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Orofacial clefts (OFC) remain among the most prevalent congenital abnormalities worldwide. In the United States in 2010 to 2014, 16.2 of 10,000 live births are born with OFC compared with 23.6 of 10,000 in Alta Verapaz, Guatemala in 2012. Demographics and cleft severity scores were retrospectively gathered from 514 patients with isolated OFC at the Children's Hospital of Philadelphia scheduled for surgery from 2012 to 2019 and from 115 patients seen during surgical mission trips to Guatemala City from 2017 to 2020. Risk factors were also gathered prospectively from Guatemalan families. The Guatemalan cohort had a significantly lower prevalence of cleft palate only compared with the US cohort, which may be a result of greater cleft severity in the population or poor screening and subsequent increased mortality of untreated cleft palate. Of those with lip involvement, Guatemalan patients were significantly more likely to have complete cleft lip, associated cleft palate, and right-sided and bilateral clefts, demonstrating an increased severity of Guatemalan cleft phenotype. Primary palate and lip repair for the Guatemalan cohort occurred at a significantly older age than that of the US cohort, placing Guatemalan patients at increased risk for long-term complications such as communication difficulties. Potential OFC risk factors identified in the Guatemalan cohort included maternal cooking-fire and agricultural chemical exposure, poor prenatal vitamin intake, poverty, and risk factors related to primarily corn-based diets. OFC patients who primarily rely on surgical missions for cleft care would likely benefit from more comprehensive screening and investigation into risk factors for more severe OFC phenotypes.
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OBJECTIVE: To determine the impact of illustrated postoperative instructions on patient-caregiver knowledge and retention. DESIGN: Prospective study with all participants receiving an educational intervention. SETTING: Pediatric plastic surgical missions in Guatemala City, Guatemala, between 2019 and 2020. PARTICIPANTS: A total of 63 majority-indigenous Guatemalan caregivers of patients receiving cleft lip and/or palate surgery. INTERVENTION: Illustrated culturally appropriate postoperative care instructions were iteratively developed and given to caregivers who were surveyed on illustration-based and text-based information at preoperative, postoperative, and four-week follow-up time points. MAIN OUTCOME MEASURE: Postoperative care knowledge of illustration-based versus text-based information as determined by the ability to answer 11 illustration- and 8 text-based all-or-nothing questions, as well as retention of knowledge as determined by the same survey given at four weeks follow-up. RESULTS: Scores for illustration-based and text-based information both significantly increased after caregivers received the postoperative instructions (+13.30 ± 3.78 % SE, + 11.26 ± 4.81 % SE; P < .05). At follow-up, scores were unchanged for illustration-based (-3.42 ± 4.49 % SE, P > .05), but significantly lower for text-based information (-28.46 ± 6.09 % SE, P < .01). Retention of text-based information at follow-up correlated positively with education level and Spanish literacy, but not for illustration-based. CONCLUSIONS: In the setting of language and cultural barriers on a surgical mission, understanding of illustration-based and text-based information both increased after verbal explanation of illustrated postoperative instructions. Illustration-based information was more likely to be retained by patient caregivers after four weeks than text-based information, the latter of which correlated with increased education and literacy.
Subject(s)
Cleft Lip , Cleft Palate , Medical Missions , Humans , Child , Cleft Lip/surgery , Cleft Palate/surgery , Prospective StudiesABSTRACT
Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0-5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of -0.9 ± 1.3 mm and -0.6 ± 1.5 mm, and a variation in height of -0.1 ± 0.9 mm and -0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.
