Treatment with convalescent plasma in solid organ transplant recipients with COVID-19: Experience at large transplant center in New York City

Solid organ transplant (SOT) recipients may be at higher risk for poor outcomes with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Convalescent plasma is an investigational therapy that may benefit immunosuppressed patients by providing passive immunity. Convalescent plasma was administered to hospitalized patients with coronavirus disease-2019 (COVID-19) at an academic transplant center in New York City. Eligible patients were hospitalized and required to have positive nasopharyngeal polymerase chain reaction (PCR) diagnosis of SARS-CoV-2 infection, be at least 18 years old, and have either dyspnea, blood oxygen saturation ≤ 93% on ambient air, respiratory frequency ≥ 30 breaths/min, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, or lung infiltrates > 50%. Thirteen SOT recipients received convalescent plasma from April 9, 2020, to May 17, 2020. The median time from symptom onset to plasma infusion was 8 days. Eight of 13 patients (62%) had de-escalating oxygenation support by day 7 post-convalescent plasma. Nine (69%) patients were discharged, 1 (7%) patients remain hospitalized, and 3 (23%) patients died. This series supports the need for additional studies on convalescent plasma use in SOT recipients with COVID-19 to better determine efficacy and identify patients who are likely to benefit.     

A study of therapy targeted EGFR/ALK mutations in Indian patients with lung adenocarcinoma: A clinical and epidemiological study

Background

Established predictive biomarkers for Non-Small Cell Lung Carcinoma (NSCLC) include sensitizing Epidermal Growth Factor Receptor (EGFR) mutations and Anaplastic Lymphoma Kinase (ALK) fusion oncogene. The primary aim of the study is to ascertain the prevalence of EGFR mutation and ALK gene rearrangement in patients of lung adenocarcinoma in Indian population and the second objective is to impress upon the importance of adequate processing of limited tissue samples.

Treatment of chronic wounds with polyurethane sponges impregnated with boric acid particles: A randomised controlled trial

The objective of this study was to investigate the effectiveness of the sponge with boric acid particles combined with the negative pressure wound treatment (NPWT) system for chronic wounds with tissue defects. Our study was designed as a prospective randomised study. One hundred patients who were planned to have NPWT due to chronic wounds were included in this study from Orthopaedics and Traumatology and Plastic Surgery clinics. Patients were divided into two groups. In the first group, a new method, boric acid impregnated sponge, combined with the NPWT system, was used, and in the second group, sponge with silver nitrate was used. Besides the wide‐broad spectrum antibacterial properties of silver nitrate, the antimicrobial, angiogenetic, and epithelial effects of boric acid were aimed to investigate by macroscopically and histopathologically. Thirty‐six patients in the silver nitrate group and 44 patients in the boric acid group completed the study. A decrease in wound size and granulation was observed in both groups. Macroscopically, a decrease in wound size reduction, epithelialization and granulation were more prominent in the first group in which boric acid impregnated sponge was used than the second group in which silver sponge was used. Moreover, microscopically, the number of fibroblasts, collagen synthesis, and angiogenesis were significantly increased in Group 1. In this clinical study, the broad‐spectrum antimicrobial properties of boric acid and its positive effect on the cells responsible for wound healing were found to be more pronounced compared to silver nitrate sponges. A combination of boric acid sponges with the NPWT system may be an alternative method for chronic wounds.     

Infant feeding practices of mothers in an urban area in Nepal.

Background: Child health in developing countries including Nepal is a matter of serious concern as the prevalence of malnutrition among children continues to be high with 48.6% of children under five in Nepal being underweight. Since infant feeding practices adopted by mothers play a major role in influencing health of these children, there is a need to study the infant feeding practices prevalent in different areas in order to have pragmatic approaches to solve this problem. Materials and methods: A cross sectional study was conducted among mothers who attended the immunization clinics of 18 wards of Pokhara municipality area. They were interviewed with a semi-structured questionnaire on various aspects of infant feeding. Result: A total of 168 mothers were interviewed and prevalence of breastfeeding was 99.4% (167). Only 43.5% of the mothers initiated breastfeeding within one hour of birth and 60.5% were practicing exclusive breastfeeding at 5 months. Almost 40% of the mothers started complementary feeding before the recommended age of 6 months and 22.5 % delayed introduction of complementary feeding beyond the recommended age. Conclusion: Breast feeding practices adopted by mothers of Pokhara urban area are still lacking in terms of late initiation of and early starting of complementary feeding. There is a need to educate the mothers regarding proper infant feeding practices. Key words: infant feeding, breastfeeding, weaning.     

The interference of the cleaning procedure of root walls with two different solvents on the adhesion of fiberglass intraradicular posts

