Otosyphilis: Two case reports and review of the English and Spanish literature of the last 24 years.

Syphilis has significantly increased its incidence in Europe and North America in the past 20 years. Although rare, sudden hearing loss might be a complication of syphilis infection. We present two cases of otosyphilis seen in our hospitals and review of the English and Spanish literature already published since 2000.

Rheumatoid meningitis: a case series report and review of modern therapeutic schemes and outcome.

INTRODUCTION: Rheumatoid meningitis (RM) is an extremely rare extra-articular complication of rheumatoid arthritis (RA), with approximately 165 cases reported world-wide. RM exhibits a broad range of symptoms, with stroke-like episodes and seizures being the most common manifestations. The primary differential diagnoses include vascular and infectious diseases. The influence of immunomodulatory medications on the pathophysiology of RM remains unclear. There are no consensus guidelines on therapeutic regimen. METHODS: We present four patients with prior history of RA that developed different neurological syndromes in correlation to radiological leptomeningitis. Clinical presentations, comorbid conditions, supplementary diagnostic assessments, treatments, and prognosis are provided. A literature review of recent immunosuppressive management in RM patients was performed. RESULTS: Three patients presented to hospital with recurrent focal seizures. Only two suffered meningism, reporting headache and fever. Magnetic resonance imaging (MRI) showed different grades of leptomeningitis across all cases. Notably, three cases demonstrated bilateral involvement extending to the pachymeninges. Two patients exhibited pronounced CSF mononuclear inflammation while extended microbiological evaluations yielded negative results. Two patients required biopsy for confirmation. The initiation of immunosuppressive therapy marked a turning point for three patients who previously exhibited progressive deterioration. Mortality was absent in all cases. CONCLUSIONS: Our experience remarks the elusive nature of RM. Rigorous exclusionary diagnostics are imperative to differentiate RM from mimicking conditions. Clinical manifestations oscillate between transient episodes and progressive neurological impairments, punctuated by frequent epileptic seizures. In scenarios where clinical worsening persists or where clinical and radiological evaluations are inconclusive, aggressive immunosuppressive therapy is recommended.

Microencapsulated essential oils influence the growth and foregut histomorphometry of Nile tilapia (Oreochromis niloticus) fingerlings.

Essential oils supplementation has potential growth-promoting, antibacterial, and immunostimulatory effects for various fish species. Dietary supplementation with essential oils improves Nile tilapia's growth and intestinal morphology. The aim of the study was to assess the effect of supplementation with microencapsulated essential oils (MEOs) containing cinnamaldehyde (53.9 %), thymol (24.2 %), and carvacrol (18.7 %) in Nile tilapia fingerlings on growth parameters and foregut histomorphometry. Six thousand fishes with initial body weights and lengths of 1.20 ± 0.32 g and 2.03 ± 0.40 cm, respectively, were reared in two separate 60 m3 circular tanks (control and supplemented with 500 mg/kg of MEOs) at a 5 kg/m3 density. Growth parameters included weight and length. Ten foregut samples per tank were collected at 0-, 15- and 30-days post-treatment. The histological analysis involved the size of intestinal folds and the number of goblet cells. Our results showed that fingerling growth parameters such as final body weight and length increased by 16.9 % and 10.43 %, respectively, with MEOs supplementation compared to the control group. Furthermore, histomorphometry results showed that the supplementation of MEOs led to a significant increase in the growth of both the width and length of intestinal folds and the number of goblet cells (p < 0.05). In conclusion, the early supplementation with MEOs improved the number, length, and width of intestinal folds and increased the number of goblet cells, positively influencing intestinal morphology and health. Additionally, MEOs improved growth parameters in Nile tilapia at 30 days of supplementation.

Applying a systems oriented ethical decision making framework to mitigating social and structural determinants of health.

Objectives: Clinical ethical decision-making models are largely geared toward individual clinician choices and individual patient outcomes, not necessarily accounting for larger systemic issues that affect optimal patient outcomes. The purpose of this paper is to provide an ethical decision-making model, drawing upon systems orientation and ethical theory, specifically incorporating and aiding in the mitigation of social and structural determinants of health. Methods: This paper presents a systems-oriented ethical decision-making framework derived from the analysis and critique of the Four-Box Method for Ethical Decision-Making by Jonsen, Siegler, and Winslade. Drawing upon both deontological and utilitarian ethical theory, the developed framework will assist providers, organizations, and health system leaders in navigating the increasingly complex ethical dimensions of care delivery for underserved patient populations, who are largely impacted by social and structural determinants of health. Results: The needs of underserved patients are inextricably linked to various social and structural determinants of health that, if left unaddressed, result in even poorer health outcomes, exacerbating existing health disparities. A systems-oriented ethical decision-making framework, centered on obligation, duty, and a utilitarian view of the optimal good, will aid providers, organizations, health system leaders, and community stakeholders in navigating the increasingly complex ethical dimensions of care delivery for underserved patient populations. Conclusion: Socioeconomic and political contexts have a significant impact on the way society is organized, how people are positioned in society, and how they will fare in terms of their health. Healthcare providers, including dentists, are largely unaware of and insensitive to the social issues that underlie the biological or psychological concerns that patients from socially disadvantaged backgrounds face. A systems-oriented ethical decision-making model will aid in mitigating social and structural determinants of health and the dental profession's obligations to the underserved.

Men of color in the health professions: Proceedings from the 2022 ADEA Men of Color in the Health Professions Summit.

