Non-affected Areas Research Articles

Regional spread of Ebola virus, West Africa, 2014.

To explain the spread of the 2014 Ebola epidemic in West Africa, and thus help with response planning, we analyzed publicly available data. We found that the risk for infection in an area can be predicted by case counts, population data, and distances between affected and nonaffected areas.

Optical Coherence Tomography Findings in Recurrent Corneal Erosion Syndrome

To report the findings of optical coherence tomography (OCT) in the corneas of patients with recurrent corneal erosion syndrome (RCES). Ten normal subjects and 25 patients with RCES were recruited for the study. Ten patients with RCES suffered from an acute episode of pain and 15 patients complained of typical chronic symptoms of RCES. All eyes were scanned with the anterior segment 5 line raster acquisition protocol of the Cirrus HD-OCT platform (Zeiss). The etiology of RCES was investigated and treatment was provided following a standard clinical protocol. Scans were obtained at different stages of the pathology and each patient was followed-up after treatment. Tear film, epithelium, basement membrane, Bowman layer, stroma, and Descemet-endothelium complex were identified by OCT in all normal corneas. The same structures were identified in nonaffected areas of RCES corneas. The findings on OCT from patients suffering from acute RCES were as follows: anterior stromal hyper-reflectivity (100%), epithelial edema (100%), and irregular breaks in the epithelium (90%). Undetected epithelial basement membrane (100%), intraepithelial basement membrane (60%), intraepithelial inclusions (60%), and anterior stromal hyper-reflectivity (40%) were seen in patients with chronic RCES. These findings correlated well with the clinical symptoms and with previously described histological reports of RCES. Corneal OCT can be useful to study and manage RCES. Specific OCT findings may clarify etiology, confirm a suspected diagnosis, and give advice on the decision to treat patients.

Cutaneous immunopathology of long-standing complex regional pain syndrome.

Both increased mast cells numbers and raised immune mediator concentrations indicate immune activation in the affected skin of patients with early complex regional pain syndrome (CRPS), but little is known about regional immune cell involvement in late-stage CRPS. The aim of the current study was to determine skin immune cell populations in long-standing CRPS. Using 6-mm skin punch biopsies from CRPS-affected and non-affected tissues, and a combination of chemical and immunofluorescence staining, we examined the density and function of key cell populations including mast cells, epidermal Langerhans cells (LCs) and tissue resident T-cells. We found no significant differences in either overall immune cell infiltrates, or mast cell density between CRPS-affected and non-affected sub-epidermal tissue sections, contrasting recent findings in early CRPS by other groups. However, CD1a(+) LC densities in the epidermal layer were significantly decreased in affected compared to non-affected CRPS limbs (p<0.01). T-cell clones isolated from CRPS-affected sub-epidermal tissues displayed a trend towards increased IL-13 production in ELISPOT assays when compared to T-cells isolated from non-affected areas, suggesting a Th2 bias. Immune cell abnormalities are maintained in late-stage CRPS disease as manifest by changes in epidermal LC density and tissue resident T-cell phenotype.

Public Health Safety in Relation to Microbiological Quality of Freshly Drawn Cow’s Milk in Bangladesh

The aim of the present study was to determine the microbial quality of freshly drawn cow’s milk belonging to the arsenic affected and non-affected areas. In the present work 25 milk sample were collected from five different arsenic affected and non-affected areas. The analysis comprised enumeration of total viable count (TVC), total coliform count (TCC) and total staphylococcal count (TSC) for the determination of sanitary quality. The highest total viable count, total coliform count and total staphylococcus count were log 5.894 ± 0.221, log 2.832± 0.129 and log 2.898 ± 0.162 respectively. Staphylococcus spp, Escherichia coli, Pseudomonas spp and Bacillus spp were isolated from the milk samples. Among them Escherichia coli were isolated from the maximum milk samples. It is found that the level of microbial quality in terms of TVC, TCC and TSC were high in arsenic affected areas than arsenic non-affected area. It also found that TVC and TCC were positively correlated with each other. This survey indicates that most of the raw milk samples were not satisfactory in course of public health standard as some pathogenic bacteria were detected from these samples and it is necessary to improve the hygienic practices required for the handling and processing of milk.DOI: http://dx.doi.org/10.3329/bjvm.v12i2.21297 Bangl. J. Vet. Med. (2014). 12 (2): 231-236

Prevalence of psychiatric symptoms in children and adolescents one year after the 2009 L'Aquila earthquake.

