Histologic Distribution of Lung and Bronchus Tumors: A Population-Based Study in the Upper Peninsula of Michigan.

INTRODUCTION: Lung cancer remains the leading cause of cancer-related mortality in the United States, with cigarette smoking recognized as the most important modifiable risk factor. The distinct smoking rates and occupational landscape in the Upper Peninsula of Michigan underscore the necessity of investigating the multifactorial influences on the prevalence and distribution of lung and bronchus cancer within this population. METHODS: This study, conducted from January 2012 to December 2022, included 1035 patients diagnosed with lung or bronchus tumors who were first seen and/or received the first course of treatment at Upper Peninsula Health Systems (UPHS) - Marquette, the largest hospital system in the Upper Peninsula of Michigan and one of only two radiation oncology treatment centers in the Upper Peninsula. RESULTS: This study demonstrated that the histologic trend of lung and bronchus cancers in a sample of 1035 patients in the Upper Peninsula of Michigan closely resembles that of national averages. Participants with a lifetime history of smoking made up 943 (91.1%) cases of patients diagnosed with lung or bronchus cancers in this study. Lifetime non-smokers only made up 53 (5.1%) cases of patients diagnosed with lung or bronchus cancers. The median age at diagnosis of participants in this study was 70 years. CONCLUSION: Our study provides significant insights into the histologic distribution of lung and bronchus cancers within the Upper Peninsula of Michigan, addressing a notable gap in the current literature for this rural and medically underserved population. The histologic distribution of lung and bronchus cancers in this region aligns with national trends. Furthermore, the distinct rates of cigarette smoking in the Upper Peninsula emphasize the critical role of smoking cessation efforts in reducing the burden of lung and bronchus cancers in this region.

A Case of a Testicular Tumor Histologically Described as a Seminoma in a Patient With an Elevated Serum Alpha-Fetoprotein.

Seminomas and non-seminomas are distinct categories of germ cell tumors arising from the testicles. This case report describes a rare occurrence of a testicular tumor exhibiting histologic characteristics of a seminoma in a 39-year-old male patient who simultaneously has an elevated serum alpha-fetoprotein (AFP). The staging characteristics of this tumor was pT1bNxM0, stage IS. This patient was treated with a right radical orchiectomy and adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. This case report describes the histologic, laboratory, and imaging findings as well as the treatment and surveillance of this patient.

Incidentally Discovered Aortic Thrombosis in a Patient Undergoing Capecitabine and Oxaliplatin Chemotherapy for Colon Cancer.

This case report describes a 68-year-old male who presented to the emergency department (ED) with nausea, vomiting, abdominal pain, diarrhea, and fatigue after starting adjuvant combination chemotherapy with capecitabine and oxaliplatin two weeks prior. Further evaluation of this patient in the ED revealed an incidentally discovered aortic thrombosis, of which this patient did not exhibit any specific symptoms. This case, among a few others, has described the development of arterial thrombosis in patients with cancer undergoing combination chemotherapy with capecitabine and oxaliplatin.

Hypnopedia in Pediatric Dentistry: A Concept That Warrants Exploration.

Scientists throughout the world have been intrigued by the concept of hypnopedia or sleep learning. This concept was initially thought to be useful in learning new languages when heard during sleep. While having been in and out of favor with researchers over the years, recent evidence has supported the possibility that hypnopedia can actually take place. Although researchers propose that no one simply can learn new facts and figures in sleep without first being aware of them, the concept of targeted memory reactivation might help to reinforce things that an individual might learn when asleep. Evidence suggests that subtle sounds presented during sleep, such as repetitive statements and encouraging words, can strengthen memory processing. This concept may be useful in pediatric dentistry in an effort to help children, especially uncooperative ones, improve their behavior while being administered dental treatment.

Development and evaluation of novel krill oil-based clomiphene microemulsion as a therapeutic strategy for PCOS treatment.