The purpose of the American Dental Education Association (ADEA) Men of Color in the Health Professions Summit, held in August 2022 at ADEA's headquarters in Washington, DC, was to gather key thought leaders across a myriad of health professions and healthcare organizations and schools to cultivate intentional cross-disciplinary efforts in championing the need to address the low number of men of color entering not only dental, but also medicine, pharmacy, and health-related research careers. A pivotal follow-up step from the inaugural ADEA President's Symposium on Men of Color in the Health Professions at the March 2022 ADEA Annual Session & Exhibition in Philadelphia, the summit brought together academic health professions leaders, government agencies, health professions associations, and other key stakeholders to develop an action plan to support men of color entering the health professions. Moving the needle forward and increasing opportunities for underrepresented men of color in the health professions requires all academic health professions to work together. Highlights of the Summit included a keynote presentation by David Satcher, MD, PhD, the 16th Surgeon General of the United States; workgroup consensus statement development; health career pathways program presentations; strategic forecasting regarding challenges and opportunities in developing a coalition of health professions organizations to support men of color in the health professions; and frameworks for exploring coalition building.

Can Probiotics, Particularly Limosilactobacillus fermentum UCO-979C and Lacticaseibacillus rhamnosus UCO-25A, Be Preventive Alternatives against SARS-CoV-2?

COVID-19, an infection produced by the SARS-CoV-2 virus in humans, has rapidly spread to become a high-mortality pandemic. SARS-CoV-2 is a single-stranded RNA virus characterized by infecting epithelial cells of the intestine and lungs, binding to the ACE2 receptor present on epithelial cells. COVID-19 treatment is based on antivirals and antibiotics against symptomatology in addition to a successful preventive strategy based on vaccination. At this point, several variants of the virus have emerged, altering the effectiveness of treatments and thereby attracting attention to several alternative therapies, including immunobiotics, to cope with the problem. This review, based on articles, patents, and an in silico analysis, aims to address our present knowledge of the COVID-19 disease, its symptomatology, and the possible beneficial effects for patients if probiotics with the characteristics of immunobiotics are used to confront this disease. Moreover, two probiotic strains, L. fermentum UCO-979C and L. rhamnosus UCO-25A, with different effects demonstrated at our laboratory, are emphasized. The point of view of this review highlights the possible benefits of probiotics, particularly those associated with immunomodulation as well as the production of secondary metabolites, and their potential targets during SARS-CoV-2 infection.

Centring anti-oppressive justice: Re-envisioning dentistry's social contract.

OBJECTIVES: We re-envision dentistry's social contract and elaborate on the idea that it is not neutral and free from such things as racism and white supremacy and can act as a tool of oppression. METHODS: We critique social contract theory through examination of classical and contemporary contract theorists. More specifically, our analysis draws from the work of Charles W. Mills, a philosopher of race and liberalism, as well as the theoretical and praxis framework of intersectionality. RESULTS: Social contract theory supports hierarchies and inequities that may be used to sustain unfair and unjust differences in oral health between social groups. When dentistry's social contract becomes a tool of oppression, its practice does not promote health equity but reinforces damaging social norms. CONCLUSION: Dentistry must embrace an anti-oppression framing of equity and elevate the principle of justice to one of liberation and not just fairness. In doing so, the profession can better understand itself, act more equitably and empower practitioners to advocate for justice in health and healthcare in its fullest sense. Anti-oppressive justice supports health not as merely an obligation but as a human duty.

In vitro cytotoxic capacity against tumor cell lines and antioxidant activity of acidic polysaccharides isolated from the Andean Patagonian fungus Phylloporia boldo.

Fungal polysaccharides possess a broad biological activity, including cytotoxic and antioxidant activities. This work aimed to evaluate the cytotoxic and antioxidant activity of the acidic polysaccharides of Phylloporia boldo strain (named PBAP40). Cytotoxic activity of polysaccharide was evaluated determining the viability of three tumor cell lines by MTT assay. The effect of acidic polysaccharide on the cell cycle of HL-60 cell line was evaluated by flow cytometry, and the antioxidant activity was determined by DPPH and ABTS assays. PBAP40 showed cytotoxic effects in tumor cell lines. Results suggest that P. boldo acidic polysaccharides arrested tumor cells in the cell cycle Sub G1 phase. The acidic polysaccharides of PBAP40 strain were not cytotoxic for the non-tumor cell line. PBAP40 also showed excellent antioxidant activity. The FT-IR analysis of the acidic polysaccharides indicated the presence of glucans bearing α- and ß- type glycosidic bonds.

Professionalism and professional identity formation in dental students: Revisiting the professional role orientation inventory (PROI).

OBJECTIVE: Professionalism is a hallmark of health professions education. Professional identity formation is a growing field of exploration in medical education, and the dental literature is sparse on just how professional identity formation is developed and assessed within dental education. METHODS: The validated professional role orientation inventory (PROI) was administered to 2nd year dental students during a spring semester ethics course. The PROI includes four 10-item scales representing four attitudinal factors: Authority, Responsibility, Agency, and Autonomy. RESULTS: When compared to a historical sample of dental students in the early 1990s, dental students today scored significantly higher on Responsibility (p = 0.0309) and lower on the Agency factor (p = 0.0001). Authority scores in the current sample of dental students were significantly associated with age and race, with an increase in age associated with a decrease in Authority (p = 0.0504) and Caucasian respondents demonstrating significantly higher scores than Asian or Other races. Debt was associated with differences in Autonomy (p = 0.0683) and Agency (p = 0.0106), with those in the 100k-300k anticipated debt range demonstrating lower levels of both Autonomy and Agency. Race was marginally associated with Responsibility with those in the Other race category (Hispanic, Black/African American, Other/Multiracial) demonstrating higher levels than Caucasian (p = 0.0513). CONCLUSION: Dental students' scores denote a continued commitment to others yet a feeling of less sense of control as a practicing professional. A redefining of professionalism to include social activism and advancing health equity is required given their altruism and commitment to others, which remains high.