Efficiency of orthopedic treatment of extensive defects of the dental series one-stage non-diskable dental implants from nanostructured titan

The article reveals the results of orthopedic treatment of 57 people with extensive defects of dentition. Through comparative analysis, it was confirmed that the use of one-stage non-separable dental implants with immediate loading of nano-structural titanium in comparison with collapsible titanium screw implants reduces the frequency of periimplantitis after surgery and promotes better survival.В статье раскрыты итоги ортопедического лечения 57 человек с обширными дефектами зубных рядов. Посредством сравнительного анализа удалось установить, что использованиенеразборных дентальных имплантов с немедленной нагрузкой из наноструктурного титана марки в сравнении с разборными винтовыми имплантами снижает частоту периимплантитов после операции и способствует лучшей приживляемости

Plasma Metabolomics in Human Pulmonary Tuberculosis Disease: A Pilot Study

We aimed to characterize metabolites during tuberculosis (TB) disease and identify new pathophysiologic pathways involved in infection as well as biomarkers of TB onset, progression and resolution. Such data may inform development of new anti-tuberculosis drugs. Plasma samples from adults with newly diagnosed pulmonary TB disease and their matched, asymptomatic, sputum culture-negative household contacts were analyzed using liquid chromatography high-resolution mass spectrometry (LC-MS) to identify metabolites. Statistical and bioinformatics methods were used to select accurate mass/charge (m/z) ions that were significantly different between the two groups at a false discovery rate (FDR) of q<0.05. Two-way hierarchical cluster analysis (HCA) was used to identify clusters of ions contributing to separation of cases and controls, and metabolomics databases were used to match these ions to known metabolites. Identity of specific D-series resolvins, glutamate and Mycobacterium tuberculosis (Mtb)-derived trehalose-6-mycolate was confirmed using LC-MS/MS analysis. Over 23,000 metabolites were detected in untargeted metabolomic analysis and 61 metabolites were significantly different between the two groups. HCA revealed 8 metabolite clusters containing metabolites largely upregulated in patients with TB disease, including anti-TB drugs, glutamate, choline derivatives, Mycobacterium tuberculosis-derived cell wall glycolipids (trehalose-6-mycolate and phosphatidylinositol) and pro-resolving lipid mediators of inflammation, known to stimulate resolution, efferocytosis and microbial killing. The resolvins were confirmed to be RvD1, aspirin-triggered RvD1, and RvD2. This study shows that high-resolution metabolomic analysis can differentiate patients with active TB disease from their asymptomatic household contacts. Specific metabolites upregulated in the plasma of patients with active TB disease, including Mtb-derived glycolipids and resolvins, have potential as biomarkers and may reveal pathways involved in TB disease pathogenesis and resolution

Use of a Molecular Diagnostic Test in AFB Smear Positive Tuberculosis Suspects Greatly Reduces Time to Detection of Multidrug Resistant Tuberculosis

Background: The WHO has recommended the implementation of rapid diagnostic tests to detect and help combat M/XDR tuberculosis (TB). There are limited data on the performance and impact of these tests in field settings. Methods: The performance of the commercially available Genotype MTBDRplus molecular assay was compared to conventional methods including AFB smear, culture and drug susceptibility testing (DST) using both an absolute concentration method on Löwenstein-Jensen media and broth-based method using the MGIT 960 system. Sputum specimens were obtained from TB suspects in the country of Georgia who received care through the National TB Program. Results: Among 500 AFB smear-positive sputum specimens, 458 (91.6%) had both a positive sputum culture for Mycobacterium tuberculosis and a valid MTBDRplus assay result. The MTBDRplus assay detected isoniazid (INH) resistanc

Diagnostic capabilities of laboratory monitoring of the cytokine status of gingival fluid in inflammatory and osteodestructive processes in periodontium

