Wrodzony hiperinsulinizm — próba optymalizacji diagnostyki i leczenia u polskich pacjentów

  Introduction: Congenital hyperinsulinism of Infancy (CHI) comprises heterogenic defects of insulin secretion with diverse molecular aetiology, histological features, severity of symptoms, and response to pharmacotherapy. The study aimed to establish the first clinical characteristics of Polish patients with CHI and to propose a novel clinical algorithm allowing the prioritisation of genetic and radiology studies, based on patient’s characteristics and response to pharmacotherapy. Material and methods: Thirty-one patients with CHI were recruited from five reference centres in Poland. Clinical and biochemical parameters were statistically evaluated and compared to those of a control group (n = 30). Results: CHI predisposes to increased birth weight (p = 0.004), lower Apgar score (p = 0.004), perinatal complications (74%), and neurological implications (48%). Diagnostic process and therapy were inconsistent. A trial of pharmacotherapy was applied in 21 patients (68%), and diagnostic imaging with 18F-L-DOPA PET was performed in only 3. Eighteen patients (58%) were surgically treated, including 8 infants (44%) aged less than 2 months. Depending on the type of resection, further hypoglycaemia was observed postoperatively in 50% (n = 9) and hyperglycaemia in 39% (n = 7) of cases. Based on foregoing results, a clinical algorithm was proposed. Conclusions: Standardisation of clinical management with the use of pharmacotherapy, genetic screening, and diagnostic imaging will allow the optimisation of therapy and minimisation of treatment complications. (Endokrynol Pol 2015; 66 (4): 322–328)    Wstęp: Wrodzony hiperinsulinizm (CHI) obejmuje heterogenną grupę zaburzeń sekrecji insuliny przez komórki β trzustki i charakteryzuje się zróżnicowaną etiologią molekularną, obrazem histopatologicznym, nasileniem objawów oraz odpowiedzią na leczenie farmakologiczne. Celem pracy było stworzenie charakterystyki klinicznej polskich pacjentów z wrodzonym hiperinsulinizmem oraz podjęcie próby stworzenia algorytmu diagnostyczno-terapeutycznego, umożliwiającego priorytetyzację badań genetycznych i obrazowych w zależności od obrazu klinicznego, wyników badań laboratoryjnych oraz odpowiedzi na leczenie farmakologiczne. Materiał i metody: Do badania włączono 31 pacjentów z rozpoznaną hipoglikemią w przebiegu hiperinsulinizmu z 5 ośrodków w Polsce. Analizę danych klinicznych oraz parametrów biochemicznych pacjentów hipoglikemią odniesiono do 30-osobowej grupy kontrolnej. Wyniki: Pacjenci z CHI charakteryzowali się znacznie wyższą masą urodzeniową (p = 0,004), niższą oceną uzyskaną w okołoporodowej skali Apgar (p = 0,004), częstszymi komplikacjami okołoporodowymi (74%) oraz powikłaniami neurologicznymi (48%). Przeprowadzona w badanej grupie diagnostyka była niespójna. U 21 pacjentów (68%) włączono leczenie za pomocą Diazoksydu, a u 3 pacjentów (9,7%) wykonano diagnostykę obrazową przy użyciu 18F-L-DOPA PET. Wśród 18 (58%) pacjentów leczonych chirurgicznie u 8 (44%) resekcję wykonano w wieku poniżej 2. miesiąca życia. Pooperacyjnie w zależności od typu wykonanej operacji obserwowano hipoglikemię u 50% (n = 9), a hiperglikemię u 39% (n = 7). Na podstawie uzyskanych wyników zaproponowano pierwszy w Polsce algorytm diagnostyczno- terapeutyczny. Wnioski: Ujednolicenie schematu postępowania diagnostycznego-terapeutycznego z wykorzystaniem wszystkich dostępnych metod umożliwi zapobieganie kolejnym epizodom choroby, oraz zminimalizuje komplikacje wynikające z leczenia. (Endokrynol Pol 2015; 66 (4): 322–328)

LC-QTOF-MS Analysis and Activity Profiles of Popular Antioxidant Dietary Supplements in Terms of Quality Control

The dietary supplements with claimed antioxidant activity constitute a substantial part of the dietary supplement market. In this study, we performed the LC-QTOF-MS analysis and investigated the activity profiles of popular antioxidant dietary supplements from different chemical groups in terms of quality control. The commonly used antioxidant tests and statistical analysis revealed that substantial part of the results was comparable if 1 g sample was considered, but while comparing single and daily doses, significant differences in antioxidant values were noticed in all assays. The best antioxidant activity was obtained in ORAC assay (from 142 to 13814 μM of Trolox equivalents per 1 g of sample), and the strongest correlation occurred between TPC and ORAC. The LC-QTOF-MS analysis revealed that catechins were present in samples having the best antioxidant activity and that dietary supplements showing the weakest activity contained very small amount of any chemical constituents

Marginal bone behavior around the dental implants with regard to the patient’s characteristics

