Cutaneous leishmaniasis reactivation 2 years after treatment caused by systemic corticosteroids - first report

American tegumentary leishmaniasis (ATL), an endemic anthropozoonosis in various countries in the world, is caused by parasites of the genus Leishmania. Despite reports on ATL reactivation as a result of immunosuppression, to the best of our knowledge, this paper describes the first case of ATL reactivation in its localized form (cutaneous leishmaniasis) associated with the administration of systemic corticosteroids. The possible action of corticosteroids on the host immune response to the parasite in patients with localized cutaneous leishmaniasis is discussed. This report demonstrates the possibility of ATL reactivation in patients using corticosteroids, an observation that should be considered in individuals treated with this medication.     

Experimental comparative study in rabbits of three different ways of cartilage graft fixation: suture, gelatin-resorcin-formaldehyde and butyl-2-cyanoacrylate

CONCLUSION: The compound gelatin-resorcin-formaldehyde (GRF) was a better stabilizing material for cartilage grafts in rabbits than butyl-2-cyanoacrylate. GRF was also better than the suture when comparing fixation of cartilage to the periosteum and inflammatory reaction. OBJECTIVE: Cartilage grafting is an interesting option for refinements on rhinoplasties. The objective of this study was to compare butyl-2-cyanoacrylate to GRF and suture to determine the efficacy of these methods in restraining grafted cartilage in rabbits. MATERIALS AND METHODS: Fifteen male adult New Zealand rabbits underwent surgery with the aim of collecting six auricular cartilage grafts from each animal. Two of these grafts in each animal were glued together with butyl-2-cyanoacrylate, two were glued together with compound GRF, and two were sewn together with nylon suture. These sandwich grafts were then glued or sutured to the periosteum of the glabella. After 2, 6, and 12 weeks, groups of five animals were sacrificed and histological analysis for inflammation was performed. Cartilage graft migration, adhesion, and deformities of the grafts were also evaluated. RESULTS: There was less migration of the cartilages glued with GRF than with cyanoacrylate and suture. GRF showed statistically less inflammatory reaction and angiogenesis than the other two methods. The three methods showed a tendency to decrease of fibrosis, inflammation, and angiogenesis as weeks passed. There was no detachment or deformity in the cartilage sandwiches sutured to the glabella's periostium. The majority of detached and deformed cartilages were those glued with cyanoacrylate. The number of detached cartilages was directly related to the number of deformed cartilages. The data were statistically significant (p<0.05).     

Robust immunogenicity to the H3N2 component of influenza A vaccine in primary Sjögren syndrome

Clinical Rheumatology - Influenza A (H3N2) virus is the major cause of morbidity/mortality due to seasonal influenza over 50&nbsp;years. Data about the safety/immunogenicity of influenza...     

Tele-practice guidelines for the symptom management of children undergoing cancer treatment

The provision of tele-practice symptom management is often without the provision of evidence-based guidelines. Under the auspices of the Pediatric Oncology Group of Ontario, a nursing task force was established to appraise the evidence and develop guidelines. Promising new efforts to enhance symptom management through tele-practice are emerging. Seven guidelines and one documentation tool were created from evidence compiled from case reports, clinical examples, and nonexperimental studies. The symptom management guidelines contribute to the paucity of literature and may serve as a useful resource for health professionals providing telephone advice and conducting tele-practice symptom management assessments.     

Treatment of intrabony periodontal defects in controlled diabetic patients with an enamel matrix derivative: a split-mouth randomized clinical trial

Clinical Oral Investigations - This split-mouth randomized controlled trial aimed to evaluate the effect of enamel matrix derivative (EMD) associated with a simplified papilla preservation flap...     

Low-level laser therapy to recovery testicular degeneration in rams: effects on seminal characteristics,scrotal temperature,plasma testosterone concentration,and testes histopathology

The aim of this study was to investigate the efficiency of low-level laser therapy (LLLT) to recovery testicular degeneration in rams. In the first study, rams were induced to testicular degeneration by scrotal insulation, and then, they were treated using LLLT at 28 J/cm² (INS28) or 56 J/cm² (INS56) energy densities. Sperm kinetics, morphology, and membranes integrity as well as proportion of lumen area in seminiferous tubule were assessed. In the second study, rams were submitted or not to scrotal insulation and treated or not by the best protocol of LLLT defined by experiment 1 (INS28). In this study were evaluated sperm kinetics, morphology, membranes integrity, ROS production, and DNA integrity. Testosterone serum concentration and proportion of lumen area in seminiferous tubule were also analyzed. Insulation was effective in promoting sperm injuries in both experiments. Biostimulatory effect was observed in experiment 1: INS28 presented smaller proportion of lumen area (P?=?0.0001) and less degeneration degree (P?=?0.0002). However, in experiment 2, there was no difference between the groups (P?=?0.17). In addition, LLLT did not improve sperm quality, and there was a decreasing for total and progressive motility (P?=?0.02) and integrity of sperm membranes (P?=?0.01) in LLLT-treated groups. Moreover, testosterone concentration was not improved by LLLT (P?=?0.37). Stimulation of aerobic phosphorylation by LLLT may have led to a deregulated increase in ROS leading to sperm damages. Thus, LLLT at energy of 28 J/cm² (808 nm of wavelength and 30 mW of power output) can induce sperm damages and increase the quantity of cells in seminiferous tubule in rams.     

