Association of sex steroid hormones and new bone formation rate after iliac onlay grafting: a prospective clinical pilot study.

PURPOSE: The present prospective study evaluates the association between new bone formation rate in the iliac onlay graft and sex steroid hormone serum levels. METHODS: A total of 15 partially or completely edentulous postmenopausal females and 9 males with less than 5 mm height of the remaining alveolar bone underwent iliac onlay grafting followed by dental implant placement using a two-stage approach. Sex hormone binding globulin and 17ß-estradiol serum levels were investigated by electrochemiluminescence immunoassay, while total testosterone level was analyzed using radioimmunoassay. At the time of implant placement, 12 weeks after grafting, bone biopsies were obtained and analyzed histomorphometrically. Statistical analysis was performed using linear mixed models. RESULTS: Grafting procedure was successfully performed in all patients. The mean new bone formation rate was 32.5% (116 samples). In men the mean new bone formation rate (38.1%) was significantly higher (p < 0.01) than in women (27.6%). Independent of gender 17ß-estradiol and testosterone were positively associated to overall new bone formation rate, albeit a significant influence was only seen for 17ß-estradiol in men (p = 0.020). Sex hormone binding globulin had no influence on new bone formation rate (p = 0.897). There was no significant association between new bone formation rate and age (p = 0.353) or new bone formation rate and body mass index (p = 0.248). CONCLUSION: Positive association of 17ß-estradiol as well as testosterone with new bone formation rate after iliac onlay grafting indicates a role of sex steroid hormones in alveolar bone regeneration, although the observed influence was only significant for 17ß-estradiol in men.

Economic Impact of the Introduction of Outpatient Medical Specialist Care (ASV) of Gastrointestinal Cancer Patients from a German Hospital Management Perspective.

INTRODUCTION: The treatment of cancer patients in Germany is characterized by sectoral separation of the in- and outpatient care accompanied by 2 separate reimbursement systems. By introducing the Guideline of Outpatient Medical Specialist Care in accordance with §116b SGB V (ASV) in 2014, the German legislation empowers office-based physicians and hospitals to jointly provide medical care in the ambulatory setting. METHODS: A 1-year period each before and after the introduction of ASV was compared by means of data from the Center for Integrated Oncology Cologne at the University Hospital of Cologne. Only adults with a reliable diagnosis of gastrointestinal tumor (GIT) were considered. RESULTS: Overall, 1,872 cases were considered in the analysis showing significant (p < 0.001) higher median values of revenues across ICD-subgroups for ASV (EUR 427.46) compared to Ambulatory Treatments in Hospitals (EUR 234.21). The exemplary analysis of revenues in neoplasms of the pancreas shows EUR 173.69 on average which are only invoiceable through ASV: flat rate incl. surcharges (EUR 117.79; 68%), structure lump sum (EUR 29.49; 17%), positron-emission tomography (PET)/CT (EUR 13.53; 18%), and ASV consultation hour (EUR 12.89; 7%). DISCUSSION/CONCLUSION: ASV leads to significant higher revenues across different ICD-subgroups for patients suffering from severe GIT. The collaboration of hospital and office-based physicians ensures patient-centered care with accumulated expertise and avoidance of double examinations. Thus, the inclusion of additional services in the Uniform Value Scale (invoiceable for ASV) is legitimated and enables cost-covering care for the involved parties.

Primeiro relato de Salmonella enterica e Campylobacter spp. isolados de Garibaldi (Chrysomus ruficapillus) e Canário-da-terra (Sicalis flaveola) silvestres / First report on the Salmonella enterica and Campylobacter spp. isolation from wild birds Garibaldi (Chrysomus ruficapillus) and Canário-da-terra (Sicalis flaveola)

Algumas espécies de aves silvestres têm sido identificadas como reservatórios de Campylobacter e Salmonella, as quais atuam como propagadoras desses micro-organismos; entretanto, não há estudo sobre o papel das aves silvestres na transmissão desses agentes patogênicos no Brasil. O objetivo do presente trabalho foi de verificar a presença desses agentes patogênicos em aves silvestres que se alimentam em lavouras orizícolas. Vinte e três Garibaldis (Chrysomus ruficapillus), uma Rolinha-picuí (Columbinapicui) e um Canário-da-terra (Sicalis flaveola) foram capturados com redes de neblina. As amostras de fezes das aves foram coletadas com o uso de zaragatoas e foram processadas para efetuar pesquisa de Campylobacter spp. e Salmonella enterica. Oito (32%) amostras de fezes de C. ruficapillus foram positivas para Campylobacter e seis (24%) foram positivas para Salmonella enterica. Cinco (20%) amostras coletadas de C. ruficapillus e uma de S. flaveola foram positivas para Salmonella. C. ruficapillus e S. flaveola mostraram ser reservatórios de Campylobacter e Salmonella e, consequentemente, podem atuar como potenciais disseminadores destes patógenos. Este é o primeiro registro de isolamento de Campylobacter e Salmonella de amostras de fezes de C. ruficapillus e S. flaveola silvestres...