A new device in immediately loaded implant treatment in the edentulous mandible

PURPOSE: This article reports preliminary clinical results of the Speed Master system, a method for immediate loading of implants for the treatment of mandibular edentulism. MATERIALS AND METHODS: Fifteen patients with edentulous mandibles were consecutively included in the study. Each received 4 implants between the mental foramina placed using the system's surgical guides. Permanent fixed prostheses fabricated over premanufactured titanium bars were attached to the implants on the day of implant placement. The patients were followed for 15 to 27 months (mean, 19 months). Peri-implant tissues were periodically evaluated. Marginal bone loss was monitored with periapical radiographs using a computerized technique. Satisfaction was assessed by means of a questionnaire. RESULTS: The overall implant and prosthetic survival rates were 100%. At the time of the final follow-up visit, mean marginal bone loss was 1.11 mm, and bleeding on probing was not observed. Only 6.7% of the patients reported any discomfort during treatment, and all patients would recommend the procedure to others. DISCUSSION: The immediate loading of implants placed in the edentulous mandible with the Speed Master surgical and prosthetic protocol reduces treatment time and number of surgical procedures in comparison to classic delayed loading protocols. CONCLUSION: The rehabilitation of the mandible with an immediately delivered occlusally loaded hybrid prosthesis supported by 4 implants does not appear to jeopardize the success of the osseointegration and represents a viable treatment     

Effect of post length on the fatigue resistance of bovine teeth restored with bonded fiber posts: a pilot study

This study evaluated the influence of the cementation length of glass fiber-reinforced composite (FRC) on the fatigue resistance of bovine teeth restored with an adhesively cemented FRC. Thirty roots of single-rooted bovine teeth were allocated to 3 groups (n = 10), according to the ratio of crown length/root length (post cementation length): group 1 = 2/3, group 2 = 1/2, and group 3 = 1/1. The roots were prepared, the fiber posts (FRC Postec Plus) were cemented, and the specimens were submitted to 2 million mechanical cycles. After fatigue testing, a score was given based on the number of fatigue cycles until fracture, and data were submitted to statistical analysis. All specimens were resistant to fatigue. Taking into account the methodology and results of this study, the evaluated fiber posts can be cemented based on the ratio of crown/root at 1/1. Further clinical studies must be conducted to verify this ratio.     

A new Hu-PBL model for the study of human islet alloreactivity based on NOD-scid mice bearing a targeted mutation in the IL-2 receptor gamma chain gene

Immunodeficient NOD-scid mice bearing a targeted mutation in the IL2 receptor common gamma chain (Il2rgamma(null)) readily engraft with human stem cells. Here we analyzed human peripheral blood mononuclear cells (PBMC) for their ability to engraft NOD-scid Il2rgamma(null) mice and established engraftment kinetics, optimal cell dose, and the influence of injection route. Even at low PBMC input, NOD-scid Il2rgamma(null) mice reproducibly support high human PBMC engraftment that plateaus within 3-4 weeks. In contrast to previous stocks of immunodeficient mice, we observed low intra- and inter-donor variability of engraftment. NOD-scid Il2rgamma(null) mice rendered hyperglycemic by streptozotocin treatment return to normoglycemia following transplantation with human islets. Interestingly, these human islet grafts are rejected following injection of HLA-mismatched human PBMC as evidenced by return to hyperglycemia and loss of human C-peptide. These data suggest that humanized NOD-scid Il2rgamma(null) mice may represent an important surrogate for investigating in vivo mechanisms of human islet allograft rejection.     

Expectant management of pneumothorax in preterm infants receiving assisted ventilation: report of 4 cases and review of the literature

Pneumothorax is a common complication in infants receiving assisted ventilation. The appropriate management of this condition is not always clearly defined, especially when a large air leak and mediastinal shift are present but the infant is hemodynamically stable. Despite the complications associated with chest tube placement, this remains the most common approach in such cases. We report 4 cases of preterm infants who developed large pneumothoraces with mediastinal shift while on assisted ventilation and were managed conservatively, with substantial improvement within 12-96 hours. In this report we also review the literature on pneumothorax in preterm infants.     

