Possible Association Between the Mallampati Score of the Oropharynx and Measures of Tongue Coating, Oral Hygiene and Periodontal Status.

PURPOSE: To assess oral hygiene and the gingival and periodontal disease status in subjects scored under the modified Mallampati classification (MMC) of the oropharynx. PATIENTS AND METHODS: The clinical parameters included recording MMC scores, simplified oral hygiene index (OHI-S), modified gingival index (MGI), tongue coating index (TCI) and periodontal status of the subjects. Eight additional parameters, which included percentage of sites with bleeding on probing (BOP), sites with probing depth (PD) ≥ 5 mm, tooth loss, attachment loss (AL):age ratio, diabetic status, smoking, the interplay of dental status and systemic factors (DS-SFI), and background characteristics (socioeconomic status and stress) were also assessed. RESULTS: Class IV MMC group showed the highest mean scores for OHI-S, periodontal status, AL:age ratio, diabetic status, background characteristics, PD ≥ 5 mm and DS-SFI when compared to other groups. In measures of OHI-S, periodontal status, PD > 5 mm, AL:age ratio and background characteristics, Class IV MMC group showed significant intergroup differences over MMC class I. Regression analysis revealed a highly significant but low degree of correlation (R2 = 0.079; p ≤ 0.001) between the predictors and the dependent values. CONCLUSION: The results suggest that increasing MMC scores can be a possible determinant in identifying gingival and periodontal disease. Any dental professional dealing with a multifactorial disease such as periodontitis can use this classification as a basic screening tool in identifying the modifiable factors of periodontitis.

Potential utility of amantadine DR/ER in persons with Parkinson's disease meeting 5-2-1 criteria for device aided therapy.

BACKGROUND: The 5-2-1 criteria (≥5 levodopa doses/day, ≥2 h OFF/day, and ≥ 1-hour dyskinesia/day) propose to identify people with Parkinson's disease (PD) who are poorly controlled on oral therapies and who may therefore benefit from device-aided therapies. Amantadine-DR/ER is the only medication FDA-approved for both dyskinesia and OFF episodes in levodopa-treated patients. In this post-hoc analysis of phase 3 clinical trials, we evaluated the efficacy and safety of amantadine-DR/ER in patients meeting 5-2-1 criteria. METHODS: Week-12 treatment differences (Amantadine-DR/ER - placebo) in the Unified Dyskinesia Rating Scale (UDysRS) and PD motor states (patient diaries) were evaluated in pooled, phase-3, double-blind trial participants meeting 5-2-1 criteria at baseline. This 5-2-1 cohort was followed into a 2-year open-label trial, where Movement Disorder Society - Unified Parkinson's Disease Rate Scale (MDS-UPDRS) Part IV scores were assessed relative to double-blind baseline. RESULTS: Of 198 enrolled participants in the phase 3 trials, 65 (33%; n = 29 placebo; n = 36 amantadine-DR/ER) comprised the 5-2-1 cohort. At Week-12 endpoint, amantadine-DR/ER significantly improved UDysRS scores (treatment difference of 9.57 ± 3.15 points, p = 0.004) and ON time without troublesome dyskinesia ('good ON', treatment difference of 2.9 ± 0.90 h/day, p = 0.002). Improvements in good ON time resulted from significant reductions in both troublesome dyskinesia and OFF time. Treatment benefit on MDS-UPDRS-Part IV was sustained through open-label, follow-up. The most common adverse events in patients who met 5-2-1 criteria and were treated with amantadine-DR/ER included falls and peripheral edema. CONCLUSIONS: Findings suggest Amantadine-DR/ER should be considered as an option for people with PD who meet 5-2-1 criteria.

Investigation of somatic single nucleotide variations in human endogenous retrovirus elements and their potential association with cancer.

Human endogenous retroviruses (HERVs) have been investigated for potential links with human cancer. However, the distribution of somatic nucleotide variations in HERV elements has not been explored in detail. This study aims to identify HERV elements with an over-representation of somatic mutations (hot spots) in cancer patients. Four HERV elements with mutation hotspots were identified that overlap with exons of four human protein coding genes. These hotspots were identified based on the significant over-representation (p<8.62e-4) of non-synonymous single-nucleotide variations (nsSNVs). These genes are TNN (HERV-9/LTR12), OR4K15 (HERV-IP10F/LTR10F), ZNF99 (HERV-W/HERV17/LTR17), and KIR2DL1 (MST/MaLR). In an effort to identify mutations that effect survival, all nsSNVs were further evaluated and it was found that kidney cancer patients with mutation C2270G in ZNF99 have a significantly lower survival rate (hazard ratio = 2.6) compared to those without it. Among HERV elements in the human non-protein coding regions, we found 788 HERVs with significantly elevated numbers of somatic single-nucleotide variations (SNVs) (p<1.60e-5). From this category the top three HERV elements with significantly over-represented SNVs are HERV-H/LTR7, HERV-9/LTR12 and HERV-L/MLT2. Majority of the SNVs in these 788 HERV elements are located in three DNA functional groups: long non-coding RNAs (lncRNAs) (60%), introns (22.2%) and transcriptional factor binding sites (TFBS) (14.8%). This study provides a list of mutational hotspots in HERVs, which could potentially be used as biomarkers and therapeutic targets.