Mild Inflammation Research Articles

Effect of omega-3 supplementation on osteoarthritis: An evidence-based case report

Background: Osteoarthritis is marked by mild inflammation, causing cartilage damage that leads to bone remodelling and potentially reduces the quality of life. Omega-3 has anti-inflammatory properties, which can help mitigate cartilage damage.
 Objective: This research aims to determine the role of omega-3 in relieving pain in patients with osteoarthritis.
 Methods: A literature search was conducted using advanced searching on three large databases: PubMed, Cochrane, and Scopus. The search used Mesh terms according to the criteria. After assessing the relevance and suitability of the literature, two articles were selected and critically evaluated based on Oxford Center for Evidence-Based Medicine.
 Results: Two systematic review-meta-analyses that meet the PICO and eligibility criteria were found. One of the literature sources does not demonstrate the effect of omega-3 supplementation on joint pain, while the other literature source shows the beneficial effects of omega-3 in reducing joint pain in osteoarthritis.
 Conclusion: Omega-3 supplementation can alleviate joint pain in individuals with osteoarthritis. Providing omega-3 may be worth considering.

Chemoprotective and immunomodulatory potential of Lactobacillus reuteri against cadmium chloride-induced breast cancer in mice

IntroductionThe current study aimed to investigate the role of probiotic Lactobacillus reuteri for the treatment and prevention of breast cancer. Materials and methodsBreast cancer was induced by using Cadmium Chloride (Cd) (2 mg/kg) in group II. Tamoxifen was administered to group III. Group IV was treated with Lactobacillus reuteri. Group V was treated with Cd for one month and divided into three subgroups including VA, VB, and VC which were treated with tamoxifen, Lactobacillus reuteri, and tamoxifen + Lactobacillus reuteri, respectively. ResultsSignificantly higher levels of TNF-α (40.9 ± 4.2 pg/mL), IL-6 (28.0 ± 1.5 pg/mL), IL-10 (60.2 ± 2.0 pg/mL), IFN-γ (60.2 ± 2.0 pg/mL), ALAT (167.2 ± 6.2 U/l), ASAT (451.6 ± 13.9 U/l), and MDA (553.8 ± 19.6 U/l) was observed in Cd group. In comparison, significantly lower levels of TNF-α (18.0 ± 1.1 pg/mL), IL-6 (9.4 ± 0.4 pg/mL), IL-10 (20.8 ± 1.1 pg/mL), IFN-γ (20.8 ± 1.1 pg/mL), ALAT (85.2 ± 3.6 U/l), ASAT (185 ± 6.9 U/l), and MDA (246.0 ± 7.5 U/l) were observed in group Cd + Tam + LR. Liver histopathology of the Cd group showed hemorrhage and ductal aberrations. However, mild inflammation and healthier branched ducts were observed in treatment groups. Furthermore, the renal control group showed normal glomerular tufts, chronic inflammation from the Cd group, and relatively healthier glomerulus with mild inflammation in treatment groups. ConclusionHence, the preventive and anticancerous role of probiotic Lactobacillus reuteri is endorsed by the findings of the current study.

Pulmonary cryptococcoma in a Friesian horse in the Netherlands

AbstractA 6‐year‐old female Friesian horse was admitted with pyrexia, dullness, weight loss, watery faeces and mild bilateral mucoid nasal discharge. Radiographic and ultrasonographic examination of the thorax indicated a large mid‐thoracic soft tissue mass, and the horse was euthanased because of a poor prognosis. At postmortem examination, it was found that the lung tissue was partly replaced by multiple to coalescing soft tissue lesions with a yellow gelatinous aspect, varying in size up to 15 × 15 × 20 cm. Histologically, the mass showed mild pyogranulomatous inflammation associated with large numbers of globular encapsulated 10–20 μm yeasts with or without narrow‐based budding, consistent with multiple coalescing cryptococcomas. Quantitative PCR testing of formalin‐fixed paraffin‐embedded tissue led to the identification of Cryptococcus gattii species complex. To the authors’ knowledge, this is the first case reported in the Netherlands of pulmonary cryptococcomas due to C. gattii sensu lato in a horse that had never travelled abroad.

