Clinical characterization of gingival type of burning mouth syndrome: a cross-sectional study.

BACKGROUND: The aim of this study is to investigate the prevalence of localized intraoral neuropathic pain in a cluster of patients who reported the involvement of gingival site as only clinical manifestation of dysesthesia, analysing type and distribution of symptoms. MATERIAL AND METHODS: Burning mouth syndrome (BMS) patients were enrolled in the study. Patients were screened through laboratory test and a conventional oral examination with periodontal chart. A questionnaire to collect data on symptoms, oral site involved, quality of sleep, anxiety was submitted to all the patients. RESULTS: A total of 236 patients were recruited. Seventy-six patients (32.2%) presented generalized type, whereas 160 (67.8%) had localized type. In the localized BMS group, the gingiva was involved in 70 patients and in 33 of these it was the only site involved. In the gingival subgroup, 35 patients reported burning, 29 pain and 24 xerostomia. CONCLUSIONS: To best our knowledge, this study is the first that analyses gingival involvement as the only site in BMS and it could encourage further investigations to understand the etiopathogenesis of gingival BMS.

Dual shape recovery of red blood cells flowing out of a microfluidic constriction.

Micropipette aspiration, optical tweezers, rheometry, or ecktacytometry have been used to study the shape recovery of healthy human Red Blood Cells (RBCs) and measure associated relaxation times of the order of 100-300 ms. These measurements are in good agreement with the Kelvin-Voigt model, which describes the cell as a visco-elastic material, predicting that its relaxation time only depends on cell intrinsic properties. However, such mechanical solicitation techniques are far from being relevant regarding RBC solicitation in vivo. In this paper, we report for the first time the existence of two different behaviors of the RBC shape recovery while flowing out of a microfluidic constricted channel. The calculation of the viscous stress corresponding to the frontier between the two recovery modes confirms that the RBC resistance to shear µ is the elastic property dominating the transition between the two recovery behaviors. We also quantified associated recovery times τ r and report values as low as 4 ms-which is almost two decades smaller than the typical RBC relaxation time-at high viscosity and flow velocity of the carrier fluid. Although we cannot talk about relaxation time because the cell is never at rest, we believe that the measured shape recovery time arises from the coupling of the cell intrinsic deformability and the hydrodynamic stress. Depending on the flow conditions, the cell mechanics becomes dominant and drives the shape recovery process, allowing the measurement of recovery times of the same order of magnitude than relaxation times previously published. Finally, we demonstrated that the measurement of the shape recovery time can be used to distinguish Plasmodium falciparum (causing malaria) infected RBCs from healthy RBCs.

The treatment with pasireotide in Cushing's disease: effect of long-term treatment on clinical picture and metabolic profile and management of adverse events in the experience of a single center.

PURPOSES: Pasireotide is the first medical therapy officially approved for adult patients with Cushing's disease (CD) experiencing failure of pituitary surgery or not candidates for surgery. The current study aimed at investigating pasireotide effects on clinical picture and metabolic profile in patients enrolled in the phase III CSOM230B2305 trial at Naples center. In addition, the current study focused on safety issues encountered during the study, detailing the management of the different adverse events associated with the treatment with pasireotide in Naples center. METHODS: Fourteen patients entered the study; eight patients, receiving pasireotide for at least 6 months, were considered for the efficacy analysis, whereas the entire cohort of 14 patients was considered for the safety analysis. RESULTS: Full or partial disease control was obtained in 85.7% of patients, according to a "per-protocol" methodology analysis, and in 42.9% of patients, according to an "intention-to-treat" methodology analysis, after 12 months of treatment. A relevant improvement in clinical signs and symptoms, mainly in facial rubor, supraclavicular fat pad, bruising, hirsutism, and muscle strength was observed; body weight, body mass index, and waist circumference significantly reduced, and a slight non-significant reduction was observed in the prevalence of visceral obesity, hypercholesterolemia, and hypertriglyceridemia. Deterioration of glucose metabolism represented the most common adverse event, occurring in 71.4% of patients, and requiring a dietary regimen as first step, metformin therapy and/or long-acting insulin as second step, and short-acting insulin, as third step; no patients discontinued treatment for hyperglycaemia. Additional adverse events of interest were nausea (21.4%), and vomiting (14.3%), spontaneously resolved in few weeks or some months, except in one patient unsuccessfully treated with metoclopramide and ondansetron, and diarrhoea (14.3%), improved with loperamide treatment. Millimetric gallstones and biliary sludge (7.1%) were managed with ursodeoxycholic acid, inducing lithiasis and biliary sludge resolution, whereas hypocortisolism-related adverse events (7.1%) were resolved with a reduction in the pasireotide dose. CONCLUSIONS: The current study on a limited series of patients contributes to confirm that pasireotide may be considered a valid option for treatment of patients with CD, although it requires an appropriate management of adverse events, especially hyperglycaemia.

