Oral helminthic infestations

Oral infections caused by helminths (worms) are rarely encountered in clinical practice, and consequently, there is a paucity of information in the medical and dental literature about these conditions. In the present article, we review the English literature related to oral helminthic infestations. The main oral infections caused by helminths include four roundworm (trichinosis, trichuriasis, filariasis, and larva migrans) and three tapeworm infections (cysticercosis, sparganosis, and echinococcosis). Cases are mainly encountered in endemic areas and mainly present a benign clinical picture. The diagnosis of oral helminthic infections is mostly established after histopathological examination, which shows parasitic larvae lined by fibrous tissue and inflammatory cells. Surgical excision is the preferred treatment of isolated oral lesions caused by helminths; however, patients should undergo thorough medical evaluation to exclude the possible involvement of other body systems.     

Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery

Objective

The aim of this study was to evaluate the efficacy of tibial autogenous bone grafting in the treatment of patients with alveolar bone defects.

Materials and Methods

The study subjects consisted of 12 patients (10 male, 2 female, age: 19-51 years) who underwent reconstructive autogenous bone-grafting procedures. The medial approach to the tibial bone was used to harvest autogenous cancellous bone grafts in all the patients. Clinical parameters (complications at the donor and recipient sites, resorption and volume of the grafts) were evaluated retrospectively.

Results

The mean age of the patients was 36.25 ± 0.9 years. Of the 12 patients, 5 (41.7%) received bone grafts for sinus augmentation, 3 (25%) for cyst cavity reconstruction and 4 (33.3%) for alveolar cleft reconstruction procedures. The average follow-up period was 28.4 months (range: 21-40 months). An average of 5.2 cm³ of cancellous bone was harvested for grafting procedures. All the grafting procedures were successful, and there were no surgical complications during the harvesting protocol. In all cases, pain and gait disturbance lasted less than 2 weeks.

Conclusion

The results of this study suggest that the use of tibial autogenous bone graft harvested using a medial approach was a safe, simple and effective method for grafting various alveolar bone defects where high amounts of cancellous bone grafts were needed with low morbidity.Key Words: Autogenous bone graft, Tibial bone, Dentoalveolar surgery     

Regional changes in renal cortical glucose, lactate and urea during acute unilateral ureteral obstruction

OBJECTIVE: Acute unilateral ureteral obstruction (UUO) leads to changes in kidney function and metabolism. Microdialysis offers the possibility of topical analysis of changes in kidney metabolism. We applied microdialysis to the porcine kidney and evaluated its impact on gross kidney function. Furthermore, we investigated regional variations in renal interstitial fluid (RIF) glucose, lactate and urea during acute UUO. MATERIAL AND METHODS: Eight anesthetized pigs were used. Microdialysis probes were inserted in the upper, middle and lower thirds of the left renal cortex and perfused with Ringer's chloride at a rate of 0.3 microl/min. Dialysates were fractionated for 30-min periods. Bilateral intrapelvic pressure, urinary output, urinary osmolality, the excretion fractions of sodium and potassium, renal blood flow and the glomerular filtration rate were measured. Subsequently, left-sided graded ureteral obstruction was initiated, using the kidney's own urine production as a counter-pressure. RESULTS: The application of three microdialysis probes did not have any impact on kidney function. Ureteral obstruction decreased RIF glucose in the upper and lower thirds of the kidney, but not in the middle third. RIF lactate did not change. Interstitial urea increased in all regions of the kidney, but most markedly in the upper and lower poles. CONCLUSIONS: Microdialysis is of potential value for assessing the renal interstitial milieu under different pathophysiological conditions. Ureteral obstruction resulted in regional differences in cortical metabolites, predominantly affecting the upper and lower poles.     

Depressive symptoms in late life: associations with apathy, resilience and disability vary between young-old and old-old

OBJECTIVE: Prior research has found that disability and apathy are associated with late-life depression. However, the effect of age on these associations in "late-life," an ambiguous term encompassing all individuals typically older than 60 years, has not been examined. We investigated the association of depression with disability, apathy and resilience across the age range of late-life. METHODS: One hundred and five community-dwelling elderly with moderate levels of disability were assessed using the Geriatric Depression Scale (GDS), Hardy-Gill Resilience Scale, Starkstein Apathy Scale and IADL/ADL questionnaire. Multiple regression analysis was used to assess relationships between depression, disability, apathy and resilience, stratified by age (<80 vs. >80). RESULTS: In the <80 year old subject group, resilience, apathy and disability scores (partial type III R(2) = 11.1%, 10.4% and 12.8%, respectively) equally contributed to the variability of GDS score. In contrast, in the >80 year old subject group, apathy (partial type III R(2) = 18.7%) had the greatest contribution to GDS score. CONCLUSIONS: In elderly persons under age 80, resilience, apathy and disability all have relatively equal contributions to depression scores, whereas in those over age 80, depression is most highly correlated with apathy. These data suggest that depressive symptoms in elderly persons have different clinical features along the age spectrum from young-old to old-old.     

