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Biomedical subjects

M Sanz

Publications and source records attributed to M Sanz.

At least 37 records · Page 2Linked to original sources

Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study.

OBJECTIVES: The aim of this double-blind, parallel study was to test the clinical efficacy of a newly developed mouthrinse in the treatment of oral halitosis in patients without periodontitis. MATERIAL AND METHODS: Forty volunteers, recruited in two centers, participated in this study. Patients were selected on the basis of (1) halitosis of oral origin, (2) full-mouth organoleptic score>1, using an arbitrary 0-5 scale, (3) level of volatile sulfur compounds (VSC)>170 parts per billion (ppb) and (4) Winkel tongue coating index (WTCI)>4 (0-12). Intervention included gargling with a mouthrinse containing chlorhexidine (0.05%), cetylpyridinium chloride (0.05%) and zinc-lactate (0.14%) or with a placebo mouthrinse without active ingredients. At days 0 and 14 clinical variables were assessed in order of performance: (1) organoleptic assessments, (2) levels of VSC, and (3) WTCI. RESULTS: Treatment with the active mouthrinse resulted in a significant mean reduction in the organoleptic score from 2.8 to 1.5 (p<0.005). In the placebo group, no significant reduction in the mean organoleptic score occurred. Consequently, this resulted, after 2 weeks, in a greater change of the organoleptic scores in the test group in comparison to the placebo group (p<0.005). The mean VSC scores were reduced from 292 to 172 ppb in the test group (p<0.005), whereas no reduction was observed in the placebo group. At the 2-week examination, the mean change of the VSC scores in the test group was significantly greater than the mean change in the placebo group (p<0.005). Neither in the test nor in the placebo group a significant reduction in tongue coating was observed. CONCLUSIONS: In conclusion, the tested mouthrinse is effective in the treatment of oral halitosis.

Adult↗

Delayed neutrophil apoptosis in chronic periodontitis patients.

BACKGROUND, AIMS: Neutrophil cells constitute the first defense barrier against the oral bacterial challenge in the periodontium. Reduction of neutrophils could impair this response against periopathogenic bacteria such as Porphyromonas gingivalis. Our previous work implicates the apoptosis of neutrophils in the pathogenesis of periodontitis. We now demonstrate that granulocyte monocyte-colony stimulating factor (GM-CSF) present in the gingival crevicular fluid (GCF) and secreted during the immune response reduces the apoptosis of neutrophils. METHOD: In this study, the presence of GM-CSF and tumor necrosis factor-alpha (TNF-alpha) in GCF was determined in samples obtained from adult patients with periodontitis and from control subjects with clinically healthy gingiva. GCF was collected for 30 s using Periopaper(R) strips, and cytokines were quantified by ELISA. We used ex vivo culture of gingival tissue biopsies for 2 and 4 days in the presence of GM-CSF. Apoptosis was determined using the terminal TdT-mediated dUTP-biotin nick end labeling (TUNEL) technique, and expression of Bax by immunohistochemistry. RESULTS: The presence of GM-CSF and TNF-alpha was detected in the majority of sites from periodontal patients (83.3% and 63.3%, respectively), presenting a total amount of 27.65 and 42.38 pg, respectively. GM-CSF reduces the neutrophil apoptosis determined by double staining with TUNEL and myeloperoxidase and by a reduction of Bax expression. CONCLUSIONS: These findings suggest a novel mechanism by which neutrophils specifically accumulate in adult patients with periodontitis.

Adult↗

The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients: a dual-centre, double-blind placebo-controlled study.

AIM: This study evaluated the microbial effects of a newly formulated mouthwash (Halita) on oral halitosis patients. METHODS: Forty subjects were included in this dual-centre, double-blind, placebo-controlled parallel study. Inclusion and exclusion criteria were used to select patients. At baseline and at 2 weeks post-treatment, full-mouth organoleptic odor scores, level of volatile sulphur compounds (VSC) and the Winkel Tongue Coating Index were recorded. Standardized samples of tongue coating, saliva and subgingival plaque were microbiologically investigated. Participants were randomly assigned to the test or placebo groups. RESULTS: High prevalences were observed for Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis in tongue coating, saliva and subgingival plaque samples. A significant positive correlation between baseline total counts of P. gingivalis in saliva samples and organoleptic and VSC scores was found. Two weeks post-treatment there was a reduction in total anaerobic counts in all samples in the test group. A significant positive correlation was observed between the reduction in total counts in saliva samples and the reduction in organoleptic scores in the test group. Significant reductions in total counts and proportions of F. nucleatum and total counts of P. intermedia in tongue coating samples were observed in the test group. CONCLUSIONS: The test mouthwash demonstrated efficacy in reducing the microbiological parameters in three oral niches in moderate to severe halitosis patients without periodontitis, and this was correlated with the improvements in organoleptic and VSC scores but not with the tongue coating scores.

