Experimental considerations of acute heat stress assays to quantify coral thermal tolerance.

Understanding the distribution and abundance of heat tolerant corals across seascapes is imperative for predicting responses to climate change and to support novel management actions. Thermal tolerance is variable in corals and intrinsic and extrinsic drivers of tolerance are not well understood. Traditional experimental evaluations of coral heat and bleaching tolerance typically involve ramp-and-hold experiments run across days to weeks within aquarium facilities with limits to colony replication. Field-based acute heat stress assays have emerged as an alternative experimental approach to rapidly quantify heat tolerance in many samples yet the role of key methodological considerations on the stress response measured remains unresolved. Here, we quantify the effects of coral fragment size, sampling time point, and physiological measures on the acute heat stress response in adult corals. The effect of fragment size differed between species (Acropora tenuis and Pocillopora damicornis). Most physiological parameters measured here declined over time (tissue colour, chlorophyll-a and protein content) from the onset of heating, with the exception of maximum photosynthetic efficiency (Fv/Fm) which was surprisingly stable over this time scale. Based on our experiments, we identified photosynthetic efficiency, tissue colour change, and host-specific assays such as catalase activity as key physiological measures for rapid quantification of thermal tolerance. We recommend that future applications of acute heat stress assays include larger fragments (> 9 cm2) where possible and sample between 10 and 24 h after the end of heat stress. A validated high-throughput experimental approach combined with cost-effective genomic and physiological measurements underpins the development of markers and maps of heat tolerance across seascapes and ocean warming scenarios.

Assessing the role of historical temperature regime and algal symbionts on the heat tolerance of coral juveniles.

The rate of coral reef degradation from climate change is accelerating and, as a consequence, a number of interventions to increase coral resilience and accelerate recovery are under consideration. Acropora spathulata coral colonies that survived mass bleaching in 2016 and 2017 were sourced from a bleaching-impacted and warmer northern reef on the Great Barrier Reef (GBR). These individuals were reproductively crossed with colonies collected from a recently bleached but historically cooler central GBR reef to produce pure and crossbred offspring groups (warm-warm, warm-cool and cool-warm). We tested whether corals from the warmer reef produced more thermally tolerant hybrid and purebred offspring compared with crosses produced with colonies sourced from the cooler reef and whether different symbiont taxa affect heat tolerance. Juveniles were infected with Symbiodinium tridacnidorum, Cladocopium goreaui and Durusdinium trenchii and survival, bleaching and growth were assessed at 27.5°C and 31°C. The contribution of host genetic background and symbiont identity varied across fitness traits. Offspring with either both or one parent from the northern population exhibited a 13- to 26-fold increase in survival odds relative to all other treatments where survival probability was significantly influenced by familial cross identity at 31°C but not 27.5°C (Kaplan-Meier P=0.001 versus 0.2). If in symbiosis with D. trenchii, a warm sire and cool dam provided the best odds of juvenile survival. Bleaching was predominantly driven by Symbiodiniaceae treatment, where juveniles hosting D. trenchii bleached significantly less than the other treatments at 31°C. The greatest overall fold-benefits in growth and survival at 31°C occurred in having at least one warm dam and in symbiosis with D. trenchii Juveniles associated with D. trenchii grew the most at 31°C, but at 27.5°C, growth was fastest in juveniles associated with C. goreaui In conclusion, selective breeding with warmer GBR corals in combination with algal symbiont manipulation can assist in increasing thermal tolerance on cooler but warming reefs. Such interventions have the potential to improve coral fitness in warming oceans.This article has an associated First Person interview with the first author of the paper.

