Urinary bladder volume and pressure at reflux as prognostic factors of vesicoureteral reflux outcome

Background: Controversy exists as to whether the outcome of vesicoureteral reflux (VUR) can be prognosticated by direct radionuclide cystography (DRC).Objective:To correlate the quantitative data obtained by DRC with disease outcome in infants with VUR and positive DRC 1 year after diagnosis. Materials and methods: The medical records of 109 children with known primary VUR diagnosed during the first year of life were studied retrospectively. One year after diagnosis all patients underwent DRC. Children with a positive first DRC were followed up for the next 36 months. Fishers exact test was used to calculate the statistical significance of differences in the number of ureters with resolved reflux, as related to quantitative data obtained during the first DRC. Results:The first DRC, performed 1 year after the initial diagnosis, was positive in 49 children (26 with bilateral reflux). Quantitative data derived from this first examination could not establish any prognostic value for a refluxing volume of <2% of the total vesical volume or a reflux at a bladder volume of more than 60% of total bladder capacity. When this limit was lowered to 45%, a statistically significant difference was found (P=0.046). Moreover, when a bladder pressure at the time of reflux of more than 20 cm H₂O was set as a criterion, an extremely significant probability value was calculated (P=0.0009). Conclusions: VUR occurring at a bladder pressure of less than 20 cm H₂O and a filling volume of less than 45% of the total bladder volume indicate a low probability for VUR resolution within the subsequent 36 months, in infants with known reflux.     

Study of conformational transitions of graft copolymers by UV spectrophotometry

UV absorption spectra of solutions of vinyl acetate polymers grafted on ethylene oxidepropylene oxide blockcopolymers in (90:10, v/v) ethanol/water mixture are investigated. The spectra of graft copolymers are clearly different from those of blends of the same composition. Conformational transitions of these copolymers occur in dilute solution at 35 and 60°C; the transitions are evidenced by UV differential spectra either compensated with solvent at the same temperature or with solution at 20°C. The absorbance measured at fixed wavelength as a function of temperature shows a change of slope at the transition points. However, the difference between the energies of solution and solvent as measured from differential spectra does not vary monotonously with temperature. It exhibits two minima corresponding to the transition temperatures. The plot of either this energy difference or the ratio of solvent maximum absorbance over solution maximum absorbance (from differential spectra) versus concentration allows to establish a critical concentration. Below this concentration a solution of grafted copolymers may be looked upon as dilute.     

Non-diabetic glomerular lesions in diabetic kidney disease: clinical predictors and outcome in an Eastern European cohort

International Urology and Nephrology - Since patients’ prognosis depends on the lesions identified by kidney biopsy (KB), we aimed to evaluate predictors of non-diabetic kidney disease (NDKD)...     

Painful jaundice revealing Kawasaki disease in a young man

Liver involvement is usually a minor manifestation of Kawasaki disease and includes hepatobiliary dysfunction or gallbladder hydrops. We describe here an unusual case of jaundice revealing an adult onset Kawasaki disease. An 18-year-old man presented with abdominal pain and jaundice associated with cholestasis as the initial manifestation of Kawasaki disease. Abdominal evaluation (ultrasonography and CT-scan) did not find abnormality. Other signs typical of the Kawasaki disease occurred a few days later and permitted diagnosis. With aspirin and intravenous immunoglobulins, outcome was favorable without any cardiovascular complication. Our case suggests that Kawasaki disease should be added to the etiological list of painful febrile icterus in young patients.     

