Improving Asthma Control through Asthma Action Plans: A Quality Improvement Project at a Midwest Community Clinic

This urban community clinic had poor asthma outcomes compared to the state of Minnesota. The standard of care supports an annual Asthma Action Plan (AAP). However, the majority of patients at this clinic had not received one. This quality improvement project aimed to improve asthma control, measured by an asthma control test of at least 20, through AAP implementation supported by all team members. The clinic’s interdisciplinary champion group implemented workflow changes via practice facilitation and Plan-Do-Study-Act cycles. Asthma control rates increased from 23% to 58% in adults and 45% to 63% in children over one year, a statistically significant change.     

Cytotoxic,antioxidant and antimicrobial activities of Nerium oleander collected in Morocco

Objective: To investigate the cytotoxic, antioxidant and antibacterial activities of ethanolic and aqueous crude extracts of Nerium oleander(N. oleander) leaves. Methods: Cytotoxic activities were evaluated by WST-1 bioassay on two human cancer cell lines, namely human colon adenocarcinoma cell line HT-29 and human breast cancer cell line MDA-MB-231. The antioxidant property of N. oleander extracts was assessed by DPPH scavenging and he agar disc diffusion method was used for the determination of an毬-carotene bleaching tests. Ttimicrobial activity against different strains. Results: Using cell viability indices, the WST-1 test revealed that both extracts reduced cell viability in both cell lines. Our results also showed that aqueous extract was more active than ethanolic extract, with IC50 values of(1.67±0.22) μg/mL and(2.36±0.44) μg/mL on MDA-MB-231 cells, and(2.89±0.35) μg/mL and(5.09±0.52) μg/mL on HT29 cells, respectively. The study of the antioxidant activity showed that N. oleander extracts had a considerable scavenging capacity and exerted a significant preventive effect against the oxidation of 毬-carotene by the peroxide radicals. However, the antibacterial test showed that both ethanolic and aqueous extracts of N. oleander had a moderate antibacterial effect limited only to Gram-positive bacteria. Conclusions: Our results shows that N. oleander aqueous and ethanolic extracts have significant cytotoxic activities against tumor cell lines and possesses a strong antioxidant capacity, suggesting the presence of active compounds in N. oleander leaves that could be a potential source of phytochemicals with high medicinal value to be used in cancer treatment and prevention.     

Heat Shock Protein-70 Expression in Vitiligo and its Relation to the Disease Activity

Background:Vitiligo is a progressive depigmenting disorder characterized by the loss of functional melanocytes from the epidermis. The etiopathogenesis of vitiligo is still unclear. Heat shock proteins (HSPs) are prime candidates to connect stress to the skin. HSPs were found to be implicated in autoimmune diseases such as rheumatoid arthritis and other skin disorders as psoriasis.Results:Our analysis revealed a significantly higher expression of HSP-70 mRNA in lesional skin biopsies from vitiligo patients compared to nonlesional skin biopsies from vitiligo patients (P < 0.001) and compared to skin biopsies from healthy controls (P < 0.001). The level of HSP-70 was not found to be correlated with age, sex, or disease duration. The expression of HSP-70 was correlated with the disease activity and patients with active vitiligo showed higher mean HSP-70 level compared to those with inactive disease.Conclusions:HSP-70 plays a role in the pathogenesis of vitiligo and may enhance the immune response in active disease.     

Unusual persistent primitive trigeminal artery with a superior duplicated basilar system

A 67-year-old patient who presented with a right cerebellar hemorrhage underwent vascular workup for suspicion of underlying vascular anomalies. A diagnostic cerebral angiogram demonstrated a duplicated basilar system fed solely by a persistent primitive trigeminal artery. The findings proved to be incidental and unrelated to the patient’s hemorrhage. These developmental abnormalities are consistent with embryological development.     

Comparative evaluation of pulpal repair after direct pulp capping using stem cell therapy and biodentine: An animal study

The response of the dentin–pulp complex in rat teeth was investigated after direct capping with biodentine with or without bone marrow‐derived stem cells (BMDSCs). Following mechanical exposure, pulps were randomly capped with one of the followings materials: calcium hydroxide, biodentine or 1 × 10⁵ BMDSCs mL^?1 + biodentine. Histological examination was performed by light microscopy after 1, 3 and 5 weeks. Inflammatory reaction, necrotic tissue formation and calcific bridge formation were scored. Analysis showed that compared with the effects of calcium hydroxide or biodentine, BMDSCs + biodentine substantially reduced inflammatory reaction and necrotic tissue while promoting calcified tissue formation. Therefore, the combination of biodentine and BMDSCs could potentially stimulate pulp tissue regeneration after direct pulp capping.     

Prevalence of malocclusions and orthodontic treatment need in 8- to 12-year-old schoolchildren in Casablanca,Morocco

ObjectivesThe purpose of this work was to evaluate the prevalence of malocclusions and orthodontic treatment need among schoolchildren in Casablanca, Morocco.Materials and methodsA sample of 1000 children aged between 8 and 12 years, with no history of orthodontic treatment, was chosen at random in state schools in different administrative areas of the city of Casablanca. Data was registered using the method of Bjork et al. (1964). Orthodontic treatment need was assessed with the index used by the Swedish National Board of Health (SweNBH).ResultsWe found Angle Class I malocclusions in 61.4%, Class II in 24%, Class III in 10% and an indeterminate molar class with one or more missing molars in 4.6% of the children. Overjet was 1–4 mm in 63.8%, 4–6 mm in 17.2% and >6 mm in 10%. Bite was normal in 65.4%, 23.6% presented an overbite greater than 4 mm, 1.7% an anterior open bite ≤3 mm, 1.2% an anterior open bite >3 mm and 0.2% a bilateral open bite. Half of the sample presented anterior crowding, while only 2.5% presented posterior crowding. In all, 84.2% of the subjects needed some orthodontic treatment, and 15.8% needed no treatment. No statistically significant difference was found between sex or age and orthodontic treatment need (P>0.05).ConclusionsThis study found a strong need for orthodontic treatment, confirming the utility of implementing a programme of bucco-dental prevention and screening for malocclusion.