text:
Periodontal diseases are inflammatory diseases resulting in the destruction of tissues of the periodontium. Although bacteria must be present for periodontal disease to occur, a susceptible host is also required, which is determined by genetic, environmental, and acquired factors. One such factor, autoimmunity, may play a role in the tissue destruction. Data indicate that some antibodies that occur in the gingival lesion are directed to host tissue components, such as type I collagen, although investigations of other periodontal autoimmune targets are limited.
Histologic sections and extracts from periodontally healthy teeth and the associated soft tissues were probed with serum from localized aggressive periodontitis (LAgP), chronic periodontitis (CP), and periodontally healthy subjects to determine autoreactivity to components of the periodontium. Any autoreactivity observed was characterized further by mass spectrometry and enzyme-linked immunosorbent assay.
Autoreactivity to components of the periodontium was observed in CP and LAgP. Known autoimmune targets, such as collagen and heat shock protein, were identified along with multiple potential autoimmune targets, including members of the extracellular matrix, such as vimentin, spectrin, filamin, actin, lamin, keratin, and tubulin. Finally, it was determined that the autoreactivity observed in LAgP was more severe and diverse than that observed in CP.
These data demonstrated that autoimmune reactivity can play a role in the tissue destruction of periodontal disease but that the nature of the autoreactivity may differ based on the type and/or stage of periodontal disease.
Antibody; autoimmunity; collagen; periodontal diseases
Reports from studies of twins, disease aggregation in families, animal models for periodontal disease, and various genetic-analysis studies have determined that genetics plays a role in the susceptibility to periodontal disease. The purpose of this pilot study was to evaluate the effect of genetics on periodontal disease by evaluating the heritability of alveolar bone loss in a captive baboon population.
A collection of baboon skulls from a pedigreed colony (for which scientists and veterinarians maintain complete genealogical and veterinary records) were obtained from the Southwest National Primate Research Center and used in this pilot study. Measurements of alveolar bone loss were performed on 390 dry baboon skulls. A periodontal probe was used to measure alveolar bone loss. Maximum likelihood methods (designed to handle complex genealogies) were used to determine the heritability of alveolar bone loss. This software utilized known pedigrees in the captive baboon sample and tested the relationship between pairwise kinship and alveolar bone loss data to determine the heritability of alveolar bone loss from periodontal disease.
Genetic data were available for 347 of the 390 specimens. Using age and sex as covariates, genetic analysis indicated a heritability of 35% (standard error=20%, p=0.01). While sex was not a significant factor in periodontal disease (p=0.96), age was highly significantly associated with periodontal disease (p<0.0001).
In this pilot study, analysis of alveolar bone loss measurements from captive baboons indicates that bone loss increases with age and that a portion of periodontal disease risk may be due to genetic variance. These findings provide evidence that periodontal disease is heritable in captive baboons and indicate that a larger, more-detailed study is warranted.
periodontitis; alveolar bone; genetics; baboons
Current scientific evidence addressing the relation between periodontitis and hypertension is limited to a few studies producing inconsistent results.
All participants of an on-going representative cohort of Puerto Rican elderly who were 70 years and older and residing in San Juan metropolitan area were invited to this cross-sectional study. Periodontal probing depth (PD) and attachment loss (AL) were summarized using CDC-AAP definition for severe periodontitis (≥2 teeth with AL ≥6mm and ≥1 tooth with PD ≥5mm). We averaged three repeated blood pressure (BP) measurements taken using a standardized auscultatory method. Information on hypertension history, use of anti-hypertensive medications and potential confounders (age, gender, smoking, heavy and binge drinking, diabetes, utilization of preventive dental services, flossing, body mass index, fruit and vegetable, whole wheat bread and high-fiber cereal consumption) was collected during in-person interviews. High BP was defined as average systolic BP ≥140 mmHg or diastolic ≥90 mmHg. Multivariate logistic regression models were used to study the relation between severe periodontitis, hypertension history and high BP.
The study population comprised 182 adults. In multivariate analysis, there was no association between severe periodontitis and hypertension history (OR=0.99, 95% CI: 0.40–2.48). Severe periodontitis was associated with high BP, with OR of 2.93 (95% CI: 1.25–6.84), after adjusting for age, gender, smoking, and binge drinking. This association was stronger when restricted to those with hypertension or taking anti-hypertensive medications: OR=4.20 (95% CI: 1.28–13.80).
Our results suggest that periodontitis may contribute to poor blood pressure control among older adults.
Periodontal diseases; periodontitis; hypertension; blood pressure
The periodontal pathogen Actinobacillus actinomycetemcomitans produces a leukotoxin that is considered a primary virulence factor in localized juvenile Periodontitis (LJP). Select strains of the bacterium contain a 530-bp deletion in the promoter region of the leukotoxin gene operon which results in enhanced transcription of the leukotoxin. DNA hybridization and polymerase chain reaction (PCR) were used to examine genetic variants of A. actinomycetemcomitans in 24 LJP-susceptible children from 21 families having a history of the disease and 34 control children from non-LJP families. A significant association was found between the detection of variants that had a deletion in the leukotoxin promoter region, indicative of a high level expression leukotoxin genotype, and conversion from a healthy periodontal status to disease. Subjects harboring A. actinomycetemcomitans of this genotype were more likely to convert to LJP than those subjects who had variants containing the full length leukotoxin promoter region (odds ratio = 22.50, 95% C.I.). These findings support the concept that highly virulent strains or clonal types of periodontal pathogens play a major role in the initiation of periodontal disease in susceptible hosts.
Periodontitis; juvenile/epidemiology; Actinobacillus actinomycetemcomitans; leukotoxin; epidemiology; polymerase chain reaction; polymorphism; restriction fragment length
Biofilm-induced inflammatory osteolytic oral infections, such as periodontitis and peri-implantitis, have complex etiology and pathogenesis. A significant obstacle to research has been the lack of appropriate animal models where the inflammatory response to biofilms can be investigated. The aim of this study is to develop a novel animal model to study the host response to Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans)–biofilm colonizing titanium implants.
Titanium implants were inoculated in vitro with A. actinomycetemcomitans, establishing a biofilm for 1 to 3 days. Biofilm-inoculated and control implants were transmucosally placed into rat hard palate or alveolar ridge. Analysis included documentation of clinical inflammation, polymerase chain reaction, and culture detection of A. actinomycetemcomitans and microcomputed tomography quantitation of peri-implant bone volume.
Viable A. actinomycetemcomitans biofilm was successfully established on titanium implants in vitro, detected by confocal laser scanning microscopy. An inflammatory response characterized by clinical inflammation, bleeding, ulceration, hyperplasia, and necrosis was observed around biofilm-inoculated implants. A. actinomycetemcomitans was detected by polymerase chain reaction and culture analysis on 100%of biofilm-inoculated implants for up to 3 weeks and 25%for up to 6 weeks. Microcomputed tomography analysis demonstrated significantly lower bone volume (P <0.05) around biofilm-inoculated implants (29.6% ± 7.6%) compared to non-inoculated implants (50.5% ± 9.6%) after 6 weeks.
These results describe a novel animal model where A. actinomycetemcomitans biofilm was established in vitro on titanium implants before placement in rat oral cavity, leading to an inflammatory response, osteolysis, and tissue destruction. This model may have potential use for investigation of host responses to biofilm pathogens and antibiofilm therapy.
Aggregatibacter actinomycetemcomitans; biofilms; dental implants; infection; models; animal; rats
Dental biofilms contain a protein that inhibits mammalian cell growth, possibly lysine decarboxylase from Eikenella corrodens. This enzyme decarboxylates lysine, an essential amino acid for dentally attached cell turnover in gingival sulci. Lysine depletion may stop this turnover, impairing the barrier to bacterial compounds. The aims of this study were to determine biofilm lysine and cadaverine contents before oral hygiene restriction (OHR), and their association with plaque index (PI) and gingival crevicular fluid (GCF) after OHR for a week.
Laser-induced fluorescence after capillary electrophoresis was used to determine lysine and cadaverine contents in dental biofilm, tongue biofilm and saliva before OHR and in dental biofilm after OHR.
Before OHR, lysine and cadaverine contents of dental biofilm were similar and 10-fold greater than in saliva or tongue biofilm. After a week of OHR, the biofilm content of cadaverine increased and that of lysine decreased, consistent with greater biofilm lysine decarboxylase activity. Regression indicated that PI and GCF exudation were positively related to biofilm lysine post-OHR, unless biofilm lysine exceeded the minimal blood plasma content in which case PI was further increased but GCF exudation was reduced.
After OHR, lysine decarboxylase activity seems to determine biofilm lysine content and biofilm accumulation. When biofilm lysine exceeds minimal blood plasma content after OHR, less GCF appeared despite more biofilm. Lysine appears important for biofilm accumulation and the epithelial barrier to bacterial proinflammatory agents.
Inhibiting lysine decarboxylase may retard the increased GCF exudation required for microbial development and gingivitis.
Gingival crevicular fluid; Gingivitis; Oral hygiene; Pathogenesis of periodontal disease(s); Microbiology
We previously reported in a cross-sectional study that patients who were in periodontal maintenance programs and were taking vitamin D and calcium supplementation had a trend for better periodontal health compared with patients not taking supplementation. The objective of the present study was to determine, for the same group of subjects, whether there was a difference in periodontal health over a one–year period.
Fifty-one patients enrolled in maintenance programs from two dental clinics were recruited. Twenty-three were taking vitamin D (≥400 international units/day) and calcium (≥1000mg/day) supplementation, and twenty-eight were not taking supplementation. All subjects had ≥2 interproximal sites with ≥3 mm clinical attachment loss. For mandibular-posterior teeth, these clinical parameters were recorded: gingival index, plaque index, probing depth, attachment loss, bleeding upon probing, calculus index and furcation involvement. Photostimulable-phosphor, posterior bitewing radiographs were taken to assess alveolar bone. Daily vitamin D and calcium intakes were estimated by nutritional analysis. Data were collected at baseline, 6 months, and 12 months.
Clinical parameters improved with time in both groups (p<0.01). When clinical measures were considered collectively, the results were borderline significant at baseline (p=0.061), significant at 6 months (p=0.049) but not significant at 12 months (p=0.114). After adjusting for covariates, the effect of supplements was significant at baseline (p=0.037), borderline at 6 months (p=0.058) and not significant at 12 months (p=0.142)
Calcium and vitamin D supplementation has a modest positive effect on periodontal health, and consistent dental care improves clinical parameters of periodontal disease regardless of such supplements. Calcium and vitamin D supplementation has a modest positive effect on periodontal health, and consistent dental care improves clinical parameters of periodontal disease regardless of such supplements. Our findings raise the possibility that vitamin D, perhaps at higher doses, may positively impact on periodontal disease severity.
vitamin D; calcium; chronic periodontitis; alveolar bone
Inflammatory periodontal diseases are a leading cause of tooth loss and are linked to multiple systemic conditions, such as cardiovascular disease and stroke. Reconstruction of the support and function of affected tooth-supporting tissues represents an important therapeutic endpoint for periodontal regenerative medicine. An improved understanding of periodontal biology coupled with current advances in scaffolding matrices has introduced novel treatments that use cell and gene therapy to enhance periodontal tissue reconstruction and its biomechanical integration. Cell and gene delivery technologies have the potential to overcome limitations associated with existing periodontal therapies, and may provide a new direction in sustainable inflammation control and more predictable tissue regeneration of supporting alveolar bone, periodontal ligament, and cementum. This review provides clinicians with the current status of these early-stage and emerging cell- and gene-based therapeutics in periodontal regenerative medicine, and introduces their future application in clinical periodontal treatment. The paper concludes with prospects on the application of cell and gene tissue engineering technologies for reconstructive periodontology.
Macrolide antibiotics yield high concentrations in inflamed tissue, suggesting that their levels in gingival crevicular fluid (GCF) could be increased at gingivitis sites. However, the increased volume of GCF associated with gingivitis could potentially dilute macrolides. To determine whether these assumptions are correct, the bioavailability of systemically-administered azithromycin was compared in GCF from healthy and gingivitis sites.
