Fem and Von Mises analysis of OSSTEM ® dental implant structural components: evaluation of different direction dynamic loads

Abstract PURPOSE: The objective of this investigation is to study prosthodontics and internal components resistance to the masticatory stress and considering different force directions by using Finite Element Method analysis (FEM). The structural materials of the components are usually Titanium alloy grade 4 or 5 and thus, guarantee the integration of the fixture in the bone due to the osteointegration phenomena. Even if the long-term dental implant survival rate is easy to be obtained and confirmed by numerous researches, the related clinical success, due to the alteration of the mechanical and prosthodontics components is still controversial. METHODS: By applying engineering systems of investigations like FEM and Von Mises analyses, it has been investigated how dental implant material was held against the masticatory strength during the dynamic masticatory cycles. A three-dimensional system involved fixture, abutment and the connection screws, which were created and analyzed. The elastic features of the materials used in the study were taken from recent literature data. RESULTS: Data revealed a different response for both types of devices, although implant neck and dental abutment showed better results for all conditions of loading while the abutment screw represented aweak point of the system. CONCLUSION: The data of this virtual model showed all the features of different prosthetic retention systems under the masticatory load. Clinicians should find better prosthetic balance in order to better distribute the stress over the component and to guarantee patients' clinical long-term results

Catalytic performance of Ce1-xLnxOy of nanocrystalline Ln (III-IV)-substituted ceria

The activity of several lanthanide promoted Ceria in CO oxidation was studied. Samples were obtained by a high yield and sustainable method by urea thermal decomposition. Precursors basic carbonates, Ce1-xLnx(OH)CO3, being Ln = La (III), Sm(III), Gd(III), Pr(III) were prepared in the range of compositions 0 to 30 at.%. These precursors were annealed to moderate temperature obtain Ln-Ce mixed oxides, at 450ºC. These exhibit large surface areas up to 120 m2/g. Their catalytic performance revealed good activity towards CO oxidation  (COOX) for all samples. However, a different behavior may be observed for Ln content higher than 20 at.%. By the reactor operation in differential conditions, the activation energy for COOX were obtained for all samples. The rise of activation energy as a function of Ln(III-IV) content is analyzed in the frame of phase stability and surface segregation

Connaissances, Attitudes, Pratiques et Croyances sur le VIH/Sida chez les creuseurs de diamant de la zone de sante de Tshishimbi au Kasai Orienral/R.D Congo

Le but de cette étude est d’apporter une pierre dans la lutte contre la pandémie du VIH/Sida dans la population des creuseurs de la zone de santé de Tshishimbi qui est une catégorie à haut risque. Pour  atteindre le but visé, l’enquête se fixe l’objectif spécifique de tester certains liens entre connaissances, attitudes, pratiques, croyances et certaines caractéristiques sociodémographiques.Il s’agissait d’une étude quantitative, du type descriptif corrélationnel transversal ; menée du 24 juillet 2014 au 24 août 2014. Les données ont été recueillies par la méthode d’enquête par questionnaire au moyen de l’interview semi structurée face - à -  face.  Notre population était constituée de 422 creuseurs de diamant.Il existe une différence hautement significative entre la connaissance des moyens de transmission du VIH/Sida par contact du sang infecté et l’âge (p=0,000),  par mère – enfant et la situation matrimoniale (p=0,000); entre la connaissance de moyen de prévention du VIH/Sida le port du préservatif et l’année d’expérience (p=0,000); entre l’abstinence et l’année d’expérience p=0,007 ; il subsiste une différence hautement significative entre la situation matrimoniale (p = 0,000) et l’effet d’avoir déjà eu les rapports sexuels occasionnels. Il existe des relations positives et significatives entre certaines caractéristiques  sociodémographiques et certaines variables liées aux connaissances, attitudes, pratiques et croyances des creuseurs de diamant de la zone de santé de Tshishimbi sur la VIH/Sida. En effet, la contamination par voie hétérosexuelle, en particulier lors de rapports tarifés, chiffrés devient de plus en plus fréquente ; ce qui laisse entendre que ces pratiques et attitudes abusives sont motivées par une connaissance insuffisante [2]. Les attitudes négatives et les croyances au sein des communautés peuvent également accroître l’auto-stigmatisation intériorisée, y compris la culpabilité, la honte et l’aliénation que ressentent les personnes vivant avec le VIH. Ainsi des actions de sensibilisation dans le cadre de la prévention pourraient aider à vaincre l’épidémie.

Vertebral carcinomatosis eleven years after advanced gastric cancer resection: A case report.

Bone metastasis is an uncommon event in advanced gastric cancer patients and bone metastases are rarely detected as isolated lesions. However, eleven years after treatment for locally advanced gastric cancer, including total gastrectomy followed by adjuvant chemotherapy, a 49-year-old female was admitted to the IX Division of General Surgery of the Second University of Naples (Naples, Italy) exhibiting severe progressive neurological symptoms. Magnetic resonance imaging indicated vertebral abnormalities, with evidence of marrow infiltration in several vertebral bodies; however, a contrast-enhanced computed tomography scan did not detect disease progression to other sites. Biopsy of the soft tissue at the level of the second lumbar vertebra (L2) revealed a metastatic lesion derived from gastric mucinous adenocarcinoma. The patient was initially treated with radiotherapy directed to the L2-L4 vertebral bodies to control the pain. Subsequently, systemic chemotherapy according to a FOLFOX-4 (leucovorin, fluorouracil and oxaliplatin) regimen commenced. However, after eight cycles, pulmonary progression of the disease occurred. Thus, palliative care was administered and the patient succumbed one month later. The late relapse of gastric cancer in the current patient may be associated with the theory of tumour dormancy

Retinoic acid synergizes with the unfolded protein response and oxidative stress to induce cell death in FLT3-ITD+ AML.

