Periodontal disease and type 1 diabetes mellitus: Associations with glycemic control and complications: An Indian perspective

AimTo evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and its relationship with diabetic metabolic control, duration and complications.Materials and methodsA comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients versus a group of non-diabetics (n = 20). Statistical analysis was performed to evaluate the relationship between periodontal parameters and degree of metabolic control, the duration of the disease and the appearance of complications.ResultsDiabetics had greater bleeding index (p < 0.001), probing pocket depth (p < 0.001) and clinical attachment level (p = 0.001). Patients diagnosed for diabetes for shorter duration of time (4–7 years) showed bleeding index-disease severity correlation to be 1.760 ± 0.434.ConclusionPatients with type 1 diabetes have increased periodontal disease susceptibility. Periodontal inflammation is greatly increased in subjects with longer disease course, poor metabolic control and diabetic complications.     

Symptomatic large bilateral adrenal metastases at presentation in small-cell lung cancer: a case report and review of the literature

The adrenal gland is a common site for metastasis from lung cancer. Adrenal metastases are usually solitary, asymptomatic and diagnosed incidentally during staging of patients with lung cancer. Bilateral adrenal metastases at the time of diagnosis are seen in 3% of lung cancer patients. Large symptomatic bilateral adrenal metastases at presentation are extremely rare and those occurring in the setting of small cell lung cancer (SCLC) have not been reported previously. Herein we describe a 46-year old male patient with SCLC who was symptomatic from large bilateral adrenal metastases at presentation. The patient was successfully treated with conventional platinum based chemotherapy and had no complications related to the large adrenal masses (intratumoral hemorrhage or adrenal insufficiency) either at presentation or subsequently during treatment and follow up.KEY WORDS : Lung cancer, adrenal gland, metastasis, mass     

Risky behaviors and factors associated with suicide attempt in adolescents.

The objective of this study was to identify the behavior risk factors associated with suicide attempt in adolescents and to determine gender-specific patterns of risk factors. In 2001, the Center for Disease Control and Prevention (CDC) conducted National Youth Risk Behavior Survey for 13,601 high school students in the U.S. Data were analyzed with logistic regressions to identify the risk behaviors. New significant risk factors (being offered illegal drugs at school, being abused by a boyfriend/girlfriend, gender, and ethnicity) were identified for suicidal attempt in adolescents. Patterns of risk behaviors differed among male and female groups. Several new risk behaviors associated with suicide attempt in adolescents were identified. There were notable differences in risk behaviors between two gender groups, especially in the area of depression. These findings could have potentially important implications for preventing adolescent suicide attempts.     

Correlation of clinical and autopsy diagnosis during a 10-year period at the Institute for Pathology and Forensic Medicine at the Military Medicine Academy in Belgrade]

The comparison between the clinical and pathohistoanatomic diagnosis of 3.929 autopsied cases is performed. In 82.5% of cases the clinical and pathohistoanatomic diagnosis were in the absolute correlation; in 8% of cases the clinical diagnosis of the basic disease has no adequate pathoanatomic characteristics, while in 4.5% of cases the clinical diagnosis of the basic disease, immediate cause of death and condition which was important for the course and outcome of the treatment were not adequate. Among the pathologic states diagnosed as: pulmonary thromboembolism, myocardial infarction and cerebrovascular insult--pulmonary embolism most often was not confirmed by autopsy (47%), while in 58% of cases it remained clinically unrecognized. Malignant tumours of the liver, pancreas and kidneys have been most frequently clinically unrecognized compared to other malignancies. Duration of hospitalization has not had the essential influence on correct establishment of the clinical diagnosis.     

