Antiresorptive and anti-angiogenic drug therapy in the pediatric population with reference to medication-related osteonecrosis of the jaw.

The objective of this study was to identify the prevalence of osteonecrosis of the jaw in a pediatric population with systemic therapeutic exposure to an antiresorptive, anti-angiogenic, and/or immunomodulating drug (ARAID), and in particular in the subgroup of patients who had undergone invasive dental treatment. This was a retrospective cohort study performed at a single center. The investigation included pediatric patients who had undergone systemic therapy with ARAIDs and who began receiving ARAID therapy at ≤16 years of age. The study included 482 patients who received ARAIDs between January 2011 and January 2021. The most common medication class was bisphosphonates (45.0%), followed by mTOR inhibitors (30.1%) and anti-angiogenics (17.8%). No diagnosis of osteonecrosis of the jaw was observed. From this population, 26 patients were noted to have undergone invasive dental treatment. The duration from treatment to the invasive procedure ranged from 0 to 5.9 years. Medication-related osteonecrosis of the jaw is extremely rare among the pediatric population - much less common when compared to the adult population. Prospective cohort studies and continued evaluation will help determine the incidence and prevalence of medication-related osteonecrosis of the jaw in pediatric patients.

Yeast red pigment modifies Amyloid beta growth in Alzheimer disease models in both Saccharomyces cerevisiae and Drosophila melanogaster.

The effect of yeast red pigment on amyloid-ß (Aß) aggregation and fibril growth was studied in yeasts, fruit flies and in vitro. Yeast strains accumulating red pigment (red strains) contained less amyloid and had better survival rates compared to isogenic strains without red pigment accumulation (white strains). Confocal and fluorescent microscopy was used to visualise fluorescent Aß-GFP aggregates. Yeast cells containing less red pigment had more Aß-GFP aggregates despite the lower level of overall GFP fluorescence. Western blot analysis with anti-GFP, anti-Aß and A11 antibodies also revealed that red cells contained a considerably lower amount of Aß GFP aggregates as compared to white cells. Similar results were obtained with exogenous red pigment that was able to penetrate yeast cells. In vitro experiments with thioflavine and TEM showed that red pigment effectively decreased Aß fibril growth. Transgenic flies expressing Aß were cultivated on medium containing red and white isogenic yeast strains. Flies cultivated on red strains had a significant decrease in Aß accumulation levels and brain neurodegeneration. They also demonstrated better memory and learning indexes and higher locomotor ability.

Can information on remaining time modulate psychophysiological parameters during an intermittent exercise?

AIM: The purpose of the present study was to verify the effect of information on remaining time on physiological and perceptual responses during an intermittent exercise. METHODS: Ten trained cyclists participated in this study (176 ± 0.4 cm; 78.5 ± 10.4 kg; 32.5 ± 6 years; peak power output: 369.8 ± 37.8 W; VO(2peak): 51.90 ± 10.37 mL/kg/min). An intermittent cycling protocol consisting of four minutes at low-intensity (50% PPO) intervals followed by one-minute high-intensity bouts (100% PPO) under three different conditions were performed: OL40=40 min open-loop with no information on remaining time; CLI40=40 min closed-loop with information on remaining time; and CLI20=20 min closed-loop with information on remaining time. Ventilatory data (VO2) and electromyographic signals (EMG) were continuously recorded, and rating of perceived exertion (RPE) was acquired at the end of the high-intensity periods. RESULTS: Results indicated that the oxygen consumption and muscle activity during OL40 were lower than CLI40. OL40 also demonstrated significantly lower VO2values compared to CLI20 during high-intensity periods at 10 and 20 min. Root mean square values from EMG data for OL40 during high-intensity periods were significantly lower at 40 min compared with CLI40, and when the high-intensity period median frequencies among protocols were compared, CLI40 presented significantly higher values than the other conditions at 5 and 10 min. CONCLUSION: Even when power output is maintained, information on remaining time may alter peripheral responses through a complex saving component to prevent higher energy expenditure during physical exercise.

