Menopausal symptoms in women treated for breast cancer: the prevalence and severity of symptoms and their perceived effects on quality of life.

OBJECTIVES: To determine, first, the prevalence and severity of various symptoms related to estrogen deficiency in women within a few years of receiving treatment for breast cancer, second, how women perceive the effects of these symptoms on their quality of life and, third, what measures have been taken to relieve vasomotor symptoms. METHODS: Two hundred women (aged 29-65 years) who had received treatment for breast cancer within the last 5 years were included in this cross-sectional survey. Information was collected about their breast cancer treatment, menopausal symptoms (Menopausal Rating Scale), the perceived effects of menopausal symptoms on their and their partner's quality of life and any treatments they were receiving for hot flushes. RESULTS: All but one woman reported at least one symptom related to the menopause (95.9% vasomotor; 83.3% psychological; 89.7% somatic). Current treatment with tamoxifen or previous chemotherapy did not influence the prevalence or the severity of hot flushes. Current antidepressant treatment was, however, significantly associated with a higher prevalence and severity of most menopausal symptoms, including hot flushes and sweats (p = 0.008). The severity of hot flushes and sweats was significantly correlated with self-assessed effects on overall quality of life (r(s) = 0.47); 56.4% of the respondents believed that menopausal symptoms had affected their partner's quality of life, the strongest correlations being with severity of sexual symptoms (r(s) = 0.56) and vaginal dryness (r(s) = 0.5). Only 21% of women experiencing hot flushes were receiving any treatment for hot flushes, with most women describing no knowledge or poor knowledge of treatment options. CONCLUSIONS: The majority of women receiving treatment for breast cancer report menopausal symptoms, which negatively correlate, not only with their own, but also with their partner's quality of life. Most women experiencing hot flushes are not receiving treatment due to lack of both awareness and confidence in the existing treatment options.     

Poly(butyl-2-cyanoacrylate) particles as adjuvants for oral immunization

The potential oral adjuvanticity of a colloidal carrier system for an adsorbed antigen was investigated and the effect of particle size of the carrier was partially determined. Ovalbumin was adsorbed onto poly(butyl-2-cyanoacrylate) particles of two different sizes and administered orally to rats previously primed by intraperitoneal injection. After 14 and 50 days, the secretory immune responses were significantly increased for animals gastrically intubated with ovalbumin adsorbed to 100 nm particles, relative to a control group response to soluble antigen.     

The mechanical properties of nanofilled resin-based composites: Characterizing discrete filler particles and agglomerates using a micromanipulation technique

ObjectiveTo assess the mechanical properties of discrete filler particles representative of several inorganic fillers in modern dental resin-based composites (RBCs) and to assess the validity of a novel micromanipulation technique.MethodRBCs with microhybrid (Filtek? Z250), ‘nanohybrid’ (Grandio) and ‘nanofilled’ (Filtek? Supreme), filler particle morphologies were investigated. Filler particles were provided by the manufacturer or separated from the unpolymerized resin using a dissolution technique. Filler particles (n = 30) were subjected to compression using a micromanipulation technique between a descending glass probe and a glass slide. The number of distinct fractures particles underwent was determined from force/displacement and stress/deformation curves and the force at fracture and pseudo-modulus of stress was calculated.ResultsAgglomerated fillers (‘nanoclusters’) exhibited up to four distinct fractures, while spheroidal and irregular particles underwent either a single fracture or did not fracture following micromanipulation. Z-tests highlighted failure of nanoclusters to be significant compared with spheroidal and irregular particles (P < 0.05). The mean force at first fracture of the nanoclusters was greater (1702 ± 909 μN) than spheroidal and irregular particles (1389 ± 1342 and 1356 ± 1093 μN, respectively). Likewise, the initial pseudo-modulus of stress of nanoclusters (797 ± 555 MPa) was also greater than spheroidal (587 ± 439 MPa) or irregular (552 ± 275 MPa) fillers.SignificanceThe validity of employing the micromanipulation technique to determine the mechanical properties of filler particulates was established. The ‘nanoclusters’ exhibited a greater tendency to multiple fractures compared with conventional fillers and possessed a comparatively higher variability of pseudo-modulus and load prior to and at fracture, which may modify the damage tolerance of the overall RBC system.     

