Why do I have white spots on my front teeth?

Aesthetics have always been important in mainstream society. Fluorosis, a condition of hypomineralization of the enamel, is at its most critical stage when a child is between 22 and 25 months of age. Because their swallowing reflex is not fully developed, children under the age of 6 can swallow between 25% and 33% of fluoridated toothpaste with each brushing. In order to better educate parents about fluorosis and its effect on children's teeth, it is worth revisiting the guidelines for toothpaste use.     

Malnutrition bei Patienten mit Ulcus cruris

Chronic wounds occur in 1-2% of the population. After the age of 80 the incidence raises up to 4-5%. Leg ulcers are the most frequent diagnosed chronic wound. In this most often affected age group malnutrition develops more frequently compared to the total population. The combined presence of chronic wounds and malnutrition suggests a potential causative connection. In this clinical investigation, data evaluating the nutritional status in patients with chronic leg ulcers, derived from clinical examination, medical history and laboratory tests was analyzed for the first time for a German patient collective. Over a time period of one year we evaluated 41 patients for body mass index, diabetes mellitus, restricted mobility, diet, nicotine and alcohol use, and blood levels of vitamins, trace elements, lipids and HbA1c. We further employed the MNA-questionnaire for malnutrition. We rarely found deficiencies but often improper nutritional practices. Thus we consider that it important to evaluate nutritional status even in obese patients with leg ulcers and poorly healing wounds.     

Clinicopathologic significance of CD105-assessed microvessel density in glottic laryngeal squamous cell carcinoma

Objective

Intratumoral microvessel density (MVD) determined with the use of antibodies to endoglin (CD105) is considered to be an important prognostic marker in a variety of malignancies. The purpose of this study has been to analyze the clinicopathologic significance of CD105-assessed MVD in SCCs primary localized in glottic region of larynx.

Methods

Surgical specimens from 40 patients with resected glottic squamous cell carcinomas were immunostained for CD105. CD105-assessed MVD was calculated at 400× magnification. Using the mean MVD as a cut-off, tumors were classified in the “high MVD” group and in the “low MVD” group. Clinicopathologic data were collected retrospectively.

Results

The mean MVD assessed by CD105 in considered glottic SCCs was 12.3 (standard deviation [SD] = 3.65). MVD varied among tissue samples from 5 to 21 (median 12.5). High MVD was significantly correlated with a more aggressive tumor phenotype, including T3–T4 tumor (Fisher exact test, P = 0.004) and advanced clinical stage (Fisher exact test P = 0.026). Kruskal–Wallis test identified significant relation between pT stages and CD105-assessed MVD (P = 0.011). CD105-assessed MVD was significantly related to malignancy recurrence presence/absence (Mann–Whitney U-test P = 0.023). Logistic regression in multivariate modality showed that MVD (odds ratio [OR] 2.29, P = 0.033, 95% confidence interval [CI] 1.06–7.53) and advanced T category (T3–T4) (OR 4.11, P = 0.026, 95% CI 2.38–9.46) were significantly related to malignancy recurrence presence/absence. Cox regression analysis revealed that expression of CD105 (P = 0.031) and N status (P = 0.014) were the independent factors for disease-free survival.

Conclusion

High expression of CD105 correlated significantly with advanced T status and locoregional recurrence. The present preliminary results suggest that CD105-assessed MVD in primary glottic squamous cell carcinomas may identify patients at risk of disease recurrence.     

Usher syndrome type 1 due to missense mutations on both CDH23 alleles: investigation of mRNA splicing

Usher syndrome (USH) is an autosomal recessive condition characterized by sensorineural hearing loss, vestibular dysfunction, and visual impairment due to retinitis pigmentosa. Truncating mutations in the cadherin-23 gene (CDH23) result in Usher syndrome type 1D (USH1D), whereas missense mutations affecting strongly conserved motifs of the CDH23 protein cause non-syndromic deafness (DFNB12). Four missense mutations constitute an exception from this genotype-phenotype correlation: they have been described in USH1 patients in homozygous state. Using a minigene assay, we have investigated these changes (c.1450G>C, p.A484P; c.3625A>G, p.T1209A; c.4520G>A, p.R1507Q; and c.5237G>A, p.R1746Q) for a possible impact on mRNA splicing which could explain the syndromic phenotype. While in silico analysis suggested impairment of splicing in all four cases, we found aberrant splicing for only one mutation, p.R1746Q. However, splicing was normal in case of p.A484P, p.T1209A and p.R1507Q. These three latter CDH23 missense mutations could interfere with functions of both, the auditory and the visual system. Alternatively, they could represent rare non-pathogenic polymorphisms.     

