Oral health–related quality of life in different clinical forms of oral lichen planus

Clinical Oral Investigations - The aim of the study was to determine the prevalence of clinical forms in a group of oral lichen planus (OLP) patients and to investigate whether the oral...     

A pilot study to investigate the feasibility and cardiac effects of pegylated liposomal doxorubicin (PL-DOX) as adjuvant therapy in medically fit elderly breast cancer patients

In this pilot study, we examined the feasibility and toxicity in 16 elderly women age > or =65 receiving six cycles of pegylated liposomal doxorubicin (PL-DOX) cyclophosphamide as adjuvant chemotherapy for breast cancer. An extensive cardiologic assessment was also performed including echocardiographic Doppler-based strain rate imaging (SRI), a promising new sensitive technique to assess cardiac function. All but one patient finished the six planned cycles without major dose reductions or delay, and with limited serious toxicity showing the feasibility of this regimen. Significant decreases in radial strain and strain rate were found after six cycles of treatment while left ventricle ejection fraction remained unchanged. SRI may be a useful tool in the follow-up of elderly patients treated with anthracyclines, allowing early initiation of preventive measures in order to prevent further irreversible cardiac damage.     

DAF/Crry double deficiency in mice exacerbates nephrotoxic serum-induced proteinuria despite markedly reduced systemic complement activity

Decay-accelerating factor (DAF) and complement receptor 1-related gene/protein y (Crry) are two membrane-anchored complement regulatory proteins in rodent. Although both proteins are broadly distributed and exert complement regulation at the same steps of the complement cascade, DAF knockout mice are viable whereas Crry knockout mice die in utero as a result of maternal complement attack. The latter outcome has prevented the dissection of overlapping functions of DAF and Crry in adult mouse tissues in vivo. By crossing female DAF(-/-)/Crry(-/-)/C3(-/-) mice with male DAF(-/-)/Crry(+/-)/C3(+/-) mice, we circumvented maternal complement attack during fetal development and generated viable DAF(-/-)/Crry(-/-)/C3(+/-) mice to address the consequence of DAF/Crry double deficiency. DAF(-/-)/Crry(-/-)/C3(+/-) mice were born at the expected frequency and survived to adulthood. However, they were found to have greatly reduced systemic complement activity due, at least in part, to spontaneous C3 activation and consumption. Plasma C3 proteins in DAF(-/-)/Crry(-/-)/C3(+/-) mice were 30% of that of wild-type mice, and serum complement activity, as assessed by zymosan and immune complex C3 opsonization assays, was 90% reduced in DAF(-/-)/Crry(-/-)/C3(+/-) mice. Remarkably, despite greatly reduced systemic complement activity, DAF(-/-)/Crry(-/-)/C3(+/-) mice developed more severe proteinuria after induction of nephrotoxic serum nephritis as compared with DAF(-/-)/Crry(+/-)/C3(+/-) and DAF(-/-)/Crry(-/-)/C3(-/-) littermate controls. The results highlight the critical and overlapping role of Crry and DAF in vivo in preventing complement activation and tissue injury.     

Case series about ex vivo identification of squamous cell carcinomas by laser-induced autofluorescence and Fourier transform infrared spectroscopy

An ex vivo case series aimed at identification of normal laryngeal tissue from laryngeal epidermoid squamous keratinized carcinoma by measuring laser-induced autofluorescence (LIAF) and Fourier transform infrared–attenuated total reflectance (FTIR-ATR) spectra is presented. The case series results were obtained for paired samples extracted from three patients (exclusion: macroscopic changes of normal vocal cord observed during surgery; surgical intervention on vocal cord, treated only with chemotherapy or radiotherapy for carcinoma; inclusion: men, aged 57–68, non-smokers). For LIAF analysis, a 375-nm picosecond pulsed laser diode with 31 MHz pulse repetition rate, 100 ps full-time width at half-maximum, and average power 0.49 μW was used. LIAF and FTIR-ATR spectra show noticeable differences between normal and malignant tissues. LIAF spectra differed in shape of emitted band, peak position, and band relative intensity of the two kinds of samples, evidencing hypsochromic shift and mean fluorescence intensity decrease of (75.42?±?3)% in malignant tissue with respect to the normal one. The lack of 1745 cm^?1 band in FTIR-ATR spectra for malignant tissues could be considered an important indicative of the presence of this kind of tissue; moreover, it resulted a greater contribution of lipids and proteins in normal tissue and of collagen in malignant tissue. Penetration depth of the evanescent wave was about 2 μm at an angle of 42°. The two spectroscopic methods are complementary, are applicable for real-time measurements, and may enhance cancer detection and diagnostics. Results presented in this study evidence the potential of the two methods for future in vivo studies.     

Duration of antibiotic therapy for critically ill patients with bloodstream infections: A retrospective cohort study

BACKGROUND:

The optimal duration of antibiotic treatment for bloodstream infections is unknown and understudied.

METHODS:

A retrospective cohort study of critically ill patients with bloodstream infections diagnosed in a tertiary care hospital between March 1, 2010 and March 31, 2011 was undertaken. The impact of patient, pathogen and infectious syndrome characteristics on selection of shorter (≤10 days) or longer (>10 days) treatment duration, and on the number of antibiotic-free days, was examined. The time profile of clinical response was evaluated over the first 14 days of treatment. Relapse, secondary infection and mortality rates were compared between those receiving shorter or longer treatment.

RESULTS:

Among 100 critically ill patients with bloodstream infection, the median duration of antibiotic treatment was 11 days, but was highly variable (interquartile range 4.5 to 17 days). Predictors of longer treatment (fewer antibiotic-free days) included foci with established requirements for prolonged treatment, underlying respiratory tract focus, and infection with Staphylococcus aureus or Pseudomonas species. Predictors of shorter treatment (more antibiotic-free days) included vascular catheter source and bacteremia with coagulase-negative staphylococci. Temperature improvements plateaued after the first week; white blood cell counts, multiple organ dysfunction scores and vasopressor dependence continued to decline into the second week. Among 72 patients who survived to 10 days, clinical outcomes were similar between those receiving shorter and longer treatment.

CONCLUSION:

Antibiotic treatment durations for patients with bloodstream infection are highly variable and often prolonged. A randomized trial is needed to determine the duration of treatment that will maximize cure while minimizing adverse consequences of antibiotics.