Super-High Magnification Dermoscopy in 190 Clinically Atypical Pigmented Lesions.

Super-high (×400) magnification dermoscopy (D400) is a new non-invasive imaging technique that has been shown to add information for the differential diagnosis of melanocytic lesions in a pilot study. Our study aimed to confirm if D400 can add details for the discrimination of clinically atypical nevus and melanoma. This is a retrospective observational, multicentric study enrolling patients who received ×20 (D20) and ×400 (D400) magnification dermoscopic examinations of pigmented skin lesions. Dermoscopic images were retrospectively evaluated by three observers for the presence/absence of nine D20 and twenty D400 dermoscopic features defined in the previous pilot study. Univariate and multivariate analyses were carried out to find predictors of benign and malignant behaviors. At D20, an atypical pigment network, blue-whitish veil, atypical vascular pattern, regression, and homogenous pattern were more frequent in melanoma than in nevi (p < 0.001). At D400, melanoma showed more frequently than benign lesions, melanocytes with an irregular arrangement and irregular in shape and size (p < 0.001). A network with edged papillae was more frequent in benign lesions than melanomas (p < 0.001). Our study confirms that D400 can identify melanocytes with an irregular arrangement, and irregularities in shape and size in melanomas, adding information to the conventional D20 examination.

Changes in biomarkers of metabolic stress during late gestation of dairy cows associated with colostrum volume and immunoglobulin content.

The objective of this observational study was to compare the metabolic status of dairy cows during the last 6 wk of gestation based on colostrum volume and immunoglobulin content. For this, healthy Holstein cows were randomly selected from 3 commercial herds in Michigan. In each farm, 4 cohorts of 21 cows (1 per season), stratified by parity, were enrolled (n = 228). Cows were blood sampled weekly during the last 6 wk of gestation, and biomarkers related to nutrient utilization, oxidant status, and inflammation were quantified in serum. Cows were milked within 6 h of calving, and the volume of colostrum produced was recorded and an aliquot collected. Concentration of IgG, IgA, and IgM were measured by radial immunodiffusion. Cows were grouped into high or low colostrum producer, high or low IgG, high or low IgA, and high or low IgM. For volume category, we arbitrarily defined 6 L of colostrum (4 L for first and 2 L for second feeding of calves) as the cutoff point, whereas for IgG we used the industry standard of ≥50 g/L. To create groups of low and high IgM or IgA, we used the median of these immunoglobulin as the cutoff point. Colostrum volume was lowest in winter, but no differences were observed among parity groups. Conversely, colostrum IgG concentration was highest in fall and winter, but colostrum IgM was lowest at these seasons. However, colostrum immunoglobulin content only showed a negative weak correlation with volume (Spearman's correlation coefficient < -0.28). Compared with low colostrum producer, high colostrum producer cows had higher concentrations of antioxidant potential and ß-hydroxybutyrate, and lower cholesterol and oxidant status index. Cows with high IgG showed higher concentrations of glucose compared with low IgG. Cows with high IgA had higher concentrations of cholesterol, reactive oxygen and nitrogen species, oxidant status index, and total protein, whereas ß-hydroxybutyrate and glucose were lower compared with low IgA. Biomarkers of metabolic stress were not significantly different between high IgM and low IgM. Nevertheless, the differences observed did not result in differences in inflammatory status between animals in any of the colostrum variable categories analyzed, suggesting that physiological homeostasis was not disrupted during late gestation in association with the colostrum variables studied. Overall, the great variability observed in colostrum variables suggests that colostrogenesis is a complex and multifactorial process. However, our results suggest that greater availability of antioxidants during late gestation could support the production of higher volumes of colostrum, which needs to be explored in future trials.

Novel Protocols for the Production of Autologous Blood Concentrates With High Platelet Volume.

Autologous blood concentrates (ABCs), specifically platelet-rich plasma (PRP), were originally discussed in the literature more than 60 years ago. Since then, protocols to fabricate PRP from patient-derived blood have steadily evolved with the aim of creating better products with more effective clinical results. Key to the protocol evolution has been the development of ABCs with higher concentrates of platelets and other blood components that enhance soft- and hard-tissue healing and, hence, regeneration. The authors present a protocol for obtaining high-platelet-concentration PRP and autogenous thrombin. This fifth-generation protocol allows PRP to be attained with a platelet concentration six times higher than that which is present in the original clot. This double-centrifugation PRP protocol is relatively simple and inexpensive, as it does not require special equipment or advanced technical knowledge by the practitioner and can readily be conducted in a private dental clinical setting.