Anti-Infective Agents, Local↗

Early onset of chemotherapy can reduce the incidence of ATRA syndrome in newly diagnosed acute promyelocytic leukemia (APL) with low white blood cell counts: results from APL 93 trial.

Treatment combining ATRA and chemotherapy (CT) has improved the outcome of APL patients, by comparison with CT alone. ATRA syndrome is a life-threatening complication of ATRA treatment whose prophylaxis remains somewhat controversial. In APL93 trial, newly diagnosed APL patients </=65 years and with initial WBC counts below 5000/mm(3) were randomized between ATRA until CR achievement followed by CT (ATRA --> CT) and ATRA with early addition of CT, on day 3 of ATRA treatment (ATRA + CT). The incidence of ATRA syndrome in the ATRA --> CT arm was 18% (22/122) as compared to 9.2% (17/184) in the ATRA + CT arm (P = 0.035). In the ATRA --> CT arm, three (2.5%) patients died from ATRA syndrome, as compared to one (0.5%) in the ATRA + CT group. Early addition of chemotherapy to ATRA in newly diagnosed APL with low WBC counts significantly reduced the incidence of ATRA syndrome.

Adult↗

Myelodysplastic syndrome after acute promyelocytic leukemia: the European APL group experience.

With improved treatment of acute promyelocytic leukemia (APL) by all trans retinoic acid (ATRA) combined to anthracycline-aracytin chemotherapy (CT), a larger number of those patients may be at risk of late complications. Recently, the Rome group reported five cases of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML, non-APL) occurring during the course of 77 APL patients (6.5%) in complete remission (CR). From 1991 to 1998, we treated 677 newly diagnosed cases of APL, and 617 of them achieved CR with ATRA combined to CT (n=579) or CT alone (n=38); 246 of them received subsequent maintenance CT with 6 mercaptopurine and methotrexate. With a median follow-up of 51 months, 6 patients (0.97%) developed MDS, 13-74 months after the diagnosis of APL. In all six cases, t(15;17) and PML-RARalpha rearrangement were absent at the time of MDS diagnosis, and karyotype mainly showed complex cytogenetic abnormalities involving chromosomes 5 and/or 7, typical of MDS observed after treatment with alkylating agents, although none of the six patients had received such agents for the treatment of APL. Our findings suggest that MDS can indeed be a long-term complication in APL, although probably at lower incidence than that previously reported.

Adolescent↗

[Intradialysis hemolysis secondary to hypophosphatemia].

We report a 76-year-old man, stable on a thrice-weekly hemodialysis program over a period of 3 years, who developed acute intradialysis hemolysis secondary to hypophosphatemia, an unusual cause of hemolysis. During the dialysis session we monitored the starting point, the severity and duration of intradialysis hemolysis. Severe hyphosphatemia is a rare cause of intradialysis hemolysis. It is important to think of his possibility to make an adequate diagnosis and treatment. The patient was treated with a phosphorus-enriched acid concentrate, bicarbonate-buffered dialysate, with biochemical and clinical improvement.

Aged↗

Fundamentals of breath malodour.

Breath malodour is a condition that has health and social implications. The origin of breath malodour problems are related to both systemic and oral conditions. The advice of dental professionals for treatment of this condition occurs with regularity since 90% of breath odor problems emanate from the oral cavity. This paper provides a comprehensive review of the etiology of breath odor, its prevalence, diagnosis, and treatment strategies for the condition.

Bacteria, Anaerobic↗

Growth inhibitory activity of indapamide on vascular smooth muscle cells.

