Morphological Changes of Parotid Gland in Experimental Hyperlipidemia

Objective. The aim of this study was to investigate the role of hyperlipidemia in the microstructure of parotid gland and its possible amelioration through statin treatment on Wistar rats. Methods. Forty Wistar rats (111.06 ± 3.36 g) were divided into 4 groups (A1, A2 controls, B1, B2 experimental). Groups A1 and A2 consumed normal cereal rodents diet during the experimental hyperlipidemic mixture. The A2 and B2 were treated with simvastatin (Zocor) 40 mg/kg/daily p.o. for 3 months. Results. Total cholesterol, triglycerides, high density lipoproteins, and low density lipoproteins were increased in groups B1 and B2 while the parotid weight was decreased. The histological findings demonstrated changes in the parotid gland morphology of the B1 and B2, such as the presence of chronic inflammation, fibrosis, lipocytes, and foci of lymphocytic infiltration. Conclusions. The influence of statin tended to predominate over the chronic inflammation while the lipocytes were decreased and remodelling of the parotid's structure occurred

Morphine administration at reperfusion fails to improve postischaemic cardiac function but limits myocardial injury probably via heat-shock protein 27 phosphorylation

Background and objectives We explored the effects of morphine administration during reperfusion period after an index ischaemia as well as potential molecular mechanisms underlying this response. This is of important clinical value, as morphine is used routinely in cardiovascular anaesthesia and in the emergency management of cardiac infarction. Methods Male Wistar rat hearts, mounted on constant flow isolated Langendorff preparation, were subjected to stabilization, 30 min of zero-flow global ischaemia and 45 min of reperfusion (CONT; n = 10). Morphine (10(-6) mol l(-1)) was administered only at reperfusion (MORPH; n = 10). Postischaemic recoveries of left ventricular developed pressure were expressed as percentage of the initial value. At the end of the experimental protocol, lactate dehydrogenase release in the perfusate was measured and the left ventricle was isolated and used for determination of oxidized actin, mitogen-activated protein kinase activation and heat-shock protein 27 phosphorylation. Results Left ventricular developed pressure percentage did not differ between groups, whereas lactate dehydrogenase release was significantly reduced in MORPH compared with CONT hearts. Left ventricular developed pressure percentage was negatively correlated with lactate dehydrogenase release in CONT hearts (r = -0.8, P = 0.006), whereas in MORPH hearts no correlation was found (r = -0.2, P = 0.57). Phosphorylated p38 mitogen-activated protein kinase, c-jun N-terminal protein kinases, extracellular signal-regulated kinases and Akt at 45 min of reperfusion were similar between groups. However, a 1.5-fold increase in phospho-heat-shock protein 27 was found in MORPH hearts compared with CONT hearts (P<0.05). Additionally, the ratio of oxidized actin to total actin was found to be 1.9-fold more in MORPH compared with CONT hearts (P<0.05). Conclusion Morphine administration at reperfusion does not affect cardiac function but limits the extent of myocardial injury, possibly through increased heat-shock protein 27 phosphorylation. Eur J Anaesthesiol 26:572-581 (C) 2009 European Society of Anaesthesiology

Conservative treatment of bisphosphonate-related osteonecrosis of the jaw in multiple myeloma patients

The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of Oral and Maxillofacial Surgeons criteria. Patients were managed with observation, oral antibacterial mouth rinse with chlorhexidine, oral antibiotics, pain control with analgesics, nonsurgical sequestrectomy with or without simultaneous administration of antibiotics, or major surgery with or without antibiotics. Healing of the lesions was achieved in 23 (60%) patients who were treated with conservative measures; the median time to healing was 12 months (95% CI: 4-21). The number of bisphosphonates infusions influenced the time to healing: the median time to healing for patients who received <16 infusions was 7 months and for those with >16 infusions was it 14 months P=0.017. We conclude that a primarily nonsurgical approach appears to be a successful management strategy for bisphosphonate-related ONJ. © 2014 Pelagia I. Melea et al