Assessing the optimal imaging modality in the diagnosis of jaw osteomyelitis. A meta-analysis.

Osteomyelitis is an inflammatory infectious disease that affects bone and bone marrow. Histopathology remains the gold standard method for diagnosis, but imaging modalities also play an important role. We systematically reviewed five articles with comparative studies on plain films, computed tomography (CT) scan, magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), positron emission tomography (PET), single photon-emission computed tomography (SPECT), scintigraphy, and SPECT/CT. Scintigraphy and SPECT/CT has the highest sensitivity of 100%. PET is only to be used in cases of follow up. Orthopantomography (OPG) is the most common initial diagnostic tool despite its low sensitivity. CT provides the necessary specificity needed for radionuclide imaging, which has the highest negative predictive value of 100% and a positive predictive value >95%. SPECT/CT with 100% sensitivity and 85% specificity can be considered as the imaging modality of choice for initial diagnosis and follow up.

Chemometrics supported optimization of a multi-attribute monitoring liquid chromatographic method for estimation of palbociclib in its dosage form: Application to a new regulatory paradigm.

OBJECTIVE: The objective of present work was to develop a validated liquid chromatographic method for the estimation of palbociclib in its solid dosage forms by employing a new systematic concept. MATERIAL AND METHOD: Risk assessment and control measures were undertaken along with chemometrics assistance to establish the robust method performance for studied analytical attributes viz. analyte retention, resolution, plate number, and tailing factor. Methanol %, flow rate, and pH were found influential on the performance of studied analytical attributes and optimized using a Box-Behnken experimental design. Monte-Carlo simulation was performed to evaluate the performance of the analytical procedure. A multi-attribute monitoring liquid chromatographic method employing methanol: 0.01M KH2PO4 buffer of pH 3.5 (70:30, v/v) was used with a reversed-phase column. Flow rate at 1.2mL/min and detection at 265nm monitored peak responses. RESULT: The method efficiently separated analyte from the internal standard caffeine (resolution>16). Specificity (resolution>2.0), linearity (2-64µg/mL), accuracy (>99%) and precision (%RSD<1%) were well in accord with regulatory requirements. Further, analyte was detected at 1µg/mL and was stable over applied stress conditions. CONCLUSION: In a nutshell, the novel approach produced an accurate method for estimation of palbociclib in tablets with optimum method performance.

Bleomycin sclerotherapy in lymphangiomas of the head and neck region: a prospective study.

Intralesional sclerotherapy for lymphatic malformations (LMs) has become a modality of choice because of the high morbidity and recurrence rates with surgical excision. Traditionally, the macrocystic variant has shown good results with sclerotherapy. This prospective study was performed to evaluate the role of bleomycin sclerotherapy in the management of different radiological variants of LM. A total of 142 patients were included in this study. The lesions were classified as macrocystic, microcystic, or mixed LMs on the basis of ultrasonography. All patients were managed by intralesional injection of bleomycin and were recalled after 4 weeks for evaluation. Colour photographs of the patients were taken before the onset of treatment and at each monthly visit, and were utilized to assess the response. Following the second, third, and fourth doses, the response was better in patients with the macrocystic variant than in those with the other two variants. However, after the completion of six doses, 80.3% of patients with the macrocystic variant, 67.4% with the microcystic variant, and 71.4% with the mixed type had a complete response. There was no difference in the overall response between the three types (P=0.28). Oedema, erythema, and local induration with fever were the most common adverse effects and were more common in younger children.

Crossover versus Stabilometric Platform for the Treatment of Balance Dysfunction in Parkinson's Disease: A Randomized Study.

Balance dysfunctions are a major challenge in the treatment of Parkinson's disease (PD). Previous studies have shown that rehabilitation can play a role in their treatment. In this study, we have compared the efficacy of two different devices for balance training: stabilometric platform and crossover. We have enrolled 60 PD patients randomly assigned to two groups. The first one (stabilometric group) performed a 4-week cycle of balance training, using the stabilometric platform, whereas the second one (crossover group) performed a 4-week cycle of balance training, using the crossover. The outcome measures used were Unified Parkinson's Disease Rating Scale (UPDRS) part II, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Six Minutes Walking Test (6MWT). Results showed that TUG, BBS, and UPDRS II improved in both groups. There was not difference in the efficacy of the two balance treatments. Patients in both groups improved also the meters walked in the 6MWT at the end of rehabilitation, but the improvement was better for patients performing crossover training. Our results show that the crossover and the stabilometric platform have the same effect on balance dysfunction of Parkinsonian patients, while crossover gets better results on the walking capacity.

