The present study indicates that the use of LLLT trans-operatively resulted in a positive biomodulative effect on the healing of bone defects associated with autologous bone grafts.

IMPORTANCE Convergent biological, epidemiological, and clinical data identified urate elevation as a candidate strategy for slowing disability progression in Parkinson disease (PD).OBJECTIVE To determine the safety, tolerability, and urate-elevating capability of the urate precursor inosine in early PD and to assess its suitability and potential design features for a disease-modification trial. DESIGN, SETTING, AND PARTICIPANTSThe Safety of Urate Elevation in PD (SURE-PD) study, a randomized, double-blind, placebo-controlled, dose-ranging trial of inosine, enrolled participants from 2009 to 2011 and followed them for up to 25 months at outpatient visits to 17 credentialed clinical study sites of the Parkinson Study Group across the United States. Seventy-five consenting adults (mean age, 62 years; 55% women) with early PD not yet requiring symptomatic treatment and a serum urate concentration less than 6 mg/dL (the approximate population median) were enrolled.INTERVENTIONS Participants were randomized to 1 of 3 treatment arms: placebo or inosine titrated to produce mild (6.1-7.0 mg/dL) or moderate (7.1-8.0 mg/dL) serum urate elevation using 500-mg capsules taken orally up to 2 capsules 3 times per day. They were followed for up to 24 months (median, 18 months) while receiving the study drug plus 1 washout month. MAIN OUTCOMES AND MEASURESThe prespecified primary outcomes were absence of unacceptable serious adverse events (safety), continued treatment without adverse event requiring dose reduction (tolerability), and elevation of urate assessed serially in serum and once (at 3 months) in cerebrospinal fluid.RESULTS Serious adverse events (17), including infrequent cardiovascular events, occurred at the same or lower rates in the inosine groups relative to placebo. No participant developed gout and 3 receiving inosine developed symptomatic urolithiasis. Treatment was tolerated by 95% of participants at 6 months, and no participant withdrew because of an adverse event. Serum urate rose by 2.3 and 3.0 mg/dL in the 2 inosine groups (P < .001 for each) vs placebo, and cerebrospinal fluid urate level was greater in both inosine groups (P = .006 and <.001, respectively). Secondary analyses demonstrated nonfutility of inosine treatment for slowing disability.CONCLUSIONS AND RELEVANCE Inosine was generally safe, tolerable, and effective in raising serum and cerebrospinal fluid urate levels in early PD. The findings support advancing to more definitive development of inosine as a potential disease-modifying therapy for PD. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00833690

Traumatic dentoalveolar injuries are frequent in children and adolescents, affecting teeth, their supporting structures and adjacent soft tissues and contributing to the appearance of major psychosocial and economic problems. Tooth avulsion, the most severe dentoalveolar lesion, is a dental emergency. The prognosis of avulsed teeth significantly depends on prompt and efficient action at the site of the accident, thus requiring that parents or caretakers be knowledgeable about the correct management of this situation. The objective of the present study was to assess the level of knowledge of parents or caretakers concerning the management of tooth avulsion and to investigate the association between level of knowledge and schooling, monthly family income and age. We interviewed 107 parents or caretakers using a 12-item questionnaire comprising objective questions whose answers received a score from 0 to 3. The results show that 99% of those interviewed would immediately seek professional help; however, 71% did not know what avulsion was. Only 3% would use milk as storage medium and 16% would attempt replantation of the avulsed tooth. The distribution of final means for the overall level of parent or caretaker knowledge was 44.63% for score 3, 15.88% for score 2, 17.99% for score 1 and 21.47% for score 0, showing a low level of knowledge concerning tooth avulsion. Schooling, monthly family income and age were not associated with the knowledge scores for any of the 12 questions. The level of parent and caretaker knowledge concerning the management of tooth avulsion is low, without association with age, schooling and monthly family income.

Background In the setting where determining extent of residual disease is key for surgical planning after neoadjuvant chemotherapy (NAC), herein we evaluate reliability of MRI in predicting pathologic complete response (pCR) of the breast primary and axillary nodes following NAC. Study Design Patients who had MRI before and after NAC between 06/2014–08/2015 were identified in a prospective database following IRB approval. Post NAC-MRI of the breast and axillary nodes was correlated with residual disease on final pathology. PCR was defined as absence of invasive and in situ disease. Results We analyzed 129 breast cancers. Median patient age was 50.8 years (range 27.2–80.6). Tumors were HER2 amplified in 52/129 (40%), estrogen receptor-positive/HER2-negative in 46/129 (36%) and triple negative in 31/129 (24%), with respective pCR rates of 50%, 11% and 29%. Median tumor size pre- and post-NAC MRI were 4.1cm and 1.45cm, respectively. MRI had a positive predictive value of 63.4% (26/41) and negative predictive value of 84.1% (74/88) for in-breast pCR. Axillary nodes were abnormal on pre-NAC MRI in 97 cases; 65 had biopsy-confirmed metastases. The nodes normalized on post-NAC MRI in 33/65 (51%); axillary pCR was present in 22/33 (67%). In 32 patients with proven nodal metastases and abnormal nodes on post-NAC MRI, 11 achieved axillary pCR. In 32 patients with normal nodes on pre- and post-NAC MRI, 6 (19%) had metastasis on final pathology. Conclusions Radiologic complete response by MRI does not predict pCR with adequate accuracy to replace pathologic evaluation of the breast tumor and axillary nodes.

Objective: To evaluate, using histological analysis, the systemic action and repair process of wounds produced on the back of rats and treated with red, infrared, or both lasers applied directly or indirectly to the wounds. Background Data: Skin tissue repair and wound healing are complex processes that involve a series of dynamic events. Many benefits are associated with biomodulation uisng laser therapy. Methods: Thirty-six male Wistar rats were divided into four groups: control (without laser), red laser (aluminium gallium indium phosphide (AlGaInP); λ = 685 nm; λ = 0.0314 cm Three wounds were produced on the back of each animal. Only the wound closest to the head was irradiated in the experimental groups. For the evaluation of skin reaction and wound healing, three animals of each group were killed at 3, 5, and 7 days postoperatively. The irradiation protocol established 48-hour intervals between applications, with the first application immediately after the surgical procedure. Results: In the red and infrared laser group, healing was more advanced in the wound located furthest from the point of laser application. The most effective healing of a proximal wound was verified in the control group on the 7th postoperative day. Conclusion: The combined application of red and infrared lasers resulted in the most evident systemic effect on the repair of skin wounds produced in rats.