The influence of experimental hyperthyroidism on responsiveness in rabbit aortic smooth muscle

This study investigated the responsiveness of hyperthyroid and control (euthyroid) rabbit aortic rings to vasoconstrictor agents. There was no significant difference between the responsiveness of hyperthyroid and control tissues to KCl. Maximum responses (E(m)) to noradrenaline and serotonin were reduced in hyperthyroid rabbit aortic rings compared to those euthyroid rings. The sensitivity (i.e., EC(50)) of hyperthyroid aortic rings to noradrenaline and serotonin compared to euthyroid controls was unchanged. The K(b) value of prazosin against 10(-6) M noradrenaline-induced contractions in eu- and hyperthyroid states was 1.97 ± 0.59 · 10(-9) M and 1.92 ± 0.79 · 10(-9) M, respectively. The K(b) value of methisergide against 10(-6) M serotonin-induced contractions in eu- and hyperthyroid states was 1.46 ± 0.80 · 10(-9) M and 1.10 ± 0.16 · 10(-9) M, respectively. These data indicate that vascular reactivity is altered in experimental hyperthyroidism and this alteration, if any, do not occur at the receptor level.     

Anglomyofibroblastoma of the vulva: Case report

Anglomyxomas are a group of relatively rare mesenchymal myxold tumors. Three types of angiomyxomas have been Identltled: superflciat anglomyxoma, aggresslve anglomyx-oma and anglomyoflbroblastoma. These tumors have a predllection for occurring in the perineum of middie-aged femaies and are often clinically diagnosed as Bartholin's cyst A case of a 42-year-old female with a perineal angiomy-ofibrobtastoma mimicking a Bartholin's cyst is presented. The pathological and clinical characteristics of this tumor are discussed.     

Antimicrobial resistance in urosepsis: outcomes from the multinational,multicenter global prevalence of infections in urology (GPIU) study 2003–2013

Objective

Primary objective was to identify the (1) relationship of clinical severity of urosepsis with the pathogen spectrum and resistance and (2) appropriateness of using the pathogen spectrum and resistance rates of health-care-associated urinary tract infections (HAUTI) as representative of urosepsis. The secondary objective was to provide an overview of the pathogens and their resistance profile in patients with urosepsis.

Population and Methods

A point prevalence study carried out in 70 countries (2003–2013). Population studied included; 408 individuals with microbiologically proven urosepsis, 1606 individuals with microbiological proof of HAUTI and 27,542 individuals hospitalised in urology wards. Main outcomes are pathogens and resistance identified in HAUTIs and urosepsis including its clinical severity. A statistical model that included demographic factors (study year, geographical location, hospital setting) was used for analysis.

Results

Amongst urology practices, the prevalence of microbiologically proven HAUTI and urosepsis was 5.8 and 1.5 %, respectively. Frequent pathogens in urosepsis were E. coli (43 %), Enterococcus spp. (11 %), P. aeruginosa (10 %) and Klebsiella spp. (10 %). Resistance to commonly prescribed antibiotics was high and rates ranged from 8 % (imipenem) to 62 % (aminopenicillin/β lactamase inhibitors); 45 % of Enterobacteriaceae and 21 % of P. aeruginosa were multidrug-resistant. Resistance rates in urosepsis were higher than in other clinical diagnosis of HAUTI (Likelihood ratio <0.05).

Conclusions

It is not appropriate to use the pathogen spectrum and resistance rates of other HAUTIs as representative of urosepsis to decide on empirical treatment of urosepsis. Resistance rates in urosepsis are high, and precautions should be made to avoid further increase.

     

Maternal serum concentrations of s-Endoglin and IL-6 in pregnancy complicated by preterm premature membrane rupture

Objective: This study aimed to investigate maternal serum concentrations of s-Endoglin and compare s-Endoglin with other inflammatory markers in prediction of time to delivery, in pregnancies complicated by preterm premature rupture of membranes (PPROM).

Materials and methods: Fifty five patients complicated by PPROM whose gestational age were between 2433 weeks and 44 matched healthy pregnant women were included in present study. Maternal concentrations of s-Endoglin concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) and compared with maternal inflammatory markers including interleukin-6 (IL-6), white blood cell (WBC) count and serum C-reactive protein (CRP). The best variable for prediction of preterm birth was computed.

Results: Mean s-Endoglin levels in PPROM were lower than control groups (0.24?±?0.12?pg/ml and 0.69?±?0.25?pg/ml, respectively, p?<?0.01). Besides IL-6 (p?<?0.01), WBC (p?=?0.016) and CRP (p?=?0.010) levels were higher in PPROM group. In PPROM group, ROC analysis results of s-Endoglin for prediction of preterm delivery <48 h, <7 days, <32 weeks were not different (p?>?0.05). For predicting preterm birth before 48 h and 7 days, only IL-6 at cut off value >0.70 (pg/ml) and >0.55 (pg/ml) had area under curve (AUC); 0.871 (0.7750.965), p?<?0.01, AUC; 0.925 (0.8560.993), p?<?0.001, respectively.

