Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs

Cerebrovascular accidents are responsible for killing or disabling more than half a million Americans every year. They are the third leading cause of death in this country. In Germany, the annual stroke incidence reaches 182 cases per 100,000 inhabitants. Stroke there is the fourth leading cause of death. There is a need of finding cost-effective means of decreasing stroke mortality and morbidity. Instruments for early diagnosis are of great humanitarian and economic importance. All possible clinical findings should be taken into account. It is not the demand of this study to present the panoramic radiograph as a screening test method for early diagnosis of atherosclerosis. The aim is to show the potential of this radiograph used in everyday clinical dental practice by the prevalence of radiopaque findings in the carotid region. This study included panoramic dental radiographs of 2,557 patients older than 30years of age. Fifty-nine percent of the patients were women and 41% were men. The radiographs were adjudged for signs compatible with carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below the intervertebral space C3-4. Of all these radiographs, 4.8% showed radiopaque findings compatible with atherosclerotic lesions. The proportion of women reached 64.8% and that of men reached 35.2%. In accordance to recent literature, the results of this study show that about 5% of the patients show radiological findings compatible with carotid arterial calcifications. Some of these patients at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph. The suspicion of carotid artery calcifications demands an impetuous referral to an appropriate practitioner who can assist in the control of risk factors and if necessary arrange surgical removal of the carotid arterial plaque. So, the dentist should be aware of this problem and able to make a contribution to stroke preventio

Preparation and Characterization of Micronized Artemisinin via a Rapid Expansion of Supercritical Solutions (RESS) Method

The particle sizes of pharmaceutical substances are important for their bioavailability. Bioavailability can be improved by reducing the particle size of the drug. In this study, artemisinin was micronized by the rapid expansion of supercritical solutions (RESS). The particle size of the unprocessed white needle-like artemisinin particles was 30 to 1200 µm. The optimum micronization conditions are determined as follows: extraction temperature of 62 °C, extraction pressure of 25 MPa, precipitation temperature 45 °C and nozzle diameter of 1000 μm. Under the optimum conditions, micronized artemisinin with a (mean particle size) MPS of 550 nm is obtained. By analysis of variance (ANOVA), extraction temperature and pressure have significant effects on the MPS of the micronized artemisinin. The particle size of micronized artemisinin decreased with increasing extraction temperature and pressure. Moreover, the SEM, LC-MS, FTIR, DSC and XRD allowed the comparison between the crystalline initial state and the micronization particles obtained after the RESS process. The results showed that RESS process has not induced degradation of artemisinin and that processed artemisinin particles have lower crystallinity and melting point. The bulk density of artemisinin was determined before and after RESS process and the obtained results showed that it passes from an initial density of 0.554 to 0.128 g·cm<sup>−3</sup> after the processing. The decrease in bulk density of the micronized powder can increase the liquidity of drug particles when they are applied for medicinal preparations. These results suggest micronized powder of artemisinin can be of great potential in drug delivery systems

Stellenwert der Muttermilch-assoziierten CMV-Infektion bei sehr unreifen Frühgeborenen

Diese Dissertation beschäftigt sich speziell mit der Fragestellung, wie groß der Stellenwert der CMV-Übertragung über Muttermilch bei sehr unreifen Frühgeborenen (<28 SSW) ist. In der vorliegenden Studie wurden 80 Frühgeborene mit einem Gestationsalter unter 28 SSW untersucht, die in den ersten 10 Lebenstagen Muttermilch erhielten. Insgesamt 35 Frühgeborene CMV-seropositiver Mütter wurden im Studienzeitraum geboren, bei 7 von ihnen war eine postnatale CMV-Infektion nachweisbar. Die CMV Transmissionsrate lag somit in der Studienkohorte bei 20 %. Betrachtet man nur die symptomatischen CMV Infektionen, lag die Rate nur bei 14 %. Zu erwähnen ist hier, dass in diversen Studien eine höhere Infektionsrate für extrem unreife Frühgeborene zu beobachten war, sodass es sich bei dem hier betrachteten Patientenkollektiv um ein besonderes Risiko-Kollektiv handelte, für welches eine potentiell höhere Rate an CMV-Infektionen zu erwarten ist (Mehler et al. 2014). Die Studienkohorte wurde mit einer historischen Kohorte verglichen, die erst ab einem Gestationsalter von 32 SSW Muttermilch erhielt. Hier ergab sich bei 43 Frühgeborenen unter 28 SSW eine Häufigkeit von 2,3 % für eine postnatale CMV Infektion. Auffallend ist, dass bereits sehr geringe Mengen an Muttermilch für eine CMV Übertragung ausreichen. In der Studienkohorte war die NEC-Inzidenz signifikant niedriger als in der historischen Kohorte (5 % versus 23,3 %; p=0,005). Grundsätzlich könnte die Einrichtung von Frauenmilchbanken ein sinnvoller Schritt sein, um das NEC- und CMV-Risiko gleichermaßen zu senken. Jedoch sollte, auch in Anbetracht der inkongruenten Studienlage bezüglich der Spätfolgen einer CMV-Infektion, nur in Ausnahmefällen auf die Verabreichung von Muttermilch verzichtet werden, da die Vorteile in den meisten Fällen überwiegen (Corpeleijn et al. 2012; Gunkel et al. 2018). Weitere Studien sind notwendig, um die Dynamik der postnatalen CMV Infektion genauer charakterisieren und konkrete Empfehlungen für ein ideales Ernährungsregime geben zu können

Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs

Cerebrovascular accidents are responsible for killing or disabling more than half a million Americans every year. They are the third leading cause of death in this country. In Germany, the annual stroke incidence reaches 182 cases per 100,000 inhabitants. Stroke there is the fourth leading cause of death. There is a need of finding cost-effective means of decreasing stroke mortality and morbidity. Instruments for early diagnosis are of great humanitarian and economic importance. All possible clinical findings should be taken into account. It is not the demand of this study to present the panoramic radiograph as a screening test method for early diagnosis of atherosclerosis. The aim is to show the potential of this radiograph used in everyday clinical dental practice by the prevalence of radiopaque findings in the carotid region. This study included panoramic dental radiographs of 2,557 patients older than 30 years of age. Fifty-nine percent of the patients were women and 41% were men. The radiographs were adjudged for signs compatible with carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below the intervertebral space C3-4. Of all these radiographs, 4.8% showed radiopaque findings compatible with atherosclerotic lesions. The proportion of women reached 64.8% and that of men reached 35.2%. In accordance to recent literature, the results of this study show that about 5% of the patients show radiological findings compatible with carotid arterial calcifications. Some of these patients at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph. The suspicion of carotid artery calcifications demands an impetuous referral to an appropriate practitioner who can assist in the control of risk factors and if necessary arrange surgical removal of the carotid arterial plaque. So, the dentist should be aware of this problem and able to make a contribution to stroke prevention