Non-O blood type is the commonest genetic risk factor for VTE: results from a meta-analysis of the literature

It is well known that the ABO blood group exerts a major influence on hemostasis, as O blood group individuals have lower von Willebrand factor and factor VIII levels than non-O blood group subjects. To evaluate the possible clinical implication of the different ABO blood groups on the risk of developing venous thromboembolism (VTE), we conducted a meta-analysis of the existing literature. After an electronic search strategy using Medline and Embase and a manual review of abstract books of the International Society on Thrombosis and Haemostasis and of reference lists of all retrieved articles, we included in the systematic review 38 studies with 10,305 VTE cases. The prevalence of non-O blood group was significantly higher in VTE patients compared with controls with a resulting pooled odds ratio (OR) of 2.09 (95% confidence interval [CI], 1.83, 2.38; p < 0.00001). Similar findings were obtained when the genotypes A1O/BO/A2B (OR 1.73, 95% CI, 1.47, 2.05; p < 0.00001) and A1B/A1A1/BB (OR 1.87, 95% CI, 1.84, 2.44; p < 0.00001) were analyzed. The maximum VTE risk was observed in non-O-factor V Leiden patients (OR 7.60, 95% CI, 3.21, 17.99), while for G20210A prothrombin mutation it was not possible to perform a pooled analysis due to a paucity of published studies. Finally, the association between non-O blood group and VTE was weaker when provoked VTE cases were considered (OR 1.33, 95% CI, 1.18, 1.50), while it was substantially unchanged when unprovoked VTE cases were analyzed (OR 1.88, 95% CI, 1.42, 2.50). In conclusion, considering its prevalence, non-O blood group is a candidate to be one of the most important genetic risk factors for venous thrombosis.     

Implant-supported mandibular splinting affects temporomandibular joint biomechanics

Objectives: Mandibular functional movements lead to complex deformations of bony structures. The aim of this study was to test whether mandibular splinting influences condylar kinematics and temporomandibular joint (TMJ) loading patterns. Materials and methods: Six subjects were analyzed by means of dynamic stereometry during jaw opening–closing with mandibles unconstrained as well as splinted transversally by a cast metal bar fixed bilaterally to two implant pairs in the (pre)molar region. Statistical analysis was performed by means of ANOVAs for repeated measurements (significance level α=0.05). Results: Transversal splinting reduced mandibular deformation during jaw opening–closing as measured between two implants in the (pre)molar region on each side of the mandible significantly by 54%. Furthermore, splinting significantly reduced the distance between lateral condylar poles (average displacement vector magnitude of each pole: 0.84±0.36 mm; average mediolateral displacement component: 45±28% of the magnitude) and led to a medial displacement of their trajectories as well as a mediolateral displacement of stress‐field paths. Conclusions: During jaw opening–closing, splinting of the mandible leads to a significant reduction of mandibular deformation and intercondylar distance and to altered stress‐field paths, resulting in changed loading patterns of the TMJ structures. To cite this article:
Zaugg B, Hämmerle CHF, Palla S, Gallo LM. Implant‐supported mandibular splinting affects temporomandibular joint biomechanics.
Clin. Oral Impl. Res. 23 , 2012; 897–901
doi: 10.1111/j.1600‐0501.2011.02241.x     

Effect of a calcium hydroxide/chlorhexidine paste as intracanal dressing in human primary teeth with necrotic pulp against Porphyromonas gingivalis and Enterococcus faecalis

International Journal of Paediatric Dentistry 2012; 22: 116–124 Background. Intracanal medication is important for endodontic treatment success as it eliminates microorganisms that persist after biomechanical preparation. Aim. To evaluate the effect of two intracanal medications against Porphyromonas gingivalis and Enterococcus faecalis in the root canals of human primary teeth with necrotic pulp with and without furcal/periapical lesion, using quantitative real‐time polymerase chain reaction (qRT‐PCR). Design. Thirty‐two teeth with necrotic pulp were used. Twelve teeth did not present lesion, and 20 teeth presented radiographically visible furca/periapical lesion. Microbiological samples were collected after coronal access and biomechanical preparation. The teeth were medicated with calcium hydroxide pastes prepared with either polyethylene glycol or chlorhexidine. After 30 days, the medication was removed and a third collection was performed. Microbiological samples were processed using qRT‐PCR. Data were analysed by Wilcoxon and Mann–Whitney tests (α = 0.05). Results. There was no significant difference in the microbiota present in the primary teeth with and without furcal/periapical lesion. Biomechanical preparation was effective in reducing the number of microorganisms (P < 0.05). The intracanal medications had similar antibacterial activity. Conclusion. The association of chlorhexidine with calcium hydroxide did not increase the antibacterial activity of the intracanal medication in the treatment of primary teeth with necrotic pulp with and without furcal/periapical lesion.     

Intra-aortic balloon pumping recruits graft flow reserve by lowering coronary resistances

Background

The intra-aortic balloon pump (IABP) is used worldwide as an anti-ischemic strategy and to reduce myocardial workload. However, whether IABP augments coronary flow after coronary bypass via a passive increase in diastolic pressure or an active response of the coronary bed remains uncertain.

Methods

We analyzed transit-time flow measurements and the contemporary changes in coronary resistances obtained during 1:1 IABP and during its cessation in 144 consecutive patients receiving prophylactic IABP before isolated coronary artery bypass grafting (n = 340 graft segments).

Results

Normally functioning grafts showed lower coronary resistances, greater percentage decrease in resistance, and greater increases in average maximum diastolic and mean flow during 1:1 IABP compared with IABP cessation (P < .001). Arterial and sequential saphenous vein grafts showed better flowmetry and greater reductions in coronary resistances compared with single venous grafts. Accordingly, graft flow reserve (defined as mean flow during 1:1 IABP/mean flow with IABP off) was recruited (graft flow reserve > 1) during 1:1 IABP in all normally functioning grafts, with higher values in single arterial or sequential saphenous vein grafts than in single venous grafts (both P < .001). Coronary resistances were higher in 7 failed grafts versus normal-functioning grafts at baseline; these did not decrease during 1:1 IABP and showed worse transit-time flow results.

Conclusions

IABP recruits graft flow reserve by lowering coronary resistance in functioning grafts. Arterial and sequential venous grafts showed greater reduction in coronary resistance compared with single saphenous grafts.     

Addition of iron to erythropoiesis-stimulating agents in cancer patients: a meta-analysis of randomized trials

Background  

Iron supplementation could improve the hematopoietic response of erythropoiesis-stimulating agents (ESAs) used for chemotherapy-induced anemia.