Is There a Positive Effect of Smoking Cessation on Periodontal Health? A Systematic Review

Background: Although the detrimental effects of tobacco on the periodontal tissues have been reported extensively, little is known about the potential beneficial effect of smoking cessation on periodontal health. The aim of this systematic review is to evaluate the effect of smoking cessation on periodontitis progression and response to periodontal therapy. Methods: Two independent reviewers completed the review process through title (n = 118), abstract (n = 24), and whole‐paper selection (n = 5). Sources include Medline and EMBASE databases (up to December 2012) and a reference list of selected studies. Prospective studies comparing progression rates of periodontitis between smokers and quitters and clinical trials evaluating the effect of smoking‐cessation programs, alone or in combination with periodontal treatment, were included. At least 1 year of follow‐up was required for inclusion. Results: Of 331 potentially relevant publications, five studies fulfilled the inclusion criteria. Because of heterogeneity of the studies, a meta‐analysis could not be performed. One study reported that the progression of clinical attachment loss (AL) ≥3 mm during a 6‐year period was approximately three times higher among smokers than quitters (P <0.001). Two studies (10 and 20 years of follow‐up) observed a decrease in radiographic bone loss of ≈30% among quitters when compared with smokers. Among individuals receiving non‐surgical periodontal treatment, quitters were more likely to have periodontal probing depth reductions (P <0.05) than non‐quitters/oscillators. No differences in AL were observed. Conclusion: Based on the limited available evidence, smoking cessation seems to have a positive influence on periodontitis occurrence and periodontal healing.     

The five-point Likert scale for dyspnea can properly assess the degree of pulmonary congestion and predict adverse events in heart failure outpatients

OBJECTIVES:

Proper assessment of dyspnea is important in patients with heart failure. Our aim was to evaluate the use of the 5-point Likert scale for dyspnea to assess the degree of pulmonary congestion and to determine the prognostic value of this scale for predicting adverse events in heart failure outpatients.

METHODS:

We undertook a prospective study of outpatients with moderate to severe heart failure. The 5-point Likert scale was applied during regular outpatient visits, along with clinical assessments. Lung ultrasound with ≥15 B-lines and an amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) level >1000 pg/mL were used as a reference for pulmonary congestion. The patients were then assessed every 30 days during follow-up to identify adverse clinical outcomes.

RESULTS:

We included 58 patients (65.5% male, age 43.5±11 years) with a mean left ventricular ejection fraction of 27±6%. In total, 29.3% of these patients had heart failure with ischemic etiology. Additionally, pulmonary congestion, as diagnosed by lung ultrasound, was present in 58% of patients. A higher degree of dyspnea (3 or 4 points on the 5-point Likert scale) was significantly correlated with a higher number of B-lines (p = 0.016). Patients stratified into Likert = 3-4 were at increased risk of admission compared with those in class 1-2 after adjusting for age, left ventricular ejection fraction, New York Heart Association functional class and levels of NT-proBNP >1000 pg/mL (HR = 4.9, 95% CI 1.33-18.64, p = 0.017).

CONCLUSION:

In our series, higher baseline scores on the 5-point Likert scale were related to pulmonary congestion and were independently associated with adverse events during follow-up. This simple clinical tool can help to identify patients who are more likely to decompensate and whose treatment should be intensified.     

Case Report of Small Cell Carcinoma of the Ovary,Hypercalcemic Type (Ovarian Rhabdoid Tumor) with SMARCB1 Mutation: A Literature Review of a Rare and Aggressive Condition

Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare and aggressive condition that is associated with the SMARCA4 mutation and has a dismal prognosis. It is generally diagnosed in young women. Here, we report a case of a young woman with SCCOHT harboring a rare molecular finding with a highly aggressive biological behavior. The patient had a somatic SMARCB1 mutation instead of an expected SMARCA4 alteration. Even though the patient was treated with high-dose chemotherapy followed by stem cell transplantation, she evolved with disease progression and died 11 months after her first symptoms appeared. We present a literature review of this rare disease and discuss the findings in the present patient in comparison to expected molecular alterations and options for SCCOHT treatment.     

