Publications by authors named "B Stewart"

1,351 Publications

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Salpingectomy confirms tubal fibroid and recurrent miscarriage rather than recurrent tubal ectopic pregnancy.

J Minim Invasive Gynecol 2021 Jun 5. Epub 2021 Jun 5.

From the Department of Gynaecology, The Royal Women's Hospital Parkville, Victoria, Australia.

This case focused on a 39-year-old female with a significant history of secondary, infertility recurrent miscarriage and recurrent suspected left tubal ectopic pregnancy which was initially managed repeatedly and conservatively with methotrexate. Eventual laparoscopic assessment and left salpingectomy instead confirmed a left, tubal fibroid. Therefore, previous episodes of suspected ectopic pregnancy were likely, recurrent miscarriage. This case provides an example of uncommon pathology, tubal leiomyoma. This highlights the careful consideration required by gynecologists when determining management pathways in early pregnancy assessment, especially for women with poor fertility history and ongoing desire to conceive.
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http://dx.doi.org/10.1016/j.jmig.2021.05.021DOI Listing
June 2021

Dental Caries in Latin American and Caribbean countries: urgent need for a regional consensus.

Braz Oral Res 2021 28;35(suppl 01):e057. Epub 2021 May 28.

Latin American Oral Health Association, LAOHA, São Paulo, SP, Brazil.

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http://dx.doi.org/10.1590/1807-3107bor-2021.vol35.0057DOI Listing
May 2021

Dental caries prevalence, prospects, and challenges for Latin America and Caribbean countries: a summary and final recommendations from a Regional Consensus.

Braz Oral Res 2021 28;35(suppl 01):e056. Epub 2021 May 28.

King's College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Dental Innovation and Translation hub, London, UK.

Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.
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http://dx.doi.org/10.1590/1807-3107bor-2021.vol35.0056DOI Listing
June 2021

De novo revertant fiber formation and therapy testing in a 3D culture model of Duchenne muscular dystrophy skeletal muscle.

Acta Biomater 2021 May 25. Epub 2021 May 25.

Donnelly Centre, University of Toronto, Toronto, ON M5S3E1, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S3G9, Canada; Department of Cell and Systems Biology, University of Toronto, Toronto, ON M5S3G5, Canada. Electronic address:

The biological basis of Duchenne muscular dystrophy (DMD) pathology is only partially characterized and there are still few disease-modifying therapies available, therein underlying the value of strategies to model and study DMD. Dystrophin, the causative gene of DMD, is responsible for linking the cytoskeleton of muscle fibers to the extracellular matrix beyond the sarcolemma. We posited that disease-associated phenotypes not yet captured by two-dimensional culture methods would arise by generating multinucleated muscle cells within a three-dimensional (3D) extracellular matrix environment. Herein we report methods to produce 3D human skeletal muscle microtissues (hMMTs) using clonal, immortalized myoblast lines established from healthy and DMD donors. We also established protocols to evaluate immortalized hMMT self-organization and myotube maturation, as well as calcium handling, force generation, membrane stability (i.e., creatine kinase activity and Evans blue dye permeability) and contractile apparatus organization following electrical-stimulation. In examining hMMTs generated with a cell line wherein the dystrophin gene possessed a duplication of exon 2, we observed rare dystrophin-positive myotubes, which were not seen in 2D cultures. Further, we show that treating DMD hMMTs with a β1-integrin activating antibody, improves contractile apparatus maturation and stability. Hence, immortalized myoblast-derived DMD hMMTs offer a pre-clinical system with which to investigate the potential of duplicated exon skipping strategies and those that protect muscle cells from contraction-induced injury. STATEMENT OF SIGNIFICANCE: : Duchenne muscular dystrophy (DMD) is a progressive muscle-wasting disorder that is caused by mutation of the dystrophin gene. The biological basis of DMD pathology is only partially characterized and there is no cure for this fatal disease. Here we report a method to produce 3D human skeletal muscle microtissues (hMMTs) using immortalized human DMD and healthy myoblasts. Morphological and functional assessment revealed DMD-associated pathophysiology including impaired calcium handling and de novo formation of dystrophin-positive revertant muscle cells in immortalized DMD hMMTs harbouring an exon 2 duplication, a feature of many DMD patients that has not been recapitulated in culture prior to this report. We further demonstrate that this "DMD in a dish" system can be used as a pre-clinical assay to test a putative DMD therapeutic and study the mechanism of action.
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http://dx.doi.org/10.1016/j.actbio.2021.05.020DOI Listing
May 2021

The effect of a toothpaste containing oleanolic acid in reducing plaque and gingivitis: a proof-of-concept randomized trial.

Int J Dent Hyg 2021 May 28. Epub 2021 May 28.

Department of Stomatology, School of Dentistry, University of São Paulo, Brazil.

Objectives: To assess the safety and efficacy of an oleanolic acid (OA)-containing toothpaste in reducing gingival inflammation and plaque in patients with gingivitis.

Methods: This proof-of-concept parallel, double-blind, randomized controlled clinical trial included 99 patients. Following a 1-week washout, patients were randomized into three groups: OA group (fluoride toothpaste containing 0.1% OA and placebo mouthwash); negative control (fluoride toothpaste and placebo mouthwash); and CHX group (fluoride toothpaste and 0.12% chlorhexidine mouthwash). Patients were clinically assessed at inclusion, pre-washout visit, baseline, and after 4-days, 1-week, and 2-weeks of twice daily use of the products. Patients received a diary for documentation of bleeding on brushing and provided unstimulated saliva samples.

Results: After two weeks, all groups showed significant reductions in all clinical parameters. The CHX group exhibited significantly greater reductions in gingival index and interproximal gingival index scores at week-2, as compared to patients in the negative control (p=0.04). In contrast, reductions in gingival index scores did not differ between CHX and OA groups and between OA and negative control groups at week-2. The CHX group had significantly greater reductions in plaque index scores at day-4, 1-week, and 2-week evaluations, as compared to the negative control and OA groups. The frequency of adverse events was similar among the groups. None of the groups reduced salivary transferrin levels. Finally, the OA group had the lowest percentage of self-reported bleeding events.

Conclusion: OA toothpaste failed to provide antiplaque and antigingivitis effects superior to those of a fluoride toothpaste after 2 weeks of use.
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http://dx.doi.org/10.1111/idh.12526DOI Listing
May 2021