Reasons for failure of total temporomandibular joint replacement: a systematic review and meta-analysis.

The aim of this study was to evaluate the revision rate after total alloplastic temporomandibular joint replacement (TMJR) and determine whether there is a higher risk of revision surgery with stock or custom-fitted prostheses (the two most current TMJR prosthesis types). A systematic review was performed, with a search of PubMed, Google Scholar, and the Cochrane Library in November 2020. Overall, 27 articles were included in this study, describing Biomet and TMJ Concepts prostheses and including postoperative data on complications requiring a return to the operating room. A total of 2247 prostheses were analysed: 1350 stock Biomet prostheses and 897 custom-fitted TMJ Concepts and custom-fitted Biomet prostheses. The global revision rate was 1.19 per 100 prosthesis-years. The most common reason for revision was heterotopic bone formation. Stock prostheses appeared to have a lower risk of revision compared to custom prostheses: rate ratio 0.52 (95% confidence interval 0.33-0.81, P-value 0.003). Regarding causes of revision, the only significant difference between the types of devices was a higher rate of heterotopic bone formation for custom-made prostheses (P = 0.001). The results of this study revealed a low revision rate post TMJR revision, with stock devices even less prone to such risk. Nevertheless, these results can be explained by the fact that custom-made prostheses are more likely to be used for cases in which the anatomy is significantly abnormal or there is a history of multiple joint surgeries, which carry a greater risk of complications and heterotopic bone formation.

Torção de cólon em um felino doméstico: relato de caso / Colon torsion in a domestic cat: case report

A torção de cólon em felinos é uma patologia rara. Os principais sinais apresentados são de abdome agudo e podem levar o animal rapidamente a óbito. O presente trabalho tem o objetivo de relatar um caso de torção de cólon em um felino. Este é o primeiro relato dessa enfermidade no Brasil. O diagnóstico foi realizado por meio do histórico e de exames de imagem. O animal foi encaminhado para a cirurgia, mas, devido à gravidade e extensão das lesões intestinais, foi realizada a eutanásia.(AU)

Colon torsion in felines is a rare pathology. The main signs presented are of acute abdomen and the condition can quickly lead to death. This paper aims to report a case of twisted colon in a feline. This is the first report of colon torsion in Brazil. The presumptive diagnosis was made through history and imaging. The patient was submitted to surgery, where, due to severity and extent of lesions, euthanasia was performed.(AU)

Amino acid supplementation is anabolic during the acute phase of endotoxin-induced inflammation: A human randomized crossover trial.

BACKGROUND & AIMS: Inflammation is catabolic and causes muscle loss. It is unknown if amino acid supplementation reverses these effects during the acute phase of inflammation. The aim was to test whether amino acid supplementation counteracts endotoxin-induced catabolism. METHODS: Eight young, healthy, lean males were investigated three times in randomized order: (i) normal conditions (Placebo), (ii) endotoxemia (LPS), and (iii) endotoxemia with amino acid supplementation (LPS + A). Protein kinetics were determined using phenylalanine, tyrosine, and urea tracers. Each study day consisted of a four-hour non-insulin stimulated period and a two-hour hyperinsulinemic euglycemic clamp period. Muscle biopsies were collected once each period. RESULTS: Endotoxin administration created a significant inflammatory response (cytokines, hormones, and vital parameters) without significant differences between LPS and LPS + A. Whole body protein breakdown was elevated during LPS compared with Placebo and LPS + A (p < 0.05). Whole body protein synthesis was higher during LPS + A than both Placebo and LPS (p < 0.003). Furthermore, protein synthesis was higher during LPS than during Placebo (p < 0.02). Net muscle phenylalanine release was markedly decreased during LPS + A (p < 0.004), even though muscle protein synthesis and breakdown rates did not differ significantly between interventions. LPS + A increased mammalian target of rapamycin (mTOR) phosphorylation (p < 0.05) and eukaryotic translation factor 4E-binding protein 1 (4EBP1) phosphorylation (p = 0.007) without activating AMPK or affecting insulin signaling through Akt. During insulin stimulation net muscle phenylalanine release and protein degradation were further reduced. CONCLUSIONS: Amino acid supplementation in the acute phase of inflammation reduces whole body and muscle protein loss, and this effect is associated with activation of mTOR and downstream signaling to protein synthesis through mTORC1, suggesting a therapeutic role for intravenous amino acids in inflammatory states. CLINICAL TRIAL REGISTRY: The Central Denmark Region Ethics Commitee (1-10-71-410-12) www.clinicaltrials.gov (identification number NCT01705782).

