Evaluation of a Clinical Index as a Predictive Tool for Primary Ciliary Dyskinesia

Background: In primary ciliary dyskinesia (PCD) there is no single diagnostic test. Different predictive tools have been proposed to guide referral of high-risk patients for further diagnostic workup. We aimed to test clinical index (CI) on a large unselected cohort and compare its characteristics with other widely used tools—PICADAR and NA-CDCF. Methods: CI, PICADAR, and NA-CDCF scores were calculated in 1401 patients with suspected PCD referred to our center. Their predictive characteristics were analyzed using receiver operating characteristics (ROC) curves and compared to each other. Nasal nitric oxide (nNO) was measured in 569 patients older than 3 years. Results: PCD was diagnosed in 67 (4.8%) patients. CI, PICADAR, and NA-CDCF scores were higher in PCD than in nonPCD group (all p < 0.001). The area under the ROC curve (AUC) for CI was larger than for NA-CDCF (p = 0.005); AUCPICADAR and AUCNA-CDCF did not differ (p = 0.093). An overlap in signs and symptoms among tools was identified. PICADAR could not be assessed in 86 (6.1%) patients without chronic wet cough. For CI laterality or congenital heart defects assessment was not necessary. nNO further improved predictive power of all three tools. Conclusion: CI is a feasible predictive tool for PCD that may outperform PICADAR and NA-CFCD.

Medullary brain abscess secondary to dental procedure caused by Streptococcus intermedius

Brainstem abscess is an uncommon occurrence in itself and an abscess in the medulla oblongata is even rarer. Although these abscesses have established association with head and neck infections, we report the first known case of medullary abscess that was found to be strongly associated with dental procedure. Important point to note is that a simple procedure like tooth extraction can predispose spread of infective seeding to distant sites. High clinical index of suspicion and early diagnosis are essential, as if left untreated, the brainstem abscess is almost always fatal otherwise.

Early Soft Tissue Response to Zirconium Oxide and Titanium Healing Abutments in Vivo: A Dog Study

Background: This study aimed to investigate clinical characteristics and early soft tissues response to zirconium oxide (Zr) and titanium (Ti) abutments in dogs. Methods: Eight implants-four at each hemi-mandible were inserted after bilateral mandibular third and fourth premolars and first molars extraction. Two Zr and two Ti healing abutments were connected in each unilateral mandible 8 weeks later. The ligation method was used to make peri-implant mucositis model. The twenty-four abutments were divided into four groups, Zr and Ti healing abutments with ligation (ZrL, TiL) and non-ligation (ZrN, TiN) groups. Clinical index, peri-implant crevicular fluid (PICF) and inflammatory cytokines (TNF-α and IL-1β), soft tissue responses were tested. Two-way analysis of variance was used to analyze the data. Results: The results showed that the clinical index were similar around Zr and Ti healing abutments. PICF in ZrL and TiL groups were significantly higher than those in ZrN and TiN groups. Immunohistochemistry demonstrated inflammatory cells were non-significant differences. Conclusion: These data indicate soft tissue responses to Zr healing abutments with peri-implant mucositis was comparable to those to Ti healing abutments in vivo, and can provide theoretical foundation for Zr’s clinical application.

Ninjurin 2 rs118050317 gene polymorphism and endometrial cancer risk

Background Endometrial cancer is one of the most common female reproductive system tumors. Ninjurin2 (NINJ2) is a new adhesion factor. As a vascular susceptibility gene, it is highly expressed in other cancers and promotes the growth of cancer cells. We conducted an association analysis between NINJ2 gene polymorphism and endometrial cancer risk. Methods Five SNPs rs118050317, rs75750647, rs7307242, rs10849390 and rs11610368 of NINJ2 gene were genotyped in 351 endometrial cancer patients and 344 healthy controls. The clinical index difference between cases and controls were tested by one-way analysis of variance. The allele and genotype frequency of cases and controls were been compared by Chi square test. The odds ratios (OR) with 95% confidence interval (95% CI) were examined by logistic regression analysis. Results The SNP rs118050317 mutant allele C and homozygote CC genotype were significant increased the endometrial cancer risk (OR 1.46, 95% CI 1.04–2.06, p = 0.028; OR 8.43, 95% CI 1.05–67.89, p = 0.045). In the clinical index analysis, there were significant higher quantities of CEA, CA125 and AFP in cases serum than controls. Conclusion The NINJ2 gene polymorphism loci rs118050317 mutant allele C was associated with an increased risk of endometrial cancer. CEA, CA125 and AFP quantities were significant higher in endometrial cancer patients.

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Versus Non-Colicky Babies.

