Clinical features of gingival lesions in patients with dystrophic epidermolysis bullosa: a cross-sectional study.

BACKGROUND: Gingival lesions in patients with dystrophic epidermolysis bullosa (DEB) are a common manifestation. However, their clinical features, frequency and severity are currently unknown. METHODS: Forty-five DEB patients were assessed by an oral medicine specialist, who analysed the presence/absence of four clinical signs (erythema, erosion/ulcer, atrophy, blister) on free and attached gingiva, using the Epidermolysis Bullosa Oropharyngeal Severity score. RESULTS: Twenty-eight (62.2%) out of 45 DEB patients showed different types of gingival lesions, whose presence/absence and total frequency/distribution were not significantly different between males and females (p=0.087 and p=0.091, respectively). Erythema was the most prevalent lesion (66.2%) and the recessive DEB severe generalized (RDEB-sev gen) reached the highest median disease activity score. A significant correlation was observed between the DEB subtypes and the disease activity median score (p<0.001), but not between age and total disease activity score in each group of DEB (p>0.05). Lastly, logistic regression showed that only gender (p=0.031) and RDEB-sev gen (p=0.001) were risks factors for the presence of gingival lesions. CONCLUSIONS: Gingival lesions in DEB patients are a relatively common entity and may have multiple clinical aspects, emphasizing the need for thorough attention and awareness among dentists.

Genotype-oropharyngeal phenotype correlation in Mexican patients with dystrophic epidermolysis bullosa.

Previous investigations have attempted to correlate the genotype with the cutaneous phenotype in patients with epidermolysis bullosa (EB), but never with the oropharyngeal phenotype. Seventeen dystrophic EB (DEB) patients were genotyped for COL7A1 gene mutations and divided into five distinct groups. Oropharyngeal disease severity was assessed with the Epidermolysis Bullosa Oropharyngeal Severity (EBOS) score by an oral medicine specialist. The genotype-phenotype correlation was calculated by Kruskal-Wallis analysis of variance using the Mann-Whitney test, applying the Bonferroni correction. The most severe oropharyngeal phenotype was found in the group with the 2470insG/3948insT mutation, with a mean disease severity score of 18.50 ± 2.12; the mildest was found in the 6862del16 mutation group, with a mean disease severity score of 0.57 ± 1.13. The most significant difference in median score was found in the total score (P = 0.009), followed by tongue (P = 0.02) and upper lip (P = 0.021), but no correlation was found between disease severity and the groups (P>0.005, after Bonferroni correction). Multiple comparisons among the five different genotypic groups revealed no statistically significant genotype-oropharyngeal phenotype correlation; it was not possible to establish which group was more severe, or to associate a specific mutation to a specific oropharyngeal phenotype.

Hereditary trichilemmal cysts: a proposal for the assessment of diagnostic clinical criteria.

Trichilemmal cysts (TCs) can occur as sporadic lesions or in hereditary-familial settings with autosomal dominant transmission. These entities have not been widely analyzed in their peculiar aspects yet. The aim of this study was to describe a cohort of patients with diagnosis of TCs through a clinical and biomolecular characterization, intended to highlight some effective diagnostic criteria for their identification. Among 149 cases of this study, 24 cases of TCs (16.1%) arose in patients with at least one first-degree relative with diagnosis of TCs. Peculiar findings concerning hereditary lesions included the multiple presentation with an early onset age. On the basis of clinical evaluation, we propose a panel of clinical and histologic criteria for the diagnosis of hereditary TCs, which includes: (i) the diagnosis of TCs in at least two first-degree relatives or in three first- or second-degree relatives in two consecutive generations; (ii) at least one of the patients with TCs diagnosed <45 years; and (iii) the diagnosis of multiple or giant (>5-cm lesions) or rare histopathologic features (proliferating and ossifying) TCs.

Value and prognostic significance of mitotic rate in a retrospective series of pT1 cutaneous malignant melanoma patients.

INTRODUCTION: Patients affected by thin melanomas (≤1mm) generally have a good prognosis; however, some have a recurrence and eventually die of the disease. The seventh edition of the American Joint Committee on Cancer (AJCC) melanoma staging system, introduced mitotic rate (MR) as one of the primary criteria for staging thin melanoma. MATERIALS AND METHODS: In this study, we sought to determine the prognostic value of mitotic rate in a retrospective cohort of localized primary cutaneous melanoma patients. RESULTS: In total, 286 cases of pT1 primary malignant melanoma occurring in the period 2003-2008 were evaluated. Mitotic counts were re-assessed on standard sections of cases without mitosis and with at least 1 mitosis at diagnosis; 5-year follow-up and recurrence-free survival were available for all patients. Of the 56 radically treated pT1b melanoma patients, 4 (7.1%) had recurrent disease. These data support the efficacy of the incorporation of mitogenicity into AJCC staging for localized cutaneous melanoma and indicate the difficulties in the accuracy and reproducibility of the mitotic count system.

