The profile of some inflammatory cytokines in gingival crevicular fluid of an young diabetic population

Rezumat. Interrelaţia diabet zaharat (DZ) status parodontal este un subiect care preocupa deopotriva lumea medicala stomatologica dar si pe cei in slujba ameliorarii si terapiei bolilor de nutritie si metabolism. In studiul de faţă ne‑am propus investigarea statusului parodontal pe un lot tanar cu DZ, prin monitorizarea clinică şi imunobiochimică la nivel local. Bilantul cli‑ nic (aprecierea statusului parodontal) şi investigaţiile de laborator (local în fluidul gingival — FCG) au fost realizate pe două loturi (44 copii si adolescenţi, cu varste intre 6‑18 ani), 22 fără afectare sistemică şi 22 cu DZ, ambele cu variate grade de alterare parodontală. Investigarea locală a răspunsului imunoinflamator generat în contextul sistemic, a vizat eva‑ luarea nivelelor locale ale unor citokine: interleukina 1β (IL‑1β), IL‑4 si IL‑5, precum şi factorul de necroză tumorală (TNF α), prin tehnici de flow citometrie. Studiul de faţă permite investigarea si evaluarea dereglarilor imunobiochimice rezultate in urma alterarii tesutului parodontal in con‑ textul bolii diabetice. Corelaţiile între potenţialul apoptotic al unora dintre citokine sugerează că afectarea atasamentului clinic la copiii şi adolescenţii cu DZ, poate fi, cel putin în parte, atribuită valorilor semnificativ crescute ale citokinelor din clasa TNF α, IL‑1β si IL‑5. La copiii si adolescentii cu diabet, este foarte importanta recunoaşterea şi manipularea terapeutică a sistemului imun, modularea ţintită a unor citokine specifice putand repre‑ zenta unul din factorii importanti în îngrijirea copilului si adolescentului diabetic.Summary. The bivalent relationship diabetes mellitus (DM) – periodontal health and disease (PD) has represented a significant interest over the years, both for dental doctors and those that treat metabolic and nutritional disorders. In this view, the present study investigated the periodontal status in a juve‑ nile population with DM, through the clinical and immune‑biochemical evaluation of some soluble chemical mediators in the gingival crevicular fluid (GCF). Clinical (periodontal status) and laboratory investigations examining the interrelation between DM and PD were performed upon 44, systemically healthy (n=22) and diabetic (n=22) children and adolescents, both with various degrees of periodontal modification. Investigation of the local (GCF) expression of the interleukin 1β, IL‑4, IL‑5 and tumor necrotic factor — TNFα has been achieved by flow cytometry. Our study allowed evaluation of the immuno‑biochemical disequilibrium resulted from the diabetes‑induced periodontal tissue injury. Correlations between apoptotic potential of some cytokines suggest that clinical attachment loss in diabetic children and adolescents could be, at least partly attributed to significant elevated levels of TNFα, IL — 1β and IL‑5. Taking into consideration the binomial relationship between DM and PD, recognition and manipulation of the immune system by targeted modulation of some specific cytokines could represent one of the important facts in the diabetic child and adoles‑ cent care

Immunohistochemical Aspects In Pleomorphic Adenoma, Related To Its Histogenesis And Malignization

Known and described since the nineteenth century as mixed tumour of salivary gland, and subsequently called pleomorphic adenoma, this tumour is a benign lesion with a complex structure, composed of epithelial type areas mixed with fibrous, mucoid or condroid stromal areas. The lesion raised many discussions related to its histogenesis and its possibility of malignancy, talks which currently continue. In order to argue for some of the theories, immunohistochemical reactions with anti-cytokeratin, anti-vimentin, anti-S100 protein, anti-p53 protein, anti-Ki67 protein, and anti-CD34 monoclonal antibodies were used. It was noted that all the cellular components of the lesion respond positively to cytokeratin and vimentin, more intensely in myoepithelial cells and periductular cells. All the proliferation markers were positive in all the cells, regardless of the morphological type and the intensity was increased in cases of malignancy. Thus, our research supports the hypothesis of the unique epithelial histogenesis and the possibility of malignization of pleomorphic adenoma, which differs from the primitive salivary gland carcinomas

