The Alcohol Harm Paradox in Periodontitis.

Individuals of lower socioeconomic position (SEP) experience a greater rate of alcohol-related harms, yet they consume equal or lower amounts of alcohol than higher-SEP individuals. This phenomenon, called the "alcohol harm paradox" (AHP), gained attention recently, and different mechanisms have been proposed to explain it. Since both SEP and alcohol have been suggested to be associated with periodontitis risk, we conducted a secondary analysis using data from the National Health and Nutrition Examination Survey 2011 to 2012 and 2013 to 2014 cycles, aiming to examine 1) whether the association between alcohol consumption and periodontitis is modified by SEP and 2) the extent to which the effect of SEP inequalities on periodontitis is mediated by and/or interacts with alcohol consumption. We set educational attainment as the main SEP proxy and tested the poverty income ratio in subsequent sensitivity analyses. Effect measure modification analysis was employed, considering heavy drinking as exposure, and causal mediation analysis based on the potential outcome's framework decomposed the effect of SEP on periodontitis in proportions attributable to mediation and interaction. Models were fitted using binary logistic regression and adjusted for sex, ethnicity, age, body mass index, smoking status, diabetes, binge drinking, and regular preventive dental visits. The analytical sample comprised 4,057 participants. After adjusting for covariates, less educated heavy drinkers presented 175% (odds ratio, 2.75; 95% confidence interval [CI], 2.04-3.72) higher odds of periodontitis than their counterparts, and super-additive associations were found (relative excess risk due to interaction: 1.35; 95% CI, 0.49-2.20). Additionally, -69.5% (95% CI, -122.1% to -16.8%) of the effects of education on periodontitis were attributable to interaction with heavy drinking, consistent with the AHP. No contribution was found for the mechanism of mediation. Heavy drinking disproportionately impacts the occurrence of periodontitis in lower-SEP individuals. Lower-SEP individuals seem to experience differential effects of heavy drinking on periodontitis.

Co-occurrence of Periodontitis and Diabetes-Related Complications.

Periodontitis is a common finding among people with diabetes mellitus (DM) and has been cited as a DM complication. Whether and how periodontitis relates to other diabetes-related complications has yet to be explored. This study aims to examine the clustering of periodontitis with other diabetes-related complications and explore pathways linking diabetes-related complications with common risk factors. Using data from participants with DM across 3 cycles of the National Health and Nutrition Examination Survey (NHANES) (n = 2,429), we modeled direct and indirect pathways from risk factors to diabetes-related complications, a latent construct comprising periodontitis, cardiovascular diseases, proteinuria, and hypertension. Covariates included age, sex, socioeconomic status (SES), smoking, physical activity, healthy diet, alcohol consumption, hemoglobin A1c (HbA1c), dyslipidemia, and body mass index (BMI). Sensitivity analyses were performed considering participants with overweight/obesity and restricting the sample to individuals without DM. Periodontitis clustered with other diabetes complications, forming a latent construct dubbed diabetes-related complications. In NHANES III, higher HbA1c levels and BMI, older age, healthy diet, and regular physical activity were directly associated with the latent variable diabetes-related complications. In addition, a healthy diet and BMI had a total effect on diabetes-related complications. Although sex, smoking, dyslipidemia, and SES demonstrated no direct effect on diabetes-related complications in NHANES III, a direct effect was observed using NHANES 2011-2014 cycles. Sensitivity analysis considering participants with overweight/obesity and without DM showed consistent results. Periodontal tissue breakdown seems to co-occur with multiple diabetes-related complications and may therefore serve as a valuable screening tool for other well-known diabetes-related complications.

Ecological characterization of a tick community across a landscape gradient exhibiting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina.

An ecological analysis of a tick (Ixodida: Ixodidae) community across a landscape gradient presenting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina was performed. Ticks were collected from vegetation and hosts between September 2014 and August 2016. A total of 12 697 free-living ticks and 3347 specimens from hosts were collected, including 317 ticks infesting humans. The values obtained show considerable species diversity in the forest environment accompanied by low equitability. The similarity index derived from a comparison of forest and agricultural environments was higher than that calculated by comparing forest and urban environments. The data suggest that although a cycle of one generation per year is apparent in some species, more than one cohort may co-exist within the populations of some of these species. Well-marked patterns of the seasonal distribution of free-living tick species emerged in environments with no anthropic modification. The results indicate that forest environments are more suitable habitats than agricultural and urban environments for many species of native tick, but are unsuitable for exotic species that have successfully established in environments that have been modified by man.