Moderate to severe hidradenitis suppurativa patients do not have an altered bacterial composition in peripheral blood compared to healthy controls.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous skin. Patients with HS often report an array of systemic symptoms such as fatigue and malaise. The aetiology of these symptoms remains unclear. Previously, various bacteria have been associated with mature HS lesions, and bacteraemia has been reported in patients with HS using traditional culturing methods. Thus, we hypothesized that a low-grade bacteraemia contributes to the symptomatology in patients with HS. OBJECTIVE: To explore the potential presence of bacteraemia in patients with HS and healthy controls. METHOD: A case-control study. Compositions of bacteria in the blood of 27 moderate to severe HS patients and 26 healthy controls were investigated using next-generation 16S ribosomal RNA gene sequencing (NGS) and routine anaerobic and aerobic blood culturing. None of the participants received any antibiotics (systemic or topical therapy) within 1 month prior to the study. HS patients with a recent flare were randomly selected by consecutive recruitment of eligible patients from the Department of Dermatology, Zealand University Hospital, Denmark. Healthy controls were recruited from the University of Copenhagen as well as from the healthcare staff. RESULTS: The different bacterial compositions were investigated using NGS and traditional anaerobic and aerobic blood culturing. Our NGS analysis provided a previously unreported characterization of the bacterial composition in peripheral blood from patients with HS and healthy controls. Overall, our data demonstrated that patients with HS do not have a different bacterial composition in their peripheral blood than healthy controls. CONCLUSION: The study suggests that the self-reported symptoms in HS such as malaise and fatigue may not be linked to bacteraemia.

The occurrence of biofilm in an equine experimental wound model of healing by secondary intention.

In humans, biofilm is a well-known cause of delayed healing and low-grade inflammation of chronic wounds. In horses, biofilm formation in wounds has been studied to a very limited degree. The objective of this study was thus to investigate the occurrence of biofilm in equine experimental wounds healing by secondary intention. Tissue biopsies from non-contaminated, experimental excisional shoulder and limb wounds were obtained on day 1-2, day 7-10 and day 14-15 post-wounding. Limb wounds were either un-bandaged or bandaged to induce exuberant granulation tissue (EGT) formation and thereby impaired healing. Presence of biofilm in tissue biopsies was assessed by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) and confocal laser scanning microscopy (CLSM). Bandaged limb wounds developed EGT and displayed delayed healing, while shoulder and un-bandaged limb wounds healed normally. Biofilm was detected in limb wounds only. At day 14-15 biofilm was significantly more prevalent in bandaged limb wounds than in un-bandaged limb wounds (P=0.003). Further, bandaged limb wounds had a statistically significant increase in biofilm burden from day 7-10 to day 14-15 (P=0.009). The finding that biofilm was most prevalent in bandaged limb wounds with EGT formation suggests that biofilm may be linked to delayed wound healing in horses, as has been observed in humans. The inability to clear bacteria could be related to hypoxia and low-grade inflammation in the EGT, but the interaction between biofilm forming bacteria and wound healing in horses needs further elucidation.

Bacterial biofilm in chronic lesions of hidradenitis suppurativa.

BACKGROUND: Chronic nonhealing or recurrent inflammatory lesions, reminiscent of infection but recalcitrant to antibiotic therapy, generally characterize biofilm-driven diseases. Chronic lesions of hidradenitis suppurativa (HS) exhibit several characteristics, which are compatible with well-known biofilm infections. OBJECTIVES: To determine and quantify the potential presence of bacterial aggregates in chronic HS lesions. METHODS: In 42 consecutive patients with HS suffering from chronic lesions, biopsies were obtained from lesional as well as from perilesional skin. Samples were investigated using peptide nucleic acid-fluorescence in situ hybridization in combination with confocal laser scanning microscopy. In addition, corresponding histopathological analysis on haematoxylin and eosin slides was performed. RESULTS: Biofilms were seen in 67% of the samples of chronic lesions and in 75% of the perilesional samples. The mean diameter of aggregates in lesional skin was significantly greater than in perilesional skin (P = 0·01). Large biofilms (aggregates > 50 µm in diameter) were found in 42% of lesional samples and in only 5% of the perilesional samples (P = 0·009). The majority of the large biofilms were situated in sinus tracts (63%) or in the infundibulum (37%). The majority of the sinus tract samples (73%) contained active bacterial cells, which were associated with inflammation. CONCLUSIONS: This study suggests that biofilm formation is associated with inflammation of chronic HS lesions. The aggregates most likely occur as a secondary event, possibly due to predisposing local anatomical changes such as sinus tracts (tunnels), keratinous detritus and dilated hair follicles.