Effect of electrode material on the sensitivity of interdigitated electrodes used for Electrical Cell-Substrate Impedance Sensing technology.

This study explores the effect of the electrode material on the sensitivity of interdigitated electrodes (IDEs) used in Electrical Cell-Substrate Impedance Sensing (ECIS) technology. This technique is a label-free method to evaluate cellular activity of adherent cells. IDEs of gold (Au), indium tin oxide (ITO) and ITO functionalized with iridium oxide (IrOx) were characterized with impedance spectroscopy and their interfacial impedances were evaluated in potassium chloride (KCl) solutions. In parallel, ECIS measurements were performed on these three electrode materials during the proliferation of the human breast cancer cell line, MCF-7. The results indicate that the difference in sensitivity to MCF-7 of the three materials might be strongly correlated to their interfacial impedances. We found that ITO electrodes coated with IrOx show slightly higher sensitivity to MCF-7 breast cancer cells while still offering transparency compared to gold, which is considered the conventional material in ECIS devices.

Determination of Red Blood Cell fatigue using electrodeformation.

In this work, we used electrodeformation (ED) [1] as a new strategy to evaluate the fatigue of healthy human Red Blood Cells (RBCs). Using dielectrophoresis (DEP) forces, we submitted RBCs to a series of elongation and relaxation cycles to model their mechanical stress in the blood circulation and we used their relaxation time as a marker to evaluate their fatigue. In this paper, we first investigated the dependency of the RBC mechanical response upon the experimental parameters, such as the viscosity ηout of the external medium, the amplitude ΔV of the applied voltage, the duration of the solicitation tsol, the number of solicitations N as well as the resting time trest between two solicitations. The impact of these parameters was evaluated through the analysis of both RBC deformation index D and relaxation time τ. Finally, the optimization of these parameters was used to monitor RBC fatigue.

A new microfluidic device for electric lysis and separation of cells.

This paper demonstrates the potential use of a new microfluidic device embedding thick electrodes for cell lysis and cell separation applications. The system consists of a microfluidic channel featuring conductive walls made of a polydimethylsiloxane (PDMS) matrix mixed with carbon nanoparticles. Cell lysis was performed electrically by applying square pulses across the channel width, which was monitored by fluorimetry. Lysed and unlysed cells showed different dielectrophoretic behavior under appropriate experimental conditions, which suggests that the developed device is suitable to perform both cell lysis and subsequent sorting of viable and dead cells.

Effects of prophylaxis with iodised salt in an area of endemic goitre in north-eastern Sicily.

In developed countries, the use of iodised salt represents the best prophylaxis of endemic goitre in areas exposed to iodine deficiency. In the present study we re-evaluated goitre prevalence and iodine intake 10 years after the introduction of iodised salt in an area of goitre endemia in north-eastern Sicily (Italy), and we compared these results with those obtained in previous surveys. Three centres with known moderate goitre endemia (Bronte, Nicosia, and Gagliano) and three other smaller ones with severe goitre endemia (Sperlinga, Villadoro, and Maniace) were studied. We surveyed 697 schoolchildren. Goitre prevalence was assessed by thyroid palpation and by a thyroid ultrasound scan. Iodine urinary excretion was also measured. Iodised salt consumption was 44% of total salt consumption. Goitre prevalence assessed by thyroid palpation was significantly decreased in all towns studied compared to previous surveys. However, the persistence of a mild goitre endemia was observed in some small rural centres (5.8% in Sperlinga/Villadoro, and 11.4% in Maniace). Goitre prevalence evaluated by thyroid ultrasound scan was greater than 5% in all centres of the endemic area and was always greater than that assessed by thyroid palpation. Iodine urinary excretion was above 100 microg/l in all localities studied. In conclusion, our studies indicate a progressive reduction in goitre prevalence over a period of about 30 years in schoolchildren in a well-characterised endemic area in northeastern Sicily. The decrease in goitre prevalence was associated with a significant increase in urinary iodine excretion. However, it may be speculated that iodine deficiency is the pre-eminent, but not the exclusive cause of goitre endemia in this area.