Setting reaction of polyacid modified composite resins or compomers.

The hardening of modified polyacid composite resins (compomers) and glass-ionomers have been studied using infrared spectroscopy. The acid-base reaction in Ketac-fil, a glass ionomer, was followed by the ratio between the COOH band located around 1715 cm⁻¹ and that corresponding to COO⁻ located around 1570 cm⁻¹. The combination of infrared analysis and band narrowing treatments enable us to propose in the glass-ionomer two maturation steps. First, a very rapid equilibrium acid-base related, and second the cross-linking of polycarboxylate with the metal ions present in the cement. In compomers, a new reaction has been described involving polymerization induced by free radicals besides the two steps associated with the acid-base reaction. Using infrared spectroscopy and band narrowing techniques, it is shown that water is essential to complete the hardening process but no acid-base reaction is produced since the COO⁻ band does not appear. The reaction associated with free radicals could be described as a polymerization of methacrylate monomers together with an aqueous dilution of the filling particles releasing different metal cations that would chelate with the polymer molecules to form a macromolecular structure.

Effect of one-year water storage on the surface microhardness of resin-modified versus conventional glass-ionomer cements.

OBJECTIVES: Conventional and resin-modified glass-ionomer cements (GIC, RM-GIC) are available for clinical use as restorative materials or as liners and bases. This study was conducted to compare the effect of a 12-month storage period in water on the surface microhardness, measured in Vickers units (VH), between a GIC and a RM-GIC group and to determine if the addition of resins improved the GIC microhardness. METHOD: VH microhardness was assessed in three GIC: Ketac-Fil, Ketac-Molar and Ketac-Silver (KF, KM, KS) and three RM-GIC: Photac-Fil, Fuji II LC and Vitremer (PF, FU, VI) stored in distilled water at 37 degrees C for 12 months. Measurements were taken at 1, 7, 15, 30, 90, 180 and 365 days. The statistical evaluation was done by means of one-way analysis of variance (ANOVA) and Tukey's multiple comparison tests. RESULTS: There are significant VH differences among the materials studied and within each material over storage time. GICs, except for KS, showed a higher VH throughout the study period. Among the RM-GIC, VI showed a significantly higher VH at 12 months than at 1 day. The VH of PF diminished in the final stage of the study, whereas that of FU stabilized. SIGNIFICANCE: The results suggest that the addition of resins to the GIC did not appear to improve the surface microhardness of these materials. Furthermore, the surface microhardness of both the conventional and resin-modified glass-ionomers suffered variations over time. However, these materials should not be deemed inadequate for use in clinical applications. Probably, conventional and resin-modified GICs placed in the oral environment would not be affected to the same extent as in in vitro tests.

Uncontrolled central adenoid cystic carcinoma: case report.

Central adenoid cystic carcinomas are rare malignancies that are believed to arise in ectopic salivary gland tissue within the maxilla or mandible. We describe the diagnosis and treatment of a central adenoid cystic carcinoma in a 54-year-old man, which we believe was a recurrence of an earlier growth that had not been completely excised. We also present a review of the literature.

Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects.