Polycystic ovary syndrome (PCOS) is frequently diagnosed hormonal disorder with reproductive and metabolic complications. The most common symptoms include cyst in ovaries, anovulation, insulin resistance, and obesity. Clomiphene citrate, an ovulating agent, is the first-line drug used to treat PCOS. We hypothesized that clomiphene citrate, by stimulating ovarian function, with krill oil used as an oil phase to improve solubility, by addressing PCOS-associated symptoms might be effective in PCOS. Hence, our goal was to target hormonal imbalance along with PCOS-associated symptoms using a single formulation. The concentration of water (X1), oil (X2), and Smix (surfactant-cosurfactant mixture) (X3) were selected as independent variables, in a simplex lattice design, from microemulsion area derived from a pseuodoternary phase diagram while the globule size (Y1) was selected as a dependent parameter. The optimized microemulsion showed good sphericity having 41 nm globule size, 0.32 poly dispersibility index and + 31 mV zeta potential. The optimized microemulsion was further evaluated in-vivo using letrozole-induced PCOS rats. Formulation treated group reversed the effect of letrozole on body weight and estrus cycle in comparison to the disease control group (p < 0.001). The formulation was also effective in reducing insulin resistance, cholesterol and serum testosterone level (p < 0.001). The in vivo results were supported by histopathological studies where the formulation-treated group showed a marked decrease in the number of cystic follicles and a remarkable increase in the number of growing follicles at variable stages, similar to the normal control group. Thus, the results confirmed that novel krill oil-based clomiphene microemulsion may become a promising therapeutic choice for the treatment of PCOS.

Minimally invasive techniques for sinus floor elevation using dental implants among Indians.

It is of interest to compare conventional lateral window technique, trans-alveolar technique with minimally invasive technique like modified trephine technique and antral membrane balloon elevation technique for sinus floor elevation in placement of dental implants. The current study included 140 participants (191 dental implants) who had maxillary posterior edentulous regions and had low sinuses and insufficient alveolar ridges but had chosen an implant-retained prosthesis. The minimally invasive techniques of sinus augmentation can be suitable alternative to conventional traumatic techniques due to low incidence of pain, gingival swelling. Moreover, the success rate of implants and increase in total bone height was almost same in minimally invasive techniques of sinus augmentation as compared to conventional traumatic techniques.

Comparative Evaluation of the Antimicrobial Activity of NeoPutty MTA and Modified NeoPutty MTA: An In Vitro Study.

Aim: Mineral trioxide aggregate (MTA) is a relatively new versatile dental material. MTA has many advantages as well as disadvantages. To reduce most of the drawbacks of MTA, a premixed bioceramic MTA, NeoPutty MTA, was introduced in 2020. In this study, we assessed the antimicrobial activity of the newer MTA, NeoPutty MTA. We modified NeoPutty MTA and compared both against Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Materials and Methods: Using the agar diffusion method, NeoPutty MTA was tested for antibacterial activity against the above-mentioned microorganisms. A base layer of Petri plates was done using Muller-Hinton agar for S. aureus, E. coli, and P. aeruginosa and brain heart infusion agar for E. faecalis. A total of 32 plates were employed; the plates were divided randomly into four test groups having eight plates each, so microorganisms were tested eight times. Three cavities were made in agar and filled with freshly mixed materials after 24 h. A pour plate seeded the microorganisms. The plates were pre-incubated for 2 h at room temperature and incubated at 37°C for 24 h. An independent observer measured the inhibition zone diameters. Results: NeoPutty MTA, when tested alone, did not show much antibacterial activity against E. faecalis, S. aureus, and E. coli but had significant antimicrobial activity against P. aeruginosa when used at different concentrations. Modified NeoPutty (NeoPutty with antibiotics added individually) showed significant antibacterial activity against these microorganisms, as seen by the zone of inhibition of these bacteria. Conclusion: Modified NeoPutty with antibiotics has a better antimicrobial effect than NeoPutty MTA.

