Dental Perspectives in Fibrous Dysplasia and McCune-Albright Syndrome

McCune-Albright syndrome (MAS) is a rare multisystem disorder characterized by the triad of polyostotic fibrous dysplasia (PFD), endocrine disorders and café-au-lait skin pigmentation. Ninety percent of MAS patients have FD lesions in the craniofacial area, resulting in significant orofacial deformity, dental disorders, bone pain and compromised oral health. Maxillo-mandibular FD is also associated with dental developmental disorders, malocclusion, and high caries index. There is limited data on the outcomes of dental treatments in maxillo-mandibular FD/MAS patients, because clinicians and researchers have limited access to patients, and there are concerns that dental surgery may activate quiescent jaw FD lesions to grow aggressively. This report highlights current perspectives on dental management issues associated with maxillo-mandibular FD within the context of MAS

Neuropathic-like pain in fibrous dysplasia/McCune-Albright syndrome

Context: Pain is a major symptom in adults with fibrous dysplasia/McCune-Albright syndrome (FD/MAS) and response to current treatments, including bisphosphonates and standard analgesics (nonsteroidal anti-inflammatory drugs and opiates) is unpredictable. No studies have explored whether the type of pain is variable in this patient group. Objective: To determine the frequency of neuropathic-like pain in patients with FD/MAS. Design: Retrospective, dual registry study. Setting: Community. Patients: FD/MAS online registries: the US-based Familial Dysautonomia Foundation (FDF) and the UK-based Rare and Undiagnosed Diseases (RUDY) study. Intervention: Subjects completed questionnaires to evaluate the presence of features of neuropathic-like pain (painDETECT) and the impact on sleep quality (Pittsburgh Sleep Quality Index) and mental health (Hospital Anxiety and Depression Scale). Descriptive statistics were used to characterize the prevalence and associated burden of neuropathic-like pain. Main Outcome Measures: Incidence of neuropathic, nociceptive, and unclear pain. Results: Of 249 participants, one third experienced neuropathic-like pain. This group had statistically significantly (P  Conclusions Neuropathic-like pain is common in patients with FD/MAS and associated with worse quality of life. Evaluation of pain in patients with FD/MAS should include assessment of neuropathic-like pain to guide personalized approaches to treatment and inform future research

Stable carbon isotopes of dissolved inorganic carbon for a zonal transect across the subpolar North Atlantic Ocean in summer 2014

The stable carbon isotope composition of dissolved inorganic carbon (δ13CDIC) in seawater was measured in samples collected during June–July 2014 in the subpolar North Atlantic. Sample collection was carried out on the RRS James Clark Ross cruise JR302, part of the “Radiatively Active Gases from the North Atlantic Region and Climate Change” (RAGNARoCC) research programme. The observed δ13CDIC values for cruise JR302 fall in a range from −0.07 to +1.95 ‰, relative to the Vienna Pee Dee Belemnite standard. From duplicate samples collected during the cruise, the 1σ precision for the 341 results is 0.08 ‰, which is similar to our previous work and other studies of this kind. We also performed a cross-over analysis using nearby historical δ13CDIC data, which indicated that there were no significant systematic offsets between our measurements and previously published results. We also included seawater reference material (RM) produced by A. G. Dickson (Scripps Institution of Oceanography, USA) in every batch of analysis, enabling us to improve upon the calibration and quality-control procedures from a previous study. The δ13CDIC is consistent within each RM batch, although its value is not certified. We report δ13CDIC values of 1.15 ± 0.03 ‰ and 1.27 ± 0.05 ‰ for batches 141 and 144 respectively. Our JR302 δ13CDIC data can be used – along with measurements of other biogeochemical variables – to constrain the processes that control DIC in the interior ocean, in particular the oceanic uptake of anthropogenic carbon dioxide and the biological carbon pump. Our δ13CDIC results are available from the British Oceanographic Data Centre – doi:10.5285/22235f1a-b7f3-687f-e053-6c86abc0c8a6