Subject(s)
Alveolar Bone Loss/drug therapy , Calcium Phosphates/pharmacology , Durapatite/antagonists & inhibitors , Silica Gel/pharmacology , Adult , Alveolar Bone Loss/prevention & control , Bone Substitutes/standards , Bone Substitutes/therapeutic use , Calcium Phosphates/therapeutic use , Double-Blind Method , Drug Combinations , Durapatite/pharmacology , Durapatite/therapeutic use , Female , Humans , Male , Maxilla/drug effects , Maxilla/physiopathology , Middle Aged , Silica Gel/therapeutic useABSTRACT
BACKGROUND: The gut is becoming increasingly recognized as the source of various systemic diseases, and recently, it has been linked to bone metabolism via the so-called gut-bone axis. The microbiome and gut-derived mediators are thought to impact upon bone metabolism, and administration of probiotics has been shown to have beneficial effects in bone. The gut brush border enzyme intestinal alkaline phosphatase (IAP) plays an important role in controlling calcium absorption, inhibiting lipopolysaccharides, and other inflammatory mediators responsible for endotoxemia and appears to preserve the normal gut microbiota. Interestingly, IAP-deficient mice (AKP3-/-) also display a significant decrease in fecal Lactobacillus, the genus shown to be beneficial to bone. MATERIALS AND METHODS: IAP mRNA levels in mouse bone were measured using quantitative real-time polymerase chain reaction. Femurs of IAP-knockout (KO) and wild-type (WT) mice were analyzed by microcomputed tomography and histopathology. Serum levels of alkaline phosphatase, calcium, and phosphorus were measured. Target cell response upon exposure to serum from IAP-KO and WT mice was quantified using primary bone marrow macrophages. RESULTS: IAP was not significantly expressed in bones of WT or KO animals. IAP (alkaline phosphatase 3) expression in bone was vanishingly low compared to the duodenum (bone versus duodenum, 56.9 ± 17.7 versus 25,430.3 ± 10,884.5 relative expression, P = 0.01). Bone histology of younger IAP-KO and WT animals was indistinguishable, whereas older IAP-deficient mice showed a distinctly altered phenotype on histology and computed tomography scan. Younger KO mice did not display any abnormal levels in blood chemistry. Older IAP-KO animals showed an isolated increase in serum alkaline phosphatase levels reflecting an environment of active bone formation (IAP-WT versus IAP-KO, 80 ± 27.4 U/I versus 453 ± 107.5 U/I, P = 0.004). There was no significant difference in serum calcium or phosphorus levels between KO and WT mice. Serum from IAP-KO mice induced a significantly higher inflammatory target cell response. CONCLUSIONS: Through its multiple functions, IAP seems to play a crucial role in connecting the gut to the bone. IAP deficiency leads to chronic changes in bone formation, most likely through dysbiosis and systemic dissemination of proinflammatory mediators.
Subject(s)
Alkaline Phosphatase/deficiency , Bone Remodeling/physiology , Duodenum/metabolism , Femur/pathology , Intestinal Mucosa/metabolism , Alkaline Phosphatase/blood , Alkaline Phosphatase/genetics , Animals , Cells, Cultured , Dysbiosis/metabolism , Female , Femur/diagnostic imaging , Femur/metabolism , Gastrointestinal Microbiome/physiology , Macrophages , Mice , Mice, Inbred C57BL , Mice, Knockout , Models, Animal , Primary Cell Culture , RNA, Messenger/isolation & purification , RNA, Messenger/metabolism , Real-Time Polymerase Chain Reaction , Specific Pathogen-Free Organisms , X-Ray MicrotomographyABSTRACT
BACKGROUND: Overweight and obesity are considered major health problems that contribute to increase mortality and quality of life. Both conditions have a high prevalence across the world reaching epidemic numbers. Our aim was to evaluate the effects of the administration of Garcinia cambogia (GC) and Glucomannan (GNN) on long-term weight loss in people with overweight or obesity. METHODS: Prospective, not-randomized controlled intervention trial was conducted. We treated 214 subjects with overweight or obesity with GC and GNN (500 mg twice a day, each) for 6 months evaluating weight, fat mass, visceral fat, basal metabolic rate, and lipid and glucose blood profiles comparing them with basal values. Some patients were carriers of polymorphisms PLIN4 -11482G > A-, fat mass and obesity-associated (FTO) -rs9939609 A/T- and ß-adrenergic receptor 3 (ADRB3) -Trp64Arg. RESULTS: Treatment produced weight loss, reducing fat mass, visceral fat, lipid and blood glucose profiles while increasing basal metabolic rate. Results were independent of sex, age or suffering from hypertension, diabetes mellitus type 2 or dyslipidemia and were attenuated in carriers of PLIN4, FTO, Trp64Arg polymorphisms. CONCLUSIONS: Administration of GC and GNN reduce weight and improve lipid and glucose blood profiles in people with overweight or obesity, although the presence of polymorphisms PLIN4, FTO and ADRB3 might hinder in some degree these effects. ISRCTN78807585, 19 September 2017, retrospective study.
