Relationship between edentulism and sleep apnea: a systematic review of the literature

Edentulism could be the cause of impaired respiratory function, especially during sleep. The aim of this systematic review of the literature was to study the relationship between edentulism and sleep apnea. The search was performed on MEDLINE (PubMed), with different Boolean equations. A manual search was also carried out. 19 articles were selected. 17 have shown that edentulism promotes the onset of obstructive sleep apnea. In 6 studies, an improvement in sleep apnea was noted with wearing the prosthesis at night, unlike the other 4 studies reported a deterioration in sleep quality with wearing the prosthesis. A strong relation was proven between obstructive sleep apnea and edentulism. This relationship has been justified mainly by the anatomical changes linked to the loss of teeth and responsible for the reduction of the retro-pharyngeal space

Interest of attachment use in the treatment of a large edentulous ridge: A clinical report

The oral rehabilitation of a large edentulous ridge is complicated by mechanical and esthetic problems. The use of an axial attachment as a complementary retention device has many benefits on the prosthetic balance and the esthetically integration of the prosthesis. To manage this procedure successfully, the rigorous study of the prosthetic space and the mastering of the implementations’ steps are necessary. The purpose of this work is to present through a clinical case the various steps of the realization of a metallic framework removable partial denture with an axial attachment and to underline the contribution of this device in the case of a large edentulous ridge

The conversion of glutamate by glutamine synthase in neocortical astrocytes from juvenile rat is important to limit glutamate spillover and peri/extrasynaptic activation of NMDA receptors

International audienceGlutamate transporters (EAATs) are important to maintain spatial and temporal specificity of synaptic transmission. Their efficiency to uptake and transport glutamate into the intracellular space depends on several parameters including the intracellu-lar concentrations of Na 1 and glutamate, the elevations of which may slow down the cycling rate of EAATs. In astrocytes, glutamate is maintained at low concentration due to the presence of specific enzymes such as glutamine synthase (GS). GS inhibition results in cytosolic accumulation of glutamate suggesting that the conversion of glutamate by GS is important for EAATs operation. Here we recorded astrocytes from juvenile rat neocortical slices and analyzed the consequences of elevated intracellular glutamate concentrations and of GS inhibition on the time course of synaptically evoked transporter current (STC). In slices from rats treated with methionine sulfoximine (MSO), a GS inhibitor, STC evoked by short burst of high frequency stimulation (HFS; 100 Hz for 100 ms) but not by low frequency stimulation (LFS; 0.1 Hz) was twice slower than STC evoked from saline injected rats. Same results were obtained for astrocytes recorded with pipette containing 3-10 mM gluta-mate and compared with cells recorded with 0 or1 mM glutamate in the patch pipette. We also showed that HFS elicited significantly larger NMDAR-excitatory postsynaptic currents (EPSCs) with a stronger peri/extrasynaptic component in pyramidal cells from MSO-treated compared with saline treated rats. Taken together our data demonstrate that the conversion of gluta-mate by GS is fundamental to ensure an efficient clearance of glutamate by EAATs and to prevent glutamate spillover. GLIA 2016;00:000-00

Flexible polyamide versus acrylic resin removable prosthesis: A systematic review of the literature

Objective: Polyamide, commonly referred to as flexible resin, has been introduced into dentures since 1950 as an alternative to polymethyl methacrylate (PMMA) resins for the fabrication of prosthetic bases. Several studies have been conducted to compare the different properties of these two materials. However, most of these studies were laboratory “in vitro” studies. The aim of this work was to compare the properties and clinical behaviour of flexible resin prosthetic bases with those of conventional resin “in vivo”, once placed into the mouth, through a systematic review of the literature.Material and methods: The search was performed on MEDLINE via the PubMed consultation interface, using the following Boolean equation: ((“Flexible denture” [Mesh]) OR (“Polyamide denture” [Mesh])) AND (“Acrylic denture” [Mesh]). This search was supplemented by a manual search on “Google Scholars”.Results: Based on previously established inclusion and non-inclusion criteria, 23 clinical studies involving a total of 713 patients were selected (10 randomised control trials, 7 non-randomised controlled clinical trials and 6 cross-sectional studies). In 15 of the 23 included studies, the flexible prosthesis showed an advantage over the conventional prosthesis in almost all parameters evaluated and for the different types of edentulism.Conclusion: Polyamide prostheses are therefore an excellent alternative to conventional methyl methacrylate prostheses as they provide more comfort, aesthetics and overall patient satisfaction. Nevertheless, based on the mechanical properties of polyamide, the indication of this material for large partial or total edentulism is still limited

Two-day seven-day course of levofloxacin in acute COPD exacerbation: a randomized controlled trial