Mutations in the TLR3 signaling pathway and beyond in adult patients with herpes simplex encephalitis.

Herpes simplex encephalitis (HSE) in children has previously been linked to defects in type I interferon production downstream of Toll-like receptor (TLR)3. In the present study, we used whole-exome sequencing to investigate the genetic profile of 16 adult patients with a history of HSE. We identified novel mutations in IRF3, TYK2 and MAVS, molecules involved in generating innate antiviral immune responses, which have not previously been associated with HSE. Moreover, data revealed mutations in TLR3, TRIF, TBK1 and STAT1 known to be associated with HSE in children but not previously described in adults. All discovered mutations were heterozygous missense mutations, the majority of which were associated with significantly decreased antiviral responses to HSV-1 infection and/or the TLR3 agonist poly(I:C) in patient peripheral blood mononuclear cells compared with controls. Altogether, this study demonstrates novel mutations in the TLR3 signaling pathway in molecules previously identified in children, suggesting that impaired innate immunity to HSV-1 may also increase susceptibility to HSE in adults. Importantly, the identification of mutations in innate signaling molecules not directly involved in TLR3 signaling suggests the existence of innate immunodeficiencies predisposing to HSE beyond the TLR3 pathway.

Platelets in cancer. From basic research to therapeutic implications.

Platelets are well-known for their major role in primary hemostasis and thrombosis. Cancer patients frequently manifest thrombotic events and present abnormalities in blood coagulation which appear to be linked to altered platelet function and turnover. Moreover, numerous studies indicate an intimate cross-talk between platelets and tumor growth, angiogenesis and metastatic dissemination. Finally, several experimental data and clinical trials suggest possible benefits of anti-platelet drugs on some cancers. Here, we will review the current state of basic biological research regarding the role of platelets in cancer progression. We also critically review the possible clinical applicability of some anti-platelet therapies to limit tumor growth and prevent metastatic dissemination.

Experimental infection of wild-caught European rabbits (Oryctolagus cuniculus) with Sarcoptes scabiei from a naturally infected wild rabbit.

Scabies was recently reported for the first time in the European wild rabbit, Oryctolagus cuniculus (Lagomorpha: Leporidae). We experimentally exposed 10 seronegative wild-caught rabbits to skin from a mangy wild rabbit. Serological, physiological, parasitological and histopathological changes were recorded. Three rabbits developed antibodies at 2-5 weeks post-infection (w.p.i.), two of which then developed lesions at 7 w.p.i. One of these had a small area of alopecia on the hind limb that healed naturally within 1 week; the other developed more extensive lesions restricted to the hind limbs (as typically observed in wild rabbits) that lasted until the rabbit died (12.5 w.p.i.). The third rabbit died of trauma 5 w.p.i. before developing any lesions. Antibodies in the healed rabbit disappeared from serum at 8 w.p.i., whereas antibody levels in the sick rabbit increased until its death. Disseminated intravascular coagulation and hepatic necrosis, probably arising from a concomitant infection with rabbit haemorrhagic disease virus, were the likely final cause of death in this rabbit. The mangy rabbit that served as a donor died of a multifocal fibrinosuppurative pneumonia that may have been secondary to the skin bacterial pyoderma.

[The outcome of pervasive development disorders after the adolescence]. / Le devenir des troubles envahissants du développement après l'adolescence.

Until the end of the 20th century, the medical literature was very pessimistic concerning the clinical and natural course of autistic spectrum disorders from childhood to adulthood. Fortunately, during the last decade, we met dramatic turnovers in the domain of pervasive developmental disorders, especially in terms of prevalence (now estimated at about 1 % of the population). Besides, for the first time, we are now able to build a strong link between recent genetic discoveries, the neurophysiopathology of autism and new subsequent therapeutic tools.