High irradiance curing and anomalies of exposure reciprocity law in resin-based materials

Objectives

The aim of this work was to investigate the effect of high irradiance curing on resultant degree of conversion of ‘flowable’ resin composites and their counterpart higher viscosity paste materials.

Methods

Five commercial flowable materials (Venus; Heraeus Kulzer, Synergy D6; Coltene, Premise; Kerr, Grandio; Voco and Gradia; GC Corp) and their counterpart higher viscosity restorative versions were tested. Specimens were cured with a halogen Swiss Master Light (EMS, Switzerland) using five different curing protocols with similar radiant exposure (18 J/cm²): 400 mW/cm² for 45 s, 900 mW/cm² for 20 s, 1500 mW/cm² for 12 s, 2000 mW/cm² for 9 s and 3000 mW/cm² for 6 s. Degree of conversion (DC) was measured in real time by Fourier transform near infrared spectroscopy (FT-NIRS).

Results

Three- and subsequent two way ANOVA testing revealed significant differences (p ≤ 0.02) with respect to “composite type” and “cure protocol” for DC for all 5 product comparisons. Supplementary one-way ANOVA also revealed significant differences between curing protocols (p < 0.05). The majority of higher viscosity resin composite paste materials exhibited similar DC regardless of curing protocol. However, a significant decrease in DC for specimens cured at 3000 mW/cm² for 6 s compared with 400 mW/cm² for 45 s was observed for the flowable materials, Grandio (41 ± 0.36 and 62 ± 1.15%, respectively) and Venus (44 ± 0.44 and 67 ± 0.44%, respectively). Conversely, other flowable materials exhibited little or no significant differences between curing modes. Generally, a higher degree of conversion was observed for flowables compared with their more viscous counterpart, except at high irradiance for those materials where a reciprocal relationship with exposure time was not observed.

Conclusions

The validity of exposure reciprocity law and final degree of conversion depends on several factors, amongst which resin viscosity and filler content were important. Practitioners should be aware of the importance of resin composite constituents and irradiation protocols. Information on material composition and appropriate radiation sources by manufacturers may assist practitioners with the selection of appropriate curing protocols for specific material/light curing unit combinations with the aim of reducing the incidence of under-cured restorations and the clinical impact thereof.     

Cure width potential for MOD resin composite molar restorations

OBJECTIVES: To investigate the capability of modern light-curing units exhibiting differences in emission spectra and light source exit window dimensions, for "one-shot" full-width curing of extensive (molar MOD) resin composite restorations. METHOD: Specimens of Tetric (TT), Tetric Ceram HB (TC), Tetric Evoceram (TE) and Tetric Ceram Bleach (TB) resin composites containing varying ratios of Lucirin (TPO) and/or camphorquinone (CQ) photoinitiators were packed into a bar-shaped mould (12 mm length x 2 mm width x 2 mm thickness). Each product was irradiated using a halogen (Optilux 401; QTH), a conventional LED (LEDemetron; LED) and two so-called "third generation" oval-footprint LED light-curing units (LCUs) of the same model. The latter featured bimodal emission spectra (blue and ultraviolet diodes) with either high (unmodified output) and approximately 50% (modified output) blue light intensity (UltraLume-5; ULs, ULm, respectively). Vickers hardness number was obtained across the lateral extent of the bar at 1mm increments from the centre point on both upper and lower surfaces of the specimens. RESULTS: Significant linear relationships (R(2)=0.71-0.98) for each distance from the central position of all LCUs were identified between measured light intensity and corresponding upper and lower surface hardness values for each product (P<0.05). No significant differences (P>0.05) were recorded in total upper surface hardness of TC or TE cured with LED (68.7+/-3.2 and 70.5+/-2.5) or ULm (56.8+/-2.0 and 57.7+/-2.0). However, upper surface hardness of TT (CQ only) cured with ULm was significantly decreased (P<0.05) compared with other LCUs. When the ratio of hardness at the edge to central positions of the bar-shaped specimens for either surface was calculated, no significant difference (P>0.05) was identified for TB (containing TPO and decreased CQ) cured with either ULs or ULm (P>0.05) and was significantly increased (P<0.05) when cured with ULs compared with LED and QTH. SIGNIFICANCE: Variability in light intensity across the curing-tip face, spectral output of dental light-curing units and differences in product photoinitiator chemistry all influence curing efficiency significantly across the width of extensive resin composite geometries.     

