Surgical treatment of inflammatory periapical cyst: a clinical case report

Among the odontogenic cysts, there are radicular cysts or also called periapical cysts, are the most common odontogenic cyst. They develop at the apex of a tooth with pulp necrosis, which may be the consequence of dental caries or trauma. they are asymptomatic, grow slowly, and are discovered on routine radiographs. With the proliferation of the ERM and its activation, there is an increase in osmotic pressure, causing the cyst to expand, normally this ERM is not activated, so only granulation tissue develops at the apex of the affected tooth. Granulation tissue is called periapical granuloma and, as such, histologically lacks an epithelial lining. In the present study, a case of a 65-year-old female patient with an inflammatory periapical cyst in the region of the lower incisors is reported

Cystic echinococcosis in dogs and children in the province of Río Negro, Argentina

Fil: Larrieu, Edmundo. Ministerio de Salud, Provincia de Río Negro, Viedma, Argentina; Facultad de Ciencias Veterinarias, Universidad Nacional de Río Negro; Argentina.  Fil: Seleiman, Marcos. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Herrero, Eduardo. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Mujica, Guillermo. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Labanchi, Jose Luis. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Araya, Daniel. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Grizmado, Claudia. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Sepulveda, Luis. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Calabro, Arnoldo. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Talmon, Gabriel. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Crowley, Pablo. Ministerio de Salud, Provincia de Río Negro, Viedma, Argentina; Facultad de Ciencias Veterinarias, Universidad Nacional de Río Negro; Argentina.Fil: Albarracin, Silvina. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Arezo, Marcos. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología; Argentina.Fil: Volpe, Marcela. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Avila, A. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Perez, Alicia. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Uchiumi, Leonardo. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Salvitti, Juan Carlos. Ministerio de Salud, Provincia de Río Negro; Argentina.Fil: Santillan, Graciela. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología; Argentina.Cystic echinococcosis (CE) is an endemic disease in the province of Río Negro, Argentina. The control program against CE has developed monitoring surveillance systems. Currently, the coproELISA/Western blot (WB) test is used to determine transmission in livestock farms (epidemiological units or EU) from collected dry field-dispersed dog feces. The objective was to evaluate the prevalence of CE on livestock farms and its relationship with CE cases in children aged 0-14 years. Canine fecal samples were obtained from randomly selected livestock farms and processed by the coproELISA/WB test. Furthermore, new cases in children in the same age group mentioned above were identified. In 278 EU, 571 samples of canine feces were obtained. There were 37 positive samples for coproELISA/WB (6.5%) and the presence of transmission was demonstrated in 37 EU (13.3%). There were no significant differences (p=0.9) with the survey conducted in the period 2003-2004 while there were significant differences (p=0.02) with the EU survey of native populations conducted in 2009-2010. With respect to animal density in the work area, the EU yielding negative results had an average of 2 dogs (SD 2.1) per EU while in the EU having positive results the average was 3 dogs (SD 4.2), showing statistically significant differences (p=0.02). In children under 15 years of age, 12 cases were diagnosed. This study has identified, on average, that the cases of hydatid disease are closer in the positive fields than in the negative fields (p=0.00307).The coproELISA/WB test allowed to identify the dispersion of CE on livestock farms and its relationship with the occurrence of cases in children in 2009-2010

Early Diagnosis, Treatment and Follow-Up of Cystic Echinococcosis in Remote Rural Areas in Patagonia: Impact of Ultrasound Training of Non-Specialists

Cystic echinococcosis (CE) is an important and widespread disease that affects sheep, cattle, and humans living in areas where sheep and cattle are raised. CE is highly endemic in rural sections of Rio Negro, Argentina, where our group is based. However, it requires continuous monitoring of both populations with human disease best assessed by means of ultrasound (US) screening. This is challenging in remote rural areas due to the shortage of imaging specialists. To overcome this hurdle, we set up a two-day training program of Focused Assessment with Sonography for Echinococcosis (FASE) on CE for family medicine practitioners with no previous experience in US. After the course, they were equipped with portable US scanners and dispatched to remote rural areas in Rio Negro where they screened patients, located and staged the cysts and decided on the treatment with the help of surgeons and radiologists in local tertiary care centers

Epidemiologia, vigilancia y control de Rabia transmitida por Murciélagos Insectívoros

An exhaustive bibliographic search was carried out on epidemiology,surveillance and control strategies for Rabies variant 4 transmitted byinsectivorous bats. Likewise, as a case study, a retrospective study ofinsectivorous bats captured by passive surveillance and analyzed todetermine the presence of rabies virus was carried out in the Provinceof Río Negro, Argentina. The objective was to update the informationon the epidemiology of rabies variant 4 and to analyze the effectivenessof the control measures usually recommended by health services.The review carried out shows only 5 notifications in South Americacorresponding to canines and felines between 2009 and 2019 andwith regard to people, three cases were reported: in Chile in 1963 and2013 and in Colombia in 2012. The identification of insectivorous batscarrying rabies ranges from 4% to 15%. For its part, the veterinarypublic health service of the Health Ministry of Rio Negro collectedinsectivorous bats from passive surveillance activities. The bats weresent to the Laboratory of the Luis Pasteur Institute in the city of BuenosAires for identification of rabies virus. A total of 294 insectivorous batswere analyzed in 26 locations. The proportion of the infected ones was14.6% (95% CI 9.5-17.8) although there were no cases in dogs, cats orpeople. Insectivorous bats can be a risk factor for canines, felines, andhumans, although notifications of variant 4 cases in these species areextremely low in South America, so an evaluation of the recommendedand applied control strategy seems to be required, so far, as it is not cost-effective, and involves increasing operating costs in financial andhuman resources, proposing more efficient risk control alternatives.Se efectuó una búsqueda bibliográfica exhaustiva sobre epidemiologia, vigilancia epidemiológica y estrategias de control de Rabia variante 4 transmitida por murciélagos insectívoros. Asimismo, como estudio de caso se efectuó un estudio retrospectivo de murciélagos insectívoros capturados por vigilancia pasiva y analizados para determinar presencia de virus rábico en la Provincia de Río Negro, Argentina. El objetivo fue actualizar la información sobre la epidemiologia de la rabia variante 4 y analizar la eficacia de las medidas de control habitualmente recomendadas por los servicios de salud. La revisión efectuada muestra en Sudamérica solo 5 notificaciones correspondientes a caninos y felinos entre 2009 y 2019 y en relación a las personas, se reportaron tres casos: en Chile en 1963 y 2013 y uno en Colombia en 2012. La identificación de murciélagos insectívoros portadores de rabia varia del del 4% al 15%. Por su parte, el servicio de salud pública veterinaria del Ministerio de Salud de Rio Negro  recogió murciélagos insectívoros a partir de actividades de vigilancia pasiva. Los murciélagos fueron remitidos al Laboratorio del Instituto Luis Pasteur de la ciudad de Buenos Aires para identificación de virus rábico. Se analizaron un total de 294 quirópteros insectívoros en 26 localidades. La proporción de infectados fue del 14,6% (IC95% 9,5-17,8) aunque sin casos en perros, gatos o personas. Los murciélagos insectívoros pueden ser un factor de riesgo para caninos, felinos y seres humanos, aunque las notificaciones de casos a variante 4 en estas especies es extremadamente bajo en América del Sur por lo que parece requerirse una evaluación de la estrategia de control recomendada y aplicada hasta el momento por no ser costo - efectiva, e implicar crecientes costos operativos en recursos financieros y humanos, proponiéndose alternativas más eficientes de control de riesgos

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements