Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants.

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years. There were 33 men and 90 women and they all recovered. The IAN was mobilised by one of two procedures, one that involves the nerve directly (transposition) and one that does not (lateralisation). During lateralisation the nerve is deflected laterally through a mandibular osteotomy, while the mental nerve and mental foramen are not manipulated. The resulting hypoaesthetic area was drawn on a graph to assess its extension. Although different techniques are available for placing implants in atrophic jaws, mobilisation of the IAN is indicated in certain cases in which other techniques are not feasible or have a high risk of complications.

Role of the catechol group in the antioxidant and neuroprotective effects of virgin olive oil components in rat brain.

The aim of the present study was to determine the role of the catechol group in the antioxidant and neuroprotective effects of minor components of virgin olive oil in rat brain tissue. Hydroxytyrosol ethyl ether (HT, 2 OH), tyrosol ethyl ether (Ty, 1 OH) and 3,4-di-ortho-methylidene-hydroxytyrosol ethyl ether (MET, no OH) were compared. Oxidative stress was induced with ferrous salts (lipid peroxidation induction), diethylmaleate (depletion of glutathione) and hypoxia-reoxygenation in brain slices. Lipid peroxidation was inhibited in direct proportion to the number of OH groups: HT>Ty>MET. Exposure to HT led to partial recovery of the glutathione system after chemical inhibition or hypoxia-reoxygenation. All three compounds inhibited cell death in hypoxia-reoxygenation experiments (HT≥Ty>MET). Peroxynitrite formation (3-nitrotyrosine) and inflammatory mediators (prostaglandin E2 and interleukin 1ß) were inhibited by all three compounds. In conclusion, the presence of OH groups in the molecule of these phenolic compounds from virgin olive oil is a determinant factor in their antioxidant effect in brain tissue, but this antioxidant effect is not the only explanation for their neuroprotective effect.

Antiplatelet effect of new lipophilic hydroxytyrosol alkyl ether derivatives in human blood.

PURPOSE: To investigate the in vitro antiplatelet and anti-inflammatory effects of five alkyl hydroxytyrosol (HT) ether derivatives in human whole blood and compare these effects with those of HT. METHODS: Blood samples from healthy volunteers were incubated with HT and HT alkyl ether derivatives (ethyl, butyl, hexyl, octyl and dodecyl). Maximum intensity of platelet aggregation was induced with collagen, arachidonic acid or ADP. Calcium-induced thromboxane B(2) and nitric oxide production, LPS-induced prostaglandin E(2) and nitric oxide production and LPS-induced interleukin 1ß production were measured. RESULTS: All compounds inhibited platelet aggregation, thromboxane B(2) and inflammatory mediators in a concentration-dependent manner. The concentrations of each compound that inhibited the corresponding variable by 50 % compared to control samples (IC(50)) were in the range of 10(-7)-10(-6) M for HT hexyl ether; for the other compounds, these values were in the range of 10(-5) M. The IC(50) for thromboxane B(2) production was in the range of 10(-4) M. The effects of HT alkyl ether derivatives were greater than those of HT. These compounds increased nitric oxide production. There was no direct relationship between the effects of these compounds and alkyl chain length. Maximum effects were observed in the C4-C6 range. CONCLUSIONS: Alkyl ether derivatives of HT exert antiplatelet and anti-inflammatory effects that are greater than those of HT.

Lack of enantiomeric influence on the brain cytoprotective effect of ibuprofen and flurbiprofen.

R(-) enantiomers of the 2-arylpropionic acid derivatives ibuprofen and flurbiprofen weakly inhibit cyclooxygenase (COX) activity. However, a possible cytoprotective effect has been proposed. The aim of the study is to investigate the possible mechanism of this effect. An in vitro hypoxia-reoxygenation model in rat brain slices was used (n=6 rats per group). After reoxygenation, we measured LDH efflux (neuronal death), brain prostaglandin E(2) (PGE(2)) concentration, interleukins (IL)-1ß and 10, oxidative and nitrosative stress (lipid peroxides, glutathione, 3-nitrotyrosine, and nitrites/nitrates). Anti-COX activity was measured in human whole blood. Racemic, R(-), and S(+) enantiomers of ibuprofen and flurbiprofen were tested. All compounds had a cytoprotective effect with IC(50) values in the range of 10(-5) M. R(-) enantiomers did not significantly inhibit brain PGE(2). The concentration of IL-1ß was reduced by 53.1% by the racemic form, 30.6% by the S(+) and 43.2% by the R(-) enantiomer of ibuprofen. The IL-10 concentration increased significantly only with S(+)-flurbiprofen (33.1%) and R(-)-flurbiprofen (26.1%). Lipid peroxidation was significantly reduced by all three forms of flurbiprofen. Nitrite + nitrate concentrations were reduced by racemic, S(+), and R(-)-flurbiprofen. Peroxynitrite formation (3-nitrotyrosine) was significantly reduced by racemic and S(+)-ibuprofen. COX inhibition is not the main mechanism of cytoprotection for these compounds. Their influence on inflammatory mediators and oxidative and nitrosative stress could account for the potential cytoprotective effect of R(-) enantiomers.