Materials and methods
Experimental gingivitis was induced in one maxillary posterior sextant in nine healthy subjects. Contralateral healthy sextants served as controls. Subjects ingested 500 mg of azithromycin followed by a 250 mg dose 24 hours later. Four hours after the second dose, plaque was removed from experimental sites. GCF was collected from 8 surfaces in both the experimental and control sextants and pooled separately. GCF samples were subsequently collected on the 2nd, 3rd, 8th and 15th days and azithromycin content was determined by agar diffusion bioassay.
On days 2 and 3, the pooled GCF volume at experimental sites was significantly higher than at control sites (P <0.01) and the total azithromycin mass in 30 second GCF samples pooled from experimental sites was significantly higher than at control sites (P < 0.02). However, there were no significant differences in azithromycin concentration between the experimental and control pools at any point. Concentrations exceeded 7.3 μg/ml on day 2 and 2.5 μg/ml on day 15.
Azithromycin concentrations are similar in GCF from gingivitis sites and healthy sites, suggesting that the processes that regulate GCF azithromycin concentration can compensate for local inflammatory changes.
Anti-infective agents; inflammation; pharmacokinetics
Understanding the molecular features of bone repair and osseointegration may aid in the development of therapeutics to improve implant outcomes. The purpose of this investigation is to determine the gene expression dynamics during alveolar bone repair and implant osseointegration.
An implant osseointegration preclinical animal model was used whereby maxillary defects were created at the time of oral implant placement, while a tooth extraction socket healing model was established on the contralateral side of each animal. The surrounding tissues in the zone of the healing defects were harvested during regeneration for temporal evaluation using histology, immunohistochemistry, laser capture microdissection, and quantitative reverse transcription–polymerase chain reaction for the identification of a panel of 17 putative genes associated with wound repair.
In both models, three distinct expression patterns were displayed: 1) genes that are slowly increased during the healing process, such as bone morphogenetic protein 4, runt-related transcription factor 2, and osteocalcin; 2) genes that are upregulated at the early stage of healing and then downregulated at later stages, such as interleukin and chemokine (C-X-C motif) ligands 2 and 5; and 3) genes that are constitutively expressed over time, such as scleraxis. Although some similarities between osseointegration and tooth extraction socket were seen, distinct features developed and triggered a characteristic coordinated expression and orchestration of transcription factors, growth factors, extracellular matrix molecules, and chemokines.
Characterization of these events contributes to a better understanding of cooperative molecular dynamics in alveolar bone healing, and highlights potential pathways that could be further explored for the enhancement of osseous regenerative strategies.
Analysis of samplings from periodontal pockets is important in diagnosis and therapy control of periodontitis. In this study, three different sampling techniques were compared to determine if one method can yield samples suitable for reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and Arg-specific gingipains. R-gingipains are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not yet been quantified.
GCF was sampled from four sites per patient (each two sites one method) in 36 chronic periodontitis patients. One week later, the procedure was repeated with alternative methods. The variables that had been determined were: loads of Aggregatibacter actinomycetemcomitans and P. gingivalis, levels of interleukin-6 and interleukin-8, activity of neutrophil elastase and level of R-gingipains.
The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from the paper strips and paper points. R-gingipains were detectable in high quantities only by washing of the periodontal pocket. The level of R-gingipains correlated with the load of P. gingivalis.
The use of paper strips is suitable for simultaneous determination of microbial and immunological parameters. Obtaining GCF by washing can be useful for special purposes. Gingipain concentration in periodontal pockets was directly determined to be up to 1.5 μM. This value indicates that most of so far identified substrates of these proteases by in vitro assays can be easily degraded in P. gingivalis infected sites.
gingival crevicular fluid; sampling techniques; Porphyromonas gingivalis; Arg-gingipain; cytokines
Fluoxetine, a selective serotonin reuptake inhibitor, has recently been found to possess anti-inflammatory properties. The present study investigated the effects of fluoxetine on inflammatory tissue destruction in a rat model of ligature-induced periodontitis (PD).
Male Wistar rats were randomly assigned into three groups (n=10 animals/group): 1) Control rats (without ligature); 2) rats with ligature + placebo (saline; oral gavage); 3) rats with ligature + fluoxetine (20 mg/kg/day in saline; oral gavage). Histological analyses were performed on the furcation region and mesial of mandibular first molars of rats sacrificed at 15 days after ligature-induced PD. Reverse transcriptase-polymerase chain reaction (RT-PCR) and zymography were performed to analyze the mRNA expression of interleukin (IL)-1β, cyclooxygenase (COX)-2, matrix metalloproteinase (MMP)-9 and inducible nitric oxide synthase (iNOS), and the MMP-9 activity, respectively, in gingival tissues samples.
Compared to the ligature + placebo group, alveolar bone loss was reduced in the fluoxetine group (P < 0.05), and the integrity of collagen fibers in the gingival tissue was maintained. Moreover, in gingival tissue sampled 3 days after ligature attachment, fluoxetine administration reduced IL-1β and COX-2 mRNA expression. Fluoxetine down-regulated MMP-9 activity, without affecting MMP-9 mRNA expression induced by ligature, compared to the ligature + placebo group (P < 0.05). These data suggested that fluoxetine suppressed proinflammatory responses, as well as proteolytic enzyme activity, induced by ligature.
In the present study, fluoxetine suppressed the inflammatory response and protected against periodontal bone resorption and destruction of collagen fibers, suggesting that fluoxetine can constitute a promising therapeutic approach for periodontal diseases.
Fluoxetine; inflammation; periodontitis; bone resorption; collagen
The proinflammatory chemokine interleukin-8 (IL8) is important in the regulation of the inflammatory response. Single nucleotide polymorphism (SNP) rs4073 have shown that the A allele up regulates the IL8 levels after stimulation with lipopolysaccharides. We investigated the association of the SNP rs4073 with chronic periodontitis.
Genotyping was performed by standard polymerase chain reaction-restriction fragment length polymorphism assay in 289 genomic DNA samples of healthy control and chronic periodontitis patients; analyses were adjusted by the multivariate logistic regression modeling. Real-time PCR performance was used to detect the levels of the IL8 mRNA.
Analysis points to a statistical significant association of chronic periodontitis with the heterozygous TA genotype (p = 0.001); the results showed an increase in the frequency of the A allele in the diseased group (36% in the control × 48% in the periodontitis group). The higher levels of the IL8 mRNA were found in the periodontitis group, mainly in individuals who presented the TA genotype (p=0.03).
The SNP rs4073 is associated with chronic periodontitis, in non-smoker Brazilian subjects, since the frequency of A allele is higher in the disease than control group and the TA genotype was associated with increased levels of IL8 mRNA transcripts.
periodontitis; polymorphism; single nucleotide; Interleukin-8; genotype; alleles
Inflammatory stimuli activate inducible nitric oxide synthase (iNOS) in a variety of cell types, including osteoclasts (OC) and osteoblasts, resulting in sustained NO production. In this study, we evaluate the alveolar bone loss in rats with periodontitis under long-term iNOS inhibition, and the differentiation and activity of OC from iNOS-knockout (KO) mice in vitro.
Oral aminoguanidine (an iNOS inhibitor) or water treatment was started 2 weeks before induction of periodontitis. Rats were sacrificed 3, 7, or 14 days after ligature placement, and alveolar bone loss was evaluated. In vitro OC culture experiments were also performed to study the differentiation of freshly isolated bone marrow cells from both iNOS KO and wild-type C57BL/6 mice. OC were counted 6 days later after tartrate-resistant acid phosphatase staining (a marker of osteoclast identity), and bone resorption activity was assessed by counting the number of resorption pits on dentin disks.
Rats with ligature showed progressive and significant alveolar bone loss compared to sham animals, and aminoguanidine treatment significantly inhibited ligature-induced bone loss at 7 and 14 days after the induction. In comparison to bone marrow cells from wild-type mice, cells from iNOS KO mice showed decreased OC growth and the resulting OC covered a smaller culture dish area and generated fewer resorption pit counts.
Our results demonstrate that iNOS inhibition prevents alveolar bone loss in a rat model of ligature-induced periodontitis, thus confirming that iNOS-derived NO plays a crucial role in the pathogenesis of periodontitis, probably by stimulating OC differentiation and activity.
Animal experimental use; bone resorption; iNOS enzyme; nitric oxide; osteoclasts; periodontitis
A major cause of chronic inflammatory periodontal diseases is Porphyromonas gingivalis (P. gingivalis), a non-motile, gram-negative, rod-shaped, anaerobic bacterium. Within gingival tissue, both macrophages and fibroblasts participate in the immune response to foreign entities by releasing cytokines and expressing molecules to recruit and activate lymphocytes. However, the contribution of gingival macrophages and fibroblasts to the immune response to P. gingivalis infection is not fully known.
The AMJ2-C8 cell line (AM cells), a mouse alveolar macrophage cell line, and ESK-1 cells, a mouse gingival fibroblast cell line made in our laboratory, were treated with lipopolysaccharide (LPS) from either P. gingivalis or Escherichia coli (E. coli). The expression of immune response molecules was quantified by real-time PCR and enzyme-linked immunoassay.
AM and ESK-1 cells responded differently to P. gingivalis and E. coli LPS stimulation. The ESK-1 gingival fibroblast cell line was more responsive to E. coli LPS stimulation as seen by elevated levels of interleukin (IL)-6, inducible nitric oxide (iNOS), and monocyte chemotactic protein-1 (MCP-1) expression relative to stimulation by P. gingivalis LPS. Conversely, the AM macrophage cell line was more responsive to P. gingivalis LPS stimulation, particularly for interleukin IL-1β, IL-6, and MCP-1, relative to stimulation by E. coli LPS.
These findings demonstrate that E. coli LPS induces a stronger cytokine/chemokine response in gingival fibroblasts, while P. gingivalis LPS induces a stronger response in macrophages.
cytokines; fibroblasts; host response; immunology; inflammation and innate immunity
This report is a further analysis of a study designed to determine clinical and microbial risk indicators for progressing periodontitis.
MATERIAL AND METHODS
One hundred and ninety subjects periodontally healthy or adults with early signs of periodontitis (20–40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. At each visit, GCF and blood were collected for determination of IL-1β content (GCF) and IL-1 genotype (blood). Inter-proximal sites with >1.5 mm increase in clinical attachment over 18 months were considered disease active. Characteristics were compared between active and inactive subjects.
IL-1β levels in GCF increased with severity of disease and correlated well with clinical signs of incipient disease. However, IL-1 genotype did not show any significant associations with disease or extent of disease.
Indicators of inflammation may be important clinical determinants of future periodontal disease progression, but IL-1 genotype was not a risk indictor for early (slight) periodontitis as defined in this subject population.
genotype; gingival crevicular fluid; health; Periodontitis; race/ethnicity smoking
Obesity is increasing in prevalence and is a major contributor to worldwide morbidity. One consequence of obesity might be an increased risk for periodontal disease, although periodontal inflammation might, in turn, exacerbate the metabolic syndrome, of which obesity is one component. This review aims to systematically compile the evidence of an obesity–periodontal disease relationship from epidemiologic studies and to derive a quantitative summary of the association between these disease states.
Systematic searches of the MEDLINE, SCOPUS, BIOSIS, LILACS, Cochrane Library, and Brazilian Bibliography of Dentistry databases were conducted with the results and characteristics of relevant studies abstracted to standardized forms. A meta-analysis was performed to obtain a summary measure of association.
The electronic search identified 554 unique citations, and 70 studies met a priori inclusion criteria, representing 57 independent populations. Nearly all studies matching inclusion criteria were cross-sectional in design with the results of 41 studies suggesting a positive association. The fixed-effects summary odds ratio was 1.35 (Shore-corrected 95% confidence interval: 1.23 to 1.47), with some evidence of a stronger association found among younger adults, women, and non-smokers. Additional summary estimates suggested a greater mean clinical attachment loss among obese individuals, a higher mean body mass index (BMI) among periodontal patients, and a trend of increasing odds of prevalent periodontal disease with increasing BMI. Although these results are highly unlikely to be chance findings, unmeasured confounding had a credible but unknown influence on these estimates.
