Increased susceptibility to amyloid toxicity in familial Alzheimer's fibroblasts

Much experimental evidence suggests that an imbalance in cellular redox status is a major factor in the pathogenesis of Alzheimer's disease (AD). Our previous data showed a marked increase in membrane lipoperoxidation in primary fibroblasts from familial AD (FAD) patients. In the present study, we demonstrate that when oligomeric structures of Abeta 1-40 and Abeta 1-42 are added to the culture media, they accumulate quicker near the plasma membrane, and are internalized faster and mostly in APPV717I fibroblasts than in age-matched healthy cells; this results in an earlier and sharper increase in the production of reactive oxygen species (ROS). Higher ROS production leads in turn to an increase in membrane oxidative-injury and significant impairment of cellular antioxidant capacity, giving rise to apoptotic cascade activation and finally to a necrotic outcome. In contrast, healthy fibroblasts appear more resistant to amyloid oxidative-attack, possibly as a result of their plasma membrane integrity and powerful antioxidant capacity. Our data are consistent with increasing evidence that prefibrillar aggregates, compared to mature fibrils, are likely the more toxic species of the peptides. These findings provide compelling evidence that cells bearing increased membrane lipoperoxidation are more susceptible to aggregate toxicity as a result of their reduced ability to counteract amyloid oligomeric attack.     

Maxillary corticotomy and extraoral orthopedic traction in mature teenage patients: a case report

AIM: The authors' propose to combine the reverse pull headgear with a Delaire type face mask and a maxillary corticotomy to treat a Class III non-growing patient with maxillary retrusion. The aim of this report is to present two cases in which this treatment strategy was successful. BACKGROUND: Several studies suggest the majority of Class III dento-skeletal malocclusions have components of maxillary retrusion. Early treatment of these patients with maxillary protraction devices have shown promising results. Facemask therapy has some important limits. Most important is the optimal timing of treatment between the ages of six to ten years. Closure of the maxillary suture occurs as a child ages which results in an increase of maxillary resistance to protraction. REPORT: A proposed therapy carried out in orthodontic and surgical phases was used in the treatment of two young patients. They were both beyond the optimal age range for the application of the orthopedic device (a girl 15 years old and a boy 16 years old), however, they had not reached the necessary skeletal maturity for orthognathic surgery. SUMMARY: The described technique has the advantage of being quick and easy to perform with a low surgical risk yielding satisfactory results after 15-20 days of therapy instead of the six to nine months associated with traditional procedures.     

Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain

AIMS: To investigate how often healthy controls and patients with myogenous masticatory pain have wake-time nonfunctional tooth contact, whether the frequency of nonfunctional tooth contact differs between genders or between weekdays and weekends, and whether it is influenced by stress levels. METHODS: The study was performed on 24 subjects: 15 controls and 9 patients with myogenous facial pain. Before data collection the subjects were trained to ascertain their ability to feel correctly whether their teeth were in contact or apart. Subsequently, for 10 days the subjects were alerted by means of a radio wave-activated wrist vibrator approximately every 20 minutes (8:00 AM to 10:00 PM) in order to report whether the teeth were in contact. Subjects also completed 2 stress assessment questionnaires, the Perceived Stress Scale (PSS) and the short version of the Trier Inventory for Assessment of Chronic Stress (TICS-S). RESULTS: There was a significantly higher frequency of wake-time nonfunctional tooth contact in myogenous pain patients than in controls (median of 34.9% and range of 26.5% to 41.3% for patients; median of 8.9% and range of 2.3% to 14.3% for controls; P < .001). In both groups the frequency of nonfunctional tooth contact did not significantly differ among the various days or between the genders. The patients had significantly higher PSS scores and reported having experienced more stressful situations in the dimensions "social overload" and "overextended at work" than the controls. However, PSS and TICS-S scores were not correlated with the frequency of nonfunctional tooth contact for either group. CONCLUSIONS: Myogenous pain patients had nearly 4 times more nonfunctional tooth contact during wake time than controls.     

Completeness and accuracy of data in spine registries: an independent audit-based study

European Spine Journal - Clinical registries are used for quality management and clinical research. Due to the importance and implications of both aims, completeness and high quality of data are of...     