Transferência de imunidade passiva e proteinograma sérico em bezerros das raças Crioula Lageana variedade Mocha e Aberdeen Angus (Red Angus) nos primeiros seis meses de vida / Transfer of passive immunity and serum proteinogram in calves of the Criollo Lageano hornless variety and Aberdeen Angus (Red Angus) breed in their first six months of life

A raça Crioula Lageana apresenta-se como uma alternativa para a pecuária moderna, devido a sua grande variabilidade genética, rusticidade e adaptação às condições ambientais do Planalto Catarinense. Estas características podem influenciar importantes eventos fisiológicos, os quais deveriam ser investigados, pois podem auxiliar no desenvolvimento de futuros programas de melhoramento animal. Sabe-se que a falha da transferência de imunidade passiva (TIP) constitui um importante fator para a elevação dos índices de mortalidade neonatal na espécie bovina. Desta forma, torna-se indispensável à avaliação dos aspectos relacionados à TIP em bezerros da raça Crioula Lageana variedade mocha e a sua comparação com outras raças de corte criadas no Planalto Serrano Catarinense. Com o objetivo de avaliar e comparar a TIP e o proteinograma sérico foram selecionados dois grupos experimentais compostos por 11 bezerros da raça Crioula Lageana variedade mocha e 14 bezerros da raça Aberdeen Angus (Red Angus). Amostras de sangue foram colhidas por meio da venopunção jugular para a mensuração da proteína total sérica (PTS), eletroforese das proteínas séricas em gel de agarose, atividade da gamaglutamiltransferase (GGT) e concentração de imunoglobulinas G (IgG) por meio do método de turvação pelo sulfato de zinco nos períodos entre 24 e 36 horas, 15, 30, 60, 90, 120, 150 e 180 dias de vida. A análise estatística dos dados foi realizada por meio da análise de variância de medidas repetidas (ANOVA), teste de Tukey para a comparação entre médias (P<0,05) e correlação entre as variáveis. Ao analisar os valores de PTS, globulinas, gamaglobulinas, IgG e atividade sérica de GGT ao nascimento (24 a 36 horas) pode se afirmar que houve adequada TIP não havendo diferença significativa entre as raças, exceto para a atividade sérica da GGT. Observaram-se variações fisiológicas na curva de proteínas séricas do nascimento até os 180 dias de idade. Forte correlação positiva foi observada entre os valores de gamaglobulina e IgG (r=0,814 para CL e r=0,877 para AA), PTS (r=0,783 para CL e r=0,947 para AA), globulinas (r=0,945 para CL e r=0,985 para AA), evidenciando que estas variáveis foram bons indicadores da TIP em bezerros ao segundo dia de vida (24-36 horas). A correlação entre gamaglobulinas e atividade da GGT foi fracamente positiva (r=0,251) para bovinos da raça Crioula Lageana variedade mocha e fortemente positiva (r=0,815) para a raça Aberdeen Angus (Red Angus), o qual foi admitido a grande variação nos valores da GGT após 24 horas de vida do bezerro. Não houve diferença na TIP entre as raças Crioula Lageana variedade mocha e Aberdeen Angus (Red Angus), ocorrendo de maneira bem-sucedida em ambas as raças. Pode-se sugerir que a raça Crioula Lageana variedade mocha seja mais tardia na síntese ativa de anticorpos, ressaltando a precocidade dos taurinos evidenciada na raça Aberdeen Angus (Red Angus).(AU)

