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Hydrogels endure various dynamic stresses, demanding robust mechanical properties. Despite significant advancements, matching hydrogels' strength to biological tissues and plastics is often challenging without applying potentially harmful crosslinkers. Using hydrogen bonds as sacrificial bonds offers a promising strategy to produce tough, versatile hydrogels for biomedical and industrial applications. Poly(methacrylic acid) (PMA)/gelatin hydrogels were synthesized by thermally induced free-radical polymerization and crosslinked only by physical bonds, without adding any chemical crosslinker. The addition of gelatin increased the formation of hydrophobic domains in the structure of the hydrogels, which acted as permanent crosslinking points. The increase in PMA and gelatin contents generally led to a lower equilibrium water content (WC), higher thermal stability and better mechanical properties. The values of tensile strength and toughness reached up to 1.44 ± 0.17 MPa and 4.91 ± 0.51 MJ m-3, respectively, while the compressive modulus and strength reached up to 0.75 ± 0.06 MPa and 24.81 ± 5.85 MPa, respectively, with the WC being higher than 50 wt.%. The obtained values for compressive mechanical properties are comparable with super-strong hydrogels reported in the literature. In addition, hydrogels exhibited excellent fatigue resistance and biocompatibility, as well as great shape memory properties, which make them prominent candidates for a wide range of biomedical applications.
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Background: Oral squamous cell carcinoma (OSCC) has numerous physical, psychosocial and financial implications, which significantly affect patients' quality of life. We aimed to determine the health-related quality of life (HRQoL) and identify quality of life (QoL) predictors in patients with OSCC. Methods: We included 64 consecutive patients aged 40 to 80 yr treated for OSCC from Jan to Dec 2021. Health-related QoL was evaluated using the 30-item Cancer Quality of Life Questionnaire (QLQ-C30) and the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-H&N35). The demographic questionnaire and clinical parameters were also presented. Results: The functioning scale in the QLQ-C30 questionnaire with the lowest average score was Global health status. The mean QLQ-C30 summary score (80.92 ± 10.4) was higher than the Global health status score (50.5 ± 22.2). In the QLQ-H&N35 questionnaire, the symptoms with highest scores were weight loss, dry mouth, and social eating. Linear regression analysis demonstrated that Global health status score was associated with education level [ß-coefficient = 19.33 (95% CI: 10.7-24.9, P=0.004], alcohol consumption [ß-coefficient=10.04 (95% CI: 4.5-14.8), P=0.023] and invasive surgical procedure [ß-coefficient=22.75 (95% CI: 15.0-30.5), P=0.002]. The QLQ-C30 summary score was associated with living alone [ß-coefficient= -20.05 (95% CI: -29.91-(-10.21), P=0.018], smoking status [ß-coefficient=4.35 (95% CI: 1.8-6.91), P=0.043] and alcohol consumption [ß-coefficient =4.59 (95% CI: 1.99-7.19), P=0.037]. Conclusion: We found several significant predictors of worse perception of HRQoL among patients with OSCC, which may be useful for specific prevention and treatment in order to achieve better QoL.
