New developments in tools for periodontal diagnosis

Objectives: For decades there has been increasing focus on the development of clinically acceptable, more sensitive and specific methods for the accurate and non‐invasive diagnosis and prognosis of periodontitis. There are several well‐known inherent drawbacks to current clinical procedures. The purpose of this article is to summarise some of the newly emerging diagnostic approaches, namely: the ultrasonographic probe; cone‐beam computed tomography; optical coherence tomography; optical spectroscopy, and proteome analysis. Results: These novel diagnostic tools complement one another and, together with conventional clinical and radiographic examination, are likely to provide more accurate methods of diagnosing periodontitis. However, these techniques are yet to be clinically validated and their potential interpreted. Conclusions: For the clinician, the planning of therapy is probably the most critical and difficult step in the treatment of patients with periodontal disease. A new paradigm for periodontal diagnosis will certainly increase understanding of periodontal diseases, which may eventually optimise the predictability of treatment and improve the clinical management of patients with periodontal disease.     

Three-dimensional quantitative structure–activity relationship CoMFA/CoMSIA on pyrrolidine-based tartrate diamides as TACE inhibitors

A series of pyrrolidine-based tartrate diamides having selective tumor necrosis factor-α converting enzyme (TACE) inhibitory activity was selected for the three-dimensional quantitative structure–activity relationship (3D-QSAR) studies. Total 76 compounds were selected by considering a high deviation in the biological activity and structural variations. The quality and predictive power of 3D-QSAR, comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) models for the atom-based, centroid/atom-based, data-based alignments were performed. Various models were developed with the help of these alignments. The best model was developed with data-based alignment. The optimal predictive CoMFA model was obtained with cross-validated r ² = 0.53 with six component, non-cross-validated r ² = 0.94, standard error of estimates 0.23, F-value = 121.98 and optimal CoMSIA model was obtained with cross-validated r ² = 0.53 with five components, non-cross-validated r ² = 0.93, standard error of estimates = 0.24 and F-value = 138.83. These models also showed the best test set prediction with predictive r ² value of 0.65 and 0.73, respectively. Thus, on the basis of predictive power COMSIA model appeared to be the best one. The statistical parameters from these models indicate that the data are being well fitted and also have high predictive ability. Moreover, the resulting 3D-CoMFA/CoMSIA contour maps provide useful guidance for designing of highly active TACE inhibitors.     

Interobserver variation in the classification of thymic tumours--a multicentre study using the WHO classification system

Aims:  To test the reproducibility of the current World Health Organization (WHO) classification of thymic epithelial tumours and to determine the level of interobserver variation within a group of pathologists, all with experience and expertise in thoracic pathology.
Methods and results:  Ninety-five thymic tumours were circulated to a group of 17 pathologists in the UK and The Netherlands over a 1-year period. Participants were asked to classify them according to WHO criteria. The diagnoses were subjected to statistical analysis and κ values calculated. The overall level of agreement was moderate (κ 0.45). When the categories were reduced in number by creating two groups, (A + AB + B1 + B2 and B3 + C), the level of agreement increased to 0.62. An alternative grouping (A + AB + B1 and B2 + B3 + C) increased it slightly further. The best agreement was in tumour types A and AB. Difficulties arose in distinguishing B1 tumours from B2 tumours and B2 tumours from B3 tumours.
Conclusions:  Although the WHO system describes a number of well-defined tumour types with clear diagnostic criteria, the overall level of agreement was moderate and improved if some groups were amalgamated.     

Outcome of Chlamydia pneumoniae associated acute ischemic stroke in elderly patients: a case-control study

Background

Limited data exists about the role of Chlamydia pneumoniae elderly patients with acute ischemic stroke.

Objective

To study the role of C. pneumoniae in elderly patients (age more than 65 years) with acute ischemic stroke and its impact on stroke out come.

Methods

We recruited 100 elderly patients with acute ischemic stroke and 100 age and sex matched controls over a period of 2 years. IgG and IgA anti C. pneumoniae antibodies were measured by microimmunofluorescence technique in patients and controls. Good outcome was defined as a Modified Rankin score (mRS) of ≤2.

Results

We found C. pneumoniae antibodies in 35% stroke patients and in 18% control subjects (p = 0.01). Good out come at 90 days follow up was found in 20/35(57.1%) seropositive stroke patients compared to 37/65(56.9%) seronegative stroke patients (p = 0.9).

Conclusions

C. pneumoniae antibody positivity was independently associated with ischemic stroke in elderly patients and its presence does not alter the stroke outcome.     

Comparison between clinical and audiological results of tympanoplasty with modified sandwich technique and underlay technique

Introduction

Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.

Stereotactic body radiation therapy (SBRT) for early-stage lung cancer in the elderly

Early-stage non-small cell lung cancer (NSCLC) is on the rise due to the implementation of screening guidelines for patients at risk for developing lung cancer. It is anticipated that as the US population continues to age, there will be a higher percentage of medically inoperable early-stage lung cancer patients. For this reason, noninvasive ablative therapies are necessary. Stereotactic body radiation therapy (SBRT) is an effective modality in addressing early-stage NSCLC. SBRT consists of high-dose radiation delivered over 3–5 treatments. Several randomized trials comparing surgery to SBRT in early-stage operable patients have unfortunately closed early due to poor accrual. However, a recent pooled analysis from 2 randomized trials (StereoTActic Radiotherapy and Radiosurgery Or Surgery for operable Early-stage non–small cell Lung cancer) comparing surgery to SBRT did show comparable local control and overall survival rates between surgery and SBRT, offering a very effective, noninvasive modality for older adult patients with early-stage NSCLC. In this review, we summarize the role of SBRT in early-stage NSCLC, in particularly applied to the older adult population.