Evaluation of single and double centrifugation tube methods for concentrating equine platelets.

The aim of this study was to evaluate single and double centrifugation tube methods for concentrating equine platelets. Whole blood samples were collected from clinically normal horses and processed by use of single and double centrifugation tube methods to obtain four platelet concentrates (PCs): PC-A, PC-B, PC-C, and PC-D, which were analyzed using a flow cytometry hematology system for hemogram and additional platelet parameters (mean platelet volume, platelet distribution width, mean platelet component concentration, mean platelet component distribution width). Concentrations of transforming growth factor beta 1 (TGF-beta(1)) were determined in all the samples. Platelet concentrations for PC-A, PC-B, PC-C, and PC-D were 45%, 44%, 71%, and 21% higher, respectively, compared to the same values for citrated whole blood samples. TGF-beta(1) concentrations for PC-A, PC-B, PC-C, and PC-D were 38%, 44%, 44%, and 37% higher, respectively, compared to citrated whole blood sample values. In conclusion, the single and double centrifugation tube methods are reliable methods for concentrating equine platelets and for obtaining potentially therapeutic TGF-beta(1) levels.

Virulence exaltation of Clostridium perfringens strains from bovines

Ten out of eighty-nine strains biochemically identified as Clostridium perfringens, isolated from bovine organs, were selected by their different results showed in toxigenicity test on mice. Those and the standard strains, ATCC types A, B, C, and D, had their virulence exalted through serial intramuscular inoculation into guinea pigs. Results showed that, for toxigenic strains (6), one or two passages were enough to cause exaltation, while for the atoxigenic (4), five or six inoculations were needed. Esterase electrophoresis of standard and isolated strains, with and without exaltation, was performed. Electrophoresis analysis permits the following conclusions: strains that do not show any clinical symptoms in mice, when exalted demonstrate decreased esterase activity; on the contrary, it is increased when correlated with animal symptoms.

Esterase electrophoresis of Clostridium perfringens bovine strains

Eighty-nine of 144 isolates of Clostridium perfringens abtained from 187 samples of 71 bovine in several Brazilian states were submitted to esterase electrophoresis for typing. Mobilites electrophoresis, as parameter, were settled down by isolates from ATCC pattern of types A, B, C, and D. Of the 89 isolates, 43 (48.3 per cent) were characterized as electrophoretic type A, 20 (22.5 per cent) as D, 18 (20.2 per cent) as C, and 3 (3.4 per cent) as B. Five (5.6 per cent) isolates did not identity with any type. Similarly esterase electrophoresis enabled the typing of 94.4 per cent of the isolates, demonstrating to be an appropriate method for animal sample analyses.

Toxigenicity characterization of Clostridium perfringens from bovine isolates

Clinical samples from 71 bovine from different Brazilian states were processed for the analysis of anaerobe organisms with emphasis on the isolation and characterization of Clostridium spp. From these eighty-nine Clostridium perfringens strains were recovered: 32 from liver, 19 from intestinal contents, 14 from kidney, 6 from rumen, 5 from nervous system, 4 from bone marrow, 2 from udder tract, blood, spleen and lung, and one from muscle. Four reference Clostridium perfringens types A, B, C, and D were used as controls in this study. All isolates were cultivated in appropriate media, and after centrifugation the supernatant and sediment were separated. From pure supernatant post exopolysaccharide (EPS) extraction, mouse toxigenicity tests were performed, determining protein and protein plus carbohydrate, respectively. ELISA was performed from sediments. The results showed that 51 (57.3 per cent) of the isolates were toxigenic to mice when inoculated by intraperitoneal route; bacteria from different organs had variable patterns of toxigenicity. Toxigenicity of EPS extracts was only expressed when protein concentration was 0.04 mg/mL and between 0.31 and 0.5 mg/mL for carbohydrate. Isolates were characterized as toxigenic when showing optimum protein and carbohydrate concentrations.

[Workload, gender and age among personnel with reported sudden lifting injuries]. / Arbejdsbelastninger, køn og alder blandt personer med anmeldte pludselige løfteskader, 1998.

