Morphological Changes of Gingiva in Streptozotocin Diabetic Rats

Gingivitis and periodontitis are chronic bacterial diseases of the underlying and surrounding tooth tissues. Diabetes mellitus is responsible for tooth deprivation both by decay and periodontal disease. The streptozotocin-induced diabetes results in a diabetic status in experimental animals similar to that observed in diabetes patients. The aim of the study was to investigate the relationship between the gingival lesions and the microangiopathy changes in streptozotocin-induced diabetes mellitus. Forty male Wistar rats were divided into two groups (control and experimental). Diabetes mellitus was induced by 45 mg/kg IV streptozotocin. The histological investigation of the marginal gingival and the relevant gingival papilla showed inflammation of the lamina propria and the squamous epithelium as well as marked thickness of the arteriole in the diabetic group, but no changes were observed in the control group. The results suggested a probable application of a routine gingival histological investigation in diabetic patients in order to control the progress of disease complications. It may be concluded that histological gingival investigation can be used as a routine assay for the control of the diabetic disease and prevention of its complications

Genomic profiling reveals spatial intra-tumor heterogeneity in follicular lymphoma

We are indebted to the patients for donating tumor specimens as part of this study. The authors thank the Centre de Ressources Biologiques (CRB)-Santé of Rennes (BB-0033-00056) for patient samples, Queen Mary University of London Genome Centre for Illumina Miseq sequencing, and the support by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London for Illumina Hiseq sequencing. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. This work was supported by grants from the Kay Kendall Leukaemia Fund (KKL 757 awarded to J.O.), Cancer Research UK (22742 awarded to J.O., 15968 awarded to J.F., Clinical Research Fellowship awarded to S.A.), Bloodwise through funding of the Precision Medicine for Aggressive Lymphoma (PMAL) consortium, Centre for Genomic Health, Queen Mary University of London, Carte d’Identité des Tumeurs (CIT), Ligue National contre le Cancer, Pôle de biologie hospital universitaire de Rennes, CRB-Santé of Rennes (BB-0033-00056), and CeVi/Carnot program

Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

<p>Abstract</p> <p>Background</p> <p>The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1^stJanuary 2009 and 31st December 2010.</p> <p>Results</p> <p>Overall, 2452 (49.4%) out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6%) needed vascular surgical intervention.</p> <p>Conclusions</p> <p>The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.</p

Missed diagnosis and overtreatment of COPD among smoking primary care population in central Greece: old problems persist

Background: The diagnosis of COPD is not always consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy in daily clinical practice, especially in primary care. This study aimed to estimate the overall COPD prevalence and severity, to identify differences between newly and previously diagnosed patients, and to evaluate the potential COPD overtreatment in a smoking population attending a primary care spirometry surveillance program. Methods: A study was conducted in 10 primary health care centers of Central Greece during a 7-month period. Eligible participants were aged ≥40 years and were either current smokers or exsmokers. Results: A total of 186 subjects were included (68% males, mean age 62.3±12.6 years, mean life-time tobacco exposure 50 pack-years). COPD prevalence was 17.8%, identified to be higher in elderly males. Forty-two percent of the COPD group were newly diagnosed patients, who were of younger age, current smokers, presented with less dyspnea and better health status, and mainly appeared with mild-to-moderate disease. Interestingly, 61.4% of non-COPD and 85.7% of newly diagnosed COPD individuals had been using inhaled medication under primary care provider’s prescription without ever undergoing spirometry or further evaluation by a pulmonologist; thus, the phenomena of COPD overdiagnosis and missed diagnosis came into the spotlight. Moreover, only 26.3% of known COPD patients were properly medicated according to GOLD guidelines, while half of them were inappropriately treated with triple inhaled therapy. Conclusion: We reported a significant prevalence of COPD in smoking population attending this spirometry program. A remarkable proportion of COPD patients were undiagnosed and made case finding worthwhile. Underutilization of spirometry in the diagnosis and management of COPD as well as general practitioners’ nonadherence to the GOLD treatment guidelines was confirmed by our data. These findings highlight the need for a major overhaul and culture change in primary care settings of Central Greece. © 2018 Stafyla et al

