Peri-implantitis, systemic inflammation, and dyslipidemia: a cross-sectional biochemical study

Purpose: The aim of this study was to compare the inflammatory and lipid profile of patients with and without peri-implantitis. / Methods: A cross-sectional biochemical study was carried out in which blood samples were collected from 16 patients with peri-implantitis and from 31 subjects with healthy implants. Clinical peri-implant parameters were obtained from all subjects. Levels of tumor necrosis factor-alpha and interleukin-10 (IL-10) were measured in serum. Lipid fractions, glucose and creatinine levels, and complete blood count were also assessed. / Results: After controlling for a history of periodontitis, statistically significant differences between peri-implantitis patients and controls were found for total cholesterol (estimated adjusted mean difference, 76.4 mg/dL; 95% confidence interval [CI], 39.6, 113.2 mg/dL; P<0.001), low-density lipoprotein (LDL) cholesterol (estimated adjusted mean difference, 57.7 mg/dL; 95% CI, 23.8, 91.6 mg/dL; P<0.001), white blood cells (WBC) (estimated adjusted mean difference, 2.8×103/μL; 95% CI, 1.6, 4.0×103/μL; P<0.001) and IL-10 (estimated adjusted mean difference, −10.4 pg/mL; 95% CI, −15.8, −5.0 pg/mL; P<0.001). The peri- implant probing pocket depth (PPD) was modestly positively correlated with total cholesterol (r=0.512; P<0.001), LDL cholesterol (r=0.463; P=0.001), and WBC (r=0.519; P<0.001). A moderate negative correlation was observed between IL-10 and PPD (r=0.609; P<0.001). / Cardiovascular diseases; Dyslipidemias; Peri-implantitis; Inflammation; Leukocytes Conclusions: Otherwise healthy individuals with peri-implantitis showed increased low- grade systemic inflammation and dyslipidemia

Prediction of stroke using deep learning model

© Springer International Publishing AG 2017. Many predictive techniques have been widely applied in clinical decision making such as predicting occurrence of a disease or diagnosis, evaluating prognosis or outcome of diseases and assisting clinicians to recommend treatment of diseases. However, the conventional predictive models or techniques are still not effective enough in capturing the underlying knowledge because it is incapable of simulating the complexity on feature representation of the medical problem domains. This research reports predictive analytical techniques for stroke using deep learning model applied on heart disease dataset. The atrial fibrillation symptoms in heart patients are a major risk factor of stroke and share common variables to predict stroke. The outcomes of this research are more accurate than medical scoring systems currently in use for warning heart patients if they are likely to develop stroke

Generational interdependencies in families: The MULTILINKS research programme

Background: We identify four research themes where MULTILINKS, a programme of research on intergenerational family ties funded through the Seventh Framework of the European Commission, has brought new and unique insights. Key premises of the MULTILINKS approach involved an emphasis on (1) both young and old in families, (2) the ways in which social policies structure interdependencies in families, and (3) the influence of historical, economic and cultural contexts. Methods: Our overview includes research done in the context of the MULTILINKS programme at large as well as the papers in this special collection. Results: Firstly, by combining macro and micro perspectives on intergenerational family constellations across Europe it has been possible to provide a more nuanced view than is common in conventional portrayals of family change. Secondly, by extending research to Eastern European countries, the programme has not only identified crucial regional differences in co-residential arrangements and intergenerational exchanges in families, but also shown that explanations of well-being differentials are similar in Eastern and Western Europe. Thirdly, by focusing on legal and policy frameworks regarding the division of care and financial responsibilities for the young and old between the family and the state, it has been possible to distinguish patterns in the degree to which national policies strengthen or weaken generational interdependencies in families. Fourthly, research conducted in the context of the MULTILINKS programme has demonstrated the usefulness of paying attention to preferences about family members' responsibilities for each other. Conclusion: Recognition of the key premises of MULTILINKS has led to challenging, critical insights on intergenerational family ties

Psoriasis vulgaris: Relationship between oral and periodontal conditions and disease severity

