Efficacy of non-surgical periodontal therapy in reducing periodontal indexes in kidney-transplant patients

Efficacy of non-surgical periodontal therapy in reducing periodontal indexes in kidney-transplant patients. I. Casula, L. Zanardini*, M. Bianchi, V. Spotti, E. Marchesini Department of Medical and Surgical Specialties and Public Health Dentale - Dental School – University of Brescia, Italy Aim: kidney-transplant patient must take cyclosporine-A and calcium channel blockers chronically. Both medicines involve a gingival overgrowth (G.O.) as a collateral effect and this is due to their dosage: it appears 1-3 months after the beginning of the therapy. The prevalence of the G.O. is 84%. The G.O. originates from anterior interdental papilla and it appears as a red and soft tumefaction, that becomes more fibrinous as time goes by. The G.O. takes place in apical-coronal verse and also in vestibular-lingual verse and it looks like a gingival hypertrophy and hyperplasia, which is due to an abnormal increase of the number of fibroblasts into gingival connective tissue. The G.O. involves a great aggregation of extracellular Matrix, or less degradation of it, or both these processes simultaneously. The G.O. leads to the formation of pseudopockets, which interfere with the correct oral hygiene practices. This condition gives rise to mature plaque retention , that leads to infection, inflammation and the increase of the G.O. This condition becomes worse because of bad pre-transplant oral hygiene state. The aim of this study is to estimate the efficacy of non-surgical periodontal therapy in reducing the G.O. in kidney-transplant patient. Materials and methods: a sample of 32 simple random kidney transplant subjects was enrolled in this study (mean age: 58,44; range: 33-81, 21 m., 11f.). All of them were taking cyclosporine A and calcium channel blockers. Patients taking idantoine, pregnant women, patients suffering from diabetes mellitus or people who have undergone gingival surgery were excluded. The study started on November 2012 and finished on September 2013. Periodontal indexes and Professional oral hygiene practices were performed by the same dental hygienist. The plaque, calculus, bleeding, G.O. and probing depth indexes were evaluated at T0, T1, T2, T3 (at 0, 2, 4, 6 months respectively). Every time the same oral hygiene protocol was applied: non-surgical periodontal therapy with ultrasonic instruments above and below the gum. Results: 787 teeth analysed and 4722 periodontal sites probed. Plaque index (PI), calculus index (CI) and bleeding index (BoP) show significant statistical reduction (p<0,0001). T-test was used for statistic analysis. PI at T0=82,09%, at T3=29,89%/ CI at T0=53,44%, at T3=23,70%/ BoP at T0=71,98%, at T3=26,18%. Probing depth (PD), at six-monthly control , shows a significant statistical reduction (p<0,0001). PD 1-3 mm at T0=16,58%, at T3=30,45%. PD 4-6mm at T0=74,06%, at T3=64,70%. PD 7-9 mm at T0=9,36%, at T3=4,85%. G.O. At T0=54,93%, at T3=44,98%, with a significant statistical reduction (p<0,0001). Conclusions: the applied oral hygiene protocol is simple but effective in reducing drug-induced gingival overgrowth in kidney-transplant patient taking Cyclosporine-A. These clinic results assure a better oral health, improving the quality of life form an aesthetic and functional point of view

Oral hygiene protocol in response to the needs of the head and neck radio treated patient