A comparison of prednisolone absorption and the effect of sodium salicylate and mannitol in normal and damaged rat bowel

A model of ulcerated bowel was produced in the rat rectum by treatment with Brij 35 suppositories. Prednisolone absorption from enemas in normal and damaged bowel was assessed using an in situ rectal loop. In animals 20 h after damage drug absorption was reduced but returned to normal levels after one week. Co-administration of equiosmolar sodium salicylate (1 and 2% w/v) and mannitol (2.5 and 4.1% w/v) solutions in normal bowel induced a significant water flux into the lumen and changed the plasma tritium profile compared to the control. In damaged bowel plasma tritium levels remained low following co-administration of mannitol (2.5% w/v) but were restored to normal control levels by co-administration of salicylate (1% w/v). The altered absorption in normal bowel can be attributed in part to osmotic stress but in damaged bowel the difference between the effect of equiosmotic solutions of salicylate and mannitol suggests that a different mechanism is operating.     

Photobiomodulation of oral fibroblasts stimulated with periodontal pathogens

Lasers in Medical Science - Photobiomodulation (PBM) utilises light energy to treat oral disease, periodontitis. However, there remains inconsistency in the reporting of treatment parameters and a...     

Lack of an association between gallstone disease and bilirubin levels with risk of colorectal cancer: a Mendelian randomisation analysis

Background Epidemiological studies of the relationship between gallstone disease and circulating levels of bilirubin with risk of developing colorectal cancer (CRC) have been inconsistent. To address possible confounding and reverse causation, we examine the relationship between these potential risk factors and CRC using Mendelian randomisation (MR).Methods We used two-sample MR to examine the relationship between genetic liability to gallstone disease and circulating levels of bilirubin with CRC in 26,397 patients and 41,481 controls. We calculated the odds ratio per genetically predicted SD unit increase in log bilirubin levels (OR_SD) for CRC and tested for a non-zero causal effect of gallstones on CRC. Sensitivity analysis was applied to identify violations of estimator assumptions.Results No association between either gallstone disease (P value = 0.60) or circulating levels of bilirubin (OR_SD = 1.00, 95% confidence interval (CI) = 0.96–1.03, P value = 0.90) with CRC was shown.Conclusions Despite the large scale of this study, we found no evidence for a causal relationship between either circulating levels of bilirubin or gallstone disease with risk of developing CRC. While the magnitude of effect suggested by some observational studies can confidently be excluded, we cannot exclude the possibility of smaller effect sizes and non-linear relationships.Subject terms: Colorectal cancer, Computational biology and bioinformatics     

The type 1 TNF receptor and its associated adapter protein,FAN, are required for TNFα-induced sickness behavior

RATIONALE: During the course of an infection, the pro-inflammatory cytokine tumor necrosis factor alpha (TNFalpha) acts in the brain to trigger development of behavioral responses, collectively termed sickness behavior. Biological activities of TNFalpha can be mediated by TNF receptor type 1 (TNF-R1) and type 2 (TNF-R2). TNFalpha activates neutral sphingomyelinase through the TNF-R1 adapter protein FAN (factor associated with neutral sphingomyelinase activation), but a behavioral role of FAN in the brain has never been reported. OBJECTIVES: We hypothesized that TNFalpha-induced sickness behavior requires TNF-R1 and that FAN is a necessary component for this response. MATERIALS AND METHODS: We determined the role of brain TNF-R1 in sickness behavior by administering an optimal amount of TNFalpha intracerebroventricularly (i.c.v., 50 ng/mouse) to wild-type (WT), TNF-R1-, TNF-R2-, and FAN-deficient mice. Sickness was assessed by decreased social exploration of a novel juvenile, induction of immobility, and loss of body weight. RESULTS: TNF-R1-deficient mice were resistant to the sickness-inducing properties of i.c.v. TNFalpha, whereas both TNF-R2-deficient and WT mice were fully responsive. Furthermore, the complete absence of TNFalpha-induced sickness behavior in FAN-deficient mice provided in vivo evidence that FAN-dependent TNF-R1 signaling is critical for this central action of TNFalpha. CONCLUSIONS: This is the first report to demonstrate that TNFalpha-induced sickness behavior is fully mediated by TNF-R1 and that the adaptor protein FAN is a necessary intracellular intermediate for sickness behavior.