Accuracy of Screening for Potentially Malignant Disorders of the Oral Mucosa by Dentists in Primary Care

Purpose: To examine the accuracy of a screening programme for potentially malignant disorders of the oral mucosa by visual inspection in primary health care. Materials and Methods: The study was based on secondary data from the Primary Care Information System maintained by seven units of family health in Sao Paulo City managed by a non-governmental agency. The reference population was composed of 15,072 residents 50 years old or more of both genders. The study population comprised 2,980 individuals. During screening in community settings, the oral mucosa was examined by trained dentists and distributed into two categories: (a) screen negative (b) screen positive. All participants underwent comprehensive clinical exams by a general dental practitioner supervised by a specialist. Individual records were grouped in a working dataset. Point and 95% confidence interval estimates were calculated regarding measures of sensitivity (Se), specificity (Sp) and positive and negative predictive values (PPV and NPV, respectively). Results: 18.0% of the population was considered screen positive. A total of 133 lesions (4.5%) were identified and 8 cases of oral cancer were confirmed, which corresponded to a prevalence rate of 27 cases in 10,000 people, a much higher rate than expected. The measures found were Se: 91.7% (85.3-95.6), Sp: 85.4% (84.1-86.7), PPV: 22.7% (19.3-26.5), NPV: 99.5% (99.2-99.8). The visual screen presented high accuracy. Conclusion: The test presented high sensibility and specificity values. From a public health point of view, the high accuracy levels showed the importance of oral health teams on family health strategy for more comprehensive primary care. Targeting risk groups and delegating the screening to community health agents may improve PPV and coverage.

Age of First Dental Visit and Predictors for Oral Healthcare Utilisation in Preschool Children

Purpose: To assess the age the of the first dental visit and the association of self-perceived oral health, socioeconomic and clinical indicators with healthcare utilisation in Brazilian preschool children. Materials and Methods: An epidemiological survey with 455 5- to 59-month-old children was conducted on National Children's Vaccination Day in Santa Maria, RS, Brazil. Data about age and reasons for the first dental visit, healthcare utilisation, socioeconomic status and self-perceived oral health were collected by means of a parental semi-structured questionnaire. Calibrated examiners evaluated the prevalence of dental caries (WHO) and dental trauma. The assessment of the association used Poisson regression models (prevalence ratio; 95% confidence interval [Cl]). Results: A total of 24.2% (95% Cl: 20.3% to 28.4%) of the study sample had already had a first dental visit. Older children, those with dental caries and dental trauma and whose mothers had a higher level of education were more likely to have gone to the dentist. Children of low socioeconomic status were more likely to have visited public than private healthcare services. The reasons for the first dental visit were associated with clinical indicators of the sample. The distribution of utilisation of the types of oral healthcare services (public or private) varied across the socioeconomic groups. Non-white children with dental caries and dental trauma tended to visit a dentist only for treatment reasons. Conclusion: Socioeconomic and clinical indicators are associated with the use of dental services, indicating the need for strategies to promote public health and reorientation of services that facilitate dental access for preschool children.

Dichotomous effects of VEGF-A on adipose tissue dysfunction

Obese fat pads are frequently undervascularized and hypoxic, leading to increased fibrosis, inflammation, and ultimately insulin resistance. We hypothesized that VEGF-A-induced stimulation of angiogenesis enables sustained and sufficient oxygen and nutrient exchange during fat mass expansion, thereby improving adipose tissue function. Using a doxycycline (Dox)-inducible adipocyte-specific VEGF-A overexpression model, we demonstrate that the local up-regulation of VEGF-A in adipocytes improves vascularization and causes a "browning" of white adipose tissue (AT), with massive up-regulation of UCP1 and PGC1 alpha. This is associated with an increase in energy expenditure and resistance to high fat diet-mediated metabolic insults. Similarly, inhibition of VEGF-A-induced activation of VEGFR2 during the early phase of high fat diet-induced weight gain, causes aggravated systemic insulin resistance. However, the same VEGF-A-VEGFR2 blockade in ob/ob mice leads to a reduced body-weight gain, an improvement in insulin sensitivity, a decrease in inflammatory factors, and increased incidence of adipocyte death. The consequences of modulation of angiogenic activity are therefore context dependent. Proangiogenic activity during adipose tissue expansion is beneficial, associated with potent protective effects on metabolism, whereas antiangiogenic action in the context of preexisting adipose tissue dysfunction leads to improvements in metabolism, an effect likely mediated by the ablation of dysfunctional proinflammatory adipocytes.