Abnormal vascular smooth muscle cell proliferation has a fundamental role in the pathogenesis of vascular diseases. Indapamide is an oral diuretic antihypertensive drug effective for patients with mild or moderate essential hypertension. We now investigated the effects of indapamide on the growth of aortic vascular smooth muscle cells (A10 cell line). Indapamide inhibited cell proliferation as measured by the tetrazolium salt XTT (sodium 3'-[1-(phenylamino-carbonyl)-3,4-tetrazolium]-bis(4-methoxy-6-nitro)benzene sulfonic acid hydrate) test. The increase in cell number was significantly reduced in the presence of indapamide 10(-6) and 5 x 10(-4) M (P < 0.05 n = 3 and P < 0.01, n = 3, respectively). Serum-induced DNA synthesis, determined as the incorporation of 5-bromo-2'-deoxyuridine (BrdU), was concentration-dependently inhibited by indapamide. BrdU incorporation was 47.2+/-1.6% (10% foetal calf serum). Indapamide treatment markedly prevented BrdU incorporation (37.2+/-2.1%, 29.2+/-4.8%, 15.0+/-1.8%, 8.7+/-2.1%) indapamide 10(-6), 10(-5), 5 x 10(-5) and 5 x 10(-4) M, respectively. Cell-cycle progression was also evaluated. Flow cytometry analysis of DNA content in synchronised cells revealed blocking of the serum-inducible cell-cycle progression by indapamide. This inhibition was abolished when the drug was added 2 h after serum repletion, indicating that indapamide must act at the early events of a cell cycle to be fully effective against DNA synthesis. In addition, serum-induced intracellular Ca2+ movements and also p44/p42 mitogen-activated protein kinase (MAPK) phosphorylation were studied in the presence or absence of indapamide. Indapamide 10(-5) and 5 x 10(-5) M decreased significantly cytosolic free calcium, and the p44/p42 mitogen-activated protein kinase phosphorylation (5 x 10(-5) M) stimulated by 10% foetal calf serum. In accordance with this finding, indapamide (5 x 10(-4) M) caused a 95% to 99% decrease in the early elevation of c-fos expression as evaluated by northern blot analysis of mRNA induced after serum addition. In conclusion, our results indicate that indapamide reduces vascular smooth muscle cell proliferation by a mechanism which involves a decrease in the intracellular Ca2+ movements that might link with the mitogen-activated protein kinase (MAPK) pathway, altering cell-cycle progression.

Animals↗

Association between antifungal prophylaxis and rate of documented bacteremia in febrile neutropenic cancer patients.

Published data have suggested a correlation between antifungal prophylaxis and bacteremia in febrile neutropenia. This correlation was investigated among 3002 febrile neutropenic patients enrolled in 4 trials during 1986-1994. Globally, 1322 patients (44%) did not receive antifungal prophylaxis; 835 (28%) received poorly absorbable antifungal agents and 845 (28%) received absorbable antifungal agents. The rates of bacteremia for these groups were 20%, 26%, and 27%, respectively (P=.0001). In a multivariate model without including antifungal prophylaxis, factors associated with bacteremia were: age, duration of hospitalization, duration of neutropenia before enrollment, underlying disease, presence of an intravenous catheter, shock, antibacterial prophylaxis, temperature, and granulocyte count at onset of fever. When antifungal prophylaxis was included, the adjustment quality of the model improved slightly (P=.05), with an odds ratio of 1.19 (95% confidence interval [CI], 0.92-1.55) for patients receiving nonabsorbable and 1.42 (95% CI, 1.07-1.88) for those who were receiving absorbable antifungal agents. Antifungal prophylaxis with absorbable agents might have an impact on the rate of documented bacteremia in febrile neutropenia. This effect should be confirmed prospectively.

Adolescent↗

Auditory P300 event related potential and serotonin reuptake inhibitor treatment in obsessive-compulsive disorder patients.

Neuropsychological findings in obsessive-compulsive disorder (OCD) have been explained in terms of reduced cognitive shifting ability as a result of low levels of frontal inhibitory activity. This deficit could be reflected in an abnormal P300 component of the event-related potential. The improvement in cognitive processing due to pharmacological treatment would modify the P300 component, bringing it close to that of normal controls. Nineteen patients suffering from OCD and 19 normal controls were recorded. We used a computerized version of the auditory 'odd-ball paradigm' to obtain the P300 component at the Pz electrode. Patients were tested twice, drug-free and under treatment with clomipramine in 250-300 mg doses. We observed the P300 component to have lower amplitude and longer latency in drug-free OCD patients when compared with controls. P300 amplitude in OCD increased after treatment, although this was supported only by a statistical trend. There was no modification in P300 latency after treatment. It is possible that inhibitory activity improves with treatment and allows patients to answer with more confidence, which results in an increase in P300 amplitude. This study suggests that cognitive dysfunction in OCD fluctuates with changes in the clinical associated with treatment, probably in relationship to central serotoninergic transmission.

