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Finally, treatment of mice with the pan-JAK inhibitor, tofacitinib reduced psoriasis-like dermatitis and epidermal pSTAT3 expression. Taken together, STAT3-signaling in keratinocytes rather than T cells was a more important determinant for psoriasis-like dermatitis in a mechanism that involved upstream keratinocyte IL-6R-signaling and downstream inhibition of type 1 immunity-associated CXCL10 responses.

The first outbreak of coronavirus disease 2019 (COVID-19) in the United States resulted in nationwide closure of dental offices that created an oral health crisis. The aim of this observational study was to analyze and compare the characteristics of patients who visited two private Endodontics offices from March-16 to May-31, 2020, compared to the same period in 2019.

Demographic, diagnostic, and procedural data of 1520 (693 in 2020; 827 in 2019) patient visits were collected. Bivariate and multiple logistic regression analyses were used to assess the impact of COVID-19 outbreak on patient-related variables.

Bivariate analyses showed that the number of patient visits decreased in April and May 2020 (P<.0001). In 2020, patients’ self-reported pain level was higher, they were more frequently diagnosed with pulp necrosis, and acute apical abscess, and they received more incisions for drainage (P<.05). Multiple logistic regression analyses showed that COVID-19 outbreak was associated with less visits for patients older in age (> 49.5 years) (odds ratio [OR], 0.720; 95% confidence interval [CI], 0.573-0.906), more patients with kidney diseases (OR, 2.690; 95% CI, 1.143-6.331), higher levels of pain on percussion (OR, 2.277; 95% CI, 1.718-3.016), less cases with previously initiated treatment (OR, 0.242; 95% CI, 0.080-0.731), less periapical diagnosis of asymptomatic apical periodontitis (OR, 0.510; 95% CI, 0.306-0.849), higher number of non-surgical root canal treatments (OR, 2.073; 95% CI, 1.397-3.074) and apicoectomies (OR, 2.799; 95% CI, 1.367-5.729).

These findings show that the public health burden of endodontic infections was more intense during the initial outbreak of COVID-19.

These findings show that the public health burden of endodontic infections was more intense during the initial outbreak of COVID-19.Extrusion of sodium hypochlorite (NaOCl) is a very rare accident with the most common complications including pain, swelling, and hematoma. It can occur even if procedural guidelines, predisposing conditions, and risk factors are taken into consideration. A 59-year-old female patient was admitted to the endodontics department to treat a left maxillary first premolar (World Dental Federation tooth 24). The medical history included osteoporosis and systemic medication with alendronate. Initially, the diagnosis was “symptomatic irreversible pulpitis” with “normal apical tissues.” During instrumentation of the buccal canal, accidental extrusion of 2.5% NaOCl occurred into the periapical tissues, resulting from misinterpretation of the working length, and caused severe pain and bleeding. The canal was immediately flushed using copious irrigation with saline solution. An analgesic and corticosteroid were prescribed. At 3 and 7 days, ecchymosis and slight hematoma were observed extraorally in the area of the affected tooth and an intraoral ulceration at the apex of the affected tooth. At 15 days, minimal signs of ecchymosis were observed, and the treatment was resumed. At 30 days after the accident, there was complete remission of the sequelae. The clinical, radiographic, and tomographic assessment after 1 month, 1 year, and 8 years showed favorable case evolution. During the 8-year follow-up, the patient maintained the systemic use of alendronate. It can be concluded that NaOCl extrusion is an accident that causes patients and clinicians to experience an unpleasant consequence. The radiographic working length should always be determined carefully. A successful outcome can be achieved in patients who take alendronate.

For many years, clinical laboratories have either verified or estimated reference intervals (RI) for laboratory tests. Those calculations have largely been performed by direct sampling analysis of ostensibly healthy individuals or by post-analysis biochemical screening. Recently however, indirect calculations have come to the forefront as an IFCC endorsed method by using normal and abnormal patient data.

Using a large database of patient test results from Laboratory Corporation of America, age and gender based RIs, inclusive of neonatal, pediatric, and geriatric populations, were determined using a modified indirect method of Hoffmann, and represent a diverse population distributed across the United States from a nation-wide system of laboratories and is unbiased with respect to age, gender, race or geography.

The tabulation of RIs using big data by an indirect method represent 72M patient test results. The table includes 266 individual analytes consisting of approximately 2,700 age categories, including tests across multiple medical disciplines.

To our knowledge, this is the largest collection of RIs that were calculated by an indirect method representing clinical chemistry, endocrinology, coagulation, and hematology analytes that have been derived with very powerful “Ns” for each age bracket. This process provides more robust RIs and allows for the determination of pediatric and geriatric RIs that would otherwise be difficult to obtain using traditional direct RI determinations.

To our knowledge, this is the largest collection of RIs that were calculated by an indirect method representing clinical chemistry, endocrinology, coagulation, and hematology analytes that have been derived with very powerful “Ns” for each age bracket. This process provides more robust RIs and allows for the determination of pediatric and geriatric RIs that would otherwise be difficult to obtain using traditional direct RI determinations.

