Interstitial Lung Disease and Sarcoidosis.

Interstitial lung disease (ILD), a clinically recognized group of diseases resulting in pulmonary fibrosis, affects up to 200 individuals per 100,000 in the United States. Sarcoidosis has a wide range of clinical manifestations including pulmonary fibrosis. Health disparities are prevalent in both ILD and sarcoidosis around socioeconomic status, race, gender, and geographic location. This review outlines the known health disparities, discusses possible determinants of disparities, and outlines a path to achieve equity in ILD and sarcoidosis.

Histopathological changes of neuronal tissue following the use of hydrogen peroxide in neurosurgical procedures.

BACKGROUND: Hydrogen peroxide (HP) is routinely used in neurosurgical procedures to achieve surgical hemostasis. However, its safety profile is still debatable with various reports depicting range of adverse effects on neuronal tissue. The objective of this paper is to evaluate the safety and efficacy of HP as a hemostatic agent in normal neuronal tissue during neurosurgical procedures conducted on rats. METHODS: One hundred rats were divided into three groups. The first and third group underwent cortical irrigation with HP and the second group underwent spinal irrigation with HP. All groups were irrigated with different concentrations of HP (1%, 3%, or 6%) for 3 min and tissue biopsies were obtained immediately afterwards (Groups A and B) or 1 week after HP irrigation (Group C). Study specimens were examined histologically and compared to control tissue. RESULTS: All rats showed normal behavioral, functional, and motor neurological activity following the procedures. Histopathologically, dark neurons were observed in all HP exposed tissue. The cytoplasm revealed condensed and dark Nissl substance and the neurites and axons exhibited a corkscrew morphology. No ischemic changes or inflammatory infiltrates were detected. The majority of dark neurons were observed at the periphery of tissue fragments. These findings were present and consistent in both the short- and long-term groups. CONCLUSION: HP irrigation showed no significant short- or long-term clinical and histopathological changes in comparison to normal saline when used on rats' neuronal tissue. This may confirm the safety of intraoperative HP usage as hemostatic agent during neurosurgical procedures.

Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background.

PURPOSE: To investigate the differences of parental acceptance of advanced behaviour management techniques (BMT) in different cultural backgrounds (Germany vs. Jordan). METHODS: A convenience sample of 100 parents each of paediatric patients at the University of Greifswald/Germany and Jordan University/Jordan completed a questionnaire to rate their acceptance of four advanced BMT (passive restraint, active restraint, nitrous oxide sedation, and general anaesthesia) using a five-point Likert scale. RESULTS: In both groups, nitrous oxide sedation was the most accepted advanced BMT (mean 3.78 ± 1.34/3.22 ± 1.50, respectively). The least acceptable technique in Germany was passive restraint (2.05 ± 1.18) and in Jordan general anaesthesia (2.11 ± 1.30). The parents in Germany are significantly more accepting of nitrous oxide sedation than are parents in Jordan (p = 0.010), while parents in Jordan are more willing to accept passive restraint (p = 0.001). The acceptance of all advanced BMT increased significantly in both groups when the treatment was urgent. CONCLUSIONS: Parental cultural background and the urgency of the treatment affect the acceptance of different BMT. Moreover, the parental attitude to the pharmacological technique has changed, as nitrous oxide sedation generally appears to be the most preferred advanced technique in both groups.

Dental trauma characteristics in the primary dentition in Greifswald, Germany: a comparison before and after German unification.

BACKGROUND: The data on the distribution and pattern of dental trauma in the primary dentition are very rare. AIM: To investigate primary dental trauma patterns in relation to gender, age, time and cause for a recent paediatric cohort and to compare this with a historic one before German unification. METHODS: This retrospective study compared the patterns of dental trauma injuries at the trauma centre at Greifswald University/Germany for a recent paediatric cohort (2014-16, 103 children) with a historic one (1974-1989, n = 120). The data contained details on etiology, injury types and treatment delivered for 450 injured teeth (247 historic, 203 recent). RESULTS: In both cohorts, the occurrence was more common in males than females (63%/55%, resp.) with an age peak from 2 to 6 years. Maxillary incisors were most affected (89.6%/88.6%, resp.) and periodontal ligament injuries dominated (77.8%/90.3%, resp.). Almost half of the injuries occurred at home (46.6%), mostly due to falling (48.5%) or during playing (37.8%) in the recent paediatric cohort which provided better forensic data due to insurance issues and potential concern about child abuse. Advice and follow up was the most common approach in the recent paediatric cohort (76%). CONCLUSION: Even after 30 years and a change in the health care system due to German unification, the patterns of dental traumatic injuries in the primary dentition were similar.

Parental acceptance of advanced behaviour management techniques in normal treatment and in emergency situations used in paediatric dentistry.