This positive association was consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease. However, with few quality longitudinal studies, there is an inability to distinguish the temporal ordering of events, thus limiting the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain. In clinical practice, a higher prevalence of periodontal disease should be expected among obese adults.
Body weight; obesity; overnutrition; periodontal diseases; review
Azithromycin is a macrolide antibiotic that is active against several periodontal pathogens. Macrolides are taken up and concentrated inside gingival fibroblasts, which could influence their pharmacokinetics. This study tested the hypothesis that steady-state levels of azithromycin are higher and more sustained in gingival crevicular fluid (GCF) than in serum.
Four healthy subjects received an initial dose of 500 mg azithromycin followed by 250 mg doses on each of the next 2 days. Serum and GCF samples were obtained 2 hours after the last dose (day 2) and on days 4 and 7. GCF samples were collected from maxillary posterior sites with paper strips. The strips were pooled and eluted with high purity water. After extraction, the azithromycin content of the serum samples and GCF eluates was determined with an agar diffusion bioassay.
On days 2, 4 and 7, the concentrations of azithromycin in blood serum were 0.22 ± 0.02, 0.08 ± 0.02 and 0.04 ± 0.01 μg/ml, respectively. The concentrations in GCF were 8.82 ± 1.25, 7.90 ± 1.72 and 7.38 ± 1.15 μg/ml, respectively. Mean GCF levels were significantly higher than mean serum levels (P ≤ 0.02, paired t-test).
The findings demonstrate that the pharmacokinetic profiles of azithromycin are different in GCF and serum. At steady state, azithromycin concentrations in GCF were higher and more sustained than those in serum. Based on previous studies, the levels observed in GCF were above the MIC for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia.
Anti-infective agents; Periodontitis; Tissue distribution
Clarithromycin inhibits several periodontal pathogens and is concentrated inside gingival fibroblasts and epithelial cells by an active transporter. We hypothesized that polymorphonuclear leukocytes (PMNs) and less mature myeloid cells possess a similar transporter for clarithromycin. It is feasible that clarithromycin accumulation inside PMNs could enhance their ability to kill Aggregatibacter actinomycetemcomitans.
To test the first hypothesis, purified PMNs and cultured HL-60 cells were incubated with [3H]-clarithromycin. Clarithromycin transport was assayed by measuring changes in cell-associated radioactivity over time. The second hypothesis was examined with PMNs loaded by incubation with clarithromycin (5 μg/ml). Opsonized bacteria were incubated at 37°C with control and clarithromycin-loaded PMNs.
Mature human PMNs, HL-60 cells differentiated into granulocytes and undifferentiated HL-60 cells all took up clarithromycin in a saturable manner. The kinetics of uptake by all yielded linear Lineweaver-Burk plots. HL-60 granulocytes transported clarithromycin with a Km of approximately 250 μg/ml and a Vmax of 473 ng/min/106 cells, which were not significantly different from the values obtained with PMNs. At steady state, clarithromycin levels inside HL-60 granulocytes and PMNs were 28- to 71-fold higher than extracellular levels. Clarithromycin-loaded PMNs killed significantly more A. actinomycetemcomitans and achieved shorter half times for killing than control PMNs when assayed at a bacteria-to-PMN ratio of 100:1 (P < 0.04). At a ratio of 30:1, these differences were not consistently significant.
PMNs and less mature myeloid cells possess a transporter that takes up and concentrates clarithromycin. This system could help PMNs cope with an overwhelming infection by A. actinomycetemcomitans.
macrolides; neutrophils; granulocyte precursor cells; periodontitis
Analysis of biomarkers in gingival crevicular fluid (GCF) may be helpful in forecasting vulnerability to future attachment loss. This paper sought to correlate GCF biomarkers of inflammation and bone resorption with subsequent periodontal attachment and bone loss in a longitudinal trial of a matrix metalloproteinase (MMP)-inhibitor.
GCF was collected from two periodontal pockets (mean 5.1 ± SD 1.0 mm) at baseline and annually in postmenopausal females with moderate/advanced periodontitis undergoing periodontal maintenance every 3–4 months during a two-year double-blind, placebo-controlled, randomized clinical trial of subantimicrobial-dose doxycycline (SDD, 20 mg bid). Subjects were randomized to SDD (n = 64) or placebo (n = 64). GCF was analyzed for inflammation markers interleukin-1β (enzyme-linked immunosorbent assay), total collagenase activity (hydrolysis of synthetic octapeptide), MMP-8 (Western blot), and bone resorption marker carboxyterminal telopeptide cross-link fragment of type I collagen (ICTP; radioimmunoassay). Generalized estimating equations were used to associate these biomarkers, categorized into tertiles, with subsequent clinical attachment (automated disk probe) or interproximal bone loss (radiography). Odds ratio (OR) values compared highest to lowest tertile groups.
Increases in GCF IL-1β and MMP-8 during the first year of periodontal maintenance were associated with increased odds of subsequent (year 2) periodontal attachment loss (OR = 1.67, p = 0.01 and OR = 1.50, p = 0.02, respectively), driven by the placebo group. Elevated baseline ICTP also was associated with increased odds of 1- and 2-year alveolar bone density loss (OR = 1.98, p = 0.0001) in placebo, not SDD, and bone height loss (OR = 1.38, p = 0.06), again driven by placebo.
These data support the hypothesis that elevated GCF biomarkers of inflammation and bone resorption from a small number of moderate/deep sites hold promise in identifying patients vulnerable to progressive periodontitis, and SDD may modify that risk.
Gingival crevicular fluid; doxycycline; periodontitis; type I collagen; interleukin-1; matrix metalloproteinase-8
Chronic kidney disease (CKD) is a worldwide health problem with increasing prevalence and poor outcomes including severe cardiovascular disease and renal osteodystrophy. With advances in medical treatment, CKD patients are living longer and require oral care. The aim of this study was to determine the effects of CKD and dietary phosphate on mandibular bone structure using a uremic mouse model.
Uremia (U) was induced in female DBA/2 mice by partial renal ablation. Uremic mice received either a normal phosphate (NP) or a high phosphate (HP) diet. Sham surgeries were performed in a control group of mice, and half received either a NP or a HP diet. At termination, animals were sacrificed and mandibles collected for microcomputed tomography (micro-CT) and histological analysis.
Sera levels of BUN, PTH and alkaline phosphatase were all significantly increased in U/NP and U/HP vs. Sham controls, while serum calcium was increased in the U/HP group and no differences were noted in serum phosphate levels between groups. Micro-CT analyses revealed a significant reduction in cortical bone thickness and an increase in trabecular thickness and trabecular bone volume/tissue volume in U/NP and U/HP groups compared to Sham/NP. A significant reduction in cortical bone thickness was also found in the Sham/HP vs. Sham/NP group. Histological evaluation confirmed increased trabeculation in the U groups.
CKD in mice, especially under conditions of high phosphate feeding, results in marked effects on alveolar bone homeostasis.
Bone biology; periodontal-systemic disease interactions; risk factor(s)
The objectives were to measure the levels of gingival crevicular fluid (GCF) biomarkers and subgingival bacterial species in periodontally healthy and periodontitis subjects in order to explore relations among these biomarkers, the subgingival microbiota, and clinical parameters of periodontal disease.
Material and methods
Clinical periodontal parameters were measured at 6 sites per tooth in 20 periodontitis and 20 periodontally healthy subjects. GCF and subgingival plaque samples were obtained from the mesiobuccal aspect of every tooth. GCF levels of interleukin-1β (IL-1β), matrix metalloproteinase-8 (MMP-8) and IL-8 were measured using checkerboard immunoblotting and the levels of 40 bacterial taxa quantified using checkerboard DNA-DNA hybridization. A subset of “clinically healthy” (CH) sites from each group was analyzed separately. Significance of differences between groups was determined using the unpaired t-test or the Mann-Whitney test. Correlations among immunological, microbiological and clinical data were determined using the Spearman rank correlation coefficient.
There were positive correlations among mean clinical parameters and mean levels of the 3 biomarkers and proportions of Orange and Red complex species (p<0.05). CH sites from periodontitis subjects had higher levels of IL-1β and IL-8 and higher proportions of Orange and Red complex species (p<0.05) than CH sites from periodontally healthy subjects. Red complex species were positively associated with the expression of all biomarkers (p<0.05), while Purple and Yellow complex species had negative correlations with IL-1β and IL-8 (p<0.05).
CH sites from periodontitis subjects present higher levels of GCF biomarkers and periodontal pathogens than CH sites from periodontally healthy subjects. Different microbial complexes demonstrated distinct associations with specific GCF biomarkers.
Periodontal diseases; Microbiology; Gingival crevicular fluid; Cytokines; Matrix metalloproteinases
Few studies have specifically examined the relationship between periodontal disease and gestational diabetes mellitus (GDM). The objective of this study was to examine whether maternal periodontal disease is associated with GDM.
A case-control study was conducted of 53 pregnant women with GDM and 106 pregnant women without GDM at Woman’s Hospital, Baton Rouge, USA. The periodontal examinations were performed by a calibrated dentist who was blinded on the diabetic status of the pregnant women. Periodontitis was defined as the presence of any site with a probing depth (PD) ≥ 4 mm or a clinical attachment loss (CAL) ≥ 4 mm. The severity of periodontal disease was measured in quartiles of PD and CAL. Univariable analysis and multivariable logistic regression were used to examine the relationships between periodontal disease and GDM.
The percentage of periodontitis was 77.4% in women with GDM and 57.5% in pregnant non-GDM women, with an odds ratio (OR) and 95% confidence interval (CI) of 2.5 (1.2–5.3). After adjusting for confounding variables of maternal age, parity, race, marital status, education, family income, smoking, alcohol consumption, systemic antibiotics in pregnancy, family history of diabetes, income, dental insurance coverage and body mass index, the adjusted OR (95% CI) was 2.6 (1.1–6.1). The adjusted ORs (95% CIs) of GDM comparing the highest-to-lowest quartiles of PD and CAL were 3.8 (1.0–14.0) and 4.5 (1.2–16.9).
This study supports the hypothesis of an association between periodontal disease and GDM.
Case-control study; gestational diabetes mellitus; periodontal disease; pregnancy
To determine: 1) if periodontal treatment in pregnant women before 21 weeks of gestation alters levels of inflammatory mediators in serum; and 2) if changes in these mediators are associated with birth outcomes.
823 pregnant women with periodontitis were randomly assigned to receive scaling and root planing before 21 weeks of gestation or after delivery. Serum obtained between 13 weeks and 16 weeks 6 days (study baseline) and 29–32 weeks gestation was analyzed for C-reactive protein, prostaglandin E2, matrix metalloproteinase-9, fibrinogen, endotoxin, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α. Cox regression, multiple linear regression, t-tests, chi-square and Fisher’s exact tests were used to examine associations between the biomarkers, periodontal treatment, and gestational age at delivery and birthweight.
796 women had baseline serum data; 620 had baseline and follow-up serum and birth data. Periodontal treatment did not significantly alter the level of any biomarker (P>0.05). Neither baseline levels nor change from baseline in any biomarker was significantly associated with preterm birth or infant birthweight (P>0.05). In treatment subjects, change in endotoxin was negatively associated with change in probing depth (P<0.05).
Non-surgical mechanical periodontal treatment in pregnant women delivered before 21 weeks of gestation did not reduce systemic (serum) markers of inflammation. In pregnant women with periodontitis, levels of these markers at 13–17 weeks and 29–32 weeks gestation were not associated with risk for preterm birth or with infant birthweight.
Pregnancy; preterm birth; periodontitis; inflammation; cytokines
Cementogenesis is sensitive to altered local phosphate levels; thus, we hypothesized a cementum phenotype, likely of decreased formation, would be present in the teeth of X-linked hypophosphatemic (Hyp) mice. Mutations in the phosphate-regulating gene with homologies to endopeptidases on the X chromosome (Phex) cause X-linked hypophosphatemia, characterized by rickets, osteomalacia, and hypomineralized dentin formation, a phenotype recapitulated in the Hyp mouse homolog. Here, we report a developmental study of tooth root formation in Hyp mouse molars, focusing on dentin and cementum.
Light and transmission electron microscopy were used to study molar tissues from wild-type (WT) and Hyp mice. Demineralized and hematoxylin and eosin–stained tissues at developmental stages 23 to 96 days postcoital (dpc) were examined by light microscopy. Immunohistochemistry methods were used to detect bone sialoprotein (BSP) distribution in Hyp and WT mouse molar tissues, and transmission electron microscopy was used to study similar molar tissues in the non-demineralized state.
Dentin in Hyp mice exhibited mineralization defects by 33 dpc, as expected, but this defect was partially corrected by 96 dpc. In support of our hypothesis, a cementum phenotype was detected using a combination of immunohistochemistry and transmission electron microscopy, which included thinner BSP-positive staining within the cementum, discontinuous mineralization, and a globular appearance compared to WT controls.
Mutations in the phosphate-regulating Phex gene of the Hyp mouse resulted in defective cementum development.
Cementum; dentin; metabolism; Phex; phosphate; X-linked hypophosphatemic