INTRODUCTION: Head and neck cancer includes mouth, larynx, pharynx and salivary glands cancers and represents about 5% of all Italian tumors and it is located at the 5th place as frequency. Every year about 12.000 new cases are diagnosed and to date the therapeutic treatments for the above mentioned tumors are: surgery, radiotherapy and chemotherapy, often combined. The oral complications, associated with radiotherapy (xerostomia, mucositis, caries, trismus, candidiasis, dysgeusia, dysphagia and osteoradionecrosis), are many and they are difficult to manage, therefore it is necessary to identify protocols and means of assistance able to relieve the discomforts and to improve the quality of life of the patients. AIM: The aim of this study is to evaluate the efficacy of oral hygiene in response to the particular needs of the head and neck radio treated patient.. MATERIALS AND METHODS: The study was conducted in order to detect and describe the oro-dental characteristics of patients undergoing radiotherapy and to detect any oral health needs. 15 head and neck radio treated patients (10 f., 5 m.) aged between 20 and have been selected. During the first visit, at t0, were performed: extra and intra-oral examination, detection of oral health indexes : plaque index and bleeding index of Ainamo & Bay (1975), motivation and home oral hygiene education; professional oral hygiene performed by the dental hygienist using: mechanical ultrasonic instrument, manual instrument above and below the gum; polishing with soft and non-abrasive cups on a low speed handpiece. Prophylaxis paste used: Elmex sensitive professional (RDA <40). At t1 (3 months) and at t2 (6 months) were performed: extra and intra-oral examination, detection of oral health indexes, motivation and home oral hygiene education, professional oral hygiene. RESULTS AND DISCUSSION: For the comparison of the data it was used the T-Test for paired data. Data were compared at T0 vs T1, T0 vs T2 and T1 vs T2 for both indexes (PI, BoP). Descriptive statistic shows as the above mentioned indexes were considerably and significantly reduced from t0 to t2. Plaque index average: t0: 79%, t1: 51%, t2: 35%, Bleeding index average: t0: 69%, t1: 44%, t2: 22%. In all the comparisons it has been found a statistically significant inferential difference (p<0,0001) CONCLUSION: The applied protocol is efficacious in oral hygiene in response of the particular needs of the patient undergoing radiotherapy to head and neck. Despite the real improvement in survival is linked to early diagnosis, we should not underestimate how patients can benefit from physical and psychological help in control of the side effects of chemo-radiotherapy. The role of the oral hygienist is essential in the follow-up of oral hygiene and food habits, in the short, medium and long term

Comparison of different primer sets for use in automated ribosomal intergenic spacer analysis of complex bacterial communities

ITSF and ITSReub, constituting a new primer set designed for the amplification of the 16S-23S rRNA intergenic transcribed spacers, have been compared with primer sets consisting of 1406F and 23Sr (M. M. Fisher and E. W. Triplett, Appl. Environ. Microbiol. 65:4630-4636, 1999) and S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 (L. Ranjard et al., Appl. Environ. Microbiol. 67:4479-4487, 2001), previously proposed for automated ribosomal intergenic spacer analysis (ARISA) of complex bacterial communities. An agricultural soil and a polluted soil, maize silage, goat milk, a small marble sample from the fac\ub8ade of the Certosa of Pavia (Pavia, Italy), and brine from a deep hypersaline anoxic basin in the Mediterranean Sea were analyzed with the three primer sets. The number of peaks in the ARISA profiles, the range of peak size (width of the profile), and the reproducibility of results were used as indices to evaluate the efficiency of the three primer sets. The overall data showed that ITSF and ITSReub generated the most informative (in term of peak number) and reproducible profiles and yielded a wider range of spacer sizes (134 to 1,387) than the other primer sets, which were limited in detecting long fragments. The minimum amount of DNA template and sensitivity in detection of minor DNA populations were evaluated with artificial mixtures of defined bacterial species. ITSF and ITSReub amplified all the bacteria at DNA template concentrations from 280 to 0.14 ng l 1, while the other primer sets failed to detect the spacers of one or more bacterial strains. Although the primer set consisting of ITSF and ITSReub and that of S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 showed similar sensitivities for the DNA of Allorhizobium undicula mixed with the DNA of other species, the S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 primer set failed to detect the DNA of Pseudomonas stutzeri

SAT0368 PREGNANCY IN WOMEN WITH SPONDYLOARTHRITIS: WHO ARE THE PATIENTS AT RISK OF DISEASE FLARE?

