Influence of the long-term use of oral hygiene products containing stannous ions on the salivary microbiome - a randomized controlled trial

Oral hygiene products containing tin are suitable to prevent erosive tooth wear, yet effects on the oral microbiota are not known yet. Therefore, this study determined the salivary microbiome of 16 participants using products with stannous ions for three years (TG) compared with a control group (CG) to assess their influence on the microbiota. Participants were included in a randomized controlled clinical trial (RCT) with biannual visits. Illumina Miseq sequencing revealed as most abundant genera: Streptococcus (TG 14.3%; CG 13.0%), Veillonella (TG 11.3%; CG 10.9%), Prevotella (TG 7.0%; CG 9.8%), Haemophilus (TG 6.6%; CG 7.2%), Porphyromonas (TG 5.9%, CG 5.1%), Leptotrichia (TG 5.8%; CG 4.9%), Actinomyces (TG 4.0%; CG 4.6%) and Neisseria (TG 5.4%; CG 4.2%). Beta-Diversity was not significantly different between groups at both time points, although significant differences between groups were found for certain taxa after three years. The genus Prevotella was found in higher abundance in CG whereas Neisseria and Granulicatella, health-associated taxa, were found more abundantly in TG. Salivary microbiota after three years reflected a composition associated with oral health, hence continual use as a preventive measure for dental erosion can be considered safe and benefitting oral health for patients with a high risk of erosion.

The German national registry for primary immunodeficiencies (PID)

In 2009, a federally funded clinical and research consortium (PID-NET, http://www.pid-net.org) established the first national registry for primary immunodeficiencies (PID) in Germany. The registry contains clinical and genetic information on PID patients and is set up within the framework of the existing European Database for Primary Immunodeficiencies, run by the European Society for Primary Immunodeficiencies. Following the example of other national registries, a central data entry clerk has been employed to support data entry at the participating centres. Regulations for ethics approvals have presented a major challenge for participation of individual centres and have led to a delay in data entry in some cases. Data on 630 patients, entered into the European registry between 2004 and 2009, were incorporated into the national registry. From April 2009 to March 2012, the number of contributing centres increased from seven to 21 and 738 additional patients were reported, leading to a total number of 1368 patients, of whom 1232 were alive. The age distribution of living patients differs significantly by gender, with twice as many males than females among children, but 15% more women than men in the age group 30 years and older. The diagnostic delay between onset of symptoms and diagnosis has decreased for some PID over the past 20 years, but remains particularly high at a median of 4 years in common variable immunodeficiency (CVID), the most prevalent PID.

The European internet-based patient and research database for primary immunodeficiencies: update 2011

In order to build a common data pool and estimate the disease burden of primary immunodeficiencies (PID) in Europe, the European Society for Immunodeficiencies (ESID) has developed an internet-based database for clinical and research data on patients with PID. This database is a platform for epidemiological analyses as well as the development of new diagnostic and therapeutic strategies and the identification of novel disease-associated genes. Since its start in 2004, 13,708 patients from 41 countries have been documented in the ESID database. Common variable immunodeficiency (CVID) represents the most common entity with 2880 patients or 21% of all entries, followed by selective immunoglobulin A (sIgA) deficiency (1424 patients, 10·4%). The total documented prevalence of PID is highest in France, with five patients per 100,000 inhabitants. The highest documented prevalence for a single disease is 1·3 per 100,000 inhabitants for sIgA deficiency in Hungary. The highest reported incidence of PID per 100,000 live births was 16·2 for the period 1999-2002 in France. The highest reported incidence rate for a single disease was 6·7 for sIgA deficiency in Spain for the period 1999-2002. The genetic cause was known in 36·2% of all registered patients. Consanguinity was reported in 8·8%, and 18·5% of patients were reported to be familial cases; 27·9% of patients were diagnosed after the age of 16. We did not observe a significant decrease in the diagnostic delay for most diseases between 1987 and 2010. The most frequently reported long-term medication is immunoglobulin replacement.

Contraceptive efficacy and safety of a low-dose oral contraceptive, (0.03 mg ethinyl oestradiol and 2 mg chlormadinone acetate) Belara®, over three medication cycles

OBJECTIVE

To describe the modulation of ovarian function during three medication cycles with 0.03 mg ethinyl oestradiol (EE) and 2 mg chlormadinone acetate (CMA), leading to inhibition of conception in healthy women.

METHODS

Phase II, single-centre, open, non-controlled trial. The main outcome measure was inhibition of ovarian activity, assessed by frequent monitoring of the presence, size and persistence of follicle-like structures using ultrasonography. Secondary parameters included: cervical reaction score (CRS-probability of fertilization), endometrial thickness (probability of nidation), and serum levels of the sex hormones oestradiol, progesterone, luteinizing hormone and follicle stimulating hormone. Safety was primarily assessed by monitoring the occurrence of adverse events.