Electrophoresis PDMS/glass chips with continuous on-chip derivatization and analysis of amino acids using naphthalene-2,3-dicarboxaldehyde as fluorogenic agent.

In this work, we developed a PDMS electrophoresis device able to carry out on-chip derivatization and quantification of amino acids (AAs) using naphthalene-2,3-dicarboxaldehyde (NDA) as a fluorogenic agent. A chemical modification of the PDMS surface was found compulsory to achieve the derivatization of AAs with NDA and a limit of detection (LOD) of 40nM was reached for glycine. Finally, we suggested the applicability of this microdevice for the analysis of real biological samples such as a rat hippocampus microdialysate.

High-dose-rate brachytherapy in the treatment of uterine cervix cancer. Analysis of dose effectiveness and late complications.

PURPOSE: This retrospective analysis aims to report results of patients with cervix cancer treated by external beam radiotherapy (EBR) and high-dose-rate (HDR) brachytherapy. METHODS AND MATERIALS: From September 1992 to December 1996, 138 patients with FIGO Stages II and III and mean age of 56 years were treated. Median EBR to the whole pelvis was 45 Gy in 25 fractions. Parametrial boost was performed in 93% of patients, with a median dose of 14.4 Gy. Brachytherapy with HDR was performed during EBR or following its completion with a dose of 24 Gy in four weekly fractions of 6 Gy to point A. Median overall treatment time was of 60 days. Patient age, tumor stage, and overall treatment time were variables analyzed for survival and local control. Cumulative biologic effective dose (BED) at rectal and bladder reference points were correlated with late complications in these organs and dose of EBR at parametrium was correlated with small bowel complications. RESULTS: Median follow-up time was 38 months. Overall survival, disease-free survival, and local control at 5 years was 53.7%, 52.7%, and 62%, respectively. By multivariate and univariate analysis, overall treatment time up to 50 days was the only statistically significant adverse variable for overall survival (p = 0.003) and actuarial local control (p = 0.008). The 5-year actuarial incidence of rectal, bladder, and small bowel late complications was 16%, 11%, and 14%, respectively. Patients treated with cumulative BED at rectum points above 110 Gy(3) and at bladder point above 125 Gy(3) had a higher but not statistically significant 5-year actuarial rate of complications at these organs (18% vs. 12%, p = 0.49 and 17% vs. 9%, p = 0.20, respectively). Patients who received parametrial doses larger than 59 Gy had a higher 5-year actuarial rate of complications in the small bowel; however, this was not statistically significant (19% vs. 10%, p = 0.260). CONCLUSION: This series suggests that 45 Gy to the whole pelvis combined with four fractions of 6 Gy to point A with HDR brachytherapy is an effective and safe fractionation schedule in the treatment of Stages II and III cervix cancer if realized up to 50 days. To decrease the small bowel complications, we decreased the superior border of the parametrial fields to the S2-S3 level and the total dose to 54 Gy.

A simple strategy for improving patient contact after ED discharge.

The purpose of this study was to assess strategies to improve telephone contact with adult patients discharged from the emergency department (ED). The basic procedure was a prospective, randomized, interventional trial of a convenience sample of patients 18 years or older being discharged from the ED. Patients were excluded if they had altered mental status or were unable to communicate with the College Research Associates (RAs). RAs asked intervention subjects a set of scripted questions confirming patients' telephone numbers and times for a follow-up call. Control subjects received routine discharge instructions from the ED staff. Subjects were called back within 4 days of ED discharge. Eighty-seven control subjects and 76 intervention subjects were enrolled. There were no significant demographic differences between the 2 groups. Forty-seven (54%) control subjects were contacted versus 58 (77%) in the intervention group (P <.003; Chi-square test). A simple patient interview conducted immediately before discharge confirming the patient's telephone number and setting a time for a follow-up call significantly improved patient follow-up contact rates.

Finite element simulation of an electroosmotic-driven flow division at a T-junction of microscale dimensions

A finite element formulation is developed for the simulation of an electroosmotic flow in rectangular microscale channel networks. The distribution of the flow at a decoupling T-junction is investigated from a hydrodynamic standpoint in the case of a pressure-driven and an electroosmotically driven flow. The calculations are carried out in two steps: first solving the potential distribution arising from the external electric field and from the inherent zeta potential. These distributions are then injected in the Navier Stokes equation for the calculation of the velocity profile. The influence of the various parameters such as the zeta potential distribution, the Reynolds number, and the relative channel widths on the flow distribution is investigated.

