変形性関節症に関連する遺伝子多型についてのシステマティックレビュー

Osteoarthritis (OA) is the complex multifactorial disease of which the etiology is not yet well defined, and recently increasing attention has focused on the genetic risk factors of OA. The purpose of this study was to analyze the published literature on the association between genetic polymorphisms and OA by a systematic review method. Papers published from 1995 to March 2005 with the keywords cytokines, polymorphisms and OA, as well as papers among the references in these papers were obtained from Plumbed. The inclusion criteria were papers on the relationship between genetic polymorphisms of the Interleukin (IL)-1, 1L-1 receptor antagonist (RA), or the Tumor Necrosis Factor (TNF)-alpha and OA, and the paper includes retrospective studies that compare the prevalence of genetic polymorphisms of OA and healthy controls. Studies with fewer than ten subjects were excluded. Only three papers met the selection criteria, and these were reviewed. Evidence-based medicine data tables were drawn for each of the three papers respectively. There were significant differences (P=0.0007) in the frequencies of the T allele of IL-1β C3954T in the genetic polymorphism between OA patients with total hip or knee replacement and healthy controls. The evidence from the articles reviewed indicated a statistically significant correlation between OA and some specific polymorphisms of IL-1, but some of the reports showed bidirectional results. Further rigorous studies based on well-defined disease and control criteria will be required to contribute to the prevention and management of OA

Oral hypofunction in the older population : Position paper of the Japanese Society of Gerodontology in 2016

Background: There is growing international interest in identifying the effects of ageing on oral health and on appropriate strategies for managing oral disorders. The Japanese Society of Gerodontology (JSG), as the official representative of researchers and clinicians interested in geriatric dentistry in Japan, makes several recommendations on the concept of “oral hypofunction.” Aims: This study proposes diagnostic criteria and management strategies to reduce the risk of oral hypofunction among older people. Conceptual Framework: We define oral hypofunction as a presentation of 7 oral signs or symptoms: oral uncleanness; oral dryness; decline in occlusal force; decline in motor function of tongue and lips; decline in tongue pressure; decline in chewing function; and decline in swallowing function. The criteria of each symptom were determined based on the data of previous studies, and oral hypofunction was diagnosed if the criteria for 3 or more signs or symptoms were met. Conclusions: We recommend that more evidence should be gathered from clinical studies and trials to clarify our diagnostic criteria and management strategies

Increase in plasma thrombin-activatable fibrinolysis inhibitor may not contribute to thrombotic tendency in antiphospholipid syndrome because of inhibitory potential of antiphospholipid antibodies toward TAFI activation

Background: The causes of thrombosis in antiphospholipid syndrome (APS) remain unknown, though several hypotheses in regard to hypofibrinolysis have been proposed. Objective: To clarify the mechanism, we measured plasma levels of thrombin-activatable fibrinolysis inhibitor (TAFI) in APS patients. Methods and Results: Both the TAFI antigen (TAFI:Ag) level measured with an ELISA, and thrombin-thrombomodulin-dependent TAFI activity (TAFI:Ac) were elevated in 68 APS patients as compared with those in 66 healthy controls, though they were lower than those in 46 patients with autoimmune diseases. As for the influence of antiphospholipid antibodies (aPL) on TAFI levels, the mean TAFI:Ac level in 39 SLE patients positive for APS was significantly lower than that in 27 SLE patients without APS, whereas there was no difference in TAFI:Ag between those groups. Furthermore, purified IgG from patients positive for aPL, and monoclonal aPL (EY2C9 and 23-1D) inhibited the activation of TAFI in a concentration dependent manner. Conclusion: These results suggest that aPL inhibits TAFI activation by affecting the function of thrombomodulin-thrombin complex through phospholipids. Although TAFI in plasma is elevated in autoimmune diseases including APS, we concluded that an elevated level is not likely a risk factor for thrombosis in APS patients, because of the inhibition of TAFI activation by aPL

Factors associated with sports-related dental injuries among young athletes: a cross-sectional study in Miyagi prefecture

Abstract Background Sports-related dental injuries, such as tooth fracture, loosening, and avulsion, are a major concern among young athletes because they directly impair oral function. Although the preventive efficacy of mouthguards has been well established, the prevalence of sports-related dental injuries remains high among young athletes. The aim of this study is to identify the variables contributing to the risk of sports-related dental injuries by conducting a survey on large population of young athletes in Miyagi prefecture. Methods A cross-sectional study was conducted with school-aged athletes (aged 6–15 years, n = 5735) using a self-reported questionnaire. The questionnaire examined general variables, including sex, age, and body mass index; sports-related variables, including sports-type, team level, activity schedule, break time, and verbal/physical abuse by coaches; and lifestyle variables related to free time, including screen-time and sleep duration. Their associations with sports-related dental injuries were examined using multivariate logistic regression models. Results The prevalence of sports-related dental injuries was 13.3% (763 of 5735 young athletes) and was higher in males (14.3%, 592 of 4132) than in females (10.7%, 171 of 1603; adjusted odds ratios [ORs] and 95% confidence intervals [CIs]: 1.48 [1.22–1.79], p < 0.001). After stratification according to sex, significant associations with the prevalence of sports-related dental injuries were evident for three variables—insufficient break time, verbal abuse, and physical punishment—in males (adjusted ORs [95% CI]: 1.35 [1.03–1.77], p = 0.032; 1.31 [1.05–1.62], p = 0.015; and 1.36 [1.06–1.75], p = 0.016, respectively) but not in females (adjusted ORs [95% CI]: 0.88 [0.53–1.47], p = 0.623; 1.29 [0.87–1.91], p = 0.206; and 0.97 [0.57–1.63], p = 0.894, respectively). Conclusions Although our results might be based on the individual athlete’s self-perception to the sports-related variables, our results suggest that insufficient break time, verbal abuse, and physical punishment from coaches are positively associated with the prevalence of sports-related dental injuries in young male athletes