Local drug delivery of alendronate gel for the treatment of patients with chronic periodontitis with diabetes mellitus: a double-masked controlled clinical trial

Background: Alendronate (ALN) increases alveolar bone density with systemic use and, has been found to increase bone formation on local delivery into the periodontal pocket. The purpose of the present study is to explore the efficacy of 1% ALN gel as a local drug delivery system in adjunct to scaling and root planing (SRP) for the treatment of intrabony defects in patients with chronic periodontitis (CP) with type 2 diabetes (DM) compared to a placebo gel. Methods: Seventy intrabony defects were treated with either 1% ALN or placebo gel. Clinical parameters were recorded at baseline, 2 months, and 6 months. Radiographic parameters were recorded at baseline and 6 months. Defect fill at baseline and 6 months was calculated on standardized radiographs using image analysis software. Results: Mean probing depth (PD) reduction and mean clinical attachment level (CAL) gain was greater in the ALN group than the placebo group at both 2 and 6 months. Furthermore, significantly greater mean percentage of bone fill was found in the ALN group (44.2% ± 11.78%) compared to the placebo group (2.8% ± 1.61%). Conclusions: In patients with type 2 DM and CP, local delivery of 1% ALN into periodontal pockets resulted in a significant increase in the PD reduction, CAL gain, and improved bone fill compared to placebo gel as an adjunct to SRP. Thus, ALN can be used as an adjunct to SRP to provide a new dimension in the periodontal therapy in the near future.     

GDNF blended chitosan nerve guides: an in vivo study

Chitosan nerve guides are currently being utilized to repair damaged or injured peripheral nerves. To enhance the nerve regeneration process, instead of using the material alone, researchers are focusing on blending different proteins or molecules with chitosan to facilitate nerve repair and regeneration. In our study, we have blended chitosan with glial cell-line derived neurotrophic factor and laminin within our nerve guides (GLC). The rat sciatic nerve injury model was used to test these nerve guides and histologically evaluated at 6, 9, and 12 weeks. Histologically at 6 weeks, the axon area and myelination are significantly higher in the GLC group compared with the controls. However, at 9 and 12 weeks control groups matched the GLC values. Thus the histological results indicate that GLC nerve guides can enhance the nerve regeneration process during the initial stages of nerve repair.     

Chemokine (CCR) and fractalkine (CX3CR) receptors and end stage renal disease

Objective and design  

Genetic polymorphisms of chemokines and their receptors were reported to be independent risk factors for inflammation associated disease. We explored the role of CCR5-Δ32, CCR5–G59029A, CX3CR1 V249I and T280M gene polymorphisms as susceptibility for end stage renal disease (ESRD).     

National prevalence estimates for cytomegalovirus IgM and IgG avidity and association between high IgM antibody titer and low IgG avidity

Primary cytomegalovirus (CMV) infection of the mother during pregnancy presents risk of CMV infection of the fetus with resulting permanent disability. CMV IgM antibody is generated following primary CMV infection but also can appear during nonprimary CMV infection and is thus of limited diagnostic use by itself. In contrast, the presence of low CMV IgG avidity has been shown to be a unique and reliable serologic indicator of primary CMV infection. We measured CMV IgG and IgM antibody levels and IgG avidity in sera from a population sample of 6,067 U.S. women aged 12 to 49 years from NHANES (National Health and Nutrition Examination Survey). The CMV IgG prevalence was 58% overall and increased strongly with age. The CMV IgM prevalence was 3.0% overall and remained relatively flat across age groups. The prevalence of low IgG avidity was 2.0% overall, decreased sharply with age, and was seen mainly among IgM-positive sera. Fourteen to 18% of the CMV IgM-positive sera were low IgG avidity, presumably representing primary CMV infection. High CMV IgM antibody titer was a strong predictor of low IgG avidity. The ability to reliably identify primary CMV infection during pregnancy is important for management of the pregnancy, including possible treatment options for the fetus. Both IgM and IgG avidity measurements provide useful clinical information for evaluating primary CMV infection, although commercial tests for CMV IgG avidity are not yet widely available in the United States.     

A randomized clinical trial of a culturally responsive intervention for African American women with asthma

Background

Few interventions have focused on the difficulties that African American women face when managing asthma.

Effectiveness of radiation therapy alone for elderly patients with unresected stage III non-small cell lung cancer

Purpose

Chemoradiotherapy is the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). Elderly patients, who are often considered unfit for combined chemoradiotherapy, frequently receive radiation therapy (RT) alone. Using population-based data, we evaluated the effectiveness and tolerability of lone RT in unresected elderly stage III NSCLC patients.