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(1) Treatment failure of oral squamous cell carcinoma (OSCC) is generally due to the development of therapeutic resistance caused by the existence of cancer stem cells (CSCs), a small cell subpopulation with marked self-renewal and differentiation capacity. Micro RNAs, notably miRNA-21, appear to play an important role in OSCC carcinogenesis. Our objectives were to explore the multipotency of oral CSCs by estimating their differentiation capacity and assessing the effects of differentiation on stemness, apoptosis, and several miRNAs' expression. (2) A commercially available OSCC cell line (SCC25) and five primary OSCC cultures generated from tumor tissues obtained from five OSCC patients were used in the experiments. Cells harboring CD44, a CSC marker, were magnetically separated from the heterogeneous tumor cell populations. The CD44+ cells were then subjected to osteogenic and adipogenic induction, and the specific staining was used for differentiation confirmation. The kinetics of the differentiation process was evaluated by qPCR analysis of osteogenic (Bone Morphogenetic Protein-BMP4, Runt-related Transcription Factor 2-RUNX2, Alkaline Phosphatase-ALP) and adipogenic (Fibroblast Activation Protein Alpha-FAP, LIPIN, Peroxisome Proliferator-activated Receptor Gamma-PPARG) markers on days 0, 7, 14, and 21. Embryonic markers (Octamer-binding Transcription Factor 4-OCT4, Sex Determining Region Y Box 2-SOX2, and NANOG) and micro RNAs (miRNA-21, miRNA-133, and miRNA-491) were also correspondingly evaluated by qPCR. An Annexin V assay was used to assess the potential cytotoxic effects of the differentiation process. (3) Following differentiation, the levels of markers for the osteo/adipo lineages showed a gradual increase from day 0 to day 21 in the CD44+ cultures, while stemness markers and cell viability decreased. The oncogenic miRNA-21 also followed the same pattern of gradual decrease along the differentiation process, while tumor suppressor miRNA-133 and miRNA-491 levels increased. (4) Following induction, the CSCs acquired the characteristics of the differentiated cells. This was accompanied by loss of stemness properties, a decrease of the oncogenic and concomitant, and an increase of tumor suppressor micro RNAs.
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Adipogénesis , Carcinoma de Células Escamosas , MicroARNs , Neoplasias de la Boca , Células Madre Neoplásicas , Osteogénesis , Humanos , Carcinoma de Células Escamosas/patología , MicroARNs/metabolismo , Neoplasias de la Boca/patología , Células Madre Neoplásicas/citología , Células Madre Neoplásicas/metabolismoRESUMEN
High elution and diffusion of 2-hydroxylethyl methacrylate (HEMA) and camphorquinone (CQ) through dentinal tubules may induce pulp injury and postoperative sensitivity. We aimed to investigate the melatonin protective effect in HEMA- and CQ-treated human dental pulp cells (hDPCs) as well as its relevance in a mechanism for postoperative sensitivity in diabetic patients. hDPCs were exposed to HEMA (5 mM) and/or CQ (1 mM) in the absence and presence of melatonin (MEL) (0.1 mM and 1 mM). Heme oxygenase-1 (HMOX1), NADPH oxidase-4 (NOX4), BCL-2-associated X-protein (BAX), B-cell lymphoma-2 (BCL-2) and caspase-3 (CASP3) gene expression levels, and superoxide dismutase (SOD) activity were measured in hDPCs while inducible nitric oxide synthase (iNOS) and melatonin protein expression were measured in human dental pulp as well, by RT-PCR, by ELISA, and spectrophotometrically. Bioinformatic analyses were performed by using the ShinyGO (v.0.75) application. Type 2 diabetic patients showed a higher incidence of postoperative sensitivity and lower melatonin and higher iNOS content in dental pulp tissue compared with non-diabetic patients. Melatonin, when co-added in hDPC culture, reverses HEMA and CQ cytotoxic effects via anti-apoptotic and anti-inflammatory/antioxidant iNOS-related effects. Enrichment analyses showed that genes/proteins, altered by HEMA and CQ and normalized by melatonin, are the most prominently overrepresented in type 2 diabetes mellitus pathways and that they share subcellular localization in different oligomeric protein complexes consisting of anti- and pro-apoptotic regulators. This is the first evidence of the ability of melatonin to counteract iNOS-mediated inflammatory and stress effects in HEMA- and CQ-treated hDPCs, which could be of significance for the modulation of presently observed immediate postoperative sensitivity after composite restoration in type 2 diabetic patients.
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Diabetes Mellitus Tipo 2 , Melatonina , Humanos , Melatonina/farmacología , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Metacrilatos/farmacología , Óxido Nítrico Sintasa de Tipo II/genética , Óxido Nítrico Sintasa de Tipo II/metabolismo , Pulpa Dental/metabolismo , Antioxidantes , Proteínas Proto-Oncogénicas c-bcl-2/metabolismoRESUMEN
Students are particularly vulnerable from the mental health aspect, which was especially recognized during the COVID-19 pandemic. This study aimed to reveal the impact of COVID-19 on quality of life (QoL) and mental health among dental students. The study was conducted on a sample of 797 students (207 male and 592 female) with an average age of 21.7 ± 2.4, from the School of Dental Medicine, University of Belgrade. The measurements used in the study were the Demographic and Academic Questionnaire, Questionnaire about exposure to COVID-19, COVID-19-Impact on QoL Questionnaire (COV19-QoL), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire (PHQ-9). The mean total score for COV19-QoL was 2.9 ± 0.9, while the diagnostic criteria of GAD-7 and depression met 19.9% and 31.4% of students, respectively. There was a positive and strong correlation between QoL, anxiety, and depression. During COVID-19, predictors for lower perceptions of QoL were female gender and death of close relatives (p = 0.049, p = 0.005, respectively). At the same time, predictors for GAD were female gender, living in dormitories, and death of close relatives (p = 0.019, p = 0.011, p = 0.028, respectively), while for depression they were year of study, living with parents, and death of close relatives due to COVID-19 (p = 0.012, p = 0.008, p = 0.029, respectively). The study showed that students' QoL and mental health during the pandemic were at high risk.
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COVID-19 , Masculino , Femenino , Humanos , Adulto Joven , Adulto , COVID-19/epidemiología , Pandemias , Calidad de Vida , Salud Mental , Estudios Transversales , Depresión/epidemiología , Estudiantes de Odontología , Ansiedad/epidemiologíaRESUMEN
BACKGROUND: Dental stem cells, which originate from the neural crest, due to their easy accessibility might be good candidates in neuro-regenerative procedures, along with graphene-based nanomaterials shown to promote neurogenesis in vitro. We aimed to explore the potential of liquid-phase exfoliated graphene (LPEG) film to stimulate the neuro-differentiation of stem cells from apical papilla (SCAP). METHODS: The experimental procedure was structured as follows: (1) fabrication of graphene film; (2) isolation, cultivation and SCAP stemness characterization by flowcytometry, multilineage differentiation (osteo, chondro and adipo) and quantitative PCR (qPCR); (3) SCAP neuro-induction by cultivation on polyethylene terephthalate (PET) coated with graphene film; (4) evaluation of neural differentiation by means of several microscopy techniques (light, confocal, atomic force and scanning electron microscopy), followed by neural marker gene expression analysis using qPCR. RESULTS: SCAP demonstrated exceptional stemness, as judged by mesenchymal markers' expression (CD73, CD90 and CD105), and by multilineage differentiation capacity (osteo, chondro and adipo-differentiation). Neuro-induction of SCAP grown on PET coated with graphene film resulted in neuron-like cellular phenotype observed under different microscopes. This was corroborated by the high gene expression of all examined key neuronal markers (Ngn2, NF-M, Nestin, MAP2, MASH1). CONCLUSIONS: The ability of SCAPs to differentiate toward neural lineages was markedly enhanced by graphene film.
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The scope of the present study was to prepare fully bio-based unsaturated polyester resins (UPRs) with comparable properties to the commercial formulations. The focus was set on the determination of the optimal prepolymer formulation using the same set of diacids (itaconic and succinic acid) and different diols (propylene glycol, isosorbide and neopentyl glycol) or its equimolar mixtures, keeping the fixed molar ratio of 1:1:2.1 in all feed compositions. Instead of commonly used styrene, bio-based dimethyl itaconate was used as a reactive diluent (RD). The rheology of the obtained resins was studied in detail. The effect of the used diol on structural (FTIR), thermal (DSC), thermomechanical (DMA), and mechanical (tensile) properties was explained. The properties of UPRs were found to be highly dependent on the diol used in the prepolymer formulation. The UPR with an equimolar ratio of propylene glycol and neopentyl glycol was shown to be the most promising candidate to compete with the commercial petroleum-based resins.