Microchannel networks for electrophoretic separations.

UV excimer laser photoablation was used to micro-machine polymer substrates not only to drill microchannel structures but also to change the surface physical properties of the substrates. We first describe how UV laser photoablation can be used for the patterning of biomolecules on a polymer and discuss parameters such as surface coverage of active antibodies and equilibration time. Secondly, we show how to design a single-use capillary electrophoresis system comprising an on-chip injector, column and electrochemical detector. The potential of this disposable plastic device is discussed and briefly compared to classical systems. Finally, preliminary results on protein separation by isoelectric focusing on a disposable microchip are presented.

Electrochemical detection in polymer microchannels.

A method, using UV laser photoablation, is presented for the fabrication and the integration of an electrochemical detector in a microchannel device, where carbon microband electrodes are placed either in the bottom or in the side walls of the rectangular microchannel. The different electrochemical cell geometries are tested with a model compound (ferrocenecarboxylic acid) in 40- and 100-µm-wide capillaries fabricated in planar polymer substrates. The experimental results are compared to numerical simulations for stagnant stream conditions. Depending on the scan rate and on the microchannel depth, the system behaves as a microband electrode until a linear diffusion field develops within the channel. The limit of detection for a one electron redox species within the 120-pL detection volume is ∼1 fmol with both cyclic voltammetry and chronoamperometric detection.

Hyperfractionated external radiation therapy in stage IIIB carcinoma of uterine cervix: a prospective pilot study.

PURPOSE: Brazil has one of the highest incidence of carcinoma of the cervix in the world. Half of the patients have advanced stages at the diagnosis. Due to this large number of patients we decided to conduct a prospective pilot study to investigate the tolerance to and survival rate with hyperfractionated external radiotherapy only in patients with Stage IIIB carcinoma of the uterine cervix. METHODS AND MATERIALS: Between January 1991 and December 1993, 23 patients underwent hyperfractionated external beam radiotherapy without brachytherapy. All cases were biopsy proven squamous cell carcinoma of cervix clinically Staged as IIIB (FIGO). Hyperfractionation (HFX) was given with 1.2 Gy doses, twice daily at 6-h interval, 5 days/week, to the whole pelvis up to 72 Gy within 30 working days. Complications were evaluated by an adaptation ot the RTOG Radiation Morbidity Scoring Table graded as 1 = none/mild; 2 = moderate, and 3 = severe. RESULTS: Follow-up ranged from 27 to 50 months (median 40 months) on the 9 to 23 living patients at the time of the analysis in December 1995. There was no severe acute toxicity, but moderate acute reaction was high: 74%. The commonest site of complication was the intestine where severe late toxicity occurred in 2 of 23 (9%). Overall survival rate at 27 months was 48% and at 40 months was 43%. DISCUSSION: There is little information in literature about HFX in carcinoma of the cervix. This is the third published study about it and the one that gave the highest total dose with external HFX of 60 x 1.2 Gy = 72 Gy. Theoretically, through the linear quadratic formula this schedule of HFX would be equivalent to 30 x 2 Gy = 60 Gy of standard fractionation, both treatments given in 30 working days. HFX schedules must be tested to establish their safety. Present results suggest being possible to further increase the total dose in the pelvis with hyperfractionated irradiation.

A irradiaçäo da cadeia mamária interna em câncer da mama / Irradiation of the internal mammary chain in breast cancer

A irradiaçäo de linfonodos da cadeia mamária interna (CMI) pode ser feita com um campo direto ou com os campos tangentes que irradiam a mama. Quando näo se dispöe de feixe de eletróns, o que é a regra no Brasil, o campo direto costuma irradiar uma área importante de mediastino, pulmäo e coraçäo, se o tumor for do lado esquerdo. A dose usual de 45 a 50 Gy em tais órgäos pode näo ser inócua, causando problemas a médio ou longo prazo, principalmente para as pacientes que väo receber quimioterapia adjuvante com drogas. Além disso, nos casos de tratamento conservador, em que a mama está presente, pode ser difícil a junçäo do campo direto com o campo tangente medial. A tentativa de irradiar a CMI por campos tangentes, entrando contralateralmente 3 cm com o campo tangente medial, pode acarretar perda completa ou dose incerta na CMI, além de irradiar demasiado o pulmäo. Por fim, com a indicaçäo frequente de quimioterapia adjuvante, muitos autores optam por näo irradiar a CMI. Este artigo faz consideraçöes sobre tais assuntos, voltando-se mais aos detalhes técnicos