INSIGHTS INTO CLINICO-MORPHOLOGICAL FEATURES AND MANAGEMENT OF CYSTIC FIBROSIS

Mucoviscidosis/ cystic fibrosis represents a potentially fatal disease, characterized by heterogeneous clinical features, mainly pulmonary, digestive, cardiac, but other systems may be involved. In recent years, there were constant concerns to identify the pathogenic disease mechanism. The molecular genetics techniques revealedin 1989 that cystic fibrosis comes from the defects of a single gene that decodes the cystic fibrosis transmembranar receptor (CFTR), a chloride channel that is distributed on a large scale in the membrane surfaces. CFTR is expressedby the airways epithelium, paranasal sinuses, pancreas, bowel, billiary tract, vasdeferens and sweat glands epithelia.Abnormalitiesin CFTR functioncause pulmonary infections and bronchectasis, leading to a respiratory insufficiency, pancreatic insufficiency and malabsorbtion, episodic intestinal obstructions, liver disease and male infertility.Atthe moment, a symptomatic treatment is available asrespiratory physiotherapy, antibiotic therapy, nebulization with mucolytics and bronchodilators, administration of protease inhibitors for pulmonary symptoms, administration of pancreatic enzymes substitutes and vitamins for pancreatic insufficiency. Though the survival rate of patients with cystic fibrosis has known important improvements in the last years, this disease remains a redoubtable adversary not only for the patient, but also for his family. Furthermore, the extremely complex physiological, biochemical and genetic profiles remains of maximum interest for the actual medical research

Hypolipemiant Actions and Possible Cardioprotective Effects of Valine and Leucine: An Experimental Study

Background and Objectives: Considering atherosclerosis as one of the more challenging threats to healthcare worldwide, any novel therapy that counteracts the risks for developing it, provides new opportunities for the management of this process. Material and methods: We performed an experimental research in which we induced a hypercholesterolemia via a cholesterol-rich diet. Our aim was to demonstrate the antiatherogenic potential of two essential amino acids (valine and leucine). The experimental study was carried out over a period of 60 days. Male Wistar rats weighing between 250–280 g were used and divided into 4 groups, each group including 8 animals. Group I—control was fed with a standard diet. Group II received cholesterol, group III cholesterol and valine and group IV cholesterol and leucine. Blood samples were collected from the retro-orbital plexus, under anesthesia with 75 mg/kg of intraperitoneal ketamine, in three different moments (R0—1st day, R1—the 30th day, R2—the 60th day) in order to measure the levels of triglycerides. Results: In R0, there were no significant differences between the average levels of triglycerides across all the groups (p p p p p Conclusions: Our data provides evidence that valine and leucine have a direct impact on the lipid metabolism parameters by lowering the level of triglycerides. The comparison of the two essential amino acids indicates that valine acts more promptly and rapidly than leucine

Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

Placental morbid adherence is a known risk factor for postpartum hemorrhage. The incidence of abnormal placental attachment has been increasing over the past few decades, mainly due to rising rates of cesarean deliveries, advanced maternal age, and the use of assisted reproductive technologies. Cesarean section is a significant risk factor for placenta increta, as it disrupts the normal architecture of the uterine wall, making it more difficult for the placenta to detach after delivery. We present the case of a woman who underwent a cesarean section at 28 weeks due to anterior placenta previa, accompanied by hemorrhage and rupture of membranes. Following the delivery, she experienced normal postoperative bleeding and was discharged home after five days. However, six weeks later, she presented with heavy bleeding, leading to the decision to perform a total hysterectomy. The levels of HCG were found to be low. The pathological examination of the specimens confirmed a diagnosis of placenta increta, as it revealed notable placental proliferation, necrotic villi, and placental invasion near the uterine serosa. Notably, we did not find any similar cases documented in the literature. Patients experiencing prolonged vaginal bleeding after childbirth and diagnosed with placenta accreta should be closely monitored through ultrasound examinations; abnormal proliferation of the placenta can occur, and prompt detection is crucial for appropriate management

