Decreased thermogenic response to an oral glucose load in older subjects.

The thermogenic response to a 100 g oral glucose load was studied by indirect calorimetry in 13 older persons (age range, 38-68 years) and compared with that of 16 young matched controls of similar body weight (age range, 19-30 years). The glucose-induced thermogenesis measured over 180 min and expressed as a per cent of the energy content of the glucose load was found to be reduced in the older subjects, i.e., 5.8 +/- 0.3 per cent vs 8.6 +/- 0.7 per cent, P less than 0.002). This was also accompanied by a significant decrease in the glucose oxidation rate when averaged over the same three-hour period following the glucose load, i.e., 153 mg/min vs 213 mg/min in the control subjects (P less than 0.001) despite a similar time course of glycemia. This study suggests that the thermogenic response to an oral glucose load is blunted in older people, and this may represent an additional factor that contributes to the decreased energy requirement with age and therefore to the increased propensity to obesity if energy intake is not adjusted.

Developmental changes in cardiac recovery from anoxia-reoxygenation.

The developing cardiovascular system is known to operate normally in a hypoxic environment. However, the functional and ultrastructural recovery of embryonic/fetal hearts subjected to anoxia lasting as long as hypoxia/ischemia performed in adult animal models remains to be investigated. Isolated spontaneously beating hearts from Hamburger-Hamilton developmental stages 14 (14HH), 20HH, 24HH, and 27HH chick embryos were subjected in vitro to 30 or 60 min of anoxia followed by 60 min of reoxygenation. Morphological alterations and apoptosis were assessed histologically and by transmission electron microscopy. Anoxia provoked an initial tachycardia followed by bradycardia leading to complete cardiac arrest, except for in the youngest heart, which kept beating. Complete atrioventricular block appeared after 9.4 +/- 1.1, 1.7 +/- 0.2, and 1.6 +/- 0.3 min at stages 20HH, 24HH, and 27HH, respectively. At reoxygenation, sinoatrial activity resumed first in the form of irregular bursts, and one-to-one atrioventricular conduction resumed after 8, 17, and 35 min at stages 20HH, 24HH, and 27HH, respectively. Ventricular shortening recovered within 30 min except at stage 27HH. After 60 min of anoxia, stage 27HH hearts did not retrieve their baseline activity. Whatever the stage and anoxia duration, nuclear and mitochondrial swelling observed at the end of anoxia were reversible with no apoptosis. Thus the embryonic heart is able to fully recover from anoxia/reoxygenation although its anoxic tolerance declines with age. Changes in cellular homeostatic mechanisms rather than in energy metabolism may account for these developmental variations.

Tratamiento de la aftosis oral recurrente. Estudio a doble ciego en 90 pacientes

Presentamos un estudio doble ciego realizado en 90 pacientes para evaluar la utilidad de usar una solución viscosa de acetonido de triamcinolona unido a neomicina en el tratamiento sintomático de la aftosis oral recurrente. Los resultados obtenidos se muestran más positivos que otros productos como la clorhexidina, la colchicina o el uso clásico de corticoides tópicos.

La prótesis bucal como causante del carcinoma espinocelular oral

La aparición de cáncer bucal está vinculada a múltiples factores de riesgo. En este artículo queremos exponer como uno de ellos la úlcera crónica producida por las prótesis dentales removibles o fijas.

La cresta alveolar atrófica en implantología oral

Los implantes dentales endoóseos constituyen una alternativa terapéutica ideal en pacienfes parcial o totalmente edéntulos; sin embargo, en ocasiones, la atrofia ósea generalizada o localizada contraindica el tratamiento, siendo necesario realizar un aumento de cresta alveolar que permita, bien simultáneamente o deforma diferida, la adecuada rehabilitación implantológica. En el presente trabajo, hacemos una revisión de las distintas técnicas y materiales utilizados actualmente en implantología, para mejorar las condiciones de recepción de los implantes, en presencia de defectos óseos.

Oral tongue squamous cell carcinoma (OTSCC): alcohol and tobacco consumption versus non-consumption. A study in a Portuguese population

There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the ¿Instituto Portugues de Oncologia de Lisboa - Francisco Gentil" IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.

Technological, biopharmaceutical and pharmacokinetic advances: new formulations of application on the skin and oral mucosa

Currently a growing interest to improve the pharmacological therapy exists, not only by the production and the appearance of new drugs, but guaranteeing that the uses of those which already exist, become more effective. In fact, the conventional pharmaceutical formulations of different drugs present a few secondary effects due to oral administration. In order to avoid these undesired side effects, the purpose of current therapeutic is the development and research of formulations as an alternative to others routes of administration. Therefore, in spite of the undoubtedly complete parenteral absorption, the transdermal and transbuccal routes appear to be a rather attractive alternative to provide an efficient absorption. In this chapter a new technological, biopharmaceutical and pharmacokinetic approach of strategies for application on skin and buccal mucosa are reported. In the future new transdermal drug delivery systems will emerge to be more effective, equipped with an improved aesthetic appearance, better adherence and greater diffusion. But to reach these aims, it is necessary previous knowledge of histology and physiology of skin, and factors involved in the penetration of drugs through it.

