Epidemiology and diagnosis of HIV-associated periodontal diseases

A review of periodontal disease as a manifestation of HIV infection suggests a shift in emphasis over the past 5 years. Initially the focus was on newly described forms of periodontal disease (ie, HIV-associated gingivitis or linear gingival erythema (LGE); HIV-associated periodontitis or necrotizing ulcerative periodontitis (NUP)). While the clinical definition of LGE varies from study to study, an association between LGE and Candida infection has been described. Furthermore, the prevalence of NUP is quite low and this disorder is associated with severe immunosuppression. In contrast, the focus today is on the accelerated rate of chronic adult periodontitis occurring in seropositive patients. While the organisms that characterize adult periodontitis in seronegative individuals are present in subgingival plaque from seropositive individuals, reports suggest that atypical pathogens are also present (ie, Mycoplasma salivarium, Enterobacter cloacae). Recent studies from our laboratory have identified a novel strain of Clostridium isolated from the subgingival plaque of injecting drug users that has pathologic potential. This organism, however, was found in both seropositive and seronegative individuals in this cohort, suggesting an association with lifestyle rather than serostatus. In addition, data has been published examining the local host response in periodontitis in seropositive individuals. Distinctly elevated levels of IgG in gingival crevicular fluid (GCF) have been observed in seropositive patients. Furthermore, data from our laboratory examining inflammatory mediators in GCF (polymorphonuclear leukocyte lysosomal enzyme β-glucuronidase and the pro-inflammatory cytokine interleukin-1β) suggests an altered response in patients with HIV infection. The alteration manifests as the absence of the expected strong correlation between polymorphonuclear leukocyte activity in the gingival crevice and clinical measures of existing periodontal disease, as well as elevated levels of interleukin-1β in sites with deeper probing depths. Therefore, it can be concluded that the progression of periodontal disease in the presence of HIV infection is dependent upon the immunlogic competency of the host as well as the local inflammatory response to typical and atypical subgingival microorganisms.     

Taurine treatment of dyskinesias: an attempt

Taurine is a sulfonic amino acid with inhibitory effects in the central nervous system. The clinical effect of taurine on dyskinesias was tested in an open trial with 14 patients. Taurine (3 g/day) was given orally in divided doses. Six patients showed an initial improvement which, however, did not persist to the end of the 6-week treatment period. No side effects were observed. It seems unlikely that taurine administration will prove effective in the symptomatic treatment of dyskinesias.     

Radiographic control of fixture-abutment connection in Brånemark implant technique

Abstract— In the treatment with osseointegrated implants ad modum Brånemark a radiographic control of the fixture-abutment connection is recommended. The purpose of the present study was to analyze the possibilities of detecting incomplete connection by radiography using the recommended technique. In an experimental model the influence of film density, orientation of the fixture hexagon, angulation between film plane and fixture axis, leakage width, and partial connection were analyzed. Slits of 0.05 mm were detectable under optimum projection conditions. On the other hand, slits of 0.1 mm were obscured even at deviations of 5°. A number of factors, e.g. low density level and "unfavorable" orientation of the hexagon in relation to the X-ray beam, reduce the possibilities of detecting slits. It is concluded that in clinical cases a demonstration of incomplete fixture-abutment connection by the use of the recommended radiographic technique radiography to some extent is fortuitous, and that radiographic control has certain limitations.     

Mitochondrial diseases and epilepsy

The mitochondrial respiratory chain is the final common pathway for energy production. Defects affecting this pathway can give rise to disease that presents at any age and affects any tissue. However, irrespective of genetic defect, epilepsy is common and there is a significant risk of status epilepticus. This review summarizes our current understanding of the epilepsy that occurs in mitochondrial disease, focusing on three of the most common disorders: mitochondrial myopathy encephalopathy, lactic acidosis and stroke-like episodes (MELAS), myoclonus epilepsy and ragged-red fibers (MERRF), and polymerase gamma (POLG) related disease. In addition, we review the pathogenesis and possible treatment of these disorders.     