Continuity and change in the Mediterranean medical tradition: Ruta spp. (rutaceae) in Hippocratic medicine and present practices.

ETHNOPHARMACOLOGICAL RELEVANCE: Ruta is a genus of Rutaceae family. It features mainly shrubby plants, native to the Mediterranean region and present in traditional medicine of this region since Antiquity. The three most diffused species Ruta chalepensis L., Ruta graveolens L., and Ruta montana (L.) L., are morphologically poorly differentiated and were probably interchangeably used during Antiquity. AIM OF THE STUDY: Hippocratic and contemporary medical applications of the Ruta genus in the Mediterranean were compared to check if they result from a continuity of use from the ancient times to nowadays. RESULTS: Ruta spp. was mainly employed in medical preparations by Hippocratic physicians as an abortifacient and emmenagogue. In addition to gynaecological conditions, in several treatises of the Corpus HippocraticumRuta spp. were also recommended as a specific remedy against pulmonary diseases. Ruta spp. leaves and also roots and seeds, were administered for internal use by Hippocratic physicians after having been soaked in wine or mixed with honey or its derivatives. Contemporary traditional uses of Ruta spp. have been assessed in detail in the whole Mediterranean area. CONCLUSION: Nowadays, Ruta spp. is used to treat different conditions but, as a general rule, the external uses are preferred as the toxicity of the plant is widely acknowledged.

Toxicity of unwanted intermediates and products formed during accidental thermal decomposition of chemicals.

The problem of the formation of unwanted substances that can occur during thermal decomposition of chemicals is studied from a toxicological point of view. Two species, ethyl parathion (a widely used pesticide) and cumene hydroperoxide (an intermediate for the industrial production of phenol and acetone), are selected for this investigation. The hazards associated to their accidental thermal decomposition are estimated on the basis of the (known) intermediates and products formed by means of a computational tool (ECOSAR programme) and assessed experimentally by means of algal bioassays. Green alga Pseudokirchneriella is used as target organism for all the toxicological assessments. The results of these tests on the samples collected during the thermal decomposition of the two studied species indicate that in the case of ethyl parathion the decomposition process gives rise to a mixture of compounds which are more toxic than the parent species. On the other hand, the decomposition of cumene hydroperoxide in cumene results into the formation of different species whose toxicity towards the adopted organism is lower than that shown by the starting compound. A procedure is proposed to ascertain when it is necessary or it is avoidable to carry out further investigations that involve the analytical resolution of mixtures resulting from the thermal decomposition process. This approach is suggested as a preliminary screening to identify the hazards associated with an accidental decomposition either of pure chemicals or of mixtures of compounds.

Biotransformation of ethinylestradiol by microalgae.

The capability of biotransformation of 11 microalgae strains was tested on ethinylestradiol (EE). Seven strains were ineffective whilst Selenastrum capricornutum, Scenedesmus quadricauda, Scenedesmus vacuolatus and Ankistrodesmus braunii biotransformed the substrate. EE was converted by S. capricornutum in three products (ethinylestradiol glucoside, 3-beta-D-glucopyranosyl-2-hydroxyethinylestradiol, and 3-beta-D-glucopyranosyl-6beta-hydroxyethinyl estradiol) in 40%, 5%, and 5% yields, respectively. S. quadricauda transformed EE into 17alpha-ethinyl-1,4-estradien-10,17beta-diol-3-one (12%) and A. braunii transformed EE into 6-alpha-hydroxy-ethinylestradiol (25%). It is noteworthy that EE is converted in 92% yield in ethinylestradiol glucoside by S. capricornutum when using optimal algal density conditions.

Effects of advanced oxidation processes (AOPs) on the toxicity of a mixture of pharmaceuticals.

The possibility of applying main AOP techniques, namely ozonation, H2O2/UV photolysis and TiO2 photocatalysis to provide a significant reduction of toxicity of pharmaceutical mixtures has been evaluated. For the preparation of the mixture six pharmaceuticals were chosen among those found at highest concentrations in Sewage Treatment Plant effluents, namely carbamazepine, clofibric acid, diclofenac, sulfamethoxazole, ofloxacin and propranolol. The blue-green alga Synechococcus leopoliensis and the rotifer Brachyonus calyciflorus were utilised to assess the toxicity of the mixtures after AOP treatments. All the toxicity tests were performed using chronic standardized bioassays. The best results were obtained with ozonation. With this type of treatment a complete removal of mixture toxicity on S. leopolensis was obtained even after the shortest time of application (1 min). The ozonation treatment leads also to removal of all the pharmaceutical mixture toxicity on B. calyciflorus, by applying the oxidizing agent for at least for 2 minutes.

[Extraction and characterization of the lipopolysaccharide of Bartonella quintana] / Estrazione e caratterizzazione del lipopolisaccaride di Bartonella quintana.

