Feasibility of intraoral ultrasonography in the diagnosis of oral soft tissue lesions: a preclinical assessment on an ex vivo specimen

Objectives

The early detection of oral soft tissue lesions is an important prognostic factor, and the possibility of using ultrasonography (US) as a diagnostic tool may improve the diagnosis and characterization of tissue alterations at an early stage. This study aims to evaluate the feasibility of intraoral US by performing a preclinical assessment of an ex vivo specimen in which focal lesions were simulated.

Materials and methods

Fourteen lesions were simulated on a freshly extracted calf tongue, by introducing in the tongue different materials mimicking the appearance of various focal lesions. The specimen was scanned with a 8 MHz US probe and computed tomography (CT) was performed to compare the two imaging techniques. Later, the specimen was dissected to set a benchmark for size assessment.

Results

US was able to identify all the simulated lesions within the tongue, resulting in one case more accurate than CT. Statistical analysis demonstrated high correlation between the measurements of the simulated lesions performed on the US images and the real size of the materials introduced in the tongue (p < 0.05).

Conclusions

This preclinical study proves that US performs well in the detection and characterization of simulated lesions of the tongue. These findings suggest that US could be effectively used in clinical applications. However, further research is mandatory to assess the reliability of in vivo US in the detection and characterization of tongue lesions as well as of other oral soft tissue alterations.

     

Food borne disease outbreaks caused by Salmonella enteritidis

OBJECTIVE: It is to describe outbreaks of salmonellosis reported from July 1993 through June 1997 in the Northwest region of S. Paulo State, Brazil, one of the areas where several foodborne outbreaks of salmonellosis have been recently detected. METHOD: Data of 19 epidemiological investigations were analysed; 87 stool specimens and 38 food samples (including 12 of shell eggs) were processed for microbiological analysis. Salmonella strains were identified by serotyping, phagetyping and antimicrobial susceptibility testing. RESULTS: There were 906 ill persons including 295 hospitalized patients. Phage type 4 (PT 4) Salmonella Enteritidis strains were isolated from 80.5% of stool samples, from all food samples and from 41.7% of eggs. Of the outbreaks, 95.7% were associated with the consumption of food containing raw or undercooked eggs. All strains were susceptible to the 13 antimicrobials, except the strains from the nosocomial outbreak. CONCLUSIONS: The results obtained show the need for the implementation of control measures regarding egg and storage, as well as for guidance to the public as to the risks involved in the consumption of inadequately prepared eggs.     

Poultry husbandry,water, sanitation,and hygiene practices,and child anthropometry in rural Burkina Faso

Poultry production in low income countries provides households with nutrient‐rich meat and egg products, as well as cash income. However, traditional production systems present potential health and nutrition risks because poultry scavenging around household compounds may increase children's exposure to livestock‐related pathogens. Data from a cross‐sectional survey were analysed to examine associations between poultry, water, sanitation, and hygiene practices, and anthropometric indicators in children (6–59 months; n = 3,230) in Burkina Faso. Multilevel regression was used to account for the hierarchical nature of the data. The prevalence of stunting and wasting in children 6–24 months was 19% and 17%, respectively, compared with a prevalence of 26% and 6%, respectively, in children 25–60 months. Over 90% of households owned poultry, and chicken faeces were visible in 70% of compounds. Caregivers reported that 3% of children consumed eggs during a 24‐hr recall. The presence of poultry faeces was associated with poultry flock size, poultry‐husbandry and household hygiene practices. Having an improved water source and a child visibly clean was associated with higher height‐for‐age z scores (HAZ). The presence of chicken faeces was associated with lower weight‐for‐height z scores, and no associations were found with HAZ. Low levels of poultry flock size and poultry consumption in Burkina Faso suggest there is scope to expand production and improve diets in children, including increasing chicken and egg consumption. However, to minimize potential child health risks associated with expanding informal poultry production, research is required to understand the mechanisms through which cohabitation with poultry adversely affects child health and design interventions to minimize these risks.     

