The oral microbiome in alcohol use disorder: a longitudinal analysis during inpatient treatment.

BACKGROUND: Alcohol use disorder (AUD)-induced disruption of oral microbiota can lead to poor oral health; there have been no studies published examining the longitudinal effects of alcohol use cessation on the oral microbiome. AIM: To investigate the oral microbiome during alcohol cessation during inpatient treatment for AUD. METHODS: Up to 10 oral tongue brushings were collected from 22 AUD patients during inpatient treatment at the National Institutes of Health. Alcohol use history, smoking, and periodontal disease status were measured. Oral microbiome samples were sequenced using 16S rRNA gene sequencing. RESULTS: Alpha diversity decreased linearly during treatment across the entire cohort (P = 0.002). Alcohol preference was associated with changes in both alpha and beta diversity measures. Characteristic tongue dorsum genera from the Human Microbiome Project such as Streptococcus, Prevotella, Veillonella and Haemophilus were highly correlated in AUD. Oral health-associated genera that changed longitudinally during abstinence included Actinomyces, Capnocytophaga, Fusobacterium, Neisseria and Prevotella. CONCLUSION: The oral microbiome in AUD is affected by alcohol preference. Patients with AUD often have poor oral health but abstinence and attention to oral care improve dysbiosis, decreasing microbiome diversity and periodontal disease-associated genera while improving acute oral health.

Mobile Health Technology Can Objectively Capture Physical Activity (PA) Targets Among African-American Women Within Resource-Limited Communities-the Washington, D.C. Cardiovascular Health and Needs Assessment.

BACKGROUND: Little is understood about using mobile health (mHealth) technology to improve cardiovascular (CV) health among African-American women in resource-limited communities. METHODS: We conducted the Washington, D.C. CV Health and Needs Assessment in predominantly African-American churches in city wards 5, 7, and 8 with the lowest socioeconomic status based on community-based participatory research (CBPR) principles. The assessment measured CV health factors: body mass index (BMI), fasting blood glucose and cholesterol, blood pressure, fruit/vegetable (F/V) intake, physical activity (PA), and smoking. Participants were trained to use a PA monitoring wristband to measure 30 days of PA, wirelessly upload the PA data to hubs at the participating churches, and access their data from a church/home computer. CV health factors were compared across weight classes. RESULTS: Among females (N = 78; 99 % African-American; mean age = 59 years), 90 % had a BMI categorized as overweight/obese. Across weight classes, PA decreased and self-reported sedentary time (ST) increased (p ≤ 0.05). Diastolic blood pressure and glucose increased across weight classes (p ≤ 0.05); however, cholesterol, glucose, and BP were near intermediate CV health goals. CONCLUSIONS: Decreased PA and increased ST are potential community intervention targets for overweight and obese African-American women in resource-limited Washington D.C. areas. mHealth technology can assist in adapting CBPR intervention resources to improve PA for African-American women in resource-limited communities.

Minimal femoral cortical thickness necessary to prevent perforation by ultrasonic tools in joint revision surgery.

Ultrasonic tools are effective in removing cement in revision surgery and almost eliminate perforation of the femoral shaft, a dangerous complication associated with cement removal using drills, chisels, osteotomes, and other tools. Clinically, the ultrasonic tool used to remove cement could not be passed through a relatively normal femoral cortex; however, a perforation occurred in a patient with a femoral cortex less than 1 mm thick. The purpose of this study was to determine how thin the femoral cortex can be and yet allow the safe use of ultrasonic tools to remove cement without the risk of perforation. A cement mantle was constructed in the intramedullary canal of human cadaver femurs. Each specimen was mounted on a jig, which was then fastened to a Materials Testing System (Minneapolis, MN). The average load generated across the cortex by the ultrasonic tools while removing cement was measured. Loads of varying magnitudes were then applied by the ultrasonic tools to femoral cortices of varying thickness. When the cortex measured 3 mm thick, perforation did not occur. When the cortex measured 2 mm, perforation was possible but required loads three to six times greater than those normally used to remove cement.

Biomechanical analysis of patellar tendon allografts as a function of donor age.

We evaluated the biomechanical properties of patellar tendon allografts from donors aged 18 to 55 years. Bone-patellar tendon-bone complexes were harvested from acceptable donors and processed. Fat and soft tissue were removed, and the tendons were sectioned lengthwise leaving the central third. Area measurements were taken, and mechanical testing was performed. Specimens were pulled to failure at a rate of 10% of the initial length per second. The force at failure, tensile stress, modulus of elasticity, and percent elongation were determined for each specimen. There was no significant correlation (P > 0.05) between age and any of the mechanical properties. Load at failure ranged from 2110 to 4650 N, with a mean of 3424 N. Regression analysis showed slightly decreasing tensile stress with increasing age, but the correlation was not significant. It appears that patellar tendon allografts from donors up to age 55 have similar mechanical properties.

Effect of an ultrasonic device on temperatures generated in bone and on bone-cement structure.

Cement removal during revision arthroplasty can be a tedious, time-consuming process. The usual methods of removing cement include high-speed drills, chisels, saws and reamers, which are often associated with fracture and/or perforation of the femoral shaft. Ultrasound has been used in dentistry to remove plaque and in ophthalmology to remove cataracts and is now applied to cement removal in orthopaedic surgery. There is little data available on the effect of ultrasound on temperatures generated in bone and on its effects on the structure of bone-cement. A cement mantle was constructed in the intramedullary canal in each of six 10 cm lengths of human cadaver femora. A temperature probe was then inserted into predrilled holes and temperatures generated by the ultrasonic device were recorded under a variety of conditions. In addition, a cement cylinder was microscopically evaluated after an ultrasonic tool had been inserted. Temperatures generated by the ultrasonic tool in cadaver bone were no higher than previously reported temperatures of 140 degrees C generated by high-speed drills. Furthermore, temperatures at the bone-cement interface never exceeded 60 degrees C when saline irrigation was used in conjunction with the ultrasonic tools, and were below 40 degrees C 1 minute after deactivation of the device. Microscopic examination shows that ultrasound produced local changes in the structure of bone-cement converting it from a microscopically spherical interlocked material to one that appears homogeneous and granular.