Psoriasis is distributed across the world with a prevalence ranging from 0.5% to 4.6% [1, 2]. This condition has been associated with other diseases, or comorbidities, such as oral cavity involvement, including oral lesions and periodontal disease, thus reaffirming that this is a systemic disease [3, 4]. Psoriasis is a chronic, inflammatory disease which is characterized by the exaggerated proliferation of keratinocytes as a result of immune system activation through T lymphocytes in focal cutaneous areas [5, 6]. In most cases of psoriasis, oral lesions are associated with the presence of geographic and fissured tongue, although data show an increased frequency of associations with generalized pustular psoriasis [7]. It has been estimated that the actual prevalence of fissured tongue and geographic tongue is 6 - 33% and 1-18%, respectively, suggesting that these might represent different expressions of the same disease [7]. However, there is no consensus of the clinical description of what could be considered an oral psoriatic lesion, oral evaluation, or examination, is not a regular procedure in patients with psoriasis [7, 8]. Oral lesions are generally asymptomatic, although there might be tongue swelling and pain when deep fissures are formed [7, 8]. Furthermore, bad tongue hygiene can cause halitosis and tissue swelling due to the accumulation of food residues in fissures, thus causing burning and stinging, especially after contact. However, this association is debatable because it is not known if such oral manifestations are a symptom of disease severity or represent an expression of the disease itself [8]. On the other hand, periodontal disease is marked by an exaggerated response of the immune system to oral microbiota, making it a chronic inflammatory disease which is mediated immunologically, in which immune cells cause inflammation and cellular destruction [9]. Although the two pathologies are similar from the immunological aspect, some characteristics still render them separate diseases and there is no real association known between them [10, 11]. New research has shown that both psoriasis and periodontal disease have both experienced increased prevalence worldwide, and have been associated with other diseases and comorbidities, thus reconfirming that these are, indeed, systemic diseases [12, 13]. There are no existing reports in the published literature which describe the prevalence and frequency of psoriasis and periodontal disease in Colombia. We considered that it was very important for such clinical data to be available because we believe that appropriate examinations should be carried out on all patients with psoriasis, who may have multiple associated comorbidities. We also believe that such examinations should be performed on a regular basis. Furthermore, it is not yet known if the diagnosis of oral psoriasis should be made when lesions in the oral cavity present by themselves, or only at the same time as skin symptoms develop. Consequently, in this study, we aimed to investigate the association between periodontal diagnosis, microbiological components, the presence of IgG against Porphyromonas gingivalis (P. gingivalis), and the clinical manifestations of psoriasis

Remote ischemic preconditioning (RIPC) protects against endothelial dysfunction in a human model of systemic inflammation: a randomized clinical trial

Objective: Inflammation, oxidative stress, and endothelial dysfunction are known to contribute to ischemia-reperfusion injury. Remote ischemic preconditioning (RIPC) protects from endothelial dysfunction and the damage induced by ischemia-reperfusion. Using intensive periodontal treatment (IPT), an established human model of acute systemic inflammation, we investigated whether RIPC prevents endothelial dysfunction and modulates systemic levels of inflammation and oxidative stress. Approach and Results: Forty-nine participants with periodontitis were randomly allocated to receive either 3 cycles of ischemia-reperfusion on the upper limb (N=24, RIPC) or a sham procedure (N=25, control) before IPT. Endothelial function assessed by flow-mediated dilatation of the brachial artery, inflammatory cytokines, markers of vascular injury, and oxidative stress were evaluated at baseline, day 1, and day 7 after IPT. Twenty-four hours post-IPT, the RIPC group had lower levels of IL-10 (interleukin-10) and IL-12 (interleukin-12) compared with the control group (P<0.05). RIPC attenuated the IPT-induced increase in IL-1β (interleukin-1β), E-selectin, sICAM-3 (soluble intercellular adhesion molecule 3), and sTM (soluble thrombomodulin) levels between the baseline and day 1 (P for interaction <0.1). Conversely, oxidative stress was differentially increased at day1 in the RIPC group compared with the control group (P for interaction <0.1). This was accompanied by a better flow-mediated dilatation (mean difference 1.75% [95% CI, 0.428–3.07], P=0.011). After 7 days from IPT, most of the inflammatory markers, endothelial-dependent and -independent vasodilation, were similar between groups. Conclusions: RIPC prevented acute endothelial dysfunction by modulation of inflammation and oxidation processes in patients with periodontitis following exposure to an acute inflammatory stimulus

Heterologous Systemic Prime–Intranasal Boosting Using a Spore SARS-CoV-2 Vaccine Confers Mucosal Immunity and Cross-Reactive Antibodies in Mice as well as Protection in Hamsters

Background: Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are administered systemically and typically result in poor immunogenicity at the mucosa. As a result, vaccination is unable to reduce viral shedding and transmission, ultimately failing to prevent infection. One possible solution is that of boosting a systemic vaccine via the nasal route resulting in mucosal immunity. Here, we have evaluated the potential of bacterial spores as an intranasal boost. Method: Spores engineered to express SARS-CoV-2 antigens were administered as an intranasal boost following a prime with either recombinant Spike protein or the Oxford AZD1222 vaccine. Results: In mice, intranasal boosting following a prime of either Spike or vaccine produced antigen-specific sIgA at the mucosa together with the increased production of Th1 and Th2 cytokines. In a hamster model of infection, the clinical and virological outcomes resulting from a SARS-CoV-2 challenge were ameliorated. Wuhan-specific sIgA were shown to cross-react with Omicron antigens, suggesting that this strategy might offer protection against SARS-CoV-2 variants of concern. Conclusions: Despite being a genetically modified organism, the spore vaccine platform is attractive since it offers biological containment, the rapid and cost-efficient production of vaccines together with heat stability. As such, employed in a heterologous systemic prime–mucosal boost regimen, spore vaccines might have utility for current and future emerging diseases.info:eu-repo/semantics/publishedVersio

Association between neuroserpin and molecular markers of brain damage in patients with acute ischemic stroke.

