A modified alar cinch suture technique

Widening of the alar base following total maxillary osteotomy is a well-known phenomenon. This change in the nasal morphology can compromise the facial aesthetics of the patient. Alar cinching through the vestibular incision used for maxillary osteotomy appears to be a simple and convenient means to narrow the alar base. We present a modified alar base cinch suturing technique and compare it with the published techniques in the literature.     

Semen analysis in chronic bacterial prostatitis： diagnostic and therapeutic implications

The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.     

International expert consensus on primary systemic therapy in the management of early breast cancer: highlights of the Fourth Symposium on Primary Systemic Therapy in the Management of Operable Breast Cancer, Cremona, Italy (2010)

A panel of international breast cancer experts formulated a declaration of consensus regarding many key issues in the use of primary systemic therapy (PST) either in clinical routine or research practice. The attainment of pathological complete response (pCR), defined as no residual invasive tumor in the surgical specimens both in breast and in axillary nodes, is one of the main goals of PST, and pCR can be used as the primary objective in prospective clinical trials. However, pCR is not a reliable endpoint with all treatment approaches, and alternatives such as Ki67 index of the residual invasive disease or after 2 weeks of PST are also potential endpoints. PST has several advantages: breast conservation and the unique opportunity to obtain information on the interaction between treatment and tumor biology. Changes in tumor biology after PST are an early phenomenon; so, an additional core biopsy performed after 14 days from treatment start should be considered in clinical trials.     

Intensity and duration of in‐vitro antibacterial activity of different adhesives used in orthodontics

This work investigated the antibacterial activity of 14 bonding agents to predict their ability to inhibit white‐spot development during orthodontic treatment. Standardized, sterilized disks of each material were continuously rinsed (for up to 180 d) in a flow of sterile saline. At predetermined time points, the residual ability of each material to inhibit bacterial growth (determined by measuring the size of inhibition halos around disks placed onto appropriate culture media seeded with Streptococcus gordonii DSM6777, Streptococcus sanguinis DSM20567, Streptococcus mutans DSM20523, or Lactobacillus acidophilus DSM20079) and biofilm formation (determined by measuring the numbers of bacteria adherent to disks following incubation in appropriate broths) was tested in triplicate and compared with the baseline activities of freshly prepared materials. Overall antibacterial and anti‐biofilm activities, adjusted for exposure time and strain of bacteria, were assessed. The decrease of antibacterial activity was faster (30–60 d) and complete for fluoride‐enriched materials, but slower (90 d) and partial for antimicrobial‐containing materials (benzalkonium chloride, zinc oxide, chlorexidine, or MDPB). Materials enriched with benzalkonium chloride, chlorexidine, or MDPB showed the highest antibacterial activities. Anti‐biofilm assays yielded similar results. These data could be helpful for clinicians in the choice of the best performing bonding agent also in light of duration of the clinical application.     

Parasitic infections detected by FLOTAC in zoo mammals from Warsaw,Poland

The aim of this study was to estimate the occurrence of intestinal parasites in groups of mammals kept in the Warsaw zoological garden (Poland). 71 pools of fecal samples were analyzed using the FLOTAC techniques. 48% of animals were positive and 47% of positivities showed multiple infections. Toxocara cati (71.4%) was found in felines; marsupials were infected with Coccidia (90%). Giardia spp. (24.0%), Blastocystis spp. (12.3%), Iodamoeba spp. (10.0%), Enterobius vermicularis (6.0%) and Entamoeba coli (3.3%) were found in primates. Gastrointestinal strongyles (60.5%) were prevalent in ruminants which resulted positive also to Coccidia (Eimeria spp. = 50.0%), Trichuris spp. (25.0%) and Nematodirus (14.0%). Strongyles (34.0%) were the most frequent parasites in monogastric herbivores, followed by Parascaris equorum (17.0%). None of the animals showed any symptom associated with gastrointestinal parasitic infections. According to our results the need to prevent, diagnose, control, and treat intestinal parasitism trough specific control programs is mandatory for animal welfare in order to limit the spread of parasitic infections in animals and humans.