The effect of ceramic surface treatment on bonding to densely sintered alumina ceramic

STATEMENT OF PROBLEM: Ceramic surface treatment is crucial for bonding to resin. High crystalline ceramics are poorly conditioned using traditional procedures. PURPOSE: The purpose of this study was to evaluate the effect of silica coating on a densely sintered alumina ceramic relative to its bond strength to composite, using a resin luting agent. Material and methods Blocks (6 x 6 x 5 mm) of ceramic and composite were made. The ceramic (Procera AllCeram) surfaces were polished, and the blocks were divided into 3 groups (n = 5): SB, airborne-particle abrasion with 110-microm Al 2 O 3 ; RS, silica coating using Rocatec System; and CS, silica coating using CoJet System. The treated ceramic blocks were luted to the composite (W3D Master) blocks using a resin luting agent (Panavia F). Specimens were stored in distilled water at 37 degrees C for 7 days and then cut in 2 axes, x and y, to obtain specimens with a bonding area of approximately 0.6 mm 2 (n = 30). The specimens were loaded to failure in tension in a universal testing machine, and data were statistically analyzed using a randomized complete block design analysis of variance and Tukey's test (alpha=.05). Fractured surfaces were examined using light microscopy and scanning electron microscopy to determine the type of failure. Energy-dispersive spectroscopy was used for surface compositional analysis. RESULTS: Mean bond strength values (MPa) of Groups RS (17.1 +/- 3.9) ( P =.00015) and CS (18.5 +/- 4.7) ( P =.00012) were significantly higher than the values of Group SB (12.7 +/- 2.6). There was no statistical difference between Groups RS and CS. All failures occurred at the adhesive zone. CONCLUSION: Tribochemical silica coating systems increased the tensile bond strength values between Panavia F and Procera AllCeram ceramic.     

INFLUENCE OF THERMAL STRESS ON MARGINAL INTEGRITY OF RESTORATIVE MATERIALS

The aim of this study was to evaluate the influence of thermal stress on the marginal integrity of restorative materials with different adhesive and thermal properties. Three hundred and sixty Class V cavities were prepared in buccal and lingual surfaces of 180 bovine incisors. Cervical and incisal walls were located in dentin and enamel, respectively. Specimens were restored with resin composite (RC); glass ionomer (GI) or amalgam (AM), and randomly assigned to 18 groups (n=20) according to the material, number of cycles (500 or 1,000 cycles) and dwell time (30 s or 60 s). Dry and wet specimens served as controls Specimens were immersed in 1% basic fuchsine solution (24 h), sectioned, and microleakage was evaluated under x40 magnification. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests: Thermal cycling regimens increased leakage in all AM restorations (p<0.05) and its effect on RC and GI restorations was only significant when a 60-s dwell time was used (p<0.05). Marginal integrity was more affected in AM restorations under thermal cycling stress, whereas RC and GI ionomer restoration margins were only significantly affected only under longer dwell times.     

Antifungal drugs combinations: a patent review 2000-2015

Introduction: Combination therapy has emerged as an approach to improve the efficacy of antifungal drugs. Its main objective is to achieve synergistic interaction with higher antifungal properties and lower toxic effects than each substance alone.

Areas covered: Twenty-four patents disclosed in the period of 2000-2015 were covered in this review. Twenty of them were devoted to pharmacodynamic potentiation, while four were dedicated to pharmacokinetic actions.

Expert opinion: The common characteristic of most patents published in this area is that the main partner is a commercial antifungal drug. In the most innovative combinations the second component was either a modifier of proton homeostasis, an antibody, an inhibitor of the adhesion of epithelial or endothelial cells or a keratinolytic agent that improves the skin penetration. The evaluation of synergism is always made with simple in vitro methods, which constitutes a weakness of the disclosed patents, due to the lack of in vivo studies, since the in vitro tests cannot predict the in vivo behavior. Also, it is surprising that none of the patents analyze the toxicity of the new combinations, taking into account that one of the main objectives of the combinations is to reduce the toxicity of the existing antifungal drugs.     

