Beyond the Chair: Public Health and Governmental Measures to Tackle Sugar

Limiting free sugars to <5% of energy intake is a World Health Organization evidence-based recommendation to protect oral health throughout the life course. Achieving this requires a concerted approach with upstream interventions, including legislation underpinning community interventions and health promotion. Global production and trade are the main drivers of sugars consumption, which can be addressed only through prioritization of health impacts in agricultural and trade agreements, including pricing and subsidies. Increasing evidence demonstrates the benefit, including dental benefits, of taxes on sugar-sweetened beverages, a major source of sugars—with taxes based on sugars content being favored due to the dual impact in incentivizing consumers to buy less and encouraging producers to use less through product reformulation. A benefit of product reformulation is that the potential impact on sugars intake occurs independent of consumer behavior change, making the benefits more equitable across social groups. Evidence from meta-analysis indicates that sugars reformulation and portion size reduction could lower energy intake by more than 10% and 16%, respectively. Sophisticated and targeted digital marketing of products high in sugars is another key driver of sugars intake. With the exception of children’s television broadcasting, marketing of products high in sugars is largely unregulated, and increased awareness of modern marketing strategies and more stringent regulation are urgently needed. To ensure a commercial level playing field, mandatory approaches are required. Midstream actions include creating healthier food environments in neighborhoods, community settings (schools, sports centers, hospitals), and workplaces. Only through coalition among authorities responsible for planning and health will “obesogenic and cariogenic” environments be replaced with those that make healthy choices the easiest choice. It is recognized that providing nutrition health education alone is insufficient to achieve necessary sugars reduction; however, education has a key role to play in changing social norms and creating drive for change.

Search for an Invisibly Decaying Z^{'} Boson at Belle II in e^{+}e^{-}→μ^{+}μ^{-}(e^{±}μ^{∓}) Plus Missing Energy Final States

Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}μ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{μ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6  GeV/c^{2}.

Automating a Process Convolution Approach to Account for Spatial Information in Imaging Mass Spectrometry Data

In the age of big data, imaging techniques such as imaging mass spectrometry (IMS) stand out due to the combination of data size and spatial referencing. However, the data analytic tools readily accessible to investigators often ignore the spatial information or provide results with vague interpretations. We focus on imaging techniques like IMS that collect data along a regular grid and develop methods to automate the process of modeling spatially-referenced imaging data using a process convolution (PC) approach. The PC approach provides a flexible framework to model spatially-referenced geostatistical data, but to make it computationally efficient requires identification of model parameters. We perform simulation studies to define optimal methods for specifying PC parameters and then test those methods using simulations that spike in real spatial information. In doing so, we demonstrate that our methods concurrently account for the spatial information and provide clear interpretations of covariate effects, while maximizing power and maintaining type I error rates near the nominal level. To make these methods accessible, we detail the imagingPC R package. Our approach provides a framework that is flexible and scalable to the level required by many imaging techniques.

A70 ASSOCIATION BETWEEN PROTON PUMP INHIBITOR USE IN HOSPITALIZED CIRRHOTICS AND DEVELOPMENT OF HEPATIC ENCEPHALOPATHY AND SPONTANEOUS BACTERIAL PERITONITIS

Background

Proton pump inhibitors (PPI) are commonly prescribed medications which are indicated in various different gastrointestinal (GI) diseases, including peptic ulcer disease, gastroesophageal reflux disorder and upper GI bleeding. There is some evidence to suggest that PPI use in cirrhosis may predispose to the development of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP), albeit with some controversy.

Aims

We aim to conduct a retrospective epidemiological analysis of the association between PPI use in hospitalized patients with cirrhosis, and prevalence of HE and SBP.

Methods

This was a retrospective cohort study of 600 adult patients (mean age 61.4 (SD=12.2)) admitted the Ottawa Hospital between January 1, 2011 and December 31, 2015 with cirrhosis. A chart review was conducted and relevant information extracted.

