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Aims: Histological diagnostic criteria are used for the assessment of the degree of dysplasia and hence the risk of cancer progression for premalignant lesions. Clonal changes in the form of hyperorthokeratosis and hyperchromasia that are sharply demarcated from adjacent areas are not currently part of the criterion for dysplasia diagnosis. The objective of this study was to determine whether such clonal change should be regarded as a diagnostic feature for dysplasia. The following histological conditions were used to define such change: (1) hyperorthokeratosis; (2) hyperchromatism but no other features of dysplasia; (3) sharp margin demarcation from adjacent area by both the hyperorthokeratosis and hyperchromasia (clonal change), and (4) no prominent rete ridges, marked acanthosis or heavy inflammation. Lesions fitting these criteria were termed orthokeratotic lesions with no dysplasia. Methods: Patients from a population-based longitudinal study with more than 10 years of follow up were analyzed. Of the 214 patients with primary oral premalignant lesions, 194 had mild or moderate dysplasia (dysplasia group) and 20 fit the criteria for orthokeratotic lesions without dysplasia (orthokeratotic with no dysplasia group). The two groups were compared for their cancer risks using clinical (site and toluidine blue), histological (nuclear phenotype score), and molecular criteria (loss of heterozygosity) and by outcome (progression). Results and conclusions: The lesions from orthokeratotic with no dysplasia group showed a similar cancer risk (clinical, histological and molecular risk) and time to progression as the dysplastic lesions. We recommend that the clonal change should be included as a criterion for dysplasia diagnosis

Intraoral and extraoral radiographic investigations play a fundamental role in all dental disciplines. For endodontic treatment it is necessary, in addition to measuring with apex locators, also various radiographs in the preoperative, operative, and final control phase.Even in surgical practice, and especially in implantology, the radiographic investigation remains essential to limit errors or complications.The mathematical approach for the determination of the length of work in endodontics is a simple and costless procedure. This work intends to expose the reasons why it should, in certain cases, be taken into consideration.

Aim: The aim of the present study is to assess the efficacy and safety of Hydroxychloroquine in comparison with Teneligliptin in type 2 diabetes patients whose blood glucose levels were inadequately controlled with metformin, Glimepiride and insulin therapy. Methods: This was a randomized, prospective, parallel-group, experimental trial done in 300 Type 2 Diabetes patients who were uncontrolled (HbA1c=7.5–10%) with metformin, Glimepiride and insulin therapy. Patients were randomly divided into two groups one received Teneligliptin 20 mg (n=152) and other received Hydroxychloroquine 400 mg (n=148) while continuing insulin therapy with other 2 OHA. Insulin doses were adjusted to maintain normal blood glucose levels. Result: The adjusted mean change from baseline to endpoint in HbA1c was −1.2±0.5% in patient group receiving Hydroxychloroquine and −0.9±0.5% in patients group receiving Teneligliptin, respectively, with a significant between-treatment difference (p<0.001). The incidence of adverse events was similar in the Hydroxychloroquine (72%) and Teneligliptin (77%) groups. However, hypoglycaemic events were less common (p<0.001) and less severe (p<0.05) in patients receiving Hydroxychloroquine than in those receiving Teneligliptin. Conclusion: Hydroxychloroquine decreases HbA1c in patients whose type 2 diabetes is poorly controlled with high doses of insulin as compare to Teneligliptin. Addition of hydroxychloroquine to insulin therapy is also associated with reduced incidence of confirmed and severe hypoglycaemia.

Climate change and the increasing global population pose a severe threat to the availability of freshwater in the world. Over consumption of water and deteriorating water quality are problems that should be addressed in order to ensure water availability for the coming decades. In this context, the increasing presence of micropollutants in water has shown to cause detrimental impact on water quality, given the negative disturbances that they can cause on human health and on the environment. Thus, it is important to study and quantify the presence of micropollutants in water bodies and also in regenerated wastewater based irrigation systems. 

Rationale: Blood Pressure measurement has transitioned to the oscillometric method in most hospitals in the United States, however out-patient offices mainly use the auscultatory technique. Objective: To determine time taken to measure blood pressure by an automatic oscillometric device compared to an auscultatory measurement device and to determine what each measurement costs. Methods: Blood Pressures were measured in a single primary care office by medical assistants (MA) for patients seen for office visits. Timed measurements were performed using an automated oscillometric Welch Allyn Connex Vital Signs Monitor (WA) and manually using a Tycos device. A minimum of 400 readings were taken with each method. Results: The average time to manually measure BP was 58.6 seconds, whereas the WA average was 39.8 seconds, 18.8 seconds faster (p<0.05). There was an improvement in measurement time with MA experience with the WA device (p<0.05). The average MA cost to measure a single BP using the manual method was $0.35 vs. the WA method ($0.24) or a savings of $0.11 per measurement. The improvement with experience of WA method reduced cost to $0.17 per measurement. Conclusion: The oscillometric method saved 17cents per measurement potentially saving $1,119 per year for our primary care practice.