Reflecting on prediction strategies for epidemics: Preparedness and public health response

ObjectiveTo provide an overview of the literature on respiratory infectious disease epidemic prediction, preparedness, and response (including pharmaceutical and nonpharmaceutical interventions) and their impact on public health, with a focus on respiratory conditions such as asthma.Data SourcesPublished literature obtained through PubMed database searches.Study SelectionsStudies relevant to infectious epidemics, asthma, modeling approaches, health care access, and data analytics related to intervention strategies.ResultsPrediction, prevention, and response strategies for infectious disease epidemics use extensive data sources and analytics, addressing many areas including testing and early diagnosis, identifying populations at risk of severe outcomes such as hospitalizations or deaths, monitoring and understanding transmission and spread patterns by age group, social interactions geographically and over time, evaluating the effectiveness of pharmaceutical and nonpharmaceutical interventions, and understanding prioritization of and access to treatment or preventive measures (eg, vaccination, masks), given limited resources and system constraints.ConclusionPrevious epidemics and pandemics have revealed the importance of effective preparedness and response. Further research and implementation need to be performed to emphasize timely and actionable strategies, including for populations with particular health conditions (eg, chronic respiratory diseases) at risk for severe outcomes.     

Gingival Fibroblasts Inhibit MMP-1 and MMP-3 Activities in an Ex-Vivo Artery Model

The main arterial pathologies can be associated with a deregulation of remodeling involving matrix metalloproteinases (MMPs), whereas gingival healing is characterized by an absence of fibrosis or irreversible elastin/collagen degradation. The aim of our study was to evaluate the effect of gingival fibroblasts on MMP-1 and MMP-3 secretion in an organotypic artery culture. MMP-1 and MMP-3 secretions and activities (dot blots, zymography, ELISA) were evaluated in coculture of rabbit artery in the presence or not of gingival fibroblasts. MMP-1/TIMP-1 and MMP-3/TIMP-1 complexes forms were measured by ELISA. Complementary studies were performed using human aortic smooth muscle cells cocultured with adventitial, dermal, or gingival fibroblasts. Our results indicated that MMP-1 and MMP-3 free-forms activities were significantly reduced in coculture. This inhibition was linked to a significant increase of TIMP-1 leading to formation of TIMP-1/MMPs complexes. Due to the presence of gingival fibroblasts, the decrease in MMP-1 and MMP-3 efficiency thus contributes to diminish the degradation of artery. This cellular therapy strategy could be promising in artery pathologies treatment.     

An in vitro study on the maturation of conventional glass ionomer cements and their interface to dentin

The objective of the study was to investigate the influence of long-term storage (up to 1 year) and coating on the variation of micro-mechanical properties of four conventional restorative glass ionomer cements (GICs) within 3.5 mm deep class I cavities. Four commercially available GICs (Riva Self Cure (SDI), ChemFil Rock (Dentsply), Fuji IX Fast and Fuji IX GP Extra/Equia (GC)) were applied to 100 teeth. In each tooth, two similar 3.5 mm deep class I cavities were prepared and filled with the GICs, with and without resin coating. The samples were stored in artificial saliva at 37 °C for 1 week, 1 month, 3 months, 6 months and 1 year. The variation in mechanical properties (indentation modulus (E) and Vickers hardness (HV)) were determined in 100 μm steps starting from the filling surface, through the intermediate layer in between dentine and GIC, and ending 100 μm in dentin. HV and E were strongly influenced by the material (P < 0.05, partial eta-squared η_P² = 0.31 and 0.23) but less by aging duration (P < 0.05, η_P² = 0.02 and 0.12) and resin coating (P < 0.05, η_P² = 0.02 and 0.03). The depth of measurement (0–2 mm) has no influence on HV (P = 0.789). HV shows a gentle increase over the 1 year storage period (P = 0.002). A ～300 μm GIC zone at the areas close to dentin with weaker properties as those measured in dentin or GIC was identified in all fillings, irrespective of the presence of coating, and at all storage periods. The thickness of this zone is more strongly influenced by storage (P < 0.05, η_P² = 0.081) than by material type (P < 0.05, η_P² = 0.056), while coating showed no influence (P = 0.869). Filler morphology and dimension were similar to upper parts of the GIC filling; however, the amount of low cations was higher. We concluded that the development of an intermediate layer in between dentine and GIC with lower mechanical properties might be responsible for the bond quality of GIC to dentine. Moreover, class I GIC restorations are unlikely to feature constant mechanical properties throughout the cavity, regardless of conditions such as aging and coating.