We previously highlighted the problem of frequent false positives in 24h urine normetanephrine(UNM) measurements owing to reference intervals that are inappropriately low for the population being screened for pheochromocytoma. Using a large population database, we devised new age-stratified reference intervals for the 24h UNM test that were higher compared to previous. However, it was uncertain as to whether this would compromise test sensitivity for true pheochromocytoma cases.

Retrospective analysis of all pheochromocytoma cases from a recently constructed provincial registry. All confirmed cases had their diagnostic UNM results retrospectively re-analysed according to the newly proposed UNM reference intervals to determine the percentage and phenotype of cases that might have been theoretically missed with the new reference range.

After excluding pediatric and non-secretory head and neck paragangliomas, there were 60 confirmed pheochromocytoma cases. Using prior reference intervals, 51/60 (85%) had aeduce the false positive rate without compromising test sensitivity for true pheochromocytoma.

Carnitine-acylcarnitine Translocase (CACT) deficiency (OMIM 212138) and carnitine palmitoyl transferase 2 (CPT2) deficiency (OMIM 60065050) are rare inherited disorders of mitochondrial long chain fatty acid oxidation. The aim of our study is to review the clinical, biochemical and molecular characteristics in children diagnosed with CACT and CPT2 deficiencies in Malaysia.

This is a retrospective study. We reviewed medical records of six patients diagnosed with CACT and CPT2 deficiencies. They were identified from a selective high-risk screening of 50,579 patients from January 2010 until Jun 2020.

All six patients had either elevation of the long chain acylcarnitines and/or an elevated (C16+C181)/C2 acylcarnitine ratio. SLC25A20 gene sequencing of patient 1 and 6 showed a homozygous splice site mutation at c.199-10T>G in intron 2. Two novel mutations at c.109C>T p. (Arg37*) in exon 2 and at c.706C>T p. (Arg236*) in exon 7 of SLC25A20 gene were found in patient 2. Patient 3 and 4 (siblings) exhibited a compound heterozygous mutation at c.638A>G p. (Asp213Gly) and novel mutation c.1073T>G p. (Leu358Arg) in exon 4 of CPT2 gene. A significant combined prevalence at 0.01% of CACT and CPT2 deficiencies was found in the symptomatic Malaysian patients.

The use of the (C16+C181)/C2 acylcarnitine ratio in dried blood spot in our experience improves the diagnostic specificity for CACT/CPT2 deficiencies over long chain acylcarnitine (C16 and C181) alone. DNA sequencing for both genes aids in confirming the diagnosis.

The use of the (C16 + C181)/C2 acylcarnitine ratio in dried blood spot in our experience improves the diagnostic specificity for CACT/CPT2 deficiencies over long chain acylcarnitine (C16 and C181) alone. DNA sequencing for both genes aids in confirming the diagnosis.

to evaluate the accuracy of the creatine kinase test in neonatal screening for Duchenne Muscular Dystrophy.

Investigations were carried out in six databases, gray literature and manual search. All studies and data extraction eligibility processes were carried out in paired mode. The methodological stringency of the studies was assessed using the modified QUADAS 2 tool. The performance measures of the test were calculated using the Meta-DiSc software, version 1.4.

11 studies were included, with a total sample of 1,416,123 newborns. The positive likelihood ratio was more than 10 in these studies. On the other hand, the negative likelihood ratio was up to 0.2 in 9/10 studies; however, when considering the upper limit of the confidence interval, only 4/10 studies showed a negative likelihood ratio less than 0.2 and in 6/11 it was greater than 0.5. Specificity was close to 1 in studies. The sensitivity was equal to or greater than 0.81 in 10/11 studies; however, when considering the reliability’s minimum interval limit, only 6/10 studies showed sensitivity equal to or greater than 0.7. Ten studies were summarized on a ROC curve indicating good performance (Area under the curve=0.9980 and Q index=0.9846).

the creatine kinase test showed good accuracy in screening for cases of Duchenne Muscular Dystrophy and may be a useful alternative in the early diagnosis of the disease followed by confirmatory genetic testing.

the creatine kinase test showed good accuracy in screening for cases of Duchenne Muscular Dystrophy and may be a useful alternative in the early diagnosis of the disease followed by confirmatory genetic testing.

Temporomandibular disorders are a cluster of orofacial conditions that are characterized by pain in the temporomandibular joint (TMJ) and surrounding muscles/tissues. Animal models of painful temporomandibular dysfunction (TMD) are valuable tools to investigate the mechanisms responsible for symptomatic temporomandibular joint and associated structures disorders. We tested the hypothesis that a predisposing and a precipitating factor are required to produce painful TMD in rats, using the ratgnawmeter, a device that determines temporomandibular pain based on the time taken for the rat to chew through two obstacles.

Increased time in the ratgnawmeter correlated with nociceptive behaviors produced by TMJ injection of formalin (2.5%), confirming chewing time as an index of painful TMD. Rats exposed only to predisposing factors, carrageenan-induced TMJ inflammation or sustained inhibition of the catechol-O-methyltransferase (COMT) enzyme by OR-486, showed no changes in chewing time. However, when combined with a precipitating event, i.