BackgroundIn 2009, an earthquake devastated the Abruzzo region in Italy. Despite the occurrence of several disasters in this country, no study on mental health of Italian children has ever been conducted in complex emergencies. Objective of the study was to assess the prevalence of psychiatric symptoms among children in the affected area 12 to 17 months after the event.MethodsA community sample of 1839 3-14 years children was identified from the general population assigned to 37 paediatricians of the National Health System, including children living in the earthquake epicentre, the surrounding earthquake zone, and the adjacent non-affected areas. Psychiatric symptoms were assessed with the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR), completed by 452 children aged 11–14 years. The association between symptoms and sociodemographic, health, family, and earthquake-related factors was examined.ResultsThe prevalence of CBCL-defined cases was 14.9% in the epicentre, 13.0% in the remainder earthquake zone, 13.9% in the unaffected area (p = .876). No differences among areas were found when comparing the YSR results. Prevalence of CBCL-defined post-traumatic stress (PTS) cases was 8.4% in the epicentre, 4.0% in the remainder earthquake zone, 2.2% in the unaffected area (p = .002). PTS and anxiety were significantly more frequent in the epicentre than in other areas only in the 6–10 year-old children group (respectively p = .009 and p = .014). In multivariate logistic analyses, factors associated with PTS were living in the epicentre (OR = 3.6) and child or maternal history of mental health care prior to the earthquake (respectively OR = 7.1 and OR = 4.5).ConclusionsChildren living in the epicentre, particularly those 6–10 years old, had the highest prevalence of CBCL-defined cases, and of PTS and anxiety symptoms one year after the earthquake. No signs of increased psychopathology were detected in younger (3–5 years) or older children (11–14 years). Family and health related factors showed stronger association with psychiatric outcomes than earthquake-related factors. The identification of populations at higher risk of developing psychiatric symptoms has implications for public health interventions in complex emergencies.

Longitudinal structure/function analysis in reticular pseudodrusen.

To describe longitudinal structure/function correlations in eyes with progressive reticular pseudodrusen (RPD). Thirteen eyes of 12 patients with exclusively RPD in the posterior pole were included (75.1 ± 5.7 years). All patients underwent spectral-domain optical coherence tomography (SD-OCT), confocal scanning laser ophthalmoscopy (cSLO), and multifocal electroretinography (mfERG) at baseline and 12-month follow-up. Size of retinal area affected by RPD, number and stages of RPD lesions, and choroidal thickness (CT) were quantified at baseline and at follow-up visit. Amplitudes obtained by mfERG in RPD eyes at baseline and follow-up were analyzed and correlated to morphologic changes. Eyes were compared to those of age-matched healthy controls. The total number of RPD lesions increased from 540 at baseline to 667 at 12-month follow-up. Mean CT was 198.5 ± 69.3 μm at baseline (control group 263.5 ± 42.6 μm; P = 0.005) and 189.2 ± 65.3 μm at follow-up (P < 0.001) (control group 265 ± 47.8 μm; P = 0.74). A mean growth of RPD-affected area of 3.3 mm(2) was measured. Multifocal ERG amplitudes decreased in both the study and control groups to a similar extent. Amplitudes differed significantly at the follow-up time point when compared between RPD-affected and nonaffected areas within the same eye. No correlations between changes of morphologic parameters and mfERG amplitude changes were found. Multifocal ERG allows for detecting a decline of function over time in eyes with progressive RPD. Yet functional decline could not be correlated to changes in individual morphologic parameters.