Effects of regular insulin or insulin LISPRO on glucose metabolism after an oral glucose load in patients with type 2 diabetes mellitus.

Seven obese Type 2 diabetic patients were studied for two 4-h periods after ingestion of a glucose load to determine the effects of preprandial subcutaneous injection of Insulin Lispro (5 min before the meal) or regular insulin (20 min before the meal) on glucose metabolism. Glucose production and utilisation were measured using a dual isotope method. After Lispro, the mean postprandial increase in plasma glucose was 29% lower and the increase in insulin concentration 25% higher than after regular insulin (p < 0.05). Suppression of endogenous glucose production was similar with both types of insulin. Thus, preprandial injection of Lispro reduced postprandial glucose increments in Type 2 diabetic patients as compared to regular insulin. This effect is best explained by the increased postprandial bioavailability of Lispro.

What influence do anticoagulants have on oral implant therapy? A systematic review.

OBJECTIVES: This systematic review aims to assess the risks (both thromboembolic and bleeding) of an oral anticoagulation therapy (OAT) patient undergoing implant therapy and to provide a management protocol to patients under OAT undergoing implant therapy. MATERIAL AND METHODS: Medline, Cochrane Data Base of Systematic Reviews, the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English-language articles published between 1966 and 2008. This search was completed by a hand research accessing the references cited in all identified publications. RESULTS: Nineteen studies were identified reporting outcomes after oral surgery procedures (mostly dental extractions in patients on OAT following different management protocols and haemostatic therapies). Five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series. The OAT management strategies as well as the protocols during and after surgery were different. This heterogeneity prevented any possible data aggregation and synthesis. The results from these studies are very homogeneous, reporting minor bleeding in very few patients, without a significant difference between the OAT patients who continue with the vitamin K antagonists vs. the patients who stopped this medication before surgery. These post-operative bleeding events were controlled only with local haemostatic measures: tranexamic acid mouthwashes, gelatine sponges and cellulose gauzes's application were effective. Post-operative bleeding did not correlate with the international normalised ratio (INR) status. In none of the studies was a thromboembolic event reported. CONCLUSIONS: OAT patients (INR 2-4) who do not discontinue the AC medication do not have a significantly higher risk of post-operative bleeding than non-OAT patients and they also do not have a higher risk of post-operative bleeding than OAT patients who discontinue the medication. In patients with OAT (INR 2-4) without discontinuation, topical haemostatic agents were effective in preventing post-operative bleeding. OAT discontinuation is not recommended for minor oral surgery, such as single tooth extraction or implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope. Evidence does not support that dental implant placement in patients on OAT is contraindicated.

Prevalence of subfoveal nodules in Coat's disease

Purpose:Coats' disease is a non-hereditary condition characterized by idiopathic retinal telangiectasia, and exudative retinopathy. Although the exudation often spreads from the main areas of telangiectasia, there is a preferential accumulation of exudation in the macular area in Coats' disease. A subfoveal nodule has usually been described in the context of resolution of macular exudates after treatment of peripheral retinal telangiectasis. Nevertheless, a recent reports stressed out an uncommon prominent subfoveal nodule with peripheral exudates as initial presentation of Coats'disease. The purpose of this study was to report the prevalence of this presentation in a cohort of patients. Methods:All consecutive patients with Coats' disease referred to the Jules Gonin Eye Hospital between January 1979 and July 2006 were included. All charts were screened for a clear cut subfoveal circular lesion on fundus photographies at initial presentation. Results:95 patients suffering of Coat's disease were enrolled. 33 out of 95 patients had subtotal or total exudative retinal detachment, which impeded macular examination. 14 out of 62 (22.6%) resting patients presented with a clear cut prominent circular subfoveal lesion at initial presentation. All patients had unilateral disease. Mean age was 5.6 ± 3.5 year old at initial presentation. There were 4 females and 10 males. Pigmentation and size of the nodule were not homogenous. Mean diameter was 1.1 ± 0.5 optic disc diameter. Conclusions:The present study shows that subfoveal nodule is not such a rare primary presentation of Coats' disease in contrast to what it has been previously reported in the literature. Thus the initial finding of prominent subfoveal nodule associated with peripheral retinal findings made the diagnosis of Coats' disease highly likely.Physicians should be aware that a proeminent subfoveal nodule is a common initial presentation of Coats' disease as it can be confused clinically with Retinoblastoma.

