Peri-Implantitis Regenerative Therapy: A Review.

The surgical techniques available to clinicians to treat peri-implant diseases can be divided into resective and regenerative. Peri-implant diseases are inflammatory conditions affecting the soft and hard tissues around dental implants. Despite the large number of investigations aimed at identifying the best approach to treat these conditions, there is still no universally recognized protocol to solve these complications successfully and predictably. This review will focus on the regenerative treatment of peri-implant osseous defects in order to provide some evidence that can aid clinicians in the approach to peri-implant disease treatment.

Characterization of vitelline vessel remnant circulation in the umbilical cord.

The vitelline circulation normally regresses by about 10 weeks gestation. Vitelline vessel remnants (VVRs) are found in approximately 4-11% of umbilical cords. While these remnants retain an active fetal circulation, this has never been studied. Using an operating microscope, VVRs were catheterized, injected with ink, and then examined grossly and histologically. Over 90% of VVRs are paired thin-walled vessels with afferent and efferent circulation completed within the cord via capillary plexuses and bridging vessels; <10% are single thin-walled arterial vessels running the length of the cord to the placental disc, with their venous return circulation via allantoic umbilical vessels.

Vitelline Vessel Remnant-Derived Funisitis Is a Sensitive and Specific Predictor of Histological Evidence of Amniotic Fluid Infection.

BACKGROUND: 4-11% of umbilical cords contain vitelline vessel remnants (VVRs). A recent study has described neutrophilic inflammation arising from VVRs and suggested an association with amniotic fluid infection (AFI). METHODS: During routine placental pathology sign-out over a six month period, we identified 70 cords with VVRs. HE-stained sections were re-examined for "VVR-derived funisitis," which was classified as low or high grade/stage based upon whether neutrophils were present only in Wharton's jelly near the VVRs or whether neutrophils were also present near the cord's amniotic surface. The same placentas were also examined for histologic evidence of AFI (maternal response = acute chorionitis or chorioamnionitis vs. fetal response = chorionic vasculitis, umbilical vasculitis, or funisitis vs. both). RESULTS: Neutrophilic inflammation arising from VVRs was present in 54.3% (38/70); 15 and 23 lesions were low and high grade/stage, respectively. "VVR-derived funisitis" was strongly associated with histological evidence of AFI elsewhere in the placenta. Its overall sensitivity and specificity were 0.94 and 0.88; when VVR-derived funisitis was high grade/stage or diagnosed in the third trimester, specificity rose to 1.0. CONCLUSION: "VVR-derived funisitis" has a strong association with histological evidence of AFI.

Green tea (Camellia sinensis) extract inhibits biofilm formation in acyl homoserine lactone-producing, antibiotic-resistant Morganella morganii isolated from Pasig River, Philippines.

The drastic development of urban districts around the world has caused changes in the environment, specifically on metropolitan waterways such as the Pasig River in the Philippines. These significant changes resulted in diversity of microorganisms and their mechanisms employed such as antibiotic resistance and their communication system or quorum sensing (QS). In this study, four bacterial isolates from Pasig River, identified as Aeromonas salmonicida, Acinetobacter sp., Morganella morganii, and Citrobacter freundii, were observed to employ short-chain acyl homoserine lactone (AHL) as their signalling molecule based on in vitro assays using the biosensor strain Chromobacterium violaceum CV026. Furthermore, M. morganii isolate was shown to be resistant to chloramphenicol. This poses a significant threat not just to public health but also to the aquatic life present in the river. Thus, green tea (Camellia sinensis) extract was tested for its capability to inhibit in vitro biofilm formation in M. morganii, as well as the short-chain acyl homoserine lactone QS system using C. violaceum ATCC 12472. Results showed that the extract significantly (p < 0.05) inhibited biofilm formation in M. morganii at as low as 62.5 µg/mL (31.55%). Increasing the concentration (500 µg/mL) did not significantly (p > 0.05) enhance the activity (41.21%). Furthermore, the extract also inhibited pigmentation in C. violaceum ATCC 12472, suggesting QS inhibition. This study adds into record the production of short-chain AHLs by Aeromonas salmonicida, Acinetobacter sp., Morganella morganii, and Citrobacter freundii, as well as the potential of green tea extract as inhibitor of biofilm formation in antibiotic-resistant M. morganii possibly through QS inhibition.