Antiviral, cyototoxic and antimicrobial activities of anthraquinones isolated from the roots of morinda elliptica

2-Formyl-1-hydroxyanthraquinone, along with ten other known anthraquinones (1-hydroxy-2-methylanthraquinone, nordamnacanthal, damnacanthal, lucidin-?-methyl ether, rubiadin, rubiadin-1-methyl ether, soranjidiol, morindone, morindone-5-methyl ether and alizarin-1-methyl ether), isolated from the roots of Morinda elliptica , were assayed for anti-HIV, cytotoxic and antimicrobial activites. Only damnacanthal showed moderate activity against HIV. It was cytotoxic towards the MCF-7 (breast carcinoma) and CEM-SS (T-lymphoblastic leukaemia) cell line. Nordamnacanthal was very cytotoxic against the CEM-SS cell lines. Other anthraquinones that showed strong cytotoxicity towards the cell lines tested were lucidin-?-methyl ether (CEM-SS and MCF-7) and rubiadin (CEM-SS). Three anthraquinones viz., nordamnacanthal, damnacanthal and morindone, were found to have strong antimicrobial activity.     

Health risks for early (≤19) and late (≥35) childbearing

Both adolescents and women of advanced reproductive age comprise distinct groups of obstetrics patients. Each has special needs and is susceptible to different obstetric risks. Pregnant teenagers appear to be at increased risk for poor maternal weight gain, abortions, hypertensive disorders and delivery of low birthweight infants. Pregnant women over the age of 34 have an increased risk for a poor obstetric outcome as a result of an increased risk for chromosomal aneuploidies and their higher likelihood of having a chronic disease, such as chronic hypertension or diabetes mellitus, to complicate their pregnancies. This study emphasises the increased maternal and fetal risks for pregnancies at these extreme age groups in a retrospective way. Prepregnancy counselling is essential for these age groups in order for a woman to be able to make an informed decision regarding the timing of childbearing.     

Demographics of enuresis patients attending a referral centre

OBJECTIVE: To study and compare the demography of enuretic children 7-16 years old attending a tertiary referral centre for childhood urinary incontinence, with that of normal children and what is generally known about enuretics from population-based studies. METHODS AND MATERIALS: This was a retrospective analysis of data compiled from 298 enuretic patients referred to The Centre of Child Incontinence, Aarhus University Hospital, Skejby, Denmark, and 53 healthy controls. Data was obtained by conducting standardised questionnaire interviews. Patients were stratified according to accompanying symptoms and severity of enuresis. Statistical analysis of the results was then performed. RESULTS: Two hundred and ninety-three patients had sufficient data registered to allow reliable analysis. Male-female ratio was 2.2:1. Primary and secondary enuresis was found in 87.4% and 11.6% of the patients respectively. Enuresis was associated with a reported history of bronchial asthma (p < 0.05), verified allergy (p < 0.05) and a positive family history of the same disorder (p < 0.01). No association with psycho-developmental factors was evident. Approximately 98% of the patients had undergone some form of therapy at presentation. 74.1% of the patients had pure monosymptomatic enuresis, 16.4% had day and night time incontinence, while the remaining 9.6% had nocturnal incontinence combined with other lower urinary tract symptoms other than daytime wetting. CONCLUSIONS: The demography of our patient population was, with a few exceptions, within the confines of what has previously been reported. Our results also reaffirmed the heterogeneity of enuretic patients.     

Incorporating bortezomib into upfront treatment for multiple myeloma: early results of total therapy 3

Total therapy 3 incorporated bortezomib into a melphalan-based tandem transplant regimen for 303 newly diagnosed patients with myeloma. Induction chemotherapy prior to and consolidation chemotherapy after transplants each consisted of two cycles of VTD-PACE (bortezomib, thalidomide, dexamethasone and 4-d continuous infusions of cis-platin, doxorubicin, cyclophosphamide, etoposide); 3-year maintenance comprised monthly cycles of VTD in the first and TD in the remaining years. The median age was 59 years (age >64 years, 28%). A minimum of 20 x 10(6) CD34 cells/kg was collected in 87% of patients; 83% completed both transplants, and only 5% suffered a treatment-related death. At 24 months, 83% had achieved near-complete remission, which was sustained in 88% at 2 years from its onset. With a median follow-up of 20 months, 2-year estimates of event-free and overall survival were 84% and 86% respectively. The 44 patients who experienced an event more often had a high-risk gene array profile, cytogenetic abnormalities and indicators of high lactate dehydrogenase, beta-2-microglobulin, creatinine and International Staging System stage. Toxicities of grade > 2 included thrombo-embolic events in 27% and peripheral neuropathy in 12%. Results of this phase-2 study demonstrated that bortezomib could be safely combined with multi-agent chemotherapy, effecting near-complete remission status and 2-year survival rates in more than 80% of patients.