Aseptic Silk Ligatures Induce Bone Resorption Around Titanium Implants: A 12-Week Pilot Study in Rabbits.

Marginal bone resorption (MBR) around dental implants may sometimes be a self-limiting condition due to balancing immunologic reactions against utilized materials rather than a progressive bacterial infection. Contrary to previous assumptions from ligature-induced experimental peri-implantitis studies, a recent 8-week experiment by the present authors showed that marginal ligatures trigger an inflammatory immune response, resulting in bone resorption around implants in the absence of plaque. The present study aimed to investigate whether this inflammatory/immunologic reaction attenuates or progresses toward implant failure after a longer healing time (12 weeks). Sterile silk ligatures were placed around the top of titanium (Ti) implants and compressed against the femoral cortical bone plate of six rabbits. A nonligated implant was used as a control. After 12 weeks of submerged healing, ground sections of implants and surrounding tissues were investigated with light microscopy. The marginal soft tissues were also analyzed using selected quantitative polymerase chain reaction (qPCR) markers. Histologically, the ligatures were outlined by immune cells, including multinucleated giant cells (MNGCs), with adjacent fibrous encapsulation and resorbed peripheral bone that contrasted from the osseointegrated nonligated control implants. The difference in expression of qPCR markers was not significant, but > two-fold upregulation of markers CD11b, IL1β, ARG1, NCF1, and CD4 and > twofold downregulation of CD8 indicated a mild, focal inflammatory/immune response against the ligatures compared to controls, with upregulation of M1 and M2 macrophages, neutrophils, and helper T-cells as well as downregulation of killer T cells. Further, the bone formation markers OC and ALPL were > two-fold downregulated (consistent with the lack of osseointegration of the ligatures) compared to control implants. Marginal silk ligatures trigger an inflammatory/immune response and aseptic bone resorption around implants. Compared to the previous 8-week study, the inflammatory reaction against the silk appears to attenuate with time, with only a mild persisting inflammation that may block osseointegration; instead, a fibrous tissue encapsulation-type reaction is maintained. This may explain why traditional ligature experiments have required regular exchange of ligatures for the bone resorption to progress.

Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause.

Background: The levels of oxidative stress and proinflammatory factors in perimenopausal females increased, and they were also deeply troubled by insomnia. The occurrence of insomnia is related to the changes of oxidative stress and inflammation levels in the body. Perimenopausal insomnia may be related to mild systemic inflammation, and oxidative stress can promote chronic inflammation. However, the underlying mechanism behind the phenomenon is still unclear. Objective: The aim was to investigate whether the occurrence of perimenopausal insomnia disorder is related to higher levels of oxidative stress and inflammation in the body, and to explore the role of inducible nitric oxide synthase (iNOS) in perimenopausal insomnia. Methods: A total of 127 perimenopausal participants were recruited in this study. Participants with global scores of the Pittsburgh sleep quality index (PSQI) >7 were diagnosed with insomnia (n = 54). The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were evaluated, and sociodemographic data were obtained. The serum concentrations of iNOS, interleukin 6 (IL6), and tumor necrosis factor α (TNFα) were measured using commercial assays. Results: In the insomnia group, IL6 levels were positively correlated with scores of component 5 and component 7 of PSQI, respectively. PHQ-9 and GAD-7 were positively correlated with the global score of PSQI component 7 and PSQI, respectively; PHQ-9 was positively correlated with the global score of PSQI component 1. Finally, PHQ-9, iNOS, and IL6 were found to be independent predictors of perimenopausal insomnia using logistic regression. Conclusions: Moderate oxidative stress caused by a certain concentration of iNOS plays a protective role in perimenopausal insomnia, while proinflammation and depression are potential risk factors.