IEA Task 64/IV
Solar Process Heat 1st Experts Meeting
Information on "Coronavirus": Update: The Experts Meeting will be organised as an online meeting. The Industry Workshop has been cancelled.
Welcome to the 1st Experts Meeting on Solar Process Heat of the joint IEA SHC Task 64 and SolarPACES Task IV on March 26th 2020. You are cordially invited to join the Task Meeting online
For participating please send an e-mail to Prof. Dr. Andreas Häberle, SPF: email@example.com . It is planned to catch up on the Industry Workshop on a later date, possibly at another place.
The industrial sector accounts for approximately 30% of the total energy consumption in the OECD countries. The major share of the energy that is needed in industrial companies, services and agriculture is used for heating and cooling of buildings and for production processes at temperatures from ambient up to approx. 400-500°C. This is a temperature range that can well be addressed with solar thermal technologies.
The newly founded IEA Task “Solar Process Heat” addresses this field of energy supply within subtasks which will be discussed on March 26th:
Subtask A: Integrated energy systems
Subtask B: Modularization
Subtask C: Simulation and design tools
Subtask D: Standardization/Certification
Subtask E: Guideline to market
We are looking forward to meeting you at Solar Process Heat 1st Experts Meeting and Industry Workshop in Cologne.
German Aerospace Center
Institute of Solar Research


