Quality of life associated with tooth loss and tooth replacement

Tooth loss leads, depending on the number and location of missing teeth, to a certain degree of loss of function. This loss of function might lead to an impairment of oral health-related quality of life. The literature provides fairly strong evidence that tooth loss is associated with impaired oral health-related quality of life. The locations where teeth are missing and the distribution in the tooth arch of the teeth that still remain have an effect on the degree to which oral health-related quality of life is impaired. These findings are independent of the context and the measurement instrument used. With respect to tooth replacement no direct evidence exists concerning which type of replacement for which cases of tooth reduction have the largest positive effect. Research in this area is still in its infancy.     

Current and Emerging Treatment Options for Castration-Resistant Prostate Cancer: A Focus on Immunotherapy

Background  

Castration-resistant prostate cancer is a disease with limited treatment options. However, the ongoing elucidation of the mechanisms underlying this disease continues to support the development of not only novel agents, but also innovative approaches. Among these therapies, immunotherapy has emerged as a promising strategy.     

Cabazitaxel in Patients With Metastatic Castration-Resistant Prostate Cancer: Results of a Compassionate Use Program in The Netherlands

BackgroundCabazitaxel has been reimbursed as a second-line therapy for patients with metastatic castrate-resistant prostate cancer (mCRPC) in the Netherlands since 2011. Before reimbursement was available, cabazitaxel was provided through a Compassionate Use Program (CUP). We report the results of the Dutch CUP, detailing the safety and efficacy of cabazitaxel in a routine clinical practice setting.Patients and MethodsSafety and efficacy data of all 5 Dutch centers participating in the cabazitaxel CUP were collected. Safety data were collected prospectively using the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3.0. Overall survival (OS) and progression-free survival (PFS), time to PSA progression (TTPP), and best clinical response were evaluated retrospectively.ResultsFifty-one patients were registered in the CUP; 49 received cabazitaxel. Forty-two of 49 patients [85.7%], 42 patients had ≥ 2 metastatic sites. Patients received on average 6 cabazitaxel cycles (range, 1-21). A dose reduction or dose delay occurred in 13 and 20 patients [26.5% and 40.9%] respectively. Prophylactic granulocyte colony-stimulating factor (G-CSF) was used in 8 patients [16.3%]. Grade ≥ 3 adverse events were observed in 25 patients [51.0%]; 16 patients [32.7%] discontinued treatment because of treatment-emergent adverse events (TEAEs). Serious adverse events (SAEs) occurred in 16 (32.7%) patients; the most frequent SAEs were hematuria (4 patients [8.3%]) and urosepsis (3 patients [6.3%]). Febrile neutropenia occurred twice; no patient had grade ≥ 3 neuropathy. No toxicity-related mortality occurred. Median follow-up was 24.1 months. Median OS was 8.7 months (interquartile range [IQR], 6.0-15.9 months); median TTPP was 2.8 months (IQR, 1.7-5.9 months).ConclusionIn the Dutch CUP, patients with advanced mCRPC had delayed tumor progression with acceptable toxicities using cabazitaxel treatment.     

Toward Personalized Sexual Medicine (Part 2): Testosterone Combined with a PDE5 Inhibitor Increases Sexual Satisfaction in Women with HSDD and FSAD,and a Low Sensitive System for Sexual Cues

IntroductionLow sexual desire in women may result from a relative insensitivity of the brain for sexual cues. Administration of sublingual 0.5 mg testosterone (T) increases the sensitivity of the brain to sexual cues. Sexual stimulation in the brain is necessary for phosphodiesterase type 5 inhibitor (PDE5i)-mediated increase in genital sexual response. Accordingly, a single dose of T+PDE5i might enhance sexual responsiveness, especially in women with low sensitivity for sexual cues.AimTo assess the hypothesis that treatment with on-demand use of T+PDE5i improves sexual functioning, particularly in women who suffer from Hypoactive Sexual Desire Disorder (HSDD) as the result of a relative insensitivity for sexual cues.MethodsIn a randomized, double-blind, placebo-controlled, crossover design, 56 women with HSDD underwent three medication treatment regimes (placebo, T+PDE5i, and T with a serotonin _1A receptor agonist; see also parts 1 and 3), which lasted 4 weeks each. In a participant-controlled ambulatory psychophysiological experiment at home (the first week of each drug treatment), physiological and subjective indices of sexual functioning were measured. In a bedroom experiment (the subsequent 3 weeks), sexual functioning was evaluated following each sexual event after the self-administration of study medication. Subjective evaluation of sexual functioning was also measured by weekly and monthly reports.Main Outcome MeasuresSubjective: sexual satisfaction, experienced genital arousal, sexual desire. Physiological: vaginal pulse amplitude. Cognitive: preconscious attentional bias.ResultsT+PDE5i, as compared with placebo, significantly improved physiological and subjective measures of sexual functioning during ambulatory psychophysiological lab conditions at home and during the sexual events, in women with low sensitivity for sexual cues.ConclusionsThe present study demonstrated that on-demand T+PDE5i is a potentially promising treatment for women with HSDD, particularly in women with low sensitivity for sexual cues. Poels S, Bloemers J, van Rooij K, Goldstein I, Gerritsen J, van Ham D, van Mameren F, Chivers M, Everaerd W, Koppeschaar H, Olivier B, and Tuiten A. Toward personalized sexual medicine (part 2): Testosterone combined with a PDE5 inhibitor increases sexual satisfaction in women with HSDD and FSAD, and a low sensitive system for sexual cues. J Sex Med 2013;10:810–823.     

