Tissue engineering of the temporomandibular joint : Where do we stand now?

Tissue engineering is an alternative to traditional strategies to repair and regenerate temporomandibular joints (TMJ). Nowadays, patients suffering from severe dysfunctions of the TMJ may undergo discectomy, a procedure that consists of removing the damaged disc in hopes of reducing the symptoms.However, tissue engineering presents a potential solution for patients suffering from these disorders, due to the lack of safety and effectiveness of TMJ disc implants. Since 1991, several studies have investigated the possibility of regenerating the articular disc. This literature review aims to expose the new challenges and techniques in TMJ disc tissue engineering whether it concerns cell sourcing, scaffold or bioreactors. As these challenges are overcome, the goal of future studies remains to create a functional biological replacement of the TMJ components

Tissue engineering of the temporomandibular joint : Where do we stand now?

Tissue engineering is an alternative to traditional strategies to repair and regenerate temporomandibular joints (TMJ). Nowadays, patients suffering from severe dysfunctions of the TMJ may undergo discectomy, a procedure that consists of removing the damaged disc in hopes of reducing the symptoms.However, tissue engineering presents a potential solution for patients suffering from these disorders, due to the lack of safety and effectiveness of TMJ disc implants. Since 1991, several studies have investigated the possibility of regenerating the articular disc. This literature review aims to expose the new challenges and techniques in TMJ disc tissue engineering whether it concerns cell sourcing, scaffold or bioreactors. As these challenges are overcome, the goal of future studies remains to create a functional biological replacement of the TMJ components

Oral plaque from Type 2 diabetic patients reduces the clonogenic capacity of dental pulp-derived mesenchymal stem cells

Type 2 diabetes (T2D) is a major metabolic disease and a key epigenetic risk factor for the development of additional clinical complications. Among them, periodontitis (PD), a severe inflammatory disease ascribable to a dysregulated physiology and composition of the oral microbiota, represents one of the most relevant complications. Periodontitis can impact the structure of the tooth and likely the stem and progenitor cell pool, which actively contributes to the periodontal microenvironment and homeostasis. Modifications of the oral plaque play a key role in the etiopathogenesis of PD caused by T2D. However, to what extent the biology of the progenitor pool is affected has still to be elucidated. In this short report, we aimed to explore the biological effects of oral plaque derived from T2D patients with PD in comparison to non-diabetic patients with PD. Oral plaque samples were isolated from T2D and non-diabetic subjects with PD. Dental pulp stem cells (DPSCs), derived from the premolar tooth, were conditioned for 21 days with oral plaque samples and tested for their clonogenic ability. Cultures were also induced to differentiate towards the osteogenic lineage, and ALP and osteocalcin gene expression levels were evaluated by real-time qPCR. Results have shown that the number of clones generated by DPSCs exposed to T2D oral plaque was significantly lower compared to controls (ctl). The multivariate analysis confirmed that the decreased clonogenesis was significantly correlated only with T2D diagnosis. Moreover, the effect of T2D oral plaque was specific to DPSCs. Indicators of osteogenic differentiation were not significantly affected. This study provides a new biological insight into the effects ascribable to T2D in PD

Cost-Effectiveness of Referring Patients to Centers of Excellence for Mitral Valve Surgery

BACKGROUND The 2014 American Heart Association/American College of Cardiology Valvular Heart Disease Guidelines state that mitral valve diseases should be repaired at a Center of Excellence (CoE). We evaluate the cost-effectiveness of such referrals. METHODS We estimate patients’ life expectancy based on projected survival of patients after mitral valve surgery and develop a cost model to calculate short- and long-term benefits and costs to both patients and payers. Benefits include increased life expectancy and avoidance of medical complications for patients. Short-term costs include all upfront payments by patients and payers at the time of discharge. Long-term costs include all payments associated with the condition that prompted the surgical procedure incurred during the remainder of a patient’s life. We assess cost-effectiveness of treating patients with various ages and major comorbidities at CoEs vs non-CoEs. RESULTS Full implementation of the guidelines would result in an increase in the percentage of patients obtaining mitral valve repair instead of valve replacement from 58% to 72%. Depending on the patient’s age and comorbidities, it would also result in a 6.64% to 12.47% reduction in mortality, 7.85% to 9.97% reduction in reoperation, 9.97% to 17.16% reduction in stroke, and an average gain of 3.77 to 9.88 months of life expectancy. Finally, greater reliance on CoEs results in financial savings to payers, due to avoidance of the costs of future complications. CONCLUSION Patients benefit from mitral valve surgery at a CoE regardless of their age or comorbidities. Payers may incur additional short-term costs when patients are referred to a CoE, but these are fully offset by long-term savings at the current repair rate gap of 24% between CoEs and non-CoEs in New York State. Redesigning co-pay structures and/or refining the set of patients who are referred to CoEs could further align the incentives of patients and payers on a case-by-case basis and achieve an even more desirable social outcome.http://deepblue.lib.umich.edu/bitstream/2027.42/111881/1/1281_Wang.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/111881/4/1281_Wang_May2015.pdfDescription of 1281_Wang_May2015.pdf : May 2015 revisio