Antimicrobial activity of fluorescent Ag nanoparticles.

UNLABELLED: The antimicrobial activity of fluorescent Ag nanoparticles of 1·5 nm (nAg-Fs) is demonstrated and compared with the other Ag nanoparticles of different shapes and size. The antimicrobial activity was evaluated using Gram-positive (Staphylococcus epidermidis NCIM2493 and Bacillus megaterium) and Gram-negative bacteria (Pseudomonas aeruginosa ATCC27853 and Escherichia coli) and fungal strains (Candida albicans and Aspergillus niger). Insights into the possible mechanism were investigated using fluorescence microscope and cytoplasmic materials release assay. The fluorescence microscopic measurements show that the nAg-Fs are localized at the centre of the cell, and 50% decrease in the fluorescence intensity was observed upon 2-h incubation. Maximum cytoplasmic release was observed with spherical Ag nanoparticles of 10 nm. Although the nAg-F shows minimum cytoplasmic release, it has the highest activity. The microbial killing effect of nAg-Fs is actually originates from its intracellular activity. The antimicrobial activity of nAg-Fs is significantly higher than the other synthesized nanoparticles of different shapes and size. The activity of the nanoparticles has been rationalized by considering the shape, size and surface structure of the particles. SIGNIFICANCE AND IMPACT OF THE STUDY: This study aims to demonstrate the size and shape-dependent antimicrobial activity of Ag nanoparticles. It is shown for the first time that the fluorescent Ag nanoparticles of 1·5 nm have superior antimicrobial activity with respect to the larger particles. The shape and size of the particles actually control their activity. The smaller particles can easily penetrate the cell wall and have pronounced activity. These findings may be useful in the development of potential antimicrobial agents.

Efficacy of a general practitioner training campaign for early detection of melanoma in France.

BACKGROUND: To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France. OBJECTIVE: To evaluate the efficacy of a general practitioner (GP) awareness and training campaign in a pilot French geographical region (Champagne-Ardenne), including 1.34 million inhabitants, 1241 GPs, 56 dermatologists and a population-based melanoma registry. METHODS: All GPs received repeated awareness postal mailings in 2008 and 398 (32.1%) attended training sessions organized by 27 dermatologists. The pre- (2005-7) and post-campaign (2009-11) periods were compared for the following: primary endpoint - the world-standardized incidence of very thick melanomas (VTM) (Breslow thickness ≥ 3 mm); secondary endpoints--the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ/all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655,000 ha), where no similar campaign was carried out. RESULTS: The incidence of VTM decreased from 1.07 to 0.71 per 100 000 habitants per year (P = 0.01), the mean Breslow thickness from 1.95 to 1.68 mm (P = 0.06) and the proportion of VTM from 19.2% to 12.8% (P = 0.01). The proportion of thin and in situ melanomas increased from 50.9% to 57.4% (P = 0.05) and from 20.1% to 28.2% (P = 0.001), respectively. No significant variation was observed in Doubs/Belfort territory. CONCLUSION: These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination.

Targeted yield concept and a framework of fertilizer recommendation in irrigated rice domains of subtropical India.

Soil test crop response (STCR) correlation studies were carried out in Vindhyan alluvial plain during 2001 to 2004 taking IR-36 as test crop to quantify rice production in the context of the variability of soil properties and use of balanced fertilizers based on targeted yield concept. The soils were developed on gently sloping alluvial plain with different physiographic settings and notable variation in drainage condition. Soil properties show moderate variation in texture (loamy to clay), organic carbon content (4.4 to 9.8 g/kg), cation exchange capacity (10.2 to 22.4 cmol (p+)/kg) and pH (5.3 to 6.4). Soil fertility status for N is low to medium (224 to 348 kg/ha), P is medium to high (87 to 320 kg/ha) and K ranges from medium to high (158 to 678 kg/ha). Database regarding nutrient requirement in kg/t of grain produce (NR), the percent contribution from the soil available nutrients [CS (%)] and the percent contribution from the applied fertilizer nutrients [CF (%)] were computed for calibrating and formulating fertilizer recommendations. Validity of the yield target for 7 and 8 t/ha was tested in farmers' fields and yields targets varied at less than 10%. The percent achievement of targets aimed at different level was more than 90%, indicating soil test based fertilizer recommendation approach was economically viable within the agro-ecological zone with relatively uniform cropping practices and socio-economic conditions.

Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia.

Steady-state blood clozapine concentrations in 58 schizophrenic patients varied more than 45-fold (40-1911 ng/mL) after fixed-dose treatment (400 mg/day). Discriminant function analysis determined that a blood clozapine concentration of 420 ng/mL optimally distinguished responders from nonresponders. After 4 weeks of treatment, only 8% of those patients with a blood clozapine concentration < 420 ng/mL responded compared with 60% of those who had a blood clozapine concentration > 420 ng/mL. When plasma concentrations were increased above 420 ng/mL (by a double-blind random assignment procedure), nonresponders increased their response rate to 73% if their plasma concentrations at Week 12 exceeded 420 ng/mL compared with a response rate of 29% if their Week 12 levels remained below 420 ng/mL (chi 2 = 4.2, p < .04).

Automated production of oxygen-15 labeled butanol for PET measurement of regional cerebral blood flow.

Because [15O]butanol is the radiopharmaceutical of choice for PET studies of cerebral perfusion and neurological activation, we have developed a microprocessor-controlled radiosynthetic system for the preparation of this radiotracer in up to ten batches at a time. An IBM-compatible minicomputer was programmed to direct the reaction of molecular [15O]oxygen with tri-(n-butyl)borane bound to alumina, followed by purification of product [15O]butanol via solid phase extraction with C18 Sep-Paks and sterile filtration. Routine batch yields of over 150 mCi were achieved with a preparation turn-around time of 6.0 min. The final product had high radiochemical purity, low chemical impurity, and was sterile and apyrogenic. This radiopharmaceutical production system is reliable and suitable for tracer production in clinical PET imaging centers.

Alterations in brain polyribosomal RNA translation and lymphocyte proliferation in prenatal ethanol-exposed rats.

The long-term effects of prenatal ethanol exposure on the properties of brain polysomes and the proliferative responses of lymphocytes to mitogenic stimulation in adult offspring were assessed. Female Sprague-Dawley rats either ingested the control or 6.6% ethanol-containing Lieber-DeCarli liquid diet during the 3rd trimester of pregnancy. Controls were age-matched and pair-fed. At 42 to 72 days of age, ethanol effects were evaluated on the (1) polysomal properties in the cerebral hemispheres, cerebellum, and hippocampal regions of the brain after translation in a messenger RNA (mRNA)-dependent rabbit reticulocyte lysate system and (2) immunologic functions of lymphocytes cultured from spleen cells by measuring their responses to mitogenic stimulation. Results showed long-term adverse effects of in utero ethanol exposure on the polysomal RNA translation in each of the three brain regions tested with free polysomal mRNAs affected more than the bound polysomal mRNAs. Of these, the hippocampal region appeared to sustain the most injurious effects. In addition, a suppression of the mitogen-induced lymphocyte proliferative responses were present under these conditions. The degree of suppression varied with the specific mitogen used. Data suggest that the ethanol effects on the CNS and lymphocyte proliferation are most possibly irreversible, and in the case of the CNS, a post-translational modification by ethanol is indicated. The reduced lymphocyte responses are suggestive of a possible interference by ethanol of the synthesis of interleukin-2 (IL-2) and/or a reduced binding of IL-2 with its receptor (IL-2 receptors).

Noninvasive detection of Helicobacter pylori colonization in stomach using [11C]urea.

Helicobacter pylori is associated with chronic type B gastritis. Diagnosis can be made on gastric biopsy specimens and noninvasively using [13C]- or [14C]urea breath tests. Both breath tests require meticulous breath collection, and false positive results are possible from urease producing oral-pharyngeal flora. We used [11C]urea, a positron-emitting radionuclide allowing dynamic imaging, to measure metabolism of urea in the stomach of biopsy documented H. pylori-positive patients. [11C]urea was synthesized from 11CO2 produced using a Van de Graaff accelerator and administered with [99mTc]DTPA to control for loss of radioactivity via gastric emptying. Images were obtained externally by gamma camera every minute and 11CO2 was monitored in the breath continuously for 30 min. An H. pylori-positive patient exhibited a 99mTc/11C activity ratio of 2:1 in the stomach 10-20 min following administration, compared to a 1:1 ratio in a negative control, indicating metabolism of urea to 11CO2 with subsequent diffusion of 11C activity out of the stomach. The 11C activity in the breath peaked at 10-20 min in the H. pylori-positive patients. The short half-life of carbon-11 (20.4 min) alleviates radiation safety concerns and results in low absorbed radiation doses to patients.