Interstitial and Langerhans' dendritic cells in chronic periodontitis and gingivitis

The aim of the present study was to compare quantitatively the distribution of dendritic cell subpopulations in chronic periodontitis and gingivitis. Fourteen biopsies from patients with chronic periodontitis and fifteen from patients with gingivitis were studied. An immunoperoxidase technique was used to quantify the number of Langerhans' cells (CD1a) and interstitial dendritic cells (factor XIIIa) in the oral and sulcular and junctional/pocket epithelia and in the lamina propria. A greater number of factor XIIIa+ dendritic cells in the lamina propria and CD1a+ dendritic cells in the oral epithelium were observed in gingivitis compared to the periodontitis group (p = 0.05). In the sulcular and junctional/pocket epithelia and in the lamina propria, the number of CD1a+ dendritic cells was similar in the gingivitis and periodontitis groups. In conclusion, the number of Langerhans' cells in the oral epithelium and interstitial dendritic cells in the lamina propria is increased in gingivitis compared to periodontitis, which may contribute to the different pattern of host response in these diseases

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Avaliação longitudinal da regeneração tecidual guiada no tratamento de lesões de bifurcação classe II : estudo clinico controlado randomico

Orientadores : Enilson Antonio Sallum, Antonio Wilson SallumTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O presente estudo avaliou clínica e radiograficamente os resultados da regeneração tecidual guiada (RTG) com uma membrana reabsorvível no tratamento de lesões de bifurcação classe II em molares inferiores durante 24 meses. Nove pacientes, cada um com duas lesões de bifurcação classe II comparáveis (18 lesões) foram avaliados. As lesões de bifurcação em cada paciente foram aleatoriamente designados para o grupo teste (técnica de RTG) ou controle (raspagem e alisamento radicular com acesso cirúrgico). Medidas clínicas e radiografias padronizadas foram obtidas antes do tratamento, e 6, 12, 18 e 24 meses após as cirurgias. A profundidade de sondagem apresentou melhora contínua significante durante 18 meses no grupo teste e 12 meses no grupo controle. Comparando as profundidades de sondagens ao longo de 24 meses à profundidade de sondagem inicial, as reduções foram significantes nos grupos teste e controle (P < 0,007, P < 0,0005, respectivamente), mas as diferenças entre os grupos não foram significantes em qualquer exame. No grupo controle houve uma tendência de ganho de nível clínico de inserção vertical aos 6 e 12 meses (P = 0,074 e P = 0,068, respectivamente); entretanto, houve perda de inserção e o que havia sido ganho foi perdido aos 18 meses. Aos 24 meses, o nível clínico de inserção vertical foi melhor no grupo teste do que no controle (P < 0,04). Houve ganho de nível clínico de inserção horizontal significante no grupo teste comparado ao grupo controle ao longo dos 24 meses (P <0,033). No grupo teste, 2 dos 9 defeitos apresentaram fechamento completo à sondagem, 1 foi convertido para classe I seis meses após as cirurgias, e 1 apresentou reabsorção radicular no fórnice da bifurcação, aos 24 meses, e foi extraído. Nenhum dos sítios controle mostrou completo fechamento ou conversão para classe I, e 2 foram convertidos para classe 111. O grupo teste mostrou perda de altura óssea, e o grupo controle ganho, aos 6 meses, sendo a diferença entre os grupos significante (P = 0,035); entretanto, a diferença entre grupos não foi significante aos 12, 18 e 24 meses. Houve ganhado significante na altura óssea no grupo teste no exame aos 24 meses (P = 0,015). No grupo controle, a altura óssea permaneceu estável durante os 24 meses. Concluindo, a RTG promoveu maior ganho de nível clínico de inserção horizontal e vertical, possibilidade de fechamento de lesões, além de maior estabilidade dos resultados ao longo de 24 meses e ganho de altura óssea comparado ao resultado aos 6 mesesAbstract: This study evaluated the treatment outcomes after guided tissue regeneration (GTR) with a resorbable membrane in class 11 furcation defects in mandibular molars over 24-month period. Nine patients with two comparable class 11 furcation defects (18 defects) were included. GTR was performed on the test group, and open flap debridement (OFD) was used as the control treatment. Clinical measurements and standardized radiographs were performed at baseline, and at 6, 12, 18 and 24 months. Probing depths continued to improve significantly over the 18-months study period in the GTR-group, and over 12-months in the OFD group. Compared to baseline, the reductions in the probing depth were significant over the 24-month period in test and control groups (P < 0.007, P < 0.0005, respectively), however the differences between test and control group were not significant at any exam. In the OFD-group there was a trend of gain of vertical clinical attachment levels for the 6 month-baseline and 12 month-baseline intervals (P = 0.074 and P = 0.068, respectively), however there was loss of CAL-v and the initial gain was lost at 18 months. At 24 months, the vertical clinical attachment evei was 12.31 mm for the GTR-group and 13.78 mm for OFD-group (P < 0.04). A significant improvement in the clinical attachment level horizontal was observed in the GTR-group compared to the OFD-group over 24 months (P < 0.03). In the GTR group, 2 out of 9 defects showed complete closure, one was converted to class I at 6 months, and one tooth was lost at 24 months because of root resorption. None of the control sites showed complete closure, and two of nine defects were class 111 at 12 months and 24 months. There was significant gain in bone height in the GTR group at 24 months (P = 0.015). Comparing GTR-group to OFD-group, there was significant loss of bone height in the GTR-group and gain in the OFD-group at 6 months (P = 0.035), however the inter-groups differences were not significant at 12, 18 and 24 months. In conclusion, GTR provided significant greater improvement than OFD in horizontal and vertical clinical attachment level, possibility of complete closure of lesions, as well as superior stability of the outcomes over the 24-month period and and gain in bone height compared to 6 month resultDoutoradoPeriodontiaDoutor em Clínica Odontológic

Factors associated with early and late failure of osseointegrated implant

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p53, p16 and Fhit Proteins Expressions in Chronic Esophagitis and Chagas Disease

Background: Models have suggested esophageal carcinogenesis can result front the alteration of sequences, leading to esophagitis, atrophy, dysplasia, carcinoma in situ and invasive carcinoma. While numerous genetic alterations have been reported in esophageal carcinogenesis, studies of benign lesions with precancerous potential are scarce. Materials and Methods: Immunohistochemistry was performed for p53, p16 and Fhit proteins in the esophageal mucosa from patients with Chagas disease (CD), chagasic megaesophagus (CM), chronic esophagitis (CE), esophageal squamous cell carcinoma (ESCC) and in normal mucosa (NM). Results: The proportion of p53-positive cases increased progressively according to the severity of the pathology CD (7.7%), CM (26.1%), CE (52.2%) and ESCC (100%). However, p16 and Fhit did not show any statistically significant differences among the groups. Conclusion: p53 overexpression is involved in the initial steps of esophageal carcinogenesis, supporting further evaluation of its utility as a marker in precursor lesions, conversely, losses of Fhit and p16 expression may not be significant.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

STAT3 expression in salivary gland tumours

The aim of the present study was to evaluate the signal transducer and activator of transcription (STAT3) expression, which is constitutively active in different types of malignant tumours, in salivary gland tumours. Fifty biopsies of salivary gland tumours (9 pleomorphic adenomas, 12 adenoid cystic carcinomas, 7 epithelial-myoepithelial carcinomas, 10 polymorphous low-grade adenocarcinomas and 12 mucoepidermoid carcinomas) and 10 normal. salivary glands were immunohistochemically labeled for STAT3 and Phospho-STAT3 (STAT3P). The labeled sections were quatitatively and quantitatively evaluated. The results showed that, in normal salivary gland, STAT3 was expressed in cytoplasm and STAT3P in nuclei of all tissue cells, except in large mucous acinar cells for which both antibodies were negative. In pleomorphic adenoma, the expression was the same as in normal glands. In malignant tumours, there were variations in the expression of these antibodies. The most important one was the presence of STAT3 in the nuclei of the malignant tumour cells, most evident in the cribriform-type of adenoid cystic carcinoma. Both toss and variation of STAT3P expression were also observed. The presence of STAT3 in the nuclei of malignant salivary gland tumours may represent an important event in oncogenesis probably contributing to tumour cell proliferation white blocking apoptosis. However, further investigation will. be necessary to support this hypothesis44543944