A comparative study of knowledge regarding emergency care during disaster between community health volunteers working in tsunami-affected and non-affected areas in Aceh Province, Indonesia

Purpose: This study aimed to describe and compare the level of knowledge regarding emergency care during disaster between community health volunteers (CHVs) working in the tsunami affected and non-affected areas in Aceh Province, Indonesia.Method: 144 CHVs from six districts in Aceh were studied during November 2011 to January 2012 to evaluate their level knowledge regarding emergency care during disaster between CHVs working in tsunami-affected 6-areas and non-tsunami-affected areas. The knowledge was assessed using the Community Health Volunteers’ Knowledge Regarding Emergency Care Questionnaire (CHVK-ECQ) with 30 true/false statements. The composite scores of each area and the total score were calculated and transformed to percentage for ease of presentation.Results: Overall, the CHVs’ knowledge in emergency care during disaster in Aceh was at a high level in both groups. However, subjects in non-affected areas had significantly higher mean rank of the overall knowledge than those in the affected areas (p = .02). In the tsunami area, the highest mean score of knowledge was in the disaster triage dimension (M= 80.62%), and the lowest mean score was in the first aid (60.48 %). In contrast, CHVs’ knowledge in the non-tsunami areas had the highest mean score in the first aid (84.52 %) and had the lowest mean score in the disaster triage (64. 38 %).Conclusion: Although both groups had high levels of overall knowledge, an education program for improved knowledge in the areas of first aid, team organization, and disaster triage should be emphasized to refresh the CHVs’ knowledge and skills for disaster management.

Three Novel Haplotypes of Theileria bicornis in Black and White Rhinoceros in Kenya.

Piroplasms, especially those in the genera Babesia and Theileria, have been found to naturally infect rhinoceros. Due to natural or human-induced stress factors such as capture and translocations, animals often develop fatal clinical piroplasmosis, which causes death if not treated. This study examines the genetic diversity and occurrence of novel Theileria species infecting both black and white rhinoceros in Kenya. Samples collected opportunistically during routine translocations and clinical interventions from 15 rhinoceros were analysed by polymerase chain reaction (PCR) using a nested amplification of the small subunit ribosomal RNA (18S rRNA) gene fragments of Babesia and Theileria. Our study revealed for the first time in Kenya the presence of Theileria bicornis in white (Ceratotherium simum simum) and black (Diceros bicornis michaeli) rhinoceros and the existence of three new haplotypes: haplotypes H1 and H3 were present in white rhinoceros, while H2 was present in black rhinoceros. No specific haplotype was correlated to any specific geographical location. The Bayesian inference 50% consensus phylogram recovered the three haplotypes monophyleticly, and Theileria bicornis had very high support (BPP: 0.98). Furthermore, the genetic p-uncorrected distances and substitutions between T.bicornis and the three haplotypes were the same in all three haplotypes, indicating a very close genetic affinity. This is the first report of the occurrence of Theileria species in white and black rhinoceros from Kenya. The three new haplotypes reported here for the first time have important ecological and conservational implications, especially for population management and translocation programs and as a means of avoiding the transport of infected animals into non-affected areas.

Effects of catalyst-generated atomic hydrogen treatment on amorphous silicon fabricated by Liquid-Si printing

The film property distributions along the thickness direction of the catalyst-generated atomic hydrogen (Cat-H*) treatment effects on hydrogenated amorphous silicon (a-Si:H) fabricated by plasma-enhanced chemical vapor deposition (plasma-CVD) and Liquid-Si printing (LSP) were systematically investigated. The a-Si:H films fabricated by LSP (L-a-Si:H) had nanosize voids; however, these films showed a decrease in void size around the surface region after Cat-H* treatment, in contrast to stable plasma-CVD films without voids. The decrease in nonaffected area by Cat-H* treatment in L-a-Si:H films improved the performance of a-Si:H solar cells with L-a-Si:H. Additionally, we achieved a 3.1% conversion efficiency for a-Si:H solar cells with L-a-Si:H as the active layer by stacking nondoped a-Si:H, fabricated by plasma-CVD, on the active layer.

Chikungunya outbreak in the Caribbean region, December 2013 to March 2014, and the significance for Europe

On 6 December 2013, two laboratory-confirmed cases of chikungunya without a travel history were reported on the French part of the Caribbean island of Saint Martin, indicating the start of the first documented outbreak of chikungunya in the Americas. Since this report, the virus spread to several Caribbean islands and French Guiana, and between 6 December 2013 and 27 March 2014 more than 17,000 suspected and confirmed cases have been reported. Further spread and establishment of the disease in the Americas is likely, given the high number of people travelling between the affected and non-affected areas and the widespread occurrence of efficient vectors. Also, the likelihood of the introduction of the virus into Europe from the Americas and subsequent transmission should be considered especially in the context of the next mosquito season in Europe. Clinicians should be aware that, besides dengue, chikungunya should be carefully considered among travellers currently returning from the Caribbean region.