Bartonella quintana has been reported as the cause of trench fever, persistent endocarditis, bacteriaemia and has been isolated with an increasing incidence in clinical specimens from AIDS patients. One of the main pathogenic factors of gram-negative bacteria, including B. quintana, is the lipopolysaccharide (LPS). However, very little information is available on the features of Bartonella LPS. The aim of the present study was to extract, purify and characterise B. quintana LPS. The effect of the LPS under scrutiny was also evaluated on TNFa release by means of the "in vitro" human whole blood model of sepsis. The Oklahoma strain of B. quintana was grown on sheep blood agar, at 37 C, in a moist atmosphere containing 5% carbon dioxide. Cells were harvested and washed in sterile and apyrogenic saline solution and LPS extracted following the procedure of Westphal e Jann (1965), modified by Minnick (1994). The LPS of B. quintana showed the migration pattern of a deep rough chemotype, and the chromogenic limulus amoebocyte lysate test (LAL test) revealed strong reactivity at low concentrations (6.2 pg/ml). Samples of human whole blood stimulated by 1000 ng/ml of B. quintana LPS released 1707 378 pg/ml of TNFa.

Medicinal plants for the treatment of urogenital tract pathologies according to Dioscorides' De Materia Medica.

The De Materia Medica of the Greek Dioscorides reports about 200 plants used for the treatment of pathologies of the urogenital tract during the 1st century AD. On the basis of explicit and implicit affirmations by Dioscorides, a theoretical system concerning the specific properties of these plants has been attempted. Comparison of the species reported by Dioscorides and Pliny the Elder for renal affections does not support the thesis of a close relationship between De Materia Medica and the Naturalis Historia.

Action of antialgal compounds fromJuncus effusus L. onSelenastrum capricornutum.

Twenty-nine free and glucosylated dihydrophenanthrenes and tetrahydropyrenes isolated fromJuncus effusus have been tested against the unicellular green algaSelenastrum capricornutum. The free compounds showed a strong inhibitory activity, while the glucosides were inactive or had a slight stimulating effect on growth. Tetrahydropyrene33, obtained by hydrolysis of the naturalß-glucosides29 and30 or by hemisynthesis from1, is the most active compound, causing 90% inhibition of the growth at 2.5 × 10(-5) M concentration. Synthetic α-glucosides28, 31, and32 showed comparable activity to those of29 and30.

Progesterone bioconversion by microalgal cultures.

Ten different strains of unicellular microalgae have been used in the bioconversion of progesterone. Regio and stereoselective reduction and hydroxylation of the title compound were induced. A 9,10-seco derivative was obtained in high yield by using Scenedesmus quadricauda.

Joseph Jacob Plenck (1735-1807).

Joseph Jacob Plenck (1735-1807) is considered to be the forerunner of modern European dermatology, who also compiled a list of about 800 plants with medicinal uses. Of these about 115 have diuretic properties and are currently included in various pharmacopeias. They were traditionally used to cure ascites of various causes, in urolithiasis, nephritis, cystitis, bladder ulcers, strangury, urinary retention and incontinence. Few of these plants have been fully investigated by modern medicinal chemists, and many are worthy of further study.

Useful plants in renal therapy according to Pliny the Elder.

The Naturalis Historia of Pliny the Elder consists of 37 books, of which 16 are devoted to botany. About 900 plants are named, but many names are synonyms and identification is often impossible. Where identification is possible it is achieved by comparison of the actual names with the vernacular names in related languages or by indirect evidence from their medical use. In this way 130 plants used in renal therapy during Roman times can be identified. Many were eaten as part of the diet, and the distinction between medicinal and edible plants was not clearcut. Pliny was also the first author to comment that wild species are more active than cultivated ones. Most of the plants reported by Pliny are also mentioned by Dioscorides, and more than 30 of them were also listed by Plenck. Several are still quoted in modern pharmacopeias.

A study in Renaissance psychotropic plant ointments.

Various historical sources from the Renaissance--including transcripts of trials for witchcraft, writings on demonology and textbooks of pharmaceutical botany--describe vegetal ointments prepared by women accused of witchcraft and endowed with marked psychoactive properties. Here, we examine the botanical composition and the possible pharmacological actions of these ointments. The results of our study suggest that recipes for narcotic and mind-altering salves were known to Renaissance folk healers, and were in part distinct from homologous preparations of educated medicine. In addition, our study reveals an unexpected connection of these vegetal psychotropes with archaic chtonic beliefs, confirming the tight association between rituals and cults entered on the Underworld and the image of the Medieval witch.

Potential allelochemicals fromPistia stratiotes L.

Among the substances isolated from ethyl ether extract ofPistia stratiotes L., linoleic acid,γ-linolenic acid, (12R,9Z,13E,15Z)-l2-hydroxy- 9,13,15-octadecatrienoicacid, (9S,10E,12Z,15Z)-9-hydroxy-10,12,15-octadecatrienoic acid, α-asarone, and 24S-ethyl-4,22-cholestadiene-3,6-dione were found to inhibit the growth of some microalgae in solid medium. Toxicity of α-asarone on the growth of sensitive algal strains in liquid medium is discussed.