A Patient with a History of Multiple Myeloma Presents for the Evaluation of Oral Lesion and Burning Sensation of the Mouth.

Multiple myeloma (MM) is a hematologic malignancy belonging to a class of disorders known as plasma cell dyscrasias. Common oral manifestations of MM include osteolytic lesions in the mandible and maxilla that can present as painful bony swellings, epulis formation, or sudden teeth movement. MM treatment is coordinated by a multidisciplinary team and is dependent upon the age and physical fitness of the patient, as well as the staging of the disease. A large proportion will be treated with intravenous bisphosphonates, such as pamidronate and zoledronic acid, which places the patients at high risk for developing medication-related osteonecrosis of the jaw (MRONJ).

A Patient Presenting for Dental Extraction After Completion of Chemotherapy.

Acute myeloid leukemia (AML) presents several oral manifestations, including gingival hyperplasia, pale mucosa, poor wound healing, petechiae, ecchymoses, candidiasis, recurrent herpes infection, and ulcerations in the oral mucosa. Chemotherapy is the first-line treatment of AML. Common dental complications of chemotherapy include mucositis, infections secondary to profound bone marrow aplasia, and gingival bleeding. When treating patients with AML, preparing a comprehensive treatment plan is essential to help minimize their risks for developing these oral complications.

Probiotics (Direct-Fed Microbials) in Poultry Nutrition and Their Effects on Nutrient Utilization, Growth and Laying Performance, and Gut Health: A Systematic Review.

Probiotics are live microorganisms which, when administered in adequate amounts, confer health benefits to the host. The use of probiotics in poultry has increased steadily over the years due to higher demand for antibiotic-free poultry. The objective of this systematic review is to present and evaluate the effects of probiotics on the nutrient utilization, growth and laying performance, gut histomorphology, immunity, and gut microbiota of poultry. An electronic search was conducted using relevant keywords to include papers pertinent to the topic. Seventeen commonly used probiotic species were critically assessed for their roles in the performance and gut health of poultry under existing commercial production conditions. The results showed that probiotic supplementation could have the following effects: (1) modification of the intestinal microbiota, (2) stimulation of the immune system, (3) reduction in inflammatory reactions, (4) prevention of pathogen colonization, (5) enhancement of growth performance, (6) alteration of the ileal digestibility and total tract apparent digestibility coefficient, and (7) decrease in ammonia and urea excretion. Thus, probiotics can serve as a potential alternative to antibiotic growth promoters in poultry production. However, factors such as the intestinal health condition of birds, the probiotic inclusion level; and the incubation conditions, feedstuff, and water quality offered to birds may affect the outcome. This systematic review provides a summary of the use of probiotics in poultry production, as well as the potential role of probiotics in the nutrient utilization, growth and laying performance, and gut health of poultry.

Conventional and functional imaging in the evaluation of temporomandibular joint rheumatoid arthritis: a systematic review.

OBJECTIVES: To evaluate the efficacy of diagnostic imaging for temporomandibular joint rheumatoid arthritis (TMJ RA). Inflammation of the TMJ has a high correlation (> 17%) with the late stages of RA. Clinical recognition of TMJ RA using diagnostic imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and cone beam computed tomography (CBCT), is limited to osseous and soft tissue components of the TMJ. Positron emission tomography (PET) and positron emission tomography/CT (PET/CT) are novel technologies that have shown increasing relevance in the detection and management of TMJ RA. METHOD AND MATERIALS: Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA, 2009) guidelines, and using databases such as PubMed, Ovid Medline, Google Scholar, Web of Science, Scopus, and EBSCOhost, 94 publications were identified, and 27 studies were selected for this systematic review. A flowchart of the comprehensive study selection was generated. Quality assessment and data extraction were performed independently by three reviewers. RESULTS: It was noted that two-dimensional radiographs, CBCT, multidetector CT, and MRI are the most commonly used methods in TMJ RA assessment, although they are not useful for determination of active disease. MRI has excellent contrast resolution and can acquire dynamic imaging for demonstration of the functionality of the TMJ. CT and ultrasound imaging also have specific indication in imaging the TMJ. PET used in conjunction with CT is the only imaging modality that can quantify TMJ RA in active disease. CONCLUSIONS: PET/CT images provide unique quantitative information that cannot be obtained from any other imaging modalities.

The effects of probiotics in lactose intolerance: A systematic review.

Over 60 percent of the human population has a reduced ability to digest lactose due to low levels of lactase enzyme activity. Probiotics are live bacteria or yeast that supplements the gastrointestinal flora. Studies have shown that probiotics exhibit various health beneficial properties such as improvement of intestinal health, enhancement of the immune responses, and reduction of serum cholesterol. Accumulating evidence has shown that probiotic bacteria in fermented and unfermented milk products can be used to alleviate the clinical symptoms of lactose intolerance (LI). In this systematic review, the effectiveness of probiotics in the treatment of LI was evaluated using 15 randomized double-blind studies. Eight probiotic strains with the greatest number of proven benefits were studied. Results showed varying degrees of efficacy but an overall positive relationship between probiotics and lactose intolerance.