Cyclooxygenase-2 prostaglandins mediate anandamide-inhibitory action on nitric oxide synthase activity in the receptive rat uterus

Anandamide, an endocannabinoid, prostaglandins derived from cyclooxygenase-2 and nitric oxide synthesized by nitric oxide synthase (NOS), are relevant mediators of embryo implantation. We adopted a pharmacological approach to investigate if anandamide modulated NOS activity in the receptive rat uterus and if prostaglandins mediated this effect. As we were interested in studying the changes that occur at the maternal side of the fetal-maternal interface, we worked with uteri obtained from pseudopregnant rats. Females were sacrificed on day 5 of pseudopregnancy, the day in which implantation would occur, and the uterus was obtained. Anandamide (2 ng/kg, i.p.) inhibited NOS activity (P<0.001) and increased the levels of prostaglandin E(2) (P<0.001) and prostaglandin F(2α) (P<0.01). These effects were mediated via cannabinoid receptor type 2, as the pre-treatment with SR144528 (10 mg/kg, i.p.), a selective cannabinoid receptor type 2 antagonist, completely reverted anandamide effect on NOS activity and prostaglandin levels. The pre-treatment with a non-selective cyclooxygenase inhibitor (indomethacin 2.5mg/kg, i.p.) or with selective cyclooxygenase-2 inhibitors (meloxicam 4 mg/kg, celecoxib 3mg/kg, i.p.) reverted anandamide inhibition on NOS, suggesting that prostaglandins are derived from cyclooxygenase-2 mediated anandamide effect. Thus, anandamide levels seemed to modulate NOS activity, fundamental for implantation, via cannabinoid receptor type 2 receptors, in the receptive uterus. This modulation depends on the production of cyclooxygenase-2 derivatives. These data establish cannabinoid receptors and cyclooxygenase enzymes as an interesting target for the treatment of implantation deficiencies.     

Surface roughness of orthodontic band cements with different compositions

Objectives

The present study evaluated comparatively the surface roughness of four orthodontic band cements after storage in various solutions.

Material and Methods

eight standardized cylinders were made from 4 materials: zinc phosphate cement (ZP), compomer (C), resin-modified glass ionomer cement (RMGIC) and resin cement (RC). Specimens were stored for 24 h in deionized water and immersed in saline (pH 7.0) or 0.1 M lactic acid solution (pH 4.0) for 15 days. Surface roughness readings were taken with a profilometer (Surfcorder SE1200) before and after the storage period. Data were analyzed by two-way ANOVA and Tukey''s test (comparison among cements and storage solutions) or paired t-test (comparison before and after the storage period) at 5% significance level.

Results

The values for average surface roughness were statistically different (p<0.001) among cements at both baseline and after storage. The roughness values of cements in a decreasing order were ZP>RMGIC>C>R (p<0.001). After 15 days, immersion in lactic acid solution resulted in the highest surface roughness for all cements (p<0.05), except for the RC group (p>0.05). Compared to the current threshold (0.2 µm) related to biofilm accumulation, both RC and C remained below the threshold, even after acidic challenge by immersion in lactic acid solution.

Conclusions

Storage time and immersion in lactic acid solution increased the surface roughness of the majority of the tested cements. RC presented the smoothest surface and it was not influenced by storage conditions.     

Impaired L1 and executive control after left basal ganglia damage in a bilingual Basque-Spanish person with aphasia

Bilinguals must focus their attention to control competing languages. In bilingual aphasia, damage to the fronto-subcortical loop may lead to pathological language switching and mixing and the attrition of the more automatic language (usually L1). We present the case of JZ, a bilingual Basque-Spanish 53-year-old man who, after haematoma in the left basal ganglia, presented with executive deficits and aphasia, characterised by more impaired language processing in Basque, his L1. Assessment with the Bilingual Aphasia Test revealed impaired spontaneous and automatic speech production and speech rate in L1, as well as impaired L2-to-L1 sentence translation. Later observation led to the assessment of verbal and non-verbal executive control, which allowed JZ's impaired performance on language tasks to be related to executive dysfunction. In line with previous research, we report the significant attrition of L1 following damage to the left basal ganglia, reported for the first time in a Basque-Spanish bilingual. Implications for models of declarative and procedural memory are discussed.