Colorimetric Diagnostic Capillary Enabled by Size Sieving in a Porous Hydrogel.

Handy and disposable point-of-care diagnostics facilitate the early screening of severe diseases in resource-limited areas. To address urgent needs in inconvenient sites, a simple colorimetric diagnostic device equipped with a capillary tube with porous hydrogel and immunocomplex particles was developed for the rapid detection of biomarkers (16 min). In this device, probe particles attach to capture particles (dp = 40 µm) and form sandwiched immunocomplexes in the presence of target biomarkers, and a red color progressively emerges when the sandwiched immunocomplex particles are blocked by the porous hydrogel embedded inside the glass capillary. Colorimetric aggregation was recorded using a smartphone and analyzed with imaging software. The limit of detection reached 1 ng/mL and showed a maximum of 79% accuracy compared with that obtained through a conventional spectrophotometric technique. The level of a diabetic retinopathy (DR) biomarker, lipocalin-1 (LCN-1), was measured in 1 µL of a human tear sample and used in testing the practicability of the proposed device. All healthy subjects showed lower intensity levels than the other diabetic counterparts (proliferative DR or nonproliferative DR patients), implying the potential of this device in clinical applications. Overall, the diagnostic device facilitates point-of-care-testing and provides a low-cost (~1 USD), compact, and reliable tool for early diagnosis in resource-limited areas.

Perforación gástrica asociada al consumo de helado con nitrógeno líquido / Gastric perforation associated with the intake of ice cream with liquid nitrogen

La ingestión de nitrógeno líquido es una causa infrecuente de perforación gástrica, se conoce poco sobre como este compuesto afecta el tejido gastrointestinal, sus mecanismos de lesión y sus consecuencias clínicas. Cada vez es más frecuente el uso del nitrógeno líquido de forma comercial en productos de repostería y gastronomía, por lo que es importante reconocer sus potenciales efectos cuando la manipulación no es la adecuada. En este caso clínico describimos una perforación gástrica secundaria al consumo de helado preparado con nitrógeno líquido.

Liquid nitrogene ingestion is a frecuent cause of gastric perforation. It is unknown how this compound afects the gatrointestinal tissue, it mechanisisms of injury and the clinical consecuences. Nowadays, the use of liquid nitrogene in gastronomy is becoming a tendency, for this reason it is important to identify the potencial healt effects of this compound when is not correctly manipulated. The following article describes a secondary gastric perforation, as a consecuence of the consumption of ice cream prepared with liquid nitrogene.

[Gastric perforation associated with the intake of ice cream with liquid nitrogen]. / Perforación gástrica asociada al consumo de helado con nitrógeno líquido.

Liquid nitrogene ingestion is a frecuent cause of gastric perforation. It is unknown how this compound afects the gatrointestinal tissue, it mechanisisms of injury and the clinical consecuences. Nowadays, the use of liquid nitrogene in gastronomy is becoming a tendency, for this reason it is important to identify the potencial healt effects of this compound when is not correctly manipulated. The following article describes a secondary gastric perforation, as a consecuence of the consumption of ice cream prepared with liquid nitrogene.

Development and validation of a prognostic index for 6- and 12-month mortality in hospitalized older adults.

BACKGROUND/AIM: Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non-disease-specific tool to predict individual mortality risk after hospital discharge in older adults. METHODS: Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later. Determinants of mortality were obtained. Using multivariable analysis, beta coeffcicients were calculated to build 2 scores able to predict mortality at 6 and 12 months after discharge. The scores were tested on a sample comprising 75% of the patients, who were randomly selected; they were validated using the remaining 25%. Discrimination was assessed using ROC curves. Scores were calculated for each patient and divided into tertiles. Survival analysis was performed. RESULTS: Determinants of mortality at 6 months were dependent ambulation at baseline, full dependence at discharge, length of stay, pluripatology, pressure ulcers, low grip strength, malignacy, and male gender. At 12 months the determinants were: dependent amblation at baseline, full dependence at discharge, pluripatology, low BMI, low grip strength, heart failure, malignacy, and male gender. Discrimination and calibration were excellent. Survival analysis demonstrated different survival trajectories (p<0.001) for each tertile in both scores. CONCLUSIONS: Our incices provide accurate prognostic information in elderly patients after discharge. They can be calculated easily, quickly and do not require technical or laboratory support, thus endorsing their value in dalily clinical practice.

