Survival of the 8.5 mm osseointegrated abutment, and its utility in the obese patient.

BACKGROUND: Most of the literature regarding osseointegrated implantation for hearing rehabilitation focuses on the 5.5 mm abutment. This study aimed to add to the data available on the survival of the 8.5 mm abutment, and to describe its utility in obese patients. OBJECTIVE: To review the outcomes of patients who received a bone-anchored hearing aid implant, and create a model comparing the mechanical forces acting upon combinations of fixture and abutment lengths. METHODS: Retrospective chart review and mathematical modelling. RESULTS: In this retrospective cohort study comprising 25 patients, less abutment overgrowth was observed in the 8.5 mm abutment recipients versus recipients of the 5.5 mm abutment. When the principle of equilibrium of a rigid body was applied, the 8.5 mm abutment was at a calculated mechanical disadvantage compared with the 5.5 mm abutment. CONCLUSION: The 8.5 mm abutment may be useful in patients with copious subcutaneous soft tissue as in the obese population. The 8.5 mm abutment has a calculated mechanical disadvantage, potentially putting the implant under greater mechanical stress; however, the clinical relevance of this is unclear.

Deletion of carboxypeptidase N delays onset of experimental cerebral malaria.

Complement contributes to inflammation during pathogen infections; however, less is known regarding its role during malaria and in the severest form of the disease, cerebral malaria. Recent studies have shown that deletion of the complement anaphylatoxins receptors, C3aR and C5aR, does not alter disease susceptibility in experimental cerebral malaria (ECM). This does not, however, preclude C3a- and C5a-mediated contributions to inflammation in ECM and raises the possibility that carboxypeptidase regulation of anaphylatoxin activity rapidly over rides their functions. To address this question, we performed ECM using carboxypeptidase N-deficient (CPN(-/-)) mice. Unexpectedly, we found that CPN(-/-) mice survived longer than wild-type mice, but they were fully susceptible to ECM. CD4(+) and CD8(+) T cell infiltration was not reduced at the peak of disease in CPN(-/-) mice, and there was no corresponding reduction in pro-inflammatory cytokine production. Our results indicate that carboxypeptidases contribute to the pathogenesis of ECM and that studies examining the contribution of other carboxypeptidase families and family members may provide greater insight into the role these enzymes play in malaria.

GC-selective DNA-binding antibiotic, mithramycin A, reveals multiple points of control in the regulation of Hdm2 protein synthesis.

The primary role of the Hdm2/Mdm2 oncoprotein is to regulate the levels and activity of the transcription factor p53. Hdm2 synthesis is itself tightly controlled and, as demonstrated by a recently described SNP (SNP309) in the hdm2-P2 promoter, minor variations in Hdm2 expression have phenotypic consequences on radiation sensitivity and cancer predisposition. To further define mechanisms regulating Hdm2 expression, we have investigated the effects of the GC-selective DNA-binding drug, Mithramycin A (MA) on hdm2 mRNA transcription, trafficking, and translation. Firstly we show that the constitutive hdm2-P1 promoter is inhibited by MA. We define, for the first time, the minimal sequence elements that are required for P1-promoter activity and identify those which confer MA sensitivity. Secondly, MA induces p53-dependent transcription from the hdm2-P2 promoter. Thirdly, and critically, MA also inhibits Hdm2 synthesis at the post-transcriptional level, with negative effects on hdm2 mRNA nuclear export and translation. This study highlights the complex interplay between the pathways that regulate Hdm2 protein synthesis in cancer cells, and furthermore emphasizes the export of hdm2 mRNA from the nucleus to the cytoplasm as a key point of control in this process.

Complementary therapies: the position of the UKCC [practice guideline].

The Council receives many enquiries about its position in relation to the use of complementary therapies in the health services. The Council's position in relation to these therapies is such that it considers their safe inclusion in the care offered to patients and clients to be properly described in three of its publications. These are: the Scope of Professional Practice, the Code of Professional Conduct and the Council's Standards for the Administration of Medicines. In applying the principles in these documents, nurses, midwives and health visitors should not only be able to provide these therapies safely but they will also be acting in a proper manner should they be called to account by the Council. Finally, the Council has no plans to register complementary therapy qualifications, as such activity lies outside its legal remit. A Council position statement on complementary therapies was prepared in November 1994.