http://academic.oup.com/milmed/article-pdf/146/7/506/24126715/milmed-146-7-506.pdf

Goodman and Gilman's The Pharmacological Basis of Therapeutics

正しい方法がわかる臨床基本手技 : from the New England journal of medicine

An adequate supply of saliva is critical to the preservation and maintenance of oral tissue. Clinicians often do not value the many benefits of saliva until quantities are decreased. Much is written on the subject of salivary hypofunction, but little attention is paid to normal salivary flow and function. This article is a brief, up-to-date overview of the literature on the basics of normal salivary composition, flow, and function. A review of the literature was conducted using MEDLINE and Healthstar (1944 through 1999); articles were selected for inclusion on the basis of relevance and significance to the clinician.

A review of saliva: Normal composition, flow, and function

Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

https://www.unitypoint.org/desmoines/filesimages/Cancer%20Education/Oncology%20Nursing%20Conference/2015/2014%20NCCN%20Clin%20Pract%20Guidelines%20Male%20Sex%20Dysf.pdf

Clinical practice guidelines in oncology

Platelet-rich plasma (PRP) has been utilized in surgery for 2 decades; there has been a recent interest in the use of PRP for the treatment of sports-related injuries. PRP contains growth factors and bioactive proteins that influence the healing of tendon, ligament, muscle, and bone. This article examines the basic science of PRP, and it describes the current clinical applications in sports medicine. This study reviews and evaluates the human studies that have been published in the orthopaedic surgery and sports medicine literature. The use of PRP in amateur and professional sports is reviewed, and the regulation of PRP by antidoping agencies is discussed.

Platelet-Rich Plasma From Basic Science to Clinical Applications

Chapter 32 – Management of Sjögren Syndrome in Patients with SLE

Tijdens orthodontische verplaatsing van gebitselementen treden veranderingen op in de samenstelling van de gingivale creviculaire vloeistof (GCF). Analyse van GCF kan leiden tot het vinden van biochemische indicatoren die kenmerkend zijn voor veranderingen in het lokale cellulaire metabolisme. Deze veranderingen in het cellulaire metabolisme kunnen zowel gerelateerd zijn aan de parodontale status van de patient als aan veranderingen op botniveau ten gevolge van de orthodontische verplaatsing van gebitselementen (Delima en Van Dyke, 2003) (afb. 14.1). Het verkrijgen van inzicht in deze indicatoren wordt van belang geacht, omdat aan de hand van deze indicatoren zowel het verloop als de uiteindelijke uitkomst van een orthodontische behandeling kan worden voorspeld (Waddington en Embery, 2001; Kavadia-Tsatala et al., 2002; Ren en Vissink 2008).