M-CSF induces the expression of a membrane-bound form of IL-18 in a subset of human monocytes differentiating in vitro toward macrophages

IL-18 is a proinflammatory cytokine belonging to the "IL-1 family" that has been shown to play a prominent role in the induction of type 1 immune responses. Here, we show that M-CSF induces the expression of a membrane-bound form of IL-18 (mIL-18) in a subset of human blood monocytes differentiating toward macrophages. While monocytes, DC, and GM-CSF-treated monocytes did not express mIL-18, its expression was detected in approximately 30-40% of M-CSF-primed macrophages differentiating from both CD16(-) and CD16(+) monocytes. Treatment with the caspase-1 inhibitor significantly reduced mIL-18 expression suggesting the requirement of an assembled inflammasome for IL-18 surface expression. Polarization toward M2 did not modify mIL-18 expression. On the contrary, LPS stimulation of both M0 and M2 (mIL-18(+) ) macrophages induced shedding of mIL-18, which was likely mediated by the activation of cellular protease(s). Importantly, the soluble form IL-18 (sIL-18) induced in autologous resting NK cells both the expression of CCR7 and the production of high amounts of IFN-γ, which was virtually abrogated by Ab-mediated neutralization of sIL-18. Overall our data shed new light on the cells and mechanisms leading to the release of sIL-18, the major IFN-γ-inducing factor in both physiological and pathological immune responses.     

Treatment of Depression in Older Adults

Depression is the most frequent mental disorder in older people, often causing emotional distress and reduced quality of life. Despite its clinical significance, depression remains underdiagnosed and inadequately treated in older patients. Regarding prognosis, data suggest that almost 70% of patients, treated long enough and with appropriate doses, recover from an index episode of depression. Antidepressants are efficient for treating depressed outpatients with several comorbid physical diseases as well as hospitalized patients, with selective serotonin reuptake inhibitors being the antidepressants of choice for older patients. Available data can guide pharmacological treatment in both the acute and maintenance stages, but further research is required to guide clinical strategies when remission is not achieved. Approaches for the management of resistance to treatment are summarized, including optimization strategies, drug changes, algorithms, and combined and augmentation pharmacological treatments. Finally, additional therapeutic choices such as electroconvulsive therapy, transcranial magnetic stimulation, and integrated psychotherapy are presented.     

Evaluation of InnoTyper® 21 in a sample of Rio de Janeiro population as an alternative forensic panel

International Journal of Legal Medicine - The use of bi-allelic markers such as retrotransposable element insertion polymorphisms or Innuls (for insertion/null) can overcome some limitations of...     

Clonal analysis of CD4-CD8- human thymocytes expressing a T cell receptor gamma/delta chain. Direct evidence for the de novo expression of CD8 surface antigen and of cytolytic activity against tumor targets

CD4-CD8- human thymocytes were obtained by treating total thymocyte suspensions with anti-CD4 and anti-CD8 monoclonal antibodies (mAb) and complement. The resulting cell populations contained virtually no CD4+, CD8+ or WT31+ cells and 17-65% CD3+ cells. In addition, analysis of cell reactivity with delta-TCS-1 mAb (specific for the C gamma 2-encoded, nondisulfide-linked form of TcR gamma/delta), revealed the presence of a variable proportion of delta-TCS-1+ cells (the % of delta-TCS-1+ cells were lower than the percentage of CD3+ cells). Upon culture in recombinant interleukin 2 (IL2, in the presence of irradiated mononuclear cells), CD4-CD8- thymocytes underwent extensive proliferation. In addition, a progressive increase of CD8+ cells (but not of CD4+ or WT31+ cells) could be detected. Cells also progressively acquired cytolytic activity against K-562 or fresh melanoma cells. Fresh CD4-CD8- thymocytes were cloned under limiting dilution conditions. The cloning efficiencies were relatively high (1/3 cells); in addition, virtually all the clonal progenies obtained displayed cytolytic activity and expressed the CD3+WT31-delta-TCS-1+ surface phenotype. About half of the clones analyzed were CD8+, whereas none expressed CD4 antigens. We conclude that (a) only delta-TCS-1-reactive, TcR gamma/delta+ cells can be isolated from CD4-CD8- thymocytes cultured in IL2, and (b) the expression of CD8 antigen and of cytolytic activity reflects a true in vitro phenotypic change of CD8-, noncytolytic precursors (and not the preferential growth of few contaminating cells).