Evaluation of arthrographically assisted splint therapy in treatment of TMJ disk displacement

Eighty-two patients with audible clicking were evaluated and treated with splints made by using arthrographic assistance. In the course of this study, it became apparent that the later the opening click, the earlier the closing click. It was not always possible to auscultate or palpate either an opening or a closing click in many patients with arthrographic findings of disk displacement with reduction. Since the opening click was the only audible sound in some patients, clinical judgment alone cannot be used to replace the displaced disk at an optimal mandibular position. The elimination of the opening click does not always signify recapture of the disk. Maxillomandibular and incisal relationships limit the amount of protrusion possible to recapture the displaced disk.     

The serum selenium concentration of patients with acute myocardial infarction

Serum selenium concentration was determined in 49 patients with acute myocardial infarction within 4 hours after the beginning of the symptoms. The mean serum selenium concentration of the patients was significantly lower than that of healthy controls (55 +/- 15 micrograms/l vs. 78 +/- 11 micrograms/l). Among the 49 patients with acute myocardial infarction 20 (41%) had serum selenium concentration below the 95% percentile of the healthy control group. It is concluded that the low serum selenium concentration was present in these patients before the acute event and was not a consequence of the myocardial infarction. No relationship was found in this study between the serum selenium concentration and the severity of myocardial infarction if the number of coronary vessels occluded is taken as the criterion of severity. Serum selenium concentration was similar in patients with 1 or more coronary vessels occluded. Patients with anterior or posterior myocardial infarction had similar serum selenium concentrations. A positive correlation was observed between serum selenium concentration and total serum creatine kinase (CK) activity and serum myoglobin (MB). The serum selenium concentration correlated negatively with the ratio CK-MB/total CK activity, which can be interpreted as minor injury of mitochondria during infarction in patients with normal serum selenium concentration.     

Effect of LSR polymorphism on blood lipid levels and age‐specific epistatic interaction with the APOE common polymorphism

The lipolysis stimulated lipoprotein receptor (LSR) is an apolipoprotein (Apo) B and ApoE receptor that participates in the removal of triglyceride‐rich lipoproteins during the postprandial phase. LSR gene is located upstream of APOE, an important risk factor for cardiovascular disease (CVD). Since the APOE common polymorphism significantly affects the variability of lipid metabolism, this study aimed to determine the potential impact of a functional SNP rs916147 in LSR gene on lipid traits in healthy subjects and to investigate potential epistatic interaction between LSR and APOE. Unrelated healthy adults (N = 432) and children (N = 328, <18 years old) from the STANISLAS Family Study were used. Age‐specific epistasis was observed between APOE and LSR, reversing the protective effect of APOE ε2 allele on cholesterol, ApoE and low‐density lipoprotein levels (β: .114, P: .777 × 10^?8, β: .125, P: .639 × 10^?3, β: .059, P: .531 × 10^?3, respectively). This interaction was verified in an independent adult population (n = 1744). These results highlight the importance of the LSR polymorphism and reveal the existence of complex molecular links between LSR and ApoE for the regulation of lipid levels, revealing potential new pathways of interest in type III hyperlipidemia and its involvement in CVD pathology.     

Open trial of cefepime (BMY 28142) for infections in hospitalized patients.

The safety and efficacy of cefepime, a new broad-spectrum, semisynthetic parenteral cephem antibiotic, were evaluated in an open trial at a single hospital. Seventy patients were treated with cefepime: 44 had lower respiratory tract infections, 4 had urinary tract infections, and 22 had skin or soft tissue infections. Of 65 clinically evaluable patients, 64 (98%) had satisfactory responses. No mortality or superinfections occurred. Of 57 respiratory and urinary tract pathogens, 54 (95%) were eradicated and 3 (5%) persisted after therapy. Five bacteremias (two with Streptococcus pneumoniae and one each with Staphylococcus aureus, Proteus mirabilis, and a coagulase-negative staphylococcus) were eradicated. MICs ranged from 1 to 8 micrograms/ml for 13 S. aureus and 9 Pseudomonas aeruginosa isolates and were less than or equal to 0.125 micrograms/ml for 10 streptococcal isolates. Adverse effects occurred in two patients: transient diarrhea and Clostridium difficile toxin in the stool in one patient and loose bowel movements and increased transaminases in the other patient. Cefepime appeared to be well tolerated in humans and was effective against a wide range of isolates, including S. aureus and P. aeruginosa.     

Magnetic bead technology in viral RNA and DNA extraction from plasma minipools

BACKGROUND: Nucleic acid testing (NAT) of pooled plasma samples from individual blood donations for viral nucleic acids has become widely established. Full automation of such sample processing can overcome many of the problems associated with methods used so far. STUDY DESIGN AND METHODS: In this study an automated extraction method for viral nucleic acids (parvovirus [PAV] B19 DNA, hepatitis B virus [HBV] DNA, and hepatitis A virus [HAV] RNA), starting directly from the minipool sample (n = 96, 9.6 mL), was evaluated. A magnetic separation module I (chemagic, Polymer Laboratories) in combination with the chemagic viral DNA and RNA kit special based on the use of magnetic beads was used for this purpose. More than 144 pools spiked with defined concentrations of reference material and an additional 102 pools negative for the analyte were extracted and amplified. The isolated viral nucleic acids were detected by polymerase chain reaction (PCR). RESULTS: The assays were highly specific and obtained a 95 percent detection limit of 875 IU per mL of pooled single donation for PAV B19, 260 IU per mL for HAV, and 1274 IU per mL for HBV, respectively. The crossing points showed variation coefficients from 1.49 to 2.76 percent. The turnaround time for the whole process was 3 hours. Testing of subpools to determine an infected single donation would be possible with the same general extraction method. A total of 102 unspiked minipools (96 x 100 microL per donation) were analyzed and none tested positive. CONCLUSION: The automated magnetic bead-based extraction in combination with real-time PCR detection can be used to routinely screen blood donations for viremic donors to further increase the safety of blood products. Minipools as well as subpools can be directly processed.     

HIV and HCV health beliefs in an inner-city community

Summary. Chronic infection with the hepatitis C virus (HCV) is more prevalent than human immunodeficiency virus (HIV) infection, but more public health resources are allocated to HIV than to HCV. Given shared risk factors and epidemiology, we compared accuracy of health beliefs about HIV and HCV in an at‐risk community. Between 2002 and 2003, we surveyed a random patient sample at a primary care clinic in New York. The survey was organized as domains of Common Sense Model of Self‐Regulation: causes (‘sharing needles’), timeline/consequences (‘remains in body for life’, ‘causes cancer’) and controllability (‘I can avoid this illness’, ‘medications may cure this illness’). We compared differences in accuracy of beliefs about HIV and HCV and used multivariable linear regression to identify factors associated with relative accuracy of beliefs. One hundred and twenty‐two subjects completed the survey (response rate 42%). Mean overall health belief accuracy was 12/15 questions (80%) for HIV vs 9/15 (60%) for HCV (P < 0.001). Belief accuracy was significantly different across all domains. Within the causes domain, 60% accurately believed sharing needles a risk factor for HCV compared to 92% for HIV (P < 0.001). Within the timeline/consequences domain, 42% accurately believed HCV results in lifelong infection compared to 89% for HIV (P < 0.001). Within the controllability domain, 25% accurately believed that there is a potential cure for HCV. Multivariable linear regression revealed female gender as significantly associated with greater health belief accuracy for HIV. Thus, study participants had significantly less accurate health beliefs about HCV than about HIV. Targeting inaccuracies might improve public health interventions to foster healthier behaviours and better hepatitis C outcomes.