Objectives
Infective endocarditis (IE) is a devastating disease with a 50% 1-year mortality rate. In recent years, medical authorities across the globe advised stricter criteria for antibiotic ...prophylaxis in patients with high risk of IE undergoing dental procedures. Whether such recommendations may increase the risk of IE in at-risk patients must be investigated.
Design
Prospectively registered systematic review and meta-analysis.
Data sources
Medline, Embase, Scopus and ClinicalTrials.gov were searched through 23 May 2022, together with an updated search on 5 August 2023.
Eligibility criteria
All primary studies reporting IE within 3 months of dental procedures in adults >18 years of age were included, while conference abstracts, reviews, case reports and case series involving fewer than 10 cases were excluded.
Data extraction and synthesis
All studies were assessed by two reviewers independently, and any discrepancies were further resolved through a third researcher.
Results
Of the 3771 articles screened, 38 observational studies fit the inclusion criteria and were included in the study for subsequent analysis. Overall, 11% (95% CI 0.08 to 0.16, I
2
=100%) of IE are associated with recent dental procedures.
Streptococcus viridans
accounted for 69% (95% CI 0.46 to 0.85) of IE in patients who had undergone recent dental procedures, compared with only 21% (95% CI 0.17 to 0.26) in controls (p=0.003). None of the high-risk patients developed IE across all studies where 100% of the patients were treated with prophylactic antibiotics, and IE patients are 12% more likely to have undergone recent dental manipulation compared with matched controls (95% CI 1.00 to 1.26, p=0.048).
Conclusions
Although there is a lack of randomised control trials due to logistic difficulties in the literature on this topic, antibiotic prophylaxis are likely of benefit in reducing the incidence of IE in high-risk patients after dental procedures. Further well-designed high-quality case-control studies are required.
Trial registration number
CRD42022326664.
Summary Objective Immune cells are involved in the pathogenesis of osteoarthritis (OA). We examined the effects of T helper (Th) cells, which induce the expression of macrophage inflammatory protein ...(MIP-1γ), on the progression of OA. Design Using anterior cruciate ligament-transection (ACLT), we induced OA in one hind-leg knee joint of B6 mice. The CD4+ T cells from splenocytes and synovium were flow-cytometrically and immunochemically evaluated, respectively. The knee joints were histologically assessed for manifestations of OA. MIP-1γ levels and nuclear factor-κB (NF-κB) in the knee joints were measured using enzyme-linked immunosorbent and immunoblotting assays, respectively; osteoclastogenesis was detected by tartrate-resistant acid phosphatase (TRAP) staining. The inflammatory responses and MIP-1γ expression were examined using immunohistochemistry. Results The number of CD4+ T cells and the expression of interferon-γ (IFN-γ) increased during OA onset (30 days after ACLT) and then decreased at a later stage of OA (90 days after ACLT). Tissue damage induced by CD4+ T cells was evident at the later stage. The activation of CD4+ T cells induced the expression of MIP-1γ and NF-κB. The expression of MIP-1γ can be detected in synovium which CD4+ T cells were infiltrated. The increased MIP-1γ expression caused an increase in the number of osteoclasts in joints. The regulation of CD4+ T cells was accompanied by increased macrophage infiltration and matrix metalloproteinase (MMP)-9 expression. Histopathological examinations revealed that CD4+ T cell knockout (CD4−/− ) mice had less expression of MIP-1γ and slower cartilage degeneration than control mice had. Conclusions CD4+ T cells were activated during the onset of OA, but cartilage damage was more prominent at a later stage. CD4+ T cells were involved in the pathogenesis of OA: they induced MIP-1γ expression and subsequent osteoclast formation.
BACKGROUND:The treatment plan for cleft lip and palate varies among centers and requires long-term evaluation of its final outcome.
METHODS:A consecutive series of patients born from 1994 to 1996 ...were reviewed. Inclusion criteria were complete unilateral cleft lip and palate, undergoing all treatment procedures performed by the team, and continuous follow-ups until 20 years of age. Exclusion criteria were incomplete data, having microform cleft lip on the contralateral side, presence of the Simonart band, and other abnormalities.