BACKGROUND: Behaviour management techniques (BMT) in children are essential to achieve a successful dental treatment, but parents are not equally accepting BMT. AIM: To investigate the parental acceptance of advanced behaviour management techniques used in paediatric dentistry in normal and in emergency situations in Germany. METHODS: Parents bringing their children for dental care answered a questionnaire on the acceptance of four advanced BMT: passive restraint, active restraint, nitrous oxide sedation and general analgesia. The study was conducted in five university dental clinics in Germany. Parents rated overall acceptance of each technique using a five points Likert scale. RESULTS: 136 parents answered the questionnaire. The acceptance of all advanced BMT was significantly higher when the treatment was urgent (p < 0.001, paired sample t test). Nitrous oxide sedation was rated as the most acceptable technique in normal treatment (52.6%) and in emergency situation (68.2%), while passive restraint was the least acceptable technique in both normal (19.9%) and emergency situation (37.8%). CONCLUSIONS: Parents in Germany are more willing to accept advanced BMT in emergency situations, with nitrous oxide being generally the most preferred technique.

Changes in the epidemiology and aetiology of dental traumatic injuries in permanent teeth in children before and after German unification.

AIM: To evaluate the longitudinal occurrence of traumatic dental injuries in permanent teeth comparing recent data from 2014 to 2016 in Greifswald after German unification with a historic sample from socialist times (1974-1989). MATERIALS AND METHODS: In this retrospective study, traumatic dental injury parameters as type, date, location, and cause of injury as well as tooth affected were extracted from the trauma records of patients from 1974 to 1989 and 2014-2016. RESULTS: The descriptive analysis of 444 teeth in 245 patients revealed that the recent and historic samples had a very similar pattern of dental trauma (201/243 teeth in 117/128 patients, respectively): Maxillary permanent central incisors were affected in 70.7% and 68.3%, respectively. Enamel-dentine fractures were the most prevalent fracture injury in both recent and historic samples (64% and 43.1%, respectively) followed by enamel fractures (20.7% and 36.9%, respectively). Subluxations were the most common luxation traumatic dental injury (44.7%) followed by lateral luxation (39.8%) as reported in the historic sample while in the recent sample subluxation constituted 42.9% of luxation injuries followed by concussion (36.2%). CONCLUSION: This study detected a very stable pattern of dental traumatic injuries over 40 years, even after the change from a socialistic society to a market economy.

Potential Uses of Isolated Toxin Peptides in Neuropathic Pain Relief: A Literature Review.

Neuropathic pain is a subset of chronic pain that is caused by neurons that are damaged or firing aberrantly in the peripheral or central nervous systems. The treatment guidelines for neuropathic pain include antidepressants, calcium channel α2 delta ligands, topical therapy, and opioids as a second-line option. Pharmacotherapy has not been effective in the treatment of neuropathic pain except in the treatment of trigeminal neuralgia with carbamazepine. The inability to properly treat neuropathic pain causes frustration in both the patients and their treating physicians. Venoms, which are classically believed to be causes of pain and death, have peptide components that have been implicated in pain relief. Although some venoms are efficacious and have shown benefits in patients, their side-effect profile precludes their more widespread use. This review identifies and explores the use of venoms in neuropathic pain relief. This treatment can open doors to potential therapeutic targets. We believe that further research into the mechanisms of action of these receptors as well as their functions in nature will provide alternative therapies as well as a window into how they affect neuropathic pain.

Differential effects of carvedilol and atenolol on plasma noradrenaline during exercise in humans.

AIMS: Evidence of long-term beneficial effects of beta-blockers on mortality and morbidity in patients with heart failure has been demonstrated in recent randomized trials. However, not all beta-blockers are identical. Carvedilol, a nonselective beta- and alpha-adrenergic blocker, can potentially blunt the release of noradrenaline by blocking presynaptic beta2-adrenergic receptors. To test this hypothesis, we have compared the effects of carvedilol and atenolol on plasma noradrenaline during exercise in healthy young volunteers. METHODS: This study investigated the differential effects of 2 weeks pretreatment with carvedilol 25 mg day(-1) and atenolol 50 mg day(-1) on plasma noradrenaline at rest and during exercise on a treadmill in a double-blind randomized crossover study, involving 12 healthy male volunteers (mean age 21.6 +/- 0.3 years). RESULTS: Haemodynamic parameters at rest and during exercise were not significantly different in either carvedilol or atenolol pretreatment groups. However, carvedilol pretreatment significantly blunted the increase in plasma noradrenaline during exercise [393.8 +/- 51.7 pg ml(-1) (pretreatment) to 259.7 +/- 21.2 pg ml(-1) (post-treatment)], when compared with atenolol [340.4 +/- 54.6 pg ml(-1) (pretreatment) to 396.2 +/- 32.0 pg ml(-1) (post-treatment)]. The difference between carvedilol and atenolol (95% confidence interval) was -145.2, -351.0, P < 0.05. CONCLUSIONS: We have demonstrated that carvedilol but not atenolol significantly blunted the increase in plasma noradrenaline during exercise. These findings may suggest a sympathoinhibitory effect of carvedilol that may enhance its ability to attenuate the cardiotoxicity associated with adrenergic stimulation in patients with heart failure.