Occlusal characteristics in subjects with or without the ability to roll the tongue

AIM

The tongue represents an important intraoral muscular force which is in direct contact with the dental arches. The objective of the current study was to compare occlusal characteristics of patients who have the ability to roll their tongue (TR+) to those who cannot (TR-).

MATERIALS AND METHODS

A hundred consecutive patients under orthodontic treatment were classified as TR+ (n=73) or TR- (n=27). Pre-treatment orthodontic study casts were used to measure intercanine and intermolar widths, arch lengths, space deficiency, overjet, overbite, presence or absence of posterior crossbite and the molar Angle class. For continuous variables, independent sample t-tests and Mann-Whitney U tests were used to examine differences between the groups. For dichotomous variables, chi-square tests were used to examine differences between groups.

RESULTS

TR+ patients showed larger mandibular inter-molar widths (1 mm, p<0.05) and less mandibular space deficiency (1.9 mm, p<0.05) than TR- patients. Mandibular space deficiency was present in the mandibular arch in 18.5% of TR+ compared to 49.3% in TR- patients (p<0.05).

CONCLUSION

The ability to roll the tongue may lead to differences in occlusal characteristics, namely an increase in mandibular intermolar width and a less mandibular space deficiency.

Recommendations for the clinical and radiological evaluation of response to treatment in metastatic renal cell cancer

The evaluation of response to treatment is a critical step for determining the effectiveness of oncology drugs. Targeted therapies such as tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors are active drugs in patients with metastatic renal cell carcinoma (mRCC). However, treatment with this type of drugs may not result in significant reductions in tumor size, so standard evaluation criteria based on tumor size, such as Response Evaluation Criteria in Solid Tumors (RECIST), may be inappropriate for evaluating response to treatment in patients with mRCC. In fact, targeted therapies apparently yield low response rates that do not reflect increased disease control they may cause and, consequently, the benefit in terms of time to progression. To improve the clinical and radiological evaluation of response to treatment in patients with mRCC treated with targeted drugs, a group of 32 experts in this field have reviewed different aspects related to this issue and have put together a series of recommendations with the intention of providing guidance to clinicians on this matter.

Open membranes are the precursors for assembly of large DNA viruses

Nucleo cytoplasmic large DNA viruses (NCLDVs) are a group of double-stranded DNA viruses that replicate their DNA partly or entirely in the cytoplasm in association with viral factories (VFs). They share about 50 genes suggesting that they are derived from a common ancestor. Using transmission electron microscopy (TEM) and electron tomography (ET) we showed that the NCLDV vaccinia virus (VACV) acquires its membrane from open membrane intermediates, derived from the ER. These open membranes contribute to the formation of a single open membrane of the immature virion, shaped into a sphere by the assembly of the viral scaffold protein on its convex side. We now compare VACV with the NCLDV Mimivirus by TEM and ET and show that the latter also acquires its membrane from open membrane intermediates that accumulate at the periphery of the cytoplasmic VF. In analogy to VACV this membrane is shaped by the assembly of a layer on the convexside of its membrane, likely representing the Mimivirus capsid protein. By quantitative ET we show for both viruses that the open membrane intermediates of assembly adopt an 'open-eight' conformation with a characteristic diameter of 90 nm for Mimi- and 50 nm for VACV. We discuss these results with respect to the common ancestry of NCLDVs and propose a hypothesis on the possible origin of this unusual membrane biogenesis.

Role of immunotherapy in castration-resistant prostate cancer (CRPC)

Initial therapy for metastatic prostate cancer consists of androgenic suppression. However, this is only a palliative treatment with an effective duration that usually lasts 12-24 months. Historically, castration-resistant prostate cancer (CRPC) had been considered a chemoresistant tumour. In 2004, docetaxel received USA Food and Drug Administration approval as a first-line treatment for metastatic prostate cancer, after two independent phase III trials showed an increased survival benefit. Recently, five new drugs have shown increased survival in CRPC: sipuleucel-T (assymptomatic or minimally symptomatic), abiraterone acetate (before and after docetaxel), cabazitaxel (after docetaxel), MDV3100 (after docetaxel) and radium-223 (not suitable for docetaxel or after docetaxel). The identification of antigens in normal prostate tissue or prostate cancer that are recognised by immune effectors cells has resulted in several new studies based on immunotherapy. Prostate cancer disease provides a test system to determine the efficacy of vaccines for different reasons. This cancer is a tumour that grows relatively slowly. Recurrence is often diagnosed early (with many patients presenting only with biochemical progression), there is a biological marker that can predict prognosis and outcome (PSA doubling time), various specific antigens have been identified and characterised, and vaccines can be used with a good safety profile combined with anti-androgen therapy, chemotherapy, or radiotherapy. Here we provide a review of the main important immune treatments in CRPC.

Impact of rapid drug susceptibility testing for tuberculosis: program experience in Lima, Peru

SETTING

Programmatic implementation of decentralized rapid drug susceptibility testing (DST) in Lima, Peru.

OBJECTIVE

Pre-post analysis compared time to diagnosis, treatment outcome and survival among patients tested with direct nitrate reductase assay (NRA) vs. indirect conventional methods.

DESIGN

From 2005 to 2009, we prospectively followed all patients referred for DST before (control) and after (intervention) NRA implementation. Among those referred for DST, NRA was used for smear-positive samples of patients with no prior history of multidrug resistance or treatment for multidrug-resistant tuberculosis (TB). Data were abstracted from patient charts and laboratory registers. Endpoints were favorable outcomes, time to result and time to death.

