Thyroid-associated ophthalmopathy in Iranian patients

We determined the frequency of clinical thyroid ophthalmopathy in Iranian patients. This cross-sectional study was performed at the Endocrinology Institute of Tehran University of Medical Sciences. All patients with documented thyroid disorders from September 2003 to July 2005 were recruited. Eye examinations included evaluation of soft tissue changes, measurement of proptosis, lid width, lagophthalmos, evaluation of eye muscle function, and determination of visual acuity. The activity of ophthalmopathy was scored according to the NOSPECS scale. Among 851 visited patients, 303 cases had thyroid eye disease (TED). The nature of the ophthalmopathy breaks down as follows: 53.4% were hypothyroid (9.3% Hashimoto disease), 5.5% euthyroid and 41.1% had Graves' disease. The prevalence of TED in males was 60% which was nearly 2 times the prevalence of TED in females. There was a significant relationship between presentation of TED and active smoking of the patients (P<0.0001) while no significant relationship with passive smoking was obtained (P=0.181). The most common clinical sign of TED in descending order respectively were proptosis with 63.4%, soft tissue involvement (40.9%), extraocular muscle involvement (22.1%), corneal involvement (12.9%) and optic nerve dysfunction (6.3%). Myasthenia gravis occurred in only 2 patients. In the logistic regression, occurrence of TED was influenced by cardiovascular disease (OR=5.346), Graves' disease (OR=47.507), radioiodine therapy (OR=2.590), and anti-thyroid medications (OR=0.650). Thyroid ophtalmopathy (orbitopathy) is a matter of important health concern among patients with thyroid disorder. Since TED occurred with a high prevalence in all thyroid states, a close collaboration between endocrinologists and ophthalmologists along with timely referrals of patients with any eye complaint is deemed necessary. Also smoking was the most important risk factor for developing TED. Therefore, it is advisable to raise awareness and to strongly encourage smokers with thyroid disorders to quit smoking.     

Soil-transmitted helminthiasis in rural south-west China: prevalence, intensity and risk factor analysis

Only few studies in rural China have explored the epidemiology of intestinal helminth infections and identified risk factors for transmission. The study was carried out in Simao and Mengla counties, where single fecal samples were collected from 317 school-aged children and from 94 inhabitants of a single village. Fecal specimens were examined with the Kato-Katz thick smear method and examined for helminth eggs. Data regarding socio-demographic and behavioral risk factors were collected using questionnaires. In Simao County the overall soil-transmitted helminthes (STH) prevalence was 40.2% (2.7, 5.4 and 35.7% for ascariasis, trichuriasis and hookworm infection, respectively). The STH infection rates were significantly higher in Mengla County, with an overall prevalence of 68.3% (19.0, 34.6 and 47.3% for ascariasis, trichuriasis and hookworm infection, respectively). Females were less likely to be infected with Trichuris trichiura (OR 0.29; 95% CI 0.15-0.56) and with hookworms (OR 0.55; 95% CI 0.33-0.93) than males. Hookworm infections were more prevalent among those 12 years of age or older (OR 2.9; 95% CI 1.2-7.1). Children of mothers with educational attainment of secondary school or higher had a protective effect against T. trichiura (OR 0.18; 95% CI 0.06-0.54) and hookworm (OR 0.21; 95% CI 0.09-0.51) infections. In the village survey, hookworm was the most prevalent species (62.8%) with infection seen in those 50 years of age and older. Based on recommended intervention strategies by the World Health Organization, Simao County should opt for school-based deworming once each year, while Mengla County should implement a similar strategy biannually, but should include the elderly population.     

Involvement of foot in patients with spondyloarthritis: Prevalence and clinical features

Background

The purpose of this study was to evaluate the foot involvement in a group of patients with spondyloarthritis in regard to symptoms, type and frequency of deformities, location and radiological changes.

Time to redefine body mass index categories in chronic diseases? Spotlight on obesity paradox

Obesity is a complex condition classically characterised by excessive body fat accumulation and represents one of the most important public health problems worldwide. Although several epidemiological studies have shown that elevated BMI is associated with higher morbidity, and with increased rate of death from all causes and from cardiovascular disease, accumulating evidence suggests that being overweight or obese may be protective (the so-called obesity paradox), at least in chronic diseases. These observations, not only question the validity of the BMI system, but also raise the intriguing question of whether we should redefine what the normal range of BMI is in individuals suffering from a chronic disease. In the present article, we review the available information on the association between elevated BMI and increased morbidity and mortality including obesity-related paradoxes, explore key aspects of the role and limitations of BMI as a measure of increased adiposity and outline potential solutions to address the current controversies regarding the impact of obesity on human health.     

Post-treatment positron emission tomography-computed tomography is highly predictive of outcome in Plasmablastic lymphoma

Purpose

Plasmablastic lymphoma (PBL) is a rare variant of diffuse large B cell lymphomas (DLBCL) clinically characterized by a poorer prognostic. Few clinical and imaging data are available and derived from pooled case reports and small series. The aim of the study was to evaluate the FDG avidity at baseline and the utility of 18-Fluorodeoxyglucose (FDG) positron-emission-tomography/computed-tomography (PET/CT) for staging and response assessment.