INTRODUCTION: In 1996 the Danish Parliament passed a new Act on industrial injuries, including the so-called sudden lifting injuries. This type of lifting injury had been experienced in some industries in connection with lifting situations causing sudden pain in the back. Less frequently, other regions of the body may be affected. This study is a distribution of a sample of reported industrial injuries of this type in groups according to types of lifts. The study also includes a comparison with parameters from the Danish Work Environment Cohort Study. MATERIAL AND METHODS: The sample consisted of a total of 482 cases of back injuries. Of these, 346 cases were distributed according to six categories of manual lifting work and to age and gender. The rest, 136 cases, were excluded for technical reasons. RESULTS: In the distribution, 8% of the cases were in jobs with many heavy lifts, 66% of the cases were in jobs with moderate daily lifted weights or in jobs with only few or light lifts. Approximately 25% of cases concerned employees performing patient transfers. The distribution contained more men than the Danish Work Environment Cohort Study, and the persons in the cases were slightly older than this reference population. DISCUSSION: Altogether, this study points towards an occurrence of sudden lifting injuries among employees performing certain types of manual lifting work. The industrial injuries cases may have been subject to some selection.

The roles of the Drosophila JAK/STAT pathway.

The JAK/STAT signal transduction pathway has been conserved throughout evolution such that true structural and functional homologues of components originally identified in vertebrate systems are also present in the model genetic system Drosophila melanogaster. In addition to roles during larval hematopoiesis reminiscent of the requirement for this pathway in mammalian systems, the JAK/STAT pathway in Drosophila is also involved in a number of other developmental events. Recent data has demonstrated further roles for the JAK/STAT pathway in the establishment of sexual identity via the early embryonic expression of Sex lethal, the segmentation of the embryo via the control of pair rule genes including even skipped and the establishment of polarity within the adult compound eye via a mechanism that includes the four jointed gene. Use of the powerful genetics in the model organism Drosophila may identify new components of the JAK/STAT pathway, define new roles for this pathway, and provide insights into the function of this signal transduction system. Here we review the roles of STAT and its associated signaling pathway during both embryonic and adult stages of Drosophila development and discuss future prospects for the identification and characterization of novel pathway components and targets. Oncogene (2000).

Relation between job strain and myocardial infarction: a case-control study.

OBJECTIVES: To study the influence of different job related and socioeconomic factors for development of myocardial infarction (MI). METHOD: The study was a case-control study of 76 male wage earners who had been admitted to hospital with MI. As a control group 176 male wage earners not admitted to hospital who were residents of the same county were used. Both groups were interviewed with an extensive questionnaire on job related conditions. Several indices on job related psychosocial factors were established in accordance with Karasek's job strain model as well as the extension of the model, the isostrain model. RESULTS: The most significant findings were consistent with Karasek's job strain model in that mean with a high degree of demand combined with a low degree of control at work had a significantly increased odds ratio (OR) 95% confidence interval (95% CI) of 2.1 (1.2 to 3.8) for MI after adjustment for age compared with men with a low degree of demand and a high degree of control at work. Further adjustment for smoking, socioeconomic status, employment sector, job category, and social network did not affect the OR substantially (OR 2.3 (1.2 to 4.4)). Other factors significantly associated to MI were job category (blue collar workers v white collar workers, OR 2.8 (1.6 to 5.8)), and employment sector (private v public, OR 3.1 (1.8 to 6.1)). CONCLUSIONS: Thus, the study confirmed the job strain model as well as the well known association between socioeconomic status and risk of MI, whereas the finding of an increased risk among employees in the private sector has not previously been described.

Work-related eye symptoms and respiratory symptoms in female cleaners.

A prospective study was conducted in order to describe the incidence of eye symptoms, nose or throat symptoms, asthma and bronchitis among cleaners compared with former cleaners and according to the 'use of sprayers'. In 1989 and in 1991 questionnaire-based studies were conducted among female cleaners employed at Danish nursing homes, schools and offices. A cohort of 1,011 females was followed over two years. At baseline in 1989, the average age was 45 years and the average of seniority was 10 years. Overall, the cleaners tended to have the same or higher risk of developing respiratory symptoms compared to former cleaners. The 'use of sprayers' during the follow-up period was associated with an increased risk of eye and respiratory symptoms.

