New pharmaceutical approaches for the treatment of food allergies

Introduction: Allergic diseases constitute one of the most common causes of chronic illness in developed countries. The main mechanism determining allergy is an imbalance between Th1 and Th2 response towards Th2.

Areas covered: This review describes the mechanisms underlying the natural tolerance to food components and the development of an allergic response in sensitized individuals. Furthermore, therapeutic approaches proposed to manage these abnormal immunologic responses food are also presented and discussed.

Expert opinion: In the past, management of food allergies has consisted of the education of patients to avoid the ingestion of the culprit food and to initiate the therapy (e.g. self-injectable epinephrine) in case of accidental ingestion. In recent years, sublingual/oral immunotherapies based on the continuous administration of small amounts of the allergen have been developed. However, the long periods of time needed to obtain significant desensitization and the generation of adverse effects, limit their use. In order to solve these drawbacks, strategies to induce tolerance are being studied, such as the use of either adjuvant immunotherapy in order to facilitate the reversion of the Th2 response towards Th1 or the use of monoclonal antibodies to block the main immunogenic elements.     

Neuroprotective effect of omega-3 polyunsaturated fatty acids in the 6-OHDA model of Parkinson's disease is mediated by a reduction of inducible nitric oxide synthase

Objective: Parkinson's disease (PD) is characterized by deterioration of the nigrostriatal system and associated with chronic neuroinflammation. Glial activation has been associated with regulating the survival of dopaminergic neurons and is thought to contribute to PD through the release of proinflammatory and neurotoxic factors, such as reactive nitric oxide (NO) that triggers or exacerbates neurodegeneration in PD. Polyunsaturated fatty acids (PUFAs) exert protective effects, including antiinflammatory, antiapoptotic, and antioxidant activity, and may be promising for delaying or preventing PD by attenuating neuroinflammation and preserving dopaminergic neurons. The present study investigated the effects of fish oil supplementation that was rich in PUFAs on dopaminergic neuron loss, the density of inducible nitric oxide synthase (iNOS)-immunoreactive cells, and microglia and astrocyte reactivity in the substantia nigra pars compacta (SNpc) and striatal dopaminergic fibers.

Methods: The animals were supplemented with fish oil for 50 days and subjected to unilateral intrastriatal 6-hydroxydopamine (6-OHDA)-induced lesions as a model of PD.

Results: Fish oil mitigated the loss of SNpc neurons and nerve terminals in the striatum that was caused by 6-OHDA. This protective effect was associated with reductions of the density of iNOS-immunoreactive cells and microglia and astrocyte reactivity.

Discussion: These results suggest that the antioxidant and antiinflammatory properties of fish oil supplementation are closely related to a decrease in dopaminergic damage that is caused by the 6-OHDA model of PD.     

Bilan des enquêtes 2012, 2013 et 2014 de l’Observatoire national français des centres spécialisés de l’obésité (oNCSO)

Objective and method

The French Obesity Plan enabled the creation of 37 Specialized Obesity Centers (CSOs) in 2012 to ensure a dual mission, the multidisciplinary management of severe or complex obesity and the organization of care channels in the regions. This report takes stock of the first three years of operation of the CSOs, based on the data collected by the National Observatory of CSOs (oNCSO), set up by the General Directorate of Hospitalization and Care.

Non-surgical treatment of peri-implant pathology

Abstract:  Introduction:  Peri-implant pathologies consist of an inflammatory process affecting the soft and hard tissues surrounding the implants. Chlorhexidine is considered the gold standard antiseptic, with a large variety of choice in administration. In this study, a protocol for the irrigation of peri-implant pockets with a chlorhexidine gel, using a plastic needle for the delivery of the product into the peri-implant pockets is described. Study participants and methods:  Nine patients with at least one implant presenting peri-implant pathology (inflamed soft tissue associated with bone loss around the implant) were enrolled in this prospective clinical study, and followed-up for 1 year, where clinical parameters such as modified plaque index, modified bleeding index, probing pocket depths, attachment levels were assessed at baseline, 1 month, and 1 year after implementation of the treatment protocol. Results:  Treatment success was achieved in eight of the nine patients (and in 11 of the 13 implants) according to the success criteria adopted by the authors of this study. Discussion:  Infection control lies at the heart of peri-implant treatment. The control of three factors such as optimal diagnosis, removal of the aetiological factor of the disease (proper removal of debris and decontamination of the peri-implant sulcus/pocket) and a good patient's oral hygiene self-care represents the key to success, resulting in good treatment outcomes when managing peri-implant pathologies. The protocol used (irrigation of peri-implant pockets with chlorhexidine gel delivered by a plastic needle) is considered to be of utility.     