BACKGROUND: Neuroserpin has shown neuroprotective effects in animal models of cerebral ischemia and has been associated with functional outcome after ischemic stroke. Our aim was to study whether neuroserpin serum levels could be associated to biomarkers of excitotoxicity, inflammation and blood brain barrier disruption. METHODS: We prospectively included 129 patients with ischemic stroke (58.1% male; mean age, 72.4 ± 9.6 years) not treated with tPA within 12 hours (h) of symptoms onset (mean time, 4.7 ± 2.1 h). Poor functional outcome at 3 months was considered as a modified Rankin scale score >2. Serum levels of neuroserpin, Interleukin 6 (IL-6), Intercellular adhesion molecule-1 (ICAM-1), active Matrix metalloproteinase 9 (MMP-9), and cellular fibronectin (cFn) (determined by ELISA) and glutamate (determined by HPLC) were measured on admission, 24 and 72 h. The main variable was considered the decrease of neuroserpin levels within the first 24 h. ROC analysis was used to select the best predictive value for neuroserpin to predict poor functional outcome due to a lack of linearity. RESULTS: The decrease of neuroserpin levels within the first 24 h was negatively correlated with serum levels at 24 hours of glutamate (r = -0.642), IL-6 (r = -0.678), ICAM-1 (r = -0.345), MMP-9 (r = -0.554) and cFn (r = -0.703) (all P < 0.0001). In the multivariate analysis, serum levels of glutamate (OR, 1.04; CI95%, 1.01-1.06, p = 0.001); IL-6 (OR, 1.4; CI95%, 1.1-1.7, p = 0.001); and cFn (OR, 1.3; CI95%, 1.1-1.6, p = 0.002) were independently associated with a decrease of neuroserpin levels <70 ng/mL at 24 h after adjusting for confounding factors. CONCLUSIONS: These findings suggest that neuroprotective properties of neuroserpin may be related to the inhibition of excitotoxicity, inflammation, as well as blood brain barrier disruption that occur after acute ischemic stroke

Heterologous Systemic Prime-Intranasal Boosting Using a Spore SARS-CoV-2 Vaccine Confers Mucosal Immunity and Cross-Reactive Antibodies in Mice as well as Protection in Hamsters

Altres ajuts: Medical Research Council MR/R026262/1Background : Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are administered systemically and typically result in poor immunogenicity at the mucosa. As a result, vaccination is unable to reduce viral shedding and transmission, ultimately failing to prevent infection. One possible solution is that of boosting a systemic vaccine via the nasal route resulting in mucosal immunity. Here, we have evaluated the potential of bacterial spores as an intranasal boost. Method : Spores engineered to express SARS-CoV-2 antigens were administered as an intranasal boost following a prime with either recombinant Spike protein or the Oxford AZD1222 vaccine. Results : In mice, intranasal boosting following a prime of either Spike or vaccine produced antigen-specific sIgA at the mucosa together with the increased production of Th1 and Th2 cytokines. In a hamster model of infection, the clinical and virological outcomes resulting from a SARS-CoV-2 challenge were ameliorated. Wuhan-specific sIgA were shown to cross-react with Omicron antigens, suggesting that this strategy might offer protection against SARS-CoV-2 variants of concern. Conclusions : Despite being a genetically modified organism, the spore vaccine platform is attractive since it offers biological containment, the rapid and cost-efficient production of vaccines together with heat stability. As such, employed in a heterologous systemic prime-mucosal boost regimen, spore vaccines might have utility for current and future emerging diseases

Assessment of information resources for people with hypodontia

Aim: To assess the adequacy of patient information to support understanding and decision-making for people affected by hypodontia. Methods: 1) Questionnaire to understand the provision of patient information by dentists; 2) Systematic search to identify online open-access patient information; 3) Quality assessment of written patient information. Results: Questionnaire response rate was 49% (319/649); 91% examined and/or treated people with hypodontia. Most general dentists referred patients to specialist services without providing written hypodontia information. The majority of dental specialists provide patient leaflets but less than a third used web-resources. Only 19% of respondents felt current resources were fit-for-purpose. Thirty-one patient resources (18 leaflets and 13 online) were assessed against quality criteria. The aim of the resource was seldom explicit, the content was often incomplete and variation in readability scores indicated high levels of literacy were required. Discussion: Access to, and quality of, patient information for hypodontia is inadequate. Current resources are not sufficiently comprehensive to prepare young patients to engage in shared dental care decisions with their parents and/or dental professionals. Conclusion: There is a need for improved access to, and provision of, information about hypodontia if dental professionals want to meet best practice guidance and involve patients in shared decision-making