The discourse of efficient speciality: Ambiguities of active participation in space with personalized location-based analytics

Ph.DDOCTOR OF PHILOSOPH

Enzimas salivales y enfermedad periodontal

Objetivos: Las enfermedades que producen daño tisular producen la liberación de diferentes enzimas relacionadas con la muerte y destrucción celular, como son la aspartato y alanino aminotransferasa (AST, ALT), lactato dehidrogenasa (LDH), creatinin kinasa (CK), alcalina y ácida (ALP, ACP) y gamma glutamil transferasa (GGT). Al tratarse la enfermedad periodontal (EP) de un proceso inflamatorio con afectación de la encía y periodonto, parece lógico pensar que la actividad enzimática debe reflejar los cambios metabólicos secundarios a esta reacción inflamatoria. Diseño del estudio: En este artículo examinamos la actividad de CK, LDH, AST, ALT, GGT, ALP y ACP en la saliva de pacientes con EP, antes y después del tratamiento periodontal (grupo experimental'30 muestras) así como en la saliva de pacientes sin enfermedad periodontal (grupo control'20 muestras). La EP se diagnosticó en base a parámetros clínicos (índice gingival'GI, sangrado al sondaje-BOP y profundidad al sondaje-PD). Todos los pacientes con enfermedad periodontal recibieron tratamiento convencional de la misma. Se registró la actividad enzimática en todos los pacientes y se cuantificó por espectrofotometría Resultados: Se observó un aumento estadísticamente significativo en la actividad de CK, LDH, AST, ALT; GGT, ALP y ACP en la saliva de los pacientes con enfermedad periodontal en relación a los resultados obtenidos en el grupo control. Se detectó una correlación positiva entre la actividad de las enzimas salivales examinadas y el valor del GI. Después del tratamiento periodontal convencional la actividad de estas enzimas salivales disminuyó significativamente. Conclusiones: Basándonos en estos resultados. Podemos concluir que la actividad de estas enzimas puede ser útil en el diagnóstico y evaluación del tratamiento de la EP.Background: Host responses to periodontal disease include the production of different enzymes that are released by stromal, epithelial or inflammatory cells. There are important enzymes associated with cell injury and cell death like: aspartate and alanine aminotransferase (AST, ALT), lactate dehydrogenase (LDH), creatine cinase (CK), alkaline and acidic phosphatase (ALP, ACP), gama glutamil transferase (GGT). Changes in enzymatic activity reflect metabolic changes in the gingiva and periodontium in inflammation. Design of Study: In this paper we have examined the activity of CK, LDH, AST, ALT, GGT, ALP and ACP in saliva from patients with periodontal disease before and after periodontal treatment (experimental group ' 30 samples) and in saliva from healthy patients (control group ' 20 samples). Periodontal disease was determined based on clinical paIndexed desrameters (gingival index (GI), bleeding on probing (BOP), probing depth (PD)). Patients with periodontal disease were under conventional periodontal treatment. Results: Obtained results were shown statistically significant increases of activity of CK, LDH, AST, ALT, GGT, ALP, ACP in saliva from patients with periodontal disease in relation to control group. There is positive correlation between the activity of examined salivary enzymes and value of the gingival index. After conventional periodontal therapy the activity of all salivary enzymes was significantly decreased. Conclusions: Based on these results, it can be assume that activity of these enzymes in saliva, as biochemical markers for periodontal tissue damage, may be useful in diagnosis, prognosis and evaluation of therapy effects in periodontal disease

Salivary enzymes and periodontal disease

Background: Host responses to periodontal disease include the production of different enzymes that are released by stromal, epithelial or inflammatory cells. There are important enzymes associated with cell injury and cell death like: aspartate and alanine aminotransferase (AST, ALT), lactate dehydrogenase (LDH), creatine cinase (CK), alkaline and acidic phosphatase (ALP, ACP), gama glutamil transferase (GGT). Changes in enzymatic activity reflect metabolic changes in the gingiva and periodontium in inflammation. Design of Study: In this paper we have examined the activity of CK, LDH, AST, ALT, GGT, ALP and ACP in saliva from patients with periodontal disease before and after periodontal treatment (experimental group ? 30 samples) and in saliva from healthy patients (control group ? 20 samples). Periodontal disease was determined based on clinical parameters (gingival index (GI), bleeding on probing (BOP), probing depth (PD)). Patients with periodontal disease were under conventional periodontal treatment. Results: Obtained results were shown statistically significant increases of activity of CK, LDH, AST, ALT, GGT, ALP, ACP in saliva from patients with periodontal disease in relation to control group. There is positive correlation between the activity of examined salivary enzymes and value of the gingival index. After conventional periodontal therapy the activity of all salivary enzymes was significantly decreased. Conclusions: Based on these results, it can be assume that activity of these enzymes in saliva, as biochemical markers for periodontal tissue damage, may be useful in diagnosis, prognosis and evaluation of therapy effects in periodontal disease