Copy number variation modifies expression profiles over developmental time

Abstract : A preliminary understanding of the phenotypic effect of copy number variation (CNV) of DNA segments is emerging. These rearrangements were shown to influence, in a somewhat dose-dependent manner, the expression of genes mapping within them. They were also shown to modify the expression of genes located on their Hanks, sometimes at great distance. Here, we demonstrate by monitoring these effects at multiple life stages, that these controls over expression are effective throughout mouse development. Similarly, we observe that the more specific spatial expression patterns of CNV genes are maintained through life. However, 'we find that some brain- expressed genes mapping within CNVS appear to be under compensatory loops only at specific time-points, indicating that the effect of CNVS on these genes is modulated during development. Notably, we also observe that CNV genes are significantly enriched within transcripts that show variable time-course expression between strains. Thus, modifying the copy number of a gene may potentially alter not only its expression level, but its timing of expression as well. Résume : Nous commençons à comprendre les effets phénotypiques liés aux séquences d'ADN qui changent de nombre de copies d'un individu a l'autre. Des travaux précédents ont montré que ces variante de nombre de copies (CNVS) avaient une influence sur l'expression non seulement des gènes se trouvant dans le réarrangement, mais aussi sur ceux se trouvant à une certaine distance. Le présent travail étudie ces effets à différents stades du développement de la souris allant d'un embryon de deux semaines à la souris adulte. Nous avons observé que certains gènes exprimés dans le cerveau semblent soumis à un contrôle plus strict a certaines étapes du développement suggèrent que l'effet des CNVs est modulé différemment au cours de la vie. Notre travail sur trois souches différentes de souris a permis de montrer que les gènes ayant un profil d'expression différent dans le temps entre souches sont enrichis en gènes se trouvant dans des CNVs. Ceci nous amène à penser que les CNVs ont, non seulement une influence sur le niveau d'expression des gènes, mais aussi sur les moments durant lesquels ils seront exprimés. Résumé pour un large public : De nombreuses maladies sont dues soit a un gain (on parle alors de duplication) soit à une perte de matériel génétique (il s'agit dune délétion). Bien que les recherches visant à identifier les mécanismes moléculaires liés à ces réarrangements de notre génome progressent continuellement, la plupart des causes des maladies génétiques restent à élucider. Certaines parties de notre génome sont présentes en un nombre de copies qui diffère d'un individu à l'autre sans pour autant provoquer une ou des maladies. Ces segments d'ADN qui varient en nombre sont appelés Copy Number Variant (CNVs). Ils couvrent environ 12% de notre matériel génétique. Des études menées sur différents modèles animaux ont montré que les CNVs avaient une influence aussi bien sur les gènes qui sont a l'intérieur des CNVs que sur ceux qui sont dans leur voisinage. Ce travail étudie l'effet des CNVs à travers différents stades du développement de la souris. Nous avons démontré que les segments d'ADN qui varient en nombre de copies ont des effets variables selon le stade auxquels ils sont mesurés. Ainsi, les CNVs ont non seulement un impact sur l'expression des gènes présents dans ces régions et dans leur voisinage, mais influencent également leurs profils d'expression au cours du temps.

Foods, nutrients and the risk of oral and pharyngeal cancer.

Background:Besides tobacco and alcohol, dietary habits may have a relevant role in oral cavity and pharyngeal (OCP) cancer.Methods:We analysed the role of selected food groups and nutrients on OCP cancer in a case-control study carried out between 1997 and 2009 in Italy and Switzerland. This included 768 incident, histologically confirmed squamous cell carcinoma cases and 2078 hospital controls. Odds ratios (ORs) were estimated using logistic regression models including terms for tobacco, alcohol and other relevant covariates.Results:Significant inverse trends in risk were observed for all vegetables (OR=0.19, for the highest vs the lowest consumption) and all fruits (OR=0.39), whereas significant direct associations were found for milk and dairy products (OR=1.50), eggs (OR=1.71), red meat (OR=1.55), potatoes (OR=1.85) and desserts (OR=1.68), although trends in risk were significant only for potatoes and desserts. With reference to nutrients, significant inverse relations were observed for vegetable protein (OR=0.45, for the highest vs the lowest quintile), vegetable fat (OR=0.54), polyunsaturated fatty acids (OR=0.53), α-carotene (OR=0.51), β-carotene (OR=0.28), β-cryptoxanthin (OR=0.37), lutein and zeazanthin (OR=0.34), vitamin E (OR=0.26), vitamin C (OR=0.40) and total folate (OR=0.34), whereas direct ones were observed for animal protein (OR=1.57), animal fat (OR=2.47), saturated fatty acids (OR=2.18), cholesterol (OR=2.29) and retinol (OR=1.88). Combinations of low consumption of fruits and vegetables, and high consumption of meat with high tobacco and alcohol, led to 10- to over 20-fold excess risk of OCP cancer.Conclusion:Our study confirms and further quantifies that a diet rich in fruits and vegetables and poor in meat and products of animal origin has a favourable role against OCP cancer.