Measurement of prompt J/psi and beauty hadron production cross sections at mid-rapidity in pp collisions at root s=7 TeV

The ALICE experiment at the LHC has studied J/psi production at mid-rapidity in pp collisions at root s = 7 TeV through its electron pair decay on a data sample corresponding to an integrated luminosity L-int = 5.6 nb(-1). The fraction of J/psi from the decay of long-lived beauty hadrons was determined for J/psi candidates with transverse momentum p(t) > 1,3 GeV/c and rapidity vertical bar y vertical bar < 0.9. The cross section for prompt J/psi mesons, i.e. directly produced J/psi and prompt decays of heavier charmonium states such as the psi(2S) and chi(c) resonances, is sigma(prompt J/psi) (p(t) > 1.3 GeV/c, vertical bar y vertical bar < 0.9) = 8.3 +/- 0.8(stat.) +/- 1.1 (syst.)(-1.4)(+1.5) (syst. pol.) mu b. The cross section for the production of b-hadrons decaying to J/psi with p(t) > 1.3 GeV/c and vertical bar y vertical bar < 0.9 is a sigma(J/psi <- hB) (p(t) > 1.3 GeV/c, vertical bar y vertical bar < 0.9) = 1.46 +/- 0.38 (stat.)(-0.32)(+0.26) (syst.) mu b. The results are compared to QCD model predictions. The shape of the p(t) and y distributions of b-quarks predicted by perturbative QCD model calculations are used to extrapolate the measured cross section to derive the b (b) over bar pair total cross section and d sigma/dy at mid-rapidity.

A UML profile for the OBO relation ontology

Background: Ontologies have increasingly been used in the biomedical domain, which has prompted the emergence of different initiatives to facilitate their development and integration. The Open Biological and Biomedical Ontologies (OBO) Foundry consortium provides a repository of life-science ontologies, which are developed according to a set of shared principles. This consortium has developed an ontology called OBO Relation Ontology aiming at standardizing the different types of biological entity classes and associated relationships. Since ontologies are primarily intended to be used by humans, the use of graphical notations for ontology development facilitates the capture, comprehension and communication of knowledge between its users. However, OBO Foundry ontologies are captured and represented basically using text-based notations. The Unified Modeling Language (UML) provides a standard and widely-used graphical notation for modeling computer systems. UML provides a well-defined set of modeling elements, which can be extended using a built-in extension mechanism named Profile. Thus, this work aims at developing a UML profile for the OBO Relation Ontology to provide a domain-specific set of modeling elements that can be used to create standard UML-based ontologies in the biomedical domain. Results: We have studied the OBO Relation Ontology, the UML metamodel and the UML profiling mechanism. Based on these studies, we have proposed an extension to the UML metamodel in conformance with the OBO Relation Ontology and we have defined a profile that implements the extended metamodel. Finally, we have applied the proposed UML profile in the development of a number of fragments from different ontologies. Particularly, we have considered the Gene Ontology (GO), the PRotein Ontology (PRO) and the Xenopus Anatomy and Development Ontology (XAO). Conclusions: The use of an established and well-known graphical language in the development of biomedical ontologies provides a more intuitive form of capturing and representing knowledge than using only text-based notations. The use of the profile requires the domain expert to reason about the underlying semantics of the concepts and relationships being modeled, which helps preventing the introduction of inconsistencies in an ontology under development and facilitates the identification and correction of errors in an already defined ontology.

Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction

Objectives Predictors of adverse outcomes following myocardial infarction (MI) are well established; however, little is known about what predicts enzymatically estimated infarct size in patients with acute ST-elevation MI. The Complement And Reduction of INfarct size after Angioplasty or Lytics trials of pexelizumab used creatine kinase (CK)-MB area under the curve to determine infarct size in patients treated with primary percutaneous coronary intervention (PCI) or fibrinolysis. Methods Prediction of infarct size was carried out by measuring CK-MB area under the curve in patients with ST-segment elevation MI treated with reperfusion therapy from January 2000 to April 2002. Infarct size was calculated in 1622 patients (PCI=817; fibrinolysis=805). Logistic regression was used to examine the relationship between baseline demographics, total ST-segment elevation, index angiographic findings (PCI group), and binary outcome of CK-MB area under the curve greater than 3000 ng/ml. Results Large infarcts occurred in 63% (515) of the PCI group and 69% (554) of the fibrinolysis group. Independent predictors of large infarcts differed depending on mode of reperfusion. In PCI, male sex, no prior coronary revascularization and diabetes, decreased systolic blood pressure, sum of ST-segment elevation, total (angiographic) occlusion, and nonright coronary artery culprit artery were independent predictors of larger infarcts (C index=0.73). In fibrinolysis, younger age, decreased heart rate, white race, no history of arrhythmia, increased time to fibrinolytic therapy in patients treated up to 2 h after symptom onset, and sum of ST-segment elevation were independently associated with a larger infarct size (C index=0.68). Conclusion Clinical and patient data can be used to predict larger infarcts on the basis of CK-MB quantification. These models may be helpful in designing future trials and in guiding the use of novel pharmacotherapies aimed at limiting infarct size in clinical practice. Coron Artery Dis 23:118-125 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

An alternative method for the simultaneous determination of copper and lead for quality control of sugar cane spirit using a nanotube-based sensor

The development of an electroanalytical method for simultaneous determination of copper and lead ions in sugar cane spirit (cachaça) using carbon paste electrode modified with ascorbic acid and carbon nanotubes (CPE-AaCNT) is described. Squarewave voltammetry (SWV) with anodic stripping was employed, and this technique was optimized with respect to the following parameters: frequency (50 Hz), amplitude (100 mV) and scan increment (9 mV). The analytical curves were linear in the range from 0.0900 to 7.00 mg L- 1 for lead and copper. The limits of detection were 48.5 and 23.9 µg L- 1 for lead and copper, respectively. The developed method was applied to the simultaneous determination of copper and lead in five commercial samples of sugar cane spirit. The results were in good agreement with those obtained by F AAS/GF AAS (flame atomic absorption spectrometry/graphite furnace atomic absorption spectrometry) and showed that CPE-AaCNT can be successfully employed in the simultaneous determination of these metals in real sugar cane spirit samples.

Application of different instrumental techniques to the selective evaluation of bio-sensible compounds in foodstuff of animal and vegetable origin

This PhD thesis describes the application of some instrumental analytical techniques suitable to the study of fundamental food products for the human diet, such as: extra virgin olive oil and dairy products. These products, widely spread in the market and with high nutritional values, are increasingly recognized healthy properties although their lipid fraction might contain some unfavorable components to the human health. The research activity has been structured in the following investigations: “Comparison of different techniques for trans fatty acids analysis” “Fatty acids analysis of outcrop milk cream samples, with particular emphasis on the content of Conjugated Linoleic Acid (CLA) and trans Fatty Acids (TFA), by using 100m high-polarity capillary column” “Evaluation of the oxidited fatty acids (OFA) content during the Parmigiano-Reggiano cheese seasoning” “Direct analysis of 4-desmethyl sterols and two dihydroxy triterpenes in saponified vegetal oils (olive oil and others) using liquid chromatography-mass spectrometry” “Quantitation of long chain poly-unsatured fatty acids (LC-PUFA) in base infant formulas by Gas Chromatography, and evaluation of the blending phases accuracy during their preparation” “Fatty acids composition of Parmigiano Reggiano cheese samples, with emphasis on trans isomers (TFA)”

Efficacia del trattamento con concentrati piastrinici (P.R.P.) nelle lesioni condrali e tendinopatie