RESULTS:A total of 72 patients were included. Average age at final evaluation was 21.3 years; 83.3 percent of patients underwent one-stage rotation-advancement lip repair and 16.7 percent underwent two-stage repair with an initial adhesion cheiloplasty. All patients underwent palate repair using the two-flap method at an average age of 12.3 months. Velopharyngeal insufficiency occurred and required surgical interventions in 19.4 percent during the preschool age and in 16.7 percent at the time of alveolar bone grafting; 56.9 percent of patients underwent secondary lip/nose revision during the growing age. Regular orthodontic treatment was administered to 34.7 percent of patients between 12 and 16 years of age. Orthodontic treatment and orthognathic surgery were applied in 37.5 percent of the patients after maturity. The average number of surgical procedures to complete the treatment was 4.8 per patient.
CONCLUSIONS:This treatment protocol provided generally acceptable final outcome after the 20-year follow-up. Some results were less ideal and have resulted in modifications of the planning and methods in the protocol.
CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
We report the first genome-wide association study in 1000 bipolar I patients and 1000 controls, with a replication of the top hits in another 409 cases and 1000 controls in the Han Chinese ...population. Four regions with most strongly associated single-nucleotide polymorphisms (SNPs) were detected, of which three were not found in previous GWA studies in the Caucasian populations. Among them, SNPs close to specificity protein 8 (SP8) and ST8 α-N-acetyl- neuraminide α-2,8-sialyltransferase (ST8SIA2) are associated with Bipolar I, with P-values of 4.87 × 10(-7) (rs2709736) and 6.05 × 10(-6) (rs8040009), respectively. We have also identified SNPs in potassium channel tetramerization domain containing 12 gene (KCTD12) (rs2073831, P=9.74 × 10(-6)) and in CACNB2 (Calcium channel, voltage-dependent, β-2 subunit) gene (rs11013860, P=5.15 × 10(-5)), One SNP nearby the rs1938526 SNP of ANK3 gene and another SNP nearby the SNP rs11720452 in chromosome 3 reported in previous GWA studies also showed suggestive association in this study (P=6.55 × 10(-5) and P=1.48 × 10(-5), respectively). This may suggest that there are common and population-specific susceptibility genes for bipolar I disorder.
Summary
Schistocytes are fragments of red blood cells (RBCs) produced by extrinsic mechanical damage within the circulation. The detection of schistocytes is an important morphological clue to the ...diagnosis of thrombotic microangiopathic anemia (TMA). Reporting criteria between different laboratories, however, are not uniform, owing to variability of shape and nature of fragments, as well as subjectivity and heterogeneity in their morphological assessment. Lack of standardization may lead to inconsistency or misdiagnosis, thereby affecting treatment and clinical outcome. The Schistocyte Working Group of the International Council for Standardization in Haematology (ICSH) has prepared specific recommendations to standardize schistocyte identification, enumeration, and reporting. They deal with the type of smear, method of counting, morphological description based on positive criteria (helmet cells, small, irregular triangular, or crescent‐shaped cells, pointed projections, and lack of central pallor). A schistocyte count has a definite clinical value for the diagnosis of TMA in the absence of additional severe red cell shape abnormalities, with a confident threshold value of 1%. Automated counting of RBC fragments is also recommended by the ICSH Working Group as a useful complement to the microscope, according to the high predictive value of negative results, but worthy of further research and with limits in quantitation.