Results

Average MELD-Na on admission was 16.2 (sd=6.7). 14.8% of patients had a history of HE, 5.0% SBP, 7.8% with history of hepatocellular carcinoma and 1.0% with history of hepatorenal syndrome. 28.5% of patients had a history of varices, of which 11.0% had previous variceal bleeding. 69.3% of patients were on a PPI during their hospitalization. Not surprisingly, patients admitted with variceal bleeding were more likely to be exposed to PPI in hospital (97.2% vs 63.2%, p&lt;0.01) Patients with a diagnosis of cirrhosis prior to index admission were more likely to be on a PPI in hospital (p=0.001) and on discharge (p=0.001). Patients with ascites were less likely to be on a PPI than those without ascites (64.1% vs 77.6%, p&lt;0.01). There was no significant correlation between in hospital PPI use and MELD score (p=0.42). Amongst patients on PPI in hospital, 85.9% remained on a PPI at discharge. Although numerically greater, no statistically significant differences were observed in terms of prevalence of HE (21.3% in patients on PPI vs 8.3% in those not on PPI (p=0.37)), nor SBP (5.7% on PPI vs. 3.7% in those not on PPI (p=0.29)).

Conclusions

We did not observe a significant difference in HE and SBP among this cohort of cirrhotic patients by in-hospital PPI use. We did however note significantly higher PPI use in patients with previous diagnosis of cirrhosis as compared to those who were newly diagnosed, as well as those whose admissions were related to bleeding. Patients with ascites had lower prevalence of PPI use. Prescribing patterns for PPIs in patients with cirrhosis warrant further attention, including clinical utility and longer-term risks and benefits of this therapy.

Funding Agencies

None

Relative Effectiveness of Selenite Cystine Broth, Tetrathionate Broth, and Rappaport-Vassiliadis Medium for Recovery of Salmonella spp. from Raw Flesh, Highly Contaminated Foods, and Poultry Feed: Collaborative Study

A collaborative study was performed in 18 laboratories to validate use of Rappaport-Vassiliadis (RV) medium in the standard culture method for recovery of Salmonella spp. from raw, highly contaminated foods and poultry feed. RV medium made from its individual ingredients and incubated at 42�C was compared with selenite cystine (SC) broth incubated at 35�C and tetrathionate (TT) broth incubated at 35� and 43�C for effectiveness in recovery of Salmonella spp. Four artificially contaminated foods (oysters, frog legs, mushrooms, and shrimp) and poultry feed and one naturally contaminated food (chicken) were analyzed. The artificially contaminated foods were inoculated with single serovars of Salmonella at target levels of 0.04 colony-forming units (CFU)/g for the low level and 0.4 CFU/g for the high level. For analysis of 1125 test portions, RV medium (42�C) recovered Salmonellairom 409 test portions; TT (43�C), from 368 test portions; TT (35�C), from 310 test portions; and SC (35�C), from 334 test portions. Overall, RV medium was comparable with or better than other selective enrichments for recovery of Salmonella from the foods in this study, except mushrooms. From mushrooms, SC broth (35�C) recovered more positive test portions than did RV medium (42�C) and TT broth (43�C). The method for detection of Salmonella in raw, highly contaminated foods and

VIDAS Enzyme-Linked Fluorescent Immunoassay for Detection of Salmonella in Foods: Collaborative Study

The VIDAS SLM method for detection of Salmonella was compared with the Bacteriological Analytical Manual (BAM)/AOAC culture method in a collaborative study. Twenty laboratories participated in the evaluation. Each laboratory tested one or more of 6 test products: milk chocolate, nonfat dry milk, dried whole egg, soy flour, ground black pepper, and ground raw turkey. No significant differences (P&lt; 0.05) were observed between the 2 methods. The 2 methods were in agreement for 99% of 1544 samples analyzed. Of the 20 samples out of agreement, 8 were VIDAS SLM positive and BAM/AOAC negative, and 12 were VIDAS SLM negative and BAM/AOAC positive. The VIDAS SLM method for detection of Salmonella in foods has been adopted first action by AOAC INTERNATIONAL.

P3674Patient characteristics and treatment patterns in the multicentre, retrospective chart review of first-time Opsumit (macitentan) users in the United States (OrPHeUS)

Introduction

The OPsumit® Historical USers cohort (OrPHeUS) is a multicentre, US, retrospective medical chart review conducted to supplement the OPsumit® USers (OPUS) Registry to fulfil the FDA request to characterise the safety of macitentan in clinical practice.

Purpose

To describe patient characteristics, treatment patterns, hepatic safety and survival in patients with pulmonary hypertension (PH) newly treated with macitentan.

Methods

OrPHeUS (NCT03197688) aimed to include 2200 new users of macitentan, between October 2013 and March 2017, who were not enrolled in OPUS. Here we present patients with follow-up data, including characteristics and treatment patterns at macitentan initiation, hepatic adverse events (HAEs) identified using preferred terms in chart entries and pharmacovigilance reporting, hospitalisations and survival.