Purpose: Recent knowledge regarding tissue biology highlights a complex regulation of growth factors in reaction to tissue damage. Platelet Rich Plasma (P.R.P.), containing a natural pool of growth factors, can be obtained in a simple and minimally invasive way and be applied to the lesion site. The aim of this study is to explore this novel approach to treat cartilage degenerative lesions of the knee and tendon chronic lesions( patellar tendon, and achilles tendon). In this study we evaluated if the treatment with PRP injections can reduce pain and increase function in cases of patellar tendinosis (Jumper’s Knee), in chronic achilles tendinopathy and in patients with cartilage injuries of the knee. Materials and Methods: 40 patients with cartilage lesion of the knee, 28 male and 12 female with mean age 47 y. (min 18- max 52 years), were treated and prospectively evaluated at a minimum 6 months follow-up; in the same way, 12 patients with achilles tendon lesion (8 male and 4 female) with mean age 44,5 y. (min 32-max 58 years) and 10 patients with “Jumper’s Knee” (8 male and 2 female) with mean age 23,2 y. (min 18-max 37 years), were evaluated at 6 months follow up. The procedure involved 3 multiple injections , performed every two weeks. All patients were clinically evaluated at the end of the treatment and at 6 months follow up. IKDC, SF36, EQ-VAS, scores were used for clinical evaluation and patient satisfaction and functional status were also recorded. Results: Statistical analysis showed a significant improvement in the SF36 questionnaire in all parameters evaluated at the end of the therapy and 6 months follow-up in both group(tendinopathies and chondral lesions), and in the EQ VAS and IKDC score (paired T-test, p<0.0005) from basal evaluation to the end of the therapy, and a further improvement was present at 6 months follow-up. Whereas a higher improvement of the sport activity level was achieved in the “Jumper’s Knee” group. No complications related to the injections or severe adverse events were observed during the treatment and follow up period. Conclusion: PRP inhibits excess inflammation, apoptosis, and metalloproteinase activity. These interactive pathways may result in the restoration of tendon or cartilage, which can with stand loading with work or sports activity, thereby diminishing pain. PRP may also modulate the microvascular environment or alter efferent or afferent neural receptors. The clinical results are encouraging, indicating that PRP injections may have the potential to increase the tendon and cartilage healing capacity in cases with chronic tendinosis and chondropathy of the knee.

Selektiver Nachweis von Uran-236 mittels hochauflösender Resonanzionisations-Massenspektrometrie

Die vorliegende Dissertation beschreibt die Entwicklung, den Aufbau und die Erprobung eines neuartigen lasermassenspektrometrischen Nachweises des Ultraspurenisotops 236U. Das Nuklid 236U wird vorwiegend in Kernreaktoren durch Neutroneneinfang aus 235U gebildet und dient damit als Schlüsselisotop zur Unterscheidung anthropogenen Urans von natürlichem Uran-Vorkommen. Mit seinem Nachweis wird die Untersuchung der Migration von Kernbrennstoff in der Umwelt und die Beantwortung kritischer Fragen in der nuklearen Forensik ermöglicht. Im Rahmen dieser Arbeit wurde das Verfahren der hochauflösenden Resonanzionisations-Massenspektrometrie auf die Anforderungen des selektiven Nachweises von Uran-Isotopen angepasst. Wesentliche Schritte waren hierbei die Untersuchung einer effizienten Atomisation von Uran-Proben, die Identifikation atomarer und autoionisierender Zustände für eine resonante Anregungsleiter, die vollständige Spezifikation der Anregungsleiter für alle Uran-Isotope und schließlich die Umsetzung der Erkenntnisse in ein analytisches Messverfahren. Die optische Selektivität des Verfahrens konnte durch Dichtematrixrechnungen zu ca. 14 Größenordnungen abgeschätzt werden; die Nachweisgrenze des Verfahrens für das Isotopenverhältnis 236U / 238U ist dabei gegenwärtig durch Untergrund begrenzt und beträgt ca. 3 · 10−8. Mit diesen Spezifikationen konnte die Linearität und Präzision des Nachweisverfahrens über einen dynamischen Bereich von vier Größenordnungen nachgewiesen werden.