The proinflammatory cytokine interleukin 18 regulates feeding by acting on the bed nucleus of the stria terminalis

The proinflammatory cytokine IL-18 has central anorexigenic effects and was proposed to contribute to loss of appetite observed during sickness. Here we tested in the mouse the hypothesis that IL-18 can decrease food intake by acting on neurons of the bed nucleus of the stria terminalis (BST), a component of extended amygdala recently shown to influence feeding via its projections to the lateral hypothalamus (LH). We found that both subunits of the heterodimeric IL-18 receptor are highly expressed in the BST and that local injection of recombinant IL-18 (50 ng/ml) significantly reduced c-fos activation and food intake for at least 6 h. Electrophysiological experiments performed in BST brain slices demonstrated that IL-18 strongly reduces the excitatory input on BST neurons through a presynaptic mechanism. The effects of IL-18 are cell-specific and were observed in Type III but not in Type I/II neurons. Interestingly, IL-18-sensitve Type III neurons were recorded in the juxtacapsular BST, a region that contains BST-LH projecting neurons. Reducing the excitatory input on Type III GABAergic neurons, IL-18 can increase the firing of glutamatergic LH neurons through a disinhibitory mechanism. Imbalance between excitatory and inhibitory activity in the LH can induce changes in food intake. Effects of IL-18 were mediated by the IL-18R because they were absent in neurons from animals null for IL-18R\u3b1 (Il18ra-/-), which lack functional IL-18 receptors. In conclusion, our data show that IL-18 may inhibit feeding by inhibiting the activity of BST Type III GABAergic neurons

Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study

Objectives: The aim of this prospective comparative clinical study was to evaluate the effect of oral anticoagulants on peri- and post-operative bleeding during simple single tooth extractions, comparing patients in treatment with vitamin K antagonists (VKAs) and patients assuming direct oral anticoagulants (DOACs). Materials and methods: Patients under oral anticoagulant therapy needing dental extraction were eligible for entering the study; patients were enrolled following inclusion and exclusion criteria and divided into VKAs and DOAC group according to the anticoagulation therapy. Included patients underwent a simple single dental extraction with elevators and forceps with a maximum surgical time of 15 minutes, without anticoagulation therapy discontinuation. All participants were assessed pre-operatively, during surgery, 30 min minutes and 7 days after surgery. Biological complications were registered and post-extraction bleeding was clinically defined according to Iwabuchi classification. Parametric and non-parametric tests were used to evaluate the variables between the groups. Results: Sixty-five patients per group were enrolled and 130 teeth were extracted. The two groups were comparable for pre-, peri-, and post-operative variables. Only 1 patient of DOAC group and 2 patients for VKA group needed medical evaluation for post-extractive bleeding. No statistically significant difference resulted in post-operative bleeding events between the groups (p = 0.425). Conclusions: DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction. Bleeding events were not statistically significant and not clinically relevant. Clinical relevance: Patients assuming DOACs can be treated similarly to patients in VKAs therapy with INR index between 2 and 3. Non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions. \ua9 2018, Springer-Verlag GmbH Germany, part of Springer Nature

O Atendimento odontológico do paciente renal terminal submetido a dialise: uma revisão atual da literatura médica vigente.

Chronic renal failure is a progressive disease characterized by a gradual destruction of the nephrons and a consequent reduction in renal function. End-stage kidney disease (ESRD) requires renal replacement therapy such as peritoneal dialysis, hemodialysis or transplantation. Patients affected by ESRD or on hemodialysis are at risk of developing a series of comorbidities, including hypertension, anemia, risk of bleeding, susceptibility to infection, side effects of medications and oral manifestations associated with the disease itself and treatment on hemodialysis. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relationship with infection, inflammation and malnutrition.A insuficiência renal crônica é uma doença progressiva caracterizada por uma destruição gradual dos néfrons e uma conseqüente redução da função renal. A doença renal em estágio terminal (DRT) requer terapia de substituição renal como diálise peritoneal, hemodiálise ou transplante. Os pacientes afetados pela DRT ou em hemodiálise correm risco de desenvolver uma série de comorbidades, incluindo hipertensão, anemia, risco de sangramento, suscetibilidade à infecção, efeitos colaterais dos medicamentos e manifestações orais associadas à própria doença e ao tratamento em hemodiálise. Nesse contexto, as doenças bucais representam uma causa potencial e evitável de maus resultados de saúde em pessoas com DRT devido à sua relação com infecção, inflamação e desnutrição