Familial multiple lipomatosis: a case report.

Lipoma is the most common type of soft tissue tumour. Multiple lipomas localised in different areas of the body are rare and can occur in specific hereditary syndromes. Familial multiple lipomatosis is a rare benign hereditary syndrome with a proposed autosomal-dominant inheritance. We present the case of a 67-year-old man with this disease. Clinical features, genetic evidence, and treatment options are reviewed.

Nucleation and growth of biomimetic apatite layers on 3D plotted biodegradable polymeric scaffolds: effect of static and dynamic coating conditions.

Apatite layers were grown on the surface of newly developed starch/polycaprolactone (SPCL)-based scaffolds by a 3D plotting technology. To produce the biomimetic coatings, a sodium silicate gel was used as nucleating agent, followed by immersion in a simulated body fluid (SBF) solution. After growing a stable apatite layer for 7 days, the scaffolds were placed in SBF under static, agitated (80 strokes min(-1)) and circulating flow perfusion (Q=4 ml min(-1); t(R)=15s) for up to 14 days. The materials were characterized by scanning electron microscopy/energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy and thin-film X-ray diffraction. Cross-sections were obtained and the coating thickness was measured. The elemental composition of solution and coatings was monitored by inductively coupled plasma spectroscopy. After only 6 h of immersion in SBF it was possible to observe the formation of small nuclei of an amorphous calcium phosphate (ACP) layer. After subsequent SBF immersion from 7 to 14 days under static, agitated and circulating flow perfusion conditions, these layers grew into bone-like nanocrystalline carbonated apatites covering each scaffold fiber without compromising its initial morphology. No differences in the apatite composition/chemical structure were detectable between the coating conditions. In case of flow perfusion, the coating thickness was significantly higher. This condition, besides mimicking better the biological milieu, allowed for the coating of complex architectures at higher rates, which can greatly reduce the coating step.

Novel hydroxyapatite/carboxymethylchitosan composite scaffolds prepared through an innovative "autocatalytic" electroless coprecipitation route.

A developmental composite scaffold for bone tissue engineering applications composed of hydroxyapatite (HA) and carboxymethylchitosan (CMC) was obtained using a coprecipitation method, which is based on the "autocatalytic" electroless deposition route. The results revealed that the pores of the scaffold were regular, interconnected, and possess a size in the range of 20-500 microm. Furthermore, the Fourier transform infra-red spectrum of the composite scaffolds exhibited all the characteristic peaks of apatite, and the appearance of typical bands from CMC, thus showing that coprecipitation of both organic and inorganic phases was effective. The X-ray diffraction pattern of composite scaffolds demonstrated that calcium-phosphates consisted of crystalline HA. From microcomputed tomography analysis, it was possible to determine that composite scaffolds possess a 58.9% +/- 6% of porosity. The 2D morphometric analysis demonstrated that on average the scaffolds consisted of 24% HA and 76% CMC. The mechanical properties were assessed using compressive tests, both in dry and wet states. Additionally, in vitro tests were carried out to evaluate the water-uptake capability, weight loss, and bioactive behavior of the composite scaffolds. The novel hydroxyapatite/carboxymethylchitosan composite scaffolds showed promise whenever degradability and bioactivity are simultaneously desired, as in the case of bone tissue-engineering scaffolding applications.

A mucinous cystadenoma in the mesentery of the right hemicolon.

Cysts of the mesentery, retroperitoneum and omentum are rare. We present a patient with a mucinous cystadenoma in the mesentery of the right hemicolon. The exact aetiology of these cysts at the aforementioned sites is still unclear. Adenocarcinomas can arise in mucinous cystadenomas. Therefore, in our opinion, to prevent spillage the right approach is to primarily perform a laparatomy instead of attempting to remove these lesions laparoscopically, even if clinical and radiological signs of malignancy are absent.

[Diagnostic image (384). A woman with a swelling in the groin after a trauma]. / Diagnose in beeld (384). Een vrouw met een zwelling in de lies na een trauma.