Short-term heart rate dynamics of women during labor.

We studied 10 minutes segments of heartbeat interval fluctuations from 18 young women in labor with normal outcome of pregnancy. Data of each studied case were classified into two distinct groups. One group involving segments where the uterine activity was observable (three or more contractions in ten minutes), and the other group of reference having segments with fewer uterine activity or not presenting contractions at all. For comparison, we also included segments collected during the last trimester of gestation prior to labor from a third group of women. Corresponding RR interval series were analyzed to estimate RR(mean), RMSSD, α(1), α(1(MAG)) and α(1(SIGN)) parameters. No significant differences among groups were identified in RMSSD, α(1) and α(1(MAG)) Nevertheless, α(1(SIGN)) did present significant differences in comparison with the last trimester results (p<0.007), revealing a subtle change in the temporal organization of maternal RR series during labor. Results of these parameters then suggest that during labor, despite preserving a concomitant non-linear influence, the maternal short-term autonomic cardiac regulation behaves with less antagonism.

Differences in the in vitro antiplatelet effect of dexibuprofen, ibuprofen, and flurbiprofen in human blood.

BACKGROUND: In this study, we compared the in vitro pharmacodynamic profile of dexibuprofen, ibuprofen, and flurbiprofen to identify possible differences in antiplatelet activity. METHODS: In whole blood samples from healthy volunteers, we measured platelet aggregation induced by adenosine diphosphate, collagen and arachidonic acid, platelet thromboxane B(2) (TxB(2)), lipopolysaccharide-induced prostaglandin E(2), leukocyte 6-keto-prostaglandin F(1α) (PGF(1α)), and nitric oxide induced by both constitutive and inducible pathways before and after incubation with increasing concentrations of acetylsalicylic acid, dexibuprofen, ibuprofen, or flurbiprofen. The concentration that inhibited (IC(50)) or increased each variable by 50% was calculated. RESULTS: All 3 drugs inhibited platelet aggregation in a dose-dependent manner, TxB(2), prostaglandin E(2), and 6-keto-PGF(1α), and increased calcium-induced nitric oxide production. Dexibuprofen showed greater antiplatelet potency than ibuprofen and flurbiprofen, and its profile was similar to that of aspirin. For example, IC(50) values for arachidonic acid-induced platelet aggregation were 0.85 ± 0.06 µM for dexibuprofen, 14.76 ± 1.22 µM for ibuprofen, 6.39 ± 0.51 µM for flurbiprofen, and 0.38 ± 0.03 µM for aspirin. All drugs inhibited both thromboxane and prostacyclin synthesis, but the IC(50) anti-TxB(2)/IC(50) anti-6-keto-PGF(1α) ratio was 0.21 ± 0.03 for dexibuprofen, 1.05 ± 0.08 for ibuprofen, 0.79 ± 0.11 for flurbiprofen, and 0.46 ± 0.06 for aspirin. All drugs increased calcium-dependent nitric oxide production. CONCLUSIONS: The aryl propionic acid derivative dexibuprofen was the most potent antiplatelet drug, and its pharmacodynamic profile is similar to aspirin.

Optimal reconstruction of historical water supply to a distribution system: A. Methodology.