Metabolism of the carcinogen (3H)6-nitrochrysene in the preweanling mouse: identification of 6-aminochrysene-1, 2-dihydrodiol as the probable proximate carcinogenic metabolite

6-Nitrochrysene (NC) is a potent lung and liver carcinogen whenadministered in multiple doses to preweanling mice. We haveinvestigated both the in vitro metabolism of (³H)NC by 9000g supernatants (S9) prepared from the livers of preweanlingmice and the in vivo metabolism of (³H)NC in these animals.The in vitro covalent binding of primary metabolites of NC toDNA after further reductive and/or oxidative metabolism wasthen examined in an attempt to define the metabolic activationpathway responsible for the formation of carcinogen-DNA adductsin NC-treated preweanling mice. NC-1,2-dihydrodiol, NC-9, 10-dihydrodiol,6-aminochrysene (AC), and several unidentified compounds werefound in ethyl acetate extracts of incubations containing (³H)NCand liver S9 from 1-or 8-day-old BLU: Ha mice. Comparison ofthe in vivo metabolism of NC in 1-day-old animals and 8-day-oldanimals which had been treated with NC on day 1 indicated thatthe formation of AC and the two NC dihydrodiols was greaterin the younger animals. Further metabolism of NC-1, 2-dihydridiolby S9 from 8-day-old mice yielded AC-1,2-dihydrodiol as a majorproduct. Incubation of AC-1,2-dihydrodiol, calf thymus DNA andliver microsomes from 3-methylcholanthrene-induced rats yieldeda single major adduct that was chromatographically and chemicallyidentical to the major adduct formed in (³HJNC-and (³H)-AC-treatedpreweanling mice. The results indicated that the major DNA adductfound in vivo is derived from the further metabolism of theproximate carcinogen AC-1, 2-dihydrodiol.     

The effects of some antibiotics on polymorphonuclear leukocyte functions of elderly patients in vitro before and after zinc supplementation

The effects of ciprofloxacin, cefodizime, rifampicine, doxycycline and cefodizime + rifampicine combination on polymorphonuclear leukocyte (PMN) functions (phagocytosis and intracellular killing activity) were investigated in vitro in elderly patients and compared with those of healthy young volunteers before and after zinc supplementation. PMNs of 13 elderly hypertensive patients and 10 healthy young volunteers were isolated by Ficoll-Hypaque gradient centrifugation method from venous blood with EDTA. The subjects were given 22 mg/daily/oral zinc supplementation for 1 month. Serum zinc levels before and after supplementation were measured by flame atomic absorbtion spectrophotometer and the effects of each drug on PMN functions at therapeutic concentrations were investigated. Ciprofloxacin significantly increased the PMN's phagocytic activity of elderly patients (p = 0.002) before zinc supplementation and significantly increased both PMN functions of elderly patients (p = 0.002) after zinc supplementation. The same antibiotic significantly increased both PMN functions of healthy young volunteers (p = 0.005 and p<0.05, respectively) before and after zinc supplementation when compared with the control (drug-free). Cefodizime significantly increased the PMN's phagocytic activity of elderly patients (p = 0.003, p = 0.002) before and after zinc supplementation when compared with the control (drug-free). It also significantly increased both PMN functions of healthy young volunteers (p = 0.005 and p<0.05, respectively) before and after zinc supplementation when compared with the control (drug-free). Doxycycline significantly increased PMN's intracellular killing activity of healthy young volunteers before zinc supplementation (p<0.05) when compared with the control (drug-free) values. Rifampicine significantly decreased PMN's phagocytic activity of elderly patients (p<0.05) after zinc supplementation. Cefodizime+rifampicine combination significantly increased PMN's phagocytic activity at therapeutic concentrations of healthy young volunteers (p = 0.005) before zinc supplementation and PMN's phagocytic activity of elderly patients (p<0.05) after zinc supplementation when compared with the control (drug-free). Consequently, in the present study from the antibiotics ciprofloxacin, cefodizime and cefodizime + rifampicine combination, which are accepted as biological response modifiers have demonstrated stimulatory effects by significantly increasing polymorphonuclear leucocyte functions (phagocytosis and/or intracellular killing activity) of elderly patients and healthy young volunteers in vitro before and after zinc supplementation. Additionally zinc supplementation has more immunostimulatory effects on PMN functions of healthy young volunteers than elderly patients.