Donor-recipient age interaction and the impact on clinical results after heart transplantation

To evaluate the impact of donor-recipient age matching on clinical outcomes after heart transplantation, a total of 509 patients (January 1990-December 2018, mean follow-up 111 ± 80 months) were stratified into 4 groups (young-R/young-D, young-R/old-D, old-R/young-D, old-R/old-D) according to the recipient (young-R < 60, old-R ≥ 60 years) and the donor (young-D < 50, old-D ≥ 50 years) age. No difference was found among 30-day mortality (P = .11) and postoperative complications between groups. Both unadjusted and adjusted survival was significantly higher for group young-R/young-D than that of other groups, in which survival was similar [adjusted HR for mortality of 2.0(1.2-3.4), 2.1(1.4-3.8) and 2.5(1.6-4.1) for groups old-R/young-D, young-R/old-D, old-R/old-D, respectively]. Compared to other groups, the incidence of grade ≥ 2 CAV was significantly lower in old-R/young-D group [adjusted HR 0.4(0.2-0.7)]. Among young recipients, the rate of acute grade ≥ 2 rejection episodes was higher in those receiving an old donor graft (P = .04). Old recipient groups were more affected by neoplasms and severe renal failure than young recipient groups (P < .01). Employment of hearts from donors ≥50 years of age adversely affects survival in recipients <60 years of age but does not influence outcomes in older recipients. Also, donor and recipient ages seem to have opposite effects on incidence of rejections and CAV of high grade.     

Changes in spino-pelvic alignment after surgical treatment of high-grade isthmic spondylolisthesis by a posterior approach: a report of 41 cases

Purpose

To analyze changes in spino-pelvic parameters (SPPs) after surgery of high-grade lumbar isthmic spondylolisthesis (HDIS).

Methods

We analyzed 41 patients affected by HDIS operated upon by attempt of reduction and posterior spinal fusion with pedicle screw systems with or without interbody fusion. Pelvic tilt (PT), lumbar lordosis (LL), pelvic incidence (PI), and sacral slope (SS) were measured, and patients were further divided into balanced and unbalanced pelvis subgroups.

Results

SS passed from 46.8° ± 9.8° preoperatively to 50.1° ± 10.1° (p = 0.02). PT passed from 26.7° ± 6.7° preoperatively to 22.9° ± 7.5° (p = 0.003). Unbalanced patients showed significantly higher PT and lower SS compared to the balanced patients preoperatively, and these corrected after surgery. Patients with instrumentation failure (n = 5) had significant increase in PT values postoperatively (p = 0.018).

Conclusions

We confirmed the positive effect of surgery on the SPPs in patients affected by HDIS, which showed different patterns of corrections with surgery for balanced and unbalanced pelvis patients.

     

Risk of COVID 19 in patients with inflammatory bowel diseases compared to a control population

BackgroundIt is unclear whether patients with inflammatory bowel disease (IBD) are at increased risk of COVID-19.ObjectivesThis observational study compared the prevalence of COVID-19 symptoms, diagnosis and hospitalization in IBD patients with a control population with non-inflammatory bowel disorders.MethodsThis multicentre study, included 2733 outpatients (1397 IBD patients and 1336 controls), from eight major gastrointestinal centres in Lombardy, Italy. Patients were invited to complete a web-based questionnaire regarding demographic, historical and clinical features over the previous 6 weeks. The prevalence of COVID-19 symptoms, diagnosis and hospitalization for COVID-19 was assessed.Results1810 patients (64%) responded to the questionnaire (941 IBD patients and 869 controls). IBD patients were significantly younger and of male sex than controls. NSAID use and smoking were more frequent in controls. IBD patients were more likely treated with vitamin-D and vaccinated for influenza. Highly probable COVID-19 on the basis of symptoms and signs was less frequent in the IBD group (3.8% vs 6.3%; OR:0.45, 95%CI:0.28–0.75). IBD patients had a lower rate of nasopharyngeal swab-PCR confirmed diagnosis (0.2% vs 1.2%; OR:0.14, 95%CI:0.03–0.67). There was no difference in hospitalization between the groups (0.1% vs 0.6%; OR:0.14, 95%CI:0.02–1.17).ConclusionIBD patients do not have an increased risk of COVID-19 specific symptoms or more severe disease compared with a control group of gastroenterology patients.