Platelet-rich plasma in combination with bovine derived xenograft in the treatment of generalized aggressive periodontitis: A case report with re-entry

Prominence has been given recently to the use of platelet-rich plasma (PRP) in combination with bone graft materials for predictably obtaining periodontal regeneration through bioengineering. The purpose of this report was to present clinical, radiographic and re-entry results of a generalized aggressive periodontitis (GAP) patient with wide intrabony periodontal defects treated with combined PRP and bovine derived xenograft (BDX). A-32 year old GAP patient who received non-surgical therapy and had 12 intrabony defects was treated with PRP and BDX combination. Prior to surgery and at 12 months, probing depth, marginal recession, relative attachment, probing bone and radiographic bone levels were measured. Re-entry was additionally performed at 12 months. Clinical and radiographic measurements together with re-entry results showed marked improvements from baseline with increased stabilization of whole dentition including the hopeless teeth. The surgical technique together with the materials used may be a possible solution for extensive bone loss.     

Women at Risk for Cardiovascular Disease Lack Knowledge of Heart Attack Symptoms

Background:

It is not known whether cardiovascular disease (CVD) risk level is related to knowledge of the leading cause of death of women or heart attack symptoms.

Hypothesis:

Women with higher CVD risk estimated by Framingham Risk Score (FRS) or metabolic syndrome (MS) have lower CVD knowledge.

Methods:

Women visiting primary care clinics completed a standardized behavioral risk questionnaire. Blood pressure, weight, height, waist size, fasting glucose, and lipid profile were assessed. Women were queried regarding CVD knowledge.

Results:

Participants (N = 823) were Hispanic women (46%), non‐Hispanic white (37%), and non‐Hispanic black (8%). FRS was determined in 278: low (63%), moderate (29%), and high (8%); 24% had ≥3 components of MS. The leading cause of death was answered correctly by 54%, heart attack symptoms by 67%. Knowledge was lowest among racial/ethnic minorities and those with less education (both P< 0.001). Increasing FRS was inversely associated with knowing the leading cause of death (low 72%, moderate 68%, high 45%, P = 0.045). After multivariable adjustment, moderate/high FRS was inversely associated with knowing symptoms (moderate odds ratio [OR] 0.52, 95% confidence interval [CI]: 0.28‐0.98; high OR 0.29, 95% CI: 0.11–0.81), but not the leading cause of death. MS was inversely associated with knowing the leading cause of death (P< 0.001) or heart attack symptoms (P = 0.018), but not after multivariable adjustment.

Conclusions:

Women with higher FRS were less likely to know heart attack symptoms. Efforts to target those at higher CVD risk must persist, or the most vulnerable may suffer disproportionately, not only because of risk factors but also inadequate knowledge. Clin. Cardiol. 2011 DOI: 10.1002/clc.22092 This work was supported in part by the US Department of Health and Human Services (1HHCWH05003‐01‐11); Arlene and Joseph Taub Foundation, Paterson, New Jersey; Edwina and Charles Adler Foundation; and by Columbia University's CTSA grant, UL1‐RR024156 from the NCRR/NIH. The authors have no other funding, financial relationships, or conflicts of interest to disclose.     

The predictive value of ectopic inner retinal layer staging scheme for idiopathic epiretinal membrane: surgical results at 12 months

Background/objectivesTo assess the effect of ectopic inner foveal layers (EIFL) based staging scheme, foveal avascular zone (FAZ) alterations and other microstructural optical coherence tomography (OCT) findings on visual function for patients undergoing idiopathic epiretinal membrane (iERM) surgery.Subjects/methodsIn this retrospective study, patients who underwent 27 G pars plana vitrectomy (PPV) for idiopathic ERM with a minimum follow-up of 12 months were included. Preoperative and postoperative OCT scans, FAZ area measurements on en face OCT angiography images and mean retinal sensitivity (MRS) using microperimetry were recorded in all cases. The correlation of FAZ area, EIFL and other OCT parameters with preoperative and postoperative best-corrected visual acuity (BCVA) was analysed.ResultsIn all, 112 eyes of 112 patients were included. Visual acuity improvement was statistically significant in all four stages; however, differences between Stages 2, 3 and 4 ERMs remained significant (p < 0.05). The presence and thickness of the EIFL was associated with worse baseline (p = 0.013; p = 0.005, respectively) and final (p < 0.001 for both) BCVA. The presence of cystoid macular oedema was associated with worse BCVA at baseline (p = 0.027) and postoperative month-6 (p = 0.04). The mean FAZ area was significantly reduced in all stages of ERM compared with the fellow eyes (p < 0.05 for all). Postoperative retinal sensitivity improvement was statistically significant in Stage 1 and Stage 2.ConclusionThe presence of EIFL is an independent predictor of worse postoperative BCVA. Accordingly, despite significant BCVA improvements in all stages of ERM, visual acuity gain remains limited in eyes with Stage 3 and Stage 4 ERM.Subject terms: Retinal diseases, Fluorescence spectroscopy     

Self-esteem in Turkish diabetic children

Self-esteem is the state of appreciation arising from the ratification of the ego concept that has resulted in self-assessment of their own skills, preferences, and psychologic traits. If people evaluate themselves in positive terms, we say they have high self-esteem. Self-esteem can be evaluated in relation to factors such as family, parents, level of education, age, occupation, and economic status. Children with diabetes mellitus type 1 live with physical, personal, and social developments that occur rapidly and intensively during adolescence. They also must cope with a chronic disease that may have a negative effect on their lives. This study was designed to evaluate the self-esteem of the children who have a diagnosis of diabetes mellitus type 1 and uses a prospective design. The sample consisted of Turkish children between the ages 10 and 14 years old. The study group was selected from the patients admitted to the diabetes outpatient clinics of the hospitals of the university and the Social Insurance Association, and had a diagnosis of diabetes mellitus type 1. The control group was selected from healthy children who were students in a primary school.     