Polysplenia and situs inversus in siblings. Case reports

Heterotaxy syndromes, otherwise laterality defects, are variations from anatomic left-right asymmetry. Situs inversus is the complete reversal of the normal situs, still situs ambiguus is the randomisation of the normal organ position. Situs ambiguus may be manifested as asplenia or polysplenia syndrome. Normal situs and both types of the heterotaxy syndromes may appear among some affected families, whereas the different situs are rarely expressed in the same family. We describe an autosomal-recessive inherited familial heterotaxy syndrome with two affected siblings - one of whom has situs inversus, and the other with polysplenia syndrome. The polysplenia syndrome was diagnosed by fetal echocardiography. Since the chromosomal or molecular diagnosis of laterality defects are accessible only in X-linked heterotaxy syndromes, the fetal echocardiography is the earliest available diagnostic method in this field. Therefore, fetal echocardiography has great importance for affected families.     

Xerostomia: diagnosis and management in dental practice

Xerostomia is a subjective sensation of oral dryness. It is caused by many factors, among them, hypo/hyper salivation. This article covers the etiology, local and systemic factors related to dryness of the mouth, its diagnosis, and clinical and at-home management of the syndrome. It also reviews the role of dental hygiene intervention to improve and promote the patient's quality of life. It is hoped this review will help dental health care providers better respond to patients afflicted with xerostomia.     

Correction to: Force–velocity profiling of sprinting athletes: single-run vs. multiple-run methods

European Journal of Applied Physiology - The author would like to correct the errors in the publication of the original article. The corrected details are given below for your reading.     

How positive and negative expectations shape the experience of visceral pain: an experimental pilot study in healthy women

Background In order to elucidate placebo and nocebo effects in visceral pain, we analyzed the effects of positive and negative expectations on rectal pain perception, rectal pain thresholds, state anxiety and cortisol responses in healthy women. Methods Painful rectal distensions were delivered at baseline, following application of an inert substance combined with either positive instructions of pain relief (placebo group, N = 15), negative instructions of pain increase (nocebo group, N = 17), or neutral instructions (control, N = 15). Perceived pain intensity, unpleasantness/aversion and urge‐to‐defecate, state anxiety and serum cortisol were determined at baseline, immediately following group‐specific instructions and on a second study day after the same instructions (test day). Rectal pain thresholds were determined at baseline and on the test day. Key Results Whereas perceived pain intensity was significantly decreased in the placebo group, the nocebo group revealed significantly increased pain intensity ratings, along with significantly greater anticipatory anxiety on the test day (all P < 0.05 vs controls). Cortisol concentrations were significantly increased in the nocebo group following treatment but not on the test day. Conclusions & Inferences The experience of abdominal pain can be experimentally increased or decreased by inducing positive or negative expectations. Nocebo effects involve a psychological stress response, characterized by increased anticipatory anxiety. These findings further underscore the role of cognitive and emotional factors in the experience of visceral pain, which has implications for the pathophysiology and treatment of patients with chronic abdominal complaints.     

Expectation‐induced placebo responses fail to accelerate wound healing in healthy volunteers: results from a prospective controlled experimental trial

Placebo responses have been shown to affect the symptomatology of skin diseases. However, expectation‐induced placebo effects on wound healing processes have not been investigated yet. We analysed whether subjects' expectation of receiving an active drug accelerates the healing process of experimentally induced wounds. In 22 healthy men (experimental group, n = 11; control group, n = 11) wounds were induced by ablative laser on both thighs. Using a deceptive paradigm, participants in the experimental group were informed that an innovative ‘wound gel’ was applied on one of the two wounds, whereas a ‘non‐active gel’ was applied on the wound of the other thigh. In fact, both gels were identical hydrogels without any active components. A control group was informed to receive a non‐active gel on both wounds. Progress in wound healing was documented via planimetry on days 1, 4 and 7 after wound induction. From day 9 onwards wound inspections were performed daily accompanied by a change of the dressing and a new application of the gel. No significant differences could be observed with regard to duration or process of wound healing, either by intraindividual or by interindividual comparisons. These data document no expectation‐induced placebo effect on the healing process of experimentally induced wounds in healthy volunteers.