Gingival hyperplasia around dental implants in jaws reconstructed with free vascularized flaps: a case report series

Free vascularized flaps are the gold standard for reconstruction of the facial skeleton after surgical ablation of pathologies or when important atrophy of the jaws exists. A frequent problem seen during prosthetic rehabilitation after reconstruction with free vascularized flaps is the onset of hyperplastic granulomatous reactive tissue around the prosthetic abutment of the implant. The features of this phenomenon seem to be directly related to the characteristics of the periimplant tissue and of the manufacturing materials of the prosthesis and abutments. This complication can be seen quite often; we found it in 7 of 40 patients (17.5%). It does not seem to significantly affect the survival rate of implants. The aim of the study was to analyze the behavior of such lesions and to suggest our clinical approach with the management of these kinds of patients and complications. To remove gingival hyperplasia, we used either a traditional cold scalpel or an electric cautery or laser. We had good results using these tools. The onset of this phenomenon was not influenced by either the kind of implant and free flaps used or by the local conditions of the patients (such as radiotherapy). The number of recurrences was highly influenced by the oral hygiene of the patients

A New Light on Vitamin D in Obesity: A Novel Association with Trimethylamine-N-Oxide (TMAO)

Abstract: Vitamin D deficiency and obesity are two public health problems extensively exacerbated over the last years. Among the several mechanisms proposed to account for the complex interplay between vitamin D and obesity, one that has gained particular attention is related to the emerging role of obesity-related changes in gut microbiota and gut-derived metabolites, such as Trimethylamine-N-oxide (TMAO). Vitamin D deficiency and high circulating TMAO levels are associated with body weight and the severity of non-alcoholic fatty liver disease (NAFLD). Considering the link of obesity with vitamin D on the one hand and obesity with TMAO on the other hand, and the central role of the liver in both the vitamin D and TMAO metabolism, the aim of this cross-sectional observational study was first, to confirm the possible inverse association between vitamin D and TMAO across different body mass index (BMI) classes and second, to investigate if this association could be influenced by the presence of NAFLD. One hundred and four adult subjects (50 males and 54 females; 35.38 ± 7.49 years) were enrolled. The fatty liver index (FLI) was used as a proxy for the diagnosis of NAFLD. Vitamin D deficiency was found in 65 participants (62.5%), while 33 subjects (31.7%) had insufficient levels, and the remaining subjects had sufficient levels of vitamin D. Subjects with both vitamin D deficiency and FLI-NAFLD had the highest TMAO levels (p < 0.001). By stratifying the sample population according to the BMI classes, vitamin D levels decreased significantly along with the increase of plasma TMAO concentrations, with the lowest vitamin D levels and highest TMAO, respectively, in class III obesity. Vitamin D levels showed significant opposite associations with circulating levels of TMAO (r = -0.588, p < 0.001), but this association was no longer significant after the adjustment for FLI values. The highest values of TMAO were significantly associated with the severity of obesity (OR 7.92; p < 0.001), deficiency of vitamin D (OR 1.62; p < 0.001), and FLI-NAFLD (OR 3.79; p < 0.001). The most sensitive and specific cut-off for vitamin D to predict the circulating levels of TMAO was ≤19.83 ng/mL (p < 0.001). In conclusion, our study suggests that high TMAO levels are associated with vitamin D deficiency and NAFLD. Further studies are required to investigate if there is a causality link or whether all of them are simply the consequence of obesity

Arctium lappa contributes to the management of type 2 diabetes mellitus by regulating glucose homeostasis and improving oxidative stress: A critical review of in vitro and in vivo animal-based studies

Diabetes is a metabolic disease highly widespread worldwide, and the most common form is the type 2 diabetes mellitus (T2DM). A large number of synthetic drugs are currently available for the treatment of diabetes; however, they present various side effects and, for this reason, people are increasingly inclined to search natural alternative treatments. Among these, Arctium lappa (A. lappa) has interesting anti-diabetic activities, exerted by improving glucose homeostasis and reducing insulin-resistance. In addition, A. lappa exerts a marked antioxidant activity, an effect known to play a pivotal role in the treatment of T2DM. The purpose of this review is to analyse scientific evidence in order to evaluate the role of A. lappa and its bioactive compounds in management of T2DM. The literature search performed provided only in vitro and animal-based studies. No clinical studies have been conducted in order to investigate the effect of A. lappa on T2DM patients. However, available literature provides evidence for further clinical trials in order to confirm these claimed activities on humans

