HLA Genes, Islet Autoantibodies and Residual C-Peptide at the Clinical Onset of Type 1 Diabetes Mellitus and the Risk of Retinopathy 15 Years Later

HLA genes, islet autoantibodies and residual C-peptide were studied to determine the independent association of each exposure with diabetic retinopathy (DR), 15 years after the clinical onset of type 1 diabetes in 15-34 year old individuals.The cohort was identified in 1992 and 1993 by the Diabetes Incidence Study in Sweden (DISS), which investigates incident cases of diabetes for patients between 15 and 34 years of age. Blood samples at diagnosis were analyzed to determine HLA genotype, islet autoantibodies and serum C-peptide. In 2009, fundus photographs were obtained from patient records. Study measures were supplemented with data from the Swedish National Diabetes Registry.The prevalence of DR was 60.2% (148/246). Autoantibodies against the 65 kD isoform of glutamate decarboxylase (GADA) at the onset of clinical diabetes increased the risk of DR 15 years later, relative risk 1.12 for each 100 WHO units/ml, [95% CI 1.02 to 1.23]. This equates to risk estimates of 1.27, [95% CI 1.04 to 1.62] and 1.43, [95% CI 1.06 to 1.94] for participants in the highest 25(th) (GADA>233 WHO units/ml) and 5(th) percentile (GADA>319 WHO units/ml) of GADA, respectively. These were adjusted for duration of diabetes, HbA(1c), treated hypertension, sex, age at diagnosis, HLA and C-peptide. Islet cell autoantibodies, insulinoma-antigen 2 autoantibodies, residual C-peptide and the type 1 diabetes associated haplotypes DQ2, DQ8 and DQ6 were not associated with DR.Increased levels of GADA at the onset of type 1 diabetes were associated with DR 15 years later. These results, if confirmed, could provide additional insights into the pathogenesis of the most common microvascular complication of diabetes and lead to better risk stratification for both patient screenings and DR treatment trials

Ocean current connectivity propelling the secondary spread of a marine invasive comb jelly across western Eurasia

Publication history: Accepted - 15 February 2018; Published - 16 May 2018.Aim: Invasive species are of increasing global concern. Nevertheless, the mechanisms driving further distribution after the initial establishment of non-native species remain largely unresolved, especially in marine systems. Ocean currents can be a major driver governing range occupancy, but this has not been accounted for in most invasion ecology studies so far. We investigate how well initial establishment areas are interconnected to later occupancy regions to test for the potential role of ocean currents driving secondary spread dynamics in order to infer invasion corridors and the source–sink dynamics of a non-native holoplanktonic biological probe species on a continental scale. Location: Western Eurasia. Time period: 1980s–2016. Major taxa studied: ‘Comb jelly’ Mnemiopsis leidyi. Methods: Based on 12,400 geo-referenced occurrence data, we reconstruct the invasion history of M. leidyi in western Eurasia. We model ocean currents and calculate their stability to match the temporal and spatial spread dynamics with large-scale connectivity patterns via ocean currents. Additionally, genetic markers are used to test the predicted connectivity between subpopulations. Results: Ocean currents can explain secondary spread dynamics, matching observed range expansions and the timing of first occurrence of our holoplanktonic non-native biological probe species, leading to invasion corridors in western Eurasia. In northern Europe, regional extinctions after cold winters were followed by rapid recolonizations at a speed of up to 2,000 km per season. Source areas hosting year-round populations in highly interconnected regions can re-seed genotypes over large distances after local extinctions. Main conclusions: Although the release of ballast water from container ships may contribute to the dispersal of non-native species, our results highlight the importance of ocean currents driving secondary spread dynamics. Highly interconnected areas hosting invasive species are crucial for secondary spread dynamics on a continental scale. Invasion risk assessments should consider large-scale connectivity patterns and the potential source regions of non-native marine species.Danish Council for Independent Research; Grant/Award Number: DFF-1325-00102B; FP7 People: Marie-Curie Actions, Grant/Award Number: MOBILEX, DFF - 1325-00025; EU, BONUS, BMBF, Grant/ Award Number: 03F0682; Excellence Cluster “Future Ocean”, Grant/Award Number: CP153

Evaluation of antifungal efficacy of QMix 2in1 as a final irrigant: An in vitro study

Background: It is known that no specific antifungal agent exists at present for irrigation of infected root canals. QMix 2in1 was investigated to determine whether they could be an alternative for sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX), and ethylenediaminetetraacetic acid (EDTA).Objective: The aim of this in vitro study was to evaluate and compare the antifungal efficacy of QMix 2in1, 5.25% NaOCl, 2% CHX, and 17% EDTA as a final rinse against Candida albicans (C. albicans).Materials and Methods: Ninety single‑rooted mandibular premolar teeth were randomly divided into four experimental (n = 20) and two control (n = 5) groups. All root canals were instrumented with Mtwo rotary file system using crown‑down technique to an apical size 40. Following root canal preparation, teeth were inoculated with C. albicans and incubated for 72 h. Teeth were irrigated with one of the following solutions as a final irrigant: (1) 5.25% NaOCl, (2) 2% CHX, (3) QMix 2in1, and (4) 17% EDTA. Aliquots from the samples were plated on 4% Sabouraud Agar, and colony‑forming units were counted.Results: QMix 2in1, 5.25% NaOCl, and 2% CHX were equally effective (P > 0.05) and significantly superior to 17% EDTA in eradicating C. albicans (P < 0.05).Conclusion: QMix 2in1 proved to be effective against C. albicans when used as a final rinse. According to the findings of the present study, QMix 2in1 may be recommended as an alternative final rinse solution.Keywords: Antifungal, Candida albicans, endodontics, final irrigant, QMi

Comparison of Tc-99m methylene diphosphonate, Tc-99m human immune globulin, and Tc-99m-labeled white blood cell scintigraphy in the diabetic foot

Purpose: The aims of this prospective study were to evaluate the contribution of Tc-99m methylene diphosphonate (MDP), Tc-99m human immune globulin (HIG), and Tc-99m white blood cell (WBC) to the diagnosis of osteomyelitis in the diabetic foot and to evaluate the surgical or medical therapy with Tc-99m HIG and Tc-99m WBC scans