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Researchers are faced with everyday demands for safer and more efficient therapy for many diseases, especially serious one such as various types of cancer. Numerous anticancer drugs are poorly-water soluble and therefore their encapsulation and controlled release remain quite challenge. In present study, we deepened our research of hydrophilic carrier based on poly(methacrylic acid) and casein (PMAC) by investigating its potential for encapsulation and controlled release of novel poorly water-soluble dihydropyrimidion-azo-pyridon compound (DHPMP). DHPMP is a dye that has been proven to show cytotoxic activity against chronic myeloid leukemia K562 cells. By encapsulating DHPMP into the carrier and delivering it into the intestines, DHPMP absorption could be the fastest and the number of therapeutic doses and side effects can be reduced. Carriers based on PMAC and DHPMP (PMAC-DHPMP) were synthetized and characterized by FTIR, SEM and single compression tests. The swelling behavior of PMAC-DHPMP carriers and cumulative DHPMP release were investigated depending on the amount of crosslinker and encapsulated DHPMP in two media which were simulating pH environments in human stomach and intestines. The prolonged and controlled release of DHPMP was achieved. In vitro cytotoxic activity of PMAC-DHPMP carriers against K562 cells and the cell cycle analysis showed great potential of the carriers for application in leukemia treatment.
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Antineoplásicos , Leucemia , Antineoplásicos/química , Preparaciones de Acción Retardada/química , Preparaciones de Acción Retardada/farmacología , Portadores de Fármacos , Liberación de Fármacos , Humanos , Hidrogeles/química , Hidrogeles/farmacología , Concentración de Iones de Hidrógeno , Agua/químicaRESUMEN
Introduction: The J Project (JP) physician education and clinical research collaboration program was started in 2004 and includes by now 32 countries mostly in Eastern and Central Europe (ECE). Until the end of 2021, 344 inborn errors of immunity (IEI)-focused meetings were organized by the JP to raise awareness and facilitate the diagnosis and treatment of patients with IEI. Results: In this study, meeting profiles and major diagnostic and treatment parameters were studied. JP center leaders reported patients' data from 30 countries representing a total population of 506 567 565. Two countries reported patients from JP centers (Konya, Turkey and Cairo University, Egypt). Diagnostic criteria were based on the 2020 update of classification by the IUIS Expert Committee on IEI. The number of JP meetings increased from 6 per year in 2004 and 2005 to 44 and 63 in 2020 and 2021, respectively. The cumulative number of meetings per country varied from 1 to 59 in various countries reflecting partly but not entirely the population of the respective countries. Altogether, 24,879 patients were reported giving an average prevalence of 4.9. Most of the patients had predominantly antibody deficiency (46,32%) followed by patients with combined immunodeficiencies (14.3%). The percentages of patients with bone marrow failure and phenocopies of IEI were less than 1 each. The number of patients was remarkably higher that those reported to the ESID Registry in 13 countries. Immunoglobulin (IgG) substitution was provided to 7,572 patients (5,693 intravenously) and 1,480 patients received hematopoietic stem cell therapy (HSCT). Searching for basic diagnostic parameters revealed the availability of immunochemistry and flow cytometry in 27 and 28 countries, respectively, and targeted gene sequencing and new generation sequencing was available in 21 and 18 countries. The number of IEI centers and experts in the field were 260 and 690, respectively. We found high correlation between the number of IEI centers and patients treated with intravenous IgG (IVIG) (correlation coefficient, cc, 0,916) and with those who were treated with HSCT (cc, 0,905). Similar correlation was found when the number of experts was compared with those treated with HSCT. However, the number of patients treated with subcutaneous Ig (SCIG) only slightly correlated with the number of experts (cc, 0,489) and no correlation was found between the number of centers and patients on SCIG (cc, 0,174). Conclusions: 1) this is the first study describing major diagnostic and treatment parameters of IEI care in countries of the JP; 2) the data suggest that the JP had tremendous impact on the development of IEI care in ECE; 3) our data help to define major future targets of JP activity in various countries; 4) we suggest that the number of IEI centers and IEI experts closely correlate to the most important treatment parameters; 5) we propose that specialist education among medical professionals plays pivotal role in increasing levels of diagnostics and adequate care of this vulnerable and still highly neglected patient population; 6) this study also provides the basis for further analysis of more specific aspects of IEI care including genetic diagnostics, disease specific prevalence, newborn screening and professional collaboration in JP countries.