Evidence for a Heterogeneous Distribution of Water in the Martian Interior

The abundance and distribution of H2O within the terrestrial planets, as well as its timing of delivery, is a topic of vital importance for understanding the chemical and physical evolution of planets and their potential for hosting habitable environments. Analysis of planetary materials from Mars, the Moon, and the eucrite parent body (i.e., asteroid 4Vesta) have confirmed the presence of H2O within their interiors. Moreover, H and N isotopic data from these planetary materials suggests H2O was delivered to the inner solar system very early from a common source, similar in composition to the carbonaceous chondrites. Despite the ubiquity of H2O in the inner Solar System, the only destination with any prospects for past or present habitable environments at this time, outside of the Earth, is Mars. Although the presence of H2O within the martian interior has been confirmed, very little is known regarding its abundance and distribution within the martian interior and how the martian water inventory has changed over time. By combining new analyses of martian apatites within a large number of martian meteorite types with previously published volatile data and recently determined mineral-melt partition coefficients for apatite, we report new insights into the abundance and distribution of volatiles in the martian crust and mantle. Using the subset of samples that did not exhibit crustal contamination, we determined that the enriched shergottite mantle source has 36-73 ppm H2O and the depleted shergottite mantle source has 14-23 ppm H2O. This result is consistent with other observed geochemical differences between enriched and depleted shergottites and supports the idea that there are at least two geochemically distinct reservoirs in the martian mantle. We also estimated the H2O content of the martian crust using the revised mantle H2O abundances and known crust-mantle distributions of incompatible lithophile elements. We determined that the bulk martian crust has approximately 1400 ppm H2O, which is likely distributed toward the martian surface. This crustal water abundance would equate to a global equivalent layer (GEL) of water at a depth of-229 m, which can account for at least some of the surface features on Mars attributed to flowing water and may be sufficient to support the past presence of a shallow sea on Mars' surface

Insights into the Martian Regolith from Martian Meteorite Northwest Africa 7034

Everything we know about sedimentary processes on Mars is gleaned from remote sensing observations. Here we report insights from meteorite Northwest Africa (NWA) 7034, which is a water-rich martian regolith breccia that hosts both igneous and sedimentary clasts. The sedimentary clasts in NWA 7034 are poorly-sorted clastic siltstones that we refer to as protobreccia clasts. These protobreccia clasts record aqueous alteration process that occurred prior to breccia formation. The aqueous alteration appears to have occurred at relatively low Eh, high pH conditions based on the co-precipitation of pyrite and magnetite, and the concomitant loss of SiO2 from the system. To determine the origin of the NWA 7034 breccia, we examined the textures and grain-shape characteristics of NWA 7034 clasts. The shapes of the clasts are consistent with rock fragmentation in the absence of transport. Coupled with the clast size distribution, we interpret the protolith of NWA 7034 to have been deposited by atmospheric rainout resulting from pyroclastic eruptions and/or asteroid impacts. Cross-cutting and inclusion relationships and U-Pb data from zircon, baddelleyite, and apatite indicate NWA 7034 lithification occurred at 1.4-1.5 Ga, during a short-lived hydrothermal event at 600-700 C that was texturally imprinted upon the submicron groundmass. The hydrothermal event caused Pb-loss from apatite and U-rich metamict zircons, and it caused partial transformation of pyrite to submicron mixtures of magnetite and maghemite, indicating the fluid had higher Eh than the fluid that caused pyrite-magnetite precipitation in the protobreccia clasts. NWA 7034 also hosts ancient 4.4 Ga crustal materials in the form of baddelleyites and zircons, providing up to a 2.9 Ga record of martian geologic history. This work demonstrates the incredible value of sedimentary basins as scientific targets for Mars sample return missions, but it also highlights the importance of targeting samples that have not been overprinted by metamorphic processes, which is the case for NWA 7034

Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>Community-acquired (CAP) and nosocomial pneumonias contribute substantially to morbidity and hospital resource utilization. Hyponatremia, occurring in >1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes.</p> <p>Methods</p> <p>To explore how hyponatremia is associated with outcomes in hospitalized patients with pneumonia, we analyzed a large administrative database with laboratory component from January 2004 to December 2005. Hyponatremia was defined as at least two [Na⁺] < 135 mEq/L within 24 hours of admission value.</p> <p>Results</p> <p>Of 7,965 patients with pneumonia, 649 (8.1%) with hyponatremia were older (72.4 ± 15.7 vs. 68.0 ± 22.0, p < 0.01), had a higher mean Deyo-Charlson Comorbidity Index Score (1.7 ± 1.7 vs. 1.6 ± 1.6, p = 0.02), and higher rates of ICU (10.0% vs. 6.3%, p < 0.001) and MV (3.9% vs. 2.3%, p = 0.01) in the first 48 hours of hospitalization than patients with normal sodium. Hyponatremia was associated with an increased ICU (6.3 ± 5.6 vs. 5.3 ± 5.1 days, p = 0.07) and hospital lengths of stay (LOS, 7.6 ± 5.3 vs. 7.0 ± 5.2 days, p < 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). After adjusting for confounders, hyponatremia was associated with an increased risk of ICU (OR 1.58, 95% CI 1.20–2.08), MV (OR 1.75 95% CI 1.13–2.69), and hospital death (OR 1.3, 95% CI 0.90–1.87) and with increases of 0.8 day to ICU and 0.3 day to hospital LOS, and over $1,300 to total hospital costs.</p> <p>Conclusion</p> <p>Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. Studies in this large population are needed to explore whether prompt correction of [Na⁺] may impact these outcomes.</p

