Double versus single cervical cerclage for the prevention of preterm births

Objective: To evaluate the effectiveness double cervical cerclage in reducing antenatal complications and improve perinatal outcomes.

Methods: We searched Medline, Scopus, Clinicaltrials.org, The Cochrane Central Register of Controlled Trials and Google Scholar search engines.

Results: Six studies were included that involved 880 women. Double cerclage was significantly superior to single cerclage in reducing preterm births <34?weeks (734 cases, OR 0.59, 95% CI 0.40, 0.86) and preterm births <28?weeks (645 cases, OR 0.43, 95% CI 0.26–0.73). It also significantly increased the gestational age (380 cases, MD 2.63, 95% CI 0.87, 4.39). However, as a technique, it failed to improve the rates of preterm births <37?weeks (740 cases, OR 0.98, 95% CI 0.72, 1.34) the incidence of chorioamnionitis (740 cases, OR 0.83, 95% CI 0.51, 1.36) and the occurrence of preterm premature rupture of the membranes (796 cases, OR 1.32, 95% CI 0.95, 1.82).

Conclusions: It seems that double cerclage effectively increases the gestational age at delivery and decreases the rates of extremely premature births. However, as a procedure, it does not reduce the incidence of antenatal morbidity or the neonatal death rates. Further research is needed in the field as our meta-analysis is limited by the small number of enrolled studies.     

Fowlpox virus recombinants expressing HPV-16 E6 and E7 oncogenes for the therapy of cervical carcinoma elicit humoral and cell-mediated responses in rabbits

Background  

Around half million new cases of cervical cancer arise each year, making the development of an effective therapeutic vaccine against HPV a high priority. As the E6 and E7 oncoproteins are expressed in all HPV-16 tumour cells, vaccines expressing these proteins might clear an already established tumour and support the treatment of HPV-related precancerous lesions.     

MHC-restricted cytotoxic T-lymphocyte assay: an improved method based on normal and SV40-immortalized rabbit epidermal target cells

Although several techniques are available to evaluate cell-mediated immunity, numerous difficulties have prevented their use in rabbits. Cytotoxic T-lymphocyte (CTL) assays have been used to determine the ex vivo cytolytic activity of CD8+ T-lymphocytes in immunization protocols. However, this assay cannot be performed with rabbit peripheral blood mononuclear cell (PBMC) targets because of their high spontaneous (51)Cr release. To overcome this intrinsic difficulty shown by rabbit cells, syngeneic normal and SV40-immortalized cells were prepared from skin biopsies. The results show that: (i) skin-derived rabbit fibroblasts can be used as target cells after infection with a fowlpox virus recombinant; (ii) SV40-immortalized skin fibroblasts appear to be more appropriate for repeated assays; (iii) antigen-expanded T-cells and fresh PBMCs can be used as effectors with a similar efficiency; and (iv) dissociation of adherent skin fibroblast target cells with EDTA is to be preferred over TrypLE enzymatic treatment.     

Investigation of the influence of gastric acid on the surface roughness of ceramic materials of metal-ceramic restorations. An in vitro study

The rehabilitation of eroded teeth in patients suffering from bulimia nervosa generally includes ceramics. This study compared the roughness of three ceramics before and after exposure to simulated vomit solution (SVS) with a pH of 3.8. Surface roughness parameters Ra, RMS, and AH were calculated using atomic force microscopy before and after exposure to SVS (novel peristaltic pump for 24 hours at 37°C) and were analyzed statistically. Apart from the initial high AH values of the glass-ceramic, none of the parameters evaluated were statistically significantly different after acid exposure. Under the limitations of this in vitro study, the investigated ceramics seem suitable for use in bulimia nervosa patients.     

Preliminary report: the effect of a 6-month dietary glycemic index manipulation in addition to healthy eating advice and weight loss on arterial compliance and 24-hour ambulatory blood pressure in men: a pilot study

We aimed to determine whether altering dietary glycemic index (GI) in addition to healthy eating and weight loss advice affects arterial compliance and 24-hour blood pressure (BP), both coronary heart disease (CHD) risk factors. Middle-aged men with at least 1 CHD risk were randomized to a 6-month low-GI (LGI) or high-GI (HGI) diet. All were advised on healthy eating and weight loss. They were seen monthly to assess dietary compliance and anthropometrics. Carotid-femoral pulse wave velocity (PWV), fasting blood lipid profile, and glucose and insulin concentrations were measured at baseline and at months 3 and 6. Six-hour postprandial glucose and insulin responses and 24-hour ambulatory BP were also assessed at baseline and month 6. Thirty-eight subjects (HGI group, n = 16; LGI group, n = 22) completed the study. At month 6, groups differed in dietary GI, glycemic load, and carbohydrate intake (P < .001). Fasting insulin concentration and insulin resistance (calculated by homeostatic model assessment) were lower in the LGI than the HGI group (P < .01). The reduction in total cholesterol and 24-hour BP was bigger in the LGI than the HGI group (P < .05); and only the LGI group had significant reductions (P < .05) in PWV, low-density lipoprotein cholesterol, and triacylglycerol concentration. There were no differences in postprandial glucose or insulin responses between the groups. The results suggest that an LGI diet may be more beneficial in reducing CHD risk, including PWV and 24-hour BP, even in the setting of healthy eating and weight loss; and thus, further study is warranted.     