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Inmunoglobulina G , Recién Nacido , Humanos , Administración Intravenosa , Escolaridad , Egipto , Europa (Continente)RESUMEN
Nowadays, unsaturated polyester resins (UPR) are mainly obtained from non-renewable resources. The ever-increasing regulations and the continuous demand for more sustainability have led to extensive research towards more environmentally suitable alternatives to petroleum-based materials. However, one of the main disadvantages of bio-based UPR is their relatively high viscosity compared to petrochemical ones. In order to overcome this drawback, in this work, we investigated the possibility to lower the resin viscosity utilizing a mixture of dimethyl itaconate (DMI) and methyl methacrylate (MMA) as a reactive diluent. The effect of the DMI and MMA ratio on resin rheological properties was investigated. The optimal curing parameters were determined and all UPRs had a high gel content, which was shown to be dependent on the DMI and MMA ratio in the formulation. Furthermore, thermomechanical and mechanical properties of the resulting network were also found to be affected by the used reactive diluent mixture. A small substitution of DMI by MMA proved to be advantageous since it offers lower resin viscosity and improved mechanical properties.
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Attitudes towards open peer review, open data and use of preprints influence scientists' engagement with those practices. Yet there is a lack of validated questionnaires that measure these attitudes. The goal of our study was to construct and validate such a questionnaire and use it to assess attitudes of Croatian scientists. We first developed a 21-item questionnaire called Attitudes towards Open data sharing, preprinting, and peer-review (ATOPP), which had a reliable four-factor structure, and measured attitudes towards open data, preprint servers, open peer-review and open peer-review in small scientific communities. We then used the ATOPP to explore attitudes of Croatian scientists (n = 541) towards these topics, and to assess the association of their attitudes with their open science practices and demographic information. Overall, Croatian scientists' attitudes towards these topics were generally neutral, with a median (Md) score of 3.3 out of max 5 on the scale score. We also found no gender (P = 0.995) or field differences (P = 0.523) in their attitudes. However, attitudes of scientist who previously engaged in open peer-review or preprinting were higher than of scientists that did not (Md 3.5 vs. 3.3, P<0.001, and Md 3.6 vs 3.3, P<0.001, respectively). Further research is needed to determine optimal ways of increasing scientists' attitudes and their open science practices.
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Revisión de la Investigación por Pares/tendencias , Preimpresos como Asunto/tendencias , Comunicación Académica/tendencias , Adulto , Anciano , Actitud , Croacia , Estudios Transversales , Docentes , Femenino , Humanos , Difusión de la Información/métodos , Personal de Laboratorio , Masculino , Persona de Mediana Edad , Revisión de la Investigación por Pares/métodos , Médicos , Psicometría/métodos , Encuestas y CuestionariosRESUMEN
BACKGROUND: When the treatment effect on the outcome of interest is influenced by a baseline/demographic factor, investigators say that an interaction is present. In randomized clinical trials (RCTs), this type of analysis is typically referred to as subgroup analysis. Although interaction (or subgroup) analyses are usually stated as a secondary study objective, it is not uncommon that these results lead to changes in treatment protocols or even modify public health policies. Nonetheless, recent reviews have indicated that their proper assessment, interpretation and reporting remain challenging. RESULTS: Therefore, this article provides an overview of these challenges, to help investigators find the best strategy for application of interaction analyses on binary outcomes in RCTs. Specifically, we discuss the key points of formal interaction testing, including the estimation of both additive and multiplicative interaction effects. We also provide recommendations that, if adhered to, could increase the clarity and the completeness of reports of RCTs. CONCLUSION: Altogether, this article provides a brief non-statistical guide for clinical investigators on how to perform, interpret and report interaction (subgroup) analyses in RCTs.
