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Introduction: Aptamers are a brand-new class of receptors that can be exploited to improve the bioactivity of tissue engineering grafts. The aim of this work was to revise the current literature on in vitro and in vivo studies in order to i) identify current strategies adopted to improve scaffold bioactivity by aptamers; ii) assess effects of aptamer functionalization on cell behavior and iii) on tissue regeneration.Methods: Using a systematic search approach original research articles published up to 30 April 2022, were considered and screened.Results: In total, 131 records were identified and 18 were included in the final analysis. Included studies showed that aptamers can improve the bioactivity of biomaterials by specific adsorption of adhesive molecules or growth factors from the surrounding environment, or by capturing specific cell types. All the studies showed that aptamers ameliorate scaffold colonization by cells without modifying the physicochemical characteristics of the bare scaffold. Additionally, aptamers seem to promote the early stages of tissue healing and to promote anatomical and functional regeneration.Discussion: Although a metanalysis could not be performed due to the limited number of studies, we believe these findings provide solid evidence supporting the use of aptamers as a suitable modification to improve the bioactivity of tissue engineering constructs.

The study of the intimate connection occurring at the interface between cells and titanium implant surfaces is a major challenge for dental materials scientists. Indeed, several imaging techniques have been developed and optimized in the last decades, but an optimal method has not been described yet. The combination of the scanning electron microscopy (SEM) with a focused ion beam (FIB), represents a pioneering and interesting tool to allow the investigation of the relationship occurring at the interface between cells and biomaterials, including titanium. However, major caveats concerning the nature of the biological structures, which are not conductive materials, and the physico-chemical properties of titanium (i.e. color, surface topography), require a fine and accurate preparation of the sample before its imaging. Hence, the aim of the present work is to provide a suitable protocol for cell-titanium sample preparation before imaging by SEM-FIB. The concepts presented in this paper are also transferrable to other fields of biomaterials research.

A stepped approach to management using these communication tips and coping strategies can help decrease the stigma of generalized anxiety disorder and increase patients' sense of ownership in their care.

Current biomedical research is centered on the study of nanomaterials and their effects in biological environments. In particular, there is an increasing interest on TiO₂ nanostructures for biomedical applications such as drug delivery or implant materials. In this framework, we present a Chemical Vapour Deposition process to synthesize titanium dioxide nanowires (NWs) on a commercially pure titanium substrate and we test the material

In the present investigation the diploid numbers 2n = 45, 2n = 46, 2n = 47, and 2n = 48 have been determined for Gobius paganellus. Specimens of different sex were found to have exactly the same karyotype. This species is characterized by two fundamental numbers: NF = 47, and NF = 48. Chromosome polymorphism due to different chromosome rearrangements within the A-type complement is present in this species.

Problem statement: Tooth loss can induce dramatical remodeling of alveolar bone because of mechanical loading impairment and strategies to help maintain adequate bone levels for subsequent therapies are sorely needed. Recent discoveries have shown that osteocytes, matrix-embedded cells in bone, respond to mechanical stimulation by modulating the expression of the Sost gene, which encodes for the protein sclerostin. This protein can oppose the WNT canonical pathway, a signaling cascade which regulates osteoblastic differentiation and bone homeostasis and thus orchestrate bone turn-over according to the skeleton’s mechanical needs. Conclusion: Experimental attempts at Sclerostin inhibition have provided interesting data on a novel approach to decrease bone resorption and promote bone formation, with important implications for the orthopedic and dental field.

Rough titanium surfaces enhance the activation of Wnt canonical signaling, a pathway required for osteoblast differentiation. The present study investigated the effects of GSK3b-inhibitor (2'Z,3'E)- 6-Bromoindirubin-3'-oxime (BIO) on osteoblastic differentiation on titanium surfaces with different topography and wettability. C2C12 cells were plated on pickled, acid-etched/sand-blasted (SLA), modified hydrophilic SLA titanium discs (modSLA) and stimulated with increasing doses of BIO. Activation of Wnt canonical signaling was measured with a reporter system. Gene expression was measured in the same cell system by Real Time PCR. Osteoblastic MC3T3 cells were then plated on discs with or without BIO and the expression of osteoblast specific genes was assessed by Real Time PCR. One mM BIO activated Wnt canonical signaling in C2C12 cells on all surfaces, and the highest effect was on rough surfaces. BIO markedly increased the expression of Osteoprotegerin and Osteocalcin in MC3T3 cells on rough surfaces at the concentration of 100 nM, and on all surfaces at the concentration of 1 mM. BIO enhances Wnt signaling activation and the expression of osteoblastic genes on rough surfaces and could be a viable approach to improve cell response to implant surfaces.

