Latent TB and depressive symptoms in household contacts of persons with active TB.

BACKGROUND: Depression is common among persons with TB and is associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. We assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment.METHODS: We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, during 2016-2018. At enrollment, HHC LTBI status was assessed using the interferon-gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) with a cut-off of ≥5. We used logistic regression to estimate the odds ratio (OR) for PHQ-9 ≥5, comparing HHCs with and without baseline LTBI.RESULTS: Among 921 HHCs, 374 (41.0%) had LTBI at baseline, and 69 (12.4%) of 567 HHCs had PHQ-9 ≥5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 ≥5 at follow-up after controlling for potential confounders (adjusted OR 1.93, 95% CI 1.09-3.39); this association was driven by greater severities of depressive symptoms.CONCLUSION: HHCs with LTBI had increased odds of depressive symptoms 1 year later. This population may benefit from mental health screening and interventions integrated into TB programs.

Efficacy of rotary instruments with greater taper in preparing oval root canals.

AIM: To compare the preparation quality of two rotary systems and NiTi-hand files in oval root canals, and to evaluate the effect of canal dimensions on the preparation. METHODOLOGY: Ninety roots with oval root canals were selected. The middle third was cross sectioned at two levels and photographed. The maximum and minimum diameters of the root and canal were recorded. Teeth were distributed in three groups (n = 30) using stratified randomization, and prepared under simulated clinical conditions with Mtwo, ProTaper, or NiTi-hand files. The pre- and post-preparation photographs were traced and superimposed, the thickness of dentine removed was measured and the ratio of prepared canal outline was calculated. The impact of preparation system and canal dimensions on the quality of the preparation was evaluated using regression analysis. RESULTS: With regards to the ratio of prepared canal outline, no statistical significant difference was found between Mtwo (0.75 [95%CI: 0.69; 0.81]) and ProTaper (0.75 [95%CI: 0.69; 0.80]), but both systems performed significantly better than NiTi-hand files (0.65 [95%CI: 0.60; 0.71]). In six root canals in Mtwo-group (20%), and eight root canals in ProTaper-group (27%), the minimal thickness of dentine-wall after preparation was less than 0.5 mm. In contrast to the maximum diameter of the root canal, the minimum diameter influenced the quality of the preparation (P = 0.0006). CONCLUSIONS: No instrumentation technique was able to circumferentially prepare the oval outline of root canals. Nevertheless, instruments with greater taper (ProTaper and Mtwo) were more efficient than NiTi- hand files, but this was, in some cases, at the expense of remaining dentine-wall thickness.

Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study.

AIM: To assess ex vivo the accuracy of various electronic apex locators in locating the apical terminus of root-end resected teeth. METHODOLOGY: Ninety extracted human posterior teeth (182 root canals) were prepared to a minimum size of 40 and filled with gutta-percha and sealer. After resection of the apical 3 mm of the root, the root canal filling was removed using HERO rotary instruments. The size of the root canal at the apical terminus after removal of the filling ranged from size 50 to 90. The root canal length to the apical terminus was determined using 3 apex locators (Root ZX, Raypex4 and Apex Pointer). A new mounting model that utilized a micrometer was used to perform the measurements and to visually determine the actual position of the apical terminus. The frequency of locating the apical terminus and the corresponding 95% confidence interval (CI) were calculated. Additionally, the coefficient of repeatability of each apex locator and the limits of inter-operator agreement were determined. RESULTS: All apex locators showed an acceptable repeatability (0.02-0.03 mm coefficient of repeatability) and narrow limits of inter-operator agreement (+0.07 and -0.07 mm). The accuracy of determining the apical terminus within 1 mm in the root canal was as follows: Root ZX 90% (164/182 root-canals) [95%CI: 86-94%], Raypex4 74% (135/182 root-canals) [95%CI: 68-80%], and Apex Pointer 71% (129/182 root canals) [95%CI: 65-77%]. No over-instrumentation resulted when the Root ZX device was used. In contrast, using the Raypex4 or the Apex Pointer device resulted in over-instrumentation in 8 of 182 root canals (4%). CONCLUSIONS: Under the conditions of this study all three apex locators were able to detect the apical terminus of root-end resected teeth with an acceptable range. The Root ZX device was the most accurate without over-instrumentation of the root canals.

Structural basis for regulation in gram-negative bacterial citrate synthases.

The citrate synthases of Gram-negative bacteria, unlike those of eukaryotes, are inhibited allosterically by NADH, but the two kinds of citrate synthase are about 30% homologous in amino acid sequence--the two Gram-negative citrate synthase sequences so far determined, from Escherichia coli and Acinetobacter anitratum, are about 70% identical. A model for the NADH-sensitive E. coli citrate synthase has been constructed using sequence homology and the known structure of the pig heart enzyme. The most reactive cysteine in the E. coli enzyme, which probably marks the NADH binding site, has now been identified as Cys-206. The model places this residue far from the active site. An E. coli citrate synthase mutant, from which a stretch of 24 amino acids has been deleted near the active site, still binds NADH normally. Two active site missense mutants of this enzyme, generated by oligonucleotide-directed mutagenesis, have lower affinities for one substrate, oxaloacetate, but also are much less sensitive to 2-oxoglutarate, an oxaloacetate analogue hitherto believed to be an allosteric inhibitor. These results confirm that NADH binds to a truly allosteric site in E. coli citrate synthase, the features of which are still to be defined; while 2-oxoglutarate is really an active-site directed inhibitor, although it may still play a regulatory role in vivo.

Structural model for the trialkyltin binding site on cat hemoglobin.

The binding site for trialkyltin complexes on the alpha- chain of cat oxyhemoglobins is proposed to involve the SG and NE2 atoms of Cys-13 and His-113 respectively. On deoxygenation, the conformation of this region changes substantially, allowing complexation only through the ND1 nitrogen atom of His-113, a much less favorable interaction. Thus the model presented explains the preferential binding of trialkyltin complexes to R-state cat hemoglobin and suggests the type of interaction that is likely to occur between these compounds and a variety of less well-characterized enzymes to produce the metabolic effects that trialkyltin complexes are known to produce in vivo.