Plasma CXCL10 correlates with HAND in HIV-infected women.

HIV-associated neurocognitive disorder (HAND) is characterized by chronic immune activation. We aimed to identify biomarkers associated with HAND and to investigate their association with cognitive function and sex, in a homogenous cohort of HIV-infected (HIV+) young adults, parenterally infected during early childhood. One hundred forty-four HIV+ Romanian participants (51% women) without major confounders underwent standardized neurocognitive and medical evaluation in a cross-sectional study. IFN-γ, IL-1ß, IL-6, CCL2, CXCL8, CXCL10, and TNF-α were measured in plasma in all participants and in cerebrospinal fluid (CSF) in a subgroup of 56 study participants. Biomarkers were compared with neurocognitive outcomes, and the influence of sex and HIV disease biomarkers was assessed. In this cohort of young adults (median age of 24 years), the rate of neurocognitive impairment (NCI) was 36.1%. Median current CD4+ count was 479 cells/mm3 and 36.8% had detectable plasma viral load. Women had better HIV-associated overall status. In plasma, controlling for sex, higher levels of IL-6 and TNF-α were associated with NCI (p < 0.05). Plasma CXCL10 showed a significant interaction with sex (p = 0.02); higher values were associated with NCI in women only (p = 0.02). Individuals with undetectable viral load had significantly lower plasma CXCL10 (p < 0.001) and CCL2 (p = 0.02) levels, and CSF CXCL10 (p = 0.01), IL-6 (p = 0.04), and TNF-α (p = 0.04) levels. NCI in young men and women living with HIV was associated with higher IL-6 and TNF-α in plasma, but not in the CSF. CXCL10 was identified as a biomarker of NCI specifically in women with chronic HIV infection.

Plasma levels of glucose and insulin in patients with brain tumors.

In the last years there were many authors that suggest the existence of an association between different components of metabolic syndrome and various cancers. Two important components of metabolic syndrome are hyperglycemia and hyperinsulinemia. Both of them had already been linked with the increased risk of pancreatic, breast, endometrial or prostate cancer. However the correlation of the level of the glucose and insulin with various types and grades of brain tumors remains unclear. In this article we have analysed the values of plasma glucose and insulin in 267 patients, consecutively diagnosed with various types of brain tumors. Our results showed no correlation between the glycemia and brain tumor types or grades. High plasma levels of insulin were found in brain metastasis and astrocytomas while the other types of brain tumors (meningiomas and glioblastomas) had lower levels of the peptide. The levels of insulin were also higher in brain metastasis and grade 3 brain tumors when compared with grade 1, grade 2 and grade 4 brain tumors.

Computational models can predict response to HIV therapy without a genotype and may reduce treatment failure in different resource-limited settings.

OBJECTIVES: Genotypic HIV drug-resistance testing is typically 60%-65% predictive of response to combination antiretroviral therapy (ART) and is valuable for guiding treatment changes. Genotyping is unavailable in many resource-limited settings (RLSs). We aimed to develop models that can predict response to ART without a genotype and evaluated their potential as a treatment support tool in RLSs. METHODS: Random forest models were trained to predict the probability of response to ART (≤400 copies HIV RNA/mL) using the following data from 14 891 treatment change episodes (TCEs) after virological failure, from well-resourced countries: viral load and CD4 count prior to treatment change, treatment history, drugs in the new regimen, time to follow-up and follow-up viral load. Models were assessed by cross-validation during development, with an independent set of 800 cases from well-resourced countries, plus 231 cases from Southern Africa, 206 from India and 375 from Romania. The area under the receiver operating characteristic curve (AUC) was the main outcome measure. RESULTS: The models achieved an AUC of 0.74-0.81 during cross-validation and 0.76-0.77 with the 800 test TCEs. They achieved AUCs of 0.58-0.65 (Southern Africa), 0.63 (India) and 0.70 (Romania). Models were more accurate for data from the well-resourced countries than for cases from Southern Africa and India (P < 0.001), but not Romania. The models identified alternative, available drug regimens predicted to result in virological response for 94% of virological failures in Southern Africa, 99% of those in India and 93% of those in Romania. CONCLUSIONS: We developed computational models that predict virological response to ART without a genotype with comparable accuracy to genotyping with rule-based interpretation. These models have the potential to help optimize antiretroviral therapy for patients in RLSs where genotyping is not generally available.

[Models of automated mandibular kinematics in the Kennedy Class I partial edentate]. / Modele ale cinematicii mandibulare automatizate la edentatul partial clasa I Kennedy.

The biunivocal relationships which exist between the elements and the functions of the dento-maxillary apparatus are also found in the determination and the effects of automated mandibulary movements in patients with class I edentation. Kinesiographic mandibulary analysis correlated with clinical observations certain characteristics can be identified of which the most evident, resulting from the edentation, and at the same time the most important from the viewpoint of dysfunctional implications is the almost permanent presence of horizontal, mainly sagittal movements of the teeth and of the temporo-mandibulary articulation. Propulsion of the mandibula in this way is at the origin of many irritative foci: in the frontal teeth that have to transmit and to take up the forces which have unfavourable directions; the muscles, especially the external pterygoidal muscles that are overstressed; the temporo-mandibulary articulation where the unfunctional relationship between the mandibular condyl, the articular disk, and the articular eminence will acquire an almost permanent character. The consolidation of the propulsed (mesial) position of the mandibula by prosthetic treatment in this position cannot have but negative effects for the elements of the dento-maxillary apparatus.

[Pathologic abrasion]. / Abraziunea patologicá.

By "pathologic abrasion" is defined the excessive loss of the hard dental substance, which may lead to a total removal of the anatomic crown. This is one of most severe affections of ADM but also one of the best tolerated for a certain length of time. Four aspects of abrasion are frequently noted:--helicoidal abrasion--ad palatum abrasion;--horizontal abrasion;--keylock type abrasion. Excessive abrasion is due to bruxisme in most of the cases, and also to diet, but to a lesser extent. In most of the patients DVO is not modified because, as abrasion persists the continuous process of dental eruption, as well as of the alveolar processes develops. This is the reason for which it has been concluded that DVO should not be removed by prosthetic therapy in patients with extreme abrasion. The most simple solutions should be selected, avoiding complicated therapies because "the ideal treatment" is not always successful for a long time.

[Correlation between occluding trauma and dental erosion]. / Corelatia dintre traumatismul ocluzal si eroziunile dentare.

The study presents data obtained by examination of a lot of patients with erosions of the teeth. At the same time histologic sections were prepared from teeth with cuneiform lesions that had to be removed as a result of parodonthopathic processes. Histological studies that have been carried out have demonstrated hyperemia of the dental pulp, and blood suffusion, sometimes accompanied by oedema. Slight rarefaction of dentine was also noted in other microscopic fields, with characteristic enlargement of the interdentinal spaces. The fact that the histological picture does not provide too much data on the etiopathogenic mechanism of the cuneiform lesions it may be considered that the occluding trauma is one of the major causes of these coronal lesions. Occluding balancing as performed by the authors in these patients have always demonstrated the presence of erosions in teeth that had suffered from occluding trauma. By this attitude and with these means of therapy one can prevent the development of new lesions of the cuneiform type, and thus contribute to the decrease in the morbidity, and to the prevention of the various disturbances in the dentomaxillary apparatus.