To compare the diagnostic performance of high-frequency ultrasound (HFU) as a first- or second-line diagnostic tool in non-palpable lesions (NPL) of the breast and to define the place of HFU in the diagnostic process, 89 women with this kind of lesion, previously detected by mammography, underwent HFU with 7.5-13 MHz transducers. The examinations were performed by two equally experienced operators of which only one (operator I) was aware of the mammographic findings. The mammographic examinations revealed the following non-palpable lesions: asymmetry-hyperdensity (17 cases), nodule (44 cases), stellate lesion (5 cases), microcalcifications (23 cases). Total sensitivity of HFU in the examinations performed by operator I was 83 %, while in the examinations performed by operator II (unaware of the mammographic findings) it was only 35 %. In all cases HFU allowed the operators to determine the basic features of the lesions. Our experience confirms that ultrasonography, even if performed with high frequency, cannot be proposed as a screening examination but may profitably be employed as a second-step technique to characterize NPL previously identified by mammography. This 'second-step' role can do the following: rule out true pathology (cases of false-positive mammography findings); furnish some basic features in the case of focal lesions; show other findings in the case of microcalcifications, such as microcysts, 'filled duct' appearance, parenchymal inhomogeneities and nodules; guide interventional procedures; and localize lesions preoperatively.

Background. Cost containment is a reality in thoracic surgery. Patient care pathways have proved effective in cardiac surgery to reduce length of stay and control costs. Methods. A multidisciplinary team formulated a pulmonary lobectomy patient care pathway to standardize care, reduce length of stay and costs, and maintain quality. Variance codes were developed to collect data prospectively on reasons for prolonged stay. A patient satisfaction survey was instituted to learn patients' responses to their hospitalization. Results. One hundred forty-seven patients underwent lobectomy in 1995 before institution of the pathway with a mean length of stay of 10.6 days and a mean cost of $16,063. The lobectomy pathway was instituted at the beginning of 1996. One hundred thirty patients underwent lobectomy in 1996 with a mean length of stay of 7.5 days ( p = 0.03) and a mean cost of $14,792 ( p = 0.47). Readmission and mortality rates were unchanged. Eighty-eight of 130 patients (68%) were able to be discharged by the target length of stay of 7 days in 1996 as opposed to 76 of 147 patients (52%) in 1995. The most common reason for delayed discharge was inadequate pain control. The majority of patients felt prepared for discharge by the seventh postoperative day (70 of 96 patients, 73%). Conclusions. The institution of a lobectomy patient care pathway appeared to reduce length of stay and costs. The pathway provided a framework to begin systematic quality control measures to enhance patient care.

Periostin is a matricellular protein highly expressed in periodontal ligament and periostium and has been shown to be required for tissue development and maintenance. We showed that the adhesion of murine osteoblastic MC3T3 cells to thiolated hyaluronic acid/polyethyleneglycol hydrogels was greatly improved by enrichment with periostin. Polished or sand-blasted/acid-etched (SLA) commercially pure titanium surfaces were also coated with this protein and periostin ameliorated cell adhesion and dramatically affected cell morphology on both surfaces, as assessed at fluorescence microscopy, scanning electron microscopy, and chemiluminescence-based viability assay. Moreover, periostin increased the expression of alkaline phosphatase, osteoprotegerin, connective tissue growth factor, collagen 1a1, osteocalcin, Runx2, and osterix transcription factors on smooth surfaces. However, it did not affect, or even decreased, the expression of these genes on SLA discs. Transcript levels for connexin 43 were greatly increased on both surfaces in the presence of periostin. Taken together, these results show that periostin coatings can be a viable approach to improve cell adhesion and differentiation on implantable biomaterials.

This article summarizes the care of patients undergoing bilateral lung volume reduction surgery as a treatment for end-stage emphysema. Surgical removal of emphysematous tissue allows for a reconfiguration of the chest wall and diaphragm, improving pulmonary mechanics. This results in reduced air trapping and improved gas exchange. It is important for nurses caring for these patients to be knowledgeable in the postoperative care of thoracic surgical patients and to have an understanding of the pathophysiology of emphysema, the medical management, and, in particular, the relationship between dyspnea and anxiety. Strategies to assist with airway clearance, control pain, prevent and alleviate dyspnea, reduce and treat anxiety, and ensure nutrition need to be incorporated into the postoperative plan of nursing care.

Objective : Subtypologies of schizophrenia based on cross-sectional criteria, such as the nomenclature of the DSMs, have not been successful in identifying valid diagnostic subgroups among patients with schizophrenia. A subtypology that uses criteria to classify individuals on the basis of longitudinal deficits in self-care may identify a more valid subgroup of schizophrenic patients. Method : This study describes the clinical characteristics ofa group of schizophrenic patients identified on the basis ofa longitudinal criterion : at least 5 years of continuous and complete dependence on others for obtaining and maintaining the basic necessities of life, including food, clothing, and shelter. Results : Sixty-one Kraepelinian schizophrenic inpatients, when compared to 80 non-Kraepelinian schizophrenic inpatients who were similar in years of illness, age, and education, demonstrated more severe negative symptoms and more severe formal thought disorder ; yet the severity of their delusions, hallucinations, and bizarre behavior did not differ significantly. None of the Kraepelinian patients and eight non-Kraepelinian patients met DSM-III-R criteria for schizoaffective disorder. Conclusions : Data from this replication study suggest that Kraepelinian schizophrenic patients, identified on the basis of a longitudinal course characterized by severe dysfunctions in self-care, may represent an alternative, and possibly more valid, method of subtyping schizophrenia.