text:
Calgary Couple Say "I Do" At YYC
Calgary residents Jeannine Beck,
27 and Fareed Rawji, 32, arrived at YYC the other day single, but boarded
their Sunwing plane as a married couple.
The Calgary couple became the first-ever to have a wedding ceremony in YYC’s new International Terminal. “Originally, we were looking at having a destination wedding, but wanted something that was truly unique,” the bride-to-be said. “Rather than having our wedding ceremony in Mexico, we thought, ‘let’s get married in Calgary in a colourful way’.” We reached out to Sunwing and the airport, who immediately jumped in and helped us organize an amazing ceremony that we and our guests will never forget. What a memorable way to start our honeymoon and life together!”
Jacqueline Grossman, Senior Director of Marketing for Sunwing Vacations: “When we first heard about Fareed and Jeannine’s request we knew immediately we had to participate. Destination weddings are a growing trend, and on May 3rd we simply proved that the journey can be just as fun.”The ceremony took place in YYC’s new International Terminal departures check-in hall, coincidentally as Sunwing marks its 10-year anniversary flying out of the gateway.

domain: news


Goa University will host a series of six lectures under the Shri Anthony Gonsalves Research chair for Western Music. Times of India, 1 month ago
1 images for "anthony gonsalves"
prime Minister, Hon. Dr. Kenny D. Anthony leaves the island today for Kingstown, St. Vincent, to attend a meeting of the Monetary Council of the Eastern Caribbean Central Bank. At that meeting, Prime Minister Anthony will also hand over the ...St Lucia Star, 2 hours ago Prime Minister Hon. leaves island for Saint Vincent , packed weekend ahead Radio Saint Lucia, 2 hours ago
The feast of St Anthony will be celebrated at St Anthony's Church, Siolim, on June 15. Masses will be held at 6am, 7.15am, 8.30am and 10.30am (high mass), at which Fr Socorro Mendes will be the main celebrant. The co-celebrants at the high mass will ...Times of India, 1 month ago Wahakotte St. Anthony's Church annual feast Sri Lanka Daily News, 1 month ago
Dr Lennox Honychurch (left) and Dr Ralph Gonsalves By Ken Richards BASSETERRE, St Kitts (WINN) -- A period of consolidation and progress, that's how St Vincent and the Grenadines prime minister, Dr Ralph Gonsalves, describes his six-month stint ...Caribbean News Now!, 1 week ago
Amar Akbar Anthony Year: 1977 Director: Manmohan Desai Producer: Manmohan Desai Cast: Amitabh Bachchan, Rishi Kapoor, Vinod Khanna, Parveen Babi, Neetu Singh, Shabana Azmi, Nirupa Roy, Pran, Jeevan Music: Laxmikant-Pyarelal Yash Chopra's ...FilmFare.com, 1 month ago
[July 24, 2014] (Targeted News Service Via Acquire Media NewsEdge) Targeted News Service Targeted News Service ALEXANDRIA, Va., July 24 -- The following federal patents were awarded to inventors in California. *** Crossbar ...TMC Net, 1 day ago
Seniors Nandy, Climax, Dias picked by ISL franchises MUMBAI: Experienced footballers Sandip Nandy, Climax Lawrence, N P Pradeep and Steven Dias were among the home-grown stars picked on day two of the domestic players draft for the Indian Super ...Afternoon Despatch & Courier, 1 day ago Bangalore pick seasoned Pradeep Deccan Herald, 2 days ago Sandip Nandy, Climax Lawrence, Steven Dias picked by ISL franchises Indian Express, 2 days ago Seniors Nandy, Climax, Dias picked by ISL franchises Deccan Chronicle, 2 days ago
More from: The Week, Mid Day...and 8 other sources
Mumbai, July 23 Athletico de Kolkata were the biggest spenders, splurging Rs.3.91 crore in buying 14 Indian players at the two-day Indian Super League (ISL) players' draft that concluded here Wednesday. In all, the six ISL franchises spent over ...ProKerala.com, 2 days ago Atletico de Kolkata biggest spender in ISL draft IBNLive India News, 2 days ago
MUMBAI: The high octane two day Hero MotoCorp Indian Super League (ISL) player draft saw Rs 24 crore being spent by teams for purchasing the players of their choice. IMG Worldwide global business development footballJefferson Slack said, We saw a ...Indian Television, 2 days ago Indian Super League domestic player draft concludes Gulf News, 2 days ago ISL Domestic Players Draft: Atletico de Kolkata get five India internationals on Day 2 Yahoo! India, 2 days ago ISL domestic player draft concludes Gulf News, 2 days ago
The Goan community shares a special relationship with Bombay. As a child growing up in a village in Goa, Bombay was that elusive city of dreams, open to all but affordable only to a few. We looked forward to visits from Goan folk settled there even ...DNA India, 5 days ago
on your WebpageAdd Widget >Get your members hooked!


text:
Cheating has finally reared its ugly head in the Valorant professional scene, as two Echo 8 members were caught using third-party applications, which led to them being permanently banned from the game.
‘Phox’ and ‘Weak’ were two of the best players in the Echo 8 line-up. They even played together under the Echo 8 banner at the EsportsDoug x eUnited Charity Clash, where Phox popped off and boasted an overall kill-to-death (K/D) of 1.45, along with an Average Combat Score of 286.
Echo 8 finished third in the competition, and Phox was able to climb up the Valorant tier in his solo-queue games and reach the Radiant rank with an incredible 75% win rate.
However, with the unfolding of recent events, Valorant fans are now quite suspicious of the legitimacy of his success.
Phox called out on cheating in Valorant
Phox put up a post on Twitter two days ago, where he explained that he would be taking a break from Valorant due to mental health issues.
However, looking at the comments in this post, that may not have been the primary reason why the pro wanted time away from the game.
A Riot employee, Matt Paoletti, replied to the tweet by saying: If you come back, please don’t cheat next time.
Phox went on to make another statement in response, where he admitted that he is a “compulsive cheater”, and Valorant wasn’t the first competitive game where he has used cheats. He has a “problem with losing” and will not be apologising to his supporters as “I knew what I was doing and I didn’t stop”.
Weak is also in the line of fire
Phox wasn’t the only member of the Echo 8 squad who was caught using third-party software.
Weak too was involved with him, but the pro did clarify on the fact that they were the only two members who used cheats, and that no other member of the Echo 8 roster knew about it.
TSM’s Mack “MackWood” Aesoph replied to Weak’s tweet with a screenshot of one of the latter's earlier posts, which claimed Weak and Phox were two of “the best players to touch this game”.
This reply is quite sarcastic, and takes a jab at the legitimacy of Weak’s successes in Valorant.
Both players have been banned
Both have now been permanently banned from the game, and their former Echo 8 team will continue to compete in the upcoming PAX Area Invitational without them.

