Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study

Objectivo

In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined.

Material and Methods

Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2^nd and 3^rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2^nd and 3^rd trimesters of pregnancy with a significant difference (p<0.05). F. nucleatum and P. intermedia were also observed in high levels.

Results and Conclusion

Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease.     

Left Ventricular Wall-Motion Changes During Eccentric Ventricular Activation in Hypertrophic Obstructive Cardiomyopathy Patients

Permanent atrial synchronized right ventricular pacing (RVP) has been shown to induce subaortic pressure gradient reduction and to lead to clinical improvement in patients suffering from hypertrophic obstructive cardiomyopathy (HOCM). It has therefore been proposed as an alternative therapy to surgery for patients refractory to drug therapy. The mechanisms underlying these beneficial effects are, however, unclear, but the electrically induced alteration of left ventricular (LV) activation sequence appears to play a major role. In this article, I summarize the data relative to the specific effects of RVP and left bundle branch block on LV contraction in normal subjects and in cardiomyopathies other than hypertrophic. I also review the characteristics of regional wall motion in HOCM, then the current data on left ventricular wall-motion changes during eccentric ventricular activation in HOCM patients equipped with a dual chamber pacemaker. On the basis of the most recent studies, preexcitation of the interventricular septum by a RV apical stimulation alters septal motion by reducing its motility or by inducing a paradoxical motion, which enlarges the LV outflow tract and thereby reduces subaortic obstruction .     

Improvement of Quality of Life by Means of Antitachy Pacing: From PainFREE to the ADVANCE-D Trial

Background: Implantable cardioverter-defibrillators (ICD) can terminate ventricular tachyarrhythmias with shocks (painful) or antitachycardia pacing (painless). According to the results of the Pacing Fast VT Reduces Shock ThErapies Trials, antitachycardia pacing (ATP) can avoid painful shocks and also increase device longevity. The purpose of the ADVANCE-D (Atp DeliVery for PAiNless ICD ThErapy) study is to determine the most appropriate ventricular tachycardia (VT) therapy, so as to optimize painless therapy for life-threatening arrhythmias.
Methods and Results: The ADVANCE-D is a prospective, multicenter, parallel, two-arm randomized study designed to evaluate the efficacy of two different sequences of ATP therapies (burst 15 pulses, 88%, vs burst 8 pulses, 88%), during an episode of spontaneous arrhythmia classified as fast VT (FVT) in patients with a Class I or IIA indication for ICD implantation (single and dual chamber devices). The primary endpoint is to compare the efficacy of two ATP therapies for FVT episodes. The study will enroll a minimum of 900 patients within 2 years, followed-up for 12 months. The investigation is expected to be completed in 2007.
Conclusions: The ADVANCE-D trial is the first large randomized clinical investigation aimed to evaluate optimal programming and efficacy of ATP.     

Combination of Flecainide and Mexiletine for the Treatment of Ventricular Tachyarrhythmias

A combination of oral flecainide and mexiletine was given to 11 patients in whom monotherapy with one of these drugs was ineffective for the suppression of inducible ventricular tachycardia or fibrillation. In eight of 11 studies, combination therapy prevented inducibility of a sustained ventricular tachycardia or resulted in induction of only nonsustained tachycardia (P = 0.0003, when compared to monotherapy). In one patient, a slow ventricular tachycardia was induced. During exercise testing ventricular tachycardia occurred in two of these nine patients, and ventricular fibrillation in another patient. Seven patients received combination on the long term, for a mean of 18 months. One patient had recurrences of ventricular tachycardia which was well tolerated. Another patient had a recurrent episode of ventricular fibrillation, but was successfully resuscitated. Severe congestive heart failure occurred in two patients. ACE inhibitors were given to them and to another four patients. No other important unwanted effects occurred. The combination of mexiletine and flecainide is very effective in suppressing inducible sustained ventricular tachycardia. The efficacy of this combination to prevent recurrences of ventricular tachyarrhythmias is acceptable. Exercise testing is of importance to unmask proarrhythmic effects before discharge from hospital.     

Stimulation of early eosinophil progenitors by a heat stable alveolar macrophage product from ovalbumin-sensitized and non-sensitized guinea pigs

Background Alveolar macrophages (AM) may participate in brochopulmonary hyperreactivity by secreting cytokines that recruit mature eosinophils, or induce eosinophil production from recruited circulating progenitors. Objective To define whether AM products can contribute to lung eosinophil production in immunized guinea pigs (GP), by analysing the effect of AM culture supernatatits (AM-SN) on in vitro eosinophilopoiesis. Methods Liquid and semi-solid bone marrow (BM) cultures were seeded witb SN from 95% pure AM exposed to LPS. Results AM-SN increased very significantly the long-term viability, cell proliferation and eosinophil production in liquid culture and supported formation of eosinophil-bearing mixed colonies, by acting on progenitors depleted of mature eosinophils. The effect on eosinophil production was not duplicated by natural or recombinant sources of GM-CSF (which nevertheless supported GM colony formation by GP BM), not by rhIL-8 (which was active on GP cells) and was not due to residual LPS. FPLC separation of active AM SN yielded a peak of apparent m.w. 43 kDa, active on both liquid and semi-solid cultures. The active moiety was heat- and trypsin-resistant. Neutralizing monoclonal antibodies to hGM-CSF, mGM-CSF, hIL-3 and mIL-3 failed to deplete the activity in AM-SN. Ovalbumin immunization induced its production by AM even without LPS challenge. Conclusions The lack of T lymphocytes among factor-producing AM, the properties of the active material, the inability of GM-CSF to reproduce these effects, and the failure of MoAbs to GM-CSF and to IL-3 to neutralize the activity indicate it is not due to the major eosinopoietic factors GM-CSF, IL-3 or IL-5.