Six adult patients (4 females and 2 males, age range 26-57 years) with Gitelman's syndrome (GS) were treated with spironolactone 200-300 mg/day (n = 5) and/or amiloride 10-30 mg/day (n = 3) for 1-18 months. The patients had hypokalemia, hyperreninemia, chloride-resistant metabolic alkalosis, renal hypomagnesemia (n = 5), and hypocalciuria (n = 5). Free water clearance studies during maximal water diuresis and furosemide administration were suggestive of a solute reabsorptive defect beyond the loop of Henle. Antialdosterone therapy induced a significant increase of PK (from 2.6 +/- 0.4 to 3.4 +/- 0.4 mM; p0.0001) and a decrease of CK (from 21.4 +/- 13.2 to 10.6 +/- 4.8 ml/min, p0.02) and FEK (from 21.0 +/- 13.6 to 13.4 +/- 5.7%; p0.03); PMg increased from 1.38 +/- 0.38 to 1.64 +/- 0.21 mg/dl (p0.03) with a parallel fall of CMg (from 5.5 +/- 2.3 to 2.9 +/- 1.5 ml/min; p0.02) and FEMg (from 5.7 +/- 2.6 to 2.9 +/- 0.6%; p0.05); arterial blood pH and HCO3- did not change (P = plasma, C = clearance, FE = fractional excretion). The creatinine clearance fell (from 90.5 +/- 16.8 to 65.8 +/- 20.9 ml/min; p0.05), and Prenin rose (from 16.6 +/- 8.9 to 35.3 +/- 25.3 ng/ml/h; p0.02, as did Paldo (from 26.1 +/- 12.3 to 109 +/- 82.6 ng/dl; p0.01), indicating extracellular fluid volume contraction; however no significant clinical symptoms of hypovolemia ensued.(ABSTRACT TRUNCATED AT 250 WORDS)

We describe two cases of hemifacial spasm (HFS) with unusual synkinetic movements between facial muscles and respiratory activity. Patient 1 developed an idiopathic HFS. She underwent microvascular decompression surgery, followed by transitory facial nerve palsy; she recovered but later developed a facial synkinesia characterized by involuntary and forced eyelid closure on spontaneous and deep breathing; the orbicularis oculi muscle was active also when her mouth was open (the so-called Marin-Amat syndrome). Patient 2, 1 year after a peripheral facial nerve palsy (Bell's palsy), developed an HFS together with synkinetic movements between the orbicularis oculi muscle and respiration. In both cases electrophy siological studies showed pathological synkinetic electromyographic activity. An enhanced hyperexcitability of brain stem interneurons and facial motoneurons could be suggested to explain the phenomenon.

Chronic periodontitis is a widespread disease affecting tooth-supporting structures that can lead to extensive loss of periodontal ligament and bone, ultimately resulting in tooth loss. Extensive evidence has demonstrated a strong association between age, metabolic disorders such as type II diabetes, oxidative stress and alveolar bone loss. The molecular players controlling bone maintenance and underlying age-related bone loss and its links to the general metabolism are currently the object of intense research.Recent findings are summarized to elucidate the molecular mechanisms linking oxidative stress, bone loss and metabolic factors.It is well known that reactive oxygen species are an inevitable consequence of cellular respiration and that organisms have developed an efficient array of defenses against them. The core of this complex defense line is a family of transcription factors, known as FoxOs, which can bind to β-catenin and initiate a transcriptional programme regulating cell apoptosis, DNA repair and degradation of reactive oxygen species. An increase in reactive oxygen species due, for example, to age or insulin resistance, generates a situation in which bone formation is impaired by activation of FoxO, and a decrease in Wnt signaling and bone resorption are promoted.The balance between FoxO and the Wnt pathway is finely tuned by systemic and local factors, creating a far-reaching mechanism that dictates the fate of mesenchymal progenitors and regulates the homeostasis of bone, providing a rationale for the impairment of systemic and alveolar bone maintenance clinically observed with age and metabolic diseases.

Rhythmic masticatory muscle activity (RMMA) is the characteristic electromyographic pattern of sleep bruxism (SB), a sleep-related motor disorder associated with sleep arousal. Sleep arousals are generally organised in a clustered mode known as the cyclic alternating pattern (CAP). CAP is the expression of sleep instability between sleep maintaining processes (phase A1) and stronger arousal processes (phases A2 and A3). This study aimed to investigate the role of sleep instability on RMMA/SB occurrence by analysing CAP and electroencephalographic (EEG) activities. The analysis was performed on the sleep recordings of 8 SB subjects and 8 controls who received sensory stimulations during sleep. Baseline and experimental nights were compared for sleep variables, CAP, and EEG spectral analyses using repeated measure ANOVAs. Overall, no differences in sleep variables and EEG spectra were found between SB subjects and controls. However, SB subjects had higher sleep instability (more phase A3) than controls (P= 0·05). The frequency of phase A3 was higher in the pre-REM sleep periods (P0·001), where peaks in RMMA/SB activity were also observed (P = 0·05). When sleep instability was experimentally increased by sensory stimuli, both groups showed an enhancement in EEG theta and alpha power (P = 0·04 and 0·02, respectively) and significant increases in sleep arousal and all CAP variables. No change in RMMA/SB index was found within either groups (RMMA/SB occurred in all SB subjects and only one control during the experimental night). These findings suggest that CAP phase A3 may act as a permissive window rather than a generator of RMMA/SB activity in predisposed individuals.