Introduction: Duration of antibiotic treatment in acute exacerbation of COPD (AECOPD) is most commonly based on expert opinion. Typical administration periods range from 5 to 7 days. A 2-day course with levofloxacin was not previously assessed. We performed a randomized clinical trial to evaluate the efficacy of 2-day versus 7-day treatment with levofloxacin in patients with AECOPD. Methods and analysis: Patients with AECOPD were randomized to receive levofloxacin for 2 days and 5 days placebo ( n  = 155) or levofloxacin for 7 days ( n  = 155). All patients received a common dose of intravenous prednisone daily for 5 days. The primary outcome measure was cure rate, and secondary outcomes included need for additional antibiotics, ICU admission rate, re-exacerbation rate, death rate, and exacerbation-free interval (EFI) within 1-year follow-up. The study protocol has been prepared in accordance with the revised Helsinki Declaration for Biomedical Research Involving Human Subjects and Guidelines for Good Clinical Practice. The study was approved by ethics committees of all participating centers prior to implementation (Monastir and Sousse Universities). Results: 310 patients were randomized to receive 2-day course of levofloxacin ( n  = 155) or 7-day course ( n  = 155). Cure rate was 79.3% ( n  = 123) and 74.2% ( n  = 115), respectively, in 2-day and 7-day groups [OR 1.3; 95% CI 0.78–2.2 ( p  = 0.28)]. Need for additional antibiotics rate was 3.2% and 1.9% in the 2-day group and 7-day group, respectively; ( p  = 0.43). ICU admission rate was not significantly different between both groups. One-year re-exacerbation rate was 34.8% ( n  = 54) in 2-day group versus 29% ( n  = 45) in 7-day group ( p  = 0.19); the EFI was 121 days (interquartile range, 99–149) versus 110 days (interquartile range, 89–132) in 2-day and 7-day treatment groups, respectively; ( p  = 0.73). One-year death rate was not significantly different between the 2 groups, 5.2% versus 7.1% in the 2-day group and 7-day group, respectively; ( p  = 0.26). No difference in adverse effects was detected. Conclusion: Levofloxacin once daily for 2 days is not inferior to 7 days with respect to cure rate, need for additional antibiotics and hospital readmission in AECOPD. Our findings would improve patient compliance and reduce the incidence of bacterial resistance and adverse effects

2-Day versus C-reactive protein guided antibiotherapy with levofloxacin in acute COPD exacerbation: A randomized controlled trial.

IntroductionDuration of antibiotic treatment in acute exacerbation of COPD (AECOPD) is most commonly based on expert opinion. Biomarker guided strategy is increasingly recommended to limit unnecessary antibiotic use. We performed a randomized controlled study to evaluate the efficacy of 2-day versus C-reactive protein (CRP)-guided treatment with levofloxacin in patients with AECOPD.MethodsPatients with AECOPD were randomized to receive oral levofloxacin daily for 7 days unless the serum CRP level decreased by at least 50% from the baseline value or levofloxacin for two days; thereafter, oral placebo tablet was prescribed according to the CRP. The primary outcome measure was cure rate, and secondary outcome included need for additional antibiotics, intensive care unit (ICU) admission, exacerbation rates and exacerbation free interval (EFI) within one-year follow-up.ResultsIn intention to treat (ITT) analysis, cure rate was 76.1% (n = 118) and 79.3% (n = 123) respectively in 2-day and CRP-guided groups. In per protocol (PP) analysis, cure rate was 73% (n = 92) and 70.4% (n = 88) respectively in 2-day and CRP-guided groups. The difference between the two groups was not significant. The need for additional antibiotics and ICU admission rates were not significantly different between the two groups. One-year exacerbation rate was 27% (n = 42) in 2-day group versus 30.3% (n = 47) in CRP-guided group (p = 0.53); the EFI was 125 days (interquartile range, 100-151) versus 100 days (interquartile range, 78-123) in 2-day and CRP-guided groups respectively (p = 0.45). No difference in adverse effects was detected.ConclusionLevofloxacin once daily for 2 days had similar efficacy compared to CRP-guided in AECOPD. This short course treatment decreased antibiotic consumption which would improve patient compliance and reduce adverse effects

Pharmacogenetic landscape of Metabolic Syndrome components drug response in Tunisia and comparison with worldwide populations

<div><p>Genetic variation is an important determinant affecting either drug response or susceptibility to adverse drug reactions. Several studies have highlighted the importance of ethnicity in influencing drug response variability that should be considered during drug development. Our objective is to characterize the genetic variability of some pharmacogenes involved in the response to drugs used for the treatment of Metabolic Syndrome (MetS) in Tunisia and to compare our results to the worldwide populations. A set of 135 Tunisians was genotyped using the Affymetrix Chip 6.0 genotyping array. Variants located in 24 Very Important Pharmacogenes (VIP) involved in MetS drug response were extracted from the genotyping data. Analysis of variant distribution in Tunisian population compared to 20 worldwide populations publicly available was performed using R software packages. Common variants between Tunisians and the 20 investigated populations were extracted from genotyping data. Multidimensional screening showed that Tunisian population is clustered with North African and European populations. The greatest divergence was observed with the African and Asian population. In addition, we performed Inter-ethnic comparison based on the genotype frequencies of five VIP biomarkers. The genotype frequencies of the biomarkers rs3846662, rs1045642, rs7294 and rs12255372 located respectively in <i>HMGCR</i>, <i>ABCB1</i>, <i>VKORC1 and TCF7L2</i> are similar between Tunisian, Tuscan (TSI) and European (CEU). The genotype frequency of the variant rs776746 located in <i>CYP3A5</i> gene is similar between Tunisian and African populations and different from CEU and TSI. The present study shows that the genetic make up of the Tunisian population is relatively complex in regard to pharmacogenes and reflects previous historical events. It is important to consider this ethnic difference in drug prescription in order to optimize drug response to avoid serious adverse drug reactions. Taking into account similarities with other neighboring populations, our study has an impact not only on the Tunisian population but also on North African population which are underrepresented in pharmacogenomic studies.</p></div

Estimating of pairwise Fst among the 11 populations.

<p>Estimating of pairwise Fst among the 11 populations.</p

Genotype frequency of significant VIP variants in Tunisian population (n = 135) compared with ten HapMap populations.

<p>Genotype frequency of significant VIP variants in Tunisian population (n = 135) compared with ten HapMap populations.</p