RESULTS

Thirty-three subjects were eligible for the trial and were included in the efficacy assessment (per protocol analysis, PPA). All subjects ovulated during the pretreatment cycle, but none during the three medication cycles. Follicular growth was profoundly suppressed during the medication phase, with residual ovarian activity occurring in only 12/83 (14.5%) treatment cycles. The CRS was negative during each medication cycle and endometrial thickness was suppressed on each medication day, with median values of 4.0-6.0 mm. EE/ CMA was well tolerated, with few adverse events reported; most were typically cycle-related and included headache, breast discomfort, nausea and vomiting.

CONCLUSION

During the administration of EE/CMA follicular development, cervical reaction and endometrial thickness are profoundly suppressed, resulting in unfavourable conditions for fertilization, implantation and, thus, pregnancy.

A robotic C-arm fluoroscope

Fluoroscopic C-arms are common devices for acquiring images during surgery. Manual positioning is time consuming and requires considerable experience. Trained users must often take several images to find the best viewing direction. If a second image must be taken from the same position, e.g. for postoperative control, the C-arm must be moved to the exact same position. Without guidance, this is often difficult to accomplish. We developed the idea to completely "robotize" a standard C-arm, i.e. to equip all joints with motors and encoders. A software environment provides for intelligent control. To archive this goal a complete kinematic analysis of the fluoroscope was necessary. On the basis of this analysis a number of clinical applications have been developed: (1) simplified positioning via cartesian control; (2) automatic acquisition of panoramic images; (3) 3D CT with arbitrary viewing angles; (4) 4D intraoperative CT with/without respiration triggering; (5) automated anatomy-oriented positioning. The goal of this research is thus three-fold: minimise radiation exposure of the OR staff, reduce positioning time and offer enhanced imaging capability.

Acne resolution rates: results of a single-blind, randomized, controlled, parallel phase III trial with EE/CMA (Belara) and EE/LNG (Microgynon)

BACKGROUND AND OBJECTIVE

Acne in women can often be successfully treated by the intake of oral contraceptives containing gestagens with anti-androgenic properties. This study aimed to evaluate the efficacy of the monophasic oral contraceptive ethinylestradiol/chlormadinone acetate (EE/CMA; Belara for the treatment of mild to moderate papulopustular acne of the face and acne-related disorders in comparison to EE/levonorgestrel (LNG; Microgynon.

METHODS

199 female acne patients were enrolled in a single-blind, randomized, multicentre phase III study and divided into two groups who received either EE/CMA or EE/LNG. The primary end point was fulfilled if the number of papules/pustules per half of the face present on admission had decreased by at least 50% in the 12th medication cycle.

RESULTS

59.4% of the women under EE/CMA and 45.9% under EE/LNG were responders. The relative frequency of women with complete resolution was 16.5% under EE/CMA and 4.3% under EE/LNG at cycle 12.

CONCLUSION

EE/CMA is an efficient treatment for women with mild and moderate papulopustular acne of the face and related disorders, reflecting the well-known anti-androgenic properties of the progestogen CMA.

Continuous insulin intravenous infusion therapy for VLBW infants

Very low birth weight (VLBW) infants less than 1,000 g often experience hyperkalemia and hyperglycemia during the initial hospital course. Hyperkalemia has been noted in 44% to 50% of infants less than 800 g birth weight or less than 28 to 29 weeks' gestation. Hyperglycemia occurs 18 times more frequently in infants less than 1,000 g than in those weighing more than 2,000 g. Insulin has been used for VLBW infants less than 1,000 g to manage hyperkalemia, control hyperglycemia, and optimize parenteral nutrition. A protocol for using exogenous insulin therapy for VLBW infants is described.

The mere exposure effect is differentially sensitive to different judgment tasks

The mere exposure effect is the increase in positive affect that results from the repeated exposure to previously novel stimuli. We sought to determine if judgments other than affective preference could reliably produce a mere exposure effect for two-dimensional random shapes. In two experiments, we found that brighter and darker judgments did not differentiate target from distracter shapes, liking judgments led to target selection greater than chance, and disliking judgments led to distracter selection greater than chance. These results for brighter, darker, and liking judgments were obtained regardless of whether shape recognition was greater (Experiment 1) or not greater (Experiment 2) than chance. Effects of prior exposure to novel shapes were reliably observed only for affective judgment tasks. These results are inconsistent with general predictions made by the nonspecific activation hypothesis, but not the affective primacy or perceptual fluency hypotheses which were discussed in terms of cognitive neuroscience research.