Consistency and diversity of spike dynamics in the neurons of bed nucleus of Stria Terminalis of the rat: a dynamic clamp study

Neurons display a high degree of variability and diversity in the expression and regulation of their voltage-dependent ionic channels. Under low level of synaptic background a number of physiologically distinct cell types can be identified in most brain areas that display different responses to standard forms of intracellular current stimulation. Nevertheless, it is not well understood how biophysically different neurons process synaptic inputs in natural conditions, i.e., when experiencing intense synaptic bombardment in vivo. While distinct cell types might process synaptic inputs into different patterns of action potentials representing specific "motifs'' of network activity, standard methods of electrophysiology are not well suited to resolve such questions. In the current paper we performed dynamic clamp experiments with simulated synaptic inputs that were presented to three types of neurons in the juxtacapsular bed nucleus of stria terminalis (jcBNST) of the rat. Our analysis on the temporal structure of firing showed that the three types of jcBNST neurons did not produce qualitatively different spike responses under identical patterns of input. However, we observed consistent, cell type dependent variations in the fine structure of firing, at the level of single spikes. At the millisecond resolution structure of firing we found high degree of diversity across the entire spectrum of neurons irrespective of their type. Additionally, we identified a new cell type with intrinsic oscillatory properties that produced a rhythmic and regular firing under synaptic stimulation that distinguishes it from the previously described jcBNST cell types. Our findings suggest a sophisticated, cell type dependent regulation of spike dynamics of neurons when experiencing a complex synaptic background. The high degree of their dynamical diversity has implications to their cooperative dynamics and synchronization

HIV-1 Tat alters neuronal intrinsic excitability

Abstract Objective In HIV+ individuals, the virus enters the central nervous system and invades innate immune cells, producing important changes that result in neurological deficits. We aimed to determine whether HIV plays a direct role in neuronal excitability. Of the HIV peptides, Tat is secreted and acts in other cells. In order to examine whether the HIV Tat can modify neuronal excitability, we exposed primary murine hippocampal neurons to that peptide, and tested its effects on the intrinsic membrane properties, 4 and 24 h after exposure. Results The exposure of hippocampal pyramidal neurons to Tat for 4 h did not alter intrinsic membrane properties. However, we found a strong increase in intrinsic excitability, characterized by increase of the slope (Gain) of the input–output function, in cells treated with Tat for 24 h. Nevertheless, Tat treatment for 24 h did not alter the resting membrane potential, input resistance, rheobase and action potential threshold. Thus, neuronal adaptability to Tat exposure for 24 h is not applicable to basic neuronal properties. A restricted but significant effect on coupling the inputs to the outputs may have implications to our knowledge of Tat biophysical firing capability, and its involvement in neuronal hyperexcitability in neuroHIV

From Erosion to Remineralization: The Possible Role of Two Topic Home Devices Used as Combined Treatment

Severe dental erosion could be one of the complications of gastroesophageal reflux disease and food disorders such as bulimia nervosa. The aim of the present in vitro study was to evaluate the remineralization efficiency and the erosion prevention capability obtained by combining the use of Elmex Erosion Protection (Elm-EP) and GC Tooth Mousse (GC-TM) in cases of strongly eroded enamel surfaces. Twenty-four specimens of bovine tooth were superficially treated with hydrochloric acid to mimic severe erosion conditions. The specimens were divided into 3 groups accordingly to a different remineralizing treatment for 15 days: immersion in artificial remineralizing saliva, brushing with Elm-EP and brushing with Elm-EP in association with a daily application of GC-TM paste. After the remineralization procedures, the specimens were exposed to a treatment with acid. The effectiveness of the treatments were assessed by surface profilometric analysis and scanning electron microscopy at four different steps. Furthermore, the quantity of the Ca2+ lost during erosion was determined. The combined action of Elm-EP and GC-TM led to a 50% roughness decrease of critically eroded dental surfaces. The tandem use of Elmex Erosion Protection and GC Tooth Mousse resulted a promising protecting strategy for the prevention of the dental mineral loss

Modulatory Effects of Plant Polyphenols on Bone Remodeling: A Prospective View From the Bench to Bedside

During the past, a more comprehensive knowledge of mechanisms implicated in bone resorption processes has driven researchers to develop a compound library of many small molecules that specifically interfere with the genesis of osteoclast precursors cells. Natural compounds that suppress osteoclast commitment may have therapeutic value in treating pathologies associated with bone resorption like osteoporosis, rheumatoid arthritis, bone metastasis, and periodontal disease. The present review is focused on the current knowledge on the polyphenols derived from plants that could be efficacious in suppressing osteoclast differentiation and bone resorption

Excitability of jcBNST neurons is reduced in alcohol-dependent animals during protracted alcohol withdrawal.