Rol van cytokinen bij de orthodontische verplaatsing van gebitselementen

Ultrasonography is a tool to assess the involvement of major salivary glands in patients with Sjögren’s syndrome (SS). Recently, the Outcome Measures in Rheumatology (OMERACT) scoring system has been developed for salivary gland ultrasonography (SGUS) in SS.[1]Incorporation of this scoring system in the 2016 American College of Rheumatology (ACR)-European League Against Rheumatism (EULAR) classification criteria might be of aid in the classification of SS.To investigate if addition of the OMERACT SGUS score influences the performance of the 2016 ACR-EULAR classification criteria for SS in daily clinical practice.This retrospective, cross-sectional study included consecutive patients of ≥18 years who visited the University Medical Centre Groningen (UMCG) between January 2017 and December 2021 for a diagnostic trajectory to determine whether they had SS. All items of the 2016 ACR-EULAR criteria were collected. Ultrasonographic images were assessed by using the Hocevar score. A transformation table was made by two experienced ultrasonographers (AS and KD) to transform the Hocevar score to the OMERACT SGUS score (range 0-12). Clinical diagnosis by the treating physician was used as gold standard. Receiver operating characteristic (ROC) analysis with area under the curve (AUC) was used to analyse the accuracy of the SGUS OMERACT score, the current ACR-EULAR classification criteria and the ACR-EULAR criteria with addition of the SGUS OMERACT score as well as to explore the optimal cut-off point to predict clinical diagnosis.Of the 419 included patients, mean age was 53±14 years, 366 (87%) were female and 164 (39%) were diagnosed with SS. Median (IQR) of the SGUS OMERACT score was 7 (4-10) in the SS group versus 1 (0-2) in the non-SS group (Table 1). The SGUS OMERACT score predicted the clinical diagnosis of SS with good accuracy, with an AUC of 0.868 (95% CI 0.830-0.906). The optimal cut-off point of the total OMERACT score to predict clinical diagnosis was ≥5, with a sensitivity of 68.9% and a specificity of 91.4%. An OMERACT score of ≥2 in at least 1 gland showed a sensitivity of 75.6% and a specificity of 85.5%.The current ACR-EULAR classification criteria showed excellent accuracy to predict clinical diagnosis, with an AUC of 0.956 (0.937-0.975). When incorporating the SGUS OMERACT score (defined as total score ≥5) as additional item in the ACR/EULAR criteria, the AUC was 0.968 (0.953-0.983). When incorporating the SGUS OMERACT score (defined as ≥2 points in 1 gland) as an additional item, the AUC was 0.967 (0.951-0.982).With the original ACR/EULAR cut-off score of ≥4 for classification as SS, the sensitivity was 92.7% and the specificity 87.5% for the current ACR-EULAR classification criteria, 93.3% and 87.1% for the ACR-EULAR criteria with addition of SGUS OMERACT positivity based on total score ≥5, and 93.9% and 85.5% for the ACR-EULAR criteria with addition of SGUS OMERACT positivity based on ≥2 points in 1 gland.Incorporating SGUS in the criteria extends the diagnostics options in patients suspected with SS. The accuracy of the ACR-EULAR classification criteria in predicting the clinical diagnosis of SS remained high after incorporating the SGUS OMERACT score.[1]Finzel S et al. Rheumatol 2020. Doi: 10.1093/rheumatology/keaa471.Table 1.Characteristics of study populationCharacteristicsSS (n = 164)No SS (n = 255)P-valueAge (years)53 ± 1453 ± 140.777Sex (female)143/164 (87.2)223/255 (87.5)0.939FS ≥1 in salivary gland biopsy107/133 (80.5)22/158 (13.9)<0.001Anti-SSA positive131/164 (79.9)32/253 (12.6)<0.001Ocular staining score ≥5*34/164 (20.7)15/255 (5.88)<0.001Schirmer ≤5 mm*109/158 (69.0)128/242 (52.9)0.001Unstimulated whole saliva ≤0.1 ml/min91/162 (56.2)90/253 (35.6)<0.001Total OMERACT score (0-12)7 [4-10]1 [0-2]<0.001Total OMERACT score ≥5 in 4 glands113/164 (68.9)22/255 (8.63)<0.001OMERACT score ≥2 in at least 1 gland124/164 (75.6)37/255 (14.5)<0.0012.Data presented as mean ± SD, median [IQR] or n (%)3.* Scored in at least 1 eyeSeveral authors of this publication are member of the European Reference Network ReCONNET.Dagmar Rebel: None declared, Liseth de Wolff: None declared, Konstantina Delli: None declared, Alja J. Stel: None declared, Helene Kokol: None declared, Arjan Vissink Grant/research support from: A. Vissink has received unrestricted grants from Bristol-Myers Squibb and Roche., Frans G.M. Kroese Speakers bureau: F.G.M Kroese has worked as a speaker for Bristol-Myers Squibb, Roche and Janssen-Cilag., Consultant of: F.G.M Kroese has worked as a consultant for Bristol-Myers Squibb., Grant/research support from: F.G.M Kroese has received unrestricted grants from Bristol-Myers Squibb., Suzanne Arends Consultant of: Suzanne Arends is consultant for ArgenX and Novartis., Hendrika Bootsma Speakers bureau: H. Bootsma has worked as a speaker for Bristol-Myers Squibb and Novartis, Consultant of: H. Bootsma has worked as a consultant for Bristol-Myers Squibb, Roche, Novartis, Union Chimique Belge and ArgenX., Grant/research support from: H. Bootsma has received unrestricted grants from Bristol-Myers Squibb, Roche and AstraZeneca.

https://ard.bmj.com/content/annrheumdis/82/Suppl_1/304.1.full.pdf

Arjan Vissink

Papers

Chapter 32 – Management of Sjögren Syndrome in Patients with SLE

Rol van cytokinen bij de orthodontische verplaatsing van gebitselementen

Pos0163 performance of the salivary gland ultrasonography omeract score in the acr-eular classification criteria for sjögren’s syndrome