Temporomandibular disorders and oral features in idiopathic inflammatory myopathies (Iims) patients: An observational study

Aim: Inflammatory idiopathic myopathies (IIMs) are inflammatory processes affecting skeletal musculature and extramuscular organs. Temporomandibular disorders (TMD) involve jaw muscles and temporomandibular joint. The aim of this observational study was to investigate the prevalence of the main TMD symptoms and signs as well as oral implications in IIM patients. Methods: The study group included 54 patients (42 women and 12 men), 22 of whom affected by dermatomyositis (DM), 29 by polymyositis (PM) and 3 by inclusion body myositis (IBM). A group of 54 patients not affected by this disease, served as CG. Oral and TMD signs and symptoms were evaluated by means of a questionnaire and through clinical examination. Results: About oral symptoms, the study group complained more frequently dysgeusia, with loss of taste or unpleasant taste (p<0.0001) and feeling of burning mouth (9.4% versus 0 controls). Xerostomia was more prevalent in the study group respect to the CG (p<0.0001). Dysphagia was reported by 48.1% of IIM patients while was absent in CG (p<0.0001). About oral signs, cheilitis (p<0.05) and oral ulcers (p<0.05) were significantly more frequent in CG. As regard to TMD symptoms, arthralgia and tinnitus didn’t showed significant differences between the two groups, while neck/shoulders and masticatory muscle pain was significantly more referred in IIM patients than in the CG (p<0.05). About TMJ signs, sounds were overlapping in the two groups: click=11.1% in both IIM patients and CG (p<0.05), crepitation in 11.1% of IIM and 9.3% of controls (p>0.05). No significant difference was detected about deflection (9.3%, p>0.05), while deviation was wider in CG (p>0.05). Active opening and lateralities showed no significant differences, while endfeel was significantly increased in IIM group for a higher presence of muscular contracture. Bruxism was present only in CG. Conclusion: The data collected from this observational study seem to support the existence of a relationship between the prevalence of TMD symptoms and signs as well as oral features in patients with myositis. A remarkable reduction of salivary flow and dysphagia were more frequent and severe in IIM patients, as well as muscle contracture and myofacial pain evoked by palpation, this result being highly significant

Microradiography as a useful technique for the rapid detection of skeletal anomalies in early sea bream juveniles

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Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake

Objectives. To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Materials and Methods. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48h after surgery. Results. oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). Conclusions. This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders

Autologous bone marrow mononuclear cells (Bmmcs) for the treatment of uncomplicated grade 2 ununited anconeal process (uap) in six dogs: Preliminary results

The aim of this study was to report the results of autologous bone marrow mononuclear cell (BMMC) transplantation as a minimally invasive treatment for grade 2 UAP in dogs. This was an observational case series on six German shepherd dogs affected by grade 2 UAP as defined according to their clinical condition as well as radiographic and CT findings. Bone marrow was collected from the iliac crest and the mononuclear fraction was separated with density gradient centrifugation. Cells were suspended in fibrin glue before BMMC administration and implanted via transcutaneous injection under IB or CT guidance, using a spinal needle directly inserted into the ossification centre between the anconeal process and the olecranon. Clinical and radiographic follow-up was performed for up to 6 months. Microradiographic assessment was performed on one dog that died of other causes. A progressive reduction of pain within 3 weeks after BMMC administration was observed in all dogs, with gradually increased weight bearing on the affected limb. Radiographic and CT follow-up revealed the progressive fusion of the ossification centre at 90 days without any signs of secondary OA. The examination of microradiographs showed newly formed bone tissue in which a residue of calcified cartilage was present at the site of BMMC implantation. On the basis of these results, BMMC therapy for grade 2 UAP may be considered to be an effective and minimally invasive treatment option for dogs

Irisin, the novel myokine responsible for benefits of physical exercise on bone

It has been recently reported that, after physical exercise activity, the skeletal muscle releases Irisin, the newly identified myokine able of driving transition of white adipocytes into brown, following a phenomenon known as the browning response. This result suggested that skeletal muscle is crucial in the regulation of energy homeostasis, supporting its role as endocrine organ that targets adipose tissue by promoting energy expenditure. In accordance with this new finding, we demonstrated that conditioned media (CM) collected from primary myoblasts of exercised mice were able to induce osteoblast differentiation in a greater extent than those of mice housed in resting conditions and this effect is Irisin-mediated. In view of further proving the involvement of Irisin in bone metabolism, we validate its direct effect on osteoblasts by using r-Irisin. Here we show that phosphorylation of MAP kinase ERK and expression of Atf 4 (p<0,001), the key trascription factor of osteoblast differentiation, were significantly increased after Irisin treatment. Furthermore, ALP and pro-Collagen I mRNA resulted up regulated (p<0,001), as we already demonstrated by treating osteoblasts with conditioned medium from primary myoblasts of exercised mice. To recapitulate in vivo the effect of physical exercise, we injected mice with r-Irisin. Our results show that BV/TV of Irisin-treated mice was higher than vehicle-injected mice. In elderly, the severe decline of skeletal muscle function, known as Sarcopenia, is associated with impaired function of bone (Osteopenia) and these two simultaneous losses of function lead to increased risk of bone fractures. In order to reveal new strategies for treatment of sarcopenia and osteopenia, we also analyzed the effect of physical activity in old mice. Our findings demonstrate that mRNA levels of the most relevant bone proteins resulted up regulated in ex-vivo osteoblast obtained from exercised old mice compared with mice kept in resting conditions. Our data highlight a novel link in muscle-fat-bone axis demonstrating that Irisin targets bone tissue directly. Future perspectives, based on these studies, could satisfy the ongoing research of exercise-mimetic therapies with anabolic action on the skeleton

LIGHT/TNFSF14 regulates estrogen deficiency-induced bone loss

Bone loss induced by ovariectomy is due to the direct activity on bone cells and mesenchymal cells and to the dysregulated activity of bone marrow cells, including immune cells and stromal cells, but the underlying mechanisms are not completely known. Here, we demonstrate that ovariectomy induces the T-cell co-stimulatory cytokine LIGHT, which stimulates both osteoblastogenesis and osteoclastogenesis by modulating osteoclastogenic cytokine expression, including TNF, osteoprotegerin, and the receptor activator of nuclear factor-κB ligand (RANKL). Predictably, LIGHT-deficient (Tnfsf14−/−) mice are protected from ovariectomy-dependent bone loss, whereas trabecular bone mass increases in mice deficient in both LIGHT and T and B lymphocytes (Rag−/−Tnfsf14−/−) and is associated with an inversion of the TNF and RANKL/OPG ratio. Furthermore, women with postmenopausal osteoporosis display high levels of LIGHT in circulating T cells and monocytes. Taken together, these results indicate that LIGHT mediates bone loss induced by ovariectomy, suggesting that patients with postmenopausal osteoporosis may benefit from LIGHT antagonism. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd

The spatial aspects of fairness

As well as their family background, an individual's chances in life are determined by the opportunities available to them in their geographical context. This chapter therefore deals with the spatial aspects of fairness. It focuses, firstly, on socio-economic factors which are not randomly distributed in space (i.e. they have a geographical pattern). Secondly, it focuses, not on first nature geographical differences which cannot be changed (such as the presence of mountains), but on second nature geographical factors (such as access to basic services or hospitals) which can be altered and which are important in overcoming a region's natural disadvantages. It then links the two