Subject(s)
Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics , Garcinia cambogia , Mannans , Obesity , Perilipin-4/genetics , Receptors, Adrenergic, beta-3/genetics , Weight Loss , Adult , Amorphophallus/chemistry , Female , Humans , Male , Mannans/pharmacology , Mannans/therapeutic use , Obesity/drug therapy , Obesity/epidemiology , Obesity/genetics , Plant Extracts/pharmacology , Plant Extracts/therapeutic use , Polymorphism, Genetic/genetics , Prospective Studies , Weight Loss/drug effects , Weight Loss/geneticsABSTRACT
BACKGROUND AND AIMS: Bacterially derived factors from the gut play a major role in the activation of inflammatory pathways in the liver and in the pathogenesis of alcoholic liver disease. The intestinal brush-border enzyme intestinal alkaline phosphatase (IAP) detoxifies a variety of bacterial pro-inflammatory factors and also functions to preserve gut barrier function. The aim of this study was to investigate whether oral IAP supplementation could protect against alcohol-induced liver disease. METHODS: Mice underwent acute binge or chronic ethanol exposure to induce alcoholic liver injury and steatosis ± IAP supplementation. Liver tissue was assessed for biochemical, inflammatory, and histopathological changes. An ex vivo co-culture system was used to examine the effects of alcohol and IAP treatment in regard to the activation of hepatic stellate cells and their role in the development of alcoholic liver disease. RESULTS: Pretreatment with IAP resulted in significantly lower serum alanine aminotransferase compared to the ethanol alone group in the acute binge model. IAP treatment attenuated the development of alcohol-induced fatty liver, lowered hepatic pro-inflammatory cytokine and serum LPS levels, and prevented alcohol-induced gut barrier dysfunction. Finally, IAP ameliorated the activation of hepatic stellate cells and prevented their lipogenic effect on hepatocytes. CONCLUSIONS: IAP treatment protected mice from alcohol-induced hepatotoxicity and steatosis. Oral IAP supplementation could represent a novel therapy to prevent alcoholic-related liver disease in humans.
Subject(s)
Alkaline Phosphatase/administration & dosage , Dietary Supplements , Fatty Liver, Alcoholic/prevention & control , Alanine Transaminase/blood , Animals , Coculture Techniques , Cytokines/analysis , Cytokines/blood , Ethanol , Fatty Liver, Alcoholic/blood , Fatty Liver, Alcoholic/enzymology , Female , Hepatic Stellate Cells/enzymology , Hepatocytes/enzymology , Intestines/enzymology , Lipogenesis , Lipopolysaccharides/blood , Liver/chemistry , Mice , Mice, Inbred C57BL , Permeability , Tissue Plasminogen Activator , Triglycerides/analysisABSTRACT
BACKGROUND: Regular physical exercise and healthy lifestyle can improve aerobic power of the elderly, although lung capacity gradually deteriorates with age. The aims of the study are: a) to evaluate the therapeutic effect of a treadmill exercise program on arterial blood oxygenation (SaO2), maximum oxygen consumption (VO2max) and maximum walking distance (MWD) in healthy elderly people; b) to examine the outcome of the program at a supervised short-term and at an unsupervised long-term. METHODS: A prospective, not-randomized controlled intervention trial (NRCT) was conducted. Eighty participants were allocated into two homogeneous groups (training group, TG, n = 40; control group, CG, n = 40). Each group consisted of 20 men and 20 women. Pre-intervention measures of SaO2, VO2max and MWD were taken of each participant 1-week before the training program to establish the baseline. Also, during the training program, the participants were followed up at the 12, 30 and 48th week. The exercise program consisted of walking on a treadmill with fixed 0 % grade of inclination 3 times weekly for 48 weeks; the first 12 weeks were supervised and the remaining 36 weeks of the program were unsupervised. Participants in the control group were encouraged to walk twice a week during 45 min, and received standard recommendations for proper health. RESULTS: Related to the baseline, the SaO2, VO2max, and MWD is greater in the intervention group at the 12(th) (p <.001), 30(th) (p <.001) and 48(th) week (p <.001). Compared with the control group, there was also a significant improvement of SaO2, VO2max, and MWD valuesin the intervention group (p <.001) at the 12(th) (p <.001), 30(th) (p <.001) and 48(th) week (p <.001). Supervised intervention shows greater improvement of SaO2, VO2max, and MWD values than in the unsupervised one. CONCLUSION: These results show that performing moderate exercise, specifically walking 3 days a week, is highly recommended for healthy older people, improving aerobic power. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12621097 .
