Frequency and prognostic value of HLA antigens in osteosarcoma patients

A homogeneous group of 53 Caucasian subjects with high-grade osteosarcoma (OS) was typed for HLA-A and B locus antigens. Although no significant differences in the distribution of these antigens were found in comparison with 425 local controls, a trend towards an increase of HLA-B18 and decrease of HLA-B21 was observed. All the patients underwent amputation plus adjuvant chemotherapy and among the 29 patients with a follow-up longer than one year, 9 out of 10 subjects with HLA-A3 antigens developed metastases within a few months. None of the OS patients had the HLA-A3, B7 haplotype which is present in linkage-disequilibrium in the control population.     

Fixed partial dentures in an up to 8-year follow-up

Information on the longevity of fiber-reinforced composite fixed partial dentures (inlay FPDs) should be considered in the selection of materials, operative techniques and patient instructions related to prognosis and long-term cost-effectiveness.

Objective

This study evaluated the long-term survival of fiber-reinforced, adhesively-bonded composite prostheses placed in posterior teeth.

Material and Methods

Twenty-one patients that received adhesively bonded polyethylene inlay FPDs in posterior teeth were selected from a private practice dental office and invited to evaluation. Of the eligible 21 patients, 13 (mean age 50.3 ±11.5 years) agreed to be enrolled as participants, providing 22 restorations, as several subjects presented more than one inlay FPD. One dentist placed all inlay FPDs using Ribbond as reinforcement and Tetric Ceram/Durafil or Charisma/Renamel composite combinations, according to manufacturer’s instructions. Two independent calibrated operators performed the evaluation, using modified USPHS criteria. Survival functions of restorations were analyzed with Kaplan-Meier and Log Rank test (α = 0.05).

Results

The majority of restorations received A or B scores. Four (18.2%) inlay FPDs fractured among the 22 evaluated. The mean estimate survival rate was 7 years (95% CI: 5.9 to 8.1), and the overall percentage of survival was 81.8%. There were no significant differences (p>0.05) between composite combinations or tooth location considering all clinical aspects evaluated and survival functions.

Conclusion

Posterior fiber-reinforced fixed partial dentures exhibited acceptable clinical performance after a period up to 8 years.     

Depth of sedation using Cerebral State Index in infants undergoing spinal anesthesia

Background: Infants are noted to frequently sleep during spinal anesthesia, with a concomitant fall in Bispectral Index. However, there are suggestions that EEG derived anesthesia depth monitors have inferior performance in infants. The aim of this study was to quantify the degree of sedation during spinal anesthesia in infants using another EEG derived measure of anesthesia effect – the Cerebral State Index (CSI). Methods: Twelve infants, <52 weeks postconceptual menstrual age, scheduled for bilateral inguinal hernia repair under spinal anesthesia were enrolled. Patients received a standard anesthetic protocol with a subarachnoid dose of 1 mg·kg^?1 of levobupivacaine 0.5%. No premedication, sedatives, opioids or anticholinergics were administrated during the perioperative period and patients were left undisturbed during the surgical time, without tactile stimulation or loud auditory stimuli. CSI score (0–100) and bust suppression (BS) (0–100%) were continuously recorded during the surgical time and then statistically re‐evaluated. Results: In all patients the CSI fell during the procedure and there were significant levels of BS recorded by the CSI monitor. The BS occurred between 12 and 34 min after spinal anesthesia with the peak being at 30 min and mean onset time being 15 (2.6) min after spinal block. A statistical significant difference was found between the lowest mean CSI as well as the highest BS if compared with their baseline values. A negative correlation was found between CSI and BS. Conclusions: The degree of burst suppression detected by the CSI in our study supports the hypothesis that infants may have discontinuous patterns of EEG during spinal anesthesia similar to those seen during emergence from general anesthesia. Moreover, the limitations in the application of the adult algorithms to infant EEG may lead to an overestimation of the degree of sedation.     

Effect of corticosteroid treatment on interleukin-1 and tumour necrosis factor secretion by monocytes from subjects with asthma

Peripheral blood monocytes (PBM) may be activated in asthmatic patients, a condition usually reverted by corticosteroid (CS) treatment. In the present research we have evaluated the spontaneous or lipopolysaccharide (LPS)-induced production of interleukin 1 (IL-1) and tumour necrosis factor (TNF) by PBM obtained from 14 asthmatic subjects during an asthmatic attack and after 1 week of CS treatment. The control group included 20 healthy volunteers. PBM obtained during severe asthma showed a pattern of IL-1 and TNF secretion similar to that of normal subjects. After CS treatment, IL-1 levels did not change significantly in comparison to baseline values, while LPS-induced TNF production was apparently related to the degree of airway obstruction after CS treatment. In fact, TNF production by PBM from CS-responsive subjects was significantly decreased in comparison to the levels determined before CS treatment, while PBM from CS-resistant subjects produced the same cytokine levels regardless of CS treatment. The present study suggests that the determination of LPS-induced TNF secretion by PBM could be used to confirm the effectiveness of CS treatment in asthma.