Conclusion: s-Endoglin as an anti-angiogenic marker seemed to have a role in pathogenesis but results of present study showed that, unlike IL-6, it was unsatisfactory for estimating time to delivery in PPROM.     

Are the flowable composites suitable for orthodontic bracket bonding?

The study aims to determine the shear bond strength (SBS) values of different flowable composites (Pulpdent Flows-Rite, 3M Filtek Flow, and Heraeus Kulzer Flow Line) in comparison with a conventional orthodontic adhesive and the bond failure sites of these composites. Eighty extracted human premolars were divided into four groups of 20 teeth each. Brackets were bonded to the teeth in each test group with different composites, according to the manufacturer's instructions. SBS values of these brackets were recorded (in MPa) using a universal testing machine. Adhesive remnant index (ARI) scores were determined after the failure of brackets. Data were analyzed using analysis of variance (ANOVA), Tukey honestly significant difference, and chi-square tests. SBS values of groups 1 (Transbond XT), 2 (Flows-Rite), 3 (Flow), and 4 (Flow Line) were found to be 17.10 +/- 2.48 MPa, 6.60 +/- 3.2 MPa, 7.75 +/- 2.9 MPa, and 8.53 +/- 3.50 MPa, respectively. The results of this study demonstrate that the orthodontic adhesive (Transbond XT) had higher SBS values than the flowable composites. Results of ANOVA revealed statistically significant differences among the groups (P < .05). The SBS values were significantly lower in all flowable composite groups than the orthodontic adhesive. ARI scores were significantly different between the orthodontic adhesive and all the flowable groups investigated. The use of flowable composites is not advocated for orthodontic bracket bonding because of significantly lower SBS values achieved.     

The effects of early preorthodontic trainer treatment on Class II, division 1 patients

The aim of this study was to clarify the dentoskeletal treatment effects induced by a preorthodontic trainer appliance treatment on Class II, division 1 cases. Twenty patients (10 girls and 10 boys, mean age 9.6 +/- 1.3 years) with a Class II, division 1 malocclusion were treated with preorthodontic trainer appliances (Myofunctional Research Co., Queensland, Australia). The patients were instructed to use the trainer every day for one hour and overnight while they slept. A control group of 20 patients (mean age 10.2 +/- 0.8 years) with untreated Class II, division 1 malocclusions was used to eliminate possible growth effects. Lateral cephalograms were taken at the start and end of treatment. Final cephalograms were taken 13.1 +/- 1.8 months after trainer application, compared with a mean of 11.2 +/- 2.4 months later for the control group. The mean and standard deviations for cephalometric measurements were analyzed by paired-samples t-test and independent-samples t-tests. At the end of the study period, the trainer group subjects showed significant changes including anterior rotation and sagittal growth of the mandible, increased SNB and facial height, reduced ANB, increased lower incisor proclination, retroclination of upper incisors, and overjet reduction. However, only total facial height increase, lower incisor proclination, and overjet reduction were significantly higher when compared with the changes observed in the control group. This study demonstrates that the preorthodontic trainer application induces basically dentoalveolar changes that result in significant reduction of overjet and can be used with appropriate patient selection.     

Clinical predictors of incipient vertebral fractures and bone mineral density in kidney transplant patients

Purpose

Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients.

Methods

Two hundred sixty-four patients (F/M 124/140, 45.3 ± 13 years) who had undergone kidney transplantation in tertiary care centers were included. Vertebral fractures were assessed semiquantitatively using conventional thoracolumbar lateral radiography in 202 of the patients.

Results

Vertebral fractures were observed in 56.4% (n = 114) of the study group. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). Bone mineral density (BMD) levels were in the normal range in 40.3% (n = 46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n = 23) and the osteopenic range in 40.3% (n = 46). Vertebral fractures were associated with age, duration of hemodialysis, BMI, and femoral neck Z score (R² 37.8%, p = 0.027).

Conclusion

As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.

     

Crohn＇s disease complicated by multiple stenoses and interna fistulas clinically mimicking small bowel endometriosis

We report a 31-year-old woman with Crohn＇s disease complicated by multiple stenoses and internal fistulas clinically misdiagnosed as small bowell endometriosis, due to the patient＇s perimenstrual symptoms of mechanical subileus for 3 years; at first monthly, but later continuous, and gradually increasing in severity. We performed an exploratory laparotomy for small bowel obstruction, and found multiple ileal strictures and internal enteric fistulas. Because intraoperative findings were thought to indicate Crohn＇s disease, a right hemicolectomy and partial distal ileum resection were performed for obstructive Crohn＇s ileitis. Histopathology of the resected specimen revealed Crohn＇s disease without endometrial tissue. The patient made an uneventful recovery from this procedure and was discharged home 10 d post-operatively. The differential diagnosis of Crohn＇s diease with intestinal endometriosis may be difficult pre-operatively. The two entities share many overlapping clinical, radiological and pathological features. Nevertheless, when it is difficult to identify the cause of intestinal obstruction in a woman of child- bearing age with cyclical symptoms suggestive of small bowel endometriosis, Crohn＇s disease should be included in the differential diagnosis.