Standardizing Postoperative Complications—Validating the Clavien-Dindo Complications Classification in Cardiac Surgery

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Myositis-specific autoantibodies,a cornerstone in immune-mediated necrotizing myopathy

Over the past few years, myositis-specific autoantibodies played an increasing role in the inflammatory idiopathic myositis definition. They became the critical immunological marker for immune-mediated necrotizing myopathy diagnosis (IMNM) since the paradigm switch from histological to serological criteria.This review is focused on the key role of the anti-signal recognition particle (anti-SRP) and the anti-3-Hydroxy-3-MethylGlutaryl-Coenzyme A Reductase (anti-HMGCR) antibodies in immune-mediated necrotizing myopathy.Anti-SRP and anti-HMGCR antibodies are robust diagnostic tools in case of both the classical subacute form and the slowly progressive form of IMNM that may mimic muscular dystrophy. Anti-SRP and anti-HMGCR patients share clinical, biological and histological features with some antibody-associated specificity. Anti-SRP patients harbour more severe muscle weakness and atrophy with severe muscle damage on magnetic resonance imaging study. Approximately 10–20% of anti-SRP patients develop extramuscular symptoms, especially lung interstitial disease. Conversely, anti-HMGCR patients are often associated with statin exposure. In both cases, patients have a poor outcome with frequent relapse and the use of combined immunotherapy. Of note, various data suggest a direct pathogenic role of these antibodies reinforcing the interest in targeted therapeutic strategy.     

Potentiation of the bactericidal activity of Harungana madagascariensis Lam. ex Poir. (Hypericaceae) leaf extract against oral bacteria using poly (D, L-lactide-co-glycolide) nanoparticles: in vitro study

Harungana madagascariensis Lam. ex Poir. (Hypericaceae) is known to have biological properties with mainly antibacterial, antifungal, and antiviral effects. The objective of this study was to investigate the in vitro bactericidal activity of the ethyl acetate H. madagascariensis leaf extract (HLE) on the main oral bacterial strains largely implicated in dental caries and gingivitis infections, and the possibility of potentialization of HLE antibacterial effects using the poly (D,L-lactide-co-glycolide) nanoparticles (PLG-NP). The microdilution technique and the interfacial polymer deposition following the solvent diffusion method were used to investigate the in vitro bactericidal activity of ethyl acetate HLE and to prepare nanoparticles, respectively. HLE showed significant bactericidal effects against the bacterial strains tested, with minimal bactericidal concentration (MBC) to 5 x 10(2) mg/l or less, except for Lactobacillus casei with 7.5 x 10(2) mg/l. With the HLE incorporated into PLG nanoparticles (HLE-PLG-NP), we observed diminution of the bactericidal concentration compared to HLE, the upper MBC being of 1.875 x 10(2) mg/l. Incorporation of the HLE into a colloidal carrier optimized its antibacterial performance.     

Multidisciplinary approach in the treatment of a patient with cleft lip and palate: a case report

Treatment of the patient with cleft lip and palate represents a real problem from both functional and esthetic points of view. Today a functional result is not enough. An esthetic result is both necessary and possible to improve the quality of life. The direct placement of an implant in the grafted alveolar cleft is not the ideal choice.
Using a rational, multidisciplinary approach, it is possible to obtain esthetic results in these patients. In our case study, a 17-year-old patient previously treated for a unilateral cleft lip and palate and agenesis of the right lateral incisor was given an osseointegrated implant. Computer-assisted dental design (Procera® CAD/CAM software, Nobel Biocare AB, Gothenburg, Sweden) was used for the prosthetic rehabilitation, and the end of growth was determined prior to placing the implant.
No sign of failure or mobility after loading has been detected at the time of this writing, 8 months after the procedure's completion, and the esthetic result is considered satisfactory by the patient and practitioners.