Successful treatment of desmoid tumor of the chest wall with tranilast: a case report

<p>Abstract</p> <p>Introduction</p> <p>Desmoid tumor is characterized by infiltrative growth and local recurrence often occurs after surgery. To reduce the local recurrence rate, adjuvant therapy, such as radiotherapy and pharmacotherapy with cytotoxic agents, anti-estrogen agents and non-steroidal anti-inflammatory drugs, is often applied. In addition, these non-surgical treatments are also performed in patients with unresectable desmoid tumors. We successfully treated a patient with a desmoid tumor with tranilast; an anti-allergic agent.</p> <p>Case presentation</p> <p>A 48-year-old Japanese man with a slow-growing desmoid tumor on his chest wall was treated with an oral administration of tranilast (300 mg per day, three times a day). Two years and two months after the commencement of his therapy, the tumor became impalpable. At this time, the oral administration of tranilast was discontinued. Two years after discontinuation of the treatment, a physical examination showed no recurrence of the tumor and he continued in a state of remission. We were successfully able to reduce the size of the tumor and thereafter maintain the reduced size.</p> <p>Conclusion</p> <p>Tranilast was clinically effective in our case, and is probably comparable to cytotoxic agents or anti-estrogen agents. Because tranilast has substantially fewer adverse effects than cytotoxic agents, it could be a very useful therapeutic agent for desmoid tumor.</p

Needle stick injuries among dental students: risk factors and recommendations for prevention

Aim: To evaluate the risk factors of needle stick injuries (NSIs) sustained by undergraduate dental students and nurse students at the King&#x0027;s College London (KCL) Dental Institute. Materials and methods: A retrospective study evaluated the incident reports relating to NSIs reported over a period of 2 years. Factors including the dental department, study year, and when the injury took place during administration of local anaesthesia (LA) and recapping conventional syringe or clearing work surface or during disposal. Results: This report showed that students are at the highest risk of NSIs at the fourth year of their 5-year BDS course. About one-third of injuries were reported among this group of students followed by year 5 students (25%). Oral surgery clinics were the major source of incident reporting when compared with other specialised dental clinics within the institute. The left hands of the students were the most frequently affected by such injuries and then the right hands of student dental nurses. The attempt of needle recapping of conventional syringes was the least reported mechanism of injuries and constituted only 15% of the total injuries and mainly occurred in third year students. The most frequent injuries among student nurses were during disposal of the needle. Conclusion: Less NSIs occur when using safety syringes. A non-recapping policy with immediate disposal of either the conventional or safety syringe systems after injection would prevent all clearance-related NSIs sustained by nurses. To avoid NSIs, education plays a vital role particularly with effective implementation of the change to safety syringes with appropriate training

Phenotypic differences between dermal fibroblasts from different body sites determine their responses to tension and TGFβ1

BACKGROUND: Wounds in the nonglabrous skin of keloid-prone individuals tend to cause large disordered accumulations of collagen which extend beyond the original margins of the wound. In addition to abnormalities in keloid fibroblasts, comparison of dermal fibroblasts derived from nonwounded glabrous or nonglabrous skin revealed differences that may account for the observed location of keloids. METHODS: Fibroblast apoptosis and the cellular content of α-smooth-muscle actin, TGFβ1 receptorII and ED-A fibronectin were estimated by FACS analysis. The effects of TGFβ1 and serum were examined. RESULTS: In monolayer cultures non-glabrous fibroblasts were slower growing, had higher granularity and accumulated more α-smooth-muscle actin than fibroblasts from glabrous tissues. Keloid fibroblasts had the highest level of α-smooth-muscle actin in parallel with their expression level of ED-A fibronectin. TGFβ1 positively regulated α-smooth-muscle actin expression in all fibroblast cultures, although its effects on apoptosis in fibroblasts from glabrous and non-glabrous tissues were found to differ. The presence of collagen I in the ECM resulted in reduction of α-smooth-muscle actin. A considerable percentage of the apoptotic fibroblasts in attached gels were α-smooth-muscle actin positive. The extent of apoptosis correlated positively with increased cell and matrix relaxation. TGFβ1 was unable to overcome this apoptotic effect of matrix relaxation. CONCLUSION: The presence of myofibroblasts and the apoptosis level can be regulated by both TGFβ1 and by the extracellular matrix. However, reduction of tension in the matrix is the critical determinant. This predicts that the tension in the wound bed determines the type of scar at different body sites

Thirty years of the human immunodeficiency virus epidemic and beyond.

