Immune Checkpoint Inhibitors and Beyond: An Overview of Immune-Based Therapies in Merkel Cell Carcinoma

American Journal of Clinical Dermatology - Merkel cell carcinoma (MCC) is an aggressive skin cancer. Until 2017, patients with advanced disease were typically treated with conventional...     

Healthy ranges of serum alanine aminotransferase levels in Iranian blood donors

AIM: The healthy ranges for serum alanine aminotransferase (ALT) levels are less well studied. The aim of this study was to define the upper limit of normal (ULN) for serum ALT levels, and to assess factors associated with serum ALT activity in apparently healthy blood donors. METHODS: A total of 1,939 blood donors were included. ALT measurements were performed for all cases using the same laboratory method. Healthy ranges for ALT levels were computed from the population at the lowest risk for liver disease. Univariate and multivariate analyses were performed to evaluate associations between clinical factors and ALT levels. RESULTS: Serum ALT activity was independently associated with body mass index (BMI) and male gender, but not associated with age. Association of ALT with BMI was more prominent in males than in females. Upper limit of normal for non-overweight women (BMI of less than 25) was 34 U/L, and for non-overweight men was 40 U/L. CONCLUSION: Serum ALT is strongly associated with sex and BMI. The normal range of ALT should be defined for male and female separately.     

Non-invasive management of fused upper incisors

The union of two different dental sprouts which can happen in any phase of dental development is commonly called fusion. This developmental anomaly may cause clinical problems including esthetic impairment, which are mainly treated by endodontic and surgical treatments. There are a few reports of conservative not invasive treatment of fused incisors teeth through restorative or prosthetic techniques. They are rarely reported in mandibular posterior teeth. This paper presents an unusual case of fusion of 7 and 8, and also 9 and 10 teeth which was treated with a nonendodontic and nonsurgical conservative approach. Patient was a healthy18-year-old female with chief complaint of bad-looking teeth that in intraoral examination revealed the fusion of 7 and 8, and also 9 and 10 teeth. The space between the mesial of the 6 and 11 teeth was reconstructed. Diastema between the fused teeth was closed. A new lateral tooth was replaced between the fused teeth (7 and 8) and 6 tooth with direct fiber-reinforced composite. The space between the fused teeth (9 and 10) and also tooth 11 was partially closed. Gingival papillas were reconstructed using pink composite. The mandibular anterior missing teeth were replaced with rochett bridge. At the end of treatment the esthetic of the patient was improved. As the treatment was not invasive, major complications are not expected; however, there is potential for eventual long-term periodontal problems due to poor oral hygiene. Debonding of the rochett bridge may happen as well.