OBJECTIVE: To evaluate and discuss the free flap reconstructive options for patients with partial and total maxillectomy defects. DESIGN: Retrospective review of cases. SETTING: Two tertiary referral centers. PATIENTS: Fifty-one patients had partial or total maxillectomy defects resulting from oncologic surgical resection, and 7 had partial maxillectomy defects resulting from trauma. Inferior or partial maxillectomy defects included 10 anterior arch and hemipalate defects and 12 subtotal or total palate defects. Total maxillectomy defects with and without orbital exenteration included 36 maxilla defects with hemipalate and malar eminence. INTERVENTION: There were 11 fibula, 14 rectus abdominis, 9 scapular, 10 radial forearm, 5 latissimus dorsi, and 13 combination latissimus dorsi and scapular flaps. MAIN OUTCOME MEASURES: Separation of the oral cavity from the sinonasal cavities, diet, type of dental restoration, type of orbital restoration, speech intelligibility, and complications. RESULTS: Only 1 flap failure was reported. There was loss of bone in 2 flaps and loss of the skin paddle in 1 flap. All palatal defects were sealed by the separation of the oral and sinonasal cavities. Thirty-eight patients were able to eat a regular diet while the remaining patients maintained a soft diet. All patients conversed on the telephone without difficulty in intelligibility. Eight patients had an implant-borne dental prosthetic, and 30 patients had a conventional partial prosthetic. Orbit restoration was achieved in 2 patients with an implant-borne prosthetic, and 6 patients retained a standard orbit prosthetic. CONCLUSIONS: Free flap reconstruction of the maxilla creates reproducible permanent separation of the oral and sinonasal cavities in a single-stage procedure. In addition, there exists the potential for dental rehabilitation with restoration of masticatory and phonatory function. Free flap reconstruction also provides a good cosmetic result, which improves patients' outlook and contributes to their overall well-being. Reconstructive flaps are designed to fit specific maxillary defects and patient needs to provide optimally functional and cosmetic results.

Estudio de la composición elemental de las aleaciones para amalgama dental / Study of elemental composition of alloy for dental amalgam

Se analizó la composición elemental de 32 aleaciones metálicas para obturación dental existentes en el comercio, de las cuales 27 eran aleaciones para amalgama de plata y 5 eran aleaciones de galio. Los resultados obtenidos fueron agrupados según la morfología del polvo e individualizados en cada aleación en cantidades superiores al I por ciento en peso de cada elemento (AU)

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Lower eyelid blepharoplasty: the aging eyelid.

The aging process affects the underlying structural integrity of the eyelids as well as the overlying skin, muscle, and fat. Gravitational descent of the deep supporting soft tissues of the eyelid complex coupled with skin texture changes exemplified by loss of skin elasticity, solar actinic changes, and dynamic and static rhytids result in the aged eyelid. Surgery of the lower eyelid on the youthful face usually involves excisional fat sculpting without skin removal. Lower eyelid blepharoplasty performed on the mature face often requires excision of periorbital fat combined with some treatment of the lower eyelid skin. In the aging eyelid, the surgeon must also be prepared to address lower eyelid laxity to prevent the potential complications of lower eyelid retraction or scleral show.

Emergency care of patients with tracheostomies: a 7-year review.

The emergency department (ED) care of a patient with a tracheostomy tube can be problematic because of difficulty with patient communication, urgency of airway control, and unfamiliarity with tracheal equipment. The objective of this study was to characterize complications of tracheostomy patients seen in the ED and provide management techniques. A retrospective study was conducted on all patients with tracheostomy complications who presented to a university, tertiary-care ED over a 7-year period. Data obtained included age, gender, operative indication, complication, time of complication, vital signs, and ED management. Descriptive statistics were used to analyze the data. During the study period, 35 patients were evaluated in the ED for 60 complications. The 60 complications were categorized into six groups: 20 (33%) patients presented with dislodged tracheal tubes, 11 (18%) presented with plugged tracheal tubes, 18 (30%) had infection, 7 (11%) had bleeding, 1 (3%) had a pnuemothorax, and 3 (5%) had tracheal/stomal stenosis. Review of the complications that place tracheostomy patients at high risk in conjunction with a review of the literature enabled the development of a standard approach to dealing with patients with tracheostomies that can facilitate proper care of the patients in the ED.

Pediatric zygomatico-orbital complex fractures: the use of resorbable plating systems. A case report.

Maxillofacial trauma in the pediatric population is infrequent--only 5% of all facial fractures occur in children. Operative intervention is indicated when a displacement of normal structures is present, resulting in either a functional or cosmetic deformity. Some midface fractures in children may be managed with closed reduction and maxillomandibular fixation. When open reduction is indicated, plate-and-screw fixation has been the preferred method of stabilization. This article presents a case of an isolated zygomatico-orbital complex fracture in a 6-year-old boy. Open reduction and internal fixation of the fractures through a preexisting facial wound were performed using a resorbable plate-and-screw system. A review of the literature and a discussion of the technique precede the case presentation. The rapid healing of pediatric facial bones does not obviate the need for fracture reduction and fixation with titanium plates and screws. The resorbable system offers an alternative with excellent results.

