Indigenous microbiota protects development of medication-related osteonecrosis induced by periapical disease in mice / 国际口腔科学杂志·英文版

Bacterial infection is a common finding in patients, who develop medication-related osteonecrosis of the jaw (MRONJ) by the long-term and/or high-dose use of anti-resorptive agents such as bisphosphonate (BPs). However, pathological role of bacteria in MRONJ development at the early stage remains controversial. Here, we demonstrated that commensal microbiota protects against MRONJ development in the pulp-exposed periapical periodontitis mouse model. C57/BL6 female mice were treated with intragastric broad-spectrum antibiotics for 1 week. Zoledronic acid (ZOL) through intravenous injection and antibiotics in drinking water were administered for throughout the experiment. Pulp was exposed on the left maxillary first molar, then the mice were left for 5 weeks after which bilateral maxillary first molar was extracted and mice were left for additional 3 weeks to heal. All mice were harvested, and cecum, maxilla, and femurs were collected. ONJ development was assessed using μCT and histologic analyses. When antibiotic was treated in mice, these mice had no weight changes, but developed significantly enlarged ceca compared to the control group (CTL mice). Periapical bone resorption prior to the tooth extraction was similarly prevented when treated with antibiotics, which was confirmed by decreased osteoclasts and inflammation. ZOL treatment with pulp exposure significantly increased bone necrosis as determined by empty lacunae and necrotic bone amount. Furthermore, antibiotics treatment could further exacerbate bone necrosis, with increased osteoclast number. Our findings suggest that the commensal microbiome may play protective role, rather than pathological role, in the early stages of MRONJ development.

Living with hypertension: a qualitative research

Background: Hypertension affects many aspects of the patients' life. Factors such as attitudes, beliefs and experiences, and social and cultural conditions of patients have effective roles in hypertension treatment process. The aim of this research was to explore perspectives and experiences of patients with hypertension while living with this disease

Methods: This is a qualitative research using content analysis approach. 27 hypertensive patients who referred to hospitals affiliated to Tehran University of Medical Sciences were selected based on purposive sampling, and semi-structured interviews were carried out. Graneheim and Lundman's approach was used for analysis of data and Lincoln and Guba's criteria were used to confirm the trustworthiness of the study's findings

Results: Experiences of the participants were divided into three main categories as follows: [1] disease shadow; [2] dual understanding of the effect of drug therapy consisting of two sub-categories known as ''perceived benefits,'' ''negative consequences''; and [3] facing the disease that includes the two subcategories of ''Compatibility'' and ''Negligence and denial''

Conclusion: Based on the findings, patients with hypertension had experienced many physical, psychological, social, familial and spiritual problems due to the disease and their cultural context. These patients obtained positive experiences following the compatibility with hypertension. Comprehensive planning tailored to the cultural, social context and their beliefs is necessary to solve problems in these patients

Serum Antibodies against Helicobacter pylori Neutrophil Activating Protein in Carriers of IL-4 C-590T Genetic Polymorphism Amplify the Risk of Gastritis and Gastric Cancer

Background: Gastric cancer arises, mainly, on an inflammatory background. Helicobocter pylori neutrophil activating [HP-NAP] protein functions as a potent pro-inflammatory mediator. Similarly, IL-4 plays a critical role in the inflammation pathway, the levels of which are altered by C to T transition at position -590 in its promoter region. Here, we have aimed to assess the risk of gastritis and gastric cancer in the co-presence of these two inflammation modulating mediators

Methods: Gastritis [n=58] and gastric cancer [n=31] patients were evaluated and compared with H. py/or/-positive asymptomatic controls [n=46], for serum antibodies against recombinant HP-NAP and IL-4 C-590T single nucleotide polymorphism using immunoblotting and PCR-RFLP, respectively. Multivariable logistic regression, adjusting for age, gender and ethnicity, was used for data analysis