Assessment of clinical depression in abdominally obese subjects with periodontal disease.

Background: Depression is a commonly prevailing condition that goes undetected in clinical settings. Both abdominal obesity and periodontal disease have a bearing on mental health and have an impact on the quality of life. Objective: To assess the level of clinical depression in abdominally obese subjects with periodontal disease. Methods: Two hundred and ten subjects with a mean age of 37.45 ± 9.59 years (males = 117; females = 93) were grouped as per their abdominal obesity and periodontal status and assessed for their clinical depression levels (mental health) using the Centre for Epidemiologic Studies-Depression Scale (CES-D). Collected data were analysed. Results: The clinical depression score significantly varied in subjects with different periodontal status in both non-obese (F (2,102) = 113.66, P < 0.0001) and abdominally obese subjects (F (2,102) = 132.04, P < 0.001). Significantly higher depression score was demonstrated in healthy (P < 0.001), gingivitis (P < 0.001), and periodontitis (P < 0.001) groups in abdominally obese subjects. Conclusion: Clinical depression is significantly associated with abdominal obesity and periodontal disease in subjects with abdominal obesity and severe periodontal disease demonstrating higher depression scores.

The Role of Online Teaching Among the Undergraduate Dental Students During the Current COVID-19 Pandemic in India: A Pilot Study

ABSTRACT Objective: To assess the usefulness of online teaching for undergraduate students during this Corona pandemic, to point the drawbacks of online teaching, and to learn the areas of improvement in online teaching for the future. Material and Methods: A descriptive cross-sectional study on 130 students was done in Bhubaneswar, Odisha, India. The questionnaire consisted of two parts, personal details and specific information. The first part of the questionnaire consisted of questions related to age, gender, etc. The second part had questions pertaining to online teaching. Pearson's Chi-square test was applied and the level of significance was set at 5%. Results: Most of the students (83.3%) were in the view that classroom lectures are the best mean of imparting knowledge, which was significant (p<0.001). A significant number of students (88.1%) agreed that online teaching is the best method of teaching apart from classroom teaching. Almost all the students (93%) agreed significantly that online teaching is the best way to learn in this present pandemic scenario. Most students (59.6%) agreed that connectivity/network issue is a major drawback in online teaching, which is again significant (p<0.001). Conclusion: Here in these testing times, the role of online teaching becomes important for medical/dental students, both undergraduates and postgraduates, to keep up with their studies.

Parental Presence in Dental Operatory as a Behaviour Management Tool on Children in Bhubaneswar, Odisha, India

Objective: To interpret the change in child's behaviour in presence/absence of parents during dental care. Material and Methods: Sixty children were examined till the age of 12 years visiting the out patient department of pediatric dentistry where parents along with the child were allowed in the operatory. After sometime parents were asked to leave and behavioural changes were noted. During revisit again the behaviour was noted according to Frankl scale. McNemar test was applied to test the behaviour response of children with parental absence/presence. The significance level was set at 5 %. Results: In 1st visit, 78.3% showed positive behaviour and 21.7% showed negative behaviour in parental absence, indicating that the child has more likelihood of showing positive behaviour in the presence of parents (p<0.001). More positive behaviour of the children is noticed, when the parents are present in 3 -5 year age group. In other 6-8 and 9-12 year age group, no difference was noticed in the presence or absence of the parents (p>0.05). In second visit, the negative behaviour reduced. When parents were absent 21.7% showed negative behaviour (p=0.000). This indicated that the child has more likelihood of showing positive behaviour in the presence of parents. Age group-wise analysis revealed that in the 3-5 years age group presence or absence of parents is a significant factor for child's behaviour. This factor is a non-issue in the elder age group like 6-8 years and 9-12 years. When the parents are absent, no significant difference was observed (p>0.05). Conclusion: There was no significant difference in parental presence/absence in elder children while the same can't be said for younger children.

Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha.