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Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Interpretación Estadística de Datos , Humanos , Modelos EstadísticosRESUMEN
PURPOSE: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used during pregnancy. Findings that prenatal NSAID exposure may affect offspring neurodevelopment have been inconsistent. We investigated the effect of prenatal NSAID exposure on childhood neurodevelopment and explored the susceptibility of our effect estimates to forms of bias via negative exposure, negative outcome, and multi-informant analyses. METHODS: In a cohort of pregnant women (n = 6876), perinatal NSAID use was assessed by prescriptions and self-report. Primary neurodevelopmental outcomes included attention problems using maternal reports at 1½, 3, and 5 years. To explore potential systematic biases, we compared estimates from maternally reported attention problems to a teacher's report and a measure of nonverbal intelligence assessed at a clinic visit at age 6 years; we also used NSAID use before pregnancy and somatic problems as a "negative" exposure and outcome, respectively. RESULTS: Maternal reports suggested that prenatal exposure to NSAIDs was associated with more attention problems at younger ages (eg, at age 3: mean difference in attention problems score: 0.30; 95% CI 0.12, 0.48). However, no strong association with attention problems was found in the teacher report, and a similarly strong association between prenatal NSAID exposure and somatic complaints suggests residual confounding by indication likely remains. Moreover, prenatal exposure to NSAIDs was not associated with an observed measure of IQ (mean difference in IQ score: -0.32; 95% CI: -1.82, 1.19). CONCLUSIONS: Jointly, our results suggest that the observed associations between prenatal exposure to NSAIDs and child attention problems reflect systematic biases of a null or small effect.
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Antiinflamatorios no Esteroideos/efectos adversos , Desarrollo Infantil/efectos de los fármacos , Trastornos del Neurodesarrollo/epidemiología , Complicaciones del Embarazo/tratamiento farmacológico , Efectos Tardíos de la Exposición Prenatal/epidemiología , Adulto , Síntomas Afectivos/inducido químicamente , Síntomas Afectivos/epidemiología , Factores de Edad , Antiinflamatorios no Esteroideos/administración & dosificación , Atención/efectos de los fármacos , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Inteligencia/efectos de los fármacos , Pruebas de Inteligencia/estadística & datos numéricos , Masculino , Países Bajos/epidemiología , Trastornos del Neurodesarrollo/inducido químicamente , Trastornos del Neurodesarrollo/diagnóstico , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: The etiology of infective endocarditis (IE) is changing. More aggressive forms with multiple IE cardiac lesions have become more frequent. This study sought to explore the relationship between contemporary causative microorganisms and IE cardiac lesions and to analyze the impact of multiple lesions on treatment choice. METHODS: In 246 patients hospitalized for IE between 2008 and 2015, cardiac lesions caused by IE were analyzed by echocardiography, classified according to the 2015 European Society of Cardiology guidelines and correlated with microbiological data. We defined a new parameter, the Echo IE Sum, to summarize all IE cardiac lesions in a single patient, enabling comprehensive comparisons between different etiologies and treatment strategies. RESULTS: Staphylococcus aureus was associated with the development of large vegetation (OR 2.442; 95% CI 1.220-4.889; p=0.012), non-HACEK bacteria with large vegetation (OR 13.662; 95% CI 2.801-66.639; p=0.001), perivalvular abscess or perivalvular pseudoaneurysm (OR 5.283; 95% CI 1.069-26.096; p=0.041), and coagulase-negative staphylococci (CoNS) with leaflet abscess or aneurysm (OR 3.451; 95% CI 1.285-9.266, p=0.014), and perivalvular abscess or perivalvular pseudoaneurysm (OR 4.290; 95% CI 1.583-11.627; p=0.004). The Echo IE Sum significantly differed between different etiologies (p<0.001), with the highest value in non-HACEK and the lowest in streptococcal endocarditis. Patients operated for IE had a significantly higher Echo IE Sum vs those who were medically treated (p<0.001). CONCLUSION: None of the IE cardiac lesions is microorganism-specific. However, more severe lesions were caused by S. aureus, CoNS, and non-HACEK bacteria. The highest propensity to develop multiple lesions was shown by the non-HACEK group. Higher Echo IE Sum in patients sent to surgery emphasized the importance of multiple IE cardiac lesions on treatment choice and potential usage of Echo IE Sum in patient management.
