Prevalence and risk-factors of neurogenic heterotopic ossification in traumatic spinal cord and traumatic brain injured patients admitted to specialised units in Australia

OBJECTIVES

To identify the prevalence and risk factors in the development of Neurogenic Heterotopic Ossification (NHO) in traumatic brain and spinal cord injured patients admitted to specialised units.

METHODS

An audit protocol was used to gather all clinically relevant data, in specific patient groups, relating to the prevalence of NHO, and was statistically analysed to identify traumatic brain injury (TBI) and traumatic spinal cord injury (TSCI) patients at high risk of developing NHO.

RESULTS

262 TBI and 151 TSCI patients were identified. NHO was diagnosed in 10 and 16 patients with TBI and TSCI, respectively; 18 clinically relevant characteristics were analysed for association with NHO in these patient groups. The only common variables associated with NHO in both neurological conditions were deep vein thrombosis and/or pulmonary emboli (DVT/PE).

CONCLUSIONS

The prevalence of NHO in TBI patients is less than one-third of that found in TSCI patients, ~4% and 11%, respectively. This study also suggests that the risk factors associated with NHO in TBI patients are distinct from those identified as risk factors in TSCI patients.

Elemental geochemistry of sedimentary rocks at Yellowknife Bay, Gale crater, Mars

Sedimentary rocks examined by the Curiosity rover at Yellowknife Bay, Mars, were derived from sources that evolved from an approximately average martian crustal composition to one influenced by alkaline basalts. No evidence of chemical weathering is preserved, indicating arid, possibly cold, paleoclimates and rapid erosion and deposition. The absence of predicted geochemical variations indicates that magnetite and phyllosilicates formed by diagenesis under low-temperature, circumneutral pH, rock-dominated aqueous conditions. Analyses of diagenetic features (including concretions, raised ridges, and fractures) at high spatial resolution indicate that they are composed of iron- and halogen-rich components, magnesium-iron-chlorine-rich components, and hydrated calcium sulfates, respectively. Composition of a cross-cutting dike-like feature is consistent with sedimentary intrusion. The geochemistry of these sedimentary rocks provides further evidence for diverse depositional and diagenetic sedimentary environments during the early history of Mars.

Final results of Australasian Gastrointestinal Trials Group ARCTIC study: an audit of raltitrexed for patients with cardiac toxicity induced by fluoropyrimidines

BACKGROUND

Cardiac toxicity an uncommon but serious side-effect of some fluoropyrimides. Cardiac toxicity from raltitrexed is rarely reported. With this background, we initiated this study to investigate the incidence of cardiac events in patients who had switched to raltitrexed following cardiac toxicity from fluoropyrimidines (5-fluorouracil or capecitabine).

PATIENTS AND METHODS

Pharmacy records were used to identify patients receiving raltitrexed from January 2004 till March 2012. Medical records were then reviewed to confirm the use of raltitrexed after cardiac toxicity from 5-fluorouracil or capecitabine. The primary end point was the rate of further cardiac events after commencing raltitrexed.

RESULTS

Forty-two patients were identified and the majority had colorectal cancer. Prior regimens included 5-fluorouracil ± leucovorin, capecitabine alone, FOLFOX, FOLFIRI, epirubicin/cisplatin/5-fluorouracil, and capecitabine/oxaliplatin. Seven patients (17%) had bolus 5-fluorouracil regimens, 26 patients (62%) had infusion 5-fluorouracil regimens, and 9 patients (21%) had capecitabine alone or in combination. Angina was the most common cardiac toxicity from 5-fluorouracil or capecitabine and usually occurred in the first or the second cycle. Four patients after their first cardiac event continued with the same 5-fluorouracil or capecitabine regimen with the addition of nitrates and calcium antagonists but still had further cardiac events. After changing to raltitrexed, either as a single agent or a continuing combination regimen, no patients experienced further cardiac toxicity.

CONCLUSION

Raltitrexed is associated with no significant cardiac toxicity in patients who have experienced prior cardiac toxicity from 5-fluorouracil or capecitabine. Raltitrexed, alone or in combination with oxaliplatin or irinotecan, provides a safe option in terms of cardiac toxicity for such patients.

Multifocal periostitis as a complication of chronic use of voriconazole in a lung transplant recipient

Fungal infections are common in solid organ transplantation. An increasing number of transplant recipients receive antifungal therapy for prolonged duration owing to invasive fungal infections. Herein, we describe a diagnosis of periostitis as a complication of chronic use of voriconazole in a lung transplant recipient. The patient was diagnosed with probable pulmonary aspergillosis and was treated with oral voriconazole for a total of 9 months. Evidence of multifocal periostitis was observed in the axial and appendicular skeleton. Early recognition of this phenomenon is important to prevent unnecessary tests and procedures. Prompt discontinuation of voriconazole should result in improvement of symptoms.

