Dental implant treatment in diabetic patients

The purpose of the present study was twofold: (1) to investigate how many diabetic patients and types of cases that are treated with dental implants in our clinic; and (2) assess the outcome of such treatment. Medical records from 782 patients were examined in patients treated by the Br?nemark method for partial or total edentulism with implant supported bridges. From these records, 25 patients (3.2%) with diabetes before implant treatment (136 implants) were identified and further studied with respect to age, gender, type of diabetes, treated jaw, degree of edentulism, bone graft, implant survival, periimplant inflammation, bleeding on probing, and radiographic bone loss. Furthermore, the patients' opinion about the outcome of the treatment was registered. The implant success rate was 96.3% during the healing period and 94.1% 1 year after surgery. Of all 38 bridges, one was lost. Few complications occurred and all patients, except for one, were satisfied with the treatment. Today, diabetic patients are being treated successfully for all types of edentulism, including bone-grafting treatment. Diabetics that undergo dental implant treatment do not encounter a higher failure rate than the normal population, if the diabetics' plasma glucose level is normal or close to normal as assessed by personal interviews.     

Comparison of the effects of simultaneous administration of vitamin C and omega-3 fatty acids on lipoproteins,apo A-I,apo B,and malondialdehyde in hyperlipidemic patients

BACKGROUND: Control of hyperlipidemia is vital in patients with cardiovascular disease (CVD). Omega-3 fatty acids (n-3FAs) have desirable effects on serum triglyceride (TG) levels, thrombosis, and arrhythmia, but lead to increases in serum low-density lipoprotein (LDL) and apo-B as well. OBJECTIVE: To determine and compare the effects of administration of n-3FAs, vitamin C (VitC) and n-3FAs + VitC on the serum levels of LDL, apoB, other serum lipids, and malondialdehyde (MDA). The present study was performed in Tehran University of Medical Sciences from 2000 to 2001. DESIGN: In a double-blind, placebo trial of parallel design, 68 hyperlipidemic patients [total cholesterol (TC) and TG greater than 200 mg/dL] were randomly assigned to receive daily 500 mg VitC, 1 g n-3FAs, 500 mg VitC + 1 g n-3FAs, or placebo (control) for 10 weeks. Fasting blood samples were collected at the beginning and at the end of the period. TG, TC, LDL-cholesterol-C (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) were measured enzymatically, VitC and MDA colorimetrically, and apo-B and apo-A-I immunoturbidometrically. The pattern of food consumption, socio-economic, and anthropometric indices were determined; there was no significant change in these indices during the study. RESULTS: There was a significant difference in the blood VitC level at the end of the study in comparison to the initial value in the VitC (p = 0.001) and VitC + n-3FAs (p = 0.027) groups. Similarly, the serum TG level at the end of study was significantly different from the initial value in the n-3FAs group (p = 0.002) and also from the final value in the control group (p = 0.013). In the VitC group, there was a significant decrease in TC (p = 0.004), apo-B (p = 0.005), and MDA (p = 0.015) at the end of study as compared to the respective initial values. There was also a significant increase in blood VitC compared to the control value (p = 0.018) and a significant decrease in MDA compared to the n-3FAs group (p = 0.034). At the end of study, in the n-3FAs group, there was a significant (p = 0.04) and a marginally significant decrease (p = 0.05), respectively, in TG/HDL and apo-B levels as compared to the initial values, and the TG/HDL ratio showed a significant decrease as compared to the control group (p = 0.047). CONCLUSION: Simultaneous administration of n-3FAs and VitC had no beneficial effects on the lipid profile of hyperlipidemic patients, but 1 g purified n-3FAs daily for 10 weeks is a beneficial supplement for decreasing TG without any increase in LDL-C, apo-B or MDA. Administration of 500 mg VitC for more than 10 weeks might decrease significantly TC and apo-B in hyperlipidemic patients.     

Serum lipid levels in an Iranian adults population: Tehran Lipid and Glucose Study

Data from 6246 participants aged 20–64 years (2339 males and 3907 females) in the cross-sectional phase of Tehran Lipid and Glucose Study (February 1999–May 2000) were used to determine distribution of serum lipid levels after 12–14 hour overnight fast. Mean total cholesterol (TC) concentration was 210 mg/dl. TC was significantly greater in females than males, 213 and 206 mg/dl, respectively (p < 0.0001). Thirty-one percent of population had TC values between 200 and 239 and 24% had values of 240 mg/dl or greater. Mean low-density lipoprotein cholesterol (LDL-C) was 129 and 135 mg/dl in males and females, respectively (p < 0.0001). Twenty-seven percent had LDL-C values between 130 and 159 and 23% had values 160 mg/dl or greater. The mean triglycerides (TGs) values were 190 and 162 mg/dl for males and females, respectively (p < 0.0001). The mean high-density lipoprotein cholesterol (HDL-C) was 39 in males and 45 mg/dl in females (p < 0.0001). The results showed higher levels of TC, LDL-C and TGs and slightly lower HDL-C in Tehranian adults than other studies in the industrialized countries.     

Synthesis and in vitro antibacterial evaluation of N-[5-(5-nitro-2-thienyl)-1,3,4-thiadiazole-2-yl] piperazinyl quinolones

A series of N-[5-(5-nitro-2-thienyl)-1,3,4-thiadiazole-2-yl]piperazinyl quinolones (7a-c) were synthesized and evaluated for in vitro antibacterial activity against some Gram-positive and Gram-negative bacteria. The antibacterial data revealed that compounds 7a-c had strong and better activity against tested Gram-positive organisms than the reference quinolones such as ciprofloxacin, norfloxacin and enoxacin. However, all three compounds were nearly inactive against Gram-negative bacteria. Compound 7a (ciprofloxacin analogue) was the most active compound against Gram-positive bacteria (MIC=0.008-0.015 mug mL(-1)).     

