The risk reduction of recurrent periodontal pathogens of local application minocycline HCl 2% gel, used as an adjunct to scaling and root planing for chronic periodontitis treatment.

BACKGROUND: The aim of this study was to evaluate the clinical and microbiological effects of local application minocycline HCl 2% gel, used as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis (CP). CP is an inflammation of periodontal tissue that is caused mainly by bacterial infection, where periodontal destruction such as loss of attachment and bone destruction occurred. METHODS: A total of 81 subjects with moderate to severe periodontitis whose baseline clinical attachment loss (CAL) was ≥4 mm were randomly assigned to receive SRP alone (control group, N=39) or SRP followed by four times of local application of minocycline HCl gel (Periocline) once a week (test group, N=42). Pocket depth, CAL, and papilla bleeding index were examined at baseline, 21 days, 2, 3, and 6 months. Subgingival plaque samples were collected with sterile curettes and were analyzed by real-time polymerase chain reaction for the presence of three periodontal pathogens (Porphyromonas gingivalis [P.g.], Tannerella forsythia [T.f.], and Treponema denticola [T.d.]) at baseline, 2, 3, and 6 months. RESULTS: The number of bacteria was reduced in both groups at 2 months after baseline (SRP treatment). The changes (2-6 months) in T.d. and T.f. counts in the test group were significantly lower than those in the control group. In the control group, a significant regrowth of P.g., T.f., and T.d. was observed from 2 to 6 months and of P.g. and T.f. from 3 to 6 months. On the other hand, in the test group, the number of the three bacteria did not significantly increase during the 6-month period. CONCLUSION: The results showed that local application of minocycline, used as an adjunct to SRP, was effective for suppressing regrowth of periodontal pathogens, suggesting its risk reduction of recurrent periodontal pathogens in CP.

Virchow's node metastasis: an unusual presentation of ovarian cancer.

Ovarian primaries of supraclavicular metastases are extremely rare. The present study reports the case of a 64-year-old female with a left supraclavicular mass without any other symptoms. After performing a fine needle aspiration biopsy for pathological examination and positron emission imaging, she was diagnosed with FIGO Stage IV high-grade serous epithelial ovarian carcinoma. After three cycles of chemotherapy with paxlitaxel and carboplatin, complete response was achieved. There are only a few reports in literature that address patients with the initial symptom of left supraclavicular mass and final diagnosis of ovarian cancer. To the best of the authors' knowledge, this is the first report to describe the successful use of PET/CT to determine the primary site.

High body-mass index is not associated with worse clinicopathological characteristics in predominantly obese breast cancer patients.

BACKGROUND: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI) is related to increased incidence of BC with poorer prognosis. AIM: The aim of the study was to evaluate the association in patients with BC between BMI at the time of diagnosis and biological characteristics, according to the menopausal status. MATERIALS AND METHODS: This retrospective study comprised a total of 318 women with BC. Clinicopathological differences between normal, overweight and obese patients according to menopausal status were evaluated. RESULTS: Premenopausal women had a significantly lower BMI than postmenopausal patients (28.7 vs. 31.5, respectively; p = 0.00001). No statistically significant association was determined between BMI and clinicopathological characteristics in either the premenopausal or the postmenopausal group (all p values are > 0.05). CONCLUSIONS: There are many conflicting results in literature on this relationship. The results of this study showed that a high BMI is not associated with worse clinicopathological characteristics in a predominantly obese population. In current medical oncology practice, BC should be evaluated on an individual patient basis and the impact of obesity on BC prognosis seems to be difficult to estimate especially in an obese population.

Primary testicular lymphoma: a single centre experience.

AIM: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin's lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. MATERIALS AND METHODS: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. RESULTS: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53-79 years). The mean follow-up time was 24.8 months (range 7-98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4-6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system after 6 months who had not received intrathecal prophylaxis. No contralateral testis relapse was observed. CONCLUSIONS: Primary testicular NHL is an uncommon entity and we evaluated 8 patients; with one relapse in central nervous system and no relapse in the contralateral testis.