Adult↗

Volatilisation of triallate as affected by soil texture and air velocity.

The rate of volatilisation of the formulated herbicide triallate was investigated in a wind tunnel under controlled wind-speed conditions. An experimental set-up is described which allows the monitoring of wind speed (w.s.), soil-water content, and the temperature of air and soil. A system controlling soil-water content is also described. The influence of air velocity and soil texture was investigated measuring the cumulative volatilisation losses of triallate from soil. The herbicide volatilisation losses after application ranged from 40% at 3 m/s to 53% at 9 m/s for loam soil and from 60% at 3 m/s to 73% at 9 m/s for sandy soil.

Air↗

Basic sciences education in the dental curriculum in Southern Europe.

A survey was conducted to determine the current status of the basic sciences education in Southern European dental schools. Responses were collected from schools in Malta, Greece, Portugal, Italy, France and Spain. The results show that there is some uniformity across Southern Europe, even if there are some variations among dental schools both within one country and among the different countries. The links with Medicine seem to be strong. Most basic sciences dental educators have a medical degree and usually have their main appointment in a medical school. The only exception to this is found in France, where the faculty, who are mostly dentists, have their main appointment in a dental school. In half of the countries, courses are given jointly to both dental and medical students. There is, in general, poor coordination between the basic science subjects and other subjects in the dental curriculum. All the surveyed schools maintain traditional curricula and teaching methodologies. However, there is an increased movement towards self-directed learning, computer-assisted learning and improved coordination with clinical subjects.

Computer-Assisted Instruction↗

Study of garlic extracts and fractions on cholesterol plasma levels and vascular reactivity in cholesterol-fed rats.

Garlic is known for its pharmacologic and nutritional properties. In previous studies, garlic elicited a reduction in plasma levels of lipids by inhibiting hepatic cholesterol synthesis. The aim of this study was to investigate in an in vivo model the effects of garlic extract and some fractions on cholesterol levels and vascular reactivity in cholesterol-fed rats. Rats were fed a cholesterol-enriched diet for 16 wk and were divided into 10 groups as follows: control and hypercholesterolemic diet groups, 4 groups fed frozen garlic fractions and 4 groups fed raw garlic fractions with different doses. Blood samples were obtained to analyze HDL and LDL cholesterol levels. After treatment, rats were killed. The heart, liver and kidneys were weighed; the aorta was isolated, mounted in organ chambers and vascular reactivity was tested. Plasma concentration of cholesterol was 58 mg/dL (100%) at the beginning of the study and increased to 102 mg/dL (153%; hypercholesterolemic group) at the end of the treatment. Plasma total cholesterol decreased in all groups treated with garlic; moreover, this effect was higher in rats fed raw garlic fractions and extracts. LDL decreased significantly with respect to the hypercholesterolemic group in all groups treated with garlic fractions and extracts (P: < 0.01); however, an increase in HDL was found in those treated with frozen fractions and extracts. The liver:body weight ratio decreased in all treated groups. The relaxing effect of acetylcholine (ACh) was enhanced in arteries contracted with noradrenaline (NE). These data suggest that garlic fractions could prevent diet-induced hypercholesterolemia and vascular alterations in the endothelium-dependent relaxation associated with atherosclerosis.

Acetylcholine↗

Comparison of calcium sulfate and autogenous bone graft to bioabsorbable membranes plus autogenous bone graft in the treatment of intrabony periodontal defects: a split-mouth study.