Missed diagnosis and overtreatment of COPD among smoking primary care population in Central Greece: old problems persist

Eirini Stafyla, Ourania S Kotsiou, Konstantina Deskata, Konstantinos I Gourgoulianis Department of Respiratory Medicine, School of Medicine, University of Thessaly, Biopolis, Larissa, Thessaly, Greece Background: The diagnosis of COPD is not always consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy in daily clinical practice, especially in primary care. This study aimed to estimate the overall COPD prevalence and severity, to identify differences between newly and previously diagnosed patients, and to evaluate the potential COPD overtreatment in a smoking population attending a primary care spirometry surveillance program. Methods: A study was conducted in 10 primary health care centers of Central Greece during a 7-month period. Eligible participants were aged &ge;40&nbsp;years and were either current smokers or exsmokers. Results: A total of 186 subjects were included (68% males, mean age 62.3&plusmn;12.6&nbsp;years, mean life-time tobacco exposure 50 pack-years). COPD prevalence was 17.8%, identified to be higher in elderly males. Forty-two percent of the COPD group were newly diagnosed patients, who were of younger age, current smokers, presented with less dyspnea and better health status, and mainly appeared with mild-to-moderate disease. Interestingly, 61.4% of non-COPD and 85.7% of newly diagnosed COPD individuals had been using inhaled medication under primary care provider&rsquo;s prescription without ever undergoing spirometry or further evaluation by a pulmonologist; thus, the phenomena of COPD overdiagnosis and missed diagnosis came into the spotlight. Moreover, only 26.3% of known COPD patients were properly medicated according to GOLD guidelines, while half of them were inappropriately treated with triple inhaled therapy. Conclusion: We reported a significant prevalence of COPD in smoking population attending this spirometry program. A remarkable proportion of COPD patients were undiagnosed and made case finding worthwhile. Underutilization of spirometry in the diagnosis and management of COPD as well as general practitioners&rsquo; nonadherence to the GOLD treatment guidelines was confirmed by our data. These findings highlight the need for a major overhaul and culture change in primary care settings of Central Greece. Keywords: COPD management, GOLD guidelines, treatment, spirometry program, primary car

The Influence of Diphenhydramine Administration on Lidocaine Protein Binding in Rat Serum and Tissues

Lidocaine is an amide type local anaesthetic and diphenhydramine is a first-generation antihistamine drug. The aim of the present study was to investigate the influence of diphenhydramine co-administration on the extent of lidocaine binding to rat serum and maxillofacial tissue proteins in order to determine a possible synergistic action that could enhance lidocaine’s anaesthetic/analgesic activity. Twenty-eight Wistar rats divided in 4 groups (I, II, Ill, IV) received lidocaine in the masseter muscle. Groups II and IV received diphenhydramine per os 2 h before lidocaine administration. Groups I and II were sacrificed after 15 min and groups III and IV 30 min after lidocaine injection. Masseter and mandible samples were isolated and incubated in NaCl 0.9% solution while serum was obtained through blood centrifugation. Free lidocaine fraction in the tissues’ incubation medium and the serum was obtained through ultrafiltration and determined by radioscopic method in a beta-counter Lidocaine’s free fraction levels (mu g g(-1)) were enhanced after 15 min under diphenhydramine co-administration in all samples from (7.1319 +/- 1.4066) x 10(-4) to (12.1097 +/- 3.7528) x 10(-4) in serum, from 0.9339 +/- 0.3077 to 2.6791 +/- 1.1648 in masseter (p&lt;0.01) and from 0.3898 +/- 0.0879 to 0.6918 +/- 0.2743 in mandible (p&lt;0.05). A statistically significant increase in free anaesthetic levels was also noticed after 30 min in serum from (8.6227 +/- 0.6902) x 10(-4) to (13.9518 +/- 4.9849) x 10(-4) (p&lt;0.05). Lidocaine’s increase could probably be attributed to mechanisms influencing its protein binding properties. Consequently, a possible synergistic action of the two drugs’ combination is demonstrated which could enhance lidocaine’s anaesthetic action, affecting depth and duration of anaesthesia