The Role of Colchicine in Treating Postoperative and Post-catheter Ablation Atrial Fibrillation

Purpose

The goal of this review was to summarize, analyze, and compare trials studying the efficacy of colchicine in the prevention of atrial fibrillation (AF) post-operatively (POAF) and post–catheter ablation. Ongoing studies and current guidelines are also presented and reviewed.

Phenotypic analyses of mononuclear cells recovered from healthy and diseased human periodontal tissues

Mononuclear cells were recovered from the gingival tissues of normal individuals and from patients with periodontal disease. Lymphocyte phenotypic markers were identified by immunofluorescence after reaction with monoclonal antibodies to T-cell subset markers. The normal tissues exhibited T4/T8 ratios almost identical to those in the peripheral blood. The diseased tissue cell ratios were significantly reduced, in both the adult periodontitis and the juvenile periodontitis groups (P<0.01 andP<0.02, respectively), indicating alterations in the T-cell subset distribution in these tissues. Each diseased patient showed a much decreased T4/T8 ratio in the gingival lymphocytes when these were compared with the peripheral blood ratio from the same patient. The T4/T8 ratios of the more severe sites were significantly lower than those of the less severe sites in the same disease category. The decreases in subset ratios could be attributed to statistically significant reductions in T4⁺-lymphocyte recoveries relative to peripheral blood and also to slight relative increases in T8⁺ lymphocytes. A highly significant (P<0.001) correlation between the average probeable periodontal pocket depth and the T4/T8 ratio of each disease category was demonstrated. The relative recoveries of B cells from the various tissues did not differ between diseased and normal tissues. It is suggested that T-cell regulatory expression in gingival tissues is distinct from peripheral blood regulatory expression and that there is a local immunoregulatory imbalance in periodontal disease.     

Zukunftstrends und Einsatzmöglichkeiten digitaler Technologien in der settingbezogenen Prävention und Gesundheitsförderung – eine Delphi-Befragung

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Digitale Technologien zeigen ein hohes Nutzenpotenzial für die Gesundheitsförderung und Prävention, eine Analyse...     

Reinforcement of a PMMA resin for fixed interim prostheses with nanodiamonds

The aim of this study was to investigate the possible reinforcement of Nanodiamonds (ND) in a PMMA resin for fixed interim restorations. The fracture toughness (K(Ic)), impact strength and the dynamic thermomechanical properties (T(g), E′, E′′, tanδ) of a series of PMMA-ND nanocomposites with different amounts of ND were evaluated. The fracture toughness increased as the ND percentage increased up to 0.38% wt but a greater amount of ND induced a decrease in K(Ic). Impact strength and Young's modulus were also increased by increasing nanoparticles content, indicating the reinforcing effect of ND. Dynamic mechanical properties were also affected. By increasing the ND content an increase of storage modulus was recorded, while glass transition was shifted at higher temperatures. Under the limitations of this study, it can be suggested that reinforcing PMMA with ND nanoparticles -especially at low concentrations- may increase the overall performance of fixed interim prostheses.     

ANCA vasculitis: time for a change in treatment paradigm? Not yet

The ANCA-associated vasculitides (AAVs) are conventionally treated with a strategy of remission induction followed by maintenance therapy using glucocorticoids combined with CYC during induction and AZA for maintenance. Recently, several randomized controlled trials have been published that question whether these drugs should remain those of choice. B-cell depletion using rituximab is at least as effective as CYC for remission induction in newly presenting patients, but long-term efficacy, safety and cost-effectiveness data are awaited, and thus rituximab should be reserved for patients at high risk of infertility. Rituximab seems to be effective at inducing remission in relapsing patients. Whether routine pre-emptive treatment with rituximab for remission maintenance is a better approach than waiting for relapse is unknown. MTX and LEF have similar efficacy to AZA, but are not significantly safer; while MMF is less effective. Thus, AZA remains the conventional maintenance drug of choice.