Correlation of the gastroesophageal flap valve grade with the surgery rate in patients with gastroesophageal reflux disease

Background

The importance of endoscopic evaluation and grading of the gastroesophageal flap valve (GEFV) in patients with gastroesophageal reflux disease (GERD) was previously demonstrated with increased acid exposure and high grades of esophagitis in those with high-grade valves. On the other hand, no data exist on the relationship between GEFV appearance and surgical rate.

Methods

For 453 patients with symptoms suggestive of GERD, GEFV grading and 24-h ambulatory pH monitoring were performed. Surgery was performed for 82 of these patients who failed medical management or had disease complications.

Results

The GEFV grade 4 patients were younger than the patients with normal GEFV (grades 1 [p = 0.017] and 2 [p < 0.001]) and showed significant male predominance. The prevalence of hiatal hernia, the degree of esophageal acid exposure, and the prevalence and degree of erosive esophagitis significantly increased with GEFV grade (p < 0.001 for all). No GEFV grade 1 patients underwent surgery compared with 4.9 % of the grade 2 patients, 20.5 % of the grade 3 patients, and 63.6 % of the grade 4 patients who had surgery for various indications (p < 0.001).

Conclusions

Esophagogastric opening estimated by endoscopic grading of the GEFV was strongly correlated with surgery rate in GERD patients. In particular, patients with grade 4 valves showed the highest rates of erosive esophagitis and axial hiatal hernia and frequently underwent surgery for either failed medical management or disease complications.     

Influence of smoking on interleukin-1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment

Toker H, Akp?nar A, Ayd?n H, Poyraz O. Influence of smoking on interleukin‐1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment. J Periodont Res 2012; 47: 572–577. © 2012 John Wiley & Sons A/S Background and Objective: The aim of this study was to evaluate the impact of smoking on the relationship between interleukin‐1 (IL‐1β) and oxidation in patients with periodontitis and response to nonsurgical periodontal therapy. Material and Methods: Data were obtained from 30 patients with generalized chronic periodontitis (15 smokers and 15 nonsmokers) and from 10 periodontally healthy controls. IL‐1β level, total oxidant status (TOS) and total antioxidant status (TAS) were recorded in gingival crevicular fluid. Probing depth, clinical attachment level, gingival and plaque indices and bleeding on probing were also measured. The gingival crevicular fluid and clinical parameters were recorded at baseline and 6 wk after periodontal treatment. Results: The study showed statistically significant improvement of clinical parameters in both smokers and nonsmokers after periodontal treatment. Moreover, the baseline IL‐1β levels were significantly higher in smokers compared with nonsmokers (p < 0.05). After periodontal treatment, the IL‐1β levels were significantly reduced in both smokers and nonsmokers (p < 0.05). There were no significant differences in TOS and TAS between periodontitis patients and healthy controls at baseline and 6 wk after periodontal treatment. The level of IL‐1β in gingival crevicular fluid was positively correlated with TOS in both smokers and nonsmokers. Conclusions: Periodontal treatment improved the clinical parameters in both smokers and nonsmokers. The results confirm that periodontal therapy has an effect on IL‐1β levels in gingival crevicular fluid, but not on TOS and TAS.     

Resonance frequency analysis of orthodontic miniscrews subjected to light-emitting diode photobiomodulation therapy

The aim of this prospective experimental study was to evaluate the effect of light-emitting diode (LED) photobiomodulation therapy (LPT) on the stability of immediately loaded miniscrews under different force levels, as assessed by resonance frequency analysis (RFA). Sixty titanium orthodontic miniscrews with a length of 8 mm and a diameter of 1.4 mm were implanted into cortical bone by closed flap technique in each proximal tibia of 15 New Zealand white adult male rabbits (n = 30). The animals were randomly divided into irradiated and control groups under different force levels (0, 150, and 300 cN). OsseoPulse? LED device (Biolux Research Ltd.) 618 nm wavelength and 20 mW/cm(2) output power irradiation (20 minutes/day) was applied to the miniscrews for 10 days. The RFA records were performed at miniscrew insertion session (T1) and 21 days after surgery (T2). Wilcoxon and Mann-Whitney U-tests were used for statistical evaluation at P < 0.005 level. It was found that initial primer stability of all miniscrews was similar in all groups at the start of the experimental procedure. Statistically significant differences were found for changes in implant stability quotient (ISQ) values between LED-photobiomodulated group and the control (0 cN, P = 0.001; 150 cN, P < 0.001; and 300 cN, P < 0.001). Significant increase was found in ISQ values of LPT applied miniscrews under 0 cN (+11.63 ISQ), 150 cN (+10.50 ISQ), and 300 cN (+7.00 ISQ) force during observation period. By the increase of force levels, it was determined that ISQ values decreased in non-irradiated control miniscrews. Within the limits of this in vivo study, the present RFA findings suggest that LPT might have a favourable effect on healing and attachment of titanium orthodontic miniscrews.     

Design,synthesis, and in vitro biological evaluation of novel thiazolopyrimidine derivatives as antileishmanial compounds

A series of thiazolopyrimidine derivatives was designed and synthesized as a Leishmania major pteridine reductase 1 (LmPTR1) enzyme inhibitor. Their LmPTR1 inhibitor activities were evaluated using the enzyme produced by Escherichia coli in a recombinant way. The antileishmanial activity of the selected compounds was tested in vitro against Leishmania sp. Additionally, the compounds were evaluated for cytotoxic activity against the murine macrophage cell line RAW 264.7. According to the results, four compounds displayed not only a potent in vitro antileishmanial activity against promastigote forms but also low cytotoxicity. Among them, compound L16 exhibited an antileishmanial activity for both the promastigote and amastigote forms of L. tropica, with IC₅₀ values of 7.5 and 2.69 µM, respectively. In addition, molecular docking studies and molecular dynamics simulations were also carried out in this study. In light of these findings, the compounds provide a new potential scaffold for antileishmanial drug discovery.     

Serum indoleamine 2,3 dioxygenase and tryptophan and kynurenine ratio using the UPLC-MS/MS method,in patients undergoing peritoneal dialysis,hemodialysis, and kidney transplantation

Background: The level and activity of indoleamine 2,3-dioxygenase (IDO) and the concentrations of L-tryptophan and its metabolite L-kynurenine were determined in association with various renal diseases. However, there have been no data regarding these parameters in patients on peritoneal dialysis compared to those undergoing hemodialysis or kidney transplantation.

Methods: This study investigated the level and activity of IDO and determined oxidative balance by calculating the total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI). We enrolled 60 kidney disease patients, including 20 on peritoneal dialysis (PD group), 19 on hemodialysis (HD group), and 21 with kidney transplantation (KT group), as well as 21 control group.

Results: IDO levels were increased in the PD, HD, and KT groups compared to the control group. The concentration of kynurenine was significantly increased in the PD group compared to the other groups (p?p?p?Conclusion: The results showed that IDO levels were increased in peritoneal dialysis and hemodialysis patients and in renal transplant recipients, while oxidative stress was found to be related to IDO activity and was most increased in the patients on peritoneal dialysis.