The Criollo Lageano breed is an alternative for modern farming, due to its high genetic variability, rusticity and adaptation to environmental conditions of the Plateau of Santa Catarina, Brazil. These characteristics can influence important physiological events which should be investigated, because they can assist in developing future programs of animal breeding. It is known that failure of passive transfer (FPT) is an important factor for the increase in neonatal mortality in cattle. Thus, it is essential to evaluate aspects related to FPT in Criollo Lageano calves and the comparison with other beef breed created in the Plateau of Santa Catarina. Aiming to evaluate and to compare the passive transfer of immunity and serum protein concentrations, two experimental groups of 11 calves of Criollo Lageano (CL) hornless variety and 14 Aberdeen Angus (Red Angus) calves were selected. Blood samples were collected by jugular venipuncture for the measurement of total serum protein (TSP) by serum protein electrophoresis in agarose gel and the activity of gamma glutamyl transferase (GGT) and concentration of immunoglobulin G (IgG) by the method of the turbidity zinc sulphate, between 24 and 36 hours, 15, 30, 60, 90, 120, 150 and 180 days. Statistical analysis of data was performed by analysis of variance (ANOVA), Tukey test for comparison of means (P<0.05) and correlation between variables. Values of TSP, globulins, immunoglobulins, IgG and serum GGT activity at birth (24-36 hours) confirmed that there was adequate TIP with no significant difference between the races, except for the serum GGT activity. Physiological variations in the curve of serum proteins from birth to 180 days of age were identified. Strong positive correlation was found between the values of gamma globulin and IgG (r=0.814 and r=0.877 for CL to AA), PTS (r=0.783 and r=0.947 for CL to AA), globulins (r=0.945 and r=0.985 for CL to AA), indicating that these variables will be good indicators of TIP in calves at the second day of life (24-36 hours). The correlation between gamma globulin and activity of GGT was weakly positive (r=0.251) for CL and strongly positive (r=0.815) for the Aberdeen Angus (Red Angus), in which a wide variation in GGT values after 24 hours of life of the calf were noticed. No difference was found in FPT between Criollo Lageano hornless variety and Aberdeen Angus (Red Angus), and was successful way in both breeds. It can be suggested that Criollo Lageano hornless variety breed is later in active antibody synthesis, highlighting the precocity of taurine evident in Aberdeen Angus (Red Angus) breed.(AU)

Influence of Kinesio Taping applied over biceps brachii on isokinetic elbow peak torque. A placebo controlled study in a population of young healthy subjects.

OBJECTIVES: To investigate the effect of Kinesio Taping (KT) applied over the biceps brachii on maximal isokinetic elbow torque. DESIGN: This study followed a single-blinded, placebo controlled, repeated measures design. METHODS: Isokinetic eccentric and concentric elbow peak torques were evaluated without taping (NT), with KT or placebo taping (PT) in 20 healthy participants. Furthermore, all the participants were required to perform a proprioceptive task of elbow joint position sense (JPS) in the same experimental conditions. RESULTS: A significant effect of taping condition was found for concentric elbow peak torque (p=0.01). Post hoc analysis revealed a statistically significant concentric elbow peak torque improvement between NT and KT (p<0.05) but not between NT and PT. As regards eccentric elbow peak torque, we found a significant effect of taping condition (p<0.0001). Significant eccentric elbow peak torque differences were observed between NT and PT (p<0.01) and between KT and PT (p<0.001), while the increase observed from NT to KT conditions failed to reach significance at a post hoc analysis. CONCLUSIONS: When applied over the biceps brachii, KT increases concentric elbow peak torque in a population of healthy participants, if compared with a PT.

The IgE repertoire in children and adolescents resolved at component level: a cross-sectional study.

BACKGROUND: It is well known that allergy evolves at clinical level from the birth to adulthood, and this has been clearly demonstrated also at a level of sensitization. However, little information is available on the evolution of the IgE repertoire directed to single allergenic components. In this cross-sectional, observational study, the evolution of the IgE repertoire was analysed at component level. METHODS: Serum samples from 901 allergic patients, stratified in 6 groups according to age, were analysed by ImmunoCAP ISAC, a microarray chip that allows to identify the presence of specific IgE towards 103 different allergen components. Total IgE were also evaluated. RESULTS: The behaviour of total IgE according to age strictly paralleled that of the sum of specific IgE directed to molecular components. As expected, food-related components (in particular those of milk and egg) were the most frequently recognized in the earliest ages, whereas specific IgE to plant allergens appeared invariably later. Nonetheless, IgE specific to mite components was the most represented in all age classes. Of note, specific IgE against cross-reacting allergens was virtually absent in the first years and tended to appear only after the age of 6. CONCLUSION: Despite this was not a study performed on a cohort of patients followed up from birth to adolescence, the molecular patterns of allergen recognition resulted modified according to age. These findings may support, at molecular level, the clinical features of the allergic march.

