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Medical Sciences	100%

Selected Abstracts

Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2006
T. R. Sissener
Objectives: To evaluate the effect of short duration 1 per cent clotrimazole flush when combined with 1 per cent clotrimazole cream instilled into the frontal sinuses for the treatment of nasal aspergillosis in 14 dogs. Methods: Fourteen dogs with clinical, radiological, serological and rhinoscopic findings consistent with nasal aspergillosis were treated by frontal sinus trephination and a short, five-minute flushing of 1 per cent topical clotrimazole solution followed by a 1 per cent clotrimazole cream instilled as a depot agent. Results: Twelve of the 14 dogs (86 per cent) responded well to treatment and either had no clinical signs after treatment or had signs consistent with mild rhinitis during a minimum follow-up period of six months. Only one dog required multiple treatments. Treatment was well tolerated by all patients, with minimal complications. Clinical Significance: This treatment compares favourably to previously published data using one-hour topical clotrimazole or enilconazole flushing treatment protocols. The treatment technique significantly reduced treatment time under anaesthesia. [source]

A prospective study on downstaging of hepatocellular carcinoma prior to liver transplantation,

LIVER TRANSPLANTATION, Issue 12 2005
Francis Y. Yao
In patients with hepatocellular carcinoma (HCC) exceeding conventional (T2) criteria for orthotopic liver transplantation (OLT), the feasibility and outcome following loco-regional therapy intended for tumor downstaging to meet T2 criteria for OLT are unknown. In this first prospective study on downstaging of HCC prior to OLT, the eligibility criteria for enrollment into a downstaging protocol included 1 lesion >5 cm and ,8 cm, 2 or 3 lesions at least 1 >3 cm but ,5 cm with total tumor diameter of ,8 cm, or 4 or 5 nodules all ,3 cm with total tumor diameter ,8 cm. Patients were eligible for living-donor liver transplantation (LDLT) if tumors were downstaged to within proposed University of California, San Francisco (UCSF) criteria.13 A minimum follow-up period of 3 months after downstaging was required before cadaveric OLT or LDLT, with imaging studies meeting criteria for successful downstaging. Among the 30 patients enrolled, 21 (70%) met criteria for successful downstaging, including 16 (53%) who had subsequently received OLT (2 with LDLT), and 9 patients (30%) were classified as treatment failures. In the explant of 16 patients who underwent OLT, 7 had complete tumor necrosis, 7 met T2 criteria, but 2 exceeded T2 criteria. No HCC recurrence was observed after a median follow-up of 16 months after OLT. The Kaplan-Meier intention-to-treat survival was 89.3 and 81.8% at 1 and 2 yr, respectively. In conclusion, successful tumor downstaging can be achieved in the majority of carefully selected patients, but longer follow-up is needed to further access the risk of HCC recurrence after OLT. (Liver Transpl 2005;11:1505,1514.) [source]

Interventions for treating traumatized permanent front teeth: avulsed (knocked out) and replanted