Microsatellite allele sizes alone are insufficient to delineate species boundaries in Symbiodinium.

Symbiodinium are a diverse group of unicellular dinoflagellates that are important nutritional symbionts of reef-building corals. Symbiodinium putative species ('types') are commonly identified with genetic markers, mostly nuclear and chloroplast encoded ribosomal DNA regions. Population genetic analyses using microsatellite loci have provided insights into Symbiodinium biogeography, connectivity and phenotypic plasticity, but are complicated by: (i) a lack of consensus criteria used to delineate inter- vs. intragenomic variation within species; and (ii) the high density of Symbiodinium in host tissues, which results in single samples comprising thousands of individuals. To address this problem, Wham & LaJeunesse (2016) present a method for identifying cryptic Symbiodinium species from microsatellite data based on correlations between allele size distributions and nongeographic genetic structure. Multilocus genotypes that potentially do not recombine in sympatry are interpreted as secondary 'species' to be discarded from downstream population genetic analyses. However, Symbiodinium species delineations should ideally incorporate multiple physiological, ecological and molecular criteria. This is because recombination tests may be a poor indicator of species boundaries in Symbiodinium due to their predominantly asexual mode of reproduction. Furthermore, discontinuous microsatellite allele sizes in sympatry may be explained by secondary contact between previously isolated populations and by mutations that occur in a nonstepwise manner. Limitations of using microsatellites alone to delineate species are highlighted in earlier studies that demonstrate occasional bimodal distributions of allele sizes within Symbiodinium species and considerable allele size sharing among Symbiodinium species. We outline these issues and discuss the validity of reinterpretations of our previously published microsatellite data from Symbiodinium populations on the Great Barrier Reef (Howells et al. 2013).

Identification of 17 novel mutations in 40 Argentinean unrelated families with mucopolysaccharidosis type II (Hunter syndrome).

Mucopolysaccharidosis type II (MPSII) is an X-linked lysosomal storage disorder caused by deficiency of the enzyme iduronate-2-sulfatase (IDS). The human IDS gene is located in chromosome Xq28. This is the first report of genotype and phenotype characterization of 49 Hunter patients from 40 families of Argentina. Thirty different alleles have been identified, and 57% were novel. The frequency of de novo mutations was 10%. Overall, the percentage of private mutations in our series was 75%.

Pacientes con sospecha de errores congéntitos del metabolismo: evaluación de la consulta a distancia en el marco del programa de referencia y contrarreferencia / Patients with suspected inborn errors of metabolism: evaluation of distance consultation within the framework of the referral/counter-referral program

Introducción: Los Errores Congénitos del Metabolismo (ECM) son enfermedades poco frecuentes, que para su diagnóstico requieren de especialistas y laboratorios específicos no disponibles en todo el país. El programa de referencia/contra-referencia del Hospital Garrahan ofrece la posibilidad de realizar consultas a través de la Oficina de Comunicación a Distancia (OCD). Objetivos: Evaluar la consulta de pacientes con sospecha de ECM en el marco del programa de referencia/contra-referencia. Comparar estas consultas con las efectuadas en forma presencial. Establecer indicadores de impacto y eficiencia asistencial para estas poblaciones. Explorar la calidad de las consultas a distancia y la percepción del consultante en relación a la respuesta obtenida. Metodología: Estudio prospectivo, observacional y comparativo.Unidad de estudio: consultas hechas a través de la OCD y consultas presenciales realizadas al servicio de ECM desde el 1 de julio de 2010 hasta el 15 de mayo de 2011. Se excluyeron las consultas sin intermediario médico y las motivadas por una pesquisa neonatal patológica. Resultados: Se realizaron 142 consultas a ECM a través de la OCD y 254 a través de otras vías de consulta presencial. El tiempo para responder a las consultas por OCD fue de X 30 hs (mediana 24,2 hs) y para las consultas presenciales (en pacientes internados: X 153,6 hs y mediana 48 hs y en pacientes ambulatorios X 1010 hs, mediana 216 hs). No hubo diferencia significativa entre ambos grupos en diagnósticos realizados (RR 0,58; IC: 0,29-1,14) ni en el tiempo necesario para alcanzar o descartar ECM (log rank test p 0,18). Tampoco hubo diferencias en la mortalidad de ambos grupos (RR: 1,1 IC 0,12-9,44). Conclusiones: La OCD es una forma eficiente de consulta al servicio de ECM con rápida respuesta del especialista,que permite diagnosticar o descartar ECM con frecuencia similar a las consultas por otras vías de consultas.