Regulated expression of leukocyte-specific transcript (LST) 1 in human intestinal inflammation

Leukocyte-specific transcript 1 (LST1) encoded peptides are involved in immunomodulation and nanotube-mediated cell-cell communication. The aim of this study was to assess the expression of LST1 in colonic epithelium and endothelium during intestinal inflammation. LST1 expression was evaluated by RT-PCR, FACS, western blot analysis, and immunohistochemistry in intestinal epithelial Caco-2 cells, human intestinal microvascular endothelial cells and in human histological specimens from inflammatory bowel disease (IBD) patients and non-IBD colitis patients. LST1 expression was significantly increased upon proinflammatory stimulation in intestinal epithelial and endothelial cells. Furthermore, LST1 tissue expression was significantly enhanced in macroscopically inflamed colonic mucosal biopsies as compared to non-affected mucosal areas. This is the first report demonstrating regulated LST1 expression in human intestinal epithelial and microvascular endothelial cells and in inflamed colonic tissue from IBD patients. Proinflammatory expression of LST1 occurs in the setting of human IBD and is not restricted to immune cell populations. Future studies are needed to further elucidate the role of soluble and membrane-expressed LST1 in the regulation of mucosal intestinal immunity and inflammation as well as to reveal possible therapeutic implications.

Did Tsunami tremor jolt microbial biomass and their activities in soils? A case study in Andaman Island, India

The nature of selected soil-chemical and microbial properties influenced by tsunami affected and non-affected areas along the border areas of the alluvial Andaman Island in India were investigated. Soils of these areas have turned saline and saline-sodic due to the ingression of sea water. The electrical conductivity of the saturation extract of the surface soil varied from 11.2 to 23.8 dS m−1 in 2005, and it was decreased to 0.8–10.3 dS m−1 in 2006 due to the heavy rain in the following year after the tsunami. Soil quality indicators, like microbial biomass C, microbial metabolic quotient, microbial respiration quotient and fluorescein diacetate hydrolyzing activity, decreased in the tsunami affected soil in 2005, but slightly increased in 2006. All microbial parameters were significantly negatively correlated with the electrical conductivity, sodium absorption ratio and exchangeable sodium percentage. Suppression of microbial biomass and their activities in the soils due to the increased-salinity is of great agronomic significance and needs suitable intervention for sustainable crop production. Significant differences were found in soil-chemical and microbial characteristics between tsunami affected and non-affected areas. Hierarchical clustering algorithm on the basis of different soil-chemical and microbial characteristics revealed that there is significant difference in grouping between tsunami affected and non-affected zones. From this study, it can be concluded that the sea water ingression detrimentally influenced the microbial properties of tsunami affected soil.

Psychosomatic Conditions of the Children and Adolescents Exposed to 5.12 Wenchuan Earthquake

A devastating earthquake registering 8.0 on the Richter Scale struck Wenchuan County in Northwest Sichuan Province in China on May 12, 2008, claiming over 69,200 lives, seriously wounding more than 374,600 people, and rendering more than 18,400 people missing. The epicenter was close to Yingxiu Township in Wenchuan County. This study aimed to investigate the psychosomatic conditions of the children and adolescents exposed to the devastating earthquake and explore the risk factors for psychosomatic symptoms. A total of 1,828 participants aged 6 to 16 years, of whom 842 from the affected area and 986 from non-affected area, were administered a Psychosomatic Conditions Scale. Each factor score, total somatic score, total psychological score, and total psychosomatic score of the experimental group were significantly higher than those of the control group (P < 0.001). Positive correlation was found between the psychological state and somatic symptoms in the experimental group(r = 0.157 ~ 0.489, P < 0.01). Respiratory system, cardiovascular system, nervous system, digestive system, urogenital system, emotion, behavior, and language, combined as a panel, were significantly differentiated between the two groups, accounting for 73.4% of the total difference. In the experimental group, the factor scores of anxiety, behavior, total psychological score, and total psychosomatic score of the girls were obviously higher than those of the boys (P < 0.01 ~ 0.05); most somatic factors and psychological factors, total somatic score, total psychological score, and total psychosomatic score of the elder adolescents were significantly higher than those of the younger children (P < 0.01 ~ 0.05). The children and adolescents exposed to 5.12 earthquake greatly suffered from terrible psychosomatic conditions, among whom the elder girls had more severe symptoms, particularly in terms of anxiety and behavior.