Anti-Inflammatory and Wound Healing Potential of Comphora Wightii, Herbal Ointment on Wistar Rats

Background:: A herbal approach to Guggulu (Commiphora wightii), as an anti-inflammatory and wound healing agent is anticipated. Phyto-constituents Guggulusterone, Naringenin, and myrrhanol were reported for the anti-inflammatory activity of Guggulu. Studies suggests, that sesame oil (Sesamum indicum L.) and Ratanjot (Arnebia nobilis) also act as potent anti-inflammatory agents.. A combination of all three of these gives a synergistic effect for anti-inflammatory and excisional wound healing activity. Materials and Method:: A simple ointment base, BP and 5% Ratanjot, and Sesame oil were prepared. All the components, i.e., Guggulu, 5% Ratanjot Sesame oil, and simple ointment base, were added and triturated uni-directionally until a smooth, homogenous mixture was obtained. 25% w/w (F1) and 27% w/w (F2) Guggulu ointment were prepared. Four groups, each with three wistar rats, were studied for fourteen days. On the fourteenth day, rats were sacrificed, and tissues were collected for histopathological studies. Result:: F1 was compared against the standard formulation (10% w/w betadine, Win-Medicare) for excisional wound healing and anti-inflammatory activity in rats. On the foutheenth day, the results for percentage wound contraction in groups 1 (Negative control, vaseline), 2 (Controlled, ointment base), 3 (F1), and 4 (positive control, standard) were found to be 12.01, 25.32, 96.14, and 81.23, respectively.. Results of histopathological studies and H&E staining supported the action of F1, as skin sections showed the junction of normal skin and wound area. Sub-epithelial tissues showed low (-) to mild (+) inflammation. Mild oedema (+) was also noted. Conclusion:: The rat group treated with F1 showed maximum wound contraction, healing, and antiinflammatory activity as per percentage wound contraction and histopathological studies

Assessing the impact of mRNA vaccination in chronic inflammatory murine model

The implications of administration of mRNA vaccines to individuals with chronic inflammatory diseases, including myocarditis, rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are unclear. We investigated mRNA vaccine effects in a chronic inflammation mouse model implanted with an LPS pump, focusing on toxicity and immunogenicity. Under chronic inflammation, mRNA vaccines exacerbated cardiac damage and myocarditis, inducing mild heart inflammation with heightened pro-inflammatory cytokine production and inflammatory cell infiltration in the heart. Concurrently, significant muscle damage occurred, with disturbances in mitochondrial fusion and fission factors signaling impaired muscle repair. However, chronic inflammation did not adversely affect muscles at the vaccination site or humoral immune responses; nevertheless, it partially reduced the cell-mediated immune response, particularly T-cell activation. These findings underscore the importance of addressing mRNA vaccine toxicity and immunogenicity in the context of chronic inflammation, ensuring their safe and effective utilization, particularly among vulnerable populations with immune-mediated inflammatory diseases.

A238 BEST APPROACH TO SURVEILLANCE COLONOSCOPY FOR COLORECTAL CANCER IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS AND INFLAMMATORY BOWEL DISEASE

Abstract Background Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease and it has been recognized as a risk factor for hepatobiliary and colorectal carcinoma (CRC). Inflammatory bowel disease (IBD) is associated with a 6-fold increased risk of CRC as compared to the general population but with co-existing PSC, this risk rises to 30-fold and hence CRC surveillance is critical in these patients. Aims We performed a systematic review of the literature on surveillance colonoscopy for CRC in patients with PSC-IBD, with the aim of identifying the most effective approach. Methods The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under ID 472215. The search was executed in the databases Medline, EMBASE, Cochrane, Web of science, Scopus and Google Scholar databases from 1947 to May 2023. Observational or randomized controlled studies were included if patients had PSC-IBD (paediatric or adult) undergoing surveillance colonoscopy. There was no restriction for language. We used a modified version of the Newcastle–Ottawa Quality Assessment Scale to assess the risk of bias. Neoplasia was defined as the presence of low-grade dysplasia, high grade dysplasia or colorectal carcinoma. Results Amongst 2900 studies identified, 7 studies met the inclusion criteria with a total number of 379 PSC-IBD patients and 1884 IBD patients (all adult). The median frequency of surveillance colonoscopy was every 0-2 years. The most common endoscopic presentation of dysplasia in PSC-IBD was a normal appearing mucosa or subtle abnormalities such as mild inflammation. Three studies performed random and targeted biopsies and only one study did quadruple random biopsy (every 10 cm of the colon). Two studies used chromoendoscopy and high-definition endoscopy whereas another two studies used white light colonoscopy. Studies varied in terms of the number of biopsies taken and timing for the frequency and initiation of surveillance. Outcomes included intensive surveillance, resection, and colectomy. Our meta-analysis of 2 studies that reported the prevalence of colorectal dysplasia in PSC-IBD patients revealed a pooled prevalence of 21% (95% CI 1.4%-28%, I2 = 0%, Pampersand:003C0.597, shown in Figure 1) Conclusions Colorectal dysplasia is prevalent in patients with PSC-IBD and is associated with worse disease outcomes. As a result, PSC-IBD patients should be screened annually from the diagnosis of PSC. However, there is variation in practice, and no clear consensus on the best approach to perform screening colonoscopy in this population. Literature comparing various approaches is very sparse. Additional high-quality studies on this subject are needed to guide practice, particularly in paediatrics where data are non-existent. Figure 1: Forest plot for meta-analysis of CRC dysplasia prevalence in PSC-IBD Funding Agencies None

