Correlation of Systemic Inflammation Parameters and Serum SLFN11 in Small Cell Lung Cancer-A Prospective Pilot Study

BACKGROUND AND OBJECTIVES

The objective of this research was to analyze the correlation of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), soluble programmed cell death ligand 1 (sPD-L1), and Schlafen 11 (SLFN11) with the response to first-line chemotherapy in a cohort of small cell lung cancer (SCLC) patients, and to determine their potential as predictive serum biomarkers.

MATERIALS AND METHODS

A total of 60 SCLC patients were included. Blood samples were taken to determine CRP, sPD-L1, and SLFN11 levels. The first sampling was performed before the start of chemotherapy, the second after two cycles, and the third after four cycles of chemotherapy.

RESULTS

The patients who died earlier during the study had NLR and SLFN11 concentrations significantly higher compared to the survivor group. In the group of survivors, after two cycles of chemotherapy, the NLR ratio decreased significantly (p < 0.01), but after four cycles, the NLR ratio increased (p < 0.05). Their serum SLFN11 concentration increased significantly (p < 0.001) after two cycles of chemotherapy, but after four cycles, the level of SLFN11 fell significantly (p < 0.01). CRP, NLR, and SLFN11 were significant predictors of patient survival according to Kaplan-Meier analysis. The combination of inflammatory parameters and SLFN11 with a cutoff value above the 75th percentile of the predicted probability was associated with significantly lower overall survival in SCLC patients (average survival of 3.6 months vs. 4.8 months).

CONCLUSION

The combination of inflammatory markers and the levels of two specific proteins (sPD-L1, SLFN11) could potentially serve as a non-invasive biomarker for predicting responses to DNA-damaging therapeutic agents in SCLC.

Changing Diagnostic Category in Development Psychiatry

INTRODUCTION

Many children and adolescents have mental problems that undermine their normal development and functioning. It is estimated that about 10% of children and adolescents suffer from mental disorders at a sufficiently severe level to cause some degree of damage and require treatment.

AIM

The aim of this paper is to determine whether there have been changes in the diagnostic categories in developmental psychiatry in children and adolescents treated at the Department for Children and Adolescent Psychiatry for the last fifteen years.

SUBJECTS AND METHODS

The survey includes 844 patients treated at the Department for Child and Adolescent Psychiatry of University Clinical Center of the Republic of Srpska in the period from April 2002 to September 2017, involving only children and adolescents who were hospitalized for the first time. The sample consisted of 453 female subjects (54, 67%) and 391 male subjects (46, 33%). Subjects were divided into three groups: group 1 - hospitalization in the period from 2002 to 2007; group 2 - hospitalization in the period from 2008 to 2012; group 3 - hospitalization in the period from 2013 to September 2017.

RESULTS

Female subjects accounted for more than half of the subjects within each group, with a mild increase in the number of patients in the last 4 years. In the overall sample, adolescents, aged 13 to 18 (51.66%) were the most frequent, with the lowest number of subjects under 6 years of age (3.91%). In the overall sample, the most frequent are: psychotic disorders in 18.60% of subjects; behavioral disorders and emotions in 17, 42% of subjects; suicide attempt, in 14.34% of subjects. By comparing data by groups, there has been a decline in psychotic disorders, and since 2008, adapting disorders and behavioral and emotional disorders have been most frequently diagnosed. There is an increase in the number of respondents who come from incomplete families in the last few years. About one-third of the sample (33.89%) were exposed to one or more types of abuse. 43.13% of children and adolescents with poor socio-economic status. Comorbid diseases are present in 5.92% of children and adolescents. In 26.18% of the sample, psychiatric disorders are present in the family history. The abuse of psychoactive substances was observed in 2.61% of adolescents, and this number has been increasing for the last five years. Family dysfunction is present in 57.35% of children and adolescents.

CONCLUSION

In our study, there was an increase in the number of children and adolescents with behavioral disorders and adjustment disorders, as well as an increase in family dysfunctionality and psychoactive substances abuse in adolescents.

Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal

OBJECTIVES

To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).

MATERIALS AND METHODS

Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.

RESULTS

Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp.

CONCLUSIONS

Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.

CLINICAL RELEVANCE

Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.

Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used

INTRODUCTION

The anterior and middle superior alveolar nerve block was claimed to be unpredictably efficient for clinical application.

OBJECTIVE

The aim of this report was to establish the efficacy of the anterior and middle superior alveolar nerve block, applied with a computer-controlled injection system or a conventional syringe, for upper premolars extraction.

METHODS

Sixty healthy adults were divided into two groups regarding the device used as follows: the first group was injected by a computer-controlled injection system, and the second group by a conventional syringe. Pain ratings were obtained via a visual analog scale (VAS) and a verbal rating scale (VRS).

RESULTS

Anterior and middle superior alveolar injection enabled a painless extraction in all patients, regardless of the local anesthetic or injection system used. It was slightly less painful when administered by a computer-controlled injection system, but insignificantly when evaluated by VRS.

CONCLUSION

The anterior and middle superior alveolar nerve block may be recommended if maxillary permanent premolars have to be extracted.

Intermittent hepatic porphyria in pregnancy with good perinatal outcome

Porphyrias are rare metabolic diseases caused by enzymatic defects of the haeme biosynthesis. Association of pregnancy and acute porphyria is rare, but mortality rate among pregnant women from acute attack has been reported up to 42%. This paper presents a patient with pregnancy complicated by intermittent hepatic porphyria with good perinatal outcome. The pattern of the attack in pregnancy varies individually and it makes porphyric pregnancies a challenge. Previously diagnosed porphyria patients should be closely monitored during pregnancy and diagnosis of acute porphyria must be also considered in all pregnant women with unexplained abdominal pain.