domain: hobby


for repeated failure to remove false information about the military operation in Ukraine. “Unfortunately, Google is becoming the main weapon: the number of fakes and extremist materials is only increasing here, and no fines and court decisions play a role for them. He added that the LPR “could cope without Google.” It will be possible to return access to the search engine when it is “corrected”; and “will start to respect people.”
Read on RBC Pro Pro On the Other Side: How to Keep Your Assets Abroad How companies deceive investors with false data What is it and why is it dangerous? At the end of March, Roskomnadzor reported that, at the request of the Prosecutor General's Office, it restricted access to News.Google, since “the Internet resource provided access to numerous publications and materials containing unreliable socially significant information about the course of a special military operation on the territory of Ukraine.”
Google confirmed problems with access to its news service and assured that this was not due to any technical problems on the part of the company. Denis Pushilin said that the company, through its services, “propagates terrorism and violence against all Russians, and especially the population of Donbass.” The day before, the same was said in the LPR
Google will be blocked in the DPR, as they believe that the search engine promotes “terrorism and violence” in relation to the residents of Donbass, said the head of the republic Denis Pushilin in Telegram. The company conducts targeted propaganda of terrorism and extremism, which means — he simply does not put his users from the Lugansk People's Republic into anything, & raquo;,— emphasized Pasechnik. He emphasized that if the search engine “stops pursuing its criminal policy and returns to the mainstream of law, morality and common sense,” then its work will be restored. According to him, on the territory of the republic “there is a real persecution of Russians, the imposition of lies and disinformation” through propaganda. The day before, a similar statement was made by the head of the LPR, Leonid Pasechnik. He stated that “a barrage of fakes and misinformation” hit the republic from Ukraine. “At the forefront of information technology in this regard” the Google search engine, which openly promotes terrorism and violence against all Russians and especially the population of Donbass on the orders of its curators from the American government, — he wrote. Articles Pro How and why to use the materials of a criminal case in an arbitration court What an Investor Should Know Articles Pro Eight Signs An Employee Might Quit Articles
Russia has also had complaints about materials that are distributed through Google services. Authors Tags Subscribe to Telegram
Истoчник rbc.ru On July 18, a court in Moscow decided to fine Google 21.7 billion rub.
Read on RBC Pro Pro International logistics in 2022: how goods are imported to Russia now Articles Pro How to lift sanctions from a person or company. “I don’t know what this is connected with, I don’t know what processes, that is, I can’t say anything,” — said Peskov. Step-by-step instructions Pro instructions How audience 50+ buys and consumes online Predictions Pro Where “nervous” habits come from and how to get rid of them Pro instructions Most sellers have raised prices on marketplaces. Then 97% of the participants spoke for the independence of the republic and joining Russia. According to him, “the vector of Pridnestrovie has remained unchanged throughout all the years of the existence of the republic”, which is reflected in the results of the referendum of September 2006. The authorities of the republic will act “pragmatically and honestly” and will not make decisions to the detriment of the people, he assured. What are their mistakes? The Moldovan government then noted that the settlement of the Transnistrian issue is possible only through a negotiation process. Dmitry Peskov: The Kremlin does not know what Pridnestrovie's statements about joining are connected with The head of the Transnistrian department earlier said that the authorities of the republic would act “pragmatically and honestly” and would not make decisions to the detriment of the people
Views of Tiraspol
The Kremlin saw media reports about Transnistria's plans to join Russia, but did not know what it is connected with, said the press secretary of the head of state Dmitry Peskov, RIA Novosti reports. The head of Zelensky's office, Alexei Arestovich, said that Moldova could ask Ukraine to help “take control of Transnistria”, the Armed Forces of Ukraine will provide assistance. Articles Pro In Moscow, 1.5 million sq. The head of Transnistria, Denis Krasnoselsky, said in May that the republic should be recognized peacefully, at the negotiating table. m of offices: what to do with them
Истoчник rbc.ru < /p>
At the end of April, several objects were attacked in Transnistria, including the headquarters of the Ministry of State Security of the republic, and a red level of terrorist threat was introduced there. Such plans were previously announced by the Foreign Minister of the unrecognized Pridnestrovian Moldavian Republic Vitaly Ignatiev in an interview with the agency. Later, it was lowered to yellow, it is still in effect.
Vessels will be checked in Turkish waters There will be no signing of a direct agreement on grain between Russia and Ukraine, Podolyak said.
Russian President Vladimir Putin held a meeting of the Russian Security Council. On Friday, delegations from Russia, Ukraine, Turkey and the UN also gathered in Istanbul to sign an agreement on grain. RBC has been broadcasting live since the beginning of the meeting
Tags Subscribe to Telegram
The deal between Ukraine and Russia on the export of grain will be concluded in two documents. While he is negotiating with Turkish Defense Minister Hulusi Akar, the video was published by the Zvezda TV channel. As Mikhail Podolyak, adviser to the head of the office of the President of Ukraine, said earlier, Kyiv will not sign a grain agreement directly with Moscow. Read on RBC Pro Pro Before 600 thousand rubles: how IT specialists are hired and how much they pay in 2022 What is it and why is it dangerous? Each country will sign a separate agreement with the UN and Turkey. dropping income: what mood is the service sector Research Pro On the other side: how to keep your assets abroad Tags Subscribe to RuTube RBC Live broadcasts, videos and recordings of programs on our RuTube channel
Истoчник rbc.ru The agreement was preceded by negotiations between Russia, Ukraine, Turkey and the UN, they took place last week. What is important to know about Lanvin Group Articles Pro 5 trillion rubles. From the Ukrainian side, Minister of Infrastructure Oleksandr Kubrakov flew in to sign the agreement. Shoigu arrived in Istanbul from the Russian side, and the Minister of Infrastructure from the Ukrainian side
Minister of Infrastructure of Ukraine Oleksandr Kubrakov and UN Secretary General Antonio Guterres in Istanbul
Ukraine signed an agreement in Istanbul with Turkey and the UN on the export of grain, reports ” ;Country.ua». Russian and Ukrainian representatives will conclude it with Turkey and the UN separately. Russia will sign the same document with Turkey and the UN, for which Defense Minister Sergei Shoigu arrived in Istanbul. According to presidential spokesman Dmitry Peskov, “not critical, <…> but still, it is very important that this grain gets to the world markets, and that the indirect restrictions that apply to our products also allow the market to receive additional volumes of both fertilizers and grain. As noted in the Kremlin, the agreement is necessary to overcome the general food crisis. The Russian proposals were largely supported, and the parties also agreed to establish a coordination center in Istanbul. At the same time, transport with wheat will not be accompanied by Russian ships, he pointed out. Earlier, he posted on Twitter a photo from negotiations with UN Secretary General António Guterres.
Authors Tags Subscribe to RuTube RBC Live broadcasts, videos and recordings of programs on our RuTube channel
Истoчник rbc.ru At the end of June, German Vice Chancellor Robert Habeck did not rule out that Russia would completely cut off gas supplies as part of an attempt to “ignite social unrest and destroy unity.” The lack of gas will lead to the cessation of the work of a number of sectors of the German economy, he specified. That's why we prefer to play it safe,” — Scholz said. Are real estate investments profitable now? Why builders do not find workers Instructions Pro How to remove sanctions from a person or company. >
“Germany can no longer rely on Russia [in gas matters]. Why You Should Stop Chasing Talent How To Pro 12 Myths About Investing From Warren Buffett's Favorite Newsletter What is it and why is it dangerous Articles Pro Migrants have gone to couriers. The Kremlin denied the agency's data. Step by Step Instructions Pro The housing market is on pause. m up to 100 million cubic meters. In mid-June, before leaving for repairs, Gazprom twice reduced the volume of deliveries: first, from the planned daily 167 million cubic meters. m, and later— up to 67 million cubic meters m. According to the operator, gas is supplied in the amount of 40%— about 67 million cubic meters m per day. The Kremlin rejected this assumption, saying that “Russia is very, very careful about its reputation, the reputation of a responsible supplier.”
Read on RBC Pro Pro Hoop, corset, abdominal exercises: do they help to reduce the waist Articles Pro The advantages of the “middle peasants”. Also, he said, Moscow's recent claims that gas supplies were cut for technical reasons are “unconvincing.”
Gas supplies via Nord Stream 1— the main route for transporting fuel from Russia to Germany— resumed on July 21 after a ten-day pause caused by planned maintenance work. Articles Pro RUB 5 trillion falling income: what mood is the service sector in? According to the German chancellor, Russia has no problems technically fulfilling all supplier obligations, but Moscow does not do this
Russia has ceased to be a reliable gas supplier for Germany, said German Chancellor Olaf Scholz, Die Zeit reports. As a result, Canada decided to send it to Germany, but, according to Reuters, the unit was stuck in Germany because Moscow did not give permission for its return transportation. The company reported that it took this step because of the delay in the return of the turbine, which was under repair in Montreal— Canada could not return due to sanctions.
The parties were going to sign the agreement separately – Ukraine with Turkey and the UN and Russia with Turkey and the UN. < /iframe>
Истoчник rbc.ru In Istanbul, Russia, Turkey, the UN and Ukraine sign an agreement on the export of Ukrainian grain.
In addition to electricity, Russia stopped supplying gas to Finland in mid-May. How to make money on it Articles Pro 12 myths about investments from the author of Warren Buffett's favorite mailing list Articles
Истoчник rbc.ru “The lack of electricity imports from Russia will be compensated by importing more electricity from Sweden and producing more electricity in Finland,” The company said in a statement. Trade between the two countries is carried out via an energy bridge across Vyborg. What are their mistakes? In early May, electricity supplies to Finland were suspended by the Russian Inter RAO due to non-payment
Views of Helsinki
The Finnish authorities are considering moving to rolling blackouts due to energy shortages, but this would be a “last resort.” This was stated in an interview with Helsingin Sanomat newspaper by Tuomas Rauhala, director of power systems operations at the Finnish power grid company Fingrid. The company noted that last year Gazprom Export Gasum supplied 1.49 bcm m of gas, which accounted for two-thirds of the total consumption in Finland. Russian energy company “Inter RAO” in early May, it stopped deliveries of electricity to the Finnish Fingrid due to non-payment. According to the Finnish power grid company Fingrid, the need for rolling blackouts is associated with a shortage of energy resources. According to Yle, in recent years, electricity imported from Russia has accounted for 10% of total consumption in Finland. According to Gazprom, the Finnish gas operator Gasum did not make timely payments for gas under the new ruble scheme proposed earlier by President Vladimir Putin. At that time, the Finnish power grid operator assured that the country's electricity supply would not be affected. Read on RBC Pro Pro Up to 600 thousand rubles: how IT specialists are hired and paid in 2022 Instructions Pro Most sellers have raised prices on marketplaces. Finland and Russia signed an agreement on bilateral electricity supplies in 2014. “Outages will last a maximum of a couple of hours and will be of a rolling nature, affecting local power networks in different parts of Finland, depending on supply and demand»,— he said. Against the backdrop of the energy crisis, Finnish authorities may also impose restrictions on household energy savings, as well as oblige companies to conserve resources during peak hours, according to the publication. Pro Chinese electric cars are pushing out the leaders of the auto industry.
The document was signed by Russian Defense Minister Sergei Shoigu and his Turkish counterpart Hulusi Akar, with the testimony of UN Secretary General António Guterres. The broadcast is conducted by RBC. After that, a similar document was signed by the Minister of Infrastructure of Ukraine Alexander Kubrakov. The material is being supplemented
Authors Tags Subscribe to Telegram RBC Stay up to date with the latest news even in conditions of blocking
Истoчник rbc.ru Russia has signed an agreement on the export of grain from Ukraine via the Black Sea with Turkey.
“We have stated from the very beginning that there will be no winners in this war, not only the warring parties, but the whole world will lose. <…> We call for an end to these clashes, — he said. Erdogan also expressed confidence that the conflict between Russia and Ukraine will eventually end at the negotiating table. Recep Tayyip Erdogan
Russia and Ukraine must immediately stop hostilities in order to avoid new victims and economic losses for all mankind. The material is being supplemented
Authors Tags RBC Comfort
Newsletter with news that
affects the quality of your life
Истoчник rbc.ru About this at the signing ceremony of the “grain agreement” Turkish President Recep Tayyip Erdogan said in Istanbul, broadcast by RBC.
Истoчник ria.ru The project is being implemented by the Ministry of Transport and Road Infrastructure of the region, the Department of Transport of the Ministry of Internal Affairs of Russia for the Central Federal District, together with the MVS Group, which acts as the operator of the system in the Moscow region. fixes the violation, but is also able to determine the identity of the offender, after which a protocol is drawn up on the basis of video materials on bringing to administrative responsibility. We expect that this measure will reduce the number of deaths, and in the future we will consider the possibility of introducing cameras with face recognition at other stations near Moscow” , – said Krotova. Railway crossing in the Ramensky District
News Deputy Prime Minister of the Moscow Region Anna Krotova. She added that the materials of the regime are transferred as an evidence base to the traffic police officers on duty at the station in real time. Pilot cameras were installed at the Udelnaya railway station in the Ramensky District.
As for the motives for the conspiracy, the lawyer believes that his client’s crime was driven by dissatisfaction with the political situation in the country and disagreement with the authorities’ policies during the coronavirus pandemic. The investigation believes that the “conspirators” made plans and exchanged views at secret face-to-face meetings, as well as in social networks, in groups with the names “United Patriots” and “Day X Germany”. Another person involved in the case was caught trying to buy pistols and machine guns – the seller turned out to be an undercover agent of special services. German Health Minister Karl Lauterbach Photo: en.wikipedia.org
It is reported that one of several detainees gave evidence (there could have been several hundred in total) – a 54-year-old former military man, now an accountant from Falkensee (Brandenburg). Further, as stated, were to follow the election of a new government. The third detainee had already acquired a weapon at the time of his arrest. As for the police and the armed forces, the negotiators hoped that the security forces would go over to their side. It is known that the man who testified was detained in the spring of this year at the same time as another several alleged accomplices. Further, in front of television cameras, they were going to issue an “arrest warrant” to the official and place him under guard. The lawyer of the detainee also reported an unexpected confession of his client: in his youth, his client studied at the Higher School of Officers of the GDR and worked for some time in Russia after German reunification. According to the publication, the conspirators were detained, and one of them gave the investigation all the details of the strange plan. The suspect's lawyer told reporters that after the kidnapping of the minister, his client also planned to hold a “constituent assembly” to restore the “functionality of the German Reich”, which, instead of the current constitution, was to be based on a modernized version of the imperial constitution of 1871. According to the published material, the plan to change the government in the country was simple and absurd. The next step in “Operation Klabautermann” is to cut off the power supply in the country to stop the dissemination of information in the media. Истoчник www.mk.ru Photo: pixabay.com
Spiegel writes about the investigation of the attempted coup in Germany, which the group was allegedly going to stage this spring covid dissidents. And in order to prepare the people for a change of power, the conspirators wanted for the first time to use the doubles of President Frank-Walter Steinmeier, Chancellor Olaf Scholz and other high-ranking politicians. “The kidnapping plan, code-named Operation Klabautermann,” was supposed to be a prerequisite for a coup in Germany, the result of which was to be the overthrow of the federal government “, writes Spiegel. It is alleged that the conspirators were going to arm themselves with Kalashnikovs and, taking the guards of the Minister of Health Karl Lauterbach by surprise, kidnap him.
Истoчник www.mk.ru 205.2 of the Criminal Code of the Russian Federation, which Volkov is charged with, the maximum punishment is seven years in prison. On the social network, the oppositionist said that he had learned about the new case from his lawyer. Photo: ru.wikipedia.org
Leonid Volkov, an ally of the oppositionist Alexei Navalny (recognized as a foreign agent), said that a a criminal case under the article on justifying terrorism. According to Art. According to him, the case is being handled by the FSB and it “seems to be the eighth.” The basis of the case, as Volkov himself stated, was his post on the social network about President Vladimir Putin.
Earlier it was reported that that the United States handed over to Ukraine 12 out of 20 HIMARS MLRS. Photo: pixabay.com
The US authorities announced another $175 million in military aid to Ukraine. President Joe Biden authorized the provision of assistance to Kyiv in the form of defense products, as well as military education and training services, the message says. This is stated in the White House statement. Истoчник www.mk.ru U.S. The Pentagon also announced plans to train Ukrainian military pilots.
Photo: Liliya Sharlovskaya
The authorities of the Kherson region decided to block the Google search engine in the region. Before the Kherson region, the Google search engine was blocked in the Donetsk and Luhansk People's Republics. As the official noted, the search engine is banned as a tool of information terrorism. Истoчник www.mk.ru Kirill Stremousov, deputy head of the military-civilian administration of the region, spoke about this. The authorities of the DPR and LPR accused him of imposing lies, disinformation, propaganda of terrorism, violence against the Russian population. Earlier, YouTube and social networks banned in Russia were blocked in the region.