A 59-year-old woman presented with persistent pain in the right hip and a hump in de groin area after a mild trauma due to a fall on the handlebars ofa bicycle. Iliopsoas bursitis was diagnosed.

Micro-computed tomography (micro-CT) as a potential tool to assess the effect of dynamic coating routes on the formation of biomimetic apatite layers on 3D-plotted biodegradable polymeric scaffolds.

This work studies the influence of dynamic biomimetic coating procedures on the growth of bone-like apatite layers at the surface of starch/polycaprolactone (SPCL) scaffolds produced by a 3D-plotting technology. These systems are newly proposed for bone Tissue Engineering applications. After generating stable apatite layers through a sodium silicate-based biomimetic methodology the scaffolds were immersed in Simulated Body Fluid solutions (SBF) under static, agitation and circulating flow perfusion conditions, for different time periods. Besides the typical characterization techniques, Micro-Computed Tomography analysis (micro-CT) was used to assess scaffold porosity and as a new tool for mapping apatite content. 2D histomorphometric analysis was performed and 3D virtual models were created using specific softwares for CT reconstruction. By the proposed biomimetic routes apatite layers were produced covering the interior of the scaffolds, without compromising their overall morphology and interconnectivity. Dynamic conditions allowed for the production of thicker apatite layers as consequence of higher mineralizing rates, when comparing with static conditions. micro-CT analysis clearly demonstrated that flow perfusion was the most effective condition in order to obtain well-defined apatite layers in the inner parts of the scaffolds. Together with SEM, this technique was a useful complementary tool for assessing the apatite content in a non-destructive way.

A Non-healing Sinus of the Lower Leg 5 Years After Vacuum-assisted Closure Therapy Due To a Gossypiboma.

Since its introduction, vacuum-assisted closure (V.A.C.® Therapy™, KCI, San Antonio,Tex) therapy has proven to be an adequate and noninvasive method in the treatment of complicated wounds. Vacuumassisted closure can be used in the treatment of many types of chronic wounds, such as venous stasis ulcers, pressure ulcers, dehisced surgical wounds, arterial and diabetic ulcers, and a wide variety of miscellaneous, long-existing wounds. Although complications related to its use are rare; localized superficial skin irritation is the most common complication reported in the literature. Further complications involve pain, infection, bleeding, and fluid depletion. Although rare, severe complications, such as toxic shock syndrome, anaerobic sepsis, or thrombosis have been reported. This case report presents an unusual complication of vacuum-assisted closure therapy, which to the authors' knowledge has only once been reported in the literature.

Immobilisation of catalase on the surface of biodegradable starch-based polymers as a way to change its surface characteristics.

In this study, a specific enzyme catalase was immobilised onto the surface of two different biodegradable materials, starch cellulose acetate (SCA) and starch polycrapolactone (SPCL) blends. This immobilisation was achieved by several different routes, mainly by covalent binding and an adsorption method using as activation agents epichlorohydrin, cyanogen bromide (CNBr), and aminopropyltriethoxysilane. The effect of the coupling pH of the enzyme-support reaction was determined in terms of activity recovery (%). The catalase immobilised on SCA showed higher activity recovery (%) for all the methods used as compared with results obtained with SPCL. The immobilisation process using epichlorohydrin as an activation agent and polyethylenimine as a spacer-arm enhanced the stability and the half-lives at pH 7.0, 30 degrees C, for immobilised catalase on both SCA and SPCL. The half-lives were respectively, 1162 and 870 h compared with other treatments and free enzyme (480 h). The free glycerol present in the immobilisation medium was also a factor that contributed toward the better performance regarding the long-term stability at 30 degrees C and neutral pH. The extension of the morphological modifications on the surface of the materials was observed by scanning electron microscopy. In general, the results indicated that the chemical modification with epichlorohydrin could provide a simple and rather efficient technique to modify the starch-based materials' surface that might be useful in several biomedical applications.

Combining topical negative pressure and a Bogota bag for managing a difficult laparostomy.

A patient with a severe intra-abdominal infection required a laparostomy. A Bogota bag was combined with topical negative pressure therapy, saving nursing time and enabling successful management of wound fluid.