Introduction: Inborn errors of metabolism (IEM) are rare dis-eases. For the diagnosis they require specialists and special-ized laboratories which are not widely available in the country. The referral/counter-referral program of the Garrahan Hospital provides the possibility of consultation with specialists through the Office of Outreach Communication (OOC). Objectives: To evaluate consultations of patients with a suspected IEM within the framework of the referral/counter-referral program and to compare them with those of patients seen at the hospital; to determine impact and efficiency of care indicators for this patient population; to assess the quality of these distance consultations and how the response is perceived by the con-sulting physician. Methodology: A prospective, observational, and comparative study was conducted. Study subject: Con-sultations made through the OOC and consultations made at the service of IEM between July 1, 2010 and May 15, 2011. Consultations that were not made by a physician or those made following neonatal screening were excluded. Results: 142 consultations for IEM were made through the OOC and 254 were made directly at the service of IEM. Mean time to respond to consultations through the OOC was 30 hours (me-dian 24.2 hours) and mean time to respond to consultations at the service of IEM was 153.6 hours (median 48 hours) for inpatients and 1010 hours (median 216 hours) for outpatients. No significant difference was found in diagnoses made (RR 0.58; CI: 0.29-1.14) or in time needed to reach a diagnosis of or rule out IEM (log-rank test p=0.18) between both groups. There were no differences found in mortality between both groups (RR: 1.1; CI: 0.12-9.44). Conclusions: The OOC is an efficient tool for consultation at the service of IEM with a fast response by the specialist allowing to diagnose or rule out IEM with a response rate similar to other forms of consultation.

A multilocus, temperature stress-related gene expression profile assay in Acropora millepora, a dominant reef-building coral.

We report an accurate multiplex reverse transcription quantitative polymerase chain reaction (RT-qPCR) assay, capable of reproducing gene expression profiles from 16 target genes [12 genes of interest (GOIs) and four reference genes (RGs)] in Acropora millepora, a common reef-building model coral species. The 12 GOIs have known or putative roles in the coral bleaching response, yet the method is not restricted to this particular assay and gene set. The procedure is based on the Beckman Coulter (Fullerton, CA, USA) GenomeLab™ GeXP Genetic Analysis System and bridges the gap between quantitative real-time PCR (qPCR) expression analysis of a single or a small number of genes and microarray gene expression surveys of thousands of genes. Despite large variation among biological replicates, the majority of GOIs were up-regulated (up to 4000%) in most colonies during a laboratory-based thermal stress experiment. Two genes, Nf-kß2 and MnSod, were consistently up-regulated in all colonies tested, and we therefore propose these as candidate markers useful for population-level evaluations of thermal stress. Our assay provides an important new tool for coral bleaching studies; because of the lower cost, labour and amount of cDNA required compared with singleplex qPCR, population-level studies with large biological replication are feasible.

Complex diel cycles of gene expression in coral-algal symbiosis.

Circadian regulation of plant-animal endosymbioses is complicated by a diversity of internal and external cues. Here, we show that stress-related genes in corals are coupled to the circadian clock, anticipating major changes in the intracellular milieu. In this regard, numerous chaperones are "hard-wired" to the clock, effectively preparing the coral for the consequences of oxidative protein damage imposed by symbiont photosynthesis (when O(2) > 250% saturation), including synexpression of antioxidant genes being light-gated. Conversely, central metabolism appears to be regulated by the hypoxia-inducible factor system in coral. These results reveal the complexity of endosymbiosis as well as the plasticity regulation downstream of the circadian clock.

