Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: a randomised multicentre study

Objective The aim of the study was to evaluate the inflammatory response to surgical trauma in minilaparotomy cholecystectomy (MC) compared to laparoscopic cholecystectomy (LC). Assessment of inflammatory response to surgical trauma in MC has not been addressed properly. Therefore, we investigated five interleukins (IL) and C-reactive protein (CRP) in MC versus LC group in a prospective randomised trial. Methods Initially, 106 patients with non-complicated symptomatic gallstone disease were randomised into MC (n?=?56) or LC (n?=?50) groups. Plasma levels of five interleukins (IL-1β, IL-1ra, IL-6, IL-8, IL-10) and hs-CRP were measured at three time points; before operation (PRE), immediately after operation (POP1) and six hours after operation (POP2). The primary end-point of the study was to compare the plasma levels of five interleukins and CRP in LC versus MC group. Results The demographic variables and the surgical data were similar in the study groups. The patients in the MC group had higher elevation of the CRP mean values post-operatively (p?=?0.01). However, the patients in the MC group had higher elevation of the IL-1ra mean values post-operatively, the mean pre-/post-operative IL-1ra values being 299/614?pg/ml in the MC group versus 379/439?pg/ml in the LC group (p?=?0.003). There was no statistical significance in IL-6 mean values between the MC and LC groups pre- and post-operatively (POP1). However, the patients in the MC group had higher IL-6 mean values six hours post-operatively (POP2), the mean IL-6 values being 27.6?pg/ml in the MC group versus 14.8?pg/ml in the LC group (p?=?0.037). In addition, the patients in the MC group had higher elevation of the IL-6 mean values post-operatively, the mean pre-/post-operative IL-6 values being 4.1/27.6?pg/ml in the MC group versus 3.8/14.8?pg/ml in the LC group (p?=?0.04). There was no statistical significance in IL-8, IL-10, and IL-1β mean values between the MC and LC groups pre- and post-operatively. Conclusion Our results suggest that the inflammatory response in MC versus LC groups was similar based on the IL-8, IL-10, and IL-1β values. A new finding with possible clinical relevance in the present work is higher relative elevation of the IL-1ra and IL-6 mean values post-operatively in the MC group.     

A new picornavirus isolated from bank voles (Clethrionomys glareolus)

A previously unknown picornavirus was isolated from bank voles (Clethrionomys glareolus). Electron microscopy images and sequence data of the prototype isolate, named Ljungan virus, showed that it is a picornavirus. The amino acid sequences of predicted Ljungan virus capsid proteins VP2 and VP3 were closely related to the human pathogen echovirus 22 (approximately 70% similarity). A partial 5' noncoding region sequence of Ljungan virus showed the highest degree of relatedness to cardioviruses. Two additional isolates were serologically and molecularly related to the prototype.     

Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy.

PURPOSE: The current study evaluated the incidence of subjective neurosensory disturbances after bilateral sagittal split osteotomy (BSSO) in relation to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the inferior alveolar nerve at operation, side of the mandible operated, and complications during and after surgery. PATIENTS AND METHODS: Thirty patients (60 sides) who had undergone a BSSO were followed up for 1 year after operation. The patients were classified into different groups according to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the nerve, and complications during or after surgery. A self-administered questionnaire was used at every follow-up to evaluate the sensations in the mental region. RESULTS: A statistically significant positive correlation was found between subjective neurosensory loss and the patient's age (P = .039), magnitude of mandibular movement (P = .044), and degree of manipulation of the nerve (P = .0007). However, no significant correlation was found between disturbances of sensation and gender, indication for osteotomy, side of the operated mandible, or intraoperative and postoperative complications. Even if all patients evaluated their sensation as "normal" 1 year postoperatively, 31% of them reported slightly altered sensation in the mental region. CONCLUSIONS: After BSSO, a prolonged neurosensory deficit is strongly related to age, the intraoperative magnitude of mandibular movement, and the degree of manipulation of the inferior alveolar nerve. However, a long-term sensory loss is very rare, and patients seem to adapt to a mild neurosensory deficit and report sensory function as "normal" despite slightly altered sensation.     