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus (HIV) as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressing social and psychological factors involved in the care of individuals continue to be important considerations

HIV Discrimination in Dental Care: Results of a Testing Study in Los Angeles County

Thirty years after HIV was first identified, for the majority of those infected in the United States, effective combination therapies to combat HIV have turned the disease into a manageable chronic condition. But HIV discrimination has still proven intractable in the field of health care. For example, a series of studies has revealed that 46 percent of skilled nursing facilities, 55 percent of OB/GYNs, and 26 percent of plastic surgeons in Los Angeles County refuse to provide services to any HIV-positive patient, in violation of state and federal law. This Study examines HIV discrimination among dentists in Los Angeles County. For people living with HIV/AIDS (PLWHA), dental care is particularly important because problems in the mouth may be the first symptoms of an HIV infection and can also signify disease progression; routine, proper dental care can have a significant impact on oral and general health. This Study reveals that 5 percent of dentists in Los Angeles County have a blanket policy of refusing to accept any HIV-positive patient, which is substantially lower than the finding for other health care providers. However, this Study also suggests that PLWHA who are poor and the most vulnerable, including women and people of color, face higher rates of discrimination. This Study goes on to explain that dentists can effectively and safely treat PLWHA, and it identifies why they are legally and ethically obligated to provide such care. After reviewing prior social science research on HIV discrimination by dentists, this Study presents its methodology and findings. Finally, it concludes by exploring potential reasons for why the documented discrimination rate is lower for dentists than it is for other health care providers in Los Angeles County, and it argues that future enforcement and education efforts should be targeted toward specific categories of dentists

HIV Discrimination in Dental Care: Results of a Testing Study in Los Angeles Study

Thirty years after HIV was first identified, for the majority of those infected in the United States, effective combination therapies to combat HIV have turned the disease into a manageable chronic condition. But HIV discrimination has still proven intractable in the field of health care. For example, a series of studies has revealed that 46 percent of skilled nursing facilities, 55 percent of OB/GYNs, and 26 percent of plastic surgeons in Los Angeles County refuse to provide services to any HIV-positive patient, in violation of state and federal law.This Study examines HIV discrimination among dentists in Los Angeles County. For people living with HIV/AIDS (PLWHA), dental care is particularly important because problems in the mouth may be the first symptoms of an HIV infection and can also signify disease progression; routine, proper dental care can have a significant impact on oral and general health. This Study reveals that 5 percent of dentists in Los Angeles County have a blanket policy of refusing to accept any HIV-positive patient, which is substantially lower than the finding for other health care providers. However, this Study also suggests that PLWHA who are poor and the most vulnerable, including women and people of color, face higher rates of discrimination. This Study goes on to explain that dentists can effectively and safely treat PLWHA, and it identifies why they are legally and ethically obligated to provide such care. After reviewing prior social science research on HIV discrimination by dentists, this Study presents its methodology and findings. Finally, it concludes by exploring potential reasons for why the documented discrimination rate is lower for dentists than it is for other health care providers in Los Angeles County, and it argues that future enforcement and education efforts should be targeted toward specific categories of dentists

HIV Discrimination in Dental Care: Results of a Discrimination Testing Study In Los Angeles County

This study used trained testers to measure the level of HIV discrimination by dentists in Los Angeles County. In total, 612 dentists’ offices were contacted in 2007 and 2008. We find that levels of HIV discrimination are lower in dental care than other health care services in Los Angeles County. However, levels of discrimination are twice as high for people living with HIV/AIDS (PLWHA) who had Denti-Cal, and three times higher for those living in the San Gabriel Valley and South SPAs. Discrimination was also higher among older dentists and dentists who did not go to dental school in the United States. The findings suggest the need for more targeted education efforts to ensure equal access to dental services for all PLWHA

HIV Discrimination in Dental Care: Results of a Testing Study in Los Angeles Study

Thirty years after HIV was first identified, for the majority of those infected in the United States, effective combination therapies to combat HIV have turned the disease into a manageable chronic condition. But HIV discrimination has still proven intractable in the field of health care. For example, a series of studies has revealed that 46 percent of skilled nursing facilities, 55 percent of OB/GYNs, and 26 percent of plastic surgeons in Los Angeles County refuse to provide services to any HIV-positive patient, in violation of state and federal law.This Study examines HIV discrimination among dentists in Los Angeles County. For people living with HIV/AIDS (PLWHA), dental care is particularly important because problems in the mouth may be the first symptoms of an HIV infection and can also signify disease progression; routine, proper dental care can have a significant impact on oral and general health. This Study reveals that 5 percent of dentists in Los Angeles County have a blanket policy of refusing to accept any HIV-positive patient, which is substantially lower than the finding for other health care providers. However, this Study also suggests that PLWHA who are poor and the most vulnerable, including women and people of color, face higher rates of discrimination. This Study goes on to explain that dentists can effectively and safely treat PLWHA, and it identifies why they are legally and ethically obligated to provide such care. After reviewing prior social science research on HIV discrimination by dentists, this Study presents its methodology and findings. Finally, it concludes by exploring potential reasons for why the documented discrimination rate is lower for dentists than it is for other health care providers in Los Angeles County, and it argues that future enforcement and education efforts should be targeted toward specific categories of dentists