Pesquisa de trastornos alimentarios en jóvenes con diabetes tipo 1: estudio comparativo con población normal / Screening of eating disorders in adolescents with type 1 diabetes: a comparative study with a normal control group

Objetivo Pesquisar Trastornos alimentarios (TA) en fase preclínica en jóvenes con Diabetes Mellitus Insulinodependiente (DMID), comparar los resultados con población control (PC) sana del estudio de la Sociedad Argentina de Pediatría (SAP) Identificar la asociación con factores metabólicos y medio-ambientales. Métodos: Entre 12/2001 y 8/2003 pediatras diabetólogos de 13 centros del país encuestaron a 270 pacientes con DMID de ambos sexos de 10 a 19a. Se utilizaron como instrumentos el EDEQ (Questionary Eating Disorders Examination), modificado con 40 preguntas y 5 subescalas, para detectar pacientes sospechosos de TA y el EDE12 para la confirmación diagnóstica. El diagnóstico de TA se basó en el DSM-IV. Se tomó una encuesta demográfica y control metabólico de los pacientes diabéticos y se evaluó antropometría (Peso, Talla, Índice de Masa Corporal (IMC)). Los resultados se compararon con 1971 controles del estudio de la SAP evaluados de igual forma. Se aplicó Chi2, test de T, Test de Fisher, Anova. Un valor de p <0.05 se consideró significativo. Se utilizó el programa EpiInfo 6.04. Resultados: El 26.5% (72/270) fue sospechoso de tener TA vs. 19.2% (380/1971) de la PC (p=0.001). Encontramos 20% de varones diabéticos sospechosos que, comparados con la PC (12%) fue mayor (p=0.001). Encontramos mayor proporción de sospechosos entre las post-menárquicas (p 0.006), los pacientes con antecedentes de problemas alimentarios (p=0.001) y los que presentaron un IMC superior al Plo.90 (p=0.03). Completó el EDE-12 el 78% de los sospechosos (56/72) confirmando TA el 94.6% (53/56). Estos pacientes presentaron trastorno alimentario no especificado (TANE). De ellos, 48 (91%) llenaron criterio de trastorno compulsivo del comer (BED). No se diagnosticó ni anorexia nerviosa (AN) ni Bulimia nerviosa (BN). 15% (11) de los sospechosos manipuló insulina. La prevalencia de sobrepeso fue de 18.8% en diabéticos vs. 26.3% en PC (p NS) Conclusión: La frecuencia de sospecha de TA así como el diagnóstico de formas subclínicas es mayor que la encontrada en la PC y la citada por la literatura. El equipo tratante deberá estar alerta en especial en las púberes postmenárquicas, los pacientes con antecedentes de problemas alimentarios y aquellos con alto IMC (AU)