text:
Martin 00-28 1929
This is the one! Martin 00-28 in Excellent Condition with No Cracks! It has a slightly oversized replacement bridge and looks to of had a neck reset. Otherwise, as stated in the certificate from Gruhn Guitars, conforms to the typical specifications of the model for the period:
14 1/8" Wide Body
12-Fret Slotted Head Stock
Adirondack Spruce Top with Scalloped Bracing
Herringbone Edge Trim
Brazilian Rosewood Back, Sides, and Peghead Veneer
Serial Number - 38537
This is an easy playing guitar projecting a sound much greater than its size. Amazing guitar. Great investment.
Please call us at 480 488 5441 before purchasing online for shipping cost. All sales are final.
To view the guitar in our shop, please call to make an appointment.


text:
One of the hottest debates today among nutrition experts is about the increasing introduction of genetically modified crop foods to modern agricultural practices.
There are some who believe that these modified foods are just as safe as natural foods. On the other side of the debate are those who believe that genetically modified (GM) foods are harmful to human health and dangerous to the environment.
It may take a while before scientists and nutritionists reach a conclusion because long-term studies on the effects of these modified food crops are few. However, the first results of such long-term studies are coming in and the case against GM foods is getting stronger.
The American Academy of Environmental Medicine strongly believes that GM foods pose serious health risks. This professional health organization support their argument against modified foods with the results of animal studies that show the dangers of GM foods.
Animal studies have demonstrated that GM foods can:
- Accelerate aging
- Cause infertility
- Disrupt the immune system
- Affect the regulation of insulin
- Cause organ failure
- Increase the risks of malignant tumors
In 2012, one French study into the long-term toxicity of GM maize highlighted the dangers of these designer foods and has renewed concern about them among scientists and in the public.
Before discussing this study, we need to understand what a genetically modified food is.

domain: health


Authorities close Pacific Coast Highway, issue flash-flood watch as storm hits Ventura County
The first in a series of storms hit Ventura County on Thursday, sending mud rushing down burned hillsides and over Pacific Coast Highway.
Caltrans closed the popular coastal route for most of Thursday as mud overwhelmed crews trying to clear lanes. The mess was nothing new, since last year’s Woolsey Fire swept through the nearby Santa Monica Mountains, leaving hillsides bare and vulnerable to debris flows.
On Thursday, mud flowed over the lanes and emptied into the ocean, turning the water the color of chocolate.
“The storm itself didn’t last as long as expected, but we did get more rain than we previously thought,” said Capt. Brian McGrath with the Ventura County Fire Department.
Ventura County woke up to flashes of lightning and crashing thunder. The National Weather Service issued a flash-flood watch for Woolsey and Hill fire burn areas, which expired at 3 p.m.
By midday, however, the rain had mostly moved on, heading south into Los Angeles County.
The forecast called for more intense rainfall Friday night into Saturday, with a possible third bout of showers Monday and Tuesday.
Meteorologist Kristen Stewart said the rain is expected to reach the county sometime after midnight Friday or early Saturday morning.
That storm could bring rain rates from a half-inch to an inch an hour, enough to trigger debris flows in recent burn areas, said Stewart, with the National Weather Service’s Oxnard office. Some spots may see even more intense rainfall of up to 1¼ inches an hour.
Also in the news:
- FEMA extends deadline for disaster registration to Feb. 15
- Storms help bulk up California’s Sierra snowpack
That could trigger more serious debris flows in burn areas and even flash flooding outside of burn areas, the agency said.
On Thursday, most of the county saw about an 1 inch to 1½ inches of rain. A gauge near the Casitas Dam in the Ojai Valley recorded close to 2 inches and some spots in the foothills and mountains topped 2 inches.
The storm flooded some local roads, closed Zuma Beach in Malibu and knocked out power to traffic signals in Oxnard.
But PCH seemed to take the biggest hit. By 9 a.m., Caltrans crews were using trucks to clear muddy water from the lanes near Deer Creek Road. The road was closed until 4 p.m. due to debris flows.
The spot just north of the Ventura-Los Angeles county line has been hit hard this winter, as rain slams into burned hillsides left bare, hardened and vulnerable to slides.
Dotted with state parks, beaches and some neighborhoods, PCH curves along the ocean, sandwiched by crashing waves and the steep slopes.
So far, storms have kept road crews busy. But homes in the area have reported only minor flooding.
Kathryn Yarnell’s home on Tongareva Street sits at the base of hills burned in the Woolsey Fire in a neighborhood near Yerba Buena Road and PCH.
The storm made her anxious, as will the ones to come.
“But I think we’re going to be OK,” she said of Thursday’s rain, noting the only damage was a leaky window.
Nearby, Neptune’s Net was closed for three weeks after the Woolsey Fire because it had no power. Mud flow fears and storms since the fire have brought nearly a week more closure.
The iconic restaurant on the county line was open Thursday but was nearly empty because its part of PCH was again closed.
The repeated closures have meant business has dropped maybe 70 percent since the fire, said manager Dan Walden.
“It’s definitely gone down,” he said, citing concerns about mud and rock slides. “People just don’t feel safe driving.”
MORE:Thomas Fire haunts drought-stressed Lake Casitas
California State Parks has prepared for a tough few rainy seasons “until we get enough deep-rooted growth” to hold back the mud and dirt, said Craig Sap, district superintendent.
Leo Carrillo State Park, just south of the Ventura County line, got hit hard in a December storm just weeks after the fire had burned through the area. At the time, thick mud also closed PCH, which runs through the park.
Officials brought in concrete barriers to protect facilities that survived the blaze, staged equipment and alerted staff they would be on call during storms.
The biggest priority will be to keep people out of harm’s way, Sap said.
People may see a fire coming, but a debris flows gives little or no warning, he said. “If a hillside lets loose, there’s nothing you can do.”
Staff writers Jeremy Childs and Alexa D’Angelo contributed to this report.


text:
Building Research Information Knowledgebase (BRIK)
NIBS and the American Institute of Architects collaborate on the development of the Building Research Information Knowledgebase – BRIK (www.brikbase.org), an interactive portal to support incorporation of multidisciplinary research in the design, construction and operation of high-performance buildings.
BRIK offers online access to professionally reviewed research and case studies in all facets of building, from predesign through occupancy and reuse. The purpose of this research portal is to heighten awareness of the importance of evidence-based design and research. The efforts to maintain and expand the portal are shared by the two organizations.
The BRIK Council serves in an advisory capacity to the project. Members meet annually at the NIBS convention and quarterly via teleconference. BRIK now has more than 3,000 pieces of research contributed by 22 organizational and private partners. Exhibit booths at AIA and NIBS national conventions foster the importance of research in the design and construction industries. An education session was offered to architects the 2019 AIA convention in Las Vegas.
Should you have any additional questions about the Building Research Information Knowledgebase (BRIK), please contact:
Manager, Research & Archives
The American Institute of Architects
Stephanie Stubbs, Assoc. AIA, PMP
Director, Facility Lifecycle Management
National Institute of Building Sciences

domain: library


text:
Chefs continue to intrigue and amaze us, but what fascinates me just as much (more, perhaps) is the food we cook at home. The everyday, essential sustenance we make for ourselves and those we love: an early meal for the kids; a meticulously planned celebration dinner; a slightly pissed midnight fridge raid.
I am clearly not alone. The interest in cookbooks by home cooks is heartwarming, and they are often the books whose spines are in tatters and whose pages are smudged with the ghosts of dinners gone by.
Nadine Levy Redzepi was an accomplished cook long before she met her husband, René, and she continues to cook every day for her family in Denmark. Her collection of recipes, published next month, is practical, utterly tempting and quietly beautiful. In this issue, we offer a taster from her book including mussels with chorizo and Danish apple dessert.
I’m sure I am not the only person to have spotted couples in restaurants spending more time on their phones than talking to one another. Is it possible, I wonder, to gauge the state of a relationship by observing a couple’s attitude to eating and cooking? We like to give food for thought, so this month we have Kathleen Alcott’s illuminating piece about couples, their food and their cooking.
We also explore the work of Asma Khan and her team at Darjeeling Express. What makes someone take the jump from studying constitutional law to running a supper club and then to opening a restaurant? A restaurant that is now breaking the mould – specialising in Indian home-cooking, prepared by an all-woman team of cooks, none of whom has cooked professionally before.
We also have dancer/choreographer Akram Khan, Lemn Sissay, Jay Rayner and, joy of joys, Grace Dent eating pizza.
RASPBERRY APPLE PASTRIES, SEE PAGE 20

domain: food


Recent reports had claimed that Meizu would be launching the Meizu E3 smartphone today. However, instead of making it official, the company has confirmed that the Meizu E3 will be unveiled on March 21.
The Weibo post that confirms the March 21 launch states that the unveil event will be held at National Convention Center in Beijing at 21:30 PM local time. The post carries an image of the aircraft and a link to the documentary filmed called “The Rocking Sky” from 2015. Meizu has bought the copyright of the movie and it is allowing user to watch it for free starting from today until March 8.
Yesterday, the Meizu E3 was spotted in colors like Black, Blue and Gold in new renders. The M851M and M851Q variants of the handset had received certification from TENAA authority in China in February. Through the TENAA listing, it has been revealed that the Meizu E3 will be arriving with a 5.99-inch display that produces FHD+ resolution and aspect ratio of 18:9.
The Meizu E3 is powered by an octa-core processor that works at 1.8 GHz. Rumors have it that the unannounced MediaTek Helio P70 chipset may power the handset. The handset may arrive in RAM options of 4 GB and 6 GB. Also, it is pegged to come in multiple storage choices like 32 GB, 64 GB and 128 GB. It is expected to receive power from a 3,300mAh battery.
The E3 may feature a selfie camera of 8-megapixel whereas the back panel of the phone may house a dual camera setup featuring a 12-megapixel sensor and a 20-megapixel sensor. It will continue to sport side-mounted fingerprint reader and Super mBack pressure-sensitive button like the Meizu 6S that was unveiled recently.
Recent leaks have also shown that the handset will have “mblu by Meizu” branding. Some rumors have claimed that there could be gaming focused and photography-centric editions of Meizu E3. The handset could be priced between around 1,799 (~$284) and 1,999 Yuan (~$315).


