The concept of hepatic artery-bile duct parallelism in the diagnosis of ductopenia in liver biopsy samples

Absence of bile ducts (BDs) in >50% of portal tracts is currently the most widely accepted criterion for the diagnosis of ductopenia. In this study, we describe an alternative method for the quantitative assessment of BDs based on the percentage of portal tracts containing unpaired hepatic arteries (HAs). Diagnostic criteria for ductopenia were defined as follows: 1. presence of at least 1 unpaired HA in >10% of all portal tracts; 2. at least 2 unpaired HAs present in different portal tracts in a given sample. In liver biopsies from patients with primary biliary cirrhosis and suspected chronic allograft rejection (n = 32), loss of BD was detected in 59.4% of patients using the unpaired HA method compared with 43.7% (P = 0.31), 21.9% (P = 0.005), and 12.5% (P = 0.001) by the traditional method, depending on specific adequacy criteria used (no adequacy criteria, >10 portal tracts, or >5 complete portal tracts per biopsy, respectively). The percentage of portal tracts containing BD(s) was significantly affected by the degree of portal inflammation, fibrosis stage, percentage of complete portal tracts, and biopsy width, whereas none of these factors influenced the prevalence of unpaired arteries. The unpaired HA method showed higher sensitivity for the detection of mild degrees of loss of BD compared with the traditional method, and was not influenced by factors that affected the percentage of portal tracts containing BDs.     

Mandibular buccal bifurcation cyst: a case report and literature review

The mandibular buccal bifurcation cyst is a cystic lesion occurring on the buccal surface of the permanent mandibular first molar in 6- to 8-year-old children. The purpose of this article was to present a case report of an 8-year-old with a radiolucent area on the permanent mandibular left first molar, with clinical, radiological, and histological characteristics compatible with the pathological entity mentioned. The treatment adopted in this case was enucleation without extraction. The patient is still under observation without any sign of recurrence.     

Eighteen‐month clinical and radiographic evaluation of two root canal‐filling materials in primary teeth with pulp necrosis secondary to trauma

Abstract – Aim: This study compared clinically and radiographically the use of zinc oxide and eugenol cement (ZOE) and a commercial calcium hydroxide and polyethylene glycol‐based paste (Calen^®) thickened with zinc oxide as root canal‐filling materials for primary teeth with pulp necrosis secondary to trauma within 18 months of follow up. Material and methods: Eligible patients of both genders aged 2 years and 6 months to 5 years and 10 months who had been referred for dental treatment at a pediatric dental trauma service and presented at least one anterior primary tooth (central and/or lateral incisor) with pulp necrosis secondary to traumatic injury were selected. Twenty‐six children (n = 31 teeth) with mean age of 3.4 years met the inclusion criteria and were enrolled after parental written consent. The root canals were instrumented and filled with either ZOE (group I; n = 15 teeth) or Calen^® paste [composition: 2.5 g calcium hydroxide, 0.5 g zinc oxide, 0.05 g colophony, and 1.75 ml polyethylene glycol 400 (vehicle)] thickened with zinc oxide (Calen^®/ZO; group II; n = 16 teeth). ZO was added to the Calen^® paste for slowing paste resorption, which should ideally occur simultaneously with the physiologic resorption of primary tooth roots. Clinical success after 18 months of follow up was considered as absence of pain, tooth mobility or fistula, and radiographic success as the partial or total remission of apical periodontitis, absence of pathological root resorption or presence of new bone formation. Results: Eighteen months after treatment, the teeth obturated with ZOE and Calen^®/ZO presented statistically similar (Fisher’s exact test; P > 0.05) success rates of 93.3% and 87.5%, respectively. Conclusion: Our results showed the clinical and radiographic outcomes for Calen^®/ZO to be equal to those for ZOE after 18 months, suggesting that both materials can be indicated for obturating primary teeth with pulp necrosis after trauma.     

Standardization of the electromyographic signal through the maximum isometric voluntary contraction

The objective of this study was to analyze the electromyographic (EMG) data, before and after normalization. One hundred (100) normal subjects (with no signs and symptoms of temporomandibular disorders) participated in this study. A surface EMG of the masticatory muscles was performed. Two different tests were performed: maximum voluntary clench (MVC) on cotton rolls and MVC in intercuspal position. The normalization was done using the mean value of the EMG signal of the first examination. The coefficient of variation CV showed lower values for the standardized data. The standardization was effective in reducing the differences between records from the same subject and in different subjects.     

Diabetes and prostate cancer risk in the REDUCE trial

Men with diabetes mellitus are less likely to be diagnosed with prostate cancer (PCa). As diabetic men have lower serum PSA, it is unclear if this is due to lower PCa incidence or reflects detection bias from fewer PSA-triggered biopsies. To account for differential biopsy rates, we used multivariate regression to examine the link between diabetes and PCa risk in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, which required all subjects to undergo biopsy regardless of PSA. We further tested for interaction between diabetes and obesity. Diabetes status and body mass index (BMI) measurements were obtained at baseline. On multivariate analysis, diabetes was not associated with PCa risk (odds ratio (OR) 1.01, 95% confidence interval 0.79-1.30, P=0.92) or risk of low- or high-grade disease (all P ≥ 0.65). When stratified by obesity, diabetes was also not associated with PCa risk in any BMI category (all P ≥ 0.15). However, there was suggestion of effect modification by obesity for high-grade disease (P-interaction=0.053). Specifically, diabetes was associated with decreased risk of high-grade PCa in normal-weight men but increased risk in obese men (OR 0.35 vs 1.38). In the REDUCE trial, when all men underwent biopsy, diabetes was not associated with lower PCa risk, but rather equal risk of PCa, low-grade PCa and high-grade PCa.