Intraoperative, real-time monitoring of blood flow dynamics associated with laser surgery of port wine stain birthmarks.

BACKGROUND AND OBJECTIVE: Port-wine stain (PWS) birthmarks affect ∼22 million people worldwide. After several treatment sessions, complete disappearance of the PWS occurs in only ∼10% of treated patients. There is a need to develop a new strategy to improve the efficacy of each treatment session and the overall treatment outcome. The study objective was to determine how intraoperative measurements of blood flow correlate with treatment response assessed several weeks post treatment. STUDY DESIGN/MATERIALS AND METHODS: We employed Laser Speckle Imaging (LSI) to measure intraoperative blood-flow dynamics. We collected data from 24 subjects undergoing laser therapy for facial PWS birthmarks. Photographs were taken before treatment and at a follow-up visit, and analyzed by two expert observers. RESULTS: Intraoperative LSI enables real-time monitoring of blood-flow dynamics in response to laser treatment and can inform clinicians on the need for focused re-treatment. The degree of PWS blanching achieved is positively correlated with the log-transformed acute blood-flow reduction (P = 0.022). CONCLUSION: LSI is a simple, intraoperative monitoring tool during laser therapy of PWS birthmarks. LSI provides a single value for blood flow that correlates well with the degree of blanching achieved with laser therapy.

Modest dietary K+ restriction provokes insulin resistance of cellular K+ uptake and phosphorylation of renal outer medulla K+ channel without fall in plasma K+ concentration.

Extracellular K(+) concentration ([K(+)]) is closely regulated by the concerted regulatory responses of kidney and muscle. In this study, we aimed to define the responses activated when dietary K(+) was moderately reduced from a control diet (1.0% K(+)) to a 0.33% K(+) diet for 15 days. Although body weight and baseline plasma [K(+)] (4.0 mM) were not reduced in the 0.33% K(+) group, regulatory responses to conserve plasma [K(+)] were evident in both muscle and kidney. Insulin-stimulated clearance of K(+) from the plasma was estimated in vivo in conscious rats with the use of tail venous and arterial cannulas. During infusion of insulin.(50 mU.kg(-1).min(-1)), plasma [K(+)] level fell to 3.2 +/- 0.1 mM in the 1.0% K(+) diet group and to only 3.47 +/- 0.07 mM in the 0.33% K(+) diet group (P < 0.01) with no reduction in urinary K(+) excretion, which is evidence of insulin resistance to cellular K(+) uptake. Insulin-stimulated cellular K(+) uptake was quantitated by measuring the K(+) infusion rate necessary to clamp plasma K(+) at baseline (in micromol.kg(-1).min(-1)) during 5 mU of insulin.kg(-1).min(-1) infusion: 9.7 +/- 1.5 in 1% K(+) diet was blunted to 5.2 +/- 1.7 in the 0.33% K(+) diet group (P < 0.001). Muscle [K(+)] and Na(+)-K(+)-ATPase activity and abundance were unchanged during the 0.33% K(+) diet. Renal excretion, which was measured overnight in metabolic cages, was reduced by 80%, from 117.6 +/- 10.5 micromol/h/animal (1% K(+) diet) to 24.2 +/- 1.7 micromol/h/animal (0.33% K(+) diet) (P < 0.001). There was no significant change in total abundance of key renal K(+) transporters, but 50% increases in both renal PTK cSrc abundance and ROMK phosphorylation in the 0.33% K(+) vs. 1% K(+) diet group, previously established to be associated with internalization of ROMK. These results indicate that plasma [K(+)] can be maintained during modest K(+) restriction due to a decrease in insulin-stimulated cellular K(+) uptake as well as renal K(+) conservation mediated by inactivation of ROMK, both without a detectable change in plasma [K(+)]. The error signals inciting and maintaining these responses remain to be identified.