BackgroundAfter 65 years of research that has been primarily directed at differentiating between normal and colicky crying, the cause of infantile colic remains elusive and no definitive cure has been found. Given the general absence of pathology, colicky crying is widely considered the extreme end of a spectrum of normal crying behavior. In the literature scattered evidence can be found suggesting that infantile colic may be the behavioral expression of physiological brainstem dysregulation, particularly of the vestibular and autonomic nuclei. The purpose of this study is to present a five-point clinical index of vestibular (hyper)activity and its application to investigate vestibular dysregulation in colicky and non-colicky babies.Methods120 consecutive colicky babies were evaluated using this index, before and after a very gentle vibratory treatment, and compared to 117 non-colicky babies.ResultsBefore treatment, of 120 colicky babies only 2 (1.7%) scored 0, whereas 118 (98.3%) scored scored 1-5. Of 117 non-colicky babies 89 (76,1%) scored 0 and 28 (23.9%) scored 1-3, none scored 4-5. The odds ratio is OR (CI 95%) 187.54 (43.52-808.09). After treatment 111 (92.5%) scored 0 and 9 (7.5%) scored 1-3, none scored 4-5. A McNemar test showed the difference before and after to be significant (χ² = 109.00, p < .001). For colicky babies the mean vestibular score is 2.88(SD 1.22), compared to 0.37(SD 0.73) for non-colicky babies, a difference of 87.2%. After treatment the score decreased from 2.88 (SD 1.12) to 0.10 (SD 0.40), or 96.5%. ConclusionColicky babies are not just infants who cry a lot. They also show clinical evidence of vestibular dysregulation. Gentle treatment aimed at relaxing tight sub-occipital musculature by means of a vibrational technique may be effective in decreasing vestibular hyperactivity, signifying an improvement in brainstem regulation. The vestibular index opens the prospect for development into a tool towards an objective and practical clinical diagnosis of infantile colic.

Ninjurin 2 rs118050317 gene polymorphism and endometrial cancer risk

Background: Endometrial cancer is one of the most common female reproductive system tumors. Ninjurin2 (NINJ2) is a new adhesion factor. As a vascular susceptibility gene, it is highly expressed in other cancers and promotes the growth of cancer cells. We conducted an association analysis between NINJ2 gene polymorphism and endometrial cancer risk.Methods: Five SNPs rs118050317, rs75750647, rs7307242, rs10849390 and rs11610368 of NINJ2 gene were genotyped in 351 endometrial cancer patients and 344 healthy controls. The clinical index difference between cases and controls were tested by one-way analysis of variance. The allele and genotype frequency of cases and controls were been compared by Chi-square test. The odds ratios (OR) with 95% confidence interval (95% CI) were examined by logistic regression analysis. Results: The SNP rs118050317 mutant allele C and homozygote CC genotype were significant increased the endometrial cancer risk (OR = 1.46, 95% CI = 1.04 – 2.06, p = 0.028; OR = 8.43, 95% CI = 1.05 – 67.89, p = 0.045). In the clinical index analysis, there were significant higher quantities of CEA, CA125 and AFP in cases serum than controls.Conclusion: The NINJ2 gene polymorphism loci rs118050317 mutant allele C was associated with an increased risk of endometrial cancer. CEA, CA125 and AFP quantities were significant higher in endometrial cancer patients.

Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment Compared to Non-Colicky Babies.

Aim: to present a five-point clinical index of vestibular (hyper)activity and its application as a tool to investigate vestibular dysregulation in colicky and non-colicky babies.Methods: 120 consecutive colicky babies, before and after treatment, were evaluated using this index and compared to 117 non-colicky babies.Results. Before treatment out of 120 colicky babies 118 (98.3%) scored 1-5 and only 2 (1.7%) scored 0. Out of 117 non-colicky babies 89 (76,1%) scored 0 and 28 (23.9%) scored 1-3, none scored 4-5. Odds ratios are OR (CI 95%) 187.54 (43.52-808.09). After treatment 111 (92.5%) scored 0 and 9 (7.5%) scored 1-3, none scored 4-5. A McNemar test showed the difference before and after to be significant (χ² = 109.00, p < .001). For colicky babies the mean vestibular score is 2.88(SD 1.22), compared to 0.37(SD 0.73) for non-colicky babies, a difference of 87.2%. After treatment the score decreased from 2.88 (SD 1.12) to 0.10 (SD 0.40), or 96.5%. Conclusion: colicky babies are not just infants who cry a lot. They also show clinical evidence of vestibular dysregulation. The vestibular index opens the prospect that it could be developed into a tool towards an objective clinical diagnosis of infantile colic.