The histopathological and morphometric investigation of the effects of systemically administered humic acid on alveolar bone loss in ligature-induced periodontitis in rats.

BACKGROUND: Humic acid is a soil extract found widely around the world. This product includes some trace elements important for human's health. The purpose of this study was to evaluate the morphometric and histopathological changes associated with an experimental periodontitis model in rats in response to systemic administration of humic acid. MATERIAL AND METHODS: Thirty-eight male Wistar rats were divided into five experimental groups: non-ligated (NL, n = 6) group; ligature-only (LO, n = 8) group; ligature + systemic administration of humic acid (20, 80 and 150 mg/kg body weight per day for 15 d respectively) (S-20, S-80 and S-150) groups. 4/0 silk ligatures were placed at the gingival margin of lower first molars of the mandibular quadrant. The animals were killed at the end of 15 d. Changes in alveolar bone levels were clinically measured, using a stereomicroscope (× 25), as the distance from the cementoenamel junction to the alveolar bone crest. Tissues were histopathologically examined to assess the differences of osteoclast numbers, osteoblastic activity and inflammatory cell infiltration among the study groups. Enzyme-linked immunosorbent assay interleukin (IL)-1ß and IL-10 levels in serum and gingival homogenates were evaluated. RESULTS: At the end of 15 d, the alveolar bone loss was significantly higher in the LO group compared to the NL, S-80 and S-150 groups (p < 0.05). In addition, the alveolar bone loss in the S-80 group was significantly lower than the LO and S-20 groups (p < 0.05). The osteoblastic activity in the S-80 and S-150 groups was significantly higher than the other groups (p < 0.05). The osteoclast number in the LO group was significantly higher than the NL, S-80 and S-150 groups (p < 0.05). Inflammatory cell infiltration was significantly higher in LO and S-20 groups than the other groups (p < 0.05). The highest serum and gingival homogenate IL-10 levels were determined in the S-80 group (p < 0.05). The serum and gingival homogenate IL-1ß levels in the LO group were significantly higher than the other groups (p < 0.05). Both 80 and 150 mg/kg dosages of humic acid significantly reduced the periodontitis-related bone loss and inflammation, but the differences between these two groups were not statistically significant (p > 0.05). CONCLUSIONS: Within the limits of this study, it can be suggested that humic acid, when administered systemically as an 80 mg/kg dose, may prevent alveolar bone loss and reduce inflammation in the rat model.

The effects of hydrogen sulphide on alveolar bone loss in periodontitis.

AIM: Hydrogen sulphide (H2S), recently considered the third endogenous gaseous transmitter capable of modulating many physiological processes. The purpose of this study was to analyze the morphometric and histopathological changes associated with experimental periodontitis in rats in response to systemic administration of H2S METHODS: Forty-eight Wistar rats were divided into six experimental groups: non-ligated (NL) group; ligature only (LO) group; systemic administration of NaHS (H2S donor drug) alone (NaHS) group (14 µmol/kg body weight per day); and ligature placed and systemic administration of three different doses of NaHS groups (14, 28 and 70 µmol/kg/day) (L-NaHS-14, L-NaHS-28 and L-NaHS-70, respectively). Silk ligatures were placed at the gingival margin of lower first molars. Changes in alveolar bone levels were clinically measured and tissues were histopathologically examined. RESULTS: At the end of 15 days alveolar bone loss significantly higher in the entire ligature (LO and L-NaHS-14, -28 and -70) groups compared to the unligated groups (P<0.05) but there were no statistically significant differences in alveolar bone loss between LO and L-NaHS groups. Osteoclast number was significantly lower in L-NaHS-70 group than those of L-NaHS-14 and L-NaHS-28 groups (P<0.05). The osteoblastic activity of the L-NaHS-14 and -70 groups were significantly higher than those of the other groups (P<0.05). CONCLUSION: The findings of this study suggested that NaHS, when administered systemically with three different doses, did not prevent or increase alveolar bone loss in the rat model.

Transforming evidence-based clinical guidelines into implementable clinical decision support services: the CAREPATH study for multimorbidity management.