Subject(s)
Exercise Therapy , Exercise Tolerance , Healthy Lifestyle/physiology , Oxygen Consumption , Walking/physiology , Aged , Efficiency, Organizational , Exercise Test/methods , Exercise Therapy/methods , Exercise Therapy/psychology , Female , Geriatric Assessment/methods , Humans , Male , Organization and Administration , Prospective StudiesABSTRACT
OBJECTIVE: To describe the complications, short- and long-term outcomes, and owner satisfaction for dogs treated with pancarpal arthrodesis (PCA) using the 2.7/3.5 mm locking and dynamic compression plate (DCP) hybrid pancarpal arthrodesis plate (hybrid DCP [HDCP]) without rigid coaptation in the postoperative period. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with carpal injuries requiring PCA (n=15). METHODS: Records (May 2007-October 2013) of dogs that had PCA using 3.5/2.7 mm HDCP (1 or 2 plates) and a Robert-Jones bandage were reviewed to determine intra- and post-operative complications and overall limb function. Follow-up was obtained by clinical evaluation at our institution and telephone interview of owners. RESULTS: Fourteen dogs had PCA stabilized with a single HDCP and 1 giant breed dog had PCA stabilized with 2 HDCP on the dorsal aspect of the carpus secured onto the 3rd and 4th metacarpal bones. Two dogs presented with bilateral injuries. Thirteen owners (87%) judged the results of surgery as excellent and 2 (13%) judged the results of surgery as good. Minor complications (4 limbs; 23%) were occasional episodes of mild lameness in 3 dogs and 3 episodes of discharging sinus tracts in a single dog. Major complications (3 limbs; 17%) included 1 surgical site infection and implant failure in a 43 kg dog with an active leishmaniasis infection and a concurrent bilateral sacro-iliac luxation. Two dogs developed episodes of discharging sinus tract and pain over the most distal screw that eventually necessitated plate removal. CONCLUSION: PCA without rigid coaptation can successfully be performed using the HDCP.
Subject(s)
Bone Plates/veterinary , Bone Screws/veterinary , Carpus, Animal/injuries , Dogs/injuries , Gait , Animals , Arthrodesis/veterinary , Carpus, Animal/surgery , Dogs/surgery , Female , Interviews as Topic , Male , Postoperative Period , Range of Motion, Articular , Retrospective Studies , Treatment OutcomeABSTRACT
The power production is force-velocity related. We hypothesized that speed-based training of lower limb using half-squat can lead to absolute and relative power improvements in concentric movement with the same external load. One group of 19 soccer players (age = 24.4 years, SD = 3.7 years) participated in a pretest-posttest power training protocol, consistent in 2 training sessions per week during 10 weeks, targeted to work the leg power by performing half-squat with a fixed external load (mean = 71.7, SD = 5.4) at 65% of 1 repetition maximum. Measurements of power (absolute [in watt] and relative [in watt per kilogram]), force (in newton), and velocity (in meter per second) (mean and peak) were made from a concentric movement of a half-squat exercise with a fixed external load. The training protocol increased relative power (mean = 47.5, SD = 47.5, p < 0.001) and absolute power (mean = 169.2, SD = 95.5, p < 0.001). Also, number of repetitions (mean = 2.9, SD = 2.4, p < 0.01), force (mean = 66.6, SD = 36.7, p < 0.001), and velocity (mean = 0.1, SD = 0.1, p < 0.001) were increased. However, only improved velocity was related to the changes in absolute (r = 0.939, p < 0.001) and relative (r = 0.757, p < 0.001) power. The speed-based training combined with moderate to high external load can lead to an improvement of absolute and relative power in concentric phases of half-squat in soccer players. This could be important for improving the performance of the players in the field.