BACKGROUND: Current literature shows that calcium sulfate can be used in guided tissue regeneration. Its biocompatibility and resorbability give it significant advantages in the treatment of periodontal and endodontic defects. Clinically guided tissue regeneration procedures have demonstrated significant positive clinical change, beyond that achieved with debridement alone, in treating intraosseous defects. The aim of the present investigation was to evaluate the clinical results obtained with autologous bone plus calcium sulfate, and to compare them with the results obtained using autologous bone plus membrane. METHODS: A total of 12 patients were treated in the present investigation. A split-mouth design was utilized. Twelve 3-wall periodontal defects were treated with calcium sulfate plus autologous bone graft (test) and compared with 12 contra-lateral defects treated with a bioabsorbable membrane plus autologous bone graft (control). Before the surgical procedure, patients were instructed about oral hygiene and scaling and root planing (SRP) was completed. Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline and 6 months. RESULTS: There were no statistical differences between test and control defects at baseline. BOP was 58% and 50% for control and test defects, respectively. Mean PD was 7.75+/-0.96 mm (control) and 8.0+/-1.28 mm (test). Mean CAL was 8.58+/-1.31 mm (control) and 8.83+/-0.91 mm (test). At 6 months, mean PD was 3.41+/-0.51 (P = 0.0022) for control defects and 3.58+/-0.51 (P = 0.0022) for test defects. CAL showed a mean gain of 5+/-0.85 for controls (P = 0.0022) and 5.25+/-0.75 for test defects (P = 0.0022). Thus, there was a mean reduction of PD of 4.33 mm (56%) for control sites and 4.42 mm (55%) for test sites. The mean clinical attachment gain was 3.57 mm for control sites and 3.58 mm for test sites. As there were no sham-operated controls, it is not clear that the healing of these test or control-treated sites was any better than similar 3-walled defects sham operated. CONCLUSIONS: Both therapies led to short-term improvement of the measured parameters; neither was superior to the other.

Absorbable Implants↗

Binding and melting of D-loops by the Bloom syndrome helicase.

Bloom syndrome is a rare autosomal disorder characterized by predisposition to cancer and genomic instability. BLM, the structural gene mutated in individuals with the disorder, encodes a DNA helicase belonging to the RecQ family of helicases. These helicases have been established to serve roles in both promoting and preventing recombination. Mounting evidence has implicated a function for BLM during DNA replication; specifically, BLM might be involved in rescuing stalled or collapsed replication forks by a recombination-based mechanism. We have tested this idea by examining the binding and melting activity of BLM on oligonucleotide substrates containing D-loops, DNA structures that model the presumed initial intermediate formed during homologous recombination. We find that BLM preferentially melts those D-loops that are formed more favorably by the strand exchange protein Rad51, but whose polarity could be less favorable for enabling restoration of an active replication fork. We propose a model in which BLM selectively dissociates recombination intermediates likely to be unfavorable for recombination-promoted replication.

Adenosine Triphosphatases↗

Nitrovasodilators, low-dose aspirin, other nonsteroidal antiinflammatory drugs, and the risk of upper gastrointestinal bleeding.

UNLABELLED: BACKGROUND The relation between medications that release nitric oxide, such as nitroglycerin and other nitrovasodilators, and upper gastrointestinal bleeding is uncertain. In animals, these medications reduce the gastric damage induced by nonsteroidal antiinflammatory drugs. Nitric oxide, however, inhibits platelet aggregation and may contribute to bleeding from an ulcer. METHODS: We performed a case-control study to determine the risk of bleeding in patients taking nitrovasodilators, low-dose aspirin, or other nonsteroidal antiinflammatory drugs. The case group was made up of 1122 consecutive patients admitted to one of four hospitals with bleeding from a peptic lesion. The 2231 control subjects were 1109 patients hospitalized for other reasons and 1122 outpatients from the same geographic area. RESULTS: In the week before admission, 520 (46.3 percent) of the patients with bleeding had taken a nonsteroidal antiinflammatory drug other than low-dose aspirin, 120 (10.7 percent) had taken low-dose aspirin (< or = 300 mg per day), 60 (5.3 percent) a nitrovasodilator, and 135 (12.0 percent) an antisecretory agent such as a histamine H2-receptor antagonist or a proton-pump inhibitor. In multivariate models that adjusted for age, sex, and clinical risk factors, the use of a nonsteroidal antiinflammatory drug other than low-dose aspirin was independently associated with an increased risk of bleeding from a peptic ulcer (odds ratio, 7.4; 95 percent confidence interval, 4.5 to 12.0), as was the use of low-dose aspirin alone (odds ratio, 2.4; 95 percent confidence interval, 1.8 to 3.3). The use of a nitrovasodilator was associated with a decreased risk of bleeding (odds ratio, 0.6; 95 percent confidence interval, 0.4 to 0.9), as was antisecretory therapy (odds ratio, 0.6; 95 percent confidence interval, 0.4 to 0.8). In patients taking any type of nonsteroidai antiinflammatory drug, the use of a nitrovasodilator or antisecretory therapy was independently associated with a decreased risk of bleeding. CONCLUSIONS: The use of nitrovasodilator drugs is independently associated with a decreased risk of upper gastrointestinal bleeding.

Aged↗