During the examination of 105 patients with inflammatory periodontal diseases, a laboratory method was developed to assess the balance between proinflammatory and osteotropic mediators to characterize the severity and course of inflammatory-destructive changes in gingivitis and chronic generalized periodontitis (CGP). Depending on the periodontal lesion, three clinical groups were formed: group 1 (n=40) - patients with catarrhal and ulcerative gingivitis, group 2 (n=32) with mild chronic hepatitis С and group 3 (n=33) with moderate CGP. In patients with gingival fluid or in the contents of periodontal pockets (PC), the concentration of tumor necrosis factor alpha (TNF-a) was determined, osteotropic mediators - ligand of soluble activator of nucleation factor Kappa В (sRANKL) and osteoprotegerin (OPG) by the immunoassay method. In patients with mild to moderate CGP, close links were established (p<0,0001) of the values of periodontal indices characterizing osteodestruction with the content of TNF-a, sRANKL and osteoprotegerin in PC fluids. In patients with formation of CGP, as well as increasing the severity of periodontal lesions in the gingival fluid, the concentration of TNF-a, sRANKL increases and the content of osteoprotegerin decreases. The change in the concentration of osteotropic mediators in the PC fluid occurred before the osteolysis in the periodontium was formed. In patients with mild CGP, a decrease in the concentration of OPG (p<0,05) and an increase in the content of sRANKL (p<0,05) in the gingival fluid relative to the norm requires active x-ray control of osteoresorption.При обследовании 105 больных с воспалительными заболеваниями пародонта разработан лабораторный способ оценки баланса между провоспалительными и остеотропными медиаторами для характеристики тяжести и течения воспалительно-деструктивных изменений при гингивите и хроническом генерализованном пародонтите (ХГП). В зависимости от поражения пародонта формировали три клинические группы: 1 группа (n=40) - пациенты с катаральным и язвенным гингивитом, 2 группа (n=32) - с ХГП легкой и 3 группа (n=33) с ХГП средней степени тяжести. У пациентов в десневой жидкости или в содержимом пародонтальных карманов (ПК) определяли концентрацию фактора некроза опухоли-альфа (ФНО-α), остеотропных медиаторов - лиганда растворимого активатора фактора нуклеации каппа В (sRANKL) и остеопротегерина (ОПГ) иммуноферментным методом. У пациентов с ХГП легкой и средней степени тя­ жести установлены тесные связи (р<0,0001) величин пародонтальных индексов, характеризующих остеодеструкцию, с содержанием в жидкости ПК ФНО-α, sRANKL и остеопротегерина. У больных при формировании ХГП, а также при усилении тяжести поражения пародонта в десневой жидкости повышается концентрация ФНО-α, sRANKL и снижается содержание остеопротегерина. Изменение концентрации остеотропных медиаторов в жидкости ПК наступало раньше, чем формировалась остеодеструкция в пародонте. У пациентов с ХГП легкой степени тяжести снижение концентрации ОПГ (р<0,05) и повышение содержания sRANKL (р<0,05) в десневой жидкости относительно нормы требует активного рентгенологического контроля остеорезорбтивных процессов

Diabetes mellitus, smoking status, and rate of sputum culture conversion in patients with multidrug-resistant tuberculosis: a cohort study from the country of Georgia.

Diabetes mellitus (DM) is a risk factor for active tuberculosis (TB) but little is known about the effect of DM on culture conversion among patients with multidrug-resistant (MDR)-TB. The primary aim was to estimate the association between DM and rate of TB sputum culture conversion. A secondary objective was to estimate the association between DM and the risk of poor treatment outcomes among patients with MDR-TB.A cohort of all adult patients starting MDR-TB treatment in the country of Georgia between 2009-2011 was followed during second-line TB therapy. Cox proportional models were used to estimate the adjusted hazard rate of sputum culture conversion. Log-binomial regression models were used to estimate the cumulative risk of poor TB treatment outcome.Among 1,366 patients with sputum culture conversion information, 966 (70.7%) had culture conversion and the median time to conversion was 68 days (interquartile range 50-120). The rate of conversion was similar among patients with MDR-TB and DM (adjusted hazard ratio [aHR] 0.95, 95%CI 0.71-1.28) compared to patients with MDR-TB only. The rate of culture conversion was significantly less in patients that currently smoked (aHR 0.82, 95%CI 0.71-0.95), had low body mass index (aHR 0.71, 95%CI 0.59-0.84), second-line resistance (aHR 0.56, 95%CI 0.43-0.73), lung cavities (aHR 0.70, 95%CI 0.59-0.83) and with disseminated TB (aHR 0.75, 95%CI 0.62-0.90). The cumulative risk of poor treatment outcome was also similar among TB patients with and without DM (adjusted risk ratio [aRR] 1.03, 95%CI 0.93-1.14).In adjusted analyses, DM did not impact culture conversion rates in a clinically meaningful way but smoking did

Diabetes mellitus and baseline characteristics of adult pulmonary MDR-TB patients in Georgia 2009–2012.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094890#pone-0094890-t001" target="_blank"><u>Table 1</u></a><u> Abbreviations</u>: RBG-random blood glucose; MDR-multidrug-resistant; STD-standard deviation; IQR-interquartile range; AFB-acid fast bacilli.</p>A<p>Based on medical records or self-reported by MDR-TB patients.</p>B<p>Statistically significant, two-sided p-value <0.05.</p>C<p>Variables with missing >5% among patients were reported in the table as a separate category but not calculated within the frequency distribution.</p>D<p>All patients had pulmonary MDR-TB; extra-pulmonary/disseminated includes those with both pulmonary and extra-pulmonary/disseminated.</p

Bivariate and multivariable hazard rate ratios for patient characteristics associated with sputum culture conversion among patients with MDR-TB in Georgia, 2009–2011.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094890#pone-0094890-t002" target="_blank"><u>Table 2</u></a><u> Abbreviations</u>: IQR-interquartile range; MDR-multidrug-resistant; cHR-crude hazard rate ratio; aHR-adjusted hazard rate ratio; RBG-random blood glucose; AFB-acid fast bacilli; Neg-negative; Dissem-disseminated TB; <b>Bold</b> indicates statistically significant, two sided p-value <0.05.</p>A<p>Among patients who converted, median time (days) from MDR TB treatment initiation until first of two consecutive negative sputum cultures ≥30 days apart among patients.</p>B<p>The adjusted model included all variables with estimates in the aHR column.</p>C<p>Any resistance to a second-line TB drug.</p>D<p>Violated proportional hazards assumptions and not included in adjusted model.</p>E<p>Missing data for this variable was recoded into no/null category.</p>F<p>All patients were pulmonary, extra-pulmonary includes those with both pulmonary and extra-pulmonary TB.</p