Methods and materials

Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare records we identified 10,376 cases of unresected stage III NSCLC that were not treated with chemotherapy, diagnosed between 1992 and 2007. We used logistic regression to determine propensity scores for RT treatment using patients’ pre-treatment characteristics. We then compared survival of patients who underwent lone RT vs. no treatment using a Cox regression model adjusting for propensity scores. The adjusted odds for toxicity among patients treated with and without RT were also estimated.

Results

Overall, 6468 (62%) patients received lone RT. Adjusted analyses showed that RT was associated with improved overall survival in unresected stage III NCSLC (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.74–0.79) after controlling for propensity scores. RT treated patients had an increased adjusted risk of hospitalization for pneumonitis (odds ratio [OR]: 89, 95% CI: 12–636), and esophagitis (OR: 8, 95% CI: 3–21).

Conclusions

These data suggest that use of RT alone may improve the outcomes of elderly patients with unresected stage III NSCLC. Severe toxicity, however, was considerably higher in the RT treated group. The potential risks and benefits of RT should be carefully discussed with eligible elderly NSCLC patients.     

Comprehensive medication reviews: Optimal delivery setting and recommendations for quality assessment

ObjectivesTo propose a metric evaluating the quality of comprehensive medication reviews (CMRs), and to discuss the optimal setting for CMR delivery.SummaryFirst, we provide a current assessment of the quality of CMRs performed in community, payer, and health system/clinic settings, with recommended opportunities for improvement. Thereafter, a companion metric for CMR quality is discussed, because this is critical to ensuring that patients are not just receiving CMR services, but that CMRs reflect evidence-based recommendations supporting optimal patient outcomes.ConclusionBased on the data currently available, accessibility to electronic medical records would enhance patient-specific recommendations to optimize CMR delivery and patient outcomes. Future studies may help to identify additional factors, such as pharmacist-physician collaboration in clinic and use of evidence-based recommendations, that can further enhance CMR quality.     

Development of human protein reference database as an initial platform for approaching systems biology in humans

Human Protein Reference Database (HPRD) is an object database that integrates a wealth of information relevant to the function of human proteins in health and disease. Data pertaining to thousands of protein-protein interactions, posttranslational modifications, enzyme/substrate relationships, disease associations, tissue expression, and subcellular localization were extracted from the literature for a nonredundant set of 2750 human proteins. Almost all the information was obtained manually by biologists who read and interpreted >300,000 published articles during the annotation process. This database, which has an intuitive query interface allowing easy access to all the features of proteins, was built by using open source technologies and will be freely available at http://www.hprd.org to the academic community. This unified bioinformatics platform will be useful in cataloging and mining the large number of proteomic interactions and alterations that will be discovered in the postgenomic era.     

Allelic variation of BAT-26 and BAT-40 poly-adenine repeat loci in North Indians.

Analysis of mononucleotide repeats BAT-26 and BAT-40 in North Indians revealed that there were germline polymorphisms at both the loci. We evaluated BAT-26 and BAT-40 in 100 normal healthy individuals from North India. The DNA from normal blood was PCR amplified using primers flanking the BAT-26 and BAT-40 loci. The allelic variation of BAT-26 and BAT-40 ranged between 117-130 and 94-112 bp respectively. The most frequent BAT-26 allele was 122 bp, which corresponded to 26 repeats and had a frequency of 32% while that of BAT-40 was 109 bp corresponding to 39 repeats with a frequency of 26%. These results suggest that polymorphisms in these poly-adenine repeat loci limit their applicability in studying the microsatellite instability in cancers.     

A Snapshot of Social Risk Factors and Associations with Health Outcomes in a Community Sample of Middle Eastern and North African (MENA) People in the U.S.

Social factors (e.g. housing, food security, etc.) contribute significantly to health. The purpose of this study is to describe social risk and social exclusion factors in one of the largest Middle Eastern and North African (MENA) populations in the U.S. and their association with health outcomes. We conducted a cross-sectional study with a community convenience sample of 412 adults who self-identify as MENA. Weighted, adjusted linear regression models were used to examine relationships of interest. Prevalent social risks included transportation barriers to healthcare (33%), food insecurity (33%), and financial strain (25%). In adjusted models, perception of being treated unfairly (Estimate (SE) 0.08 (0.04), p?<?0.05) and fear of deportation (0.26 (0.06), p?<?0.001) were associated with more social risk factors. More social risk factors were associated with worse self-reported health (0.09 (0.03), p?<?0.01), more chronic conditions (0.11 (0.03), p?<?0.004), and more mental health symptoms (0.34 (0.14) p?<?0.01).Social risk is high among those perceiving unfairness and fear deportation. Those with more social risk factors reported worse health. These findings have implications for social needs screening and referral models that can best serve U.S. MENA sub-populations.