Prevalence and risk factors associated to pruritus in Plasmodium vivax patients using chloroquine in the Brazilian Amazon

Chloroquine-induced pruritus has been described as a common adverse event in African patients being treated for Plasmodium falciparum malaria, and has been associated with treatment discontinuation in this setting. In Latin America, where Plasmodium vivax is the most common species causing malaria and chloroquine is still used as the first-line schizonticidal for treating this parasite infection, there are no reports on chloroquine-induced pruritus. This study aimed to estimate the frequency of pruritus and associated risk factors in P. vivax-infected patients treated with chloroquine in a reference centre in the Brazilian Amazon. In this cross-sectional study, patients who were prescribed with chloroquine for the treatment of microscopy-confirmed P. vivax infection in the past five days were actively asked about the occurrence of any level of pruritus and potential risk factors were investigated. Univariable and multivariable logistic regression was performed for the analysis of possible risk factors in two sets of patients: (1) all the patients interviewed and (2) restricted to patients with previous use of chloroquine. Among the 510 patients interviewed, 20.4% (95%CI: 16.9–23.9%) developed any level of pruritus during treatment with chloroquine. Most episodes of pruritus occurred during the first two days of treatment and the most common location was hands and feet. In multivariate analysis performed in the entire population, the only risk factors independently associated to pruritus were allergy history (adjusted odds ratio [AOR]: 1.83; 95%CI 1.02–3.31; p = 0.044) and high parasitaemia (AOR: 1.96: 95%CI 1.22–3.13; p = 0.005). In the analysis restricted to the 215 patients with previous use of chloroquine, previous chloroquine-induced pruritus was a strong predictor of pruritus occurrence (AOR: 11.84: 95%CI 3.15–44.47; p < 0.001). Two patients (0.4%) interrupted treatment due to the severity of pruritus. Pruritus is a common adverse event in patients being treated with chloroquine for P. vivax malaria in the Brazilian Amazon. Host–parasite interaction may play a relevant role in the development of pruritus and concurs with the finding of strong association of pruritus with high parasitaemia and allergy history. Patients with previous chloroquine-induced pruritus had a high risk for developing pruritus. Due to its high frequency, this side effect cannot be neglected as it can have major implications on patients’ compliance to treatment hampering elimination efforts in the region.     

Design of a multiplex PCR method for detection of toxigenic-pathogenic in Vibrio cholerae

ObjectiveTo study virulence and regulatory genes (hlyA, ctxB, tcpI) in clinical strains of Vibrio cholerae (V. cholerae), simultaneously.MethodsThree important genes, tcpI, hlyA and ctxB were used for detection of toxigenic and pathogenic V. cholera by chain reaction assay method.ResultsAccording to the results of the PCR, the incidence of hlyA, tcpI, and ctxB genes in clinical isolates was obtained as 94.7% (72 sample), 90.8% (69 sample), and 92.1% (70 sample), respectively. Five strains possessed all genes except ctxB, six strains possessed all genes except tcpI, four strains possessed all genes except hlyA, one strain possessed only hlyA and 60 strains contained a combination of three genes, Including hlyA, ctxB and tcpI.ConclusionsResult show that this method could be reliable to detect toxigenic-pathogenic strains of V. cholerae in Iran.     

Thermal characterisation of PEGylated mucin

ObjectiveTo investigate the characteristics of PEGylated mucin and its potential usage.MethodsMucin was extracted from giant African land snails and PEGylated mucin was prepared with different ratios of PEG 2000-Mwt and mucin (1 : 1, 0 : 1, 2 : 1, 1 : 3 and 3 : 1 to form batch A-E) using solvent technique. The physicochemical properties of mucin were identified and the solubility of mucin was assessed. The thermal properties of PEGylated mucin were measured by differential scanning calorimetry (DSC).ResultsCarbohydrates, proteins and trace amounts of fats were present in snail mucin. The mucin powder was water-soluble at 30°C and more water-soluble at 35°C, but not soluble; in acetone, ethanol, 0.1 M NaOH, 0.1M H₂SO₄ and 0.1 NH₄OH was water-soluble. The melting point T_m ranged from 58.58 °C to 61.17 °C, crystallization temperature Tc 37.08 °C to 39.83 °C, and glass transition temperature Tg 126.85 °C to 138.39 °C. The variation in T_m, T_c, and T_g with the composition in the PEGylaton showed that an interaction between PEG and mucin occured.ConclusionsThis result can serve as a basis for further evaluation of the PEGylation method and be used for drug delivery.