Measurement of transcutaneous carbon dioxide in low birthweight infants during the first two weeks of life

With the advent of pulse oximetry, there has been a general decrease in the use of transcutaneous (Tc) blood gas monitoring in intensive care environments. The available data, however, suggest that arterial carbon dioxide pressure (PCO2) levels are best estimated by Tc methods. In this study, we report our experience using routine Tc PCO2 monitoring in 32 consecutive infants less than 2 weeks of age with birthweights less than 1500 g. A total of 644 simultaneous pairs (Tc PCO2 versus arterial PCO2) were obtained. Pairs were categorized according to a 2 x 2 matrix design based on sensor temperature (40 degrees or 43 degrees C) versus site of arterial sampling (umbilical [UAC] or peripheral artery catheter [PAC]). Sampling via the UAC resulted in excellent correlation between sample pairs at both sensor temperatures with similar regressions between groups. Sampling via the PAC, however, yielded poor correlation between sample pairs and a significantly different regression from both UAC groups. Based on these findings, we advocate the use of a sensor temperature of 40 degrees C in very low birthweight infants for tracking Tc PCO2 values. In addition, we suggest that inaccuracies in PAC sampling may lead to erroneous PCO2 determinations. We conclude that routine monitoring of Tc PCO2 is accurate and serves a useful and continuing role in the neonatal intensive care environment.

Stock-taking concerning international activities in the field of biotechnology. A basis for research policy decisions

The objective selection of biotechnological priority areas in accordance with global goals established by the government, which is undertaken jointly by science, industry and the government, poses some problems. In order to objectify decisions, therefore, a data recording system has been developed by way of example (for the field of biotechnology in Japan), which enables an analysis to be made of research activities to date as well as forecasts of the future development.

Treatment of the blastic transformation of chronic granulocytic leukemia using high dose BCNU chemotherapy and cryopreserved autologous peripheral blood stem cells

Seven nonsplenectomized patients with blastic CGL have received high dose BCNU chemotherapy followed by cryopreserved peripheral blood stem cells (PBSC). The PBSC obtained at diagnosis were stored in the vapor phase of liquid nitrogen in 10% dimethyl sulfoxide for 11-46 months prior to use. Patients received 2.9 X 10(8) (1.9-7.8) thawed washed mononuclear cells/kg over 30 minutes with minimal morbidity. One patient was not rendered pancytopenic and died with blastic leukemia at 4 months. One patient, previously treated with daily busulfan, died of progressive hepatic failure 2 months after high dose BCNU. Restoration of the chronic phase of CGL was observed in the remaining five patients. Peripheral blood counts returned to normal ranges after a median of 19 days. Median survival for all patients is 11 months. Cytogenetic studies revealed elimination of acquired aneuploid cell lines in four of seven patients with persistence of Ph1. We conclude that: 1) frozen PBSC retain their viability for up to 4 years after cryopreservation and 2) the use of autologous PBSC following ablative chemotherapy may be associated with both symptomatic and karyotypic improvement in patients with blastic CGL.

Effect of acyclovir and interferon on human hematopoietic progenitor cells

Continuous in vitro exposure of human bone marrow cells to acyclovir (approximately 200 microM) or human leukocyte interferon (approximately 250 U/ml) caused 50% inhibition of granulocyte colony-forming cell differentiation. Colonies expressed in the presence of either agent were reduced both in size and number. Erythroid progenitors were more resistant than granulocyte progenitors to the antiproliferative effects of acyclovir. Progenitor cells of patients recovering from cytotoxic chemotherapy were no more sensitive to the effects of acyclovir or interferon than were cells obtained from patients before chemotherapy.

Prolonged cryopreservation of human bone marrow

We tested the viability of human bone marrow stored for 40 to 42 months in the vapor phase of liquid nitrogen. A median of 2 X 10(10) nucleated cells obtained from eight patients were concentrated to 1.3 X 10(10) using discontinuous centrifugation. These were stored in polyolefin bags in volumes of 100 to 500 ml using 10% dimethyl sulfoxide (DMSO) as cryoprotectant. Cell number and granulocyte - monocyte colony - forming cell (CFU-c) plating efficiency were determined before freezing and after thawing, after dilution and removal of DMSO, and after 2 to 4 hr of additional incubation. The median difference in cell number and CFU-c plating efficiency after this prolonged storage was -9 and +2%, respectively. Dilution, washing, and a 2-hr incubation were associated with cell losses of 24, 24, and 19% and increases in CFU-c plating efficiency, ranging from 22 to 79%. The number of viable CFU-c was never significantly lower than the number of CFU-c stored or initially thawed. Vapor phase storage appears to be adequate for prolonged human bone marrow cryopreservation using CFU-c viability as a determinant.