Is area affected by flood or stagnant water independently associated with poorer health outcomes in urban slums of Dhaka and adjacent rural areas?

This study investigated the association of flood/stagnant water (FSW) with various health outcomes among respondents living in urban slums of Dhaka and adjacent rural areas. We also assessed the differences of individual-, household- and area-level characteristics between the FSW-affected and non-affected areas. Bangladesh as a whole and slums in the megacity of Dhaka in particular are severely affected by the FSW. Data were collected from 3,207 subjects (aged 10+ years) through baseline surveys conducted in March 2008 and 2009. Twelve big slums in Dhaka and three adjacent villages were selected as study areas. Face-to-face interviews using a multidimensional pre-tested questionnaire were conducted by the trained university graduates. We performed various types of analyses ranging from the simple frequency analysis to the multivariable-adjusted logistic regression modelling. Our empirical findings suggest that slums were more affected by the FSW as compared to the rural areas. People living in the FSW-affected areas were more vulnerable in terms of individual-, household- and area-level characteristics than non-affected people. Age was also significantly associated with various health outcomes. According to multivariable analyses controlled for various factors, the FSW-affected people reported significantly higher likelihoods of health symptoms (namely fever, cold/cough, weakness), communicable diseases (namely diarrhoea and gastric disease) and poor mental well-being as compared to the non-affected people. Only the burden of non-communicable diseases was lower in the FSW-affected areas than the non-affected areas. Our findings lead us to conclude that the FSW-affected area is an independent risk factor for various physical and mental health problems. Urban slums are more affected than rural areas by the FSW. Therefore, we underscore the necessities of well-designed and comprehensive public health interventions focusing on individual, community and higher levels of interventions to reduce the FSW-related health and other consequences among the people living in the FSW-affected areas and urban slums in the rapidly growing city of Dhaka, Bangladesh.

A COMPARATIVE STUDY OF KNOWLEDGE REGARDING EMERGENCY CARE DURING DISASTER BETWEEN COMMUNITY HEALTH VOLUNTEERS WORKING IN TSUNAMI-AFFECTED AND NON-AFFECTED AREAS IN ACEH PROVINCE, INDONESIA

Purpose: This paper is a report of a survey to describe and compare the level of knowledge and compare these knowledge between community health volunteers (CHVs) working in the tsunami affected and nonaffected areas in Aceh Province, Indonesia Method: 144 CHVs from six districts in Aceh were studied during November 2011 to January 2012 to evaluate their level knowledge regarding emergency care during disaster between CHVs working in Tsunami affected areas and non Tsunami affected areas. The knowledge was assessed by using the Community Health Volunteers’ Knowledge Regarding Emergency Care Questionnaire (CHVK-ECQ) with 30-statement true/false. The composite scores of each area and the total score were calculated and transformed to percentage for ease of presentation.Results: Overall, the CHVs’ knowledge in emergency care during disaster in Aceh was at a high level in both groups. However, subjects in non-affected areas had significantly higher mean rank of the overall knowledge than those in the affected areas (p = .02). In the tsunami area the highest mean score was for the disaster triage dimension (M= 80.62%), and the lowest mean score was in the first Aid (60.48 %). And on the contrary in the non tsunami areas the highest mean score was for First Aid (84.52 %) and the lowers mean score was for disaster triage (64. 38 %). Conclusion: This finding indicated that although both groups had high levels of overall knowledge, education program for improved knowledge in the areas of first aid, team organization, and disaster triage should be established to refresh the CHVs’ knowledge and skills for the disaster management. Keywords: Knowledge, skills, community health volunteers, and natural disaster

Fibrocytes Are Involved in Inflammation as well as Fibrosis in the Pathogenesis of Crohn’s Disease