High grade glioblastoma is associated with aberrant expression of ZFP57, a protein involved in gene imprinting,and of CPT1A and CPT1C that regulate fatty acid metabolism

The diagnosis of glioblastoma is still based on tumor histology, but emerging molecular diagnosis is becoming an important part of glioblastoma classification. Besides the well-known cell cycle-related circuitries that are associated with glioblastoma onset and development, new insights may be derived by looking at pathways involved in regulation of epigenetic phenomena and cellular metabolism, which may both be highly deregulated in cancer cells. We evaluated if in glioblastoma patients the high grade of malignancy could be associated with aberrant expression of some genes involved in regulation of epigenetic phenomena and lipid metabolism. We measured the mRNA levels of ZFP57, TRIM28, CPT1A, CPT1B, and CPT1C in a cohort of 80 patients divided in two groups: grade II and grade IV. We evidenced that high grade glioblastoma is associated with increased level of ZFP57, a protein involved in gene imprinting, and aberrant expression of CPT1A and CPT1C, regulators of fatty acid oxidation. Our study may pave the way to identify new markers that could be potentially useful for diagnosis and/or prognosis of glioblastoma.     

Giant hydronephrosis due to ureteropelvic junction obstruction in a child: CT and MR appearances

Giant hydronephrosis caused by congenital ureteropelvic junction (UPJ) obstruction is a rare urological entity in childhood. We report a case of giant hydronephrosis in a 12-year-old boy presented with abdominal distension. Radiological features of this rare entity are discussed with an overview of sonographic findings, especially including CT and MR appearances. The current literature is also reviewed.     

Pediatric focal xanthogranulomatous pyelonephritis: dynamic contrast-enhanced MRI findings

Xanthogranulomatous pyelonephritis (XPN) is the result of chronic renal infection. It is very rare in childhood and the focal form, which is said to be more common in children, is often misdiagnosed as a renal tumor. We report a case of a focal XPN in a 14-year-old girl. The true preoperative diagnosis may be very hard in children especially in the focal form but it seems to be possible by the help of dynamic contrast-enhanced MRI.     

CT findings of abdominal tuberculosis in 12 patients.

Our purpose was to evaluate the Computed Tomography (CT) findings of the abdominal tuberculosis (TBC) retrospectively which was diagnosed histopatologically. This study included 12 patients. All patients were evaluated by abdominal CT study. Most findings of CT studies were mesenteric calcified or noncalcified lymphadenopathies, ascites, thickened intestinal wall located on the right lower quadrant of abdomen, thickening of peritoneum, mottled soft-tissue densities in omentum and mesenterium. In addition, one of the patients had bilateral calcified adrenal glands and one of them had calcified mass in adrenal gland. If peritoneal thickening, ascites, abdominal lymphadenophaties and thickened intestinal walls are obtained, TBC should be considered in differential diagnosis in developing countries.     

Octreotide improves reperfusion-induced oxidative injury in acute abdominal hypertension in rats

Ischemia/reperfusion injury plays an important role in the pathogenesis of abdominal compartment syndrome, which is characterized by increased intra-abdominal pressure. The aim of this study was to investigate whether octreotide, a synthetic somatostatin analogue, improves the reperfusion injury after decompression of acute abdominal hypertension. This study was carried out in Wistar albino rats. With the rats under anesthesia, an arterial catheter was inserted intraperioneally and with the use of an aneroid manometer connected to the catheter, intra-abdominal pressure was kept at 20 mm Hg (ischemia group) for 1 hour. In the ischemia/reperfusion group, pressure applied for 1 hour was decompressed and a 1-hour reperfusion period was allowed. In another ischemia/reperfusion group, octreotide was administered (50 μg/kg intraperitoneally) immediately before the decompression of intra-abdominal pressure. At the end of the experiment, liver and intestinal tissues were taken and malondialdehyde (an index of lipid peroxidation) and glutathione (a key to antioxidant) levels andmyeloperoxidase (an index of tissue neutrophil inflltration) activity were estimated. The results demonstrated that tissue levels of malondialdehyde and myeloperoxidase activity were elevated, whereas glutathione levels were reduced in both the ischemia and ischemia/reperfusion groups. Octreotide treatment reversed these oxidant responses. In conclusion, increased intra-abdominal pressure causes oxidative organ damage and octreotide, by controlling the reperfusion of abdominal organs and inhibiting neutrophil inflltration, could improve the reperfusioninduced oxidative damage. Therefore its therapeutic role as a “reperfusion injury-limiting” agent must be further elucidated in intra-aortic pressure-induced abdominal organ injury. Presented at the Forty-Fourth Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, Florida, May 18–21, 2003 (poster presentation).