Effect of valproic acid on histone deacetylase expression in oral cancer (Review).

Oral squamous cell carcinoma (OSCC) is a frequent human malignancy that demonstrates a range of genetic and epigenetic alterations. Histone deacetylases (HDACs) are key epigenetic regulators of cell-cycle progression, differentiation and apoptosis and their dysregulation is implicated in cancer development. HDACs are promising targets for anticancer therapy through the utilisation of HDAC inhibitors (HDACis). OSCC cells have been shown to have low levels of histone acetylation, suggesting that HDACis may produce beneficial effects in patients with OSCC. Valproic acid (VPA) is a class I and IIa HDACi and, therefore, may be useful in anticancer therapy. VPA has been reported as a chemo-preventive epigenetic agent in individuals with high-risk oral dysplasia (OD) and thus associated with a reduced risk of HNSCC. It is hypothesised that HDAC inhibition by VPA triggers a change in the expression levels of different HDAC family gene-members. The present review summarises the current literature on HDAC expression changes in response to VPA in oral cancer patients and in vitro studies in an effort to better understand the potential epigenetic impact of VPA treatment. The present review outlined the need for exploring supportive evidence of the chemo-preventive role played by VPA-based epigenetic modification in treating oral pre-cancerous lesions and, thus, providing a novel tolerable chemotherapeutic strategy for patients with oral cancer.

Adverse Events of the Long-Term Use of Opioids for Chronic Non-cancer Pain: A Narrative Review.

BACKGROUND: The long-term use of opioids for chronic non-cancer pain (CNCP) has drawn more attention and debate. Although opioids are frequently used to treat chronic pain, their effectiveness and safety over extended periods are still unknown. OBJECTIVES: The purpose of this review is to provide an overview of what is currently known about the adverse events of long-term use of opioids in CNCP. It also delivers patient-centered strategies designed to mitigate these risks. METHODS: We conducted a literature search in PubMed, MEDLINE, EMBASE, and Web of Science databases. Search terms included CNCP, pain pathophysiology, opioid pharmacodynamics, opioid prescribing trends, guidelines for opioid use, and opioid side effects.  Results: Our review highlights that while opioids may provide short-term relief from CNCP, their effectiveness diminishes over time due to the development of opioid tolerance. This tolerance often leads to increased dosages, which can subsequently result in opioid dependence. Additionally, long-term opioid therapy is associated with a spectrum of adverse effects, including constipation, drowsiness, respiratory depression, and potential for drug interactions. Furthermore, our review indicates that alternative pain management strategies play a crucial role in controlling CNCP. They offer significant benefits with fewer adverse events. These strategies include non-opioid medications, physical therapy, cognitive-behavioral therapy (CBT), various interventional procedures, injection therapy, and acupuncture. CONCLUSION: Using opioids to manage CNCP presents several challenges. Given these challenges, alternative treatments are being considered as viable options. Moreover, it is crucial to customize treatment plans to align with the patients' specific health requirements, existing conditions, and potential risks to ensure the best possible outcomes.

Co-infection by Cryptococcus neoformans fungaemia and non-tuberculous mycobacteria with Pneumocystis jiroveci pneumonia in a newly diagnosed HIV-infected patient.

Opportunistic infections are common in human immunodeficiency virus (HIV)-infected patients. Co-infections with Cryptococcus neoformans and Mycobacterium species together with Pneumocystis jiroveci pneumonia (PCP) are rare and typically occur in immunocompromised individuals, particularly acquired immunodeficiency syndrome patients.

Effect of denervation on burn wound healing.

The skin is a natural barrier between the interior milieu of the organism and its environment. This barrier has multiple physiological functions and may be affected by an array of pathologies including wounds and burns. The present study aims to determine the effect of the nervous system on wound healing. Specifically, this study tested the effect of denervation by chemical ablation on the burn wound healing process using guanethidine for denervation of the sympathetic postganglionic neurons and resiniferatoxin for denervation of the sensory capsaicin-sensitive fibres. Animals were divided into 8 different groups: (1) control group, (2) sensory denervated and burned, (3) sensory denervated non-burned, (4) sympathetic denervated and burned, (5) sympathetic denervated non-burned, (6) vehicle sensory burned, (7) vehicle sympathetic burned, (8) non-denervated burned. We measured different morphologic and biochemical parameters such as wound surface area, histological alterations and mast cells. In addition, NGF, IL-1ß, IL-6 and IL-8 levels were determined using the ELISA technique. The gross observations, the histological data including mast cell modulation, as well as the molecular data, speak in favour of a significant delay in burn wound healing caused by sensory denervation. On the other hand, results support the positive role of sympathetic denervation in speeding up the healing process. The dual effect of the nervous system on burn wound healing is being documented in an animal model for the first time.

La peau est une barrière naturelle entre le milieu intérieur et son environnement. Elle a des fonctions physiologiques multiples et peut être atteinte par de nombreuses pathologies parmi lesquelles plaies et brûlures. Cette étude a pour but d'évaluer les effets du système nerveux sur la cicatrisation et plus particulièrement ceux de la dénervation chimique par guanéthidine des neurones sympathiques post ganglionnaires ainsi que celle des fibres sensitives à capsaïcine par résiniferatoxine. Des animaux ont été répartis en 8 groupes : (1) contrôle, (2) dénervation sensitive + brûlure, (3) dénervation sensitive sans brûlure, (4) dénervation sympathique + brûlure, (5) dénervation sympathique sans brûlure, (6) solvant de résiniferatoxine + brûlure, (7) solvant de guanéthidine + brûlure, (8) pas de dénervation + brûlure. Nous avons mesuré plusieurs paramètres morphologiques et biochimiques parmi lesquels la surface brûlées, les anomalies histologiques et la fonction mastocytaire. NGF, IL1b, IL6 et IL8 ont été mesurés par méthode ELISA. L'observation clinique, les données histologiques dont la modulation mastocytaire ainsi que les données moléculaires orientent vers un ralentissement de la cicatrisation après dénervation sensitive alors que la dénervation sympathique l'accélère. C'est la première fois que ces effets opposés des dénervations sélective est observée chez l'animal.