The aim of this study is to analyze the morphology and proliferation of human osteoblastic cells in vitro on five commercially available titanium surfaces.Human primary cells of the osteoblastic lineage were obtained from bone explants. The cells were plated on polished (T1), machined (T2), sand-blasted/acid-etched (T3), sand-blasted/acid-etched, modified with hydrogen peroxide rinse (T4), and plasma-sprayed titanium (T5) disks. Cell morphology was studied after 6, 24, 72 h, 7 and 14 days of culture by scanning electron microscopy. The formation and distribution of focal adhesions was investigated by immunocytochemical staining at 3, 6 and 24 h. Cell growth was measured by an MTT assay after 3, 7 and 9 days of culture. Moreover, the production of osteocalcin and osteoprotegerin (OPG) was evaluated in the supernatants by ELISA.Morphological analysis revealed that substrate topography profoundly affected cells' shape and their anchoring structures. Large lamellipodia were formed on polished and machined surfaces, while thin filopodia were more frequently observed on T3 and T4 samples. Moreover, cells formed stronger focal adhesions on T3 and T4 surfaces, and cell proliferation was higher on rough surfaces. Osteocalcin production was higher on the T4 surface, whereas OPG steadily increased on every surface.Taken together, these data show that all the surfaces allowed cell attachment, adhesion and proliferation, but T4 and T5 surfaces appeared to be a better substrate for the adhesion, proliferation and differentiation of cells of the osteoblastic lineage.

The crystal structures of the title tryptophan-containing dipeptides, C14H17N3O3·H2O, (I), C13H15N3O3·2H2O, (II), and C13H15N3O3·H2O, (III), respectively, contain at least one water mol­ecule of solvation. As a result, the crystal packing of these compounds is composed of regions of water-mediated hydrogen bonding and tryptophan ring-to-ring stacking separated by the length of the mol­ecule. The tryptophan rings stack in a continuous layer that, when viewed edge-on from the outermost part of the tryptophan ring, exhibits a herring-bone motif. However, owing to the lack of direct overlap of adjacent rings, no degree of π contact or long-range delocalization of ring systems is possible here. The overall molecular conformations of (I) and (III) contain a folding of one peptide over the other, such that a minimum in molecular volume occurs without any intramolecular hydrogen bonding. In these two dipeptides, extensive hydrogen bonding is observed to and from the single water mol­ecule of solvation. In the crystal structure of (II), however, an extended mol­ecule conformation complements a more extensive hydrogen-bonding scheme involving two water mol­ecules of solvation per dipeptide.

This article presents a comprehensive review of the topic of placebos, with a special focus on placebo analgesia. It includes a discussion of how placebos work (the placebo effect) and how patients react to them (the placebo response). A literature search was performed to identify relevant literature and publications related to the topic, and a qualitative assessment of papers was undertaken based on accepted rules for scientific evidence. The major finding from this review was that concepts about placebo effects and responses have changed dramatically over the years, especially in more recent years. This has occurred primarily as a result of more sophisticated experimental protocols using placebos in clinical studies of patients in pain, as well as various studies involving normal subjects. Our understanding of the biological and psychological mechanisms underlying placebo effects has expanded significantly due to recent developments in the technology of brain imaging. Based on findings from brain-imaging analyses, we now know that placebo analgesia is definitely a real (i.e., biologically measurable) phenomenon. It can be pharmacologically blocked and behaviorally enhanced, and these responses have been demonstrated to be similar to those elicited by administration of "real" analgesic substances. Psychological mechanisms involved in placebo analgesia include expectancy, meaning response, and classical conditioning. This article concludes with an emphasis on understanding therapeutic responses to various treatments for temporomandibular disorders (TMD). Acupuncture and splint therapy can be good examples of powerful placebos in the field of TMD, and both of these are discussed in detail. Present knowledge suggests that every treatment for pain contains a placebo component, which sometimes is as powerful as the so-called "active" counterpart. While the deceptive use of placebos must be considered unethical, every health provider who is treating pain patients must be aware of this important phenomenon in order to harness its huge potential.