Lack of neo-sensitization to Pen a 1 in patients treated with mite sublingual immunotherapy.

BACKGROUND: Some studies reported the possible induction of food allergy, caused by neo-sensitization to cross-reacting allergens, during immunotherapy with aeroallergens, while other studies ruled out such possibility. OBJECTIVES: The aim of this study was to evaluate the development of neo-sensitization to Pen a 1 (tropomyosin) as well as the appearance of reactions after ingestion of foods containing tropomyosin as a consequence of sublingual mite immunization. MATERIALS AND METHODS: Specific IgE to Tropomyosin (rPen a 1) before and after mite sublingual immunotherapy in 134 subjects were measured. IgE-specific antibodies for mite extract and recombinant allergen Pen a 1 were evaluated using the immunoenzymatic CAP system (Phadia Diagnostics, Milan, Italy). RESULTS: All patients had rPen a 1 IgE negative results before and after mite SLIT and did not show positive shrimp extract skin reactivity and serological rPen a 1 IgE conversion after treatment. More important, no patient showed systemic reactions to crustacean ingestion. CONCLUSIONS: Patients did not show neo-sensitization to tropomyosin, a component of the extract (namely mite group 10) administered. An assessment of a patient's possible pre-existing sensitisation to tropomyosin by skin test and/or specific IgE prior to start mite extract immunotherapy is recommended. TRIAL REGISTRATION: This trial is registered in EudraCT, with the ID number of 2010-02035531.

Case report of a sarcoma botryoides of the uterine cervix in fertile age and literature review.

INTRODUCTION: The sarcoma botryoides of the cervix uteri occurs very rarely in fertile women. CASE: Here is a case of a 35-year-old fertile woman, who developed a sarcoma botryoides of the cervix uteri. The diagnosis required clinical examination, ecography, NMR, CT scan and a pathological examination of the surgical sample. Radical surgery and chemotherapy was performed. The patients is still living after more than 1 year after treatment. DISCUSSION: Although the combined modality approach has given, if not constant, acceptable outcomes, a larger investigation on all the cases of sarcoma botryoides of the cervix uteri is expected.

Effect of sublingual immunotherapy with grass monomeric allergoid on allergen-specific T-cell proliferation and interleukin 10 production.

BACKGROUND: Sublingual immunotherapy (SLIT) is safe and efficacious in the treatment of patients with allergic rhinitis. Although favorable clinical effects have been observed with controlled trials as early as a few months since the beginning of treatment, few biological changes induced by SLIT have been demonstrated. OBJECTIVE: To investigate in grass-allergic patients the effect of a 2-month SLIT regimen, administered with a simplified protocol without up-dosing, on proliferation and production of cytokines characteristic of the regulatory T-cell phenotype (interleukin 10 [IL-10] and transforming growth factor beta [TGF-beta]) by allergen-specific T cells. METHODS: Patients were recruited to the study in January 2006. SLIT was performed by self-administration and was continued for 60 days from February to April 2006. Eleven grass pollen-allergic patients with seasonal rhinitis were treated daily before the pollen season for 2 months with a modified allergen (monomeric allergoid) derived from a 3-grass pollen extract. Allergen-specific proliferation and production of IL-10 and TGF-beta were measured on peripheral blood mononuclear cells at baseline and treatment end. Tetanus toxoid served as the control antigen. RESULTS: After SLIT, allergen-specific (P = .002) but not tetanus toxoid-specific proliferation decreased, whereas IL-10 transcription increased (P < .001). TGB-beta transcription was also increased after treatment, although not statistically significantly (P = .06). Changes in proliferation to allergen and in IL-10 transcription were correlated (r = -0.82, P = .003). CONCLUSIONS: A short-term course of SLIT with modified allergen in grass-allergic patients is associated with the reduction of allergen-specific proliferation and with the up-regulation of the IL-10 regulatory cytokine.