Background:Patients with Spondyloarthritis (SpA) can experience flares during pregnancy and postpartum even though the available data are limited and not conclusive.Objectives:To assess disease activity and treatment modification during pregnancy and postpartum in patients with SpA and to identify risk factors for disease flare.Methods:Data on SpA pregnancies prospectively-followed in a pregnancy clinic from 2010 to 2019 were retrospectively analysed. Disease activity was assessed during each trimester and postpartum using ASDAS-CRP or DAS28-CRP. Flare was defined as an increase of disease activity leading to treatment modification (introduction or increase ≥5mg/day of prednisone, introduction of cDMARD or bDMARD)1.Results:Data on 50 pregnancies in 46 patients were collected (mean age at conception 33±4.7 years; median disease duration: 60 months (IQR 24-132); 33 psoriatic arthritis, 6 axialSpA, 2 reactive arthritis, 2 IBD-related SpA; 6 undifferentiated SpA, 1 juvenile idiopathic arthritis). Six pregnancies ended in miscarriage, so they weren't considered for the analysis of flares during pregnancy (table 1). Fifteen out of 44 (34%) pregnancies had at least one flare during pregnancy (6, 7 and 4 during 1st, 2ndand 3rdtrimester respectively; 2 pregnancies had multiple flares). A higher rate of flare was observed in pregnancies of patients with axial involvement (p=0.01), on treatment with bDMARDs at preconceptional visit (p=0.03) and who stopped TNFi at positive pregnancy test (p=0.03). Peripheral involvement was associated with a lower rate of flares (p=0.02). Medications resumed during pregnancy were steroids (in 6 pregnancies), cDMARDs (2 sulfasalazine, 1 cyclosporine) and bDMARDs (4 certolizumab, 4 etanercept). During postpartum period flares were recorded in 46% of patients.Table 1.clinical features, medication and disease activity in pregnancies with flare vs without flareCLINICAL FEATURESFLARE (15)NO FLARE (29)pAxial involvement, n (%)11/15 (73)9/29 (31)0.01Peripheral arthritis, n (%)8/15 (53)26/29 (90)0.02Enthesitis, n (%)5/15 (33)14/29 (48)nsDactilitis, n (%)3/15 (20)8/29 (28)nsPsoriasis, n (%)6/15 (40)17/29 (59)nsIBD, n (%)2/15 (13)0nsUveitis, n(%)1/15 (7)3/29 (10)nsHLAB27 +7/11 (64)5/12 (42)nsMEDICATION HISTORYbDMARDs, n (%)11/15 (73)7/29 (24)0.003bDMARDs at preconception visit, n (%)8/15 (53)6/29 (21)0.04bDMARDs stopped at positive pregnancy test, n (%)7/15 (47)4/29 (14)0.03cDMARDs, n (%)12/15 (80)25/29 (86)nsDISEASE ACTIVITYACTIVE DISEASE* preconception visit, n(%)3/14 (21)4/23 (17)nsACTIVE DISEASE 1sttrimester, n(%)6/15 (40)1/29 (3)0.004ACTIVE DISEASE 2ndtrimester, n(%)8/15 (47)2/29 (7)0.001ACTIVE DISEASE 3rdtrimester, n(%)2/15 (13)1/29 (3)ns*DAS28-CRP>3.2 or ASDAS-CRP≥2.1Conclusion:In our cohort of prospectively-followed SpA pregnancies, 34% experienced a flare during pregnancy and 46% during postpartum. Flares occurred especially in those patients who discontinued TNFi early in pregnancy and with axial involvement. When resumed during pregnancy, TNFi was able to control the disease. At preconception counselling, the continuation of TNFi during pregnancy should be considered to ensure a better control of disease.References:[1]Fischer-Betz R et al.Arthritis Rheumatol. 2015; 67.Disclosure of Interests: :None declare

Nomenclatural Assessment Of Goniotrichum Kützing, Erythrotrichia Areschoug, Diconia Harvey, And Stylonema Reinsch (Rhodophyta)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149711/1/tax03682.pd

Molecular Tools for Monitoring the Ecological Sustainability of a Stone Bio-Consolidation Treatment at the Royal Chapel, Granada