Aim: This study was undertaken to examine the effect of root canal (RT) sealers content and the cleaning procedure of RT walls on bond strength (BS) of a fiber reinforced composite (FRC) post cemented with resin-based or zinc phosphate cement. Materials and methods: Forty bovine roots were divided into 2 groups (n = 20) and obturated with gutta-percha points plus Sealer 26 sealer or gutta-percha points plus N-Rickert sealer. In each group, half (n = 10) of intracanal walls was cleaned with ethanol and the other half with sulfuric ether. In each of these subgroups, half of intracanal posts (n = 5) were cemented with Bistite resin-based cement and half with zinc phosphate cement. Specimens were submitted to pull-out test and tensile force until post dislodgement. The maximum forces required for post removal was expressed in MPa, means were submitted to statistical analysis (Analysis of Variance Test, a = 0.05). Results: Fiber reinforced composite cemented with zinc phosphate were significantly more retentive than those cemented with Bistite (p < 0.05). Regarding the influence of eugenol-based sealer on post retention, there was a statistically significant difference (p < 0.05) only between groups cemented with Bistite, in which canals filled with N-Rickert + gutta-percha showed lower BS than canals filled with Sealer 26 + gutta-percha. Conclusion: Despite endodontic cement used, higher pull-out bond strength were obtained when posts were cemented with zinc phosphate. Clinical significance: The importance of ethanol or sulphuric ether application to properly replace water from intraradicular dentine still requires further investigations, especially to clarify if this technique may reduce the effect of aging and improve the stability of the bond, when used to cement fiber posts into the root canal. Keywords: Laboratory research, Dentin, Eugenol, Resin cements, Root canal filling material, Pull-out test, Cleaning procedure. How to cite this article: Gomes MF, Botta SB, Matos AB, Garone- Netto N. The Interference of the Cleaning Procedure of Root Walls with Two Different Solvents on the Adhesion of Fiberglass Intraradicular Posts. J Contemp Dent Pract 2012;13(3):275-279. Source of support: Nil Conflict of interest: None declared.     

Different therapeutic modalities for treatment of melasma

Background Chemical peels and topical depigmenting agents have become a popular modality in the treatment of melasma. Aims To compare the clinical efficacy of trichloroacetic acid peel 20%vs. Jessner’s solution peel vs. the topical mixture of hydroquinone 2% and kojic acid. Patients and methods Forty five patients with melasma were randomly assigned into three groups of fifteen patients each. Group A received Jessner’s solution peel, group B received trichloroacetic acid peel 20%, and group C received topical hydroquinone 2% and kojic acid. All patients were seen in follow‐up period after 16 weeks; clinical evaluation using Melasma Area and Severity Index (MASI) score and photography were recorded before and after treatment and after 16 weeks. Results There was a decrease in MASI score in all three groups after treatment and after follow‐up period but after treatment MASI score was statistically significantly lower in group A than group C (P = 0.01), and it was also statistically significantly lower in group B than group C (P < 0.001) but there was no statistically significant difference between groups A and B. After the follow‐up period, MASI score was statistically significantly lower in group A than group C (P < 0.001), statistically significantly lower in group B than group C (P < 0.001), and statistically significantly lower in group B than group A (P = 0.035). The statistical analysis was done through one‐way anova followed by least significant difference (LSD). Conclusion Trichloroacetic acid 20% showed better results than Jessner’s solution as peeling agent and hydroquinone 2% with kojic acid as a topical agent in the treatment of melasma.     

Astigmatism induced by oblique clear corneal incision: right vs. left eyes

BACKGROUND: To compare the induced astigmatism after phacoemulsification in the right vs. the left eye. METHODS: An oblique clear corneal incision was made in a superotemporal location in the right (n = 344) and a superonasal location in the left (n = 292) eye. Retrospectively, patient characteristics, pre- and postoperative visual acuity, and induced astigmatism values were compared. Statistical analysis was performed with the Student t , chi2, and Mann-Whitney U tests. RESULTS: The proportion of against-the-rule astigmatism and surgically induced astigmatism values were significantly larger in the left-eye group (p < 0.001). INTERPRETATION: Surgically induced astigmatism occurred to a greater extent in the left eyes compared with the right, possibly because of structural differences.     

Effect on astigmatism of the location of clear corneal incision in phacoemulsification of cataract

PURPOSE: To investigate the refractive results of clear corneal incision performed at the steepest meridian of pre-existing corneal astigmatism. METHODS: One hundred eighty-two patients with astigmatism > 0.75 diopters (D) were evaluated. Superior, temporal, nasal, superotemporal, or superonasal clear corneal incisions were performed at the steep meridian. Refraction, visual acuity, and topography values were evaluated, and changes in surgically induced astigmatism were calculated by vector analysis using the Fourier formula. Paired t test was used to compare mean values. RESULTS: Postoperative cylinder values showed minor changes in all groups, except the nasal group. Nasal incision increased preoperative cylinder from 1.13 D to 1.83 D 6 months after surgery. Temporal and superotemporal incisions resulted only in small astigmatic changes. Conversely, superior, superonasal, and nasal incisions induced more pronounced astigmatism. CONCLUSIONS: Performing clear corneal incision for phacoemulsification of cataract at the steep meridian resulted in small changes with temporal incisions, whereas nasal incisions resulted in higher surgically induced astigmatism.     

Necrotizing sarcoid granulomatosis in a family of patients with sarcoidosis reinforces the association between both entities

Necrotizing sarcoid granulomatosis (NSG) is a rare entity mainly characterized by a prominent granulomatous vasculitis affecting middle-aged or old individuals and with a favorable prognosis. Although many believe it is a variant of sarcoidosis, the proper classification is still a matter of debate as some of its features are found in sarcoidosis but also in Churg-Strauss syndrome, Wegener's disease and hypersensitivity pneumonitis. In this paper, we described for the first time a case of NSG in a family with several cases of sarcoidosis, reinforcing the relationship between NSG and sarcoidosis. Additional interesting findings were the young age of the patient (15 years old), the symptoms limited to the respiratory tract (uncommon when NSG affects youngsters) and the increase in serologic markers of autoimmune disease. Though complete criteria for autoimmune disease were not present, systemic lupus erythematosus and Sjogren's syndrome are possible candidates. As sarcoidosis is described to be associated with several autoimmune diseases, this finding is an additional suggestion of the relationship between both entities.