Relation between Body Mass Index and Knee Osteoarthritis in Pre-Elderly to Elderly at Orthopedic Poly of Dr. Mohamad Soewandhie Regional Public Hospital Surabaya

Osteoarthritis is a degenerative joint disease characterized by painful joints, particularly prevalent in older individuals, attributed to mild inflammation resulting from bone-end friction. A study conducted in Surakarta revealed a 4.9-fold increase in osteoarthritis risk among individuals with a BMI >25 compared to those with a BMI of 18.5-25.0. This research aims to investigate the association between knee osteoarthritis and BMI among elderly patients at the orthopedic outpatient clinic of Sesyapdhio Hospital, Surabaya. Using cross-sectional observational analysis, osteoarthritis patients were identified. The findings indicate a correlation between higher BMI and increased severity of osteoarthritis, contrasting with milder cases observed in individuals with normal BMI. Spearman's rank correlation review revealed a strong positive correlation (r=0.554) between BMI and osteoarthritis severity at Sexygandhio Hospital Surabaya. This study's unique contribution lies in its focused exploration of the relationship between BMI and osteoarthritis severity in elderly patients, offering insights into potential interventions tailored to BMI-specific risk profiles.

Lipoprotein Glomerulopathy With Complete Resolution With Fenofibrate: Report of First Case From Pakistan.

Background: Lipoprotein glomerulopathy is an infrequent glomerular disorder that culminates in nephrotic syndrome and often progresses to kidney failure. Whereas most patients have been reported in Japan and China, limited reports have been documented outside these regions. This patient represents the first report of lipoprotein glomerulopathy in Pakistan. Case Presentation: A 25-year-old male patient, hypertensive for 2 years, presented with progressive body edema, frothy urine, and fatigue. Examination revealed elevated blood pressure, bilateral pedal edema, and positive shifting dullness. Laboratory results showed significant proteinuria and elevated cholesterol and triglyceride levels. Renal biopsy revealed enlarged glomeruli with a dilated capillary lumen filled with pale-staining mesh-like material "lipoprotein thrombi." Mild tubular atrophy and interstitial inflammation were observed. No interstitial fibrosis was evident. Electron microscopy detailed the lipoprotein thrombi with lipid granules and vacuoles of various sizes. A diagnosis of lipoprotein glomerulopathy was rendered. Treatment with fenofibrate, rosuvastatin, and captopril led to notable improvements in symptoms, blood pressure, and lipid levels during a 6-month follow-up. Subsequent biopsy showed complete resolution of the lipoprotein thrombi and a significant reduction in subendothelial granular densities. However, the flocculent subendothelial material persisted to some extent despite the complete resolution of lipoprotein thrombi. Conclusion: This report underscores the rarity of lipoprotein glomerulopathy in Pakistan and contributes valuable insights into its histopathologic features and global epidemiology. This unique instance aims to raise awareness among healthcare professionals, aiding in improved recognition of this rare entity. The favorable response to fenofibrate treatment underscores its effectiveness in managing lipoprotein glomerulopathy.

Parasites of Stray Cats in Iran: A Parasitological and Histopathological Study.