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Absceso/microbiología , Aneurisma Falso/microbiología , Endocarditis/microbiología , Aneurisma Cardíaco/microbiología , Pericardio/microbiología , Adulto , Anciano , Estudios de Cohortes , Ecocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones Estafilocócicas/microbiología , Staphylococcus aureusRESUMEN
The fruit fly immune system is a valuable model for invertebrate and innate immunity. Cellular immune reactions in Drosophila are of great interest, especially the molecular genetic mechanisms of hemocyte differentiation and the encapsulation of foreign bodies. Here we report that changes in the lamin gene cause melanotic masses. These darkened clusters of cells result from autoimmune-like encapsulation of self-tissue, as shown by the presence in lam larvae of lamellocytes, effector hemocytes that appear in larvae following wounding or parasitization. Lamins thus affect immunity in Drosophila, and lam mutations can serve as genetic tools to dissect cellular immune signaling and effector pathways.
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Autoinmunidad/genética , Diferenciación Celular/genética , Proteínas de Drosophila/genética , Reacción a Cuerpo Extraño/genética , Hemocitos/inmunología , Laminas/genética , Mutación/inmunología , Animales , Diferenciación Celular/inmunología , Proteínas de Drosophila/inmunología , Drosophila melanogaster , Reacción a Cuerpo Extraño/inmunología , Laminas/inmunologíaRESUMEN
Aim of our study was to determine the treatment habits of hypertension by general practitioners (GPs) as well as the monthly costs of prescribed antihypertensive drugs and their share in the total prescription drug expenditure approved by the Croatian Institute for Health Insurance (CIHI), the compulsory health insurance system. The study was performed in six GPs offices in Zagreb, serving 8,866 patients, in December 2005. The monthly costs of antihypertensive drugs prescribed by the GPs was obtained by summarizing the prices of all antihypertensive drugs prescribed in one month and then comparing the sum with total monthly prescription drug expenditure approved by the CIHI. The type and dosage of prescribed antihypertensive drugs were also analyzed. Hypertension was diagnosed in 2,342 (26.4%) patients. The monthly costs of prescribed antihypertensive drugs accounted for 52.33% of the total amount approved for medications by the CIHI. 945 (40.0%) hypertensive patients were taking antihypertensive monotherapy. The most frequently prescribed drugs as monotherapy were ACE inhibitors (38.3%), calcium-channel blockers (26.7%), beta blockers (18.6%), and diuretics (10.3%). a antagonists (3.6%). Angiotensin receptor blockers (2.5%) were rarely prescribed. As combination therapy, ACE inhibitors and diuretics (30.4%) were most frequently used. More than 50% of the funds allocated to GPs for medications were spent for the treatment of only one disease. The most used antihypertensive drugs were ACE inhibitors.
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Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Adolescente , Adulto , Anciano , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Médicos de Familia , Estudios Retrospectivos , Población UrbanaRESUMEN
BACKGROUND: The purpose of this study was to evaluate the efficacy of corticosteroid injection and determine the duration of symptom-free period after treatment with a single ultrasound-guided injection for a painful Morton's neuroma. MATERIALS AND METHODS: From May 2002 to November 2003, 35 consecutive patients (7 males, 28 females) (mean age, 54; age range, 29 to 77 years) underwent a single ultrasound guided corticosteroid injection. Thirty-nine injections were performed as 4 patients had bilateral Morton's neuromas. The injection of 1.0 cc Celestone Chronodose (5.7 mg/ml) with 0.5 cc of 1% lidocaine was performed into the symptomatic intermetatarsal web-space. The efficacy of the injection was determined by the Johnson grading scale, and modified lower extremity functional scale. RESULTS: On the Johnson scale, 15 of 39 (38%) neuromas showed complete satisfaction 9 months after treatment and 11 of 39 (28%) were satisfied with minor reservations. A total of 26 of 39 (66%) neuromas had a positive outcome 9 months after the injection. On the functional daily activity (FDA) scale, 20 of 39 (51%) neuromas showed no difficulty and 4 of 39 (10%) indicated minor difficulties, which was considered a positive outcome 9 months after injection. Complete pain relief was achieved in 11 of 39 (28%) neuromas 9 months after treatment. Twelve of 39 (31%) neuromas did not respond to conservative treatment and required surgery. The results of treatment suggested improvement in efficacy if injection was used early. The size of the lesion measured on ultrasound showed no correlation with pain relief after injection. CONCLUSION: A single corticosteroid injection can offer short-term pain relief in the conservative management of Morton's neuroma.