Compton Scattering from the Deuteron and Extracted Neutron Polarizabilities

Differential cross sections for Compton scattering from the deuteron were measured at MAX-lab for incident photon energies of 55 MeV and 66 MeV at nominal laboratory angles of $45^\circ$, $125^\circ$, and $135^\circ$. Tagged photons were scattered from liquid deuterium and detected in three NaI spectrometers. By comparing the data with theoretical calculations in the framework of a one-boson-exchange potential model, the sum and difference of the isospin-averaged nucleon polarizabilities, $\alpha_N + \beta_N = 17.4 \pm 3.7$ and $\alpha_N - \beta_N = 6.4 \pm 2.4$ (in units of $10^{-4}$ fm$^3$), have been determined. By combining the latter with the global-averaged value for $\alpha_p - \beta_p$ and using the predictions of the Baldin sum rule for the sum of the nucleon polarizabilities, we have obtained values for the neutron electric and magnetic polarizabilities of $\alpha_n= 8.8 \pm 2.4$(total) $\pm 3.0$(model) and $\beta_n = 6.5 \mp 2.4$(total) $\mp 3.0$(model), respectively.Comment: 4 pages, 2 figures, revtex. The text is substantially revised. The cross sections are slightly different due to improvements in the analysi

Examining the Forces Associated with Heading in Collegiate Soccer Athletes

Context: Repetitive sub-concussive impacts have recently been recognized as a contributing factor of long-term cognitive deficits. The potential for this to affect soccer players participating at a high level is great due to the constant intentional use of the unprotected head when playing. Examining the force with which a soccer ball strikes an athlete\u27s head during the act of heading is important to determine if there is a potential risk for long term consequences. Objective: The purpose of this study was to determine how much force is associated with heading in soccer. The variability between goal and corner kicks and throw-ins were examined. A secondary purpose was to determine if this information is indicative of soccer players potentially being at risk due to repetitive sub-concussive impacts. Design: This was a prospective descriptive study which examined the forces transferred from a soccer ball to the head during simulated soccer heading scenarios. Setting: Collegiate soccer conditions in the Mid-Atlantic part of the country. Patients and Other Participants: Using a sample of convenience, three male collegiate soccer players between the ages of 19-22 playing at a D1 level at the time of the study were used. Subjects were selected if they headed the ball five or more times in a game, had five or more years of playing experience at the time of the study and had not had any head or neck injuries in the six months preceding the study. Interventions: Each subject went through a series of 3 different heading scenarios, heading the ball 5 times for each scenario. Heading was done with goal kicks, corner kicks and throw-ins. Pressure film on the subjects\u27 head recorded the force during the act of heading. Film was changed following each header and then sent to the lab for analysis. The analysis included minimum, maximum and average pressure. Main Outcome Measures: The forces recorded with heading the soccer ball during all three heading scenarios will be comparable to the numbers seen with football and ice hockey players. The forces seen with a goal kick will be higher on average than those recorded with corner kicks and throw-ins. Results: Ball speeds were found to range from 26-57 mph across 42 trials of three different heading scenarios. Goal kicks were found to produce the highest speeds and forces recorded with throw-in\u27s produced the lowest speeds and forces. Forces ranged from 364.34 lbf -- 1070.18 lbf. Conclusions: Current research suggests that while the forces acting on the head during heading are below the accepted value for concussion there is still a risk for cumulative damage secondary to repetitive impacts sustained at sub-concussive levels. Further examination of duration of impact, acceleration/deceleration of the head and cognitive testing in former players who were considered headers is suggested to better understand the risk posed by repetitive heading

Barriers to treatment of hepatitis C in HIV/HCV coinfected adults in Brazil

The objective of this study was to assess the prevalence of barriers to interferon treatment in a population of HIV/HCV coinfected patients. A cross-sectional study was conducted at two AIDS Outpatient Clinics in Brazil. the study included all HIV infected patients followed at these institutions from January 2005 to November 2007. Medical records of 2,024 HIV-infected patients were evaluated. the prevalence of anti-HCV positive patients among them was 16.7%. Medical records of HCV/HIV coinfected patients were analyzed. 189 patients with the following characteristics were included in our study: mean age 43 years; male gender 65%; former IDUs (52%); HCV genotype 1 (66.4%); HCV genotype 3 (30.5%); median CD4+ T cell count was 340 cells/mm(3). Among 189 patients included in the analyses, only 75 (39.6%) were considered eligible for HCV treatment. the most frequent reasons for non-treatment were: non-compliance during clinical follow-up (31.4%), advanced HIV disease (21.9%), excessive alcohol consumption or active drug use (18.7%), and psychiatric disorders (10.1%). Conclusions: in Brazil, as in elsewhere, more than half of HIV/HCV coinfected patients (60.4%) have been considered not candidates to received anti-HCV treatment. the main reasons may be deemed questionable: non-adherence, drug abuse, and psychiatric disease. Our results highlight the importance of multidisciplinary teams to optimize the access of coinfected patients to HCV treatment.Fac Med ABC, Infect Dis Res Unit, São Paulo, BrazilAIDS Outpatient Clin, São Paulo, BrazilUniversidade Federal de São Paulo, AIDS Outpatient Clin, Fac Med, São Paulo, BrazilUniversidade Federal de São Paulo, AIDS Outpatient Clin, Fac Med, São Paulo, BrazilWeb of Scienc