The current study investigated the race- and age-dependent alterations in global DNA methylation on the development and progression of squamous cell carcinomas (SCCs) of the lung.Methylation status was evaluated in SCC and in the associated uninvolved bronchial mucosa (UBM) and epithelial hyperplasia (EH) of 53 Whites and 23 African Americans by using an antibody specific for 5-methylcytosine (5-mc). A low 5-mc score indicates global hypomethylation of DNA.5-mc scores of SCC were significantly lower compared to 5-mc scores of UBM and EH in Whites (p0.05). In African Americans, 5-mc scores of SCCs were not significantly different from 5-mc scores of UBM and EH, suggesting an involvement of methylation in the development of SCCs in Whites, but not in African Americans. 5-mc scores were lower in younger subjects compared to older subjects in Whites. Since cancers in younger subjects tend to be more aggressive than cancers in older subjects, these observations may suggest that hypomethylation may have contributed to aggressiveness cancers of younger Whites. Hypomethylation of SCCs in White men was associated with shorter survival from the disease.These preliminary results suggest that the methylation status of DNA may affect the development, aggressiveness, and prognosis of SCCs in Whites.

Keywords: sleep; bruxism; temporomandibular disorders; dopamine D2 receptors; polysomnography; arousal; parasomnias

Background Condom use at first coitus is associated with greater lifetime condom use. Little is known, however, about factors which influence non-use of condoms at first coitus. Methods Data were analysed from a cross-sectional study on condom use behaviours conducted among 98 heterosexual male students attending two Georgia universities. Men were asked to recall condom use during first and subsequent coitus. Multivariable logistic regression was conducted to evaluate factors associated with non-use of condoms at first coitus and how non-use influenced their future condom beliefs and use. Results Participant averaged 22.4 years at interview, 16.8 years at first intercourse (range:13–23), and 5.6 years (range:0–12) between first condom use and time of interview. Overall, 47 men (48%) reported not using condoms at first coitus, and not initiating use until an average of 13 acts after sexual debut (med=5; range:1–100). Reasons for eventual condom initiation included: concern about infection/pregnancy (53%), partner insistence (32%), and condoms being available (15%). Compared with men who used condoms at first intercourse, men initiating use afterwards were significantly more likely to report their first condom experience was negative (62% vs 35%, aOR=2.8, 95% CI 1.1 to 7.2), and were less inclined to use condoms subsequently based on this first experience (34% vs 14%, aOR=3.4, 95% CI 1.2 to 8.8). However, measurement of condom use during most recent coitus did not differ significantly between men who initiated condom use after vs at their first intercourse both at last sex (43% vs 55%) and for both consistent use during the last month (43% vs 39%) and year (26% vs 20%). Conclusions Public health efforts should emphasise the importance of condom use at first intercourse. Counselling should be provided to help prepare men for a positive first experience with condoms, given that this experience may affect immediate subsequent condom use following sexual debut.

The program “Caldaia Sicura” is a complex aimed at improving safety and energy efficiency of heating systems and to reduce emissions. It involves the major players of local government in the sector of energy and environment, the trade associations, fuel suppliers and the local energy agency (ANEA). So as the program has been carrying out by dept of Municipality of Naples (“Servizio Progettazione e Valutazione Ambientale” — Mr. B. Sciannimanica; “Servizio Attivita Amministrative” — Mrs. M. Aprea); by Craftsmen Associations (Confartigianato, CNA, CASArtigiani, CLAAI); by ANEA (Agenzia Napoletana Energia Ambiente) the Naples Agency for Energy and the Environment.

This report describes a 26 year old woman with a Coxsackie B virus infection complicated by an acute pandysautonomic and sensory neuropathy. Electrophysiological studies suggested an axonal neuropathy. A sural nerve biopsy performed early in the disease showed axonal degeneration with a virtual absence of unmyelinated fibres and moderate loss of myelinated fibres, mainly affecting the small fibres; this differs from previous reports. An immune-mediated or direct virus action might explain the pathogenesis of this unusual evolution of a viral infection.

Although cervical cancer is a common female cancer, little attention has been given to genetic susceptibility factors. The present case-control study was undertaken to examine MTHFR polymorphism as a potential molecular marker of cervical intraepithelial neoplasia (CIN) susceptibility and to relate the findings to smoking, HPV infection, ethnicity, parity and oral contraceptive use, which are known risk factors for cervical cancer. A base change from C to T at the nucleotide position 677 of the MTHFR gene results in substitution of valine (GTC) for alanine (GCC). The homozygous normal (Ala/Ala), homozygous mutant (Val/Val), and heterozygous mutant (Ala/Val) genotypes for the MTHFR gene were determined in cervical tissues of 64 cases of CIN lesions and 31 controls. The genotype frequencies of both Val/Val (17%) and Ala/Val (56%) were significantly higher in subjects with CIN lesions compared to controls with Val/Val (10%) and Ala/Val (39%), (trend p = 0.03). The results suggested a significantly increased CIN risk with an alanine to valine substitution at amino acid 223 of MTHFR with an odds ratio of 2.9 (95% confidence interval: 1.2-7.9, p = 0.02). Age, ethnicity, smoking and oral contraceptive use were weakly and nonsignificantly associated with CIN risk. HPV infection was associated with a statistically nonsignificant threefold increase in CIN risk. Parity and MTHFR genotype displayed a strong interaction. Neither nulliparous women with MTHFR polymorphism nor parous women without the polymorphism were at higher risk than women who did not have children and were MTHFR homozygous normal (the reference category). Women with mutant MTHFR genotype who had children, however, showed a significantly higher risk of CIN, with an odds ratio of 23 (95% confidence interval: 2.3-225) as compared to the reference category. No other factors displayed such a strong pattern of interaction. Since MTHFR polymorphism and pregnancy increases folate requirements and can impair folate status, this association could reflect an inadequate response of mutant MTHFR genotype carriers to the increased demand for folate imposed by pregnancy. Tissue folate deficiency, in turn, could increase the risk of CIN in the affected women.