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Betametasona/análogos & derivados , Antepié Humano/inervación , Glucocorticoides/administración & dosificación , Neuroma/tratamiento farmacológico , Neoplasias del Sistema Nervioso Periférico/tratamiento farmacológico , Adulto , Anciano , Betametasona/administración & dosificación , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Neuroma/complicaciones , Neuroma/diagnóstico por imagen , Dolor/etiología , Dolor/prevención & control , Neoplasias del Sistema Nervioso Periférico/complicaciones , Neoplasias del Sistema Nervioso Periférico/diagnóstico por imagen , Resultado del Tratamiento , UltrasonografíaRESUMEN
Controversy exists as to whether the deletion/deletion (DD) genotype of angiotensin l-converting enzyme (ACE) gene polymorphism is associated with coronary heart disease (CHD). There are only a few studies dealing with this issue in the elderly, also with controversial results. The aim of this study was the assessment of correlation between genetic markers and the risk of CHD in the elderly. The results indicated DD genotype importance for CHD in the elderly as proven by discriminant analysis (chi2 = 25.77; df = 16; p = 0.0620). However, the use of univariate method demonstrated no correlation between DD genotype of ACE gene polymorphism and coronary artery disease. D allele of ACE gene was associated with higher activities of ACE plasma. A weak, but increased risk of MI is associated with high frequency of DD genotype in the elderly. Strong correlation between ACE polymorphism and ACE plasma activities was demonstrated.
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Enfermedad Coronaria/genética , Eliminación de Gen , Peptidil-Dipeptidasa A/genética , Polimorfismo Genético , Anciano , Femenino , Genotipo , Humanos , MasculinoRESUMEN
INTRODUCTION: The "Twinfield Perimeter" can be used for white-on-white and blue-on-yellow perimetry. Since the normative database which is used fort the calculation of the visual field indices for both strategies is based on data from white-on-white perimetric evaluations of normal persons using the "Tübinger Automatikperimeter", the validity of this approach may be questioned. In the study presented here we compared the correlation of white-on-white (W/W) and blue-on-yellow (B/Y) visual fields in glaucoma patients with a hemifield scotoma. PATIENTS AND METHODS: One eye each from 40 normal persons and from 40 glaucoma patients was included in the study. Both W/W-perimetry and B/Y-perimetry was performed using the "Twinfield Perimeter" (Oculus, Modell 56 900, Wetzlar, Germany). From the sensitivity values determined with the 30/2 strategy, we calculated the mean sensitivity (MS), mean deviation (MD) of the total field and of both hemifields (HMS bzw. HMD) separately. Normal values derived from the normal persons of the present study were compared with the normal values used by the Twinfield Perimeter. To determine the strength of the association of B/Y- and W/W-hemifield scotoma, we calculated the linear correlation coefficient (Pearson's R) between the HMD of B/Y und W/W-hemifields. RESULTS: MS of both glaucoma patients and normal persons were determined to be significantly higher for B/Y visual fields (14.17 +/- 4.15 and 20.97 +/- 3.56) when compared with W/W-visual fields (10.70 +/- 3.19 or 15.98 +/- 3.3). When normal values from the Twinfield Perimeter were applied, the MD for normal persons was calculated to be - 4.69 +/- 3.22 compared with 0 +/- 3.6 when the MD was calculated with the normal values from the study. For both normal values we confirm a strong correlation between HMD-values of W/W- and B/Y-visual fields. CONCLUSIONS: Since the mean sensitivity of B/Y visual fields is higher than the mean sensitivity of W/W visual fields, calculations of the MD of B/Y visual fields of glaucoma patients should be based on normative databases which are derived from B/Y visual fields of normal persons.