Association between TH2 Cytokine Gene Polymorphisms and Risk of Bullous Pemphigoid

Background: T-helper 2 (Th2)-associated cytokines are involved in the pathogenesis of bullous pemphigoid (BP), an autoimmune skin disease. Increased expression of Th2 cytokines such as interleukin-4 (IL-4), IL-5, IL-6, IL-10, and IL-13 have been observed in serum, skin biopsies and/or blister fluid. This study aimed to uncover a possible association between Th2 cytokine genetic variations and susceptibility to BP.Methods: In a cohort study, blood samples of BP patients and controls were obtained and variations in IL-4 (rs2243250 and rs2070874), IL-4R (rs1805010), IL-5 (rs2069812), IL-6 (rs1800795), IL-10 (rs1800896, rs1800871, and rs1800872), and IL-13 (rs1800925 and rs20541) were genotyped by PCR-RFLP assays. Furthermore, quantitative expression levels of IL-13 gene were evaluated by real-time RT-PCR analysis.Results: Among the studied variations, a significantly higher frequency of the C-allele was observed in IL-13 gene variation (rs1800925) in the healthy individuals than BP patients. This may indicate a protective effect of C-allele on predisposition to BP. Considering individuals carrying polymorphic genotypes compared to wild genotype, the minor G-allele of IL-4R rs1805010 and A-allele of IL-13 rs20541 had a promotive and protective effect, respectively, on predisposing to the development of BP. No significant difference in IL-13 mRNA expression was detected between BP patients and healthy individuals.Conclusions: Our results indicate that IL-13 rs1800925 variation may be a protective genetic marker for the development of BP. Given this preventive effect against BP, therapeutic strategies could potentially be developed interfering with the functions of IL-13 cytokine, which seems to be integral in the pathogenesis of eosinophilic inflammatory disorders, such as BP.

Effect of bonding application time on the microleakage of Class V sandwich restorations

BACKGROUND

The aim of this study was to assess the effect of bonding application time on the microleakage of Class V sandwich restorations.

METHODS

Eighty non-carious third molars were randomly divided into 16 groups. Two Class V cavities were prepared on the buccal and lingual surfaces of teeth. Three groups were restored with Fuji II GIC and treated with a total-etch bonding system (Stea/SDI) immediately after insertion, at 7 minutes and 15 minutes after mixing the glass ionomer cements (GICs). Another three groups were restored with Riva Self Cure GIC and treated with the total-etch system identically. The other six groups were subjected to self-etching bonding (Frog/SDI) after GIC placement in an identical procedure. The remaining groups were made using light cure GICs (Fuji II or Riva Light Cure) in conjunction with the total-etch or self-etching systems. Cavities were then restored with composite (Valux plus, 3M/ESPE). Samples were subsequently immersed in 2% methylene blue solution for 48 hours and observed under a stereomicroscope after sectioning. Four-scale grading was used to assess microleakage in occlusal and gingival walls. Data were analysed using Kruskal-Wallis and Mann-Whitney tests.

RESULTS

The self-etching bonding system exhibited more microleakage in occlusal margins regardless of time. Over time, microleakage significantly decreased in gingival margins in all self-cure groups except for Riva Self Cure treated with the total-etch system (p < 0.05).

CONCLUSIONS

Bonding application time had no effect on the microleakage of occlusal margins. However, maturation of GICs induced a decreased microleakage in gingival margins.

Vaginal versus oral misoprostol for second-trimester pregnancy termination: a randomized trial

The purpose of this study was to compare the efficacy and side effects of two different misoprostol regimens for second-trimester pregnancy termination. Sixty women in second trimester of gestation with indications for pregnancy termination were randomly assigned in two equal groups to receive either vaginal or oral misoprostol. The dosing regimen was 400 microg as the initial dose followed by 400 microg up to 3 doses (1200 microg) if needed in each group. Efficacy and side effects were compared. The percentage of women who delivered was significantly higher in vaginal group than the oral group (86.7 vs. 43.3 p = 0.0006). No significant differences in complication rates and induction to delivery interval were noted between the two groups. Vaginal administration of misoprostol resulted in a higher success rate for second trimester pregnancy termination, whereas, no significant differences in induction to delivery time and complication rates were noted between vaginal and oral groups.

Vaginal Misoprostol versus high dose of oxytocin for labor induction: a comparative study

To compare the efficacy and complications of intravaginal Misoprostol with oxytocin for induction of labor this study was carried out. One hundred and ten term pregnant women with Bishop score of < or = 4 were randomized into two groups. Fifty five patients received 50 microg intravaginal Misoprostol 2 times at 6 h intervals (Misoprostol group), the second group received oxytocin infusion (6 mu min(-1)) for induction of labor (oxytocin group n = 55). The time from induction to delivery, the route of delivery, fetal outcome and maternal complications were recorded. There was no statistically significant difference regarding demographic or clinical characteristics between two groups. Induction success within the first 12 h were 80 and 33.3% for Misoprostol and oxytocin groups respectively (p<0.05). The average time from induction to delivery was 10. 6 +/- 3.7 and 17 +/- 7.2 h in the Misoprostol and oxytocin administered groups, respectively (p<0.05). The rate of vaginal delivery was significantly higher in misoprostol group (72.7%) when compared with oxytocin group (45.5%). Low Apgar score, meconium stain amniotic fluid, abnormal FHR and precipitating labor was similar in both groups (p>0.05). We concluded misoprostol 50 microg vaginally (every 6 h, up to 100 microg) safely and effectively induces labor and it is recommended for parturient women with Bishop score < or = 4 and the use of this drug could produce several beneficial effects, particularly a decrease in the incidence of cesarean delivery.

The effect of dexamethasone on postoperative vomiting and oral intake after adenotonsillectomy

OBJECTIVE

Vomiting is one of the most important postoperative complications of adenotonsillectomy. This study was designed to determine the effectiveness of preoperative intravenous dexamethasone on postoperative emesis.

METHODS

In a double-blind, placebo-controlled clinical trial, 100 patients aged 5-15 years, ASA classes I and II were randomly selected to receive either 0.5 mg/kg IV dexamethasone (n=50), as study group or an equivalent volume of saline preoperatively, as control group. The anesthetic regimen and surgical procedures were standardized for all patients. The incidence of early and late vomiting, the time to first oral intake and duration of intravenous hydration were compared in both groups.

RESULTS

Data analysis showed that the overall incidence of early and late vomiting was significantly lesser in dexamehasone group than the control one. The time to first oral intake and duration of IV therapy were also significantly shorter in dexamethasone group.

CONCLUSION

A single dose of dexamethasone significantly decreased the incidence of postoperative vomiting in early and late recovery phase and shortened the time to first oral intake and the duration of IV therapy.