Single dose regorafenib-induced hypertensive crisis.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper reports the first case of Grade IV hypertension after the first dosage of regorafenib. We can suggest that hypertension is an idiosyncratic side effect unrelated to the dosage.

Mean platelet volume could be a useful biomarker for monitoring epithelial ovarian cancer.

New studies show that inflammatory markers and blood cells may be related to epithelial ovarian cancer (EOC). We aimed to examine whether mean platelet volume would be a useful marker for EOC patients to predict tumour burden and prognosis, and investigate the difference in MPV values between EOC patients and healthy controls. We retrospectively investigated 113 ovarian cancer patients who underwent surgery between January 2008 and July 2012 and 90 healthy subjects. MPV levels were significantly higher in preoperative EOC patients compared with healthy subjects (8.26 fl vs 7.71 fl; p = 0.004). Also NLR and PLR values were significantly higher in EOC patients (NLR, 3.48 vs 2.37; p = 0.000; PLR, 241 vs 148; p = 0.000). Surgical tumour resection resulted in a significant decrease in MPV levels (8.26 fl vs 7.61 fl; p = 0.001). NLR values also decreased after tumour resection significantly similar to CA125 (NLR, 3.48 vs 2.49; p = 0.000). Our data suggests that MPV could be a promising and easily available biomarker for monitoring EOC patients.

Effects of rosiglitazone on plasma brain natriuretic peptide levels and myocardial performance index in patients with type 2 diabetes mellitus.

Thiazolidinediones (TZD) have become a powerful tool for lowering insulin resistance. The problem of cardiovascular adverse events including fluid retention and risk of heart failure should be well known and recognised. We aimed to evaluate the long-term effects of rosiglitazone on cardiac function and fluid dynamics. Forty-six type 2 diabetic patients were randomised to treatment with rosiglitazone or metformin or to a control group. There are no significant differences between the groups in the duration of diabetes, HbA1c, plasma brain natriuretic peptide (BNP) levels, body mass index and myocardial performance indexes (MPIs) before the treatment. After three and six months all these parameters were repeated. Rosiglitazone increased plasma BNP levels and worsened MPIs 3 months after the start of treatment. Also left ventricular end-systolic volume increased and weight gain was observed. But these results were statistically non-significant (all p>0.05). When we continued rosiglitazone treatment to six months the increase in BNP levels became soft and statistically significant improvements were seen in MPIs (p<0.01). Also left ventricular end-systolic volume decreased significantly (p=0.004) and weight gain was stopped. In patients with type 2 diabetes, TZD treatment might have slight adverse effects on ventricular contractility and fluid dynamics at the beginning of the therapy. However, these changes seem to stabilise in the long term.

The influence of experimental hyperthyroidism on responsiveness in rabbit aortic smooth muscle.

This study investigated the responsiveness of hyperthyroid and control (euthyroid) rabbit aortic rings to vasoconstrictor agents. There was no significant difference between the responsiveness of hyperthyroid and control tissues to KCl. Maximum responses (E(m)) to noradrenaline and serotonin were reduced in hyperthyroid rabbit aortic rings compared to those euthyroid rings. The sensitivity (i.e., EC(50)) of hyperthyroid aortic rings to noradrenaline and serotonin compared to euthyroid controls was unchanged. The K(b) value of prazosin against 10(-6) M noradrenaline-induced contractions in eu- and hyperthyroid states was 1.97 ± 0.59 · 10(-9) M and 1.92 ± 0.79 · 10(-9) M, respectively. The K(b) value of methisergide against 10(-6) M serotonin-induced contractions in eu- and hyperthyroid states was 1.46 ± 0.80 · 10(-9) M and 1.10 ± 0.16 · 10(-9) M, respectively. These data indicate that vascular reactivity is altered in experimental hyperthyroidism and this alteration, if any, do not occur at the receptor level.