OBJECTIVE: Early intervention is aimed at preventing or mitigating common pediatric oral diseases and conditions while initiating a relationship between the mother, the child, and the dental caregiver. Every expectant mother should receive oral health education and risk assessment. There are a number of reports that showed the association between oral diseases and preterm, low birth weight, and gestational diabetes. The purpose of this study is to understand the attitude and knowledge regarding prenatal as well as infant oral health care among gynecologists in the medical colleges in Bhubaneswar, Odisha, India. MATERIALS AND METHODS: The study involved a survey involving gynecologists in medical colleges in Bhubaneswar, Odisha. A pretested questionnaire was provided to all the gynecologists (21) working in the medical colleges in Bhubaneswar regarding prenatal and perinatal oral health care. RESULTS: The study gave an idea that most gynecologists working in a medical college in Bhubaneswar, Odisha, India, had adequate knowledge regarding oral health of expectant mothers, but lack in knowledge when it comes to imparting knowledge on infants' health care. CONCLUSION: There is an adequate knowledge among the gynecologists about oral health of expectant mothers and infants, but still, there is a need of a multidisciplinary collaboration among gynecologists, pediatricians, and pediatric dentists to prevent the dental diseases rather than treating them.

Unique metastases of ALK mutated lung cancer activated to the adnexa of the uterus.

Anaplastic lymphoma kinase (ALK) fusion positive non-small cell lung cancer (NSCLC) is a relatively novel molecular subtype in lung cancer. ALK targeted therapies such as crizotinib increase survival benefit in this patient population. However, further understanding of the disease subtype including patterns of metastasis and pathways of treatment resistance are needed. We describe a 50 year-old-woman diagnosed with stage IV NSCLC, T2N3M1b, ALK fusion positive disease. Although her initial sites of metastasis included the liver and bone, her story is notable for crizotinib resistant growth of a metastatic lesion to her adnexa. This report brings to attention unique mechanisms of metastasis in ALK positive patients.

Development of carbamazepine transnasal microemulsion for treatment of epilepsy.

Carbamazepine is widely preferred therapy for the treatment of epilepsy. However, oral therapy results in slower brain uptake and systemic side effects. Intranasal route can achieve faster brain uptake, but poor aqueous solubility of carbamazepine is the main obstacle for administration by nasal route. The purpose of this study was to prepare and evaluate intranasal oil in water microemulsion of carbamazepine to improve its solubility and enhance the brain uptake. Intranasal microemulsion of carbamazepine was prepared by water titration method using oleic acid as oil, Tween 80 as surfactant and Transcutol® as cosurfactant. Microemulsions were evaluated for various physical parameters including globule size, viscosity, pH and conductivity. Toxicity study of microemulsion was carried out by employing sheep nasal mucosa. The microemulsion was also evaluated by maximal electric shock, and the brain uptake study was done using HPLC method. The microemulsion was stable and transparent with average globule size of 21.03 nm and did not show any toxic symptoms. It showed reduction in the hind limb extension phase and faster recovery from seizures in comparison to oral microemulsion and nasal solution. Higher brain/plasma ratio was obtained with nasal microemulsion in comparison to ratio obtained after intraperitoneal injection of carbamazepine solution.

Rare uterine cancers.

The most common malignant tumour of the uterus is endometrioid endometrial cancer. However, many less common malignant diseases also develop in the uterus, including both carcinomas and sarcomas. Most notable of these tumours are papillary serous carcinomas, clear-cell carcinomas, carcinosarcomas, stromal sarcomas, and leiomyosarcomas. These less common cancers can be aggressive, and account for a greatly disproportionate amount of deaths from uterine cancers. Because they are uncommon, physicians will usually have seen only a few cases, and randomised data to guide treatment often do not exist. This review summarises the epidemiology, clinical characteristics, and prognoses of the less common malignant diseases of the uterus, and presents the information available to guide the clinician about treatment options.