Subject(s)
Lower Extremity/physiology , Muscle Strength/physiology , Physical Conditioning, Human/methods , Running/physiology , Soccer/physiology , Adult , Humans , Male , Young AdultABSTRACT
The generate-recognize model and the relational-item-specific distinction are two approaches to explaining recall. In this study, we consider the two approaches in concert. Following Jacoby and Hollingshead (Journal of Memory and Language 29:433-454, 1990), we implemented a production task and a recognition task following production (1) to evaluate whether generation and recognition components were evident in cued recall and (2) to gauge the effects of relational and item-specific processing on these components. An encoding task designed to augment item-specific processing (anagram-transposition) produced a benefit on the recognition component (Experiments 1-3) but no significant benefit on the generation component (Experiments 1-3), in the context of a significant benefit to cued recall. By contrast, an encoding task designed to augment relational processing (category-sorting) did produce a benefit on the generation component (Experiment 3). These results converge on the idea that in recall, item-specific processing impacts a recognition component, whereas relational processing impacts a generation component.
Subject(s)
Concept Formation/physiology , Mental Recall/physiology , Recognition, Psychology/physiology , Adult , Cues , Humans , Models, Psychological , Young AdultABSTRACT
The antihypertensive drug atenolol was found to induce chromosome loss, detected as micronuclei in the peripheral lymphocytes of treated patients. The fundamental question which chromosomes the micronuclei were derived from remains to be answered. Analysis of structural chromosomal aberrations (CAs) and expression of fragile sites (FS) were pursued in this study. They revealed a significantly higher incidence of chromosomal aberrations (chromatid and chromosome breaks) in patients compared with controls, where 10 FS emerged as specific. Also, the band 17q12-21, where known fragile sites have not been reported, was only expressed in atenolol-treated patients. Fluorescence in situ hybridization using chromosome-specific probes revealed the preferential involvement of chromosomes 7, 11, 17 and X in the micronuclei (MN) of patients. The results also suggest a correlation between chromosomal fragility and content of MN, and support the findings for a linkage between hypertension and a locus on chromosome 17.
Subject(s)
Antihypertensive Agents/toxicity , Atenolol/toxicity , Chromosome Fragility/drug effects , DNA Damage , Hypertension/drug therapy , Lymphocytes/drug effects , Micronuclei, Chromosome-Defective/drug effects , Adult , Aged , Case-Control Studies , Chromosome Fragile Sites , Chromosomes, Human, Pair 17/genetics , DNA Damage/drug effects , Female , Humans , In Situ Hybridization, Fluorescence , Karyotyping , Male , Micronucleus Tests , Middle AgedABSTRACT
BACKGROUND: There is compelling evidence pointing out that stress and depression produce a dramatic impact on human well-being mainly through impairing the regular function of the immune system and producing a low-chronic inflammation status that favors the occurrence of infections, metabolic diseases, and even cancer. The present work aims to evaluate the stress/depression levels of some patients treated in an antiaging unit and detect any potential relationship with their immune system status prior of the implementation of a physical/psychological program designed to prevent health deterioration. METHODS: We evaluated 48 patients (16 men and 32 women with a mean age of 55.11 ± 10.71 years) from middle-upper class from psychological and immunological points of view. In particular, we analyzed neutrophil chemotaxis and phagocytosis; lymphocyte chemotaxis and proliferation, and natural killer (NK) cell activity. RESULTS: Women showed more depressive symptoms than men. Chemotaxis levels of lymphocytes and neutrophils in women showed a significant reduction compared with those in men. We also found a strong negative correlation between depression and NK cell function. This correlation was also significant independently of gender. CONCLUSION: We conclude that NK activity is affected at least by depression state, and we propose that a combined treatment consisting of cognitive behavioral therapy and physical activity programs might improve patient health deterioration.