Media Reporting of Health Interventions: Signs of Improvement, but Major Problems Persist

Background: Studies have persistently shown deficiencies in medical reporting by the mainstream media. We have been monitoring the accuracy and comprehensiveness of medical news reporting in Australia since mid 2004. This analysis of more than 1200 stories in the Australian media compares different types of media outlets and examines reporting trends over time. Methods and Findings: Between March 2004 and June 2008 1230 news stories were rated on a national medical news monitoring web site, Media Doctor Australia. These covered a variety of health interventions ranging from drugs, diagnostic tests and surgery to dietary and complementary therapies. Each story was independently assessed by two reviewers using ten criteria. Scores were expressed as percentages of total assessable items deemed satisfactory according to a coding guide. Analysis of variance was used to compare mean scores and Fishers exact test to compare proportions. Trends over time were analysed using un-weighted linear regression analysis. Broadsheet newspapers had the highest average satisfactory scores: 58% (95% CI 56–60%), compared with tabloid newspapers and online news outlets, 48% (95% CI 44–52) and 48% (95% CI 46–50) respectively. The lowest scores were assigned to stories broadcast by human interest/current affairs television programmes (average score 33% (95% CI 28–38)). While there was a non- significant increase in average scores for all outlets, a significant improvement was seen in the online news media: a rise of 5.1% (95%CI 1.32, 8.97; P 0.009). Statistically significant improvements were seen in coverage of the potential harms of interventions, the availability of treatment or diagnostic options, and accurate quantification of benefits. Conclusion: Although the overall quality of medical reporting in the general media remains poor, this study showed modest improvements in some areas. However, the most striking finding was the continuing very poor coverage of health news by commercial current affairs television programs

A conserved fungal glycosyltransferase facilitates pathogenesis of plants by enabling hyphal growth on solid surfaces

Article Authors Metrics Comments Related Content Abstract Author summary Introduction Results and discussion Conclusions Methods Supporting information Acknowledgments References Reader Comments (0) Media Coverage (0) Figures Abstract Pathogenic fungi must extend filamentous hyphae across solid surfaces to cause diseases of plants. However, the full inventory of genes which support this is incomplete and many may be currently concealed due to their essentiality for the hyphal growth form. During a random T-DNA mutagenesis screen performed on the pleomorphic wheat (Triticum aestivum) pathogen Zymoseptoria tritici, we acquired a mutant unable to extend hyphae specifically when on solid surfaces. In contrast “yeast-like” growth, and all other growth forms, were unaffected. The inability to extend surface hyphae resulted in a complete loss of virulence on plants. The affected gene encoded a predicted type 2 glycosyltransferase (ZtGT2). Analysis of >800 genomes from taxonomically diverse fungi highlighted a generally widespread, but discontinuous, distribution of ZtGT2 orthologues, and a complete absence of any similar proteins in non-filamentous ascomycete yeasts. Deletion mutants of the ZtGT2 orthologue in the taxonomically un-related fungus Fusarium graminearum were also severely impaired in hyphal growth and non-pathogenic on wheat ears. ZtGT2 expression increased during filamentous growth and electron microscopy on deletion mutants (ΔZtGT2) suggested the protein functions to maintain the outermost surface of the fungal cell wall. Despite this, adhesion to leaf surfaces was unaffected in ΔZtGT2 mutants and global RNAseq-based gene expression profiling highlighted that surface-sensing and protein secretion was also largely unaffected. However, ΔZtGT2 mutants constitutively overexpressed several transmembrane and secreted proteins, including an important LysM-domain chitin-binding virulence effector, Zt3LysM. ZtGT2 likely functions in the synthesis of a currently unknown, potentially minor but widespread, extracellular or outer cell wall polysaccharide which plays a key role in facilitating many interactions between plants and fungi by enabling hyphal growth on solid matrices