Background: Biomineralization processes have recently been applied in situ to protect and consolidate decayed ornamental stone of the Royal Chapel in Granada (Spain). While this promising method has demonstrated its efficacy regarding strengthening of the stone, little is known about its ecological sustainability.Methodology/Principal Findings: Here, we report molecular monitoring of the stone-autochthonous microbiota before and at 5, 12 and 30 months after the bio-consolidation treatment (medium/long-term monitoring), employing the well-known molecular strategy of DGGE analyses. Before the bio-consolidation treatment, the bacterial diversity showed the exclusive dominance of Actinobacteria (100%), which decreased in the community (44.2%) after 5 months, and Gamma-proteobacteria (30.24%) and Chloroflexi (25.56%) appeared. After 12 months, Gamma-proteobacteria vanished from the community and Cyanobacteria (22.1%) appeared and remained dominant after thirty months, when the microbiota consisted of Actinobacteria (42.2%) and Cyanobacteria (57.8%) only. Fungal diversity showed that the Ascomycota phylum was dominant before treatment (100%), while, after five months, Basidiomycota (6.38%) appeared on the stone, and vanished again after twelve months. Thirty months after the treatment, the fungal population started to stabilize and Ascomycota dominated on the stone (83.33%) once again. Members of green algae (Chlorophyta, Viridiplantae) appeared on the stone at 5, 12 and 30 months after the treatment and accounted for 4.25%, 84.77% and 16.77%, respectively.Conclusions: The results clearly show that, although a temporary shift in the bacterial and fungal diversity was observed during the first five months, most probably promoted by the application of the bio-consolidation treatment, the microbiota tends to regain its initial stability in a few months. Thus, the treatment does not seem to have any negative side effects on the stone-autochthonous microbiota over that time. The molecular strategy employed here is suggested as an efficient monitoring tool to assess the impact on the stone-autochthonous microbiota of the application of biomineralization processes as a restoration/conservation procedure.This work was supported by the European Regional Development Fund (ERDF), Junta de Andalucía (Spain) and the “Fortalecimiento de la I+D+i” program from the University of Granada, co-financed by grant RNM-3493 and Research Group BIO-103 from Junta de Andalucía, as well as by the Spanish Government through “José Castillejo” program from the “Ministerio de Educación, Cultura y Deporte” (I+D+i 2008-2011), and by the Austrian Science Fund (FWF) under Grant “Elise-Richter V194-B20”

Manipulating the Hype: contemporary art's response to media cliches

Manipulating the Hype addresses art’s reaction to the barrage of signs produced by the media. The paper researches contemporary art’s response to clichéd media stereotypes and elucidates artists’ multifaceted perspective on overtly obvious yet widely embraced paradigms marketed by the media. Contemporary art’s strategic reconfiguration of media stereotypes is a valuable introspection upon the superficiality and impracticability of advertising and entertainment industry constructs. By reconsidering the mediated image, art has the ability to inspire reevaluation of cultural values. The thesis additionally attempts to ascertain the reinterpretation of media stereotypes as a common thread linking principal art movements and historically significant artworks from around the world since 1960. How does contemporary art respond to the extensive cultural influence of the media? Is a reaction to mass media a thematic commonality linking contemporary artists in the age of globalization? Manipulating the Hype is a dual outcome investigation comprised of written thesis and studio practice. The written thesis combines experience from a lengthy professional practice with historical and theoretical research. The visual thesis consists of twelve photographic works taken at on the Big Island of Hawaii. The images juxtapose artificial icons of power from popular culture with the natural force of the active lava flow. The process of research discloses how the advertising and entertainment industries capitalize upon innate human desires through the manipulative proliferation of archetypal imagery. Furthermore, the thesis establishes the widespread retort to media clichés as a palpable commonality in studio practices worldwide. The findings in the research make evident that although contemporary art does not have sufficient influence to reform the media, it can heighten public awareness of media tactics