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Gut barrier dysfunction and gut-derived chronic inflammation play crucial roles in human aging. The gut brush border enzyme intestinal alkaline phosphatase (IAP) functions to inhibit inflammatory mediators and also appears to be an important positive regulator of gut barrier function and microbial homeostasis. We hypothesized that this enzyme could play a critical role in regulating the aging process. We tested the role of several IAP functions for prevention of age-dependent alterations in intestinal homeostasis by employing different loss-of-function and supplementation approaches. In mice, there is an age-related increase in gut permeability that is accompanied by increases in gut-derived portal venous and systemic inflammation. All these phenotypes were significantly more pronounced in IAP-deficient animals. Oral IAP supplementation significantly decreased age-related gut permeability and gut-derived systemic inflammation, resulted in less frailty, and extended lifespan. Furthermore, IAP supplementation was associated with preserving the homeostasis of gut microbiota during aging. These effects of IAP were also evident in a second model system, Drosophilae melanogaster. IAP appears to preserve intestinal homeostasis in aging by targeting crucial intestinal alterations, including gut barrier dysfunction, dysbiosis, and endotoxemia. Oral IAP supplementation may represent a novel therapy to counteract the chronic inflammatory state leading to frailty and age-related diseases in humans.
Subject(s)
Aging/physiology , Alkaline Phosphatase/metabolism , Alkaline Phosphatase/pharmacology , Intestinal Mucosa/enzymology , Aging/drug effects , Animals , Drosophila melanogaster , Gastrointestinal Microbiome/drug effects , Homeostasis/drug effects , Homeostasis/physiology , Intestinal Mucosa/drug effects , Mice , Permeability/drug effectsABSTRACT
The design and implementation of a solar tracker based on panoramic images captured by a fisheye camera are proposed. Such images receive a digital treatment to estimate the sun azimuth and the elevation angles. These angles are fed to a microcontroller, handling an accelerometer with a gyroscope, that positions the solar tracker to the angle of solar elevation and a compass to set the azimuth angle concerning the north, either magnetic or geographic. The proposed system works satisfactorily to guide the solar tracker regardless of whether it is a sunny or cloudy day.
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Aims: In this study we wanted to figure out if there was a correlation between OPRM1 N40D, TRPV1 I316M, TRPV1 I585V, NOS3 -786T>C and IL6 -174C>G polymorphisms and the response to locally applied articaine-epinephrine anesthetic. Methods: In this observational study, 114 oral cell samples of patients anesthetized with articaine-epinephrine (54 from men 60 from women), were collected from dental centers in Madrid (Spain). High molecular weight DNA was obtained from oral mucosa cells. The analysis of OPRM1 N40D (rs1799971), TRPV1 I316M (rs222747), TRPV1 I585V (rs8065080) and IL6 -174C>G polymorphism was performed through real-time PCR allelic discrimination using TaqMan probes. Polymorphism NOS3 -786T> C (rs2070744) was analyzed using RFLP-PCR. Results: The studied polymorphisms are involved neither in the response to the anesthetic, nor in the intensity of perceived dental pain. However, in a subset of female patients we found that TRPV1 I316M was associated with a delayed onset of anesthesia. Conclusions: There is no association among these polymorphisms and the time elapsed between the application of the anesthetic and the onset of its effect.
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PURPOSE: This study represents a systematic review of the literature to assess the effectiveness of strontium-coated titanium surfaces on osseointegration in experimental assays with healthy, nonosteoporotic and/or nonosteopenic animals. MATERIALS AND METHODS: An electronic search was conducted of the databases MEDLINE/PubMed, Wiley Library, and Web of Science through 2018, with the aim of identifying studies on the osseointegration of titanium implants modified with strontium. RESULTS: A total of 255 papers were found, of which 11 were included in this systematic review. The primary result was the percentage of bone-to-implant contact (BIC) around the titanium implants with or without a strontium-coated surface. The different techniques used to coat titanium surfaces with strontium recorded significant results in terms of the improvement in the implant's quality, as they increased its contact with the bone, bone area, and bone formation, as well as enhanced its biomechanical properties. CONCLUSION: Nine of 11 studies reported that titanium implants coated with strontium showed significantly higher BIC (P < .001 to P < .05). This coating also improved the implants' biomechanical properties.