The New Jersey Department of Health and Senior Services (NJDHSS), with support from the Agency for Toxic Substances and Disease Registry (ATSDR) conducted an epidemiological study of childhood leukaemia and nervous system cancers that occurred in the period 1979 through 1996 in Dover Township, Ocean County, New Jersey. The epidemiological study explored a wide variety of possible risk factors, including environmental exposures. ATSDR and NJDHSS determined that completed human exposure pathways to groundwater contaminants occurred in the past through private and community water supplies (i.e. the water distribution system serving the area). To investigate this exposure, a model of the water distribution system was developed and calibrated through an extensive field investigation. The components of this water distribution system, such as number of pipes, number of tanks, and number of supply wells in the network, changed significantly over a 35-year period (1962--1996), the time frame established for the epidemiological study. Data on the historical management of this system was limited. Thus, it was necessary to investigate alternative ways to reconstruct the operation of the system and test the sensitivity of the system to various alternative operations. Manual reconstruction of the historical water supply to the system in order to provide this sensitivity analysis was time-consuming and labour intensive, given the complexity of the system and the time constraints imposed on the study. To address these issues, the problem was formulated as an optimization problem, where it was assumed that the water distribution system was operated in an optimum manner at all times to satisfy the constraints in the system. The solution to the optimization problem provided the historical water supply strategy in a consistent manner for each month of the study period. The non-uniqueness of the selected historical water supply strategy was addressed by the formulation of a second model, which was based on the first solution. Numerous other sensitivity analyses were also conducted using these two models. Both models are solved using a two-stage progressive optimality algorithm along with genetic algorithms (GAs) and the EPANET2 water distribution network solver. This process reduced the required solution time and generated a historically consistent water supply strategy for the water distribution system.

Optimal reconstruction of historical water supply to a distribution system: B. Applications.

In a recently completed case-control epidemiological study, the New Jersey Department of Health and Senior Services (NJDHSS) with support from the Agency for Toxic Substances and Disease Registry (ATSDR) documented an association between prenatal exposure to a specific contaminated community water source and leukaemia in female children. An important and necessary step in the epidemiological study was the reconstruction of the historical water supply strategy of the water distribution system serving the Dover Township area, New Jersey. The sensitivity of solutions to: (1) pressure and pattern factor constraints, (2) allowable operational extremes of water levels in the storage tanks, and (3) the non-uniqueness of the water supply solution are analysed in detail. The computational results show that the proposed approach yields satisfactory results for the complete set of monthly simulations and sensitivity analyses, providing a consistent approach for identifying the historical water supply strategy of the water distribution system. Sensitivity analyses indicated that the alternative strategy obtained from the revised objective function and the variation of constraints did not yield significantly different water supply characteristics. The overall analysis demonstrates that the progressive optimality genetic algorithm (POGA) developed to solve the optimization problem is an effective and efficient algorithm for the reconstruction of water supply strategies in water distribution systems.

Kikuchi-Fujimoto disease. A case report.

Histologically, Kikuchi-Fujimoto disease (KFD) is a necrotising, self-limiting lymphadenitis. It typically affects the lymph nodes of the neck and it is often accompanied by a high fever. The present paper documents the case of a 28-year old male carrier of KFD. From the x-ray images, the KFD clinically appeared to be a submandibular salivary gland tumor. An ultrasound study led us to believe that it was more likely a branchial cyst. Malignant lymphoma can be mistaken for KFD, thus the diagnosis must be precise and the differentiation is crucial.

[Wunderlich syndrome caused by the rupture of a simple cyst in a patient treated with acetyl salicylic acid]. / Síndrome de Wunderlich por rotura de quiste simple en paciente tratada con ácido acetil salicílico.

Report case of a Wunderlich syndrome due to spontaneous rupture of a simple renal cyst. The patient is a 77-year old, hypertensive female who was on routine treatment with Aspirin. The rarity of retroperitoneal haemorrhage with this origin is documented; also the influence of aspirin as predisposing factor for this condition is ruled out. Brief evaluation of the various diagnostic means available. An accurate evaluation that may allow to adopt a conservative aptitude is recommended.

Estimating exposure to volatile organic compounds from municipal water-supply systems: use of a better computational model.