Cellular polarization involves the generation of asymmetry along an intracellular axis. In a multicellular tissue, the asymmetry of individual cells must conform to the overlying architecture of the ...tissue. However, the mechanisms that couple cellular polarization to tissue morphogenesis are poorly understood. Here, we report that orientation of apical polarity in developing Madin-Darby canine kidney (MDCK) epithelial cysts requires the small GTPase Rac1 and the basement membrane component laminin. Dominant-negative Rac1 alters the supramolecular assembly of endogenous MDCK laminin and causes a striking inversion of apical polarity. Exogenous laminin is recruited to the surface of these cysts and rescues apical polarity. These findings implicate Rac1-mediated laminin assembly in apical pole orientation. By linking apical orientation to generation of the basement membrane, epithelial cells ensure the coordination of polarity with tissue architecture.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Obesity is a major risk factor for many common diseases and has a substantial heritable component. To identify new genetic determinants, we performed exome-sequence analyses for adult body mass index ...(BMI) in up to 587,027 individuals. We identified rare loss-of-function variants in two genes (BSN and APBA1) with effects substantially larger than those of well-established obesity genes such as MC4R. In contrast to most other obesity-related genes, rare variants in BSN and APBA1 were not associated with normal variation in childhood adiposity. Furthermore, BSN protein-truncating variants (PTVs) magnified the influence of common genetic variants associated with BMI, with a common variant polygenic score exhibiting an effect twice as large in BSN PTV carriers than in noncarriers. Finally, we explored the plasma proteomic signatures of BSN PTV carriers as well as the functional consequences of BSN deletion in human induced pluripotent stem cell-derived hypothalamic neurons. Collectively, our findings implicate degenerative processes in synaptic function in the etiology of adult-onset obesity.
The use of conventional and patterned sapphire substrates (PSSs) to fabricate InGaN-based near-ultraviolet (410 nm) light-emitting diodes (LEDs) was demonstrated. The PSS was prepared using a ...periodic hole pattern (diameter: 3 /spl mu/m; spacing: 3 /spl mu/m) on the (0001) sapphire with different etching depths. From transmission-electron-microscopy and etch-pit-density studies, the PSS with an optimum pattern depth (D/sub h/=1.5 /spl mu/m) was confirmed to be an efficient way to reduce the thread dislocations in the GaN microstructure. It was found that the output power increased from 8.6 to 10.4 mW, corresponding to about 29% increases in the external quantum efficiency. However, the internal quantum efficiency (@ 20 mA) was about 36% and 38% for the conventional and PSS LEDs, respectively. The achieved improvement of the output power is not only due to the improvement of the internal quantum efficiency upon decreasing the dislocation density, but also due to the enhancement of the extraction efficiency using the PSS. Finally, better long-time reliability of the PSS LED performance was observed.
By the electrostatic discharge (ESD)/matching co-design methodology, a wideband low-noise amplifier (LNA) using a grounded spiral inductor in conjunction with a MOM capacitor for ESD protection and ...wideband matching is demonstrated in a 65 nm CMOS. The shunt inductor provides an effective bidirectional ESD protection to the ground and the series capacitor greatly enhances the breakdown level in the current discharge path. The measurement results demonstrate an over 8 kV human-body-model ESD protection level with almost no RF characteristic degradation after ESD zapping. Under a power consumption of 5.6 mW, the ESD-protected LNA presents a flat NF and power gain of 3.3-3.9 dB and 16.6-17.9 dB, respectively, in the frequency range of 18.5-24.5 GHz, and a 3 dB bandwidth of 17.5-26 GHz is achieved.
Summary
In recognition of the need for a standardization of the measurement of the erythrocyte sedimentation rate (ESR), the International Council for Standardization in Haematology makes the ...following recommendations: (i) The reference method for measurement of the ESR should be based on the Westergren method, which is a specific test for the ESR, with modifications, (ii) The reference method for measurement of the ESR should use either whole blood anticoagulated with EDTA and later diluted with sodium citrate or saline (4 : 1) or whole blood anticoagulated with sodium citrate (4 : 1) in Westergren pipettes, (iii) The ESR pipettes can be of glass or plastic (with specific characteristics). It must be colourless; a minimum sedimentation scale of 200 mm, a minimum bore of 2.55 mm, which should be constant within 5%. A protocol for the evaluation of alternative methodologies against the reference method is outlined: The new technologies must be tested over a range of ESR values of 2–120 mm. In this comparison, 95% of the differences should be 5 mm or less, with larger differences associated with higher ESR values. A minimum of 40 samples should be tested in 3 different groups of values: 1–20, 21–60 and more than 60 mm. The statistical methods recommended for ESR evaluations are the coefficient of correlation, the Passing‐Bablock regression and the Bland‐Altman statistical method. This reference method replaces all earlier standardized and reference methods.
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