We previously showed that fibrocytes, a hematopoietic stem cell source of fibroblasts/myofibroblasts, infiltrated the colonic mucosa of a murine colitis model. We investigated whether fibrocytes were involved in the pathogenesis of Crohn's disease. Human surgical intestinal specimens were stained with anti-leukocyte-specific protein 1 and anti-collagen type-I (ColI) antibodies. Circulating fibrocytes in the human peripheral blood were quantified by fluorescence-activated cell sorting with anti-CD45 and anti-ColI antibodies. Cultured human fibrocytes were prepared by culturing peripheral CD14(+) monocytes. In the specimens of patients with Crohn's disease, the fibrocyte/total leukocyte percentage was significantly increased in inflammatory lesions (22.2 %, p < 0.01) compared with that in non-affected areas of the intestine (2.5 %). Interestingly, the percentage in fibrotic lesions was similar (2.2 %, p = 0.87) to that in non-affected areas. The percentages of circulating fibrocytes/total leukocytes were significantly higher in patients with Crohn's disease than in healthy controls. Both CXC-chemokine receptor 4(+) and intercellular adhesion molecule 1(+) fibrocyte numbers were significantly increased in Crohn's disease, suggesting that circulating fibrocytes have a higher ability to infiltrate injured sites and traffic leukocytes. In cultured fibrocytes, lipopolysaccharide treatment remarkably upregulated tumor necrosis factor (TNF)-α mRNA (17.0 ± 5.7-fold) and ColI mRNA expression (12.8 ± 5.7-fold), indicating that fibrocytes stimulated by bacterial components directly augmented inflammation as well as fibrosis. Fibrocytes are recruited early in the inflammatory phase and likely differentiate into fibroblasts/myofibroblasts until the fibrosis phase. They may enhance inflammation by producing TNF-α and can directly augment fibrosis by producing ColI.

Hunner’s lesions

The article in this issue of CUAJ on endoscopic ablation of Hunner’s ulcers1 raises several issues related to interstitial cystitis/painful bladder syndrome (IC/PBS) that are noteworthy: IC/PBS is common, Hunner’s ulcers are rare, but their presence should prompt biopsy and fulguration. Interstitial cystitis is common.2 Payne and colleagues1 cite 10-year-old data showing that the prevalence of IC/PBS approaches 1 million people in the United States.3,4 Even this number underestimates its true prevalence.5,6,7 A recent, exhaustive study with over 100 000 American households with follow-up interviews for possible IC/PBS subjects shows a prevalence estimate of 3% to 6% of American women over the age of 18 meet symptom criteria for IC/PBS.8 Urologists undoubtedly encounter IC/PBS patients frequently in their practices.6 Hunner’s ulcers represent the minority of IC/PBS cases, typically less than 7% of patients. Moreover, this study mirrors others in that Hunner’s ulcers generally occur in older patients, with median ages of 53 to 65.9–11 Historically, Hunner’s ulcers were considered the hallmark of IC/PBS. Yet, they are rare and seen primarily in advanced phases of IC/PBS. Hunner’s ulcer patients tend to be more symptomatic (more pain, more nocturia, smaller voided volumes) and may have increased mast cell counts below the denuded epithelium.12,13 Importantly, the absence of Hunner’s ulcers on cystoscopy does not exclude IC/PBS as a diagnosis. In the younger patient whose symptoms suggest IC/PBS, cystoscopy may show a normal-appearing bladder.2,14 A normal cystoscopy does not exclude IC/PBS. In the current study, the authors describe a non-validated test, whereby “touching” the patch of denuded epithelium with the cystoscope tip produced pain, and their control was to “touch” similarly non-affected areas. In my experience of outpatient flexible cystoscopy with IC/PBS patients with Hunner’s ulcers, small volumes of bladder filling reproduce their pain. I am not convinced that “touching” the lesion to reproduce pain is a valid test. More importantly, the image of the Hunner’s ulcer is difficult to distinguish from carcinoma in situ. Any patient with these cystoscopy findings should undergo bladder biopsy, at which time the lesion can be fulgurated or ablated. The excellent results reported in this study1 mirror my own experience, in that I find older IC/PBS patients frequently have Hunner’s ulcers, and they obtain symptom relief from fulguration of the ulcer.11 In my follow-up of these patients, if they have flare-ups, I am quick to repeat the cystoscopy. If I find a recurrent ulcer, and it is re-fulgurated, these patients tend to obtain symptom relief.

