regularly or at all.

Conclusions

Care-dependent home-dwelling older people with remaining teeth generally were less frail, scored better on physical functioning and general health and had better QoL than edentulous older people. Dental and periodontal problems were seen in approximately 50% of the elderly.

Clinical relevance

Notwithstanding their common dental problems, frailty, health, and QoL are better in home-dwelling older people with remaining teeth. To maintain this status, we advise not only dentists, but also health care workers and governments, to encourage people to maintain good oral health.

https://ift.tt/2EJ2W0o

Evaluation of occlusal caries detection and assessment by visual inspection, digital bitewing radiography and near-infrared light transillumination

Abstract

Aim

This study compared the diagnostic outcomes of visual inspection (VI), digital bitewing radiography (BWR), and near-infrared light transillumination (NIR-LT, DIAGNOcam, KaVo, Biberach, Germany) for occlusal caries detection and assessment of posterior teeth.

Participants and methods

This study included 203 patients (mean age 23.0 years). All individuals received a meticulous VI. Additionally, BWR and NIR-LT images were collected. All BWR and NIR-LT images were blindly evaluated for the presence of enamel caries lesions (ECLs) and dentin caries lesions (DCLs). The descriptive statistical analyses included calculation of frequencies, cross tabulations, and pairwise comparisons using Pearson chi-square tests.

Results

The majority of ECLs/DCLs were detected by VI in this low-risk adult population. The additional diagnostic outcomes in terms of ECLs/DCLs amounted to 5.0% (BWR) and 6.8% (NIR-LT). The combined usage of VI/NIR-LT or VI/BWR identified 95.7 and 94.4% of all ECLs/DCLs on occlusal surfaces, respectively.

Conclusion

This comparative diagnostic study showed that VI detected the majority of occlusal caries lesions. Both additional methods showed limited benefits. Due to the valuable features of NIR-LT, i.e., X-ray freeness and clinical practicability, this method might be preferred over X-ray-based methods. Nevertheless, BWRs should be prescribed in clinical situations where insufficient fillings or multiple (deep) caries lesions are diagnosed or where there is a need to assess the caries extension in relation to the pulp.

Clinical relevance

VI has to be understood as caries detection method of choice on occlusal surfaces in low-risk adult population which may help to avoid multiple diagnostic testing, overdiagnosis, and overtreatment.

https://ift.tt/2AWYr1v

Evaluation of an ex vivo porcine model to investigate the effect of low abrasive airpolishing

Abstract

Objectives

Evaluation of an ex vivo porcine model to investigate the influence of periodontal instrumentation on soft tissue.

Material and methods

In each of 120 pig mandibles, one molar tooth was chosen at random and instrumented. For subgingival debridement, two different low abrasive airpolishing powders (glycine d₉₀ = 25 μm, erythritol d₉₀ = 14 μm, n = 30 teeth each), curets, and a piezoelectric ultrasonic scaler were used (n = 30 teeth each). Thirty teeth in 30 other mandibles served as the untreated control. Gingival biopsies were histologically assessed for destruction using a four-graded scale.

Results

The porcine model was deemed suitable for the planned investigation. Hand instrumentation and ultrasonic scaling caused higher tissue damage than both low abrasive airpolishing modes (Fisher's exact test, p = 0.0025). Glycine powder led to less, yet non-statistical noticeable gingival changes compared to erythritol-based powder (Fisher's exact test, p = 0.39).

Conclusion

An animal model using pig jaws may be used as a preliminary model to analyze histological effects of periodontal instrumentation in advance of studies performed in human tissues. Among the techniques assessed, low abrasive airpolishing (LAA) caused the smallest tissue damage.

Clinical relevance

To avoid gingival damage using LAA, histological observations of gingival tissue are needed. Since numerous powders for LAA have been developed and it may be expected that additional products will follow, it appears to be useful to establish ex vivo animal models to prove the powders safety.

https://ift.tt/2vvjGCs