Results: In terms of susceptibility to gastritis, seropositivity to HP-NAP projected a risk impact of 4.62 fold [OR=4.62, 95% Cl=l.50-14.22], which when present in IL-4 -590 T carriers augmented the risk up to 9.7 fold [OR=9.70, 95% CI=2.06-45.69]

A similar pattern, but of a stronger magnitude, occurred for the risk of gastric cancer, which was estimated at 9.07 fold [OR=9.07, 95% Cl=1.99-42.0] for HP-NAP-seropositive subjects and was drastically amplified [OR=33.64, 95% 0=2.06-548.68], when double-positive [HP-NAP seropositive/IL-4 -590 T carrier] subjects were examined against double negatives [HP-NAP seronegative/IL-4 -590 CC]

Conclusion: Our preliminary data indicate that serum antibodies against HP-NAP represent a state of risk, which is further exacerbated in IL-4 -590 T carriers. These biomarkers, if validated in larger prospective studies, can be used to screen for gastric cancer susceptibility

Age-specific gastric cancer risk indicated by the combination of Helicobacter pylori sero-status and serum pepsinogen levels

Serologic screening of gastric cancer [GC] by serum pepsinogens [sPG] levels and Helicobacter pylori [Hp] sero-status, though highly informative, has provided heterogeneous results. Here, we have evaluated the modifying effects of demographic factors on the risk impact of Hp sero-status/sPG levels in gastric cancer, with particular emphasis on age. A cross-sectional study was carried out on 1341 individuals [GC = 578, healthy = 763], who were stratified into two age groups: 35-59 years [middle-aged, n = 830] and >/= 60 years [60 years-plus, n = 511]. Demographic factors and serological states [Hp sero-staus and sPG levels] were recorded by subject interview and serum ELISAs, respectively. Covariate-specific odds ratios were calculated by multivariable logistic regression. Hp infection was consistently associated with increased sPGI and sPGII levels in the 60 year-plus, but not the middle-aged group. The joint examination of the variable states of the three serum biomarkers [Hp serology, sPGI, and sPGI/II ratio], in the 60 year-plus age group, demonstrated a stepwise escalation of risk from the single [sPGI[low]; OR = 2.6], to double [sPGI[low]/sPGI/II[low]; OR = 3.55, and Hp[positive]/sPGI[low]; OR = 5.0] and ultimately triple [Hp[positive]/PGI[low]/PGI/II[low]; OR = 10.48] positive states, in reference to the triple negatives. However, this pattern was not exhibited in the middle-aged subjects. Age was clearly identified as a modifying factor on the risk projection of the combined states of Hp serology and sPG levels in gastric cancer screening, reflected by the augmented [tilde10.5 fold] risk of GC in the triple positive [Hp[positive]/sPGI[low]/sPGI/II[low]] 60 year-plus subjects, which was not evident in the middle-aged group

An exemplar university professor from students' perspective in Tehran University of Medical Sciences: a qualitative study

Universities should play an important role in education commensurate with the expectations of stakeholders and of the community as well. The university professors and teachers have critical positions in education. This research aimed to explore the perspective of students in Tehran University of Medical Sciences [TUMS] about characteristics of a model teacher. Inductive qualitative content analysis was used to explore students' perspective based on naturalistic philosophy. The participants in this study were 19 students who were enrolled in various courses at TUMS. To collect data, semi-structured in-depth individual interviews were used. Findings were analyzed using conventional content analysis approach. The results of the study led to the identification of three main themes: teacher's science, moral imperatives in education, and communication with students. The first and third theme had a subtheme called science and oration and flexibility of classroom atmosphere. Regarding a considerable proportion of family caregivers of patients with heart failure were suspected cases of mental health disorders, routine assessment of mental health in this group of caregivers should be consider to identify those at risk, also clinical team should design and implement effective programs aimed at improving the mental health especially in caregiver who provide care for younger patients

Significance of Attending to Instrument Planning and Validation Stages in Nursing Discipline

No abstract available.