Multifocal Electroretinography in Eyes with Reticular Pseudodrusen

The aim of our study was to evaluate the impact of reticular pseudodrusen (RPD) on retinal function by multifocal electroretinography (mfERG), and combined simultaneous confocal scanning laser ophthalmoscopy (cSLO) and spectral-domain optical coherence tomography (SD-OCT). We included 19 eyes of 15 patients with RPD in the posterior pole and no other phenotypic retinal alteration were included (7 females and 8 males, age 77.2 ± 5.1 years) as well as 24 eyes of 17 healthy control subjects (7 females and 10 males, age 73.2 ± 5.9 years). All patients underwent fundus photography, SD-OCT, fluorescence angiography (FA), fundus autofluorescence, and near-infrared reflectance cSLO. mfERG measurements were performed by stimulating the retina by a field of 103 hexagons covering an area of approximately 30°. Amplitudes and latencies of focal retinal responses obtained at affected and nonaffected sites of RPD eyes and retinal responses of healthy control subjects were compared. In all included study eyes, RPD stages 1-3 could be demonstrated clearly in SD-OCT, FA, and cSLO. The mean amplitudes measured in the areas affected by RPD were 12.5 to 53.1 nV/deg² (control group 19.4-50.1 nV/deg²). The mean latencies were 33.2 to 41.3 ms (control group 33.6-39.7 ms). mfERG amplitudes and latencies of retinal areas affected by RPD were not altered significantly when compared to corresponding nonaffected areas. mfERG measurements did not show a definite influence on electrophysiologic activity in retinal areas affected exclusively with RPD.

Bone mineral density measurements performed by cone-beam computed tomography in the bisphosphonate-related osteonecrosis-affected jaw

The aims of this study were to determine the bone mineral density (BMD) in bisphosphonate-related osteonecrosis of the jaw (BRONJ) by cone-beam computed tomography (CBCT) measurements and to correlate these measurements with the current stages recommended by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Bone mineral density measurements of various areas in 24 bisphosphonate-related osteonecrosis (BRON) jaws were evaluated by CBCT. Another 24 age- and sex-matched patients without any bone pathologies served as the control group. Data acquisition was highly standardized to ensure maximum reliability in the comparisons of BMD measurements by CBCT. Compared with the control group, the bisphosphonate patients had significantly higher (p ≤ 0.01) BMDs in the non-affected jaw areas ipsilateral and contralateral to the BRON within the maxilla and mandible. The highest BMDs within the BRON jaws were observed in the BRON-adjacent areas relative to the non-affected ipsilateral and contralateral areas. Regarding the correlation with the AAOMS stages, the BMDs of the evaluated areas of BRONJ showed no significant differences (p ≥ 0.05) between the stages. Bisphosphonate-related bone pathologies can be detected by CBCT and are associated with increased BMDs, not only in clinically obvious BRONJ areas, but also in clinically unapparent areas, suggesting a subclinical general osteosclerosis of the jaw. The data transferability to other CBCT devices needs to be further elucidated and compared with multislice CT.

Potential role for magnetoencephalography in distinguishing low- and high-grade gliomas: a preliminary study with histopathological confirmation

Gliomas are the most common form of tumor in the CNS and are exceptionally heterogeneous. Accurately characterizing gliomas, in terms of grade and type, is essential for predicting the rate of tumor progression. Histopathological grading and analysis based on biopsied tissue remains the gold standard, but non- and semi-invasive neuroimaging also plays a key role. Neuroimaging has been used to guide and optimize biopsies for several decades, but more recently molecular imaging and variants of MRI have shown promise in independently predicting glioma grade. Here we evaluated whether magnetoencephalographic (MEG) measurements of population-level physiology within the glioma space were predictive of the inherent grade of the tissue, based on definitive histopathological analyses. High-density MEG data were recorded from 11 patients who were undergoing functional mapping in preparation for resective surgery. The primary results indicated that glioma grade was positively correlated with the local amplitude of activity within the glioma space in the theta (4-7 Hz), alpha (8-14 Hz), and beta bands (14-30 Hz). Additionally, activity within the glioma was significantly elevated relative to the nonaffected homologue area in the same frequency bands. These results indicate that pathological levels of synchronization exist within the tumor space and that MEG may be a viable tool for noninvasively differentiating gliomas by their grade. Although these results should be considered preliminary and are only correlative in nature, these data suggest that MEG can potentially detect neurophysiological signatures or markers that predict the inherent grade of a glial tumor.