Mini-invasive surgery of infratemporal fossa schwannomas.

BACKGROUND: Infratemporal fossa schwannomas are benign, encapsulated tumours of the trigeminal nerve limited to the infratemporal fossa. Because of the complications and significant morbidity associated with traditional surgical approaches to the infratemporal fossa, which include facial nerve dysfunction, hearing loss, dental malocclusion and cosmetic problems, less invasive alternatives have been sought. METHODS: This paper reports two cases of infratemporal fossa schwannomas treated in 2012 using mini-invasive approaches. The literature regarding different infratemporal fossa approaches was reviewed. RESULTS: The first schwannoma was 30 mm in size and was removed completely by a preauricular subtemporal approach. The second one was 25 mm in size and was removed completely using a purely transnasal endoscopic approach. In both cases, there were no intra-operative or post-operative complications. CONCLUSION: These two approaches allow non-invasive and wide exposure of the infratemporal fossa as compared to classical approaches. Surgical approach should be selected according to the tumour's anatomical location with respect to the maxillary sinus posterior wall. The preauricular subtemporal approach is recommended for tumours localised posterolaterally with respect to the maxillary sinus posterior wall. Medial and anterior tumours near the maxillary sinus posterior wall can be best removed using a transnasal endoscopic approach.

Post-operative complications following dental extractions at the School of Dentistry, University of Otago.

OBJECTIVES: To determine the frequency and correlates associations of post-extraction complications at a dental school. DESIGN: Retrospective review of patient records. SETTING: Exodontia clinic at the School of Dentistry, University of Otago, Dunedin. MAIN OUTCOME MEASURES: Provider characteristics, patient demographic characteristics, patient medical history, teeth extracted and occurrence of postoperative complications. RESULTS: Of the 598 extractions (540 routine and 58 surgical) which were undertaken in the audit period, 74 (12.4%) resulted in post-operative complications. Dry socket and post-operative pain were the major complications. A higher complication rate was found among patients treated by fourth-year undergraduate students than among those treated by more senior students or staff. Post-operative complications were not significantly associated with patients' ethnicity or medical history. CONCLUSION: The rate of postoperative complications at the Univeristy of Otago's Faculty of Dentistry is consistent with reports in existing literature and inversely associated with operators' experience.

Otitis media with effusion in Lebanese children: prevalence and pathogen susceptibility.

OBJECTIVE: To determine the prevalence and resistance profile of bacterial pathogens present in the middle ear of children with otitis media with effusion, and to report beta-lactamase-negative, ampicillin-resistant bacteria for the first time in Lebanese children. METHOD: We included 62 patients younger than 12 year (107 ears), who underwent myringotomy with tympanostomy tube placement for persistent otitis media with effusion. Bacteria were identified by Gram staining and biochemical tests, and antibiotic sensitivities tested by the disc diffusion method and via minimum inhibitory concentration (E-test). RESULTS: The commonest pathogen was Haemophilus influenzae (62 per cent), followed by Streptococcus pneumoniae (26 per cent). The H influenzae resistance profile was highest for amoxicillin (81.0 per cent) and lowest for cefotaxime (19.0 per cent). There was a high risk of developing H influenzae antibiotic resistance among children with a history of smoking exposure (p = 0.001), recurrent upper respiratory tract infection (p = 0.001) or previous antibiotic treatment (p = 0.005). Fifty-two per cent of H influenzae colonies were found to be beta-lactamase-negative and ampicillin-resistant. CONCLUSION: In these children with persistent otitis media with effusion, H influenzae was the most prevalent bacteria. It showed a high incidence of resistance to the antibiotics most commonly prescribed to treat acute otitis media.

[On the epidemiology of recurrent and chronic brochopulmonary diseases-an examination of about 18000 children. 2. Investigations in the district of Quedlinburg (author's transl)]. / Zur Epidemiologie rezidivierender und chronischer bronchopulmonaler Erkrankungen-eine Untersuchung an etwa 18000 Kindern 2. Mitteilung: Untersuchung im Kreise Quedlinburg

Report of an epidemiological study in the district of Quedlinburg. This district comprises parts of the mountains of the Harz and an area in front of the Mountains. 4544 children were examined in the age-groups 5.-6., 8.-9., 11.-12. and 14.-15. years of life. In 3,4% of all children a chronic or recurrent nonspecific lung disease was discovered (in 2,5% a recurrent bronchitis, in 0,48% a chronic bronchitis and in 0,24% bronchial asthma). With increasing age the number of diseased children decreases. Differences in the frequency of the diseases between boys and girls could not be found. There were no differences in the rate of the diseases between the towns with somewhat higher degree of air pollution (Quedlinburg and Thale) and the other parts of the district. The frequency of bronchitis however was significantly higher in the mountains of the Hartz than in the lower situated territory, perhaps due to the rougher climate in the mountains.