Subject(s)
Dental Implants , Osseointegration , Strontium , Titanium , Animals , Coated Materials, Biocompatible , Models, Animal , Prostheses and Implants , Surface PropertiesABSTRACT
BACKGROUND: We study the prevalence of acute myeloid leukemia (AML) among patients with severe gingival enlargement. MATERIAL AND METHODS: We retrospective reviewed the clinical records of patients with severe gingival enlargement, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and gingival bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique. RESULTS: A correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean gingival bleeding index was ≥3 and the degree of dental mobility ≥2.3. 1.7% of patients, with severe gingival hyperplasia were diagnosed with AML. We found a significant association between gingival bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. CONCLUSIONS: Severe gingival enlargement, abundant gingival bleeding, and dental mobility could be early manifestations of a blood dyscrasia. Key words:Acute myeloblastic leukemia, gingival hyperplasia, bleeding, tooth motility, oral health.
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OBJECTIVES: In the present article, we aim to review the main intra- and post-operative complications associated with two different therapeutic approaches for treating mandibular condylar fractures: conservative (CTR) and surgical treatment (ORIF, Open Reduction and Internal Fixation). MATERIAL AND METHODS: We have carried out a retrospective, meta-analytic, observational study using literature review, covering the period between 2000- September 2017. The data obtained were processed using statistical software SPSS v.0.18 and R v.2.11.1. The chi-squared test was used for comparison of relative frequencies for independent samples. RESULTS: A total of 2458 patients with 2810 fractures were collected for study. Patients treated with CTR and ORIF were an average of 29 years old, of those treated with CTR, 72.37% and 27.63% were male or female respectively and, of those treated with ORIF, 70.36% and 29.64% were male or female respectively. The main complications suffered by CTR and ORIF patients were: asymmetry (10.2%/6.4%), residual pain (6.5%/5.6%), temporomandibular joint and articular imbalance (15.9%/10.3%) and malocclusion (11.1%/4.0%), respectively. We only found significant differences between CTR and ORIF in the number of cases of temporomandibular joint and articular imbalance and malocclusion. Facial nerve damage was found exclusively among ORIF patients (8.6%) of which 8.3% were temporary and 0.3% permanent. CONCLUSIONS: The complications associated with either technique are minimal and infrequent, resulting in successful outcomes with minimal morbidity. CTR are associated with complications deriving from delayed mobilization leading to functional limitation, whereas the main complication associated with ORIF treatment was facial nerve damage.
Subject(s)
Conservative Treatment/methods , Mandibular Condyle/injuries , Mandibular Fractures/surgery , Mandibular Fractures/therapy , Orthopedic Procedures/methods , Conservative Treatment/adverse effects , Facial Nerve Injuries/etiology , Humans , Orthopedic Procedures/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/pathologyABSTRACT
BACKGROUND: Intestinal alkaline phosphatase (IAP) plays a pivotal role in maintaining gut health and well-being. Oral supplementation with IAP in mice improves gut barrier function and prevents luminal proinflammatory factors from gaining access to the circulation. In this study, we sought to explore the relationship between IAP and tight junction protein (TJP) expression and function. STUDY DESIGN: The effect of IAP deletion on TJP levels was studied in mouse embryonic fibroblasts (MEFs) generated from IAP-knockout and wild type mice. Regulation of TJPs by IAP was assayed in the human colon cancer Caco-2 and T84 cells by overexpressing the human IAP gene. Tight junction protein levels and localization were measured by using RT q-PCR and antibodies targeting the specific TJPs. Finally, the effect of IAP on inflammation-induced intestinal permeability was measured by in vitro trans-well epithelial electrical resistance (TEER). RESULTS: Intestinal alkaline phosphatase gene deletion in MEFs resulted in significantly lower levels of ZO-1, ZO-2, and Occludin compared with levels in wild-type control cells; IAP overexpression in Caco-2 and T84 cells resulted in approximate 2-fold increases in the mRNA levels of ZO-1 and ZO-2. The IAP treatment ameliorated lipopolysaccharide-induced increased permeability in the Caco-2 trans-well system. Furthermore, IAP treatment preserved the localization of the ZO-1 and Occludin proteins during inflammation and was also associated with improved epithelial barrier function. CONCLUSIONS: Intestinal alkaline phosphatase is a major regulator of gut mucosal permeability and appears to work at least partly through improving TJP levels and localization. These data provide a strong foundation to develop IAP as a novel therapy to maintain gut barrier function.