Results

OrPHeUS included 2982 patients newly treated with macitentan and with follow-up data; the reason for macitentan prescription was pulmonary arterial hypertension (PAH) in 2362 (79.3%) patients, other PH aetiologies in 612 (20.6%) patients and 8 patients with other/unknown reasons. At macitentan initiation, the median (Q1, Q3) age of the patients was 62 (51, 72) years and 73.9% were female. WHO functional class (FC) was documented in 654 (21.9%) patients, 35.6% of patients were in FC I/II and 64.4% in FC III/IV; median (Q1, Q3) 6-minute walk distance, documented in 411 (13.8%) patients, was 293 (200, 383) metres. At macitentan initiation, 41.5% (n=1239) of patients were not receiving PAH therapy, 46.3% (n=1382) were already receiving one PAH therapy and 11.9% (n=356) were already receiving two PAH therapies. The median (Q1, Q3) exposure to macitentan was 14.9 (5.6, 27.1) months; 57% and 43% of patients had exposures of >12 and >18 months. During the exposure period, 933 (31.3%) patients discontinued treatment, including 474 (15.9%) patients who discontinued due to an adverse event (AE), 6 (0.2%) due to a HAE, 449 (15.1%) for reasons other than an AE/HAE, and 4 (0.1%) for unknown reasons. There were 275 (9.2%) patients who experienced ≥1 HAE (incidence rate [IR]: 0.07 [95% CI, 0.06, 0.08] per 1 person-year); alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥3x upper limit of normal (ULN) were experienced by 113 (3.8%) patients (IR: 0.028 [95% CI, 0.023, 0.033] per 1 person-year); ALT/AST ≥x3 ULN and bilirubin ≥2x ULN was experienced by 33 (1.1%) patients (IR: 0.008 [95% CI, 0.006, 0.011] per 1 person-year). There were 1148 (38.5%) patients who experienced at least one hospitalisation (IR: 0.36 [95% CI, 0.34, 0.39] per 1 person-year). The 12-month Kaplan-Meier survival estimate was 92% (95% CI, 91, 93).

Conclusion

OrPHeUS provides additional real-world evidence in patients newly treated with macitentan, confirming the hepatic safety profile of macitentan.

Acknowledgement/Funding

Actelion Pharmaceuticals Ltd

The effects of cereal type and α-tocopherol level on milk production, milk composition, rumen fermentation, and nitrogen excretion of spring-calving dairy cows in late lactation

Grass-based production systems use concentrate supplementation primarily when pasture quality and availability have declined. Barley is a common concentrate ingredient; however, oat grain grows well in Ireland, is a source of lipids and fiber, and may provide an alternative to barley. The antioxidant α-tocopherol (α-TOC) plays a role in cell membrane structure, and it has the potential to improve tight junction structures of the mammary gland that deteriorate in late lactation. The objective of this research was to investigate the effect of cereal type and α-TOC level on milk yield, milk composition, rumen fermentation, and N excretion in late-lactation dairy cows at pasture and when housed indoors on grass silage. Forty-eight Holstein Friesian dairy cows were blocked on days in milk (+185 d in milk) and balanced for parity, pre-experimental milk yield, milk composition, and body condition score and assigned to 1 of 4 dietary treatments in a randomized complete block design (n = 12). The dietary treatments were control (C) base diet; base diet + barley-based concentrate + low α-TOC (350 IU/kg) (B); base diet + oat-based concentrate + low α-TOC (350 IU/kg) (O); and base diet + oat-based concentrate + high α-TOC (1,050 IU/kg) (O+T). Following a 14-d acclimation period, diets were offered for a 49-d experimental period at pasture (P1) and a 21-d experimental period indoors (P2). The base diet was grazed grass in P1 and grass silage in P2. In P2, cows on C also received 2.65 kg (dry matter) of a standard concentrate. In P1, supplementation increased milk and milk solids yield (B: 20.7 kg/d, 1.74 kg/d; O: 20.6 kg/d, 1.81 kg/d; O+T: 20.5 kg/d, 1.77 kg/d, respectively) compared with C (17.8 kg/d, 1.60 kg/d). Cows offered B had a lower milk fat (4.60%) concentration than C (5.00%) and O (4.90%). In P2, cereal type and α-TOC level did not alter milk production. In conclusion, concentrate supplementation increased milk and milk solids yield and cows offered O had a higher milk fat concentration than cows offered B. Increasing the level of α-TOC had no major effect on production parameters measured in P1 or in P2.