Introduction: The CAREPATH Project aims to develop a patient-centered integrated care platform tailored to older adults with multimorbidity, including mild cognitive impairment (MCI) or mild dementia. Our goal is to empower multidisciplinary care teams to craft personalized holistic care plans while adhering to evidence-based guidelines. This necessitates the creation of clear specifications for clinical decision support (CDS) services, consolidating guidance from multiple evidence-based clinical guidelines. Thus, a co-creation approach involving both clinical and technical experts is essential. Methods: This paper outlines a robust methodology for generating implementable specifications for CDS services to automate clinical guidelines. We have established a co-creation framework to facilitate collaborative exploration of clinical guidelines between clinical experts and software engineers. We have proposed an open, repeatable, and traceable method for translating evidence-based guideline narratives into implementable specifications of CDS services. Our approach, based on international standards such as CDS-Hooks and HL7 FHIR, enhances interoperability and potential adoption of CDS services across diverse healthcare systems. Results: This methodology has been followed to create implementable specifications for 65 CDS services, automating CAREPATH consensus guideline consolidating guidance from 25 selected evidence-based guidelines. A total of 296 CDS rules have been formally defined, with input parameters defined as clinical concepts bound to FHIR resources and international code systems. Outputs include 346 well-defined CDS Cards, offering clear guidance for care plan activities and goal suggestions. These specifications have led to the implementation of 65 CDS services integrated into the CAREPATH Adaptive Integrated Care Platform. Discussion: Our methodology offers a systematic, replicable process for generating CDS specifications, ensuring consistency and reliability across implementation. By fostering collaboration between clinical expertise and technical proficiency, we enhance the quality and relevance of generated specifications. Clear traceability enables stakeholders to track the development process and ensure adherence to guideline recommendations.

Implementation of HL7 FHIR-Based Interoperability Profiles to Manage Care Plans for Multimorbid Patients with Mild Dementia.

Management of multimorbidity in patients with mild dementia and mild cognitive impairment introduces additional challenges. The CAREPATH project provides an integrated care platform to assist both healthcare professionals and patients and their informal caregivers in the day-to-day management of care plans for this patient population. This paper introduces an HL7 FHIR-based interoperability approach for exchanging care plan action and goals with the patients and collecting feedback and adherence information from patients. In this way, seamless information exchange between healthcare professionals, patients and their informal care givers is achieved to support patients in their self-care management journey and increase their adherence to their care plans despite the burdens of mild dementia.

Interoperable E-Health System Using Structural and Semantic Interoperability Approaches in CAREPATH.

Technical and semantic interoperability are broadly used components of interoperability technology in healthcare. Technical Interoperability provides interoperability interfaces to enable data exchange within different healthcare systems, despite any underlying heterogeneity. Semantic interoperability make different healthcare systems understand and interpret the meaning of the data that is exchanged, by using and mapping standardized terminologies, coding systems, and data models to describe the concept and structure of data. We propose a solution using Semantic and Structural Mapping techniques within CAREPATH; a research project designed to develop ICT solutions for the care management of elderly multimorbid patients with mild cognitive impairment or mild dementia. Our technical interoperability solution supplies a standard-based data exchange protocol to enable information exchange between local care systems and CAREPATH components. Our semantic interoperability solution supplies programmable interfaces, in order to semantically mediate different clinical data representation formats and incorporating data format and terminology mapping features. The solution offers a more reliable, flexible and resource efficient method across EHRs.

SSR-based molecular analysis of economically important Turkish apricot cultivars.

Turkey is not only the main apricot (Prunus armeniaca) producer and exporter in the world, but it also has a wide variety of apricot germplasms, owing to its close proximity to the centers of apricot origin. However, there is little or no genetic information on many apricot cultivars that are extensively cultivated in Turkey. We examined the genetic relatedness of 25 Turkish and four exotic apricot cultivars using SSR (simple sequence repeat) markers that were either previously developed for apricot, or for peach (P. persica), a close relative of apricot. Allele diversity (with an average allele number of 6.37) at the SSR loci and the heterozygosity rates (with an average Ho value of 0.648) of these cultivars were found to be higher than in previous studies that used the same loci for apricot. This fact might be attributed to the analysis of different numbers of accessions in the different studies. No correlations were found between the genetic relatedness and the geographical distributions of these cultivars. The data reported here will assist in the prevention of confusions in the apricot propagation and breeding in Turkey. The findings can also be directly compared with other studies that used the same SSR markers on apricot.

Eastern Anatolian apples with a unique population structure are genetically different from Anatolian apples.

The origin of the apple is known to be the Transcaucasian region. Eastern Anatolia, which is located on the migration routes from Asia to Europe, has a rich and an uncharacterized apple germplasm and the characterization of apple genetic sources from this region is important for both evolutionary studies and apple breeding. In this study, 94 M. domestica accessions originated from seven diverse regions within Eastern Anatolia were studied using 16 SSR (simple sequence repeat) loci. SSR markers we used produced high allele numbers in all loci and CH02d11 (PI: 0.059) with 18 alleles was the most informative locus. In addition, 14 identical accession groups were identified. Most likely due to self-incompatibility, relatively high levels of heterozygosity (Ho: 0.696) was found for Eastern Anatolia apples. Structure Harvester analyses of East Anatolian apple accessions showed that although each group seems to be somewhat distinct, some levels of admixture with other populations might also exist. Due to a significant gene flow between all pairs of seven apple populations, a limited (low) differentiation was found between the populations. Comparisons using 16 common SSR loci revealed that Eastern Anatolia accessions were genetically different from Anatolian accessions. In addition, based on FCA, and Nei's genetic distance analyses, Eastern Anatolian apples were found to be genetically different from the commercial apple cultivars Golden Delicious and Florina. Our results suggesting that Eastern Anatolia apple populations have a unique structure will be useful for future genetic and evolutionary studies on apples.