REGIONAL DIFFERENCES IN THE POPULATION NATURAL INCREASE IN THE REPUBLIC OF MACEDONIA

The vital statistic data analyses indicate major changes in the components of the natural increase of the population in Macedonia. The trend of decreasing number of births and increased number of deaths led to a reduction in the natural population increase rate that in 2013 reached the value of 1.9‰. At the beginning of the 21st century there are obvious differences in the values of the natural population increase in demographic and spatial aspect. Particular attention is given to the differences in the level of the population natural increase among municipalities and regions in the Republic of Macedonia. These problems come as a result of the impact of the social and economic transformations. This is the case of large part municipalities in Macedonia, which means that these municipalities are characterized by a negative population natural increase. At the same time, this leaves demographic, social and economic consequences to their development, followed by numerous problems. The main aim of this research is to determine the regional differences in the positive component of the population natural increase, i.e. crude birth rate, TFR and the natural increase rate and to identify the regions in the Republic of Macedonia that are highly disadvantaged

The subcoronary Toronto stentless versus supra-annular Perimount stented replacement aortic valve: Early clinical and hemodynamic results of a randomized comparison in 160 patients

BackgroundA stentless valve is expected to be hemodynamically superior to a stented valve. The aim of this study was to compare early postoperative hemodynamic function and clinical events in a randomized, prospective series of 160 stentless and stented biological replacement aortic valves.MethodsWe randomized 160 consecutive patients on 1 surgeon’s list to receive either a Toronto stentless porcine valve (St Jude Medical, Inc, St Paul, Minn) or a Perimount stented bovine pericardial valve (Edwards Lifesciences, Irvine, Calif). Echocardiography was performed at discharge, between 3 and 6 months, and at 1 year after surgery. Statistical analysis was performed by both intention to treat and actual valves implanted.ResultsThe mean labeled size of both designs of valve was 24.7. There were no statistically significant differences in results at any time interval or whether analysis was performed by actual valves implanted or intention to treat. At 3 to 6 months for the Toronto versus the Perimount valve, the effective orifice area was 1.58 versus 1.66 cm2, the mean pressure difference was 7.54 versus 7.42 mm Hg, and the peak velocity was 2.07 versus 2.0.1 m/s. There was no difference in mortality, regression of left ventricular hypertrophy, or complications other than paraprosthetic regurgitation at 12 months or on follow-up for a proportion of the sample to 8 years. The incidence of regurgitation through the valves was similar for Toronto (10%) and Perimount (13.8%) at 1 year, but mild paraprosthetic regurgitation was found in 5 patients with the Perimount valve and none with Toronto valves.ConclusionsThere were no significant differences in hemodynamic function or clinical events between the stented and stentless biological valves chosen for comparison in the early postoperative period or in preliminary follow-up to 5 years

World Forum for Spine Research: The intervertebral disc: First Japanese Meeting, Kyoto, Japan, 23–26 January 2008

No abstract

Stem Cell-Based Dental Tissue Engineering

The development of biological and biomaterial sciences profiled tissue engineering as a new and powerful tool for biological replacement of organs. The combination of stem cells and suitable scaffolds is widely used in experiments today, in order to achieve partial or whole organ regeneration. This review focuses on the use of tissue engineering strategies in tooth regeneration, using stem cells and stem cells/scaffold constructs. Although whole tooth regeneration is still not possible, there are promising results. However, to achieve this goal, it is important to understand and further explore the mechanisms underlying tooth development. Only then will we be able to mimic the natural processes with the use of stem cells and tissue engineering techniques

Balancing the Global Distribution of Phosphorus With a View Toward Sustainability and Equity

Limitations in the geological reserves of phosphate rock, the source of fertilizer phosphorus, are not currently considered in agricultural practices or global trade, a very short‐sighted approach considering that there is no “alternative fuel” for plant growth. Thus, it is important to understand the science of phosphorus‐crop growth dynamics as a function of grain type, plant uptake, climate, and past fertilizer phosphorus application history. Recent work on modeling these factors on the global scale (Kvakić et al., 2018) provides the first scientific backdrop for developing an understanding of fertilizer phosphorus balances, and for informing forward‐looking practices and policies that regulate toward long‐term sustainability rather than short‐term profit