SAT-262 Differential Metabolic, Thermal, and Pulmonary Responses to Early Life Ozone Exposure in Male and Female Rats

The essential role that early life events (i.e., intrauterine growth restriction) and environmental exposures (i.e., air pollution) play in development of childhood asthma and obesity are only partly understood. Notably, asthmatic children who develop obesity through adolescence have poorer disease outcomes. In our previous studies we showed that exposure of Long-Evans rats to the oxidant air pollutant, ozone (O₃), during implantation [gestational days (GD) 5 and 6; 0.8 ppm x 4h] resulted in growth restriction at GD21. The aims of this study were to determine whether gestational ± repeated peri-adolescent O₃-exposure (0.4-0.8 ppm x 4h; once/week at 5, 6, and 7 weeks-of-age) would alter offspring metabolism, body, or lung growth, and acute thermal or pulmonary responses to O₃. Using 2-way ANOVA with Dunnett’s post hoc correction, responses in males (M) and females (F) were evaluated separately; all O₃-exposed groups were compared to controls [air-exposed dams + PN-Air-(x3)] of the corresponding sex. By postnatal (PN) day 45, results showed that in males, dam O₃-exposure was associated with augmented body “height” (skull base-to-tail head) and increases in serum triglyceride, and cholesterol levels; but not body weight, weight adjusted by height (gm/cm), or corrected lung (fixed) volume (mL/cm height x100%). PN-O₃x3 exposures were associated with increased HOMA-IR ratios and further increases in cholesterol. In females, dam O₃-exposure was associated with lower lung volumes and increased serum cholesterol; while PN-O₃x3 exposure was associated with reduced weight/height (gm/cm). For both sexes, the degree of acute hypothermia was altered in association with both dam- and especially PN-O₃ exposures; whereas lung injury (e.g., increased protein leakage) and inflammation (e.g., neutrophils) in lung lavage fluid, were increased chiefly by PN-O3 exposure. Particularly in males, lesser inflammatory responses were observed in O₃+O₃x3 rats (e.g., reduced KC-GRO and IL-6 cytokine levels) compared to Air+O₃x3 rats. Conversely, lavage fluid TNFα concentrations were increased only in the O₃+O₃x3 males. Taken together, data suggest that O₃ exposure during gestation played a greater role in predisposing offspring to dyslipidemia, whereas peri-adolescent exposure dominated the acute hypothermia and inflammatory responses. Importantly, males exposed to both gestational and postnatal O₃ appeared to (A) develop greater dyslipidemia (a precursor of metabolic syndrome) and (B) altered lung innate inflammatory responses − potentially influencing T_H-1 to T_H-2 balance (a precursor to allergic asthma) later in life. (This abstract does not reflect USEPA policy).

The effect of concentrate supplementation type on milk production, dry matter intake, rumen fermentation, and nitrogen excretion in late-lactation, spring-calving grazing dairy cows

In Ireland, milk is primarily produced using a spring-calving grass-based system, with the use of concentrate supplementation mainly when pasture availability and quality are reduced. In the autumn, when cows are in late lactation, reduced pasture productivity results in reduced milk yield and altered milk composition. Nitrogen utilization efficiency also reduces as lactation progresses. Concentrate supplementation has been found to increase milk production and reduce nitrogen (N) excretion, as high-N grass is usually replaced by a lower-N supplement; however, there is a paucity of information with regard to the optimum type of supplementation in late lactation. Therefore, the objective of this research is to investigate the effect of different concentrate supplementation types, based on barley or maize, on milk production, dry matter intake (DMI), rumen fermentation, and N excretion in late-lactation, spring-calving, grazing dairy cows. Thirty-six Holstein Friesian dairy cows were blocked on days in milk (185 DIM) and balanced for parity, pre-experimental milk yield, milk composition, and body condition score. Cows were randomly assigned to 1 of 3 dietary treatments in a randomized complete block design (n = 12). The 3 treatments consisted of a perennial ryegrass-based pasture-only (PO) treatment and pasture plus either of 2 supplementary concentrates, based on barley (PB) or maize (PM). The diets were fed for a 14-d acclimatization period and then for a further 63-d experimental period. Cows offered PO had a lower daily milk yield (15.1 kg) than PB (18.2 kg) or PM (16.8 kg). Similarly, PO had lower daily milk solids yield (1.46 kg) than PB or PM (1.68 and 1.53 kg, respectively). Cows offered PB had a greater milk yield and higher fat and protein yields than those offered PM. Offering PB increased total DMI (19.5 kg) compared with PO (17.7 kg), and milk response to concentrates was also greater for PB compared with PM (1.21 vs. 0.71 kg of milk per kg of concentrate). Cows offered PB had increased N in milk compared with PO. In conclusion, concentrate supplementation based on barley or maize resulted in increased milk and milk solids yield compared with offering PO. Cows offered barley had a greater response to concentrates and increased milk and milk solids yield in comparison to maize and showed increased N partitioning in milk compared with PO. A barley-based concentrate increased total DMI compared with PO.