IgE profiles of Bermuda grass pollen sensitised patients evaluated by Phleum pratense allergens Phl P 1, 2, 4, 5, 6 , 7, 11, 12.

BACKGROUND: Despite the difference in geographical dominance of certain grasses, a high degree of allergenic similarity or cross-reactivity between Bermuda grass pollen (BGP) and timothy grass pollen (TGP) has been previously demonstrated. The aim of the present study was to ascertain the sensitisation to TGP in 411 patients known for their reactivity to BGP extracts by analysing their reactivity to crude timothy pollen extract and timothy pollen purified allergens, establishing their specific IgE-profiles. METHODS: Using the immunoenzymatic CAP method we evaluated IgE-specific antibodies for BGP- and TGP- extracts and the timothy recombinant (r) and natural (n) allergens rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5, rPhl p 6, rPhl p 7, rPhl p 11, and rPhl p 12. RESULTS: BGP-IgE positive patients (median = 8.0 kUA/l, 2.8-22.2 kUA/l 25th-75th percentile) simultaneously had IgE positive results for TGP (100% of subjects)(median = 48.9 kUA/l, 19.8- > 100 kUA/l 25th-75th percentile) and high prevalence of sensitization to 6/8 Phleum pratense allergens (Phl p 1, 2, 4, 5, 6, 11, markers of genuine sensitisation to TGP) other than profilin and calcium binding protein. More than 72% of BGP allergic patients were co-sensitised to rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5, rPhl p 6. A decrease of total and specific IgE with patients' age was observed. CONCLUSIONS: Our data show that all BGP-allergic patients simultaneously exhibit higher IgE antibody levels to recombinant and natural P. pratense allergens as well as to crude TGP extract. This suggests that when choosing an immunotherapeutic regimen for BGP-sensitised patients (after establishing their IgE profile via purified TGP-allergens), subcutaneous or sublingual TGP-extract vaccines in appropriate doses, in order to influence T epitope specificity, might be beneficial. Though extremely uncommon, in cases where a patient is exclusively BGP allergen-sensitised, BGP-extract therapy is the appropriate therapeutic response.

Evaluation of serum IgG4 antibodies specific to grass pollen allergen components in the follow up of allergic patients undergoing subcutaneous and sublingual immunotherapy.

BACKGROUND: A number of reports suggest that induction of IgG 'blocking antibodies' may be important for successful allergen immunotherapy. Nevertheless, a significant increase in specific IgG and IgG4 antibodies has not been consistently demonstrated for sublingual immunotherapy (SLIT). METHODS: The present observation included three groups of grass pollen allergic patients all submitted to three different allergen immunotherapeutic regimens in an open, non-placebo controlled clinical study: (i) 16 patients underwent a modified 'cluster' regimen of weekly injections of a standardized aluminium-absorbed Phleum pratense extract for 5 weeks, followed by 3 weeks of maintenance injections. (ii) Fifteen patients were treated with standardized timothy grass pollen-allergen oral vaccine. In the first session of a SLIT protocol without up-dosing, each patient received 2.4 ml of sublingual vaccine containing about 57 microg of Phl p 5 and received a maintenance dose of 24 microg of Phl p 5 once a day for 120 days. (iii) Fourteen subjects were treated with a standardized allergen extract containing 5-grass pollen mixture; a SLIT protocol was performed without up-dosing, administering a dose corresponding to about 10.0 microg/ml grass-pollen Group 5 and a maintenance dose of 4 microg of grass-pollen Group 5 once a day for 135 days. Patients' sera were characterized in detail by determining IgG4 antibodies to rPhl p 1, 2, 5, 6, 7, 11, 12 and nPhl p 4 and eosinophil cationic protein before the start of immunotherapy and during the peak of pollen season. RESULTS: No relevant systemic side effects were registered in patients treated with the modified cluster subcutaneous immunotherapy (SCIT) protocol and the two SLIT protocols without build-up phase. After SCIT all patients had high titres of serum allergen-specific IgG4 antibodies. High-dose SLIT led to an IgG4 increase comprising 25% of the SCIT level, while low-dose SLIT increased to 4% of the SCIT. Furthermore, the increase of specific IgG antibodies corresponds to a decrease of serum ECP during allergen exposure. CONCLUSIONS: These preliminary data seem to indicate that: (i) pre-seasonal high-dose SLIT protocol without build-up phase is safe and well-tolerated by allergic patients; (ii) compared to IgG4 levels induced by SCIT, only a high-dose SLIT regimen results in an appreciable serum specific IgG4 increase.