Role of tumor necrosis factor and interleukin-1 in endotoxin-induced middle ear effusions.

In a rat model, we investigated the role of tumor necrosis factor (TNF) and interleukin-1 (IL-1) in endotoxin-induced middle ear effusions (MEEs). After the eustachian tube was obstructed, the middle ear was transtympanically injected with 35 microL of either 1) 1 mg/ mL lipopolysaccharide (LPS); 2) LPS and 100 micrograms TNF binding protein (TNFbp); 3) LPS and 1 microgram IL-1 receptor antagonist (IL-1ra); or 4) LPS, TNFbp, and IL-1ra. Every 2 hours, the fluid within the middle ear was collected, and the quantity of albumin in the fluid, an index of vascular leakage, was determined by enzyme-linked immunosorbent assay. After 6 hours, the middle ear was fixed for histologic analysis. The TNFbp significantly attenuated vascular extravasation into the middle ear. The IL-1ra did not significantly alter effusion development. These results indicate that TNF, but not IL-1, is a mediator of LPS-induced MEE. Therefore, TNFbp may represent a novel approach to the treatment of otitis media with effusion.

Effects of Bafilomycin A1 and Metabolic Inhibitors on the Maintenance of Vacuolar Acidity in Maize Root Hair Cells.

Proton pumps of tonoplast membranes have been studied extensively in vitro, but data concerning their regulation in vivo are lacking. Effects of either anoxia, or the addition of KCN, 2-deoxy-d-glucose (deoxy-glucose), or bafilomycin-A1 (BAF) on vacuolar pH of maize (Zea mays L.) root hair cells were followed by fluorescence microscopy after loading of 2[prime]7[prime]-bis-(2-carboxyethyl)-5-(and-6) carboxyfluorescein. Root hair cells were able to maintain vacuolar acidity for at least 2 h in the presence of either 10 mM KCN or 50 mM deoxy-glucose or during anoxia. Treatments with either deoxy-glucose or KCN reduced total tissue ATP more than anoxia. ADP accumulated during anoxia and treatment with KCN as detected by in vivo 31P-NMR spectroscopy, but not during deoxy-glucose treatment. With control roots and roots treated with deoxy-glucose, the presence of BAF, a specific inhibitor of the V-type ATPase, caused alkalization of the vacuolar pH. However, either in the presence of KCN or under anoxic conditions, BAF was relatively ineffective in dissipating vacuolar acidity. Therefore, under anoxia or in the presence of KCN, unlike the situation with air or deoxy-glucose, the V-type ATPase apparently is not required for maintenance of vacuolar acidity.

Dentin bond strength of fluoride-releasing materials.

PURPOSE: To evaluate the shear bond strength to dentin of fluoride-releasing materials. MATERIALS AND METHODS: Human, noncarious extracted permanent molars stored in distilled water were used. Flat buccal and lingual dentin surfaces were ground wet on 600-grit silicon carbide paper. The teeth were then distributed at random into four groups of 5 teeth (10 surfaces) each: Group 1: Fuji II LC; Group 2: Vitremer; Group 3: VariGlass; Group 4: Dyract. Cylindrical samples of the glass ionomers were prepared in plastic molds and bonded to the dentin surface according to the manufacturers' instructions. All samples were placed in distilled water for 24 hours, thermocycled for 500 cycles in distilled water at 5 degrees C and 55 degrees C and sheared with an Instron at a crosshead speed of 0.5 mm/minute. RESULTS: In MPa: Group 1: 15.96 +/- 3.28; Group 2: 9.70 +/- 2.43; Group 3: 13.48 +/- 3.35; Group 4: 21.14 +/- 5.32. ANOVA revealed that Dyract had a significantly higher bond strength than all the other products tested (P < 0.0001). Vitremer had a significantly lower bond strength. Fuji II LC had no significant difference from VariGlass. Fracture patterns, examined with the SEM, were cohesive within the cement for all groups.

