Background: This study was conducted to examine the relationship between maternal periodontal disease and plasma angiogenic factor expression of soluble fms‐like tyrosine kinase (sFlt)‐1.
Methods: ...This was a nested case‐control study of 220 women, including 45 healthy women with evidence of active periodontal disease, 98 women without evidence of active periodontal disease, 13 women with fetal exposure to oral pathogens, and 64 women without fetal exposure to oral pathogens. Active periodontal disease was defined as the presence of moderate/severe periodontal disease and evidence of periodontal disease progression. Fetal exposure to oral pathogens was determined by fetal immunoglobulin M (IgM) umbilical cord seropositivity. Maternal plasma was collected at <26 weeks of gestation; umbilical cord blood was collected at delivery. sFlt‐1 was measured with an immunoradiometric assay. Demographic and medical data were chart ed. Maternal variables and sFlt‐1 concentrations were compared between cases and controls using the Student t and χ2 tests and analysis of variance.
Results: The median sFlt‐1 concentration at the time of enrollment for all women was 2,374 pg/ml (interquartile range IQR: 1,504 to 3,194 pg/ml). Women with evidence of fetal exposure to oral pathogens had significantly higher sFlt‐1 concentrations compared to IgM‐negative fetuses (3,383 pg/ml IQR: 2,610 to 4,244 pg/ml versus 2,123 pg/ml IQR: 1,456 to 3,011 pg/ml; P = 0.03).
Conclusion: Fetal exposure to oral pathogens was associated with increased plasma concentrations of sFlt‐1 early in pregnancy.
Leukocyte count is an independent predictor of stroke. We investigated the association between leukocyte count and progression of aortic atheroma over 12 months in stroke/transient ischemic attack ...(TIA) patients.
Consecutive ischemic stroke and transient ischemic attack patients underwent 12-month sequential transesophageal echocardiography and were assessed for total and differential leukocyte counts on admission. Paired aortic plaque images were assessed for several parameters, including changes in grade, intimal-medial thickness (IMT), and cross-sectional area. Multivariate linear and logistic regressions were used to calculate the effect of leukocyte count on the change in aortic atheromas over 12 months.
Of the 115 participants (mean+/-SD age, 64.6+/-11.9 years; 53.1% men; 73.4% white, 24.2% black, and 2.3% Asian), 45 (35%) showed clinically significant progression of aortic atheromas (maximal change in IMT >0.70 mm over 12 months). The mean admission leukocyte count was higher in the progression group compared with the no-progression group (8.6+/-2.2 vs 7.3+/-2.2 x 10(9)/L respectively, P=0.002). Each unit increase in leukocyte count was associated with a 0.26-mm increase in aortic arch IMT over 12 months (P=0.006). After adjustment for other atherosclerosis risk factors, the relation persisted (mean increase in aortic arch IMT per unit increase in leukocyte count=0.27 mm, P=0.007). Each unit increase in leukocyte count was associated with an increased risk of significant progression of aortic atheromas (adjusted odds ratio=1.33; 95% CI, 1.09 to 1.61).
In stroke/transient ischemic attack patients, leukocyte count is independently associated with the progression of aortic atheroma over 12 months (>0.70 mm), which is associated with cardiovascular risk.
Objective
To systematically review the efficacy of multicomponent treatment of fibromyalgia syndrome (FMS).
Methods
We screened Medline, PsychINFO, Scopus, and the Cochrane Library (through December ...2007), as well as reference sections of original studies, reviews, and evidence‐based guidelines. Randomized controlled trials (RCTs) on the multicomponent treatment (at least 1 educational or other psychological therapy with at least 1 exercise therapy) of FMS were analyzed.
Results
We included 9 (of 14) RCTs with 1,119 subjects (median treatment time 24 hours) in the meta‐analysis. Effects were summarized using standardized mean differences (SMDs) or weighted mean differences (WMDs). There was strong evidence that multicomponent treatment reduces pain (SMD −0.37; 95% confidence interval 95% CI −0.62, −0.13), fatigue (WMD −0.85; 95% CI −1.50, −0.20), depressive symptoms (SMD −0.67; 95% CI −1.08, −0.26), and limitations to health‐related quality of life (HRQOL) (SMD −0.59; 95% CI −0.90, −0.27) and improves self‐efficacy pain (SMD 0.54; 95% CI 0.26, 0.82) and physical fitness (SMD 0.30; 95% CI 0.02, 0.57) at posttreatment. There was no evidence of its efficacy on pain, fatigue, sleep disturbances, depressive symptoms, HRQOL, or self‐efficacy pain in the long term. There was strong evidence that positive effects on physical fitness (SMD 0.30; 95% CI 0.09, 0.51) can be maintained in the long term (median followup 7 months).
Conclusions
There is strong evidence that multicomponent treatment has beneficial short‐term effects on the key symptoms of FMS. Strategies to maintain the benefits of multicomponent treatment in the long term need to be developed.
A recent statute quietly passed by Congress during the last legislative session has created a category of class actions eligible for original jurisdiction in federal district courts upon showing ...minimal diversity. Offenbacher evaluates the potential problem areas of § 1369 as well as discuss the future of this controversial but potentially expansive measure. She organizes this discussion into an examination of three main parts of the statute: the general provision that confers minimal-diversity jurisdiction, the intervening-parties provision, and the limitations provision that excludes certain case from the statute.
Porphyromonas gingivalis (P. gingivalis), an important periodontal pathogen in adult chronic periodontitis, has been reported to colocalize in human atheromatous lesions. We have studied the ...phagocytosis and survival of P. gingivalis in human monocytes, together with the cellular responses of infected human monocytes. Human monocytes were cocultured with P. gingivalis and the external bacteria were killed with metronidazole and gentamycin. Localization of P. gingivalis in cells was studied by transmission electron microscopy (TEM). The survival of P. gingivalis was determined by lysing the monocytes and plating on blood agar under anaerobic conditions. Interleukin-1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were determined using specific enzyme-linked immunosorbent assays (ELISAs) kits. The transwell chamber system was used to investigate the chemotactic response of the infected cells. TEM showed that P. gingivalis organisms were localized within the autophagosome-like structure of monocytes. No significant difference on the survival of P. gingivalis at 0, 4 and 8 h after infection was found. IL-1beta and TNF-alpha were present in the cell culture media in response to bacterial challenge. The infected monocytes showed a normal chemotactic response to monocyte chemotactic protein-1 (MCP-1). The number of monocyte cells migrating through membrane in the presence and absence of P. gingivalis were 18.64 +/- 2.33 x 10(4) cells and 19.11 +/- 1.76 x 10(4) cells respectively. The number of viable P. gingivalis per monocyte following translocation in response to the chemotactic gradient was 5.83 +/- 1.45 x 10(-3) CFU/cell. The results indicate that P. gingivalis can stimulate cytokine production and survive in monocytes without affecting cell migration.
We reviewed the MRIs of 49 asymptomatic volunteers (age range, 31 to 77 years) and of 50 MS patients (age range, 14 to 63) for areas of increased signal (AIS) and features discriminating MS lesions ...from lesions seen with normal aging. We obtained optimal specificity of MRI interpretation (100%) if we required at least two of the following three AIS features--size greater than or equal to 6 mm, abutting ventricular bodies, infratentorial location--for a positive MRI diagnosis of MS. Applying these criteria to the MRIs of elderly patients with suspected MS should significantly improve specificity (p less than 0.001) over current quantitative criteria (at least three AIS greater than or equal to 3 mm) without significantly decreasing sensitivity.
ABSTRACT
We report the case of a 65‐year‐old man who presented with mild, rapidly improving stroke symptoms. Acute magnetic resonance imaging disclosed no diffusion abnormalities but a tandem ...internal carotid artery/distal middle cerebral artery occlusion associated with a large corresponding deficit on perfusion imaging. In addition, there was a cross‐flow to the middle cerebral artery via the anterior communicating artery. Therefore, intravenous thrombolysis was initiated that led to rapid reopening of the middle cerebral artery and left the patient free of symptoms. Our observation highlights the possible benefit of systemic thrombolytic treatment even in the setting of an internal carotid artery occlusion and the substantial contribution of multimodal magnetic resonance imaging for a risk‐benefit estimate.
Letter to the Editor: Authors' response Friedewald, Vincent E.; Kornman, Kenneth S.; Offenbacher, Steven ...
Journal of periodontology,
February 2010, 2010-Feb, 2010-02-00, 20100201, Letnik:
81, Številka:
2
Journal Article
Purpose This study was designed to identify risk indicators for the prevalence at enrollment and incidence over 36 months of periodontal pathology and coronal caries experience affecting third molars ...in a community-based study of people over 65 years of age. Subjects and Methods Data from a subsample of 810 dentate subjects from the Piedmont 65+ Study were available for analyses. All visible teeth were examined. Periodontal probing measures were taken at 2 sites, mesiobuccal and buccal/facial. Clinical data on caries experience were collected by visual-tactile examination. At enrollment, 340 subjects had at least 1 visible third molar; all were examined for caries experience. Periodontal probing measures were available for 277 of these same subjects. The significance of the possible risk indicators for periodontal pathology and caries affecting third molars was determined by χ2 tests. Statistical significance was set at .05. Logistic multivariable models were used to derive odds ratios and 95% confidence intervals. Results African-American subjects were more likely to have visible third molars ( P < .01). Caucasian subjects were more likely to have third molar coronal caries experience ( P < .01), as were subjects with greater than a high school education and those with a dental visit within 3 years (both P < .01). However, African American subjects were more likely to have periodontal pathology, CALs ≥ 3 mm on third molars ( P < .01), as were those who used tobacco ( P < .01). None of the other risk indicators we studied were associated with progression of periodontal pathology or coronal caries experience on visible third molars. Conclusion In this population study of senior adults, Caucasians and African Americans appear to have different levels of risk for caries experience and periodontal pathology affecting retained third molars.
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