A variety of jaw and facial reflexes can be evoked by orofacial mechanical or electrical stimuli. Because of its possible diagnostic utility in the management of pain and dysfunction of the masticatory system, the exteroceptive suppression that can be evoked in the masseter and temporalis muscles has been particularly investigated. A review of the different studies emphasizes the crucial importance of the area stimulated and the type of stimulation used to evoke the reflex. More recent studies have applied the necessary standardization of stimulus intensity, clenching levels, recording procedures, and unbiased interpretation of the reflex components in muscle electromyographic (EMG) activity. Controversial results have been reported regarding the differences in these inhibitory (and excitatory) reflex responses between temporomandibular disorder or headache patients and controls. Even if the absence of a second inhibitory phase in the masseteric EMG activity of the patients is a frequent finding, its sensitivity and specificity as a diagnostic tool for myogenous pain or bruxism remain to be tested. Controlled studies on the duration of the second exteroceptive suppression period in tension-type headache patients could not confirm the initially reported difference between patients and asymptomatic subjects. Studies that involve experimentally induced muscle pain could provide better insight into the characteristics of the afferent fibers and synaptic circuitry that are involved in the jaw and facial reflexes.

Toxicity limits the use of methotrexate.To identify risk factors for methotrexate-induced lung injury in patients with rheumatoid arthritis.Case-control study.One private and five academic rheumatology practices.Methotrexate recipients with rheumatoid arthritis with and without lung injury.Potential risk factors examined were sociodemographic and lifestyle characteristics, medical history, clinical and ancillary features and treatment of rheumatoid arthritis before methotrexate therapy, and characteristics of methotrexate therapy. Cases of lung injury were defined according to the modified criteria of Searles and McKendry.Ninety-four percent of the study participants were white, and 67% were women. Case-patients (n = 29) were older than controls (n = 82) (61.5 compared with 54.5 years of age). The strongest predictors of lung injury, after adjustment for other variables, were older age (odds ratio [OR], 5.1 [95% CI, 1.2 to 21.1]), diabetes (OR, 35.6 [CI, 1.3 to infinity]), rheumatoid pleuropulmonary involvement (OR, 7.1 [CI, 1.1 to 45.4]), previous use of disease-modifying antirheumatic drugs (OR, 5.6 [CI, 1.2 to 27.0]), and hypoalbuminemia (OR, 19.5 [CI, 3.5 to 109.7]). Previous use of disease-modifying antirheumatic drugs and hypoalbuminemia had very large attributable risks.Knowledge of the risk factors that predispose patients with rheumatoid arthritis to the toxic effects of methotrexate on the lung may provide a rationale for monitoring high-risk patients and may facilitate their management.

Eighty-two patients were observed at the Dental Department at Parma University. Seventy-six of them had renal transplant and 6 liver transplant. They were in immunosuppressive therapy with cyclosporina, 42 of them were also in calcium antagonist therapy. Gingival hypertrophy was observed in 52 subjects (63.4%) 25 (30%) patients underwent surgical operation, 6 of them (24%) showed a relapse about 3 months after the first operation. Clinical data were measured in accordance with 5 indicators: the level of oral hygiene, cyclosporinemia, contemporaneous use of calcium antagonist, the duration of therapy and the DMF index. By the results obtained, it's possible to suppose that the gravity of the disease is related to the contemporaneous use of calcioantagonist, but it wasn't highly significant (p0.05). The degree of oral hygiene was decidedly in relation to the most severe forms of gingival hyperplasia (grade 2-3), (p0.001). No relation was found for the duration of therapy, distribution of the DMF index and the level of drugs in the blood.

In contrast to limb muscles, little is known about the role of the asymmetric tonic neck reflex (ATNR) on jaw-elevator muscles. The effect of rotation of the head on the H-reflex in the anterior part of the temporal muscle after masseteric nerve stimulation was evaluated. Eight healthy volunteers (7 males and 1 female, age range 18 to 27 years, mean age 22 years) participated. The masseteric M-response and the masseteric and temporal H-reflexes were elicited by stimulating the masseteric nerve using a monopolar needle technique. The electromyographic activity of the muscles was recorded by surface electrodes. The ATNR was modified by changing position of the head: 30 degrees rotation towards the stimulated side (+N), 30 degrees rotation towards the non-stimulated side (-N) and 0 degree central position (C). The heteronymous temporal H-reflex was elicited at a stimulus intensity of 120% maximal M-response at a frequency of 1 Hz, in random series of 5 to 20 sweeps, up to 30-50 sweeps for each position. On-line averaging was performed. A significant reduction of the H-reflex amplitude was observed in the -N position (p-0.02 paired "t"-test, p = 0.015 Wilcoxon signed rank test), while a significant increase was present in the +N position (p = 0.007 PTT and WSR). Also multivariate analysis yielded a significant influence of head rotation on H-reflex amplitude (p = 0.0032). It can be concluded that the ATNR has a significant influence on the H-reflex of the human temporal muscle.