RESULTS

Of those patients who met the criteria for NRA, 740 underwent NRA and 621 underwent conventional DST. NRA yielded test results for 78.4% of cases vs. 68.8% for conventional DST (P < 0.0001); the median time to result was 44 vs. 133 days, respectively (adjusted HR 0.64, 95%CI 0.56-0.73). Among individuals without previous anti-tuberculosis treatment, NRA was associated with a favorable treatment outcome (adjusted OR 1.39, 95%CI 1.01-1.90) and prolonged survival (adjusted HR 0.53, 95%CI 0.31-0.90).

CONCLUSION

Direct NRA significantly shortened time to test result and improved treatment outcomes and survival in certain groups.

Emerging therapies for urothelial cancer

Urothelial carcinoma is one of the leading causes of death in Europe and the United States. Despite its chemosensitivity, median overall survival for advanced disease is still nearly 1 year. Most second-line chemotherapeutic agents tested have been disappointing. Thus, new treatment strategies are clearly needed. This review focuses on emerging therapies in urothelial carcinoma. Results from recent clinical trials, investigating the activity of new generation cytostatic agents, as well as results from studies assessing the toxicity and efficacy of novel targeted therapies, are discussed. In this setting, anti-epidermal growth factor receptor, angiogenesis, and phosphatidylinositol 3-kinase/mammalian target of rapamycin inhibitors account for the majority of phase I and II trials.

Structured light scanning to evaluate three-dimensional anthropometry in HIV facial lipoatrophy

The psychological and social impact of the lipodystrophy syndrome on HIV-infected individuals may be quite considerable and adversely affect their quality of life. Currently no validated assessment tool for facial lipoatrophy is available. The main objective of this paper is to evaluate the reliability of interactive anthropometric landmark localization based on digitized 3D facial images. By comparing both computed tomography (CT) and structured light scanning we try to demonstrate that surface scanning shows a higher sensitivity in measuring facial reference points. Besides, we evaluate the reproducibility of facial 3D white-light scans. Three HIVpositive men attending our plastic surgery outpatient clinic for treatment of facial lipodystrophy were enrolled in the study. Localization of anthropometric landmarks measurements was performed on the patients. All patients underwent a facial CT and a facial white-light scanning on the same day. The inter-landmark distances measured on facial models developed from CT aided with VirSSPA 3D software and structured light scanning were compared to the real human models. We found that facial distances measured in the CT 3D reconstruction showed a mean error margin of 0.357 cm from the real distances measured on patients. On the contrary, mean error margin with the white-light scanning was of 0.096 cm. In both cases, measurements were found to be statistically significant (P<0.05). When compared to CT reconstructions, white-light surface scanning offers a more accurate landmark localization as well as reliable reconstructions of up to less than the tenth of a millimetre as average when compared to real measurements on facial human models.

Methicillin-susceptible Staphylococcus aureus clone related to the early pandemic phage type 80/81 causing an outbreak among residents of three occupational centres in Barcelona, Spain

In the 1950s an unusually virulent and transmissible penicillin-resistant Staphylococcus aureus clone harbouring Panton-Valentine leukocidin (PVL) genes, known as phage type 80/81 and subsequently identified as multilocus sequence type (ST) 30, emerged and caused serious infections in hospitals and the community. We describe an outbreak of skin infections caused by a PVL-positive, methicillin-susceptible S. aureus (MSSA) strain of ST1472, related to phage type 80/81, in three associated occupational centres. After identification of the first patient an active case-finding strategy was initiated among the three centres. Epidemiological and clinical features were indistinguishable from outbreaks currently caused by community-acquired methicillin-resistant S. aureus. The S. aureus was cultured and identified from nasal swabs and skin lesions by conventional methods; PVL was detected using a PCR assay. Pulsed-field gel electrophoresis and DNA-array-based genotyping were applied to MSSA isolates. MSSA was identified in nasal swabs from 49 of 133 individuals (37%). A single pulsed-field gel electrophoresis pattern, belonging to ST1472 (CC30) and PVL positivity, were detected in 20 individuals, including eight of 18 skin cultures, i.e. 15% of the screened individuals were colonized by the epidemic strain. Nasal and cutaneous decontamination with 5% nasal mupirocin ointment and 2% aqueous chlorhexidine was implemented for all individuals. Patients with active skin infections were treated with a first-generation cephalosporin. General recommendations were made to prevent cross-transmission. No new cases were reported over the following 90 days.

Sorption isotherm studies of Cd(II) ions using living cells of the marine microalga Tetraselmis suecica (Kylin) Butch

The present work reports the use of living cells of the marine microalga Tetraselmis suecica for the biosorption of cadmium ions. For a better understanding of the biosorption characteristics, three fractions of removed cadmium (total, bioadsorbed and intracellular) were measured in the cells after 24 and 72 h of exposure to different initial cadmium concentrations (0.6-45 mg L(-1)). Both the Langmuir and Freundlich models were suitable for describing the sorption of cadmium ions by this microalga. The maximum sorption capacity was estimated to be 40.22 mg Cd g(-1) after 72 h using the Langmuir sorption model. In the lower cadmium concentrations, metal removed intracellularly was higher than that removed on the microalgal cell surface. Therefore, the intracellular fraction contributed more to the total removed cadmium than the fraction bioadsorbed to the cellular surface. The results showed that the cadmium removal capacity using living biomass could be much more effective than with non-living biomass due to the intracellular bioaccumulation. According to the microorganism selected and its tolerance to the toxic effect of the metal, the cadmium content in the intracellular fraction can become very significant, just like it happened with Tetraselmis.