Objective: To screen eating disorders (ED) in the pre-clinical phase in adolescents with insulin-dependent diabetes mellitus (IDDM), to compare the results with a healthy control group (CG) of the Sociedad Argentina de Pediatría (SAP) study, and to identify associated metabolic and environmental factors. Methods: Between 12/2001 and 8/2003 pediatricians specialized in diabetes from 13 centers in Argentina interviewed 270 male and female patients with IDDM between 10 and 19 years. The QEDE (Questionnaire Eating Disorders Examination) was used, modified with 40 questions and 5 subscales, to detect patients with possible ED and the EDE12 to confirm the diagnosis. The diagnosis of ED was made using the DSM-IV. Demographic and anthropometric data (weight, height, body mass index (BMI)) were registered and the patients were metabolically controlled. The results were compared with the data of 1971 controls from the SAP study that were similarly assessed. Chi square test, T test, Fisher test, and Anova were used for the statistical analysis. A p value of <0.05 was considered significant. EpiInfo 6.04 was used. Results: Of the patients, 26.5% (72/270) was suspected of having an ED vs. 19.2% (380/1971) of the CG (p=0.001). Of the male IDDM patients, 20% was suspected of having an ED compared to 12% of the CG (p=0.001). We found a higher rate of suspected cases among post-menarche girls (p 0.006), patients with a history of eating disturbances (p=0.001), and those who had a BMI greater than the 90th percentile (p=0.03). Of the patients suspected of having an ED, 78% (56/72) filled out the EDE-12, confirming the ED in 94.6% of the cases (53/56). These patients presented with non-specified eating disorders (NOSED). Forty-eight 48 (91%) met the criteria of binge-eating disorder (BED). Neither anorexia nervosa (AN) nor bulimia nervosa (BN) was diagnosed. Fifteen percent (11) of those suspected having an ED manipulated insulin. The prevalence of overweight was 18.8% among the IDDM patients vs. 26.3% in the CG (p NS). Conclusion: Suspicion of ED and sub-clinical forms of ED was more frequent in the IDDM group than in the CG or than mentioned in the literature. The treating team should specially be alert in post-menarche adolescents, patients with a history of eating disturbances, and in those with a high BMI (AU)

Leuconostoc durionis sp. nov., a heterofermenter with no detectable gas production from glucose.

Three lactic acid bacterial (LAB) strains obtained from a Malaysian acid-fermented condiment, tempoyak (made from pulp of the durian fruit), showed analogous but distinct patterns after screening by SDS-PAGE of whole-cell proteins and comparison with profiles of all recognized LAB species. 16S rRNA gene sequencing of one representative strain showed that the taxon belongs phylogenetically to the genus Leuconostoc, with its nearest neighbour being Leuconostoc fructosum (98 % sequence similarity). Biochemical characteristics and DNA-DNA hybridization experiments demonstrated that the strains differ from Leuconostoc fructosum and represent a single, novel Leuconostoc species for which the name Leuconostoc durionis sp. nov. is proposed. The type strain is LMG 22556(T) (= LAB 1679(T) = D-24(T) = CCUG 49949(T)).

Prevalence of eating disorders in Argentine boys and girls, aged 10 to 19, who are in primary care. A two-stage community-based survey.

The objective of this paper is to describe the prevalence of eating disorders (ED) in Argentina, in a randomly assigned national community-based sample of 1,231 girls and 740 boys in primary care, aged 10 to 19.9. A two-stage design was followed; subjects were screened with a self-report measure (EDE-Q4), and diagnosed with an expert-based interview (EDE-120D). Height, weight and BMI were measured and five subscales of the SCL90-R were completed. More than one quarter (a 26.4%) of the sample had a BMI greater than the 90th percentile, and these accounted for 48% of the suspected cases of ED. Only 42% returned for the EDE-12 interview; diagnosis was confirmed for 137 cases (6.9% of the total sample): 6.6% BED; 0.05% BN, and 0.3% EDNOS other than BED. Binge eating and restraint of food intake related directly to BMI and purging behaviors were very rare. More subjects than expected were found to be overweight and this related directly to the diagnosed ED. Psychological distress was directly related the presence of eating disturbances.

Evaluación del estado nutricional en una población de niños internados en el Hospital Garrahan / Nutritional assessment of children hospitalized in Garrahan Pediatric Hospital