The study focuses on the assessment of chromosomal damage associated with folate and vitamin B12 deficiency, and with cigarette smoking in a tissue directly exposed to cigarette smoke (buccal mucosa) while controlling for potential confounding factors. A cross-sectional study was carried out among 39 current smokers (CSs) and 60 noncurrent smokers (NCSs). Buccal mucosal cells, saliva, and blood samples were collected from each subject. The Health Habits and History Questionnaire (Block et al., 1986) was modified to obtain dietary and other relevant information. Methods used to measure folate, vitamin B12 levels, and the frequency of micronucleated cells in buccal mucosal cells gave reproducible results. The study results suggest that CSs have buccal mucosal folate and vitamin B12 levels that are lower than those among NCSs. CSs were three times more likely to have micronucleated buccal mucosal cells compared to NCSs. There appeared to be no association between low buccal folate and vitamin B12 levels chromosomal damage. The salivary vitamin B12 concentrations and plasma vitamin C and E concentrations, however, seem to be marginally protective against the occurrence of buccal mucosal micronuclei, whereas plasma beta-carotene seems to increase the occurrence of micronuclei. Overall, the results do not support the concept that localized folate and vitamin B12 deficiencies in the buccal mucosal cells of smokers are associated with chromosomal damage in those cells. The presence of vitamin B12 deficiencies in the buccal mucosal cells of smokers are associated with chromosomal damage in those cells. The presence of vitamin B12 in the immediate environment (saliva) and vitamin C and E in the plasma, however, appear to be marginally protective against chromosomal damage in buccal mucosal cells.

We compared the mother's recall of her child's antibiotic use with the information obtained from the child's health records, while studying the association between antibiotic use and prevalence of mutans streptococci among 102 (5-12 years) inner-city black children. Poor recall of the mother (concordance ratio = 62 percent; kappa = 0.18, p = 0.06) and the lower frequency reported by her (p = 0.02) biased the positive association between child's antibiotic use during the second year of life and oral presence of mutans streptococci toward the null value (Odds Ratio [OR] based on health records = 3.1, 95 percent Confidence Interval [CI] = 1.03-9.3; OR based on mother's recall = 1.6, 95 percent CI = 0.44-5.8). Multiple logistic regression analysis failed to identify any significant determinant of the accuracy of the mother's recall. Since mothers considerably underestimate child's use of antibiotics, at least among inner-city low income blacks, this method of data collection should be limited to circumstances where no other options are available, and such results should be interpreted with caution.

We examined 6 normal volunteers (3 males and 3 females, age 26-30). They were requested to clench as hard as they could until they felt pain. The experiment was repeated one hour later. Emg was recorded during the fatiguing exercise and the recovery period. We couldn't determine the muscle conduction velocity, probably because of the anatomy of the temporal muscle. The mean of the power spectrum showed wide variability and proved unsuitable for clinical applications, both for diagnosis and follow-up.

High plasma homocyst(e)ine (Hcy) concentrations may be a determinant of coronary artery disease (CAD). Folate and vitamin B-12 are required for the primary metabolic pathway to reduce Hcy concentrations. The interrelationships of Hcy and these two vitamin cofactors were investigated in a case-control study of 101 white males aged 30-50 y with angiographically demonstrated CAD, and 108 white male, similarly aged, control subjects living in the same community as the patients. The odds ratio (OR) of CAD per quartile increase of plasma Hcy concentration based on control values was 1.6 (95% CI: 1.3, 2.1). After age, HDL and LDL cholesterol, body mass index, smoking, hypertension, and diabetes were controlled for, Hcy remained an independent risk factor (OR: 1.4; 95% CI: 1.0, 2.0). The OR change per quartile increase of folate concentration was 0.8 (95% CI: 0.6, 1.0). This difference was reduced (OR: 0.9; 95% CI: 0.7, 1.2) after Hcy adjustment. No difference in the geometric mean of vitamin B-12 concentration was found between patients and control subjects, both 5.8 nmol/L. However, after Hcy and the other CAD risk factors were controlled for, the OR per quartile increase in vitamin B-12 concentration was 1.5 (95% CI: 1.0, 1.8). Reduction in plasma Hcy by interventions to increase plasma folate concentration may decrease CAD risk.

A case of Holmes-Adie syndrome was studied clinically and electrophysiologically. A total loss of tendon reflexes was observed in upper and lower limbs. The main electrophysiological finding was a marked increase of the central conduction time after stimulation of peroneal and tibial nerves. Motor evoked potentials in soleus muscle after transcranial magnetic stimulation showed normal threshold and latencies. We suggest that tendon areflexia could be a consequence of a dysfunction of somatosensory large diameter afferent fibres at the spinal level.