Olive leaf extract inhibits metastatic melanoma spread through suppression of epithelial to mesenchymal transition

Olive tree leaves are an abundant source of bioactive compounds with several beneficial effects for human health, including a protective role against many types of cancer. In this study, we investigated the effect of an extract, obtained from olive tree (Olea europaea L.) leaves (OLE), on proliferation, invasion, and epithelial to mesenchymal transition (EMT) on metastatic melanoma, the highly aggressive form of skin cancer and the deadliest diseases. Our results demonstrated that OLE inhibited melanoma cells proliferation through cell cycle arrest and induction of apoptotic cell death. Moreover, OLE suppressed the migration, invasion, and colonies formation of human melanoma cells. Similar to our in vitro findings, we demonstrated that the oral administration of OLE inhibited cutaneous tumor growth and lung metastasis formation in vivo by modulating the expression of EMT related factors. In addition, the anti-proliferative and anti-invasive effects of OLE against melanoma were also related to a simultaneous targeting of mitogen-activated protein kinase and PI3K pathways, both in vitro and in vivo. In conclusion, our findings suggest that OLE has the potential to inhibit the metastatic spread of melanoma cells thanks to its multifaceted mechanistic effects, and may represent a new add-on therapy for the management of metastatic melanoma

Free boundary problem for the role of planktonic cells in biofilm formation and development

The dynamics of biofilm lifecycle are deeply influenced by the surrounding environment and the interactions between sessile and planktonic phenotypes. Bacterial biofilms typically develop in three distinct stages: attachment of cells to a surface, growth of cells into colonies, and detachment of cells from the colony into the surrounding medium. The attachment of planktonic cells plays a prominent role in the initial phase of biofilm lifecycle as it initiates the colony formation. During the maturation stage, biofilms harbor numerous microenvironments which lead to metabolic heterogeneity. Such microniches provide conditions suitable for the growth of new species, which are present in the bulk liquid as planktonic cells and can penetrate the porous biofilm matrix. We present a 1D continuum model on the interaction of sessile and planktonic phenotypes in biofilm lifestyle which considers both the initial attachment and colonization phenomena. The model is formulated as a hyperbolic-elliptic free boundary value problem with vanishing initial value. Hyperbolic equations reproduce the transport and growth of sessile species, while elliptic equations model the diffusion and conversion of planktonic cells and dissolved substrates. The attachment is modelled as a continuous, deterministic process which depends on the concentrations of the attaching species. The growth of new species is modelled through a reaction term in the hyperbolic equations which depends on the concentration of planktonic species within the biofilm. Existence and uniqueness of solutions are discussed and proved for the attachment regime. Finally, some numerical examples show that the proposed model correctly reproduces the growth of new species within the biofilm and overcomes the ecological restrictions characterizing the Wanner-Gujer type models.Comment: 17 pages, 9 figures, preprint versio

CO2 laser ablation of oral leukoplakia: with or without extension of margins?

The purpose is to determine the sufficient extension of margins during laser ablation of oral leukoplakia and observe its short-term recurrence rate. Materials and Methods.The study was designed as a randomized controlled clinical trial was conducted on 33 oral leukoplakia lesions diagnosed in 30 patients (16 Females and 14 Males) with an age range between 39 and 79 years. The lesions were divided into three groups; Group A: 11 lesions in 11 patients, in which the laser ablation was done for the entire lesion without extension of margins; Group B: 11 lesions in 8 patients, in which the laser ablation was done for the lesion adding at least 3mm extension of margins; and finally the Group Control: consists of 11 untreated lesions in 11 patients, in which only “wait and see” approach was done. Results. Complete healing of 13 lesions occurred in both groups A and B. Complete regression of 3 lesions occurred in Group Control. After 6 months of follow-up, 6 of 9 lesions in both groups A and B that showed the recurrence, had shown an initial recurrence after 3 weeks of the laser ablation. Patients with no history of smoking habits showed complete healing of 87.5%, while in ex-smokers complete healing was 42.8%. The statistical analysis was performed, and the averages of all groups are significantly different (p &lt;0.00001).Discussion.The primary treatment focuses on the elimination of associated risk factors (smoking, alcohol, and local irritating factors). In the literature, the recurrence rate varies between 13.6% and 40.7%, while in our study, it was 45.5% in Group A and 36.4% in Group B. Conclusion.The recommended extension of margins should be at least 3mm in width. Further research can be performed to evaluate the immediate re-ablation of the lesions which showed an initial recurrence after 3 weeks of laser ablation