Programmed cell death-1 and its ligands: Current knowledge and possibilities in immunotherapy

Programmed Cell Death-1 (PCD-1) is a key immune checkpoint receptor, which mainly expresses on activated T, B, Dendritic (DC), Natural Killer (NK), and Treg cells. On the surface of activated T-cells, PCD-1 expression is upregulated after the recognition of peripherals antigens by T cells; subsequently, the elevated binding of PD-1 to Programmed Death Ligand-1 (PD-L1) and Programmed Death Ligand-2 (PD-L2) becomes a key step for downstream inhibitory signaling. Although the role of PD-L1 has been evaluated more thoroughly by clinical research, and PD-L1 has also been used more widely in the clinical setting, PD-L2 also plays an important role in the negative regulation of T-cells, one of the necessary conditions that lead to immune tolerance. Expression of PD-L1 either in tumors or in infiltrating immune cells has been verified predominantly by Immunohistochemistry (IHC) in a variety of tumors, suggesting a role for the PD-1/PD-L1 axis as a prognostic trait and therapeutic target across multiple histotypes. The complex interplay between these factors plays a major role in the diffusion and clinical application of PD-L1 IHC assays as predictive biomarkers of response to PD-1/PD-L1 inhibitors. Checkpoint blockades are registered for the treatment of various cancers, including gynecological malignancies

Preliminary outcomes of five-year survival for ovarian malignancies in profiled Serbian Oncology Centre

Objective: The present study purposed to determine characteristics of ovarian carcinoma and to analyze predictors of survival in patients with ovarian carcinoma. Method: A retrospective cohort study was conducted including the patients with diagnosed ovarian carcinoma treated at the Clinic for Operative Oncology, Oncology Institute of Vojvodina in the period from January 2012 to December 2016. Seventy-two women with ovarian carcinoma were included in the analysis. The data about the histological type of tumor, disease stage, treatment, lymphatic infiltration, and surgical procedure were collected retrospectively, using the database of the institution where the research was conducted (BirPis 21 SRC Infonet DOO ‒ Information System Oncology Institute of Vojvodina). Descriptive statistics and multivariate analysis using Cox proportional hazards model were performed. Results: The univariate Cox regression analysis identified histology, tumor grade, FIGO (International Federation of Gynecology and Obstetrics) stage, NACT (Neoadjuvant Chemotherapy), number of therapy cycles, type of surgery, and chemotherapy response as independent predictors of mortality. Finally, the type of tumor and chemotherapy response had an increased hazard ratio for mortality in the multivariate Cox regression model. Herewith, the percentage of high-grade, advanced-stage ovarian cancer patients with complete response to chemotherapy, absence of recurrent disease, and lymphovascular space invasion were significant predictors of survival in patients with ovarian carcinoma. Conclusions: Herein, emerging data regarding precision medicine and molecular-based personalized treatments are promising and will likely modify the way the authors provide multiple lines of treatments in the near future

Updates on the Treatment of Pterygium

Pterygium is an ocular disease characterised by the growth of fibrovascular conjunctiva on the cornea. It occurs more often in men, at an older age, and in individuals exposed to ultraviolet radiation. Surgical treatment is the primary treatment for pterygium and there are two common procedures for pterygium excision. In the first method, the head of the pterygium is separated from the corneal surface using a surgical blade. The second method is based on avulsion. Other approaches to excising the pterygium include the use of argon laser and excimer laser. Because of a high recurrence rate, adjuvant therapies, including radiotherapy, chemotherapy, and graft procedures, are used after pterygium excision. These procedures have become the standard long-term treatments for pterygium. Radiotherapy is based on beta irradiation. Chemotherapy includes the use of mitomycin C, 5-fluorouracil, bevacizumab, and loteprednol etabonate. Graft procedures include amniotic membrane grafts and conjunctival autografts. Many surgeons believe that using mitomycin C and conjunctival autografts provides the best outcomes in terms of recurrence, cosmetics and patient satisfaction

Comparing the interactive effects of water and nitrogen on durum wheat and barley grown in a Mediterranean environment