The association of nutritional factors with cervical dysplasia was examined through a case-control study. Analysis was conducted in 257 cases and 133 controls confirmed both by cytological examination and colposcopic findings. A 24-h dietary recall questionnaire was used to assess nutritional intake. Various risk factors (including age at first intercourse, number of sexual partners, parity, cigarette smoking, oral contraceptive use, human papillomavirus type 16 infection, and age and race) were adjusted for their potential confounding effects. While analyses were also performed to adjust for total calories, results were not changed significantly. Among the nutrients examined, vitamin A intake showed a significantly increased risk at the lowest quartile compared to the highest quartile, with an odds ratio of 2.2 (95% confidence interval, 1.2-4.2). A significant trend of increasing risk was also observed with lower intake of vitamin A (P = 0.05). Riboflavin showed increased risk at the two lower quartiles of intake with a trend test P value of 0.04. Increased risk was also found for lower intakes of vitamin C compared to the highest intake level. For folate, increased risk was found in the second highest quartile compared with the highest quartile with an odds ratio of 2.0 (95% confidence interval, 1.0-3.8). The calcium:phosphorus ratio showed an increased risk at the lowest level (odds ratio, 2.0; 95% confidence interval, 1.0-4.3). Insufficient intake of vitamin A, riboflavin, ascorbate, and folate is associated with an increased risk of cervical dysplasia.

The recently discovered apelin family of peptides mediate their actions by a single G-protein coupled receptor, APJ. We have previously shown that apelins have three major actions in the human cardiovascular system: endothelium-dependent vasodilatation; direct vasoconstriction by interacting with smooth muscle APJ receptor and increased cardiac contractility by action on cardiac myocytes. Our aim was to discover shorter sequences of (Pyr1)apelin-13 retaining agonist activity and use a computational ligand-based strategy to design cyclic peptide agonists and antagonists. Over 50 compounds were synthesised and tested in a competition binding assay. Functional assays for agonists measured vasoconstrictor action in endothelium-denuded human saphenous veins. Antagonist activity was measured in cyclic AMP assays against (Pyr1)apelin-13. Data are expressed as mean±SE, pD2=−log10EC50, Emax=maximum response. The predicted cleavage product of the angiotensin converting enzyme 2 (ACE-2), apelin-13(1–12), inhibited radiolabelled apelin binding and was identified as the shortest sequence potently constricting endothelium-denuded saphenous vein (pD2 9.07%±0.40, Emax 29.30%±9.43% KCl, n=5). The most potent cyclic analogue identified, MM07, inhibited binding with a KD=86%±30 nM, (n=3) and pD2 10.53%±0.24, Emax 21.80%±5.72% KCl, n=3) with a comparable potency and efficacy to (Pyr1)apelin-13 (pD2=8.8%±0.3, Emax 26%±4%, n=15). MM54 inhibited binding, KD=3.42%±0.45 μmol/l, (n=3) and was identified as an antagonist with a pA2 value of 5.9 in a cyclase inhibition assay. The novel cyclic peptide MM07 retains potency and we have identified the first apelin receptor antagonist, MM54 as a pharmacological tool to characterise the apelin system and in the design of small molecule drugs.

The clinical involvement of the facial nerve is a rare finding among the initial symptoms of acoustic neurinomas. However, compression of the facial nerve is a common intraoperative finding. Blink reflex was recorded in 20 patients affected by cerebellar-pontine angle tumor confirmed at surgery. Recordings were also made of the M-response of the facial nerve from the naso-labial folds. In 6 cases jaw reflex was also recorded. In summary, these electrophysiological studies revealed a facial nerve damage in 13 and a trigeminal nerve dysfunction in 2 out of 18 clinically unaffected patients. The combined study of the 3 tests proved to be useful when the blink reflex showed an isolated R1 delay, that is, in cases in which the level of damage along the trigemino-facial reflex arc cannot be defined by the recording of the blink reflex alone.

To test the hypothesis that nutritional deficiency affects the incidence of cervical dysplasia in young women.Case-control study. Participants were derived from community family-planning clinics and referrals to a colposcopy center.A total of 726 subjects were screened, yielding 294 cases of dysplasia and 170 controls defined by coexistent cytologic and colposcopic evidence.Planned prior to data collection. Odds ratios were computed using logistic regression models to evaluate association between cervical dysplasia and sociodemographic, sexual, and reproductive factors; smoking; oral contraceptive use; human papillomavirus (HPV) infection; and 12 nutritional indices determined by blind analysis of nonfasting blood specimens.The number of sexual partners, parity, oral contraceptive use, and HPV-16 infection were significantly associated with cervical dysplasia. Plasma nutrient levels were generally not associated with risk. However, red blood cell folate levels at or below 660 nmol/L interacted with HPV-16 infection. The adjusted odds ratio for HPV-16 was 1.1 among women with folate levels above 660 nmol/L but 5.1 (95% confidence interval, 2.3 to 11) among women with lower levels. Interactions of red blood cell folate levels with cigarette smoking and parity were also present but were not statistically significant.Low red blood cell folate levels enhance the effect of other risk factors for cervical dysplasia and, in particular, that of HPV-16 infection.