Decreased hernia recurrence using autologous platelet-rich plasma (PRP) with Strattice™ mesh in a rodent ventral hernia model

Background

Recurrence after ventral hernia repair (VHR) remains a multifactorial problem still plaguing surgeons today. Some of the many contributing factors include mechanical strain, poor tissue-mesh integration, and degradation of matrices. The high recurrence rate witnessed with the use of acellular dermal matrices (ADM) for definitive hernia repair has reduced their use largely to bridging repair and breast reconstruction. Modalities that improve classic cellular metrics of successful VHR could theoretically result in improved rates of hernia recurrence; autologous platelet-rich plasma (PRP) may represent one such tool, but has been underinvestigated for this purpose.

Methods

Lewis rats (32) had chronic ventral hernias created surgically and then repaired with Strattice? mesh alone (control) or mesh + autologous PRP. Samples were harvested at 3 and 6 months postoperatively and compared for gross, histologic, and molecular outcomes of: neovascularization, tissue incorporation, peritoneal adhesions, hernia recurrence, and residual mesh thickness.

Results

Compared to control at 3 months postoperatively, PRP-treated rats displayed significantly more neovascularization of implanted mesh and considerable upregulation of both angiogenic genes (vEGF 2.73-fold, vWF 2.21-fold) and myofibroblastic genes (αSMA 9.68-fold, FSP-1 3.61-fold, Col1a1 3.32-fold, Col31a1 3.29-fold). Histologically, they also showed enhanced tissue deposition/ingrowth and diminished chronic immune cell infiltration. Peritoneal adhesions were less severe at both 3 (1.88 vs. 2.94) and 6 months (1.63 vs. 2.75) by Modified Hopkins Adhesion Scoring. PRP-treated rats experienced decreased hernia recurrence at 6 months (0/10 vs. 7/10) and had significantly improved ADM preservation as evidenced by quantification of residual mesh thickness.

Conclusions

PRP is an autologous source of pro-regenerative growth factors and chemokines uniquely suited to soft tissue wound healing. When applied to a model of chronic VHR, it incites enhanced angiogenesis, myofibroblast recruitment and tissue ingrowth, ADM preservation, less severe peritoneal adhesions, and diminished hernia recurrence. We advocate further investigation regarding PRP augmentation of human VHR.

     

Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches

This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.     

Analysis of symptomatic and asymptomatic primary root canal infections in adult Norwegian patients

Introduction

This molecular study analyzed the microbiota of primary root canal infections from adult Norwegian patients.

Methods

Samples were taken from the necrotic root canals of teeth with symptomatic (n = 13) or asymptomatic (n = 21) apical periodontitis and chronic apical abscesses (n = 9). DNA was extracted from samples, and bacterial identifications were performed by a closed-ended reverse-capture checkerboard approach targeting 50 candidate endodontic pathogens.

Results

Bacterial DNA was detected in all cases. In teeth with asymptomatic apical periodontitis, the most frequent taxa were Dialister invisus (71%), Fusobacterium nucleatum (62%), and Porphyromonas endodontalis (62%). In chronic apical abscesses, the most prevalent taxa were P. endodontalis (100%), D. invisus (89%), Parvimonas micra (78%), and Solobacterium moorei (78%). In teeth with symptomatic apical periodontitis, the most prevalent taxa were D. invisus, P. endodontalis, S. moorei, Propionibacterium acnes, and Streptococcus species (all in 69%). None of the targeted taxa were significantly associated with either sinus tract or pain (P > .05), except for Selenomonas sputigena, which was more frequently found in painful cases (P = .04). No taxa were found in significantly higher levels in any conditions (P > .05). Cluster analyses revealed bacterial groupings that differed between cases with and without pain.

Conclusions

Although basically the same species were highly prevalent in the different conditions examined and none of the most prevalent taxa were positively associated with symptoms, results revealed that species formed different partnerships and associations in samples from teeth with or without pain. Therefore, it is possible that more virulent multispecies communities can form as a result of overall bacterial combinations and give rise to acute inflammation.