Genome-wide approaches (GWA) in oral and craniofacial diseases research

Oral Diseases (2012) Underlying molecular genetic mechanisms of diseases can be deciphered with unbiased strategies using recently developed technologies enabling genome-wide scale investigations. These technologies have been applied in scanning for genetic variations, gene expression profiles, and epigenetic changes for oral and craniofacial diseases. However, these approaches as applied to oral and craniofacial conditions are in the initial stages, and challenges remain to be overcome, including analysis of high throughput data and their interpretation. Here, we review methodology and studies using genome-wide approaches in oral and craniofacial diseases and suggest future directions.

Oral Health Disparities and the Future Face of America

The 4th Annual AADR Fall Focused Symposium (FFS), "Oral Health Disparities Research and the Future Face of America", took place on November 3-4, 2011 in Washington, DC. The FFS strategy was developed by the AADR to help provide additional opportunities for members to engage in research discussions during the year by identifying specific research topics of interest among the 21 Scientific Groups and 4 Networks of the IADR and targeting a focused topic area for the FFS. The conference attracted an international group of approximately 120 registrants, including participants from Canada, India, Mexico, and China; 4 oral sessions and 32 poster presentations were offered.

Rehabilitation of cardiac patients in the twenty-first century: changing paradigms and perceptions

Rehabilitation of the coronary patient has changed dramatically over the past 40 years. The deleterious effects of prolonged bed rest have prompted the liberalization of activity soon after an acute cardiac event. Exercise-based cardiac rehabilitation has been shown to provide a 20-24% reduction in total and cardiovascular-related mortality. Adjunctive upper body aerobic exercise and mild to moderate resistance training can improve muscular strength and endurance in clinically stable coronary patients and attenuate the cardiovascular demands of occupational and leisure-time activities. Risk stratification has emerged as the centrepiece of strategies aimed at stabilizing or enhancing the clinical status of post-myocardial infarction patients, as well as vocational counselling. Moreover, randomized controlled trials have confirmed the hypothesis that lipid lowering is associated with, and possibly preceded by, plaque stabilization and a reduction in the risk of recurrent cardiac events.

In vitro generation of mature human osteoclasts

Mononuclear precursors of human osteoclasts are found in the CD14(+) monocyte fraction of circulating peripheral blood mononuclear cells (PBMCs). It is possible to generate osteoclasts in vitro from PBMCs cultured with macrophage colony-stimulating factor and receptor activator for nuclear factor κB ligand. In these cultures, however, it is not possible to distinguish the effect of a specific agent on osteoclast resorption activity as opposed to osteoclast differentiation. To produce a population of mature human osteoclasts to study osteoclast lacunar resorption specifically, we cultured CD14(+) human monocytes on hydrophobic dishes in order to generate and maintain osteoclasts in suspension prior to culturing them on coverslips and dentine slices. Multinucleated cells formed in these cultures expressed vitronectin receptor, tartrate-resistant acid phosphatase, and cathepsin K. These cells also produced F-actin rings and were capable of extensive lacunar resorption on dentine slices after 24 h in culture. Lacunar resorption was inhibited by calcitonin and zoledronate but not by osteoprotegerin. This method of generating a highly enriched population of mature human osteoclasts should provide a valuable means of specifically assessing the effect of molecular factors (e.g., cytokines, growth factors, hormones) and therapeutic agents on osteoclast resorption activity.

Oral treatment of rodents with insecticides for control of sand flies (Diptera: Psychodidae) and the fluorescent tracer technique (FTT) as a tool to evaluate potential sand fly control methods

In laboratory studies, insecticides (diflubenzuron, novaluron, methoprene and, pyriproxyfen) that have been incorporated into rodent diets were effective as feed-throughs against sand fly larvae. Novaluron also was effective against sand fly larvae at low concentrations and under simulated field conditions. Ivermectin has been shown to be effective as a systemic insecticide, killing 100% of blood-feeding sand flies for up to seven d after rodents were treated. The fluorescent tracer technique (FTT) is the use of certain fluorescent dyes (rhodamine B or uranine O) as feed-through transtadial biomarkers for phlebotomine sand flies, systemic biomarkers for blood-feeding sand flies, and permanent markers for nectar-feeding sand flies. The results of these laboratory studies provide proof of concept for the FTT and indicate that the FTT could be used to delineate specific foci with rodent/sand fly associations that would be susceptible to control by using feed-through or systemic insecticides, or foci where insecticide-treated sugar baits could be used against sand flies.

Comparison of tuberculin activity using the interferon-gamma assay for the diagnosis of bovine tuberculosis

In this study, interferon-gamma (IFN-gamma) responses in whole blood cultures stimulated with tuberculins from different sources were compared with regard to their diagnostic reliability in cattle experimentally and naturally infected with Mycobacterium bovis. The IFN-gamma responses to different concentrations of purified protein derivatives (PPDs) from M bovis and Mycobacterium avium were quantified. Significant differences (P<0.05) between sources and concentrations of PPDs used for stimulation were detected, indicating a need for standardisation of PPDs used in the IFN-gamma assay. Additionally, a tool named'relative potency 30' that allows rapid comparison of batches and sources of PPDs was defined.