[Publications by university Departments of Anaesthesiology from Germany, Austria and Switzerland in 2011-2015 : Scientific publications by university hospitals in D‑A-CH]

BACKGROUND

This study presents a count of publications and citations for all articles published by university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. The results were compared with former analyses of these countries from 2001-2010 as well as similar international studies.

METHODS

We performed a PubMed search based on PERL-scripts for all publications originating from university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. According to their author's affiliation, articles were assigned to their affiliated university department. Publications were considered an original article if the category of publication was classified as original research in PubMed. Predatory journals were omitted by using PubMed-listed journals only. Data of citations was retrieved from Thomson Reuter's ISI Web of Knowledge. The following indicators were reported: the number of publications and original articles (counting each author and first authors only) and the share of original articles out of all publications. With regard to citations, we reported the overall number, the percentage of publications, which were cited at least once and the median of citations per publication and per original article as well as the calculated h-index.

RESULTS

The 47 university Departments of Anaesthesiology published 4.697 articles between 2011 and 2015, which make up 89% of all anaesthesiology research originating from Germany, Austria and Switzerland (overall 5.284 publications). Of these, 1.037 (22%) were classified as original articles. Considering only articles with first authors, equalizing a change of PubMed's affiliation field policy in 2012 to compare the numbers with previous periods, 3.709 publications and 821 original articles were published. 90% of all publications and 96% of original articles, respectively, were cited at least once. Publications were cited six times, while original articles were cited nine times. The university department of Anaesthesiology in Zurich published most (n = 245), while most original articles were published in Vienna (n = 77). The highest share of original articles was achieved by Vienna (37%). Publications from Berlin - Benjamin Franklin and Jena (11 citations per publication) and original articles from Essen (23,5 citations per original article) achieved the highest citation rates.

DISCUSSION

In contrast to the worldwide increasing trend, the number of publications of the university Departments of Anaesthesiology in Germany, Austria and Switzerland stagnated. The share of original articles out of all publications continues to decline in comparison to 2001-2010 (-6%). Despite this, original articles were cited more frequently and thus had a higher value for the scientific community. The reasons of the decrease in the number of original articles remain unclear and require further investigation to reverse this negative trend.

CONCLUSION

Strategies to foster academic work in anaesthesiology in Germany, Austria and Switzerland are required.

Hazards and disasters in the geological and geomorphological record: a key to understanding past and future hazards and disasters

Hazards and disasters have occurred throughout Earth's History and thus the geological record is an important resource for understanding future hazards and disasters. The Earth Science Group (ESG) of the Consortium of European Taxonomic Facilities (CETAF) carried out a “Hazard and Disaster Event Survey” to identify Earth Science collections in European museums that represent hazards and disasters throughout the geological record, and recent times. The aim is to use the collections within the survey as an educational and research resource that promotes the importance of museum collections for understanding past and future hazard and disaster events. The survey pinpointed a wide variety of hazards (e.g. earthquakes, volcanism, floods, impact events, etc.), representing a vast time span in Earth’s history (Proterozoic to Holocene), that are documented in the collections of the participating museums. Each hazard and disaster event has been described in terms of how they are preserved (e.g. fossil record or rock record), spatial scale, impact on life, and geological age. Here we showcase seven examples in detail which include well-known and less-known events from the survey that have contributed to our understanding of hazard and disaster processes and their impact on life. Also we present general conclusions and lessons learnt from the “Hazard and Disaster Event Survey”.

Abstract P4-13-02: Selective androgen receptor modulator RAD140 inhibits the growth of endocrine-resistant breast cancer models with defined genetic backgrounds

Estrogen receptor α-positive (ER+) breast cancer is routinely treated with therapies targeting the ER axis. However, de novo and acquired resistance to the standard-of-care treatment occur in a significant subset of patients. Multiple mechanisms have been proposed for the resistance, among which genetic alterations to the coding gene of ERα, ESR1, have been extensively studied. Notably, ESR1 hotspot mutations within the ligand binding domain (LBD), novel fusion proteins consisting of the N-terminal domain of ER and the C-terminal domain of a partner gene, and ESR1 gene amplification have been found to be enriched in endocrine-resistant, metastatic breast cancers. Together these ER gene alterations present new challenges in the management of ER+ breast cancer and call for the development of new agents to supplement the current standard-of-care. Around 90% of the ER+ breast cancer cases are also androgen receptor (AR) positive (AR+). Mounting preclinical evidence has demonstrated that AR agonists suppress AR and ER positive (AR/ER+) breast cancer cell growth, in line with clinical activity of androgens. We recently reported the oral selective androgen receptor modulator (SARM) RAD140 is a potent, tissue-selective AR agonist in breast cancer cells which significantly inhibited the growth of AR/ER+ patient-derived xenograft (PDX) models, partly via inhibiting ESR1 gene expression and ER signaling. It also elicited enhanced tumor growth inhibition when combined with a CDK4/6 inhibitor.

Here we further examine the activity of RAD140 in AR/ER+ breast cancer models that are endocrine-independent with a spectrum of ESR1 genetic alterations. In PDX models harboring ESR1 amplification or fusion, RAD140 inhibited tumor growth to a greater degree than fulvestrant, a standard-of-care selective ER degrader (SERD). These results are consistent with the clinical history of the donor patients whose diseases relapsed from or progressed rapidly on fulvestrant. In PDX models with ESR1 Y537S mutation, RAD140 showed anti-tumor activity comparable to that of fulvestrant. Notably, RAD140 treatment also led to substantial reduction of proliferation and colony formation in cell line models recapitulating resistance to the combination of estrogen deprivation and CDK4/6 inhibition.

In summary, RAD140 showed marked anti-tumor activity in AR/ER+, endocrine-resistant breast cancer models with defined genetic background. Importantly, in models with ESR1 amplification and fusion, the AR-targeting RAD140 exhibited more profound inhibitory activity compared with fulvestrant. In models with an ESR1 mutation, the efficacy of RAD140 and fulvestrant was comparable. These results lend support to a clinical hypothesis that AR/ER+, endocrine-resistant tumors with these genetic backgrounds may benefit from AR agonist-based treatment. RAD140 is currently being evaluated in hormone receptor positive (HR+) breast cancer patients (NCT03088527).

Citation Format: Yu Z, He S, Miller C, Saeh J, Hattersley G, O'Neill A. Selective androgen receptor modulator RAD140 inhibits the growth of endocrine-resistant breast cancer models with defined genetic backgrounds [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-02.

Comparing the periodontal tissue response to non-surgical scaling and root planing alone, adjunctive azithromycin, or adjunctive amoxicillin plus metronidazole in generalized chronic moderate-to-severe periodontitis: a preliminary randomized controlled trial

BACKGROUND

The usefulness of administrating adjunctive systemic antibiotics to expedite healing of periodontal tissues is a topic of interest given the lack of clear guidelines.

AIM

To compare clinical outcomes in patients given adjunctive azithromycin (AZ), adjunctive amoxicillin plus metronidazole (AMX + MTZ), or scaling and root planing (SRP) alone in the treatment of moderate-to-severe chronic periodontitis.

METHODS

Thirty-eight patients were randomly assigned into: SRP alone; 500 mg AMX plus 400 mg MTZ three times per day for 7 days; or 500 mg AZ for 3 days. Antibiotics were administered after the first SRP session and clinical parameters for full-mouth and baseline probing pocket depth (PPD) categories were reviewed 2-months post-treatment.

RESULTS

Thirty-four of 38 patients completed the study. All groups experienced significant improvements in full-mouth clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing. AZ exhibited greater reductions in PPD than SRP alone for baseline severe sites, whilst AMX+MTZ showed significant improvements in PPD and CAL than SRP alone for baseline moderate and severe sites. Of the two antibiotic therapies, AMX+MTZ showed greater reductions in PPD compared with AZ in baseline moderate sites only.

CONCLUSIONS

For patients with moderate-to-severe periodontitis, adjunctive systemic antibiotics might result in greater clinical benefits.