Prevalence and classification of HIV-associated oral lesions

OBJECTIVES: An International Workshop addressed the prevalence and classification of HIV/AIDS associated oral lesions.
DESIGN: Five questions provided the framework for discussion and literature review. What is the prevalence of oral lesions in children and adults? Should the accepted classification of HIV-related oral lesions be modified in the light of recent findings? Why is there a gender difference in the prevalence of oral lesions in developed and developing countries? Are there unusual lesions present in developing countries? Is there any association between modes of transmission and the prevalence of oral lesions?
RESULTS: Workshop discussion emphasized the urgent need for assistance in the development of expertise to obtain accurate global prevalence data for HIV-associated oral lesions. Oral candidiasis has been consistently reported as the most prevalent HIV-associated oral lesion in all ages. Penicilliosis marneffei, a newly described fungal infection, has emerged in South-east Asia. Oral hairy leukoplakia and Kaposi's sarcoma appear to be associated with male gender and male-to-male HIV transmission risk behaviours. These lesions occur only rarely in children.
CONCLUSIONS: Additional prevalence data are needed from developing countries prior to substantially altering the 1993 ECC/WHO Classification of oral lesions associated with adult HIV infection. The workshop confirmed current oral disease diagnostic criteria.     

Direct quantitation of IgG subclasses 1, 2, and 3 bound to red cells by Rh1 (D) antibodies

The authors developed quantitative radioimmunoassays to allow direct measurement of total human IgG and individual IgG subclasses among antibodies bound to cell surfaces. The assays use four mouse monoclonal radioiodinated antibodies, one that reacts equally well with all four human IgG subclasses and three that are specific for human IgG subclasses 1, 2, or 3. The assays were used to analyze IgG subclass composition in 21 high-titer anti-D samples from Rh-negative volunteers immunized for Rh immunoglobulin production. Anti-D activity was restricted primarily to the IgG1 and IgG3 subclasses. Eleven of 21 sera demonstrated red cell antibodies with a marked predominance of IgG1 (87 +/- 3.6% of total IgG antibody, +/- SEM) and low levels of IgG3 (1.4 +/- 0.73%). In the remaining 10 sera, IgG3 made up a greater proportion of total IgG antibody (32 +/- 3.8%), although IgG1 was still predominant (61 +/- 4.1%). This observed dichotomy in the IgG subclass profiles of different anti-D sera may be a consideration in the selection of anti-D sera for the production of the immunoglobulin used in the prophylaxis of Rh-incompatible pregnancies.     

Isolated headache as the presenting clinical manifestation of intracranial tumors: a prospective study

Isolated headache as the presenting clinical manifestation of intracranial tumors: a prospective study. Cephalalgia 1994;1'4:270-1. Oslo. ISSN 0333-1024We prospectively studied over two years the incidence of headache as the initial and isolated clinical manifestation of adult patients suffering from intracranial tumors ( n = 183). Fifteen patients (8%) exhibited headache as their first and isolated clinical manifestation. Age, sex, neoplasm localization, or pathological diagnosis did not correlate with the presence of headache. Posterior fossa location and hydrocephalus, though not reaching statistical significance, were more frequent in patients who presented with headache as the first symptom. At the moment of diagnosis, 59 (31%) of the patients admitted to headache, though only I out of the 15 patients starting as headache still had this symptom as the only manifestation. From our experience in adults, isolated headache for longer than 10 weeks will only exceptionally be secondary to an intracranial neoplasm.     

The dystrophin gene and cognitive function in the general population

The aim of our study is to investigate whether single-nucleotide dystrophin gene (DMD) variants associate with variability in cognitive functions in healthy populations. The study included 1240 participants from the Erasmus Rucphen family (ERF) study and 1464 individuals from the Rotterdam Study (RS). The participants whose exomes were sequenced and who were assessed for various cognitive traits were included in the analysis. To determine the association between DMD variants and cognitive ability, linear (mixed) modeling with adjustment for age, sex and education was used. Moreover, Sequence Kernel Association Test (SKAT) was used to test the overall association of the rare genetic variants present in the DMD with cognitive traits. Although no DMD variant surpassed the prespecified significance threshold (P<1 × 10⁻⁴), rs147546024:A>G showed strong association (β=1.786, P-value=2.56 × 10⁻⁴) with block-design test in the ERF study, while another variant rs1800273:G>A showed suggestive association (β=−0.465, P-value=0.002) with Mini-Mental State Examination test in the RS. Both variants are highly conserved, although rs147546024:A>G is an intronic variant, whereas rs1800273:G>A is a missense variant in the DMD which has a predicted damaging effect on the protein. Further gene-based analysis of DMD revealed suggestive association (P-values=0.087 and 0.074) with general cognitive ability in both cohorts. In conclusion, both single variant and gene-based analyses suggest the existence of variants in the DMD which may affect cognitive functioning in the general populations.     