Photocatalytic degradation of ibuprofen using titanium oxide: insights into the mechanism and preferential attack of radicals

The present work studied ibuprofen degradation using titanium dioxide as a photocatalyst. Mechanistic aspects were presented and the preferred attack sites by the OH˙ radical on the ibuprofen molecule were detailed, based on experimental and simple theoretical-computational results. Although some previous studies show mechanistic proposals, some aspects still need to be investigated, such as the participation of 4-isobutylacetophenone in the ibuprofen degradation and the preferred regions of attack by OH˙ radicals. The photodegradation was satisfactory using 0.03 g of TiO₂ and pH = 5.0, reaching 100% decontamination in 5 min. The zeta potential curve showed the regions of attraction and repulsion between TiO₂ and ibuprofen, depending on the pH range and charge of the species, influencing the amount of by-products formed. Different by-products have been identified by GC-MS, such as 4-isobutylacetophenone. Ibuprofen conversion to 4-isobutylacetophenone takes place through decarboxylation reaction followed by oxidation. The proposed mechanism indicates that the degradation of ibuprofen undergoes a series of elementary reactions in solution and on the surface. Three different radicals (OH˙, O₂⁻˙ and OOH˙) are produced in the reaction sequence and contribute strongly to the oxidation and mineralization of ibuprofen and by-products, but the hydroxyl radical has a greater oxidation capacity. The simple study using the DFT approach demonstrated that the OH˙ radical attacks preferentially in the region of the ibuprofen molecule with high electronic density, which is located close to the aromatic ring (C C bond). The presence of the OH˙ radical was confirmed through a model reaction using salicylic acid as a probe molecule.

The degradation of ibuprofen undergoes a series of elementary reactions, generating different radicals which attack preferentially in the region of the ibuprofen with high electron density.     

HDAC and MAPK/ERK Inhibitors Cooperate To Reduce Viability and Stemness in Medulloblastoma

Journal of Molecular Neuroscience - Medulloblastoma (MB), which originates from embryonic neural stem cells (NSCs) or neural precursors in the developing cerebellum, is the most common malignant...     

Early child stimulation and attention-related executive functions at 11 years: 2004 Pelotas birth cohort study

The study aimed to explore associations between socioeconomic position (SEP) indicators, early child stimulation (ECS) and attention-related executive functions (EF) at age 11. Children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort (n = 4231, non-response rate at recruitment < 1%) and followed from birth to age 11. SEP variables were family income and maternal schooling. At the 24 and 48-month follow-ups, five markers of cognitive stimulation and social interaction were recorded and positive answers were summed to a score ranging from 0 to 5. At age 11, attentional-switching and control, and selective-attention were assessed using the adapted Test-of-Everyday-Attention-for-Children (TEA-Ch). We used multivariable logistic regression models and mediation analysis to investigate potential mediator role of ECS in the association between SEP and EF. 3106 children were included in the analyses. Less than 7% of the more stimulated individuals showed low performance in attention-related EFs at age 11 compared with almost 20% in the bottom groups of stimulation. Higher child stimulation scores were associated with fewer impairments in attentional-control (OR adj 0.84; CI 95% 0.72–0.98) and attentional-switching (OR adj 0.85; CI 95% 0.73–0.99). Mediation analysis suggested that for attentional-switching, ECS mediated almost 20% of the total protective effect of maternal schooling for impaired EF. Assuming causal relationships, if maximum stimulation was provided to all children, the advantageous effect of maternal schooling on EF would be reduced by 47%. ECS may represent a protective factor for cognitive impairments in childhood and can be easily implemented at relatively low cost.

     

Herpes simplex virus 2 vasculitis as cause of ischemic stroke in a young immunocompromised patient

Journal of NeuroVirology - Herpes simplex virus 2 (HSV-2) is a very rare cause of central nervous system (CNS) infections. We report a case of a young woman with a left middle cerebral artery (MCA)...     

Simultaneous detection of West Nile and Japanese encephalitis virus RNA by duplex TaqMan RT-PCR

West Nile virus (WNV) and Japanese encephalitis virus (JEV) are important mosquito-borne viruses of the Flaviviridae family, associated with encephalitis, mainly in humans and horses. WNV is also pathogen for many bird species. The incidence of human and animal WNV infections in Europe has risen, mostly in recent years, and JEV was detected in 2011 in mosquitoes collected in Italy and may emerge in Europe in the same way as other flaviviruses had emerged recently (USUTU and Bagaza virus) and should be regarded as a potential threat to public health.