Acute myeloid leukemia (AML) is often characterized by the expression of fusion or mutant proteins that cause impaired differentiation and enhanced proliferation and survival. The presence of mutant proteins prone to misfolding can render the cells sensitive to endoplasmic reticulum (ER) stress and oxidative stress that could otherwise be overcome. Here, we show that the triple combination of the differentiating agent retinoic acid (RA), the ER stress-inducing drug tunicamycin (Tm), and arsenic trioxide (ATO), able to generate oxidative stress, leads to the death of AML cell lines expressing fusion proteins involving the gene MLL and the internal tandem duplication (ITD) in the FLT3 tyrosine kinase receptor. Importantly, the combination of RA, Tm, and ATO decreased the colony-forming capacity of primary leukemic blasts bearing the FLT-ITD mutation without affecting healthy hematopoietic progenitor cells. We demonstrate in cell lines that combination of these drugs generates ER and oxidative stresses and impairs maturation and causes accumulation of FLT3 protein in the ER. Our data provide a proof of concept that low amounts of drugs that generate ER and oxidative stresses combined with RA could be an effective targeted therapy to hit AML cells characterized by MLL fusion proteins and FLT3-ITD mutation

Ultrasound in the evaluation of enthesitis: status and perspectives

Introduction: An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter. Methods: Search was performed in PUBMED and EMBASE. Both grey-scale and Doppler definitions of enthesitis, including describing features of enthesitis, were collected and metrological qualities of studies were assessed. Results: After selection, 48 articles were analyzed. The definition of ultrasound enthesitis and elementary features varied among authors. Grey-scale enthesitis was characterized by increasing thickness (94% of studies), hypoechogenicity (83%), enthesophytes (69%), erosions (67%), calcifications (52%), associated bursitis (46%) and cortical irregularities (29%). Only 46% of studies reported the use of Doppler. High discrepancies were observed on frequency, type of probe and Doppler mode used. Face and content validity were the most frequently evaluated criteria (43%) followed by reliability (29%) and responsiveness (19%). Conclusions: Ultrasound has evidence to support face, content validity and reliability for the evaluation of enthesitis, though there is a lack of well-reported methodology in most of the studies. Consensus on elementary lesions and standardization of exam is needed to determine the ultrasound definition of enthesitis in grey-scale and in Doppler for future applications.15 page(s

Apremilast retention rate in clinic practice:observations from an Italian multi-center study

Objective There are few real-world setting studies focused on apremilast efectiveness (i.e., retention rate) in psoriatic arthritis (PsA). The main aim of this retrospective observational study is the assessment of apremilast 3-year retention ratein real-world PsA patients. Moreover, the secondary objective is to report the reasons of apremilast discontinuation and thefactors related to treatment persistence. Methods In ffteen Italian rheumatological referral centers, all PsA consecutive patients who received apremilast were enrolled. Anamnestic data, treatment history, and PsA disease activity (DAPSA) at baseline were recorded. The Kaplan–Meier curve and the Coxanalysis computed the apremilast retention rate and treatment persistence-related risk factors. A p-value<0.05 was considered statistically signifcant. Results The 356 enrolled patients (median age 60 [interquartile range IQR 52–67] yrs; male prevalence 42.7%) median observation period was 17 [IQR 7–34] months (7218 patients-months). The apremilast retention rate at 12, 24, and 36 months was, respectively, 85.6%, 73.6%, and 61.8%. The main discontinuation reasons were secondary inefcacy (34% of interruptions), gastro-intestinal intolerance (24%), and primary inefcacy (19%). Age and oligo-articular phenotype were related to treatment persistence (respectively hazard ratio 0.98 IQR 0.96–0.99; p=0.048 and 0.54 IQR 0.31–0.95; p=0.03). Conclusion Almost three-ffths of PsA patients receiving apremilast were still in treatment after 3 years. This study confrmed its efectiveness and safety profle. Apremilast appears as a good treatment choice in all oligo-articular PsA patients and in those ones burdened by relevant comorbiditi

Opportunistic infections in immunosuppressed patients with juvenile idiopathic arthritis: analysis by the Pharmachild Safety Adjudication Committee

Background To derive a list of opportunistic infections (OI) through the analysis of the juvenile idiopathic arthritis (JIA) patients in the Pharmachild registry by an independent Safety Adjudication Committee (SAC). Methods The SAC (3 pediatric rheumatologists and 2 pediatric infectious disease specialists) elaborated and approved by consensus a provisional list of OI for use in JIA. Through a 5 step-procedure, all the severe and serious infections, classified as per MedDRA dictionary and retrieved in the Pharmachild registry, were evaluated by the SAC by answering six questions and adjudicated with the agreement of 3/5 specialists. A final evidence-based list of OI resulted by matching the adjudicated infections with the provisional list of OI. Results A total of 772 infectious events in 572 eligible patients, of which 335 serious/severe/very severe non-OI and 437 OI (any intensity/severity), according to the provisional list, were retrieved. Six hundred eighty-two of 772 (88.3%) were adjudicated as infections, of them 603/682 (88.4%) as common and 119/682 (17.4%) as OI by the SAC. Matching these 119 opportunistic events with the provisional list, 106 were confirmed by the SAC as OI, and among them infections by herpes viruses were the most frequent (68%), followed by tuberculosis (27.4%). The remaining events were divided in the groups of non-OI and possible/patient and/or pathogen-related OI. Conclusions We found a significant number of OI in JIA patients on immunosuppressive therapy. The proposed list of OI, created by consensus and validated in the Pharmachild cohort, could facilitate comparison among future pharmacovigilance studies