Purification and characterization of toxins from wheat isolates of Drechslera tritici-repentis, Bipolaris bicolor, and Bipolaris sorokiniana

Low molecular weight metabolites produced by Bipolaris bicolor, Bipolaris sorokiniana, and Drechslera tritici-repentis are considered to be toxins that facilitate disease in wheat cultivars. Several such toxins were isolated from these fungi. Electrophoresis demonstrated bands of proteins that reduce shoot inhibition in susceptible plants but not in resistant plants. Chlorophyll content was reduced during the first 10 hours of light in the susceptible plants and after 18 hours in the resistant plants. The enzyme beta-1,3-glucanase increased in the resistant plants after treatment with toxins, but in the susceptible plants this enzyme decreased compared to the control. This suggests that the toxin was a protein and the susceptible plants needed other mechanisms for induce resistance.

Cancer incidence in urban bus drivers and tramway employees: a retrospective cohort study.

OBJECTIVE: To investigate the risk of cancer associated with exposure to air pollution among bus drivers and tramway employees. METHODS: A retrospective cohort study of 18,174 bus drivers or tramway employees in Copenhagen in the period 1900-94. Data on employment were obtained from company files. Information on cancer was obtained from the Danish Cancer Registry. RESULTS: Findings showed that bus drivers or tramway employees had an increased risk of all malignant neoplasms (standardised incidence ratio (SIR) 1.24, 95% confidence interval (95% CI) 1.19 to 1.30). The relative risk was significantly increased for both men and women (SIR 1.24, 95% CI 1.19 to 1.30 and 1.28, 1.06 to 1.53, respectively). People employed for < 3 months had no increased risk of cancer (1.04, 0.81 to 1.31). For men who were employed for > 3 months the risk of lung cancer (1.6, 1.5 to 1.8), laryngeal cancer (1.4, 1.0 to 1.9), kidney cancer (1.6, 1.3 to 2.0), bladder cancer (1.4, 1.2 to 1.6), skin cancer (1.1, 1.0 to 1.2), pharyngeal cancer (1.9, 1.2 to 2.8), rectal cancer (1.2, 1.0 to 1.5) and liver cancer (1.6, 1.2 to 2.2) was significantly increased. For women employed for > 3 months the risk of lung cancer was significantly increased (2.6, 1.5 to 4.3). CONCLUSION: This cohort study shows that bus drivers and tramway employees are at an increased risk of developing several types of cancer. This might be due to the exposure to air pollution during working hours or to other risk factors, primarily smoking.

CD34+ cell dose and CD33- subsets: collection and engraftment kinetics in autologous peripheral blood stem cells transplantation.

BACKGROUND AND OBJECTIVE: We analyzed the factors that affected the number and quality of peripheral blood stem cells (PBSC) collected for transplant in order to establish a minimum threshold for rapid hematopoietic recovery. DESIGN AND METHODS: From January 1995 to November 1996, a consecutive series of 67 patients, with hematologic and solid tumors underwent autologous PBSC transplantation. Collection of PBSC was performed after mobilization with granulocyte-colony stimulating factor (G-CSF) or with chemotherapy (CT) plus G-CSF. We calculated the factors that influenced PBSC collection, the kinetics of granulocyte and platelet recovery and the threshold value of CD34+ cells for a rapid recovery. The data were analyzed by means of multivariate Cox regression model and the receiver operating characteristic (ROC) methodology. RESULTS: Our results showed that mobilization with chemotherapy plus G-CSF was associated with a higher yield of PBSC in comparison with mobilization with G-CSF alone. Disease status, fewer cycles of conventional prior chemotherapy and absence of prior radiation therapy also influenced the yield of PBSC. The number of CD34+ cells, CD34+CD33- cell subsets, the mobilization schedule, and the conditioning regimen correlated significantly with time to hematopoietic recovery. In the multivariate analysis only the CD34+CD33- cell content and the total number of CD34+ were related with rapid neutrophil and platelet recovery, respectively. Use of G-CSF after transplant significantly shortened the neutrophil recovery time only in patients transplanted with suboptimal dose of PBSC. INTERPRETATION AND CONCLUSIONS: These data suggest the utility of quantitation of CD34+ cells subsets to predict quick engraftment.