Cadmium induces apoptosis and genotoxicity in rainbow trout hepatocytes through generation of reactive oxygene species

Cadmium poses a serious environmental threat in aquatic ecosystems but the mechanisms of its toxicity remain unclear. The purpose of this work was first to determine whether cadmium induced apoptosis in trout hepatocytes, second to determine whether or not reactive oxygen species (ROS) were involved in cadmium-induced apoptosis and genotoxicity. Hepatocytes exposed to increasing cadmium concentrations (in the range of 1-10 microM) showed a molecular hallmark of apoptosis which is the fragmentation of the nuclear DNA into oligonucleosomal-length fragments, resulting from an activation of endogenous endonucleases and recognized as a 'DNA ladder' on conventional agarose gel electrophoresis. Exposure of hepatocytes to cadmium led clearly to the DEVD-dependent protease activation, acting upstream from the endonucleases and considered as central mediators of apoptosis. DNA strand breaks in cadmium-treated trout hepatocytes was assessed using the comet assay, a rapid and sensitive single-cell gel electrophoresis technique used to detect DNA primary damage in individual cells. Simultaneous treatment of trout hepatocytes with cadmium and the nitroxide radical TEMPO used as a ROS scavenger, reduced significantly DNA fragmentation, DEVD-related protease activity and DNA strand breaks formation. These results lead to a working hypothesis that cadmium-induced apoptosis and DNA strand breaks in trout hepatocytes are partially triggered by the generation of ROS. Additional studies are required for proposing a mechanistic model of cadmium-induced apoptosis and genotoxicity in trout liver cells, in underlying the balance between DNA damage and cellular defence systems in fish.     

Dietary factors and body mass index in a group of Iranian adolescents: Tehran lipid and glucose study--2

OBJECTIVE: To study the prevalence of overweight and obesity in an adolescent population in Tehran and to determine possible association with energy and nutrient intake and distribution of energy over the day. METHOD: A cross-sectional study on 177 boys and 244 girls between 10-19 years old was performed. Overweight and obesity were defined by using recommended body mass index (BMI) cut-off values for adolescents. Total energy intake, percent of energy derived from protein, carbohydrate and fat and percent of energy supplied by each meal and snack were assessed by means of two 24-hour dietary recalls. RESULTS: Prevalence of overweight and obesity was 10.7 and 5.1 in boys and 18.4 and 2.8 in girls, respectively. The composition of diet was not different between overweight/obese and normal weight subjects. BMI was related with breakfast energy percentage in girls (r = -0.18, p < 0.01), with total energy intake in boys (r = 0.23, p < 0.01), and with lunch energy percentage in both sexes. In boys (r = 0.16, p < 0.05) and in girls (r = 0.22, p < 0.01). CONCLUSION: High prevalence of overweight and obesity among adolescents was seen. In boys some relationship between total energy intake, distribution of energy over the day and BMI was seen. In girls BMI was only related with distribution of energy over the day.     

Estimation of HIV Prevalence,Risk Factors,and Testing Frequency among Sexually Active Men Who Have Sex with Men,Aged 18–64 Years—New York City, 2002

Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4% overall (95% confidence interval [CI] = 7.5–9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black (12.6%, 95% CI = 9.8–17.6), aged 35–44 (12.6%, 95% CI = 10.4–15.9), or 45–54 years (13.1%, 95% CI = 10.2–18.3), and residents of Manhattan (17.7%, 95% CI = 14.5–22.8). Overall, 37% (95% CI = 32–43%) of MSM reported using a condom at last sex, and 34% (95% CI = 28–39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates (11.0–13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population, condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom use and encouraging safer sex practices among all sexually active MSM, particularly those groups with low levels of condom use and multiple sex partners At the time this work was conducted, Manning and Marx were with the Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA; Thorpe, Ramaswamy, Hajat, Marx, Karpati, Mostashari, and Pfeiffer are with the New York City Department of Health and Mental Hygiene, New York, NY, USA; Nash is with the Department of Epidemiology and International Center for AIDS Care and Treatment Programs, Columbia Mailman School of Public Health, New York, NY, USA; Manning is with the Massachusetts Department of Public Health, Bureau of Family and Community Health, Boston, MA, USA.     

Conceptualizing a Quality Plan for Healthcare

Today, health systems around the world are under pressure to create greater value for patients and society; increasing access, improving client orientation and responsiveness, reducing medical errors and safety, restraining utilization via managed care, and implementing priority allocation of resources for high-burden health problems are examples of strategies towards this end. The quality paradigm by virtue of its strategic consumer focus and its methods for achieving operational excellence has proved an effective approach for creating higher value in many sectors. If applied in a deliberate and holistic manner, the quality paradigm can bring about a more cost-effective organization of the health systems. In this article, we apply quality concepts to healthcare in a conceptual format; we characterize the health system's customers and outputs with their quality dimensions. The product of this effort is a blueprint for a customer-driven health system which identifies six types of customers, nine types of outputs and the associated operations. As a preliminary step, a new analysis and definition of health and disease is provided. Rethinking the structure of health system in this manner and the related conceptual model can guide medical research, health sciences education, and health services policy, and help the practitioner to integrate all modern trends in healthcare delivery.