Effect of APF gel on light-cured glass ionomer cements: an SEM study.

This SEM study evaluated the micro morphological effect of a 1.23% acidulated phosphate fluoride gel (Oral-B)(APF) on the surface of VariGlass and Vitrebond light-cured glass ionomer cements with or without Ketac Glaze protective surface glazing. Glass ionomer (GI) cylinders (area 6.69 mm) were prepared and divided into six groups of 10 specimens each: Group 1: VariGlass; Group 2: VariGlass + APF gel for 4 minutes; Group 3: VariGlass + Ketac Glaze; Group 4: VariGlass + Ketac Glaze + APF for 4 minutes; Group 5: Vitrebond; Group 6: Vitrebond + APF gel for 4 minutes; Group 7: Vitrebond + Ketac Glaze; Group 8: Vitrebond + Ketac Glaze + APF for 4 minutes. The cements were handled according to manufactures' instructions, except for the groups using the glaze after light-curing the GI. The Ketac Glaze resin was painted with a brush over the GI surface and cured with visible light (Demetron) for 30 seconds. The fluoride gel was left in contact with the surface for 4 minutes, rinsed and dried. All specimens were then mounted on aluminum stubs, coated and evaluated under the SEM. The results indicated that the APF gel etches both GI surfaces considerably and that the unfilled resin glaze protects the GIs from the erosive effects of the APF gel.

Inner ear damage secondary to diabetes mellitus. II. Changes in aging SHR/N-cp rats.

The congenic spontaneous hypertensive/National Institutes of Health (Bethesda, Md)-corpulent rat (SHR/N-cp) is a model for non-insulin-dependent diabetes mellitus. A previous study in our laboratory found significant loss of outer hair cells (OHC) in diabetic rats at 5.0 months of age. Our present study was designed to further evaluate the effects of the diabetic state on the inner ear in 10.5-month-old rats. The following comparisons were made: diabetic vs euglycemic control animals; obese vs lean phenotypes; and sucrose vs starch as the source of dietary carbohydrate. Cochleas were removed, fixed, stained, mounted on slides, and analyzed for OHC loss. We found a significant OHC loss in the cochleas of all diabetic animals. No statistical difference was found when comparing obese and lean phenotypes. Increased OHC loss was observed in all sucrose-fed vs starch-fed diabetic animals, although this increase was not statistically significant. Compared with an earlier study, an increase in OHC loss was also noted in the 10.5-month-old lean SHR/N-cp animals. Our results indicate that there is a relationship between non-insulin-dependent diabetes mellitus and inner ear damage and suggest that OHC loss is related to hyperglycemia and a genetic predisposition for glucose intolerance.

Inner ear damage secondary to diabetes mellitus. I. Changes in adolescent SHR/N-cp rats.

The association between diabetes mellitus and hearing impairment has been debated in many previous studies. The spontaneous hypertensive/NIH-corpulent (SHR/N-cp) rat has been shown to be a unique genetic model for non-insulin-dependent diabetes mellitus. Seventeen diabetic and 17 control young male rats were divided into groups according to diet and phenotype. The rats were fed either 54% of sucrose or 54% starch diets for 3.5 months and killed at 5 months. The cochleas were fixed, decalcified, dissected, and stained for hair cell counting. A significant loss of outer hair cells was noted in the diabetic obese (SHR/N-cp) animals when compared with the control obese (LA/N-cp) animals in every group. Although no significant difference was noted between the diabetic obese (SHR/N-cp) animals receiving the starch and sugar diets, the diabetic obese (SHR/N-cp) animals were more severely affected than the nondiabetic lean (SHR/N-cp) rats.