Gut microbial flora is the largest micro-ecosystem in the human body, it is symbiotically associated with the host; and maintains normal physiological processes in a dynamic equilibrium state. A plethora of evidence supports that gut microbial flora influences the neurotransmitters of the central nervous system. This gut flora influences cognitive function, anxiety, depression; and mood disorders as they are capable of synthesizing neurotransmitters in the nervous system. Therefore intake of probiotics influences gut microbiome; and depression. The versatility and number of gut microbial flora varies individually, so the content of common gut microbes may affect the neurotransmitters, manipulating the gut microbiota with probiotics offers a novel approach to treat brain disorders such as depression via GUT-BRAIN AXIS. The present review outlines the aspect of such alterations and how modulation of gut microbiota influences depression.

In 1874 J.M. Charcot was the first to describe ALS amyotrophic lateral sclerosis, a disease with an high non response therapy rate also to the actual therapy. ALS is not clearly associate to only single etio-patogenetic movens but many process seem involved. Also the strange geographic diffusion of different forms contribute to a complex syndromic pathology. The introducing of new theories and approach can help to find more efficacy therapeutic strategies. In this work the different neuronal damage movens and new therapeutic strategies are analyzed to produce a Unic global response to the pathologic process useful in next clinical application. Genetic factors must be considered also added to environmental movens but also to the endogenous microenvironment of motoneuron involved. A toxicological-biochemical-imunological approach can be useful tool to find new therapeutic strategies. Or to improve local availability of pharmacological molecules.

Infantile cystinosis is a lysosomal storage disease leading to end stage kidney disease at early ages. There is no effective treatment and patients require long term dialysis or kidney transplant for survival. We present our experience on three affected children who received HLA matched allogeneic stem cell transplant. The protocol used was novel and designed to promote engraftment. The primary endpoint was safety for treatment related mortality or morbidity; All three children survived without serious adverse effects during extended follow up for over 4 years. Although we could not prove engraftment, all three children met secondary end point of sustained target functions over a 6 month follow-up. Further studies are warranted to further evaluate safety and efficacy of MSC treatment for infantile cystinosis.

The city of Santo Amaro (Bahia, Brazil) gained visibility among the scientific community due to the contamination of the Subaé River by lead and cadmium from the PLUMBUM Mineração e Metalurgia Ltda industry, on the banks of the river in 1956, which produced lead ingots The present work aimed to investigate the adsorption capacity of heavy metals (Pb and Cd) of EPS produced by bacterial species from the Subaé River, for possible future application of these biopolymers in bioremediation processes in areas impacted by the aforementioned heavy metals. Subaé river water was collected for physical-chemical analysis and bacterial isolation. It was verified that all isolated bacteria produced an expressive amount of Exopolysaccharide (EPS). Thus, the optimization of this production in different sugars (sucrose, glucose, and mannitol) and in three different pHs: 5.5; 6.5, and 7.5. All bacteria produced EPS in large quantities and the best sugar was sucrose at pH 7.5. In order to use the EPS for the bioremediation area, the adsorption test of lead and cadmium was carried out by the isolated EPS. 0.5 g of the EPS was dissolved in 50 ml of deionized water, then the solutions of metals, lead acetate, and cadmium sulfate (procedure performed separately) were incubated at 28 °C for 16 h after that period, and were centrifuged. Samples were filtered to separate the insoluble EPS and the filtrates obtained were used in the quantification of the metals by atomic absorption (FAAS- Flame Atomic Absorption Spectrometry). Bacillus spp., Bacillus cereus, Staphylococcus spp., and Serratiamarcescens, all showed tolerance to the tested metals, due to the efficiency in the adsorption capacity of the EPS, and it was possible to distinguish seven genera, Klebsiella pneumonia, Pseudomonas aeruginosa, Lysinibacillus spp. to be used in the bioremediation of environments contaminated with heavy metals.

This study aimed to investigate the relationship between muscle weakness and cancer-related symptoms in patients undergoing chemotherapy for hematological malignancies and solid tumors. We recruited hospitalized patients older than 20 years who were receiving chemotherapy. Patients were divided into a solid tumor (n=74) and hematological malignancy (n=80) group. Age, body mass index (BMI), strength and thickness of the quadriceps femoris muscle, serum albumin and C-reactive protein levels, blood hemoglobin concentration, fatigue, psychological distress and pain, and duration of hospitalization were assessed. Eight physical symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, and diarrhea) were also evaluated. Correlation and multiple regression analyses were conducted to identify factors affecting muscle strength in each group. Muscle strength was associated with fatigue in the solid tumor group and with age, BMI, muscle thickness, albumin and hemoglobin in the hematological malignancy group. Therefore, factors contributing to muscle strength might differ between patients with solid tumors and those with hematological malignancies. In particular, fatigue was an important factor in patients with solid tumors, while anemia was an important factor in patients with hematological malignancies. We therefore suggest that different treatments for muscle weakness might be considered for patients with these cancer types.