Many zoonotic parasitic diseases, including Toxocara cati, may be spread by stray cat populations. This study aimed to determine the prevalence of parasites by performing parasitological and histopathological examinations on stray cats in Shiraz, Iran. A total of 106 stray cats from different geographical areas of Shiraz, southern Iran, were examined for the presence of parasites. The overall prevalence was found to be 83.02% (88/106), and eight parasites were found. The parasites included three genera of cestodes [Joyeuxiella echinorhynoides (52.83%), Taenia taeniaeformis (21.70%), and Dipylidium caninum (1.89%)], three nematodes [Physaloptera praeputialis (23.59%), Toxocara cati (15.09%), and Rictularia sp. (1.89%)], one protozoa [Isospora spp. (6.60%)], and one arthropod [Ctenocephalides felis (5.66%)]. The prevalence did not significantly differ between males and females. It did appear, nevertheless, that the age of cats may be regarded as a risk factor for these parasitic infections. Histopathological examination revealed some parasite-induced lesions in the intestine and stomach, including hyperemia, hemorrhage, mucosal destruction and inflammation. The lung tissues showed some histopathological lesions such as hemorrhage, edema, emphysema and mild inflammation, and dormant larvae were found in one tongue sample. The results of the present study showed that parasitic infections and, more importantly, T. cati are relatively prevalent in stray cats, and the people living in this area are at serious risk of this zoonotic disease. The cats in this region need to be monitored, and specific preventive measures should be developed by public health officials.

HISTOPATOLOGICAL CHANGES OF WHITE RATS' SKIN CAUSED BY APPLICATION OF MIMOSIN FROM SIMPLISIA OF THE LAMTORO LEAF

Mimosine is one of the substances contained in lamtoro (Leucaena leucocephala) leaves. The toxic effect of mimosine on livestock is highly dependent on the concentration of mimosine in feed ingredients and the length of time livestock consume feed high in mimosine. This study aims to determine the histopathology of white rat skin exposed to mimosine compounds with different doses. This study used male white rats with Wistar strain, 2 months old and 300-350 g body weight. The 20 rats used were divided into four treatment groups, namely P0 (negative control, P1 (positive control, given standard mimosine 5 mg/head/day), P2 (given lamtoro leaf simplisia at a dose of 50 mg/head/day orally), P3 (given lamtoro leaf simplisia at a dose of 150 mg/head/day). On the 15th day of necropsy, the skin organs were taken and fixed using 10% NBF. After the skin organs were fixed, histopathology preparations were made using HE staining. Histopathologic examination was performed including three lesion variables: hair follicle necrosis, congestion, and inflammation. The severity of the lesions was scored as 0, 1, 2, and 3 for normal, mild, moderate and severe lesions, respectively. Data were then analyzed using Kruskal-Wallis and Mann-Whitney non-parametric tests. The results showed that exposure to mimosine from lamtoro leaf simplisia did not cause hair loss in experimental animals as it does in cattle. However, exposure to mimosine in P1 (5 mg/head/day) and P3 (150 mg/head/day) caused histopathological skin lesions in the form of congestion, necrosis, and mild inflammation. The results showed that exposure to mimosine from lamtoro leaf simplisia did not cause hair loss in experimental animals as it does in cattle. However, exposure to mimosine in P1 (5 mg/head/day) and P3 (150 mg/head/day) caused histopathological skin lesions in the form of congestion, necrosis, and mild inflammation. The conclusion of the study is that mimosine compounds from lamtoro leaf simplisia cause histopathological changes in white rat skin tissue, especially congestion lesions. However, there was no difference in the effect of mimosine administration from lamtoro leaf simplisia between a dose of 50 mg/head/day and a dose of 150 mg/head/day on the histopathology of rat skin tissue. Further research needs to be done on the effect of exposure to mimosine from lamtoro leaf simplisia with higher concentrations.