We analyzed the relationship between marginal bone loss around dental implants and selected personal characteristics of patients (gender, age and cigarette smoking) undergoing dental rehabilitation because of missing teeth. The study comprised 28 patients aged 37-66 years (11 men and 17 women) who had 240 implants inserted. The assessment of marginal bone loss in the examined patient cohort was made based on ortho-pantomographic X-ray images. For evaluation of the condition of the marginal bone around the implants during 46-month follow-up, with relation to the sociodemographic features of the patient, multi-generational linear models were used. Studies show that the loss of marginal bone around the implant increased with the age of the patient, but did not correlate significantly with the patient’s gender or smoking habit

The Relationship Between Marginal Bone Loss Around Dental Implants and the Specific Characteristics of Implant-Prosthetic Treatment

The marginal bone loss around dental implants is an important indicator that helps to evaluate the course and the final outcome of implant-prosthetic treatment. It is, therefore, important to understand the factors that may affect this. The aim of the study was to assess the impact of the specific characteristics of implant-prosthetic treatment on the marginal bone loss around implants. The study included 28 patients, aged 37-66 years, treated with dental implants. Every patient received at least one of the two types of implants: with Morse taper connection and with internal hexagonal connection. The average marginal bone loss around the implants was evaluated on the basis of the panoramic radiographs. The maximum follow-up period after implantation was 46 months. The peri-implant marginal bone loss was evaluated taking into consideration the implant localisation, the procedure of sinus lift with bone augmentation, implant type, implant diameter, vertical implant position relative to the compact bone level and the type of prosthetic restoration, the time between implantation and loading with prosthetic restoration, as well as the time between loading and the measurement of marginal bone loss. The correlation between bone loss and the selected characteristics of the treatment was assessed using generalised estimating equations (GEE). An objective analysis was enabled via the applied research model: evaluation of an impact of the specific implant-prosthetic treatment characteristics on peri-implant marginal bone loss in patients treated with implants with different implant-abutment interface systems. The results of the study showed that peri-implant marginal bone loss increased significantly with implant localisation in canine sites (compared to the localization in premolar sites), as well as with prosthetic restorations in the form of dentures (compared to bridges), and decreased when implants were placed below the compact bone level (compared to those placed at the bone level). At the same time, marginal bone loss was not significantly related to implant diameter or to the sinus lift procedure. The results obtained seem extremely useful in everyday clinical practic

Selected caries diagnostic methods

Standard caries diagnostic methods include a visual tactile method, as well as several radiographic methods. The former is a subjective method, while bitewing radiographs and digital radiographs (radiovisiography) enable detection of caries lesions only after 30% of hard dental tissue mineral substances have been lost. The paper presents methods based on electrical and optical phenomena that allow early caries diagnosis. Strengths and weaknesses of each presented method are discussed, basing this on recent literature review. The methods of caries detection generally used in daily clinical practice, combined with alternative methods, make it possible to significantly increase the effectiveness of dental caries diagnosis

Evaluation of apical root resorption occurrence in orthodontic patients treated with fixed braces depending on selected clinical parameters

An aim of the work was analysis of the possible connections between the selected clinical parameters and external apical root resorption (EARR) in patients after orthodontic treatment

The prevalence of selected genes involved in biofilm formation in Candida albicans isolated from the oral cavity

Introduction.C. albicans genome sequencing enables investigation of the role of particular genes in biofilm formation involving the yeast-like fungi

Non-carious lesions in patients treated for functional temporomandibular disorders

Introduction. Numerous clinical symptoms found in patients with temporomandibular disorders include non-carious lesions, such as V-shaped lesions, wear facets, enamel cracks, and impressions on the tongue or changes in the buccal mucosa. In addition, loosening and dislocation of teeth may occur

Cigarette smoking and dental implant tooth replacement therapy: A questionnaire survey among patients receiving implant prosthetic treatment

Chronic nicotinism has negative effects, both local and systemic. Its local effects are related to both the immediate thermal influence, as well as the toxic action of the substances contained in the smoke. In addition, the microflora colonizing dental plague is changed. The damage and the inflammatory processes that are incurred, affect the bone tissue of the alveolar processes, the mucosa, gums, and the tooth enamel. In this study, the tobacco smoking-related profile of patients being treated by way of implants was determined. Moreover, the relationship between cigarette smoking and pain sensation was assessed in patients undergoing surgical and prosthetic procedures in the oral cavity. The questionnaire survey covered 464 patients receiving prosthetic treatment at the “Dental” Non-Public Health Care Centre in Tomaszow Mazowiecki. The patients answered questions concerning their sex, age, the period of smoking, number of cigarettes smoked per day and the sensation of pain during bone reconstruction, implant placement and prosthetic procedures. The most numerous group of patients treated with implants were women: either non-smoking or smoking for less than 20 years at a level of less than 20 cigarettes a day, and men aged 40-60 years who have been smoking for over 20 years, at more than 20 cigarettes a day. The results of the survey reveal that non-smoking patients felt pain during bone reconstruction, implant placement and prosthetic procedures more frequently

Antimicrobial efficacy of Colgate Plax Cool Mint® mouthwash – in vivo studies

Hygienic procedures in oral cavity, both teeth brushing and using mouthwashes, have an influence on the composition and quantity of oral microflora. The aim of the work was to evaluate the impact of regular use of selected mouthwash on the titer of Lactobacillus and Streptococcus bacteria and Candida yeast-like fungi in the saliva