Identification of grass pollen allergens by two-dimensional gel electrophoresis and serological screening.

Approximately 50% of allergic patients are sensitized against grass pollen allergens. The characterization of specific immunoglobulin E (IgE) reactivity to allergen components in pollen-allergic patients is fundamental for clinical diagnosis and for immunotherapy. Complex allergen extracts are commonly used in diagnostic tests as well as in immunotherapy preparations, but their composition in single allergenic molecules is only partially known. Diagnostic tests which utilize recombinant or immuno-purified allergens have been made available in clinical practice. They allow to obtain specific profiles of IgE reactivity, but the panel of available molecules is far from complete. Here, we used a proteomic approach in order to detect grass allergens from a natural protein extract. A five-grass pollen extract used for diagnosis and immunotherapy was resolved by two dimensional gel electrophoresis (2-DE), and assayed with 9 sera from pollen-allergic patients whose sensitization profile was dissected by using IgE reactivity to recombinant allergens. 2-DE immunoreactivity patterns were matched with IgE reactivity to identify protein spots as candidate allergens. Identity was confirmed by mass spectrometry analysis. We identified 6 out of 8 expected clinically relevant allergens in the natural grass extract. Moreover, we identified different molecular isoforms of single allergens, thus obtaining a more detailed profile of IgE reactivity. Some discrepancies in protein isoform profile and sera immunoreactivity between recombinant and native allergen 5 from Phleum pratense were observed and a new putative allergen was described. The proteomic approach applied to the analysis of a natural allergen allows the comprehensive evaluation of the sensitization profile of allergic patients and the identification of new allergens.

CT-guided radiofrequency ablation: a potential complementary therapy for patients with unresectable primary lung cancer--a preliminary report of 33 patients.

OBJECTIVE: We report our preliminary evaluation of the effectiveness, safety, technical feasibility, and complications of palliative CT-guided radiofrequency ablation of unresectable primary pulmonary malignancies. SUBJECTS AND METHODS: Thirty-three patients (26 men and seven women; age range, 44-75 years; mean age, 66 years) with unresectable malignant lung neoplasms underwent 35 CT-guided tumor ablation sessions. Follow-up CT was performed 6 months (29 cases) and 1 year (10 cases) after treatment. In 19 patients, these findings were correlated with cytohistopathologic assessment obtained with CT-guided fine-needle aspiration biopsy or core biopsy at 6-month follow-up. Size and CT appearance of the treated lesions were correlated with cytohistologic features and clinical scores. RESULTS: Thirty-five technically successful radiofrequency ablation treatments were performed. The only complications in the periprocedural period were three cases of minor pneumothorax, five cases of sputum cruentum, and three asymptomatic pleural effusions. Contrast-enhanced CT performed at 6-month follow-up showed four cases of complete and 13 cases of partial lesion ablation, 11 cases of stabilized lesion size, and one case of increased lesion size. Contrast-enhanced CT performed at 1-year follow-up showed unchanged lesion size in six cases and reduction in four cases. Six-month cytohistologic examinations showed total coagulation necrosis in seven lesions and partial necrosis in 12. Clinical improvement in pretreatment symptoms was observed in 12 of 29 patients seen at 6-month follow-up. Eight patients died within 1 year of treatment of non-procedure-related causes. CONCLUSION: Our experience suggests that radiofrequency ablation can be used successfully in unresectable lung cancer as an alternative or complementary treatment to radio- or chemotherapy. Larger studies are necessary to fully evaluate its potential combination with other treatment techniques.

Prevalence of serum IgE antibodies to the Staphylococcus aureus enterotoxins (SAE, SEB, SEC, SED, TSST-1) in patients with persistent allergic rhinitis.