Methods

Patients with newly diagnosed PBL seen at Lymphoma Study Association centers during the period 2005–2015 were included if they underwent a PET/CT at staging and at the end of treatment (eotPET) and had received an anthracycline-based first line therapy. EotPET scans were analyzed using the 5-point-scale visual analysis in accordance with Lugano criteria. Patients were classified in complete metabolic response (CMR) or no-CMR including partial metabolic response (PMR), stable disease (SD) and progression disease (PD). EotPET results were assessed for the ability to predict event free survival (EFS) and overall survival (OS).

Results

Thirty-five PBL patients fulfilled the inclusion criteria. The median follow-up was 34 months (2.8–120 months). FDG avidity was found in all patients at diagnosis. Most patients (80%) achieved CMR, and 20% were no-CMR including 9% PMR, 6% SD, and 6% PD. A CMR after first line chemotherapy predicted higher EFS (p?<?0.0001) and OS (p?=?0.0006).

Conclusions

This study confirmed the FDG avidity of PBL subtype and the usefulness of PET/CT scanning in restaging an aggressive lymphoma at the completion of chemotherapy. EotPET can predict outcomes following treatment in patients with PBL.

     

CGP12177-induced haemodynamic and vascular effects in normotensive and hypertensive rats

CGP12177 is a non-conventional partial agonist, known to have cardiostimulating and vasorelaxant properties related to its agonist action on the low affinity state of the beta(1)-adrenoceptor (beta(1LA)-adrenoceptor). In normotensive Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SHR), CGP12177-induced vasorelaxant effects were analysed in hindquarter vessels to assess modifications in hind limb vascular resistance, and in femoral artery rings. The global haemodynamic effects induced by CGP12177 were also investigated using telemetry in conscious animals. In hindquarters vasculature precontracted with 5-hydroxytryptamine, CGP12177 (0.16 to 475 microg) produced a similar dose-dependent decrease in hindquarters perfusion pressure in both strains. Vasorelaxation was not modified by nadolol, a beta(1) and beta(2)-adrenoreceptor antagonist, nor by L748337, a beta(3)-adrenoceptor antagonist, but was concentration dependently inhibited by bupranolol, a beta(1LA)-adrenoceptor antagonist at high concentrations. In femoral artery rings from WKY rats and SHR, CGP12177 produced a concentration-dependent relaxation, which was unaffected by nitric oxide synthases inhibition but was significantly reduced in the presence of bupranolol. With double cardiac autonomic blockade (atropine plus atenolol) in conscious WKY rats and SHR, CGP12177 greatly increased heart rate with minor changes in mean arterial pressure in both strains. Conversely, in the absence of double cardiac autonomic blockade, the amplitude of CGP12177-induced heart rate increase was less pronounced and had an hypotensive effect. The reduction in tachycardia and the hypotension were significantly greater in SHR compared to WKY rats. In conclusion, in both strains, CGP12177 produced vasodilating effects in hindquarter vessels and femoral arteries that can be attributed to a beta(1LA)-adrenoceptor stimulation. In conscious WKY rats and SHR, CGP12177-induced cardiostimulation and hypotension were not significantly different after baroreflex blockade, but were decreased and increased respectively, in the presence of baroreflex activity.     

Culture of human gingival fibroblasts on a biodegradable scaffold and evaluation of its effect on attached gingiva: a randomized, controlled pilot study

BACKGROUND: An adequate width of attached gingiva is necessary to maintain healthy periodontium, especially in orthodontics or restorative treatments in periodontics. The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique. METHODS: This study was conducted on nine patients (18 sites) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw. A small portion (approximately 3 x 2 x 1 mm) of attached gingiva (epithelial + connective tissue) was removed with a surgical blade. After culture of gingival fibroblasts, 2 x 10(5) cells in 250 microl nutritional medium were added to 250 microl collagen gel. One tooth in each patient was randomized to receive a periosteal fenestration technique for gingival augmentation (control) or a tissue-engineered mucosal graft (test). Clinical parameters measured at baseline and 3 months included width of keratinized tissue, probing depth, and width of attached gingiva. RESULTS: An increased amount of keratinized tissue was seen at all treated sites after 3 months. The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites; this difference was significant (P < 0.05). CONCLUSION: Based on the results of this investigation, the tissue-engineered mucosal graft is safe and capable of generating keratinized tissue.     

Mud-Based Construction Material: Promising Properties of French Gravel Wash Mud Mixed with Byproducts,Seashells and Fly Ash as a Binder

The French gravel industry produces approximatively 6.5 million tons of gravel wash mud each year. This material offers very promising properties which require an in-depth characterization study before its use as a construction material, otherwise it is removed from value cycles by disposal in landfills. We examined the suitability of gravel wash mud and seashells, with fly ash as a binder, as an unfired earth construction material. Thermal and mechanical characterizations of the smart mixture composed of gravel wash mud, Crepidula fornicata shells and fly ash are performed. The new specimens exhibit high compressive strengths compared to usual earth construction materials, which appears as a good opportunity for a reduction in the thickness of walls. The use of fly ash and Crepidula shells in addition to gravel wash mud provides high silica and calcium contents, which both react with clay, leading to the formation of tobermorite and Al-tobermorite as a result of a pozzolanic reaction. Considering the reduction in porosity and improvements in strength, these new materials are good candidates to contribute significantly to the Sustainable Development Goals (SDGs) and reduce carbon emissions.