Efficacy of 2% Hydroxypropyl Methylcellulose and Bandage Contact Lens for the Management of Dry Eye Disease after Cataract Surgery

Objectives. To investigate the effect of 2% hydroxypropyl methylcellulose (HPMC) and bandage contact lens (BCL) on dry eye disease after cataract surgery. Methods. This prospective randomized controlled trial included 63 eyes which were divided into the balanced salt solution (BSS), HPMC, BCL, and combined HPMC and BCL (H&B) groups. The Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), and average tear break-up time were measured before cataract surgery and 30 days postoperatively. Differences in corneal nerve fiber (CNF) and dendritic cell (DC) density in various directions were evaluated and compared. The CNFs and DCs in central and infratemporal directions were observed using in vivo confocal microscopy. Data were evaluated using the Kruskal–Wallis rank-sum test and analysis of variance. Results. The differences in variations in OSDI and TMH after cataract surgery between the four groups were statistically significant (P<0.05). The postoperative OSDI of the HPMC group decreased compared with their preoperative OSDI. A statistically significant difference in the variations of OSDI score was observed between the HPMC and other groups (P<0.05). The postoperative variations in TMH in the HPMC group were significantly higher than those observed preoperatively and significantly differed between HPMC and BCL groups and between BCL and H&B groups (P<0.05). Postoperatively, the density of corneal DCs decreased in BSS and HPMC groups and increased in BCL and H&B groups (P<0.001). Conclusions. The application of 2% HPMC in cataract surgery has a certain effect on managing dry eye after cataract surgery. Although the use of BCLs after cataract surgery has some benefits, it may cause mild ocular surface inflammation. Nevertheless, using 2% HPMC with BCLs in the perioperative phase of cataract surgery can alleviate the subjective discomfort of patients and can safely and effectively replace eye patch after cataract surgery.

Post-COVID-19 Vaccination Myocarditis: A Histopathologic Study on a Monocentric Series of Six Cases.

Many reports on the development of myocarditis following coronavirus disease 2019 (COVID-19) vaccination (PCVM) have emerged. However, only a few case studies have investigated endomyocardial biopsy (EMB) results. This study describes the clinicopathologic features of PCVM. We surveyed all hospitalized patients in a single university hospital in Korea and identified six cases of PCVM. All six patients underwent EMB, five of whom were men aged 15-85 years. All patients developed cardiac dysfunction. Among these patients, two had mild disease without sequelae, whereas the other four had dilated cardiomyopathy with depressed cardiac function. All six cases demonstrated lymphohistiocytic myocarditis. Two of our cases fulfilled the criterion of CD3+ T lymphocytes > 7 cells/mm2 (Case nos. 3 and 6), while the remaining four cases did not fulfill the Dallas criteria. In conclusion, most PCVM cases showed mild degree inflammation histopathologically, and some cases could not fulfill the Dallas criteria and were classified as borderline myocarditis.

Histological evaluation of the regenerative potential of a novel photocrosslinkable gelatin-treated dentin matrix hydrogel in direct pulp capping: an animal study

BackgroundTo assess histologically the success of the pulp capping approach performed in traumatically exposed dogs’ teeth using a novel injectable gelatin-treated dentin matrix light cured hydrogel (LCG-TDM) compared with LCG, MTA and TheraCal LC.MethodsSixty-four dogs’ teeth were divided into two groups (each including 32 teeth) based on the post-treatment evaluation period: group I: 2 weeks and group II: 8 weeks. Each group was further subdivided according to the pulp capping material into four subgroups (n = 8), with subgroup A (light-cured gelatin hydrogel) as the control subgroup, subgroup B (LCG-TDM), subgroup C (TheraCal LC), and subgroup D (MTA). Pulps were mechanically exposed in the middle of the cavity floor and capped with different materials. An assessment of periapical response was performed preoperatively and at 8 weeks. After 2 and 8-week intervals, the dogs were sacrificed, and the teeth were stained with hematoxylin-eosin and graded by using a histologic scoring system. Statistical analysis was performed using the chi-square and Kruskal-Wallis tests (p = 0.05).ResultsAll subgroups showed mild inflammation with normal pulp tissue at 2 weeks with no significant differences between subgroups (p ≤ 0.05), except for the TheraCal LC subgroup, which exhibited moderate inflammation (62.5%). Absence of a complete calcified bridge was reported in all subgroups at 2 weeks, while at 8 weeks, the majority of samples in the LCG-TDM and MTA-Angelus subgroups showed complete dentin bridge formation and absence of inflammatory pulp response with no significant differences between them (p ≤ 0.05). However, the formed dentin in the LCG-TDM group was significantly thicker, with layers of ordered odontoblasts identified to create a homogeneous tubular structure and numerous dentinal tubule lines suggesting a favourable trend towards dentin regeneration. TheraCal LC samples revealed a reasonably thick dentin bridge with moderate inflammation (50%) and LCG showed heavily fibrous tissue infiltrates with areas of degenerated pulp with no signs of hard tissue formation.ConclusionsLCG-TDM, as an extracellular matrix-based material, has the potential to regenerate dentin and preserve pulp vitality, making it a viable natural alternative to silicate-based cements for healing in vivo dentin defects in direct pulp-capping procedures.