Novel Points of Attack for Targeted Cancer Therapy

New molecular insight reveals novel points of attack for targeted cancer therapy. The recent advances in cancer genomics and novel insight into the complex biology of cancer make the promise of personalized, targeted cancer medicine closer than ever. The massive parallel sequencing endeavours performed by The Cancer Genome Atlas, the International Cancer Genome Consortium and by numerous individual investigators have provided a comprehensive genomic characterization of a wide range of cancers. The joint efforts enabled by the improved sequencing technology have demonstrated that individual cancers comprise mutational repertoires with only a few frequently recurrent driver genes. Thus, the identification of new drug targets and novel drugs have accelerated and renewed the hopes of personalized cancer therapy achieving clinical reality for a wider range of cancers. Together with cost‐effective sequencing technology to perform comprehensive mutational profiling of each individual cancer, this provides the basis for a personalized cancer medicine revolution within the next few years. The aim of this MiniReview is to provide an overview of the history and evolution of targeted cancer therapy, exemplified by molecularly targeted drugs successfully implemented in the clinic. Furthermore, we aim to highlight novel molecular targets for therapeutic intervention, as well as the main present challenges including inter‐ and intratumor heterogeneity and cellular plasticity in addition to the importance of the tumor micro‐environment. Many cancer patients already receive some form of tailored therapy, and recent evidence suggests that novel and highly innovative, targeted approaches are on their way into the clinic.     

Assessment of the effect of high or low protein diet on the human urine metabolome as measured by NMR

The objective of this study was to identify urinary metabolite profiles that discriminate between high and low intake of dietary protein during a dietary intervention. Seventy-seven overweight, non-diabetic subjects followed an 8-week low-calorie diet (LCD) and were then randomly assigned to a high (HP) or low (LP) protein diet for 6 months. Twenty-four hours urine samples were collected at baseline (prior to the 8-week LCD) and after dietary intervention; at months 1, 3 and 6, respectively. Metabolite profiling was performed by (1)H NMR and chemometrics. Using partial least squares regression (PLS), it was possible to develop excellent prediction models for urinary nitrogen (root mean square error of cross validation (RMSECV) = 1.63 mmol/L; r = 0.89) and urinary creatinine (RMSECV = 0.66 mmol/L; r = 0.98). The obtained high correlations firmly establish the validity of the metabolomic approach since urinary nitrogen is a well established biomarker for daily protein consumption. The models showed that trimethylamine-N-oxide (TMAO) is correlated to urinary nitrogen. Furthermore, urinary creatine was found to be increased by the HP diet whereas citric acid was increased by the LP diet. Despite large variations in individual dietary intake, differentiated metabolite profiles were observed at the dietary group-level.     

GAD-7量表精确诊断广泛性焦虑障碍

问题：广泛性焦虑障碍（GAD）-7量表的诊断精确性如何？ 方法 设计：采用盲法比较GAD-7量表与DSM—Ⅳ中的GAD标准。[第一段]     

Performance for obtaining maximal gain from a program for digital subtraction radiography

Abstract – The aim of this study was to evaluate the effect on subtraction image quality of number of a) gray shades sampled during camera recording, and b) reference points positioned in the two images to be subtracted. Intraoral radiographs were obtained in each of 12 patients, one at 0° and one at 15° horizontal angulation in a standardized recording procedure. The radiographs were videorecorded twice sampling 1) 160–180 and 2) 200–220 shades of gray. The 0° radiographic image was digitally copied. Subtractions were performed between the identical (0°/0°) and the non-identical (0°/15°) radiographs from both gray shade samples after positioning 5, 10, 15, and 20 reference points, respectively, in each of the images to be subtracted. The standard deviation in the subtraction image histogram was used as the test parameter for image quality. No differences existed between image quality obtained from the radiographs sampled using 160–180 and 200–220 shades of gray (P>0.05). The standard deviation fell continuously, the more reference points were positioned in the images. For the 0°/0° images the difference was statistically significant between the 5 and 10 point images ( F= 0.045) while for the 0°/15° images differences existed between 5 and 10 point images (P = 0.077) and the 10 and 15 point images ( P= 0.048). The precision of reference point positioning as evaluated in the two identical images was satisfactory, the divergence being on average 1.4 pixels. The conclusion from cost/benefit analysis was that, when working with subtraction radiography, time should not be spent adjusting camera diaphragm to utilize the full range of gray shades but rather on a precise positioning of 10–15 reference points in the images to be subtracted.