Infection with Possible Novel Parapoxvirus in Horse,Finland, 2013

A horse in Finland exhibited generalized granulomatous inflammation and severe proliferative dermatitis. After euthanization, we detected poxvirus DNA from a skin lesion sample. The virus sequence grouped with parapoxviruses, closely resembling a novel poxvirus detected in humans in the United States after horse contact. Our findings indicate horses may be a reservoir for zoonotic parapoxvirus.     

Ethnic Differences in Gestational Weight Gain: A Population-Based Cohort Study in Norway

Objectives To explore ethnic differences in gestational weight gain (GWG). Methods This was a population-based cohort study conducted in primary care child health clinics in Groruddalen, Oslo, Norway. Participants were healthy pregnant women (n = 632) categorised to six ethnic groups (43 % were Western European women, the reference group). Body weight was measured at 15 and 28 weeks’ gestation on average. Data on pre-pregnancy weight and total GWG until delivery were self-reported. The main method of analysis was linear regression adjusting for age, weeks’ gestation, pre-pregnancy body mass index, education and severe nausea. Results No ethnic differences were observed in GWG by 15 weeks’ gestation. By 28 weeks’ gestation, Eastern European women had gained 2.71 kg (95 % confidence interval, CI 1.10–4.33) and Middle Eastern women 1.32 kg (95 % CI 0.14–2.50) more weight on average than the Western European women in the fully adjusted model. Among Eastern European women, the total adjusted GWG was 3.47 kg (95 % CI 1.33–5.61) above the reference group. Other ethnic groups (South Asian, East Asian and African) did not differ from the reference group. When including non-smokers (n = 522) only, observed between-group differences increased and Middle Eastern women gained more weight than the reference group by all time points. Conclusions Eastern European and Middle Eastern women had higher GWG on average than Western European women, especially among the non-smokers. Although prevention of excessive GWG is important for all pregnant women, these ethnic groups might need special attention during pregnancy.     

Congenital pseudarthrosis of the tibia. Treatment and outcome at skeletal maturity in 10 children.

We present the clinical characteristics of 14 children with congenital pseudarthrosis of the tibia (CPT) treated in northern Finland at Oulu University Hospital during the years 1968-1996. The incidence of CPT in northern Finland was 3.5/10(5) during years 1962-1996, which is higher than in previous reports. The estimated prevalence of pseudarthrosis was 1.8/10(5). The first 10 children with a mean follow-up time of 19 years from the first grafting procedure and 14 years from the last grafts, all had a solid bony union and could walk without external support at the last follow-up. The best treatment, especially in unfavorable types, seems to be a radical resection of the pseudarthrosis and reconstruction with a free vascularized fibular graft.     

Increasing predoctoral dental students' motivations to specialize in prosthodontics

This study provides data about factors that influence dental students' decision of which specialty to pursue and describes program changes in prosthodontics designed to expand student interest in a prosthodontics training program. Of 176 current and recently graduated students at Harvard School of Dental Medicine, 167 responded to the e-mail survey for a 94.9 percent response rate. Using the Pearson chi-square analysis, we analyzed nine factors to determine their contribution to these students' choice of specialty. Two factors, lecture and faculty/mentoring, were highly significant (p<0.006) regarding impact on the students' introductory experience with prosthodontics. When choosing a specialty, 44 percent of all students ranked "enjoyment of providing the specialty service" as the most important factor. Students wishing to specialize in prosthodontics, however, ranked four significant factors: enjoyment of providing the specialty service (p<0.037, p<0.057); faculty influence (p<0.0002, p<0.0001); length of program (p<0.039, p<0.006); and cost of program (p<0.023, p<0.004). Respondents also ranked the nine American Dental Association-recognized specialties regarding their perceptions of future salary and impact on the dental profession. They ranked prosthodontics fourth for future salary and fifth for impact on the profession. At the same time that this study was being conducted, key changes were being made in the graduate prosthodontics program; those appear to have had a positive impact on students' interest in pursuing prosthodontics as a specialty.