Postoperative discomfort after Nd:YAG laser and conventional frenectomy: comparison of both genders.

BACKGROUND: Evidence has suggested that males and females experience and report feeling pain differently. The aim of this study was to determine the postoperative perception levels of both females and males after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser frenectomy and conventional frenectomy, and to compare the perceptions between genders. METHODS: Eighty-nine patients requiring frenectomy were randomly assigned to have treatment with either the conventional frenectomy or with the Nd:YAG laser. Postoperative discomfort (pain, chewing, talking) was recorded using a visual analog scale (VAS) on the operation day and postoperative days 1, 3, 7 and 10. RESULTS: According to the female VAS scores of the pain, chewing and speaking discomfort were statistically higher in the conventional group than those of the laser group on the operation day, and on the first and third postoperative days. Pain discomfort in males was statistically higher in the conventional group than those of the laser group on the operation day. Speaking discomfort in males was statistically higher in the conventional group than those of the laser group on the operation day and the first postoperative day. CONCLUSIONS: The present study indicated that Nd:YAG laser treatment used for frenectomies provides better postoperative comfort for each gender, especially in females in terms of pain, chewing and speaking than the conventional procedure up to the seventh postoperative day. According to our results, Nd:YAG laser may provide a safe, bloodless, painless surgery and an impressive alternative for frenectomy operations.

Myasthenia gravis: how to treat?

Myasthenia Gravis is an acquired autoimmune disorder caused by a neuromuscular transmission defect which is clinically characterized by fluctuating weakness of voluntary muscles and fatigability. It can be diagnosed by clinical features, clinical, pharmacological and electrophysiological tests and serological evaluation. Treatment modalities include symptomatic treatment in the form of cholinesterase inhibitors and plasmapheresis and immunotherapy in the form of immunosuppressant medications, immunomodulating therapy and thymectomy. No single regimen is appropriate for all patients and up to now no mode of therapy has been proven to be clearly superior. The response to any form of treatment is difficult to assess because the severity of symptoms fluctuate. We retrospectively analyzed the clinical records of 33 myasthenia gravis patients which were managed at our clinic between 1995-2003. All patients were treated with anticholinesterase medications sometime during their treatment. Most patients recieved immunosupressant and/or immunomodulator therapy. Patients were referred for thymectomy when indicated. We evaluated the outcome with different treatment modalities, focusing on the role of thymectomy. We also investigated the possible correlations between clinicopathological features and clinical outcome. We conclude that as for the medical treatment of myasthenia gravis azathioprine plus steroid improves the outcome; and for the surgical treatment, early thymectomy should be performed in all generalize myasthenia patients.

The biosynthesis of oxylipins of linoleic and arachidonic acids by the sewage fungus Leptomitus lacteus, including the identification of 8R-Hydroxy-9Z,12Z-octadecadienoic acid.

When the sewage fungus Leptomitus lacteus was grown in liquid culture aerobically and then transferred to medium containing long-chain fatty acids, it produced a number of oxygenated fatty acids. From linoleic acid (18:2n-6), the major metabolite produced was R-8-hydroxy-9Z,12Z-octadecadienoic acid (8R-HODE), with additional quantities of 8,11-di-HODE, 11,16-di-HODE, and 11,17-di-HODE. Other fatty acid derivatives identified included 7-HODE, 10-HODE, and 13-hydroxy-octadecamonoenoic acid. Arachidonic acid (20:4n-6) was metabolized primarily to 18- and 19-hydroxy-eicosatetraenoic acids (18- and 19-HETE) also as R enantiomers, along with smaller quantities of 17-HETE, 9-HETE, 14,15-dihydroxy-eicosatrienoic acid and 11,12,19-trihydroxy-eicosatrienoic acid. The oxygenated products of long-chain fatty acids, in particular the biosynthesis of 8R-HODE, a compound classified as a precocious sporulation inducer, were similar to those produced by an unrelated fungal species in the Ascomycota, the take-all fungus Gaeumannomyces graminis. As in G. graminis, the biotransformation of linoleate to 8R-HODE was not significantly inhibited by exposure of the organism to CO. This indicated that the enzyme responsible for 8R-HODE biosynthesis in Leptomitus could be similar to that of G. graminis; yet we did not detect 7,8-di-HODE as a product of 18:2n-6 metabolism as in G. graminis. CO did inhibit the biosynthesis of 14,15-di-HETE, 18-HETE, and 19-HETE in L. lacteus, which suggested the involvement of a cytochrome P450-type monooxygenase. The biosynthesis of 8R-HODE from 18:2n-6 was found to occur in certain cell lysates, specifically in low speed (15,000 x g) supernatant, following cell disruption.