Alcohol dependence and withdrawal has been shown to cause neuroadaptive changes at multiple levels of the nervous system. At the neuron level, adaptations of synaptic connections have been extensively studied in a number of brain areas and accumulating evidence also shows the importance of alcohol dependence-related changes in the intrinsic cellular properties of neurons. At the same time, it is still largely unknown how such neural adaptations impact the firing and integrative properties of neurons. To address these problems, here, we analyze physiological properties of neurons in the bed nucleus of stria terminalis (jcBNST) in animals with a history of alcohol dependence. As a comprehensive approach, first we measure passive and active membrane properties of neurons using conventional current clamp protocols and then analyze their firing responses under the action of simulated synaptic bombardment via dynamic clamp. We find that most physiological properties as measured by DC current injection are barely affected during protracted withdrawal. However, neuronal excitability as measured from firing responses under simulated synaptic inputs with the dynamic clamp is markedly reduced in all 3 types of jcBNST neurons. These results support the importance of studying the effects of alcohol and drugs of abuse on the firing properties of neurons with dynamic clamp protocols designed to bring the neurons into a high conductance state. Since the jcBNST integrates excitatory inputs from the basolateral amygdala (BLA) and cortical inputs from the infralimbic and the insular cortices and in turn is believed to contribute to the inhibitory input to the central nucleus of the amygdala (CeA) the reduced excitability of the jcBNST during protracted withdrawal in alcohol-dependent animals will likely affect ability of the jcBNST to shape the activity and output of the CeA

Can Periodontal Disease Be Considered Linked to Obesity and Lipoinflammation? Mechanisms Involved in the Pathogenesis Occurrence

Obesity is a systemic disease, associated with an increased risk of cardiovascular disorders, type 2 diabetes, cancer, asthma, and osteoarthritis. Overweight and obesity have been suggested to be associated with periodontitis as published in studies and narrative summaries. Obesity and periodontal diseases are very prevalent in the world, and both can lead to severe chronic health conditions and impair people\u2019s life quality. Knowledge of how immune mechanisms and inflammatory responses are regulated is critical for understanding the pathogenesis of complex diseases, such as periodontitis. In conditions of overweight, it has been demonstrated that approximately 70\u201380% of individuals present an adipose tissue turnover that is both structurally and func- tionally causing of the systemic inflammatory reaction. The objective of this review is to explore the influence of lipoinflammation. The effects of lipoinflammation and obesity on development of periodontal disease are reported together with the exploration of the mechanisms of interaction between these two diseases

Prevalence of dental caries among schoolchildren from North-eastern Italian population

BACKGROUND: The longitudinal aspect of dental caries has not been previously reported for the Italian population. The primary object of the present study is to collect information of the prevalence of dental decay among the schoolchildren of primary school of Gradisca d'Isonzo (GO) and to analyze the tendency of caries among the students followed since the first year of school. METHODS: Subsequent examinations hold from 2011 to 2015 has been conducted by two calibrated examiners. Oral hygiene instruction and motivation followed the visits. According to WHO principals DMFT and dmft were recorded. The children in the survey were divided into 5 groups according to their ages (6, 7, 8 and 9 years), and these groups were considered separately. Descriptive and statistical analysis of the data was conducted. RESULTS: More than 400 pupils were recruited, resulting in almost 900 examinations during 5 years. Overall, the %dft ≥1 children range from 18.9% (10 years, 2013) to 53.5% (8 years, 2011) across the different age groups. Overall, the %DFT≥1 children range from 8.3% (6 years, 2011) to 44.1% (10 years, 2012) across the different age groups. CONCLUSIONS: Within the limits of the present study, the WHO goals are still not met, among the population in exam. Our results show a trend of decay diminution that enhances in the cohort of 10-aged children suggesting the importance of dental education. Furthermore, the lack of pediatric initiatives of oral hygiene may be overcome by a national intensive educational program, supported by further scientific evidence