BACKGROUND: Enterotoxins produced by Staphylococcus aureus and their specific IgE antibodies were thought to be important in worsening atopic dermatitis. However, few studies have documented an association between S. aureus or its exotoxins and exacerbations of upper airway/nasal disease. In the current study, we determined the prevalence of serum-specific IgE towards staphylococcal enterotoxin A, B, C, D (SEA, SEB, SEC, SED) and toxic shock syndrome toxin 1 (TSST-1) in patients suffering from rhinitis and/or asthma due to allergy. Therefore, we examined whether SEA, SEB, SEC, SED and TSST-1 were important in worsening the clinical status of patients allergic to house dust mites by means of assessing serum eosinophil cationic protein (ECP), which is thought to be a reliable marker of asthma and rhinitis severity. METHODS: 198 patients with persistent allergic rhinitis and/or asthma due to house dust mites were evaluated. Specific IgE towards SEA, SEB, SEC, SED, TSST-1, timothy grass and birch pollen recombinant allergens, and other aeroallergen extracts from common allergen sources were evaluated by the Pharmacia CAP System. Serum ECP was assessed, too. RESULTS: The percentages of sensitization to staphylococcal enterotoxins of 198 house dust mite-allergic patients were as follows: TSST-1-specific IgE 24.7% (n=49), SEC-specific IgE 22.2% (n=44), SEB-specific IgE 15.1% (n=30), SEA-specific IgE 9.1% (n=18), and SED-specific IgE 5.5% (n=11). Out of 198 individuals allergic to house dust mites 136 patients suffering from persistent rhinitis were subdivided into two subgroups: 53 patients with serum-specific IgE to at least one staphylococcal enterotoxin and 83 patients without specific IgE towards staphylococcal enterotoxins. Patients sensitive to staphylococcal enterotoxins had higher serum ECP levels than patients lacking specific IgE to SEA, SEB, SEC, SED and TSST-1(geometric mean 24.3 vs. 16.6 microg/100 ml; p=0.029), as well as total IgE levels (geometric mean 564 vs. 161 kU/l, p=0.00063) and specific IgE to Dermatophagoides pteronyssinus (geometric mean 16.7 vs. 6.6 kU/l; p=0.0235) and Dermatophagoides farinae (geometric mean 18.6 vs. 7.8 kU/l; p=0.0246). CONCLUSION: A status of sensitization to staphylococcal enterotoxins seems to be a factor increasing serum ECP, which is thought to be a reliable marker of clinical severity of allergic disease. Therefore, the evaluation of SEA, SEB, SEC, SED and TSST-1-specific IgE antibodies may have additional significance for the prognosis of persistent allergic diseases of the upper airway.

A multicenter prospective evaluation of 2-months loaded Osseotite implants placed in the posterior jaws: 3-year follow-up results.

In this prospective study, the clinical outcome of 2-months loaded implants placed in the posterior jaws was evaluated after up to 3 years of functional loading. 405 Osseotite implants with microtextured acid-etched surface were consecutively placed in 11 fully and 164 partially edentulous patients (mean age 53.5 +/- 15.3 (S.D.) years) using a one-stage technique. 282 implants, supporting 154 restorations, were placed in the mandible, while 123 implants, supporting 75 restorations, were placed in the maxilla. A total of 99 single-tooth restorations, 119 short-span fixed bridges and 11 full-arch prostheses were applied. The mean time interval from surgery to connection of provisional restoration was 2.0 +/- 0.7 months. 9 failures were reported up to 3 years of follow-up; of these, 4 mandibular and 2 maxillary implants failed during the initial healing period (before prosthesis connection), while 3 mandibular implants failed after loading. No other complications occurred throughout the study. Life table analysis showed a cumulative survival rate of 97.5% for the mandible and 98.4% for the maxilla. Post-loading implant survival rate was 98.9% for the mandible and 100% for the maxilla. The excellent outcome of this interim report suggests that microtextured Osseotite implants in the posterior jaws may safely bear a functional load applied 2 months after insertion. The results of the present study are particularly encouraging for implants placed in the maxilla, since both a significant reduction of the healing period compared to the 6 months suggested by the classical Brånemark protocol, and an excellent post-loading function may be achieved also in low quality bone.