Proton beam radiation therapy for vestibular schwannomas-tumor control and hearing preservation rates : a systematic review and meta-analysis

ObjectiveProton beam therapy is considered, by some authors, as having the advantage of delivering dose distributions more conformal to target compared with stereotactic radiosurgery (SRS). Here, we performed a systematic review and meta-analysis of proton beam for VSs, evaluating tumor control and cranial nerve preservation rates, particularly with regard to facial and hearing preservation.MethodsWe reviewed, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) articles published between 1968 and September 30, 2022. We retained 8 studies reporting 587 patients.ResultsOverall rate of tumor control (both stability and decrease in volume) was 95.4% (range 93.5-97.2%, p heterogeneity= 0.77, p<0.001). Overall rate of tumor progression was 4.6% (range 2.8-6.5%, p heterogeneity < 0.77, p<0.001). Overall rate of trigeminal nerve preservation (absence of numbness) was 95.6% (range 93.5-97.7%, I-2 = 11.44%, p heterogeneity= 0.34, p<0.001). Overall rate of facial nerve preservation was 93.7% (range 89.6-97.7%, I-2 = 76.27%, p heterogeneity<0.001, p<0.001). Overall rate of hearing preservation was 40.6% (range 29.4-51.8%, I-2 = 43.36%, p heterogeneity= 0.1, p<0.001).ConclusionProton beam therapy for VSs achieves high tumor control rates, as high as 95.4%. Facial rate preservation overall rates are 93%, which is lower compared to the most SRS series. Compared with most currently reported SRS techniques, proton beam radiation therapy for VSs does not offer an advantage for facial and hearing preservation compared to most of the currently reported SRS series

A Retrospective Clinical Trial Regarding Oral Rehabilitation Diagnosis Strategies Based on Stomatognathic System Pathology

Introduction: Orofacial pain is a common occurrence in daily dental practice; it is frequently attributed to temporomandibular dysfunction, one of its major causes, followed by pathology of the salivary glands, without avoiding interference at the level of the pain pathways caused by complications of periodontal pathology. The main objective of this study is to identify an important cause of pain in the oral–maxillofacial territory by quantifying the changes at the salivary glandular level using stereological methods. The secondary objective of the present research is to identify the implications of periodontal changes as a consequence of salivary quantitative and qualitative changes, quantified using periodontal indices, on the balance of the temporomandibular joint, dysfunction of it being an important cause of facial pain and having a profound impact on the complex oral rehabilitation algorithm of each clinical case, a condition evaluated with the analysis of the results of the Souleroy questionnaire. Material and methods: In a retrospective study, we evaluated the clinical results obtained after applying complex rehabilitation treatment to 35 subjects, 20 women and 15 men with salivary and TMJ dysfunctions, selected between 2020 and 2021 from the Clinic of Maxillofacial Surgery, Iasi. Results and discussion: The most common symptoms of temporomandibular disorders (TMDs) that were identified through the Souleroy questionnaire were pain and different types of damage to the masticatory muscles. The most significant changes in elders are reported in the case of serous cells, which reduced their percentage volume from 46.7% to 37.4%. Conclusion: As regards stereological analysis in conjunction with histological images, there were significant changes in diameters, perimeters, and longitudinal axes in the adult patients as opposed to the elderly patients, which were also influenced by the type of pathology at this level. The scores recorded on the diagnostic Souleroy scale indicated a large number of patients with low efficiency and maximum stress levels: 20.0% in level 1, 25.7% in level 2, and 25.7% in level 3