Peri-implantitis increases the risk of medication-related osteonecrosis of the jaws associated with osseointegrated implants in rats treated with zoledronate

This study evaluated the peri-implant tissues under normal conditions and under the influence of experimental peri-implantitis (EPI) in osseointegrated implants installed in the maxillae of rats treated with oncologic dosage of zoledronate. Twenty-eight senescent female rats underwent the extraction of the upper incisor and placement of a titanium dental implant (DI). After eight weeks was installated a transmucosal healing screw on DI. After nine weeks, the following groups were formed: VEH, ZOL, VEH-EPI and ZOL-EPI. From the 9th until the 19th, VEH and VEH-EPI groups received vehicle and ZOL and ZOL-EPI groups received zoledronate. At the 14th week, a cotton ligature was installed around the DI in VEH-EPI and ZOL-EPI groups to induce the EPI. At the 19th week, euthanasia was performed, and the maxillae were processed so that at the implanted sites were analyzed: histological aspects and the percentage of total bone tissue (PTBT) and non-vital bone tissue (PNVBT), along with TNFα, IL-1β, VEGF, OCN and TRAP immunolabeling. ZOL group presented mild persistent peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling, but lower for VEGF, OCN and TRAP in comparison with VEH group. ZOL-EPI group exhibited exuberant peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling when compared with ZOL and VEH-EPI groups. Zoledronate disrupted peri-implant environment, causing mild persistent inflammation and increasing the quantity of non-vital bone tissue. Besides, associated with the EPI there were an exacerbated inflammation and even greater increase in the quantity of non-vital bone around the DI, which makes this condition a risk factor for medication-related osteonecrosis of the jaws.

Chronic electrical stimulation with a peripheral suprachoroidal retinal implant: a preclinical safety study of neuroprotective stimulation.

Extraocular electrical stimulation is known to provide neuroprotection for retinal cells in retinal and optic nerve diseases. Currently, the treatment approach requires patients to set up extraocular electrodes and stimulate potentially weekly due to the lack of an implantable stimulation device. Hence, a minimally-invasive implant was developed to provide chronic electrical stimulation to the retina, potentially improving patient compliance for long-term use. The aim of the present study was to determine the surgical and stimulation safety of this novel device designed for neuroprotective stimulation. Eight normally sighted adult feline subjects were monocularly implanted in the suprachoroidal space in the peripheral retina for 9-39weeks. Charge balanced, biphasic, current pulses (100μA, 500 µs pulse width and 50 pulses/s) were delivered continuously to platinum electrodes for 3-34weeks. Electrode impedances were measured hourly. Retinal structure and function were assessed at 1-, 2-, 4-, 6- and 8-month using electroretinography, optical coherence tomography and fundus photography. Retina and fibrotic thickness were measured from histological sections. Randomized, blinded histopathological assessments of stimulated and non-stimulated retina were performed. All subjects tolerated the surgical and stimulation procedure with no evidence of discomfort or unexpected adverse outcomes. The device position was stable after a post-surgery settling period. Median electrode impedance remained within a consistent range (5-10kΩ) over time. There was no change in retinal thickness or function relative to baseline and fellow eyes. Fibrotic capsule thickness was equivalent between stimulated and non-stimulated tissue and helps to hold the device in place. There was no scarring, insertion trauma, necrosis, retinal damage or fibroblastic response in any retinal samples from implanted eyes, whilst 19% had a minimal histiocytic response, 19% had minimal to mild acute inflammation and 28% had minimal to mild chronic inflammation. Chronic suprathreshold electrical stimulation of the retina using a minimally invasive device evoked a mild tissue response and no adverse clinical findings. Peripheral suprachoroidal electrical stimulation with an implanted device could potentially be an alternative approach to transcorneal electrical stimulation for delivering neuroprotective stimulation.