The Southington, Connecticut, water-supply system is characterized by a distribution network that contains more than 1 700 pipeline segments of varying diameters and construction materials, more than 186 mi (299 km) of pipe, 9 groundwater extraction wells capable of pumping more than 4 700 gal/min (0.2965 m3/s), and 3 municipal reservoirs. Volatile organic compounds, which contaminated the underlying groundwater reservoir during the 1970s, contaminated the water-supply system and exposed the town's residents to volatile organic chemicals. We applied a computational model to the water-supply system to characterize and quantify the distribution of volatile organic compounds in the pipelines, from which we estimated the demographic distribution of potential exposure to the town's residents. Based on results from modeling analyses, we concluded the following: (a) exposure to volatile organic compound contamination may vary significantly from one census block to another, even when these census blocks are adjacent to each other within a specified radius; (b) maximum spatial spread of contamination in a water-distribution system may not occur under peak demand conditions, and, therefore, maximum spatial distribution of the exposed population also may not correspond to peak demand conditions, and (c) use of the proposed computational model allows for a more refined and rigorous methodology with which to estimate census-block-level contamination for exposure assessment and epidemiologic investigations.

Tratamiento de las neumonías con clindamicina / Treatment of pneumonias with clindamycin

En un estudio multicéntrico se administró monoterapia clindamicina para el tratamiento de 31 episodios de neumonía comunitaria producida por grampositivos. Sólo se registró un fracaso terapéutico. En el resto de los pacientes, la fiebre, recuento total de leucocitos y cantidad de esputo disminuyeron significativamente al quinto día de tratamiento. La tolerancia fue excelente, con un caso de flebitis durante la administración intravenosa y uno de intolerancia gástrica cuando se usó la vía bucal

Double-blind comparison of ciprofloxacin with cefotaxime in the treatment of skin and skin structure infections.

Oral ciprofloxacin (750 mg twice daily) was compared with intravenous cefotaxime (2 g three times daily) as therapy for 61 episodes of skin and skin structure infections occurring in adult patients. A variety of infections including cellulitis, infected ulcers, abscesses, and other miscellaneous infections were treated. Clinical cure was achieved in 77 percent (24 patients) of 31 patients treated with ciprofloxacin and in 76 percent (22 patients) of 28 patients treated with cefotaxime. The response was slower in infected diabetic patients than in non-diabetic patients in both groups. Side effects were minimal and appeared only in the cefotaxime group. Ciprofloxacin taken twice daily was as effective as cefotaxime administered intravenously three times daily in the treatment of skin and skin structure infections.

Presentación clínica del absceso perinéfrico, de 1980 a 1985 / Clinical presentation of perinephric abscess from 1980 to 1985

Durante el periodo comprendido entre 1980 a 1985 se diagnosticaron 10 abscesos perinéfrico en siete mujeres y tres varones. La edad promedio fue de 43.1 años. La evolución promedio de 174.7 días. Los síntomas prominentes fueron dolor (costovertebral/abdominal), calosfríos repetidos y fiebre. A la exploración física se encontró una tumoración en nueve de los diez casos. La hemoglobina promedio fue de 9.94 con un recuento total de leucocitos de 16,360. Todos los pacientes tenían alteraciones en la urografía excretora sugestivas de absceso perinéfrico. Las enterobacterias gramnegativas sensibles predominaron (siete de 10) como los agentes etiogénicos. Esta entidad se debe sospechar en mujeres/varones mayores de 40 años, con diabetes sacarina no insulinodependiente, anémicos, con duración de signos y síntomas de más de una semana, a los que se les practicó una urografía excretora

Actividad analgísica de la combinación fija dihidroergotamina paracetamol y cafeína en el tratamiento de cefalias de diverso origen / Analgesic activity of the fixed combination of dihydroergatamine, paracetamol and caffeine in the treatment of cephaleas of various origins

En un estudio abierto para valorar la eficacia y tolerancia de una asociación fija de dihidroergotamina, paracetamol y cafeína en el tratamiento de cefaleas de diverso origen, se incluyeron 36 pacientes de ambos sexos con edades comprendidas entre 12 y 72 años, que recibieron el citado fármaco en dosis de 2 grageas cada 6 horas, hasta suprimir el dolor o alcanzar la dosis máxima de 6 grageas al día. El preparado redujo la intensidade del dolor de 3 + ou - 0.13 a 0.36 + ou - 0.11 al quinto día de tratamiento. Dicha reducción fue muy significativa, y se logró con dosis baja del medicamento (2.61 + ou - 0.18 grageas/día en promedio), la cual descendió durante el transcurso del estudio, hasta 1 gragea/día aproximadamente. La tolerancia fue excelente; en sólo 8.3% de la población estudiada se registraron efectos secundários