La malnutrición en la población hospitalizada se asocia con aumento de la mortalidad, complicaciones médicas, prolongación de la hospitalización y mayores costos. El objetivo del presente estudio fue conocer la prevalencia de malnutrición aguda y crónica en la población hospitalizada e identificar factores asociados. El estudio fue un corte transversal,, que incluyo a todos los pacientes internados en las salas de cuidados intermedios y moderados durante la semana del 12 al 19 de mayo del 2003. El diagnóstico nutricional se basó en métodos antropométricos, aplicando la clasificación de Waterloo modificada. La evaluación incluyó una encuesta administrada por el mismo médico que realizó la antropometría con datos de filiación y procedencia y con información sobre nivel de educación y actividad laboral de los padres, características de la vivienda , número de habitantes por cuarto, ingresos económicos, beneficios de planes sociales y cobertura social. Resultados: Fueron evaluados 198 pacientes con una edad media de 5,2 años más o menos 5, el 42,5% de los pacientes con compromiso nutricional: 19% malnutridos emaciados, 7,9% acortados y emaciados, 15,6% acortados y sobrepeso u obesidad el 11,7% de la población. De los niños con deficit de peso/talla (total 26,9%), el 12, 3% presentó un deficit leve, el 11,2% moderado y el 3,4% grave. 1 de acuerdo al nivel de ingreso las familias se clasificaron como indigentes (ingreso menor de $ 330 ): 43%; pobres (ingreso menor de $ 724) 37%; y con necesidades básicas satisfechas 20%. No se encontró asociación con variables sociales. Las variables biológicas que se asociaron con mayor frecuencia de malnutrición fueron la edad (p=0,04), la condición de cronocidad (p<0,01), y la duración de la internación mayor de 25 días (p=0.04%). En el subgrupo de pacientes evaluados co menos de 5 días de internados conpatologías agudas la frecuencia de malnutridos emaciados fue de 12,6%, de acortados 18,2, normales 60,6%, sobrepeso 9%.

Comparison of ready-to-use EMDOGAIN-gel and EMDOGAIN in patients with chronic adult periodontitis.

OBJECTIVES: The aim of this multicenter trial was to compare the clinical and radiographical outcome of a ready-to-use Emdogain-gel (test) with the marketed Emdogain (control). METHODS: Subjects with bilateral infrabony defects > or =4 mm deep and > or =2 mm wide according to radiographs were selected. 88 subjects with probing pocket depth (PPD) > or =6 mm > or =1 month after supervised oral hygiene and scaling participated. At baseline plaque index, bleeding on probing, PPD and probing attachment level were recorded and reproducible radiographs for computer-based bone level measurements were taken. In each subject, 1 tooth was randomly treated with the test and 1 tooth with the control gel. Examinations were repeated 8 and 16 months post-operatively. RESULTS: After 16 months, the mean test PPD was 4.1 mm and the mean control PPD 4.2 mm. The mean gain of attachment was 2.7 mm for test and 2.9 mm for the control sites, and the radiographic measurements demonstrated a mean gain of 1 mm for both test and control sites. CONCLUSION: This series of cases demonstrated a statistically significant reduction of pocket depths and gain of attachment and bone after 8 and 16 months with no difference between the 2 preparations.

Comparison of a manual and a new electric toothbrush for controlling plaque and gingivitis.

In the present clinical trial, the effect on existing plaque and gingivitis of a new electric toothbrush (ET) was compared to that of a manual toothbrush (MT). 40 medical students, age 18-30 years, participated. Plaque index (PlI) and gingival index (GI) were recorded at 6 sites at all teeth. At baseline, a PlI and GI > 1 were required. The participants were at random allocated to a group using either ET or MT and were instructed only to use the assigned toothbrush, brushing each morning and evening for 2 min. No oral hygiene instruction was given. Re-examination was done after 1, 2 and 6 weeks. In the MT group, a minor decrease in mean PlI was found after 6 weeks (all sites: from 1.2 to 1.1, approximal sites: from 1.4 to 1.2). The corresponding figures in the ET group were: 1.2 to 0.6 and 1.4 to 0.8. After 6 weeks, the % of sites with visible plaque with MT was: 24% (all sites) and 30% (approximal sites) and with ET 8% and 9%, respectively. With MT, mean GI was unchanged after 6 weeks compared to baseline, whereas with ET, the changes were from 1.1 to 0.9 (all sites) and from 1.1 to 1.0 (approximal sites). The % of sites with GI score > or = 2 had not changed after 6 weeks with MT (all sites: 11%, approximal sites: 13%). With ET, these results were 3% and 4%, respectively.