AUSTRALIAN DENTAL JOURNAL, Issue 2 2010
P Day
Background:, Dental trauma is common. One of the most severe injuries is when a permanent tooth is knocked completely out (avulsed) of the mouth. In most circumstances the tooth should be replanted as quickly as possible. There is uncertainty on how best to prepare teeth for replantation. Objectives:, To compare the effects of a range of interventions for managing traumatized permanent teeth with avulsion injuries. Search strategy:, The Cochrane Oral Health Group's Trials Register (to 28th October 2009); CENTRAL (The Cochrane Library 2009, Issue 4); MEDLINE (1950 to October 2009); EMBASE (1980 to October 2009); http://www.clinicaltrials.gov/;www.controlled-trials.com/ and reference lists of articles were searched. There were no language restrictions. Selection criteria:, Only randomized controlled trials (RCTs), that included a minimum follow-up period of 12 months, for interventions for avulsed and replanted permanent teeth were considered. Data collection and analysis:, Two review authors independently extracted data and assessed trial quality and the risk of bias in studies to be included. Main results:, Three studies, involving a total of 162 patients and 231 teeth were identified. Study one (with a high risk of bias) investigated the effect of extra-oral endodontics. This showed no significant difference in radiographic resorption compared with intra-oral endodontics provided at week 1 for teeth avulsed for longer than 60 minutes dry time. Study two (which had a moderate risk of bias) investigated a 10-minute soaking in thymosin alpha 1 prior to replantation and then its further use as a daily gingival injection for the first 7 days. They reported a strong benefit at 48 months (14% with periodontal healing in the control group versus 77% for the experimental group). Study three (with a high risk of bias) investigated a 20-minute soaking with gentamycin sulphate (4 × 107 U/L) for both groups prior to replantation and then the use of hyperbaric oxygen daily in the experimental group for 80 minutes for the first 10 days. They reported a strong benefit at 12 months (43% periodontal healing versus 88% for the experimental group). There was no formal reporting of adverse events. Authors' conclusions:, The available evidence suggests that extra-oral endodontics is not detrimental for teeth replanted after more than 60 minutes dry time. Studies with moderate/high risk of bias indicate that soaking in thymosin alpha 1 and gentamycin sulphate followed by hyperbaric oxygen may be advantageous. However, they have not previously been reported as interventions for avulsed teeth and need further validation. More evidence with low risk of bias is required and, with the low incidence of avulsed teeth, collaborative multicentre trials are indicated. Plain language summary:, Treatments for managing knocked out and replanted front teeth. Injuring your front teeth during childhood is common. One of the most severe injuries occurs when the tooth is knocked totally out of the mouth (avulsed). Often the best option is to replant the tooth as quickly as possible. This is true only for permanent teeth. Once replanted the tooth can heal in two ways if managed correctly. Ideally the ligament around the root reforms and the tooth can be expected to last as long as any other tooth; this is known as ,periodontal healing'. When there is too much damage to the ligament, healing occurs by bony replacement and the tooth is replaced by bone and lost over a few years. This is called ,bony healing'. Bony healing causes significant problems in the medium term for children and treatments for this are the subject of a different Cochrane review. A missing front upper tooth or teeth, as a result of not replanting an avulsed tooth or as a treatment for bony healing, can have a major effect on dental and facial ,good looks'. This can affect the individual's self-esteem and general social interaction, as well as how others think and see them. This Cochrane review investigated what treatments encourage the tooth to repair by periodontal healing. Three studies were found. The benefits of these treatments require further investigation before specific medicaments can be advised. This is because the studies had weakness in their design which may have influenced the benefits they found. The following general treatment principle can be concluded which reinforces current treatment guidelines: For teeth with little chance of periodontal healing, a root canal treatment can be carried out before the tooth is replanted without further detrimental effects. [source]

Potential biomarkers involving IKK/RelA signal in early stage non-small cell lung cancer

CANCER SCIENCE, Issue 3 2008
Xianqing Jin
The clinical relevance of nuclear factor ,B (NF-,B) and its regulatory molecules on prognosis of patient with early stages of non-small cell lung cancer (NSCLC), remains unclear. Therefore, we conducted biomarker analyses with survival in patients with stages I and II NSCLC. Tumor samples were collected from 88 patients with early-stage NSCLC (stages I, II). A minimum follow-up period of 5 years was required. RelA, phosphorylated I,B (pI,B,), pIKK,/, were detected by immunostaining. NF-,B DNA binding activity was assessed by electrophoretic mobility shift assay. Association of clinical and pathologic variables (e.g. sex, age, pathologic stage) with relevant molecules was determined by Pearson's ,2 test or Fisher's exact test. Survival analysis based on single expression of RelA, pI,B,, pIKK,/, as well as composite expressions were evaluated using Cox proportional hazards regression models, and log rank test followed Kaplan-Meier estimates. RelA, pI,B,, pIKK,/, were observed as increased expression in NSCLC tissues compared with adjacent normal tissues and normal lung tissues. These molecules were associated with tumor-node-metastasis stages, T stages and histological status, respectively. Among the molecules analyzed, RelA and pI,B,-positive were statistically significant predictors of patient death in the entire patient population adjusted by age, gender and smoking status; furthermore both RelA and pI,B,-positive was the strongest prognostic indicators of poor prognosis by univariate and multivariate analyses. Borderline positive correlations were observed between RelA and pI,B, or pIKK,/, expression. In this cohort of early-stage NSCLC patients, molecular markers, especially composite application of multiple biomarkers (both nuclear RelA and cytoplasmic pI,B-, expression) that independently predict overall survival have been identified. (Cancer Sci 2008; 99: 582,589) [source]