Characterization and Local Emission Sources for Ammonia in an Urban Environment

Ammonia levels were evaluated in the urban environment of Madrid City, Spain. A total of 110 samplers were distributed throughout the city. Vehicle traffic density, garbage containers and sewers were identified as local emission sources of ammonia. The average ammonia concentrations were 4.66?±?2.14 µg/m³ (0.39–11.23 µg/m³ range) in the winter and 5.30?±?1.81 µg/m³ (2.33–11.08 µg/m³ range) in the summer. Spatial and seasonal variations of ammonia levels were evaluated. Hotspots were located in the south and center of Madrid City in both winter and summer seasons, with lower ammonia concentrations located in the north (winter) and in the west and east (summer). The number of representative points that were needed to establish a reliable air quality monitoring network for ammonia was determined using a combined clustering and kriging approach. The results indicated that 40 samplers were sufficient to provide a reliable estimate for Madrid City.     

Relationship between periodontal parameters and plasma cytokine profiles in pregnant woman with preterm birth or low birth weight

Objectives

The aim was to determine whether clinical periodontal parameters are associated with plasma anti- and/or pro-inflammatory cytokines in pregnant woman with preterm birth (PB) or low birth weight (LBW) neonates.

Materials and methods

An observational case-control study was performed in 131 puerperal women: mothers of PB/LBW neonates (cases, n?=?67) and mothers of full-term normal-weight neonates (controls, n?=?64). Sociodemographic and periodontal data was gathered from all participants, and interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17, IL-23, and tumor necrosis factor alpha (TNF-α) were determined in plasma.

Results

In multiple linear regression models, clinical attachment loss was associated with TNF-α (0.28?±?0.14; 95 % confidence interval (CI) [0.006, 0.553]) and IL-1β (0.43?±?0.21; 95 %CI [0.018, 0.842]), independent of group membership. IL-1β (?1.67?±?0.27, 95 %CI [?2.199, ?1.141]), IL-6 (?0.86?±?0.27; 95 %CI [?1.389, ?0.331]), and IL-8 (?3.84?±?0.50, 95 %CI [?4.820, ?2.860]) were lower, and IL-10 (0.86?±?0.26; 95 %CI [0.350, 1.370]) was higher in cases versus controls after adjusting for potential confounders.

Conclusions

Clinical attachment loss was associated with plasma TNF-α and IL-1β levels. No plasma cytokine profiles suggestive of systemic inflammatory response were observed in the pregnant women with PB/LBW neonates.

Clinical relevance

Clinical attachment loss, as the main periodontal measure, is associated with TNF-α and IL-1β plasma levels in pregnant women. No relationship was found between PB/LBW and the markers of systemic inflammatory response assessed in this study.

     

Glycaemic,blood pressure and cholesterol control in 25 629 diabetics

Objective

To examine and compare the extent to which people with type 2 diabetes (T2DM) are achieving haemoglobin A_1c (HbA_1c), blood pressure (BP) and LDL cholesterol (LDL-C) treatment targets.

Methods

A review of databases (MEDLINE Ovid, Pubmed and Sabinet) was performed and limited to the following terms: type 2 diabetes mellitus AND guideline AND goal achievement for the years 2009 to 2014 (five years).

Results

A total of 14 studies (25 629 patients) were selected across 19 different countries. An HbA_1c level of 7.0% (or less) was achieved by 44.5% of subjects (range 19.2–70.5%), while 35.2% (range 7.4–66.3%) achieved BP of 130/80 mmHg (or less), and 51.4% (range 20.0–82.9%) had an LDL-C level of either 2.5 or 2.6 mmol/l (100 mg/dl or less).

Conclusion

Despite guideline recommendations that lowering of HbA_1c, BP and lipids to target levels in T2DM will lead to a reduction in morbidity and mortality rates, we found that control of these risk factors remains suboptimal, even across different settings.