A Rare Case of Endometriosis in Urinary Bladder

Endometriosis with involvement of urinary tract is a rare occurrence. It is a chronic condition with presence of endometrial tissue outside uterine cavity. Most likely location is peritoneal surface of pelvis. We present a case of 32 year old female presenting with pelvic pain. On sonography bladder mass was detected. Transurethral resection of bladder mass revealed foci of endometriosis with mild inflammation in stroma. The diagnosis relies on identification of atleast two of the three components: endometrial glands, endometrial stromal cells or recent or old haemorrhage. Endometriosis with minimal stroma should be differentiated from invasive adenocarcinoma of the bladder. This case reports demonstrates that endometriosis in bladder although rare should always be ruled out by proper histological examination and save patient from unnecessary overtreatment.

Platelet and white blood cell counts correlate with leptin and body mass index in Japanese adolescents.

Obesity is associated with mild chronic inflammation, frequently observed along with increased platelet and white blood cell (WBC) levels in adults. We aimed to clarify the relationship between peripheral blood cell count, body mass index standard deviation score (BMI-SDS), and adipocytokine levels in obese adolescents. Participants included 31 patients with obesity (age: 13.1 ± 3.1 yr) and 28 normal-weight controls (age: 13.3 ± 1.9 yr). Obesity was defined as a percentage of overweight ≥ 20%; patients with type 2 diabetes were excluded. As sex differences were observed in blood cell counts, the analysis was performed after adjusting for sex differences. The obese group has significantly higher WBC, red blood cell, and platelet counts, as well as high serum leptin levels and Homeostasis Model Assessment of insulin resistance (HOMA-IR) scores compared with those of the control group. In all participants, BMI-SDS significantly correlated with WBC and platelet counts. Platelet count correlated with serum leptin and glucose levels, whereas WBC count correlated with serum leptin, insulin, HOMA-IR, and glucose levels. Statistical analysis showed that serum leptin level significantly influenced the platelet count and HOMA-IR score affected WBC count. Increased platelet and WBC counts in adolescents with obesity may increase the risk of thrombosis.

Herpetic keratouveitis: A three year follow‐up case

Aims/Purpose: Herpetic keratouveitis1 is a common presentation to Eye Casualty but due to the broad spectrum of manifestations that it can present with, it is an easy diagnosis to miss. The aim of this report is to create awareness among ophthalmologists of how this disease can present, appropriate clues to the diagnosis as well as how it should be managed.Methods: A 76 year old male presented to the eye emergency department with a 1 week history of significant visual deterioration (6/90 pinhole), redness and photophobia in his left eye. He was initially treated 6 weeks prior with a course of tapering steroid drops for presumed acute anterior uveitis which led to an initial improvement in symptoms, followed by a sudden worsening of symptoms. Ocular examination revealed a 9 mm × 8 mm central corneal ulcer with a satellite lesion superonasally, Descemet folds, reduced corneal sensation with mild anterior chamber inflammation and no posterior segment pathology. Corneal scrapes as well as PCR was sent for culture and sensitivity.Results: PCR revealed a positive result for herpes simplex virus and the patient showed significant improvement with oral acyclovir, topical gancyclovir ointment and topical steroid drops. In the 3 years following the initial presentation, the patient has had 3 further episodes of left herpetic keratouveitis and has now been put on lifelong maintenance dose oral acyclovir and FML drops.Conclusions: We report this case to highlight the key clinical features compatible with herpetic keratouveitis. This disease can be chronic and should be considered in any patient presenting with chronic anterior uveitis not improving with steroid drops. PCR remains the gold‐standard for diagnosis however this is not always positive and clinical diagnosis remains key.Reference1. Cunningham E.T. Diagnosing and treating herpetic anterior uveitis. Ophthalmology 2000; 107(12: 2129–30. doi:10.1016/s0161‐6420(00)00287‐6.