Flexural strength of provisional crown and fixed partial denture resins

STATEMENT OF PROBLEM: Provisional prostheses are subject to flexure under function. Selection of the appropriate material for their fabrication is difficult given the limited evidence-based information on the flexural strength of provisional resins. PURPOSE: This study compared the flexural strength of 5 methacrylate-based resins and 8 bis-acryl resins used to fabricate provisional crowns and fixed partial dentures. MATERIAL AND METHODS: Bar-type specimens were fabricated according to American National Standards Institute/American Dental Association specification 27. After being immersed in artificial saliva at 37 degrees C for 10 days, the specimens were fractured under 3-point loading in a universal testing machine at a crosshead speed of 0.75 mm/min. Maximal loads to fracture in Newtons were recorded. Mean flexural strengths were calculated in MPa (n = 10 per group). Comparisons were made with analysis of variance and Duncan's multiple range test (P<.05). RESULTS: Mean flexural strengths ranged from 56.2 to 123.6 MPa. There were 4 statistically similar groups. The group with the highest strengths consisted of 4 bis-acryl materials (Provipont, Integrity, Protemp 3 Garant, and Luxatemp). CONCLUSION: Within the limitations of this study, flexural strengths were material- rather than category-specific. Some, but not all, bis-acryl resins demonstrated significantly superior flexural strength over traditional methacrylate resins.     

Toothache prevalence and associated factors: a life course study from birth to age 12 yr

This study estimated the lifetime prevalence of toothache at ages 6 and 12 yr, the prevalence of toothache during the last month, and their association with social, behavioural and clinical exposures in the course of life of 339 12-yr-old children from a birth cohort in Pelotas, Brazil. Exploratory variables were collected in the perinatal study and during several follow-up studies. Prevalence ratios were calculated using Poisson regression, following a hierarchical conceptual model. The lifetime prevalence of toothache at ages 6 and 12 yr were 39% [95% confidence interval (CI) = (34;45)] and 63% [95% CI = (58;69)], respectively. Toothache during the last month was reported by 11% [95% CI = (8;15)]. Children who did not live with their biological father at birth, and children with higher dmf-t counts, reported a higher lifetime prevalence of toothache at age 6 yr. Children experiencing poverty between ages 0 and 4 yr, with higher dmf-t and DMF-T indexes presented a greater lifetime prevalence of toothache at 12 yr. Toothache within the last month was more likely to be reported by girls and by children who did not live with their biological father at birth. Preventive strategies should be implemented in early stages of the life cycle, taking into account the socio-economic and family context in which pain mostly occurs.     

Oral complaints in progressive systemic sclerosis: two cases report

Progressive systemic sclerosis is a chronic sclerotic disease which causes diffuse, increased deposition of extracellular matrix in connective tissue with vascular abnormalities, resulting in tissue hypoxia. Aesthetic and facial dysfunction are followed by important oral and facial manifestation of disturbances such as xerostomia, the lack of saliva in the mouth, and its associated complications. Most clinical manifestations begin with tongue rigidity. The facial skin changes and bone resorption of mandible angle are often reported. Other systemic changes include the involvement of internal organs which leads to serious complications as well as disorders in the cardiac muscle and Raynaud's phenomenon. The objective of the this paper is to report two cases of systemic sclerosis in patients with oral and facial manifestations of the disease. A brief review of the literature, focusing on deontological alterations is also presented.