The understanding of the interactive effect of water and N availability, associated with the ability of crops to efficiently use these resources, is a crucial issue for stabilizing cereal production in Mediterranean areas. A 3-year side by side experiment on durum wheat and barley, under different water regimes and nitrogen levels, was carried out in a typical Mediterranean environment of Southern Italy, to identify the outstanding features of these species that contribute to enhanced grain yield and improved water and nitrogen use efficiency. Wheat and barley response was assessed under three water supply regimes (I100, I50, I0: full irrigation, 50% of full irrigation and rainfed) coupled with two N fertilizer levels (high N: 120 kg ha-1 and low N: not fertilized). In order to evaluate barley yield response under lower N rates, 60 kg ha-1 were applied in 2006. The occurrence of abundant rainfall during the experimental period determined only mild water stress during most of the growing season, especially in 2006 and 2007. Under these conditions, nitrogen fertilization was the main factor affecting crop response, and different crop traits in response to irrigation were primarily evident on tissue N concentrations. Grain number per unit land area explained a high proportion of grain yield and it was mainly influenced by N fertilization. Water availability enhanced N absorption: the response of both crops to N fertilization, in terms of N uptaken and grain N concentration, was higher in the year characterized by greater water availability during the most sensitive stages to drought stress. Under unfertilized conditions, the two crops showed similar response in terms of number of grains per unit land area; under N fertilization, barley exhibited a higher increase in number of grains per unit land area, but wheat achieved similar yields as consequence of the higher grain weight. In years characterized by similar average productivity of wheat, barley did not show further increase in number of seeds, even doubling the rate of N supplied. By increasing irrigation water supply, the two crops showed a similar yield response, but a different N partition, as confirmed by the lower nitrogen harvest index values for barley over 2007-2008. At similar total availability of N, barley reached higher N utilization efficiency than wheat, mainly because of a lower N concentration in the grain rather than a higher efficiency in using the available N. © 2009 Elsevier B.V. All rights reserved

Eugenol-based temporary luting cement possesses antioxidative properties

Introduction. Antioxidants protect against reactive oxygen species and expose beneficial anti-inflammatory activity when in contact with biological tissues. Dental materials that are used as temporary luting on fixed dental restorations are often in contact with injured gingival tissue, hence they should contain anti-inflammatory characteristics that are essential after prosthetic procedures preceding cementation of final restauration. Objective. The aim of this study was to investigate the antioxidant effect through the oxidation inhibition (OI) of mixed dental cement for temporary luting or their liquid component. Methods. Eight study groups were prepared each by ten samples: 1) ex tempore preparation of zinc-oxide eugenol paste (Kariofil Z Galenika, Serbia), 2) Viko Temp paste (Galenika, Serbia), 3) Temp Bond NE paste (Kerr, Germany), 4) ScutaBond (ESPE, Germany), 5) Cp-CAP paste (Germany, Lege Artis) and oil component of 6) Kariofil Z, 7) Viko Temp and 8) Cp-CAP. The samples were subjected to spectrophotometer to measure OI 2,2’-azino-di-(3-ethyl-benzthiazoline-6-sulphonic acid) (ABTS) using Randox kit, United Kingdom. The control samples were pure ascorbic acid (1% w/v). Results. High values of OI exposed materials (groups 1, 5, 6, 7, 8) with content of eugenol (or its derivates) in the range of 100-88.8% were statistically more significant than the values of non-eugenol substances (groups 2, 3, 4) with the range of 8.2-43.5%. Conclusion. Eugenol containing temporary fixation materials show significant antioxidative properties and therefore they may be used in those clinical situations where surrounding gingival tissue is injured during restorative procedure. [Projekat Ministarstva nauke Republike Srbije, br. III 45005

Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

Introduction/Objective Pseudoexfoliation syndrome is characterized by abnormal production and ac-cumulation of fibrillar, white-gray, “dandruff-like” material in almost all ocular structures. The aim of this study was to examine effect of selective laser trabeculoplasty in pseudoexfoliation glaucoma patients. Methods Thirty-two patients (47 eyes) with medically uncontrolled pseudoexfoliation glaucoma were enrolled. All the patients could not reach target intraocular pressure with maximal tolerated medical therapy before treatment. Selective laser trabeculoplasty was performed with about 100 non-overlapping spots. Intraocular pressure was measured one hour, seven days, four weeks, three, six, twelve, eighteen, and twenty-four months after the procedure. Results The mean base intraocular pressure was 23.45 mmHg (SD = 3.07). Statistically significant reduction of mean intraocular pressure was observed at all follow-ups except one hour after treatment. Mean intraocular pressure after 24 months was 18.39 mmHg (SD = 1.82). Success, defined as intraocular pressure reduction from base intraocular pressure by more than 20% after 24 months, was achieved in 27 eyes (57.45%). We did not find any influence of sex and age on selective laser trabeculoplasty effects in pseudoexfoliative glaucoma patients. Baseline intraocular pressure is proved to be a reliable predictor of intraocular pressure-lowering effect, as there was a strong correlation between baseline intraocular pressure and the percentage of reduction of intraocular pressure after 24 months (r = 0.71, p < 0.01). Conclusion Selective laser trabeculoplasty is a safe and effective method for the reduction of intraocular pressure in pseudoexfoliation glaucoma patients and should be used more often in this challenging form of glaucoma. Baseline intraocular pressure seems to be a reliable predictor of success