text:
Few people like visiting the dentist. They schedule those appointments simply because it is the only way to protect their teeth and mouth from cavities and other oral health issues. However, visiting the dentist can take a toll on children, especially the younger lasses and lads. In fact, for some kids, dental visits are detrimental and terrifying. It is important to visit the dentist, however. It is the only way to protect the teeth and ensure a lifetime of good oral health. How can you minimize the dental fears that your child experiences when it’s time for a dentist visit?
Prepare the Child for the Visit
When it is time to go to the dentist, prepare your child, careful that you don’t’ provide so many details that it becomes overwhelming to them. Kids want to know as they’re very curious. However, if you tell them too much or say it in a way that they don’t understand, it only worsens the situation.
Choose the Right Dentist
The right dentist for your child’s dental care needs makes a tremendous difference in their overall comfort at the facility. Most parents prefer to schedule service at the katy pediatric dentist because care is more personalized to the needs of kids. A little research is all that it takes to find a dentist that will excite your child, not scare them.
Don’t Talk Harshly About the Dentist
Kids mimic their parents and the things they see them do and the words they hear them say. If they see that you’re afraid of going to the dentist or hear you talking about scary experiences, they’ll likely feel the same emotions. When the kids are around, always say nice things about the dentist and never show your fears, if there are any present.
Dentistry is something that many of us flounder about, mainly because we aren’t sure as to what we’ll need to do and how we can help our kids to get what they need when it comes to accomplishing healthy patterns. When should we first take our kids to the dentist? Are there things that we need to think about and how are we going to ensure that we’ve got everything in order for them?
Looking for dentistry for children middleboro can take a little bit of time and effort if you aren’t completely sure what you’re looking for. You will find that there are a number of different things that you could be doing and that are going to allow you to sort out exactly what needs to happen. You can talk to different dentists about what they are doing and work out exactly what may be necessary as you figure out how you want to help your child to start healthy habits and get them used to the dentist.
Look at what you’ve got going on and how you may want to try and sort out exactly what is waiting for you on the other side. By taking the time to actually learn about the options that are out there and to see what can happen is going to allow you to figure out what is going on and how you may want to try and move ahead as well. Look at what there is for you to find and how you may want to try and work out what makes sense. When all is said and done, you’ll feel better about how you do things and you will know that your child is on their way toward being their best in terms of oral health.
When you’re dealing with pain regularly, you want to find solutions that make sense for what you need and how you want to get ahead. How can you work things out so that you feel less pain? Are there considerations that you can make to work things out and how can you know that you’re doing everything possible to stay ahead of your pain? There is some proof that procedures like acupuncture sarasota can actually go a long way toward helping you to sort out your pain and feel better about what’s going on with it.
As you look at all of the different things that you can do with the help of an acupuncturist, you will notice that there are a lot of factors that can come up when you’re looking at what is going on here. Acupuncture actually has a long history of working quite well and there is a lot of proof to show that it can make a big difference as to what your next steps may be. By working out all of the details and knowing what you can do, you can find a lot of ways to get things done.
Take a look around at everything that is in your area and figure out what is going to make the biggest difference as you sort out details and figure out what it is that you will need to do in order to stay ahead of everything. As you find out what pain management options work well for your needs, you will also find that there are a lot of different ways in which you may want to try and work it out. See what is available, know what you’ve got waiting for you and figure out how you want to start working on your pain.
There are a lot of professionals out there that have been trying to make sure that they can get people what they need in terms of health concerns. Think about all of the things that you may be trying to do and that you may be working toward with so many little things that your back may be dealing with, is it time for you to check out your options when it comes to a chiropractor andersonville?
You see, your back is one of the most important things for you to try and take care of. If you don’t do things right, you’re going to be a lot more likely to end up in a situation where you can’t get your body to do what you want it to do. A chiropractor is going to be able to look at the issue at hand and work through it in a way that works for your needs. Then, you can work through the issues and find a way to get it all done that makes sense and helps you to feel better every single time that you go from place to place.
Look into the chiropractors in your area and figure out what it is that you’re going to need to do in order to stay ahead of back problems. They are going to be able to give you guidance and you’ll notice that there are many options that they can work with on. Take some time to work out everything that is necessary and talk to people about what it is that you want to accomplish. Then, when all is said and done, you’ll be ready to work out the details and know what your next steps are going to be so that you can live with minimal pain.
When you’ve been under the pressure that comes with addiction and other similar issues, you have likely been looking at many different things that can come up and help you to be your best here. How can you make sure that you’re doing everything possible to stay ahead of things? Are there ways to know that you’re doing everything possible to stay ahead and how can you get the best results so that you can get and stay as sober as possible?
Working out the details of 12 step sobriety charlotte nc is something that is you need to be able to do. Taking the time to really look at the details of everything can help you to sort out exactly what may be necessary for your life to turn around. Yes it’s going to be hard. But if you can get connected with the right people and know that what you’re doing is going to make sense for your situation, you’ll often notice that there are a lot of ways that you can just go ahead with the things that need to be done and worked out in the midst of everything.
Talking with the right people and working out what you need to do can actually be a big part of ensuring that you’ve got everything in order in a way that makes sense. You can find out a lot and know that you’ve got everything in order and can make sense of what needs to occur. You will often see that there are a lot of different ways that you can accomplish your ideas and, in the long run, you can actually start to see a healthier, better life for everything that you’re trying to do in the long run as well.
Dental care is important at any age. Even babies need dental visits by their first birthday. But, how often should you see the dentist to maintain the best oral health? If you ask your kids, they might say that 2:30 (tooth-hurty) is the best time to see the dentist, but the truth is this joke won’t keep your teeth at their best!
Regular dentist visits keep the teeth pearly white and healthy so you’ll enjoy that beautiful smile for a long time to come. If you do not take care of your teeth, cavities and a plethora of additional problems are likely going to occur. It is important to keep your teeth healthy at home. But it is also important to visit the dentist to keep the teeth in good condition.
Schedule an appointment with the family dental skippack pa once every six months. He’ll clean the teeth at this visit and look in your mouth to see if there are any issues with the mouth, teeth, or the gums. These problems, when spotted early, are easier to teat. It is imperative that you make the two annual visits to the dentist if you want your teeth to be beautiful.
Of course, there are dental problems that might occur in between these visits. Do not wait until the bi-annual visit to seek dental care. Delaying dental care when there is a problem only worsens the situation and could cost you a tooth or cause a need for a root canal. Those are two experiences that you simply don’t want to endure.
Schedule those two visits per year. Isn’t your smile worth a couple hours of your time every year? Of course it is. Now it is time to make your way to the dentist to get the expert care that your teeth deserve.
Sometimes surgery is necessary for medical conditions so you will be able to get better. Times like these, you will need to find a good surgeon to do the job. When you go to the right doctor, they should be able to recommend the surgeon that is right for you.
Find a good General surgeon in Broward so that you can get the surgery you need without any complications. Look to excellent local physician services for what you need and get on the road to recovery fast.
Surgery can be complicated and that is why you will need to consult with a general surgeon regarding your situation. They will be able to tell if you need further help from a specialist or not. Typically, a general surgeon can perform all routine surgeries.
Specialists are needed at certain times when specific types of surgery are needed. If that is the case, then the specialist will be recommended. Still you can choose who you want to be your surgeon. That means you will need to look for a team of experts.
That team of experts will be comprised of different surgeons and other medical practitioners who meet and consult with one another on many different issues. The advantage of this is that you have a team of doctors on your side when you need them the most.
Time for surgery is a difficult time for anyone. Sometimes there is fear about going into the surgery and that means you should have all the support you can get. With the right team of specialists, you will have answers to all your questions as well as a caring group of doctors.
Find the right team of specialists and general surgeons for you. Go for a consultation or a second opinion before your surgery to allay any fears.
Getting an MRI is a bit of a big deal. There are always new things going on and you want to be sure that you look at as much information as possible so that you know what to expect. MRI’s give us a lot of information about what we need to do and it can help you to work out options that are going to be helpful as you go along. But, do you need to go to a special location to get an advanced MRI imaging in Toms River? Or are there options that you can look at that will make things a little easier for you in the meantime?
As you look at what you’re going to have to do and how you want to do it, you will want to talk to your doctor and see if they have any ideas or suggestions as to what may need to be done and how you want to get there. By taking the time to look at specialized things and knowing that you’re getting the best care, you will be that much closer to working out what sort of help you may need and how you may want to spend money to get it to happen.
Your insurance agency, your doctor, and referring doctors will be able to help you figure out what is necessary and how you want to try and get things done. As you learn about the ways that you can move forward and get what is necessary, you’ll notice that there are a lot of methods that you can use to get ahead of everything. Why not talk to your doctor to see what they have to say, and then you can start the process of ensuring that you’ve got all you need to get the results necessary for your procedure.
You care about how your skin and complexion look so you want to do everything you can to make it look the best possible. That is why you go to a dermatologist because they know all there is to know about skin and can provide you with advanced treatment options.
Wrinkles, fine lines, blemishes, and unwanted facial hair can all be treated in different ways to improve the situation. You don’t have to live with bad skin. When you are looking for advanced dermatology, colorado has the services that you are seeking so passionately.
You are on the right track by looking for a dermatologist to help with any conditions. The treatments that they provide make a huge difference in the way you look. That difference is very positive. You will look younger, smoother, and better overall.
Scarring can be reduced too and this is something that laser treatments can do. You will find that the scars are greatly reduced with the use of this kind of treatment. Ask your dermatologist about this option if that is part of the reason you are going in.
There are two different types of peels. One is a chemical peel and the other is laser treatment. Sometimes people do not like the chemical peels and will opt on for laser treatments instead. The point is that both work to make your skin better, just in different ways.
Find a good local dermatologist today and get started on the way to looking and feeling better. This will be a boost